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April 2017
A special supplement to The News Sun, The Herald Republican and The Star.
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Health and Wellness
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Welcome Summer is almost upon and it’s time to get many people start thinking about becoming more active. Along with becoming more active, there are things we should do on a constant basis to maintain a healthy lifestyle. Nutrition is big and contributes greatly to not only our health, but our outlook on life. In this section you will find stories about maintaining a healty diet, diabetes
awareness and more. Also, there’s an important piece about getting annual physicals and routine wellness checks people should try to obtain. There are also of stories that we hope you find helpful as you strive to lead a healthy lifestyle. We also hope you find the advertising messages informative, too. This section may also be found online at KPCNews.com.
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Health and Wellness
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Diabetes education and prevention BY ASHLEE HOOS ahoos@kpcmedia.com
Diabetes is on the rise across America, and not just in adults. According to the 2009 - 2012 statistics provided by the National Diabetes Statistics Report, it was estimated that 208,000 youth under the age of 20 were already diagnosed with either type 1 or type 2 diabetes, and 1.7 million adults over the age of 20 were diagnosed. Cameron Hospital Community Diabetes Educator John White, RN, CDE, said, “There are 29 million people in the United States with diabetes, and 8 million of those aren’t even aware they have it.” Another 37 percent of adults ages 20 and over were determined to be prediabetic. This determination applied to the entire population of the United States means an estimated 86 million Americans are prediabetic according to the report. Prediabetes is a condition where the diagnosed person has a high blood glucose or hemoglobin A1C, but the numbers are not yet in the range to be considered diabetic. People diagnosed as prediabetic have an increased risk of developing type 2 diabetes, but not all will develop the disease.
White said, “Diet, exercise and modest weight loss are the best ways to better oneself to avoid diabetes. I also can’t overstress the importance of yearly checkups and blood work, especially if you have a family history of diabetes.” Type 1 diabetes develops when the cells that produce the hormone insulin in the pancreas are destroyed. Typically, the peak diagnosis age for this type is mid-teens. Type 1 accounts for approximately 5 percent of adults with diagnosed diabetes. These diabetics require insulin injections or an insulin pump. Type 2 diabetes usually occurs later in life, and usually begins with insulin resistence. This type accounts for 90 - 95 percent of diabetes diagnoses in the United States. It is uncommon in children and adolescents, but can happen. The risk for developing type 2 diabetes is associated with age, obesity, family history METRO CREATIVE CONNECTION of diabetes, history of gestational diabetes, impaired glucose metabolism, physical Glucose mentoring is important for people with diabetes. inactivity and race. Diabetes can cause a number of other White said, “By working closely with their taking medication as prescribed, and carb complications, including heart disease, stroke, health care team, doing daily monitoring of counting and exercise can help diabetics better kidney disease, blindness and premature death. blood sugar, daily self-checks and foot care, See DIABETES page 11
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The role insulin plays in the body METRO CREATIVE CONNECTION
Insulin plays a key role in metabolic functions in the body. People with diabetes have an intimate knowledge of insulin, particularly if they do not produce enough naturally. However, the rest of the public may be less knowledgeable about the role of insulin and its impact on overall health. Insulin is produced in the pancreas of the human body. Its most important function is the way it interacts with glucose (blood sugar) to allow the cells of the body to use that glucose as energy. Insulin can be viewed as a type of key that unlocks the cells and enables glucose to enter. The pancreas senses when there is a spike in glucose in the bloodstream and reacts by producing insulin. According to the Hormone Health Network, insulin also works to ensure the liver stores excess glucose so that it is not actively in the blood. Stored glucose is called glycogen. This glycogen can be converted into fat when it is needed. Insulin also affects other metabolic processes, such as the breakdown of protein or fat.
If insulin is not being produced in the right amounts, the result is high blood sugar, or hyperglycemia. Chronic hyperglycemia is the hallmark of diabetes mellitus. Complications of high blood sugar include damage to the nervous system, kidneys, eyes, and the extremities. Type 1 diabetes occurs when the pancreas fails to produce enough insulin. Supplementation with insulin will be necessary to avoid drastic changes in blood glucose levels. When a person has type 2 diabetes, cells fail to respond to insulin properly. This is referred to as insulin resistance. As the disease progresses, a lack of insulin may also develop. Typically with this type of diabetes, excessive body weight and not enough exercise are the culprits in insulin resistance. Eating a healthier diet and becoming more physically active can help reverse the condition. Too little glucose in the blood (hypoglycemia) can make a person feel irritable, tired or confused. Low blood sugar can lead to loss of consciousness. That is why it is crucial that blood sugar concentrations remain relatively stable.
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Without insulin, the body could not effectively make use of the energy obtained through eating and drinking. Insulin helps unlock cells so that glucose can be used to its full potential.
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Health and Wellness
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Physical exams are important BY ASHLEE HOOS ahoos@kpcmedia.com
There are a multitude of annual exams available these days from various physicians. It can be overwhelming when deciding what to get and how to prioritize one workup over another. Do I need blood work done? How about a full physical? Mammogram? Colonoscopy? Should I be having my bone density checked? How are my teeth? My eyes? All of these are questions that could be going through your head, and knowing what to get done and when is important to your overall health and wellbeing. Parkview Health’s website recommends that people at different ages get different exams done. Cameron Hospital Community Health Educator John White, RN, CDE, said, “Regular physical exams allow you to work with your physician to set healthy goals as your bodies and habits change.” In your 20s, get your baselines set. It recommends a cholesterol panel, blood pressure checks, a yearly physical exam for both men and women, pap
smears every three years with sexually transmitted infection screenings, annual clinical breast exams and monthly self breast exams for women, annual testicular exams with STI screenings for men, both hearing and vision exams, semi-annual dental visits and baseline mole and skin exams. It is also recommended that people in their 20s get a flu shot annually, a tetanus diptheria and pertussis vaccine once every 10 years, human papillomavirus series completed by age 26 and the meningococcal vaccine with a titer to follow. In your 30s, annual follow up with the baselines is recommended. It is also recommended that you follow up as needed with vision and hearing tests. Get other tests such as skin checks done, also as needed. In your 40s, men should be adding in annual testicular and prostate exams with a physician and women should be adding annual mammograms. Other tests, such as vision and hearing can continue to be done as needed along with skin exams. In your 50s, people should be adding a bone density screening, annual
colonoscopy, and men by 55 should be having PSA screenings done to test for prostate cancer. A thyroid test should also be added in by your fifties. In your 60s, continue with traditional yearly exams, listed above. Women should continue with bone density screenings as well. Women should continue with an annual pap smear with HPV testing until age 65, then consult with their primary care physician to see how to proceed. By your 60s, consult with your healthcare provider on pneumococcal vaccination. Also, discuss a single dose of the zoster vaccine for shingles prevention. In your 70s, women by this point should be discussing cervical cancer screenings with a primary care provider in addition to continuing with their annual checkups. Men should be discussing prostate cancer screenings along with their workup. Both men and women should pursue a bone density screening as well as their yearly colonoscopy and continued hearing, vision and skin exams as needed. If not already done, zoster for
shingles should be talked about with a healthcare provider. Also discuss pneumococcal with a healthcare professional. White said, “Physical exams are important because they can catch minor problems before they become major ones. Our bodies change as we age and unfortunately our parts do wear out.” For all ages, Parkview’s website recommends an annual influenza vaccine. Also, it recommends updating the Tdap vaccine every 10 years for continued protection. To prioritize each workup, talk with your primary care provider to see how it is best for you and your overall health. “Definitely get a yearly physical workup with your doctor. It is a top priority. Make sure to take an updated medication list for review, especially if you work with multiple physicians or specialists. For other exams, such as vision or hearing, follow your doctor’s recommendations,” said White. For more information from Parkview Health, visit http://www.parkview. com/en/well-being/Center-for-HealthyLiving.
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Moderation is key to developing a healthy diet BY EMELINE RODENAS erodenas@kpcmedia.com
AUBURN — With an abundance of new healthy food options, developing a healthy diet can seem nearly impossible. With these tips from the DeKalb Health dietetics department, a healthy diet can be as simple as making a few small changes. Rhonda Walton, a dietitian at DeKalb Health since 2008, says “developing a healthy diet is more complicated now than ever. Nutritional headlines coming out now are completely contradictory to last week’s headlines.” A healthy diet can mean different things for different people but DeKalb Health defines it as “eating regularly balanced meals daily, with one to two carefully chosen snacks.” The general guideline for a healthy diet is the Healthy Food Plate program. The Healthy Eating Plate, created by nutrition experts at Harvard School of Public Health, includes five food
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groups: vegetables, fruits, whole grains, healthy proteins, and dairy. One basic rule is eating three meals a day, which allows the endocrine system to regulate itself and find its balance. Waiting too long between meals or eating a meal too soon after a previous meal puts the body into a “feast or famine” mood. This upsets the digestion process, which needs time to process nutrients, according to Walton. Understanding a healthy diet can differ from one person to another is important. For example, an athlete who exercises four hours a day, every day, will need to take in more calories than a senior citizen with limited mobility. Factors such as hereditary and health conditions, dietary limitations, and activity levels all make a difference in dietary needs. A balanced meal would include a five-ounce chicken breast, three-ounce of a starch such as a potato or pasta, a serving of vegetables, a 1/2 cup of fresh fruit and a glass of milk. People allergic
to lactose can choose to opt for soy, rice or almond milk instead. Walton said there have been “lots of changes in food manufacturing, based on customer demand mostly.” Additionally, companies are now minimizing the use of trans-and-saturated-fats in foods. These types of fats are man-made and humans cannot break them down properly. The daily recommended dose of saturated and trans-fats is 7 percent. Meats, especially red meats, are heavy in these fats. People can also add ancient grains such as quinoa, couscous and bulgur, which have a higher protein content than other grains to their diets. Portions still need to be watched though, according to Walton. Making responsible snack choices is another good habit in developing a healthy diet. For example, fruit, yogurt, peanut butter and crackers or cheese and crackers, fresh vegetables with a bit or ranch dressing are all good options.
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“It’s all trial and error for each person. Food has to be palatable and conform to personal tastes, otherwise people won’t eat it,” Walton says. Taking a multi-vitamin and staying hydrated are also are part of a healthy diet. Additional supplements can be prescribed by a doctor if people are deficient in Vitamin D or iron, for example. Regarding hydration, recommendations by world health organizations estimate people should drink a minimum of 64 ounces of fluids daily. Some of the biggest challenges people face today regarding healthy diets are the convenience and availability of fast food and the lack of time for sit-down meals. With busy school and work schedules, it can be hard to resist the fast-food option from the nearest Wendy’s instead of preparing a meal ahead of time. When it comes to a healthy diet, ”The key to everything is moderation,” Walton says.
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Keep your heart running strong into your golden years METRO CREATIVE CONNECTION
Heart health should be a concern for people of all ages, but especially so for men and women over 50. That’s because, according to the American Heart Association, even men and women who are free of cardiovascular disease at age 50 are at a significant lifetime risk of developing the disease. But heart disease does not have to be an accepted byproduct of aging. For example, a 2014 study published in the AHA journal Circulation found that maintaining or increasing physical activity after age 65 can improve the heart’s well-being and lower risk of heart attack. In addition to increasing physical activity as they age, older men and women who understand heart disease and learn to recognize its symptoms have a greater chance of minimizing its affects and lowering their risk of having a heart attack.
What are the symptoms of heart disease? Heart disease is a blanket term
used to describe a host of conditions, so symptoms vary depending on each individual condition. The following are some of the more widely known conditions and their symptoms: • Hypertension: Also known as high blood pressure, hypertension is a largely symptomless form of heart disease. The AHA notes that the idea that hypertension produces symptoms such as difficulty sleeping, facial flushing, nervousness, and sweating is a misconception. Symptoms typically do not alert men and women to the presence of hypertension, highlighting the emphasis men and women should place on routine visits to the doctor’s office, where their blood pressure can be taken. • Heart attack: The symptoms of a heart attack are different than the symptoms of heart disease that may lead to heart attack. The former can be found by visiting www.heart.org. Signs that you may be heading toward a heart attack include undue fatigue, palpitations (the sensation that your heart is skipping a beat or beating too See HEART page 10
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Heart disease kills millions of people across the globe each year, many of whom are over 50. But men and women who learn about heart disease and how to reduce their risk stand a far greater chance of fighting the disease.
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Exercise tips for beginners METRO CREATIVE CONNECTION
The right combination of diet and exercise is one of the keys to a long and healthy life. While many people find adapting to a healthier diet challenging, that challenge often pales in comparison to the intimidation felt when working out for the first time in years. Exercising after an extended period of inactivity may intimidate people who choose to workout at gyms, where fellow gym members may appear to be in tip-top shape. Overcoming that intimidation factor can be as simple as working out with a friend or working with a personal trainer, each of whom can offer the support and guidance beginners need when reacclimating themselves to more active lifestyles. In addition to the buddy system, beginners can employ the following strategies to make their return to exercise go as smoothly as possible.
• Gradually build up your exercise tolerance. When you exercise, your body releases neurotransmitters known as endorphins, which trigger positive feelings in the body. Those positive feelings can be addictive, but it’s important that beginners do not go too hard too quickly when beginning a new exercise regimen. Gradually build up your exercise tolerance, exercising two or three days per week and taking a day off between workouts when you start. As your body becomes more acclimated to exercise, you can start to workout more and with more intensity. • Stretch after working out. Stretching can improve flexibility, and that may decrease your risk of future injury. In addition, improved flexibility may improve your exercise performance by improving your range of motion and helping your muscles work more
effectively. Muscles contract during a workout, and stretching after workouts can help reset those muscles to their natural position. Include both static stretching and foam rolling in your post-workout stretching routine. • Find a routine that works for you. Many men and women feel they must sign up for a gym membership upon resolving to adopt a more active lifestyle. While gyms afford you the opportunity to strength train and get in your cardiovascular exercise, they’re not for everyone. The best approach and the one that’s likely to be most successful over the long haul is to find an exercise routine that engages you and that you find enjoyable. If the gym is not for you, try to find a routine that still includes both strength training and cardiovascular exercise. Strength training can make your body more durable, and cardiovas-
cular exercise can reduce your risk for various health problems, including heart disease. • Track your progress. One way to stay motivated is to keep track of your progress. If you’re working out but not monitoring your results, you may not feel like you’re getting anywhere. Keep a workout diary, tracking both your successes and failures, so you can see what’s working and what’s not. The longer you stay committed to your workout routine, the greater the likelihood that you will be tracking more successes than failures, and those successes can provide the motivation to keep you going on those inevitable days when you want to skip workouts. Returning to exercise after an extended period of inactivity can be quite the challenge, but it’s nothing motivated men and women cannot overcome.
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Health and Wellness
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How to bake healthier treats
METRO CREATIVE CONNECTION
Baking can be a relaxing and rewarding pastime that parents can share with their children. Baking promotes a variety of skills, including the ability to follow instructions and make measurements. Baking also employs mathematics, making baking a rather delicious science experiment. Perhaps one of the few pitfalls of baking is indulging in too many sweet treats when taste testing and then enjoying the fruits of your labors. But bakers concerned about their health can substitute healthy ingredients when recipes call for foods bakers would prefer to avoid. The following ingredients can make healthy additions to baked-good recipes without sacrificing flavor. • Whole wheat flour: Flour is at the heart of many baking recipes, including those for cakes, cookies and pies. Refined white flour may not be the healthiest ingredient, so try whole wheat flour, which is full of nutrients and an extra dose of fiber. Fiber can help lower the risk for heart disease and diabetes. Try slightly less than one cup of whole
wheat flour for regular flour as a swap if a recipe calls for one cup of flour. • Fruit puree: When a recipe calls for oil, margarine, butter or shortening, consider replacing such ingredients with fruit purees, which often add moisture and texture just as well but without the same amount of calories. Applesauce and prunes can be helpful in chocolate dishes. Pumpkin or sweet potato are other purees that can add a nutritional boost as well. • Greek yogurt: Greek yogurt is a powerhouse of protein and flavor with relatively few calories per serving. It can make a super substitution in recipes for things like sour cream, buttermilk or even cream cheese. • Applesauce: Believe it or not, unsweetened applesauce also can replace some or all of the sugar in a recipe. When doing a 1:1 ratio swap, reduce the amount of liquid in the recipe by 1⁄4 cup. • Marshmallow or meringue: Ever check the nutritional information for many store-bought cake frostings? See TREATS page 10
METRO CREATIVE CONNECTION
Cut calories, fat and sugar from baked goods with some simple and healthy substitutions.
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TREATS From page 9
They pack a considerable amount of calories, sugar and fat. Some also are made with hydrogenated oils. Consider using a marshmallow fluff or homemade meringue to top cupcakes or decorate cookies. • Stevia: Stevia is an herbal plant that grows primarily in South America. Stevia has a long history as a sweetener in that area, and now has become a popular sugar substitute elsewhere. Stevia is an all-natural, no-calorie, no-carbohydrate sweetener. The FDA approved only the purified form of stevia, called stevioside. Remember to check each brand’s sugar-to-stevia ratio
April 22, 2017
to make sure you get the right measurements for your recipe. • Egg whites: Replace a whole egg in a recipe with two egg whites or 1⁄4 cup of egg substitute. • Chocolate nibs: Nibs are processed morsels that do not have the same amount of added sugar as many chocolate chips. Dark chocolate nibs can provide a healthy dose of antioxidants as well. • Evaporated skim milk: Try evaporated skim milk in place of heavy cream to make whipped cream for a low-fat option. Baking brings family together, and the treats prepare can make an enjoyable finale to a great meal. With healthy substitutions, any recipe can be altered for the better.
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HEART From page 7
rapidly), dyspnea (difficulty or labored breathing), chest pain or discomfort from increased activity. • Arrhythmia: Arrhythmia means your heartbeat is irregular, and men and women often mistakenly believe arrhythmia only afflicts those who already have been diagnosed with heart disease or have had a heart attack. But arrhythmia can affect even those men and women who have healthy hearts and no history of cardiovascular disease. Symptoms of arrhythmia can vary greatly, from a single premature beat to a series of premature beats that occur in rapid succession. Arrhythmia that lasts long enough to affect heart function may include symptoms such as rapid heartbeat, fatigue, dizziness, lightheadedness, shortness of breath, and chest pain.
How can I protect my heart? Heart healthy habits take some effort,
but men and women can protect their hearts regardless of their ages. • Get sufficient exercise. At least 30 minutes of exercise per day can protect against disease. • Quit smoking. Smoking increases your risk for a host of ailments, including heart disease. Quitting is a great way to start getting your heart and other parts of your body back on track. • Include heart-healthy foods in your diet. A diet that is rich in fruits and vegetables and low in cholesterol, salt and saturated fat promotes heart health. • Don’t drink alcohol to excess. Like smoking, drinking alcohol to excess can lead to a host of problems, such as high blood pressure, arrhythmia and high cholesterol, each of which increases your risk of heart disease. • Lose weight. Being overweight or obese is a major risk factor for heart disease. If you have already started to exercise daily and eat a more heart-healthy diet, then you’re on your way to losing weight. Consult your physician if diet and exercise don’t seem to be helping you to shed pounds.
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DIABETES From page 3
their own health. “Diabetes is a progressive disease and it tends to get worse over time, but it can be controlled. There is no cure for diabetes,” said White. In Indiana, House Bill 1642 was proposed in January, 2017 as an act to amend the Indiana Code concerning health. HB 1642 will assign the issue of rising diabetes diagnoses and its associated costs to a study committee during the 2017 legislative interim. White wrote a letter to the senators urging them to pass HB 1642 because 11.4 percent of Hoosiers are currently diagnosed with diabetes with more being at-risk. He was sure to point out the financial toll on the state healthcare system as more people are diagnosed, urging them to pass the bill to assess the situation and the resources available to reduce the incidence of diabetes in Indiana. As of April 6, the bill has been returned from the senate to the house without amendments and was signed by the speaker. Across America, diabetes has direct medical costs of $176 billion annually according to the 2012 report. Indirectly, the cost is $69 billion, and this cost includes work loss, disability and premature death. Average medical expendeture is 2.3 times higher for those diagnosed with diabetes than
those without according to the 2012 National Diabetes Statistics Report. There are resources both locally and online for diabetes and prediabetics to connect, learn about their condition and to work on better overall health. White is a certified diabetic educator certified through the National Certification Board of Diabetes Educators. He does inpatient and out patient diabetic education, one-on-one consultations, and offers an all day class once a month at Cameron Hospital, Angola. White also works along with Cameron’s registered dietitian to help with diabetic meal planning and education. The program is recognized by the American Diabetes Association. White also recommended www.dlife. com, www.diabetesselfmanagement.com and www.healthmonitor.com/diabetes for online resources. For prediabetics, the YMCA offers a program from several of their locations, including Fort Wayne and Whitley County, for diabetes prevention. www.ymca.net/ diabetes-prevention offers more information on the program and how to get involved. As White emphasized, prevention is key, but by using the resources at hand locally, people with diabetes and prediabetes can work to slow the deterioration of their condition. Although diabetes cannot be reversed, prediabetes can be as long as the affected person takes the necessary steps.
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