Healthy Living September 2018 by KPC Media Group

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Healthy Living

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September 16, 2018

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Food myths abound With so much information circulating about what foods are “good” and “bad,” the internet and diet trends don’t always make it more clear — causing a lot of confusion for the average consumer.

Processed foods

One thing that seems to be universally accepted right now, however, is that processed foods should be avoided as much as possible. “The more processed foods are the more inflammation they can cause, so that causes the body to work harder and spend more time with metabolizing, putting the body through stress,” said Dr. Lynn Saur, medical director of urgent care and occupational medicine at Cameron Memorial Community Hospital. “Overall, body inflammation is not healthy. It causes some pH problems, makes the body a little more acidic, and sicknesses and cancers grow in a more acidic environment.” While Saur said cutting out processed foods won’t cure diseases, she said eating a healthier diet can help in the prevention of diseases. In fact, there are certain ingredients she advises her patients to avoid, including high fructose corn syrup, monosodium glutamate (MSG) and red dye for children. “The problem with high fructose corn syrup is it gets broken down into sugar that goes directly into the bloodstream and fat that goes to the liver,” she said. Some may think they need to eat processed foods because fruits, vegetables and less-processed food is more expensive, but Parkview Noble Center for Healthy Living Community Nurse Leshia Howell said people need to think about the cost of their health in the long run. “We want our plate to be colorful,” she said. “We want a healthy balance. We would really rather have that plate filled up with vegetables and a nice protein.”

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Healthy Living

Juice

Juice is one example where a food may seem less processed and healthier than it is, Howell said, adding many juices are high in sugar and low in actual fruit. “If people are interested in drinking more juice than water or pop, they really need to make sure it’s the 100 percent fruit juice…(and) take time to read those labels,” she said. Howell encouraged people to avoid juices with a first ingredient of fructose, another form of sugar. She also advised paying attention to serving sizes as well.

Gluten free

With the idea of cutting out processed foods, Saur said sometimes going gluten free can be a “shortcut” to removing processed foods from one’s diet. This is because, at least for now, most gluten-free foods are less processed than some of their gluten equivalents. “Gluten free, so far anyway, stays away from the processed wheats,” she said. A gluten-free diet is also crucial for those with celiac disease and gluten allergies, Saur said.

Carbohydrates

Another popular food pariah is carbohydrates, but Howell reminded people that not all carbs are bad. “We really need a combination of carbohydrates, proteins and fats in our diet. That is a healthy diet,” she said. “We need quick energy; we need calories that can sustain our energy from protein.” The real problem comes from overconsumption of carbs, especially simple ones such as sugars and starches. Instead, Howell advises eating more complex carbohydrates, which take longer for the body to process, in moderation, and pairing them with protein.

Fats

Avoidance of fats is another common

Reading labels is important when making informed food choices.

myth, Saur said. “That’s one of the big myths, that low-fat is the way to go,” she said. While this was touted in the 1970s and ‘80s, new research suggests it’s not that simple. There are several kinds of fats: saturated, unsaturated and trans fats. Unsaturated fats, which are generally liquid at room temperature, are the best for you, according to an article from Harvard Health Publishing. Saturated fats, which are solid at room temperature, are better for you than once thought, though perhaps not as healthy as unsaturated fats, according to the article. Trans fats are “the worst type of dietary fat,” according to Harvard Health Publishing. “(Trans fat) is a byproduct of a process

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called hydrogenation that is used to turn healthy oils into solids to prevent them from becoming rancid,” the article states. The problem is that when these healthy fats become hydrogenated, their cellular bonding becomes irregular, which allows “pollutants and cancer-causing agents (to) actually slip through the membrane barrier of the cell,” Saur said. The Food and Drug Administraton has determined that trans fats, which is commonly listed as partially hydrogenated vegetable oil (PHO) on ingredient lists, are not safe, according to the FDA’s website. “PHOs are the primary dietary source of artificial trans fat in processed foods. Removing PHOs from processed foods could prevent thousands of heart attacks and deaths each year,” the website states. SEE FOOD, PAGE 11

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September 16, 2018

Speak to your doctor before dieting About once a week, Dr. Bret Kueber, a family practice physician with DeKalb Health, sees someone in his office who shows certain symptoms. “We see people come in here who are more irritable, they get angry, they can’t sleep at night,” Kueber said. After some digging, Kueber said he’ll discover the person has been taking a weight loss supplement they saw on TV, with negative consequences. When asked about a common health care myth he sees, the use of these supplements was the first one that came to his mind. “There’s some pretty outrageous claims by some of these supplement companies and it’s like, you know, if it were that easy everybody would do it,” Kueber said. He added that losing about one to two pounds a week is normal and that patients shouldn’t be losing more than eight pounds a month. Many of the weight loss supplements are basically caffeine or guarana, which he said is “basically another form of caffeine.” The supplements attempt to speed up a person’s metabolism by giving them about the equivalent of six cups of coffee “in the hopes that you’ll burn more calories and lose more weight,” Kueber explained. Another popular one, Thrive, is basically the same thing with a vitamin added. “That rarely works, and there’s a lot of side effects to those meds,” he said. Rather than losing weight, people see issues of caffeine overload: irritability, sleeplessness and more. But weight-loss supplements aren’t the only issue. Kueber said people need to be careful and speak with their doctor before trying diets, especially ones that require strict fasting. He

used the keto diet as an example. “You have to be really careful, especially if you have other medical conditions like high cholesterol or diabetes or things like that,” he said. “There are a lot of changes to the body that happen when you go on a strict fasting diet basically that puts you into a place where your body is not used to burning the kind of energy that the keto diet produces. The body’s used to burning sugar and when you go to ketones it takes some getting used to.” One of the side effects of the keto diet is what’s known as the “keto flu,” which Kueber said is a side effect of transitioning the body and the brain from burning glucose to burning ketones, the latter of which are harder for the brain to use as fuel. “During that transition…it can cause issues with memory and fatigue and concentration difficulties and all sorts of things until you get used to it,” he said. Fasting diets can be especially dangerous for diabetics who have to monitor their blood sugar. “(It’s) really dangerous for diabetics to start doing something like that without knowing exactly what’s going on,” Kueber warned. The best way to lose weight in a healthy way, Kueber said, is with lifestyle modifications rather than dieting. “The big issue with diets, is if you go on a diet, someday you’re going to go off the diet. So what happens is people will yo-yo with their weight,” he said. “The best way to do it is a lifestyle modification, which basically means something you can stick to for the rest of your life.” Sometimes changes can be as simple as eating fewer processed foods or drinking less pop, he said. “It’s just amazing how getting off some of

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Many dietary supplements are full of caffeine, Dr. Bret Kueber said.

this processed sugar we eat will make a huge difference in how you feel,” Kueber said. He also advised people not to eat three hours before bedtime. “When you go to sleep your metabolism slows down and if you’ve got a lot of food in your stomach that gets digested overnight

it’s stored as fat because you can’t burn the calories,” he said. “The key thing is to make these small changes, these changes that you can live with for the rest of your life that will improve your health more than just getting you to lose weight.”

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September 16, 2018

There is no magic exercise for weight loss While there is no magic exercise that will help a person lose weight quickly or tone his or her abs, there is a simple way to use exercise to get healthier: move more. Dr. Bret Kueber, a family practice physician at DeKalb Health, said one of the biggest exercise myth he encounters is all the appliances that promise quick abdominal development. “It is very, very hard to lose focused fat over a particular area of the body,” he said. One of the reasons these devices don’t create flat abs quickly is because there are two areas of fat in that region: one below the skin but on top of the abdominal muscles and visceral fat, which sits under the muscles. “Losing that (visceral) fat is actually very healthy to do, we don’t want a lot of visceral fat,” Kueber said, adding that visceral fat is shown to increase the risk of heart attacks and strokes. Unfortunately, those ab exercises and

equipment, when they do burn fat, burn it from all over the body. The best way to target visceral fat specifically is through aerobic exercise or “things that increase your heart rate,” Kueber said. Ideally, a person wants to be around 80 percent of his or her maximum heart rate when doing aerobic exercise for fat loss, and do it for 20 to 30 minutes three to four times a week, he said. “(Aerobic exercise) increases your metabolism, not just while you’re doing the exercise but for the remainder of the day that you’ve done the exercise, and that kind of slow, increased demand for calories tends to pull that visceral fat into the equation so you start burning that,” Kueber said. But to achieve that, you still don’t necessarily need fancy exercise equipment. “My basic philosophy is, if you want to lose weight, watch what you’re eating, gradually substitute healthier foods for

Target heart rate Age

Target heart rate zone 50-85 percent

Average maximum heart rate

100-170 bpm

200 bpm

97-165 bpm

195 bpm

95-162 bpm

190 bpm

93-157 bpm

185 bpm

90-153 bpm

180 bpm

88-149 bpm

175 bpm

85-145 bpm

170 bpm

83-140 bpm

165 bpm

80-136 bpm

160 bpm

78-132 bpm

155 bpm

75-128 bpm

150 bpm

72-123 bpm

145 bpm

Target heart rate during moderate intensity activities is about 50-70 percent of maximum heart rate, while during vigorous physical activity it’s about 70-85 percent of maximum. Information from the American Heart Association.

non-healthier foods and then get out and move,” said Dr. Lynn Saur, medical

director of urgent care and occupational SEE WEIGHT LOSS, PAGE 7

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Healthy Living

Dispelling heart disease myths With heart disease and hypertension prevalent in northeast Indiana, Leshia Howell, community nurse for the Parkview Noble Center for Healthy Living, wanted to debunk some common heart myths.

Myth: I’m too young to worry about heart disease.

“How you live now affects your risk for later on in life,” Howell said. Plaque can begin accumulating in a person’s arteries in their childhood and adolescence, Howell said, adding one in three people in the U.S. have heart disease, “and they’re not all senior citizens.” “It’s really important to start thinking about your lifestyle at a younger age rather than waiting until you’re 50 or 60 years old and say, now is when I really need to start thinking about this,” she said.

one’s blood pressure, maintaining a healthy weight, controlling blood sugar, and not smoking. “You absolutely can control those risk factors,” Howell said, adding several of these risk factors — including high cholesterol, high blood pressure and diabetes or pre-diabetes — can be caught and monitored with preventive screenings. “At least you have that knowledge that you are at risk and you can do something about it. … Let’s control what we can control,” she said.

Myth: I feel fine so I don’t have to worry about my blood pressure.

“Hypertension, high blood pressure is a silent killer. About 103 million U.S. adults have high blood pressure, and a lot of them don’t know it so they don’t have symptoms,” Myth: I don’t need to have my Howell said. cholesterol checked until I’m Even symptoms of high blood pressure middle aged. are not the most obvious, with Howell saying The American Heart Association common ones are having a lot of headaches, recommends getting one’s cholesterol checked vision disturbances and “not quite feeling every five years beginning at age 20, Howell right.” said, especially if there is a family history of Even without symptoms high blood high cholesterol or heart disease. pressure should be taken seriously: it is a risk Howell encouraged people to get their factor for stroke, and “if uncontrolled it will current cholesterol levels checked, then watch lead to serious health problems,” Howell said. for changing trends and make adjustments “By the time you have symptoms you’re accordingly. already probably (in) the works for having a stroke or a TIA (transient ischemic attack, or Myth: Heart disease runs in my mini stroke),” she said. family so there’s nothing I can do to People are encouraged to get their blood prevent it. pressure checked regularly and at different times of the day because it fluctuates. Many “I hear that a lot,” Howell said. “If you do have a family history it does put you at higher locations offer this service, from pharmacies to doctor’s offices and clinics to the Center for risk but you can do things now to help to Healthy Living, Howell said. prevent that. There are many risk factors that “It’s important to know what your baseline we can control.” is and look for trends,” she said. Howell encouraged those with a family Howell also encouraged people to look for history of heart disease to take preventtive measures like getting cholesterol under control, risk factors of high blood pressure, including, moving more, eating healthier and being more according to the American Heart Association: mindful of what a person is eating, watching • Family history

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High blood pressure can lead to serious health issues, so it’s important to have it checked regularly.

• Age: “The older you are, the more likely you are to get high blood pressure,” according to heart.org. • Gender: “Until age 64, men are more likely to get high blood pressure than women are. At 65 and older, women are more likely to get high blood pressure,” the website states. • Race: “African-Americans tend to develop high blood pressure more often than people of any other racial background in the United States,” according to heart.org. • Chronic kidney disease • Lack of physical activity • An unhealthy diet, especially one high in sodium • Being overweight or obese • Drinking too much alcohol • Sleep apnea • High cholesterol • Diabetes • Smoking and tobacco use • Stress

• Certain other medical conditions

Myth: Ignorance is bliss.

Some people don’t want to know if they have or are at risk for a certain medical condition, Howell said. However, more people are becoming aware, and more hospitals and insurance companies are encouraging preventive measures, she said. “The big thing that I would really love people to know is get your screenings, know as much about your body as you possibly can know…get your baselines, take advantage of the health fairs…and be advocates for their own health,” Howell said. She also encouraged people to get health information from reputable sources and ask their doctors and pharmacists questions. In addition, Howell urged people to be honest about their own lifestyle choices and where there could be room for improvements. “It’s so much cheaper to prevent than it is to treat,” she said.

WEIGHT LOSS FROM PAGE 6

medicine at Cameron Memorial Community Hospital. Yes, just movement. “I don’t necessarily like the word exercise, I like the word movement. People think if they’re not going to the gym or running or doing this expensive workout that they’re not exercising,” Parkview Noble Center for Healthy

Living Community Nurse Leshia Howell said. On the contrary, every little bit helps, from parking farther away to more labor-intensive activities like shoveling snow, raking leaves or scrubbing the floor. “All of those little things matter. Your body doesn’t know you’re not in the gym. … As long as you’re moving your body and you’re not being sedentary, that’s

what it’s about,” she said. Saur agreed, arguing many people lose weight when they join the military, not from using fancy equipment but just from being very active. “Just get out and move and do what you like to do and that will help you burn fat, tone up and lose weight, and then if you’re losing weight and some muscles aren’t as strong as others that’s when you

do your targeted exercises,” she said. Seeing these changes is just about putting in the work, not getting the newest piece of equipment, Kueber said. “Everybody in today’s society wants a quick fix, they want it now and they want it with as little effort as possible, but you really need to put in the effort and exercise if you want to get to goal,” he said.

Healthy Living

September 16, 2018

Seniors can help prevent Medicare fraud Seniors can play an important role in helping to prevent Medicare fraud. Medicare fraud, waste and abuse costs taxpayers at least $60 billion a year, Indiana Senior Medicare Patrol Program Director Nancy Gilmer Moore said. The most recent scam centers on new Medicare cards, which were mailed to Hoosiers starting in April. The new cards replace a senior’s Social Security number on the card with a “random alphanumeric number,” Gilmer Moore said. However, scammers are trying to use this time to trick seniors, she added. “Scammers are still calling people under the auspices of something else but really what they want is that Social Security number so they might even say to them, we need your old (card),” Gilmer Moore said. “People are supposed to destroy their old card.” If a senior hasn’t yet received their new card, he or she should call 1-800-MEDICARE. Another popular scam involves durable medical equipment, or DME, she said.

“The biggest fraud right now nationwide with Medicare is knee brace, back brace, shoulder brace, all these braces,” Gilmer Moore said. “They call people relentlessly. It’s like 25 calls a day.” The problem is that often seniors are sent or tricked into buying DME that they don’t need. While it may cost them nothing, it can cost a lot to taxpayers, Gilmer Moore said. Another popular scam is hospice scam, where seniors are listed as being under hospice care when they aren’t. “They bill for a level of care beyond what a patient needs,” Gilmer Moore said. “That apparently is one of the biggest (scams right now).” Seniors are often the targets of these scams because they are more likely to be trusting, pick up the phone and be too polite to hang up. “One of the problems (too) is older adults are often ashamed when they do fall victim and so they won’t talk about it, so that just perpetuates the scam,” Gilmer Moore added. Phone scammers will often use Medicare in their name to try to sound SEE MEDICARE, PAGE 11

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Seniors can help prevent Medicare fraud by checking their Medicare summary notices for any duplicated or unexpected charges.

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Healthy Living

Antibiotics not a cure-all Antibiotics are not a cure-all and should be used with caution, said Dr. Lynn Saur, medical director of urgent care and occupational medicine at Cameron Memorial Community Hospital. “Most doctors agree that there are too many antibiotics that are prescribed,” she said. Antibiotics are used for the treatment of bacterial infections, not viral infections, according to the Mayo Clinic, adding that “according to the Centers for Disease Control and Prevention, up to one-third to one-half of antibiotic use in humans is unnecessary or inappropriate.” The overuse of antibiotics causes several problems. One is antibiotic resistance, which occurs when an antibiotic no longer affects a certain strain of bacteria, according to the Mayo Clinic. “The overuse and misuse of antibiotics are key factors contributing to antibiotic resistance,” the clinic’s website states. “Antibiotic resistance is one of the world’s most pressing health problems.” Overuse of antibiotics can cause problems for individuals as well, Saur said. “When you go on antibiotics they do weaken (the) immune system by about

80 percent for about four to six weeks… and they wipe out any memory that you’ve seen this bug you’re fighting, so you better be sure you need to go on antibiotics,” she said. This happens in part because antibiotics wipe out good bacteria in the intestines, which are “tightly related” to a person’s health and immune system, Saur said. “Every time you get through a cold, a cough, a sinus infection, an ear infection without antibiotics, your body can remember that bug and build immunities so you don’t get sick with that bug ever again,” she said. Saur specified that she is not telling people who seriously need antibiotics not to seek them. Rather, she encouraged people to speak with their doctors about all possible remedies for their illness. “It is a good idea, if you’re really sick, (to) have the doctor help you decide do you need antibiotics or not,” Saur said. “There are several things that I usually give people to help them get through it. … All doctors have their ways. It’s not a worthless visit when you go in when you’re sick and the doctor doesn’t give you antibiotics. There are other ways and suggestions that we can

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Antibiotics cannot treat viral infections and should be used with caution.

help you with that.” She said this approach seems to be working with her patients. “I’m finding more and more people are willing to listen to simple things that will help them stay out of the doctor’s

office, stay off antibiotics,” Saur said. For more information on antibiotics and antibiotic resistance, visit mayoclinic.org/healthy-lifestyle/ consumer-health/in-depth/antibiotics/ art-20045720.

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September 16, 2018

YOUR FUTURE WATER’S WORTH IT®

We all have something at stake when it comes to water, and everyone shares responsibility for it. We need to be unified in our efforts to keep our water clean and healthy. Turning on the tap or flushing the toilet is as simple as turning a knob or pushing a handle. What you don’t see is the vast infrastructure - 800,000 miles of water pipe and 600,000 miles of sewer line - that takes over from there. Every community is literally built on top of this infrastructure and wouldn’t be possible without it. These systems have worked silently for years, in some cases more than a century, without major interruptions, but now they need your attention. Your investment is needed to keep infrastructure functional for current and future generations.

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• In 2006, U.S. infrastructure was number six on the World Economic Forum’s ranking of best national infrastructure systems. By 2012, we had fallen to number 16! • More than $180 billion is needed to repair or replace U.S. water, wastewater and stormwater systems. Investing in water infrastructure will produce healthier communities, reduce water pollution, and directly generate nearly 1.9 million jobs. An additional 800,000 jobs will come from increased economic activity in related sectors.

Why should you care about water?

Our communities and our lives are built on water. In addition to protecting our health and the environment, we need clean water for a healthy and growing economy. Clean water and wastewater services support a $50 billion per year recreation industry, $300 billion in coastal tourism, $45 billion in commercial fishing and shell fishing industries and hundreds of billions of dollars a year in basic manufacturing. Without water, we don’t have a future.

• Don’t take water for granted. The water we have now is all that we will ever have. Use it wisely. • Think before you flush. Everything you send down the pipe ends up at your local wastewater treatment plant. We are all part of the water cycle. We all live downstream. • Educate yourself. Take a tour of your local water and wastewater treatment plant to learn what happens to the water that you drink and use. • Read and understand your water and wastewater bill. • Stay informed about the water quality issues facing your community by contacting your local municipality and attending public meetings.

You need water. Water needs you.

Indispensable to jobs, the economy, our health and our communities, water runs through out lives in many ways, Everyone uses water and everyone is responsible for it. We must all work together to keep our water clean and healthy. To do that, we each need to learn to value water.

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September 16, 2018

Healthy Living

FOOD: Most salts 40 percent sodium

MEDICARE: Seniors can be savvy consumers

FROM PAGE 3

FROM PAGE 8

In fact, foods using partially hydrogenated oils should be out of distribution by 2021, according to FDA website. Because of the belief that all fat is bad, low-fat foods became more popular, but this is also problematic, said Dr. Bret Kueber, a family practice physician with DeKalb Health. He used low-fat salad dressing as an example. “What do they do to replace the flavor with in a low-fat salad dressing? They put sugar in it,” Kueber said. “Sugar and salt are the two cheapest flavor additives that are out there, followed closely by high fructose corn syrup.” Diet beverages with sugar substitutes are also problematic in that anything with a sweetener — whether sugar or otherwise — increases one’s appetite. In fact, diabetes and obesity have “skyrocketed” since the low-fat trend began, Saur said. “There is a proper amount of fat to eat and if you go over that, that’s bad,” she said.

Salt

One last myth Howell said she regularly encounters is that sea or kosher salts contain less sodium than traditional table salt. “Actually it’s pretty much the same,” she

said, adding all three tend to have about 40 percent sodium. One advantage to table salt is that it is also usually contains iodine, which is important for thyroid function, according to the National Institutes of Health Office of Dietary Supplements.

Trend diets

While there is never a shortage of new trendy diets promising to help people lose weight by eliminating or focusing on one food, Saur advised sticking to tried-and-true methods. “Everybody wants a new, trendy thing… and they’ll go buy a book that presents something a different way. And when you look back on how to stay healthy and lose weight, it’s kind of the same old principles it’s always been: eat less, exercise more,” she said. “Basically stay away from the extremes, do things gradually. Everybody has a short timeline of expectations. If they want to lose weight, they want to lose 10 pounds in two weeks. And you might be able to do that eating grapefruits (only), but that’s not going to last and it is extreme and it can put your body under quite a bit of stress that you’ll pay for later.”

credible, Gilmer Moore said, and will tell seniors they qualify for something at no cost to them. They may also ask the senior if they have pain, but “who doesn’t at 85?” Gilmer Moore said. Often, seniors may realize the call is a scam but may agree to something in hopes that the calls stop. However, seniors are an essential part of helping to keep themselves and others from falling victim to these scams. One of the most important things they can do is be savvy consumers. “Don’t order anything over the TV, the phone, postcards. Talk to your doctor” about any medical devices or treatments you might need, Gilmer Moore said. “And don’t feel pressured.” The Senior Medicare Patrol encourages people to screen their calls and, if they do answer, to feel OK with hanging up on someone who is trying to scam them. Though they can be overwhelming, Gilmer Moore said it is also important for seniors to review their Medicare summary notices for any incorrect charges.

“Medicare beneficiaries get those but often they don’t review them, especially if they’ve got a supplement and really they don’t owe any money, then they just let it go. But we all need to be good consumers, conscientious consumers, so it goes back to reading those summary notices, monitoring that, making sure you’re not being charged for something you’ve never received or something you don’t need,” she said. If a person does think they’ve been victimized by a scam or that someone was trying to scam them, they can contact the Senior Medicare Patrol at 1-800-986-3505. If a senior is confused about their Medicare summary reports or needs any help navigating any kind of Medicare needs, Gilmer Moore suggested contacting the State Health Insurance Assistance Program at 800-452-4800. Seniors can also keep informed about the latest scams and how to protect themselves by visiting SMPResource.org or Facebook.com/ INSMP.

Healthy Living

September 16, 2018