Health and Fitness Guide

Page 1

A Supplement of THE MAUI NEWS – Wednesday, January 30, 2013 – Page T1


OFF FOR GOOD Discover one Maui resident’s road to better health

Paia resident Mike McMullen understands that numbers don’t lie. In October 2012, he stepped on the scale and faced the bitter reality: at 380 pounds, he was not only severely obese, but his blood pressure numbers were at 170/100. At age 61, McMullen was facing a laundry list of life-threatening complications including hypertension and diabetes. Something needed to change — so he decided to reclaim his life, one pound at a time. McMullen’s doctor referred him to Maui Medical Group’s weight manage-

ment clinic, where he was introduced to the Ideal Protein Weight Loss Method. The program is a medically designed system that results in fat loss while sparing muscle mass. “I wanted to feel a sense of energy and vitality, as well as avoid future medical problems,” said McMullen, who admits that he had already been through several unsuccessful attempts to lose weight. “I’ve tried at least five or six weight loss programs, but a lot of times, once people reach their goal weight, they abandon their program

and put the weight back on,” he explained. This time, he’s planning on losing the weight — and keeping it off. His goal weight is 190, but after more than three months with the Ideal Protein Weight Loss Method program, McMullen has already lost 50 pounds and improved his blood pressure to 145/70. And while he understands his transformation is far from finished, McMullen reports that he can already feel a difference in his everyday routine. “Now that I’ve been on this program for awhile, I

notice that when you’re eating right, you just feel different,” he said. “You feel like you have the energy to be active and get involved in things. You want to do them and you want to be more engaged in life in general.” The Ideal Protein Weight Loss Method is a four-phase protocol, which helps stabilize the pancreas and blood sugar levels while burning fat and maintaining muscle and other lean tissue. The plan involves mixing homemade meals with prepackaged foods, while trained and certified health professionals guide each client through the program. “I’ve never seen another program where there’s such a support system. They’re there meeting with you every single week, giving you encouragement, asking

you questions,” McMullen said, adding that his coach has even called him on the weekend to check in. McMullen points out that this isn’t a diet, but rather a “nutrition program.” For him, it’s not about a quick fix — it’s a lifestyle change. For example, through Maui Medical Group’s weight management clinic, he has learned that good health starts with positive food choices. “The biggest issue with weight control is what you put in your mouth,” he explained. “I’ve learned that many times appearances in food and the way it’s marketed makes it seem like it’s healthy for you, when in reality it’s not.” Maui Medical Group will host informational meetings detailing the program (see right).

Ideal Protein Weight Loss Method

What: Informational meetings When: 5:30 to 7 p.m. tonight, Feb. 12 and 27 Where: Maui Medical Group, 2180 Main St. in Wailuku, 7th floor conference room RSVP: Call 242-4241 Details: www.ideal protein.com

Mike McMullen has lost 50 pounds since beginning the Ideal Protein Weight Loss Method late last year, as documented in the photos below.

OCT. 2012

JAN. 2013

383 pounds

333 pounds

A Supplement of THE MAUI NEWS – Wednesday, January 30, 2013 – Page T2


GET READY TO ZUMBA! When you think of Zumba, you think of fast-paced, exhilarating, exciting and fun. That’s exactly what Keoni Manuel is — fun! This energetic man is not only the founder and kumu hula for Te Tiare Patitifa for the past 25 years, but one year ago he opened Keoni’s Hot Lava Dancefit studio in Wailuku and has been transforming women’s lives ever since. In addition, his love for hula has taken Manuel and his halau outside of Hawaii to perform at travel conventions on behalf of both Mana Kai Maui Resort and Maui Visitors Bureau. Manuel’s halau is open to everyone, and he doesn’t charge enrollment fees. He simply has a passion for

teaching his culture and love of all things Polynesian. Manuel introduced Hot Hula Fitness on Maui last year, but his love for Zumba led him to become a certified instructor. Next month, he will travel to Los Angeles with fellow instructors from across Hawaii to attend a national Zumba convention. The “Hawaii Dreams” group, headed by Zumba Educational Specialist Madalene Aponte, will be recognized for its Polynesian-style Zumba teachings. Manuel offers the following classes for all ages and levels: ■ Zumba Toning (incorporates weights) ■ Zumba Sentao (uses a chair)

■ Zumba Gold: low impact, great for those with injured knees and seniors ■ Zumbatomic: fun dance fitness for kids and Aqua Zumba He opened the studio to allow his halau students and parents a fun option to getting fit and welcomes participants of all ages. The introductory class is free, and punch cards are available for $40, which can be used towards 10 classes in one month (a savings of $10). Keoni’s Hot Lava Dancefit also offers pilates and boot camp classes at its studio, located at 380 Ho‘okahi St., 2nd floor in the Wailuku Industrial Area. For more information, call 269-9152 or visit www.hotlavadancefit.com.

Kumu hula and dance instructor Keoni Manuel of Keoni’s Hot Lava Dancefit is offering classes for Zumba enthusiasts of all ages and ability at his studio in Wailuku Industrial Area.

A Supplement of THE MAUI NEWS – Wednesday, January 30, 2013 – Page T3


GREEN MACHINE Gardens can be great training grounds for fitness buffs (AP) — Add trails for jogging. Build benches for workouts. Use trees and fence posts for stretching. Lose even more calories by squatting or lifting while weeding, planting, hauling and digging. You can personalize your garden to fit your energy level. Equipment such as exercise beams and conditioning ladders are inexpensive and simple to make, while portable gear like weighted rollers, jump ropes, dumbbells and Swiss balls can be eased into the routines. “If you have children's play equipment, it is easy to add a pull-up bar or climbing frame for adults to a tree house,” said Bunny Guin-

ness, a landscape architect who runs a garden design business near Peterborough in central England. Gardening in and of itself can be a formidable calorie burner, said Guinness, who with physiotherapist Jacqueline Knox wrote “Garden Your Way to Health and Fitness” (Timber Press. 2008). Regular physical activity reduces the risk of many illnesses, and gardening can provide it, said Margaret Hagen, an educator with University of New Hampshire Cooperative Extension. “Raking is like using a rowing machine,” Hagen said. “Turning a compost pile is similar to lifting

weights. Carry a gallon sprinkling can of water in each hand and you've got 8pound dumbbells. Pushing a lawnmower is like walking on a treadmill, only much more interesting.” Even more calories are burned when calisthenics are included in the mix. Add push-ups, chin-ups, bridging, power lunges and dips to the workouts. Warm up before you begin to avoid cramping and joint pain. Pace yourself. Hydrate, especially if you're gardening out in the sun. Avoid bending by using telescoping pruners, edgers and weeders. Opt for lightweight and easy-to-grip hand tools. Work ergonomically.

“Walking is man’s best medicine” - Hippocrates

Walking to school is fun and a great physical activity. Potential benefits of physical activity for youth are: -weight and blood pressure control -bone, muscle and joint health -reduction in risk of diabetes -improved psychological welfare -better academic performance For more information about Walk to School days and other Safe Routes to Schools programs contact the Maui County Dept of Public Works at 270-7745 or email Eng.Traffic@co.maui.hi.us

Stress good posture and balance. “As someone who has had a back issue, I do try to follow my physical therapist's advice and be careful to kneel instead of stooping while gardening, and to lift with bent knees and a straight back,” Hagen said. “One of the things I like most about gardening is that because you stretch and move in so many directions, it works all your muscle groups, releasing tension everywhere in your body.” Don't forget to include mental health in your landscape design. Add tranquil herb gardens, soothing fountains and small sitting areas for meditation, relaxing and cooling off. “Any gardener can tell you that there is nothing like spending time outdoors gardening to refresh the soul,” Hagen said. “Psychologically, I'm sure it provides the same benefits to gardeners that recent research says recess provides to schoolchildren.” Good nutrition also is an important part of any fitness package, and few things taste better than food served fresh from the garden. “If you can boost your health and avoid stresses and strains in the process, it becomes all the more satisfying,” Guinness said.

County of Maui/RYAN PIROS photo

Mayor Arakawa leads the way in celebration of national Walk to School Day AP photos

Bunny Guinness uses a tree to stretch (top) and garden bench for exercise. GarFor more information about NPAC, email Sandra McGuinness at dening can be a formidable workout and calorie burner, especially when adding smcguinn@hawaii.edu or call 264-7895 calisthenics to the mix, along with stretching to avoid cramping and joint pain. A Supplement of THE MAUI NEWS – Wednesday, January 30, 2013 – Page T4


STEPPING IT UP

Sandra McGuinness enjoys a walk with her canine companion.

Shed pounds and get social, one step at a time By SANDRA MCGUINESS For The Maui News

Now that we’re one month into 2013, I wonder how many of us are sticking to our New Year’s resolutions. According to an article in Forbes magazine, about 40 percent of Americans make New Year’s resolutions yet only 8 percent achieve them. The article by Dan Diamond suggests several reasons we fail — including setting unachievable, irrational or unspecific goals. I have had some successful and some not-so-successful accomplishments with my own resolutions. What has worked for me, though, as a definite health benefit, is walking, twice a day, pretty much every day — rain or shine. It began in 2002, when my daughter and I adopted two dogs from the humane society. It was then that we started a twice-daily routine of walking for about 15 to 20 minutes in the morning and afternoon. Not only have I shed some pounds in the process,

but I’ve also had dozens of conversations with my neighbors, have seen unbelievably beautiful sunsets and sunrises, and seen the return of a kolea (Pacific golden plover) every year to the same spot in our neighborhood. I’ve even done homework on my walks and have memorized several (Hawaiian) chants. Walking is a good form of exercise that is not only a great social experience, but one that, according to the Mayo Clinic, can help us lower our LDL (“bad”) cholesterol, raise our HDL (“good”) cholesterol, lower our blood pressure, manage our weight, improve our mood, and improve our stamina. I remember huffing and puffing up an incline on my road when I first started walking regularly. Now, I don’t even notice the hill. To find out if walking is good for our health, two researchers from University College London looked at research conducted between 1970 and 2007 in peer-reviewed English language journals. They identified

18 studies (from seven countries on three continents) that met their standards for quality. Each study collected information about participants’ walking habits with information about cardiovascular risk factors. Individuals were tracked for an average of 11.3 years. The analysis showed that walking reduced the risk of cardiovascular events by 31 percent and it cut the risk of dying during the study period by 32 percent (in both men and women). The health benefits and protection were evident even at distances of just 5.5 miles per week and at a pace as casual as 2 miles per hour. Walking is easy to do, doesn’t require a set schedule, is socially fun, and is good for you. If you want to increase your physical activity but don’t know where to start, I would suggest walking. But please remember, before starting any exercise or physical activity regimen, consult with your health care provider. For more information

about the benefits of walking or about the Nutrition & Physical Activity Coalition of Maui County, contact Sandra McGuinness at 264-7895 or email smcguinn@hawaii.edu

The Maui News / MATTHEW THAYER photo

and APPEAL (Asian Pacific Partners for Empowerment, Advocacy and Leadership) Fellow and a board member of the state Cancer Control Coalition, Maui Family YMCA, and Maui County

Volunteer Action Center. She is a Hawaiian culture practitioner with Na Hanona Kulike ‘ O Pi‘ ilani under the direction of na Kumu Kapono‘ai Molitau and Sissy Lake Farm.

■ Sandra McGuinness is coordinator of the Maui County Nutrition & Physical Activity Coalition. She is a Weinberg Foundation

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RIDOLFINO

JUDY

For those of us not blessed with the footwork of Fred Astaire or Ginger Rogers, the thought of taking a dance class might be a little frightening. But Judy Ridolfino, dance instructor of Judy’s Gang, says that even the clumsiest among us can benefit from hitting the dance floor once in awhile. In fact, says Judy, dance comes naturally to everyone, regardless of how pretty we look doing it. Here, she talks about what makes dance a smart way to exercise.

Q & A with Judy Ridolfino Q: In your opinion, what are the three biggest health benefits of dancing? JR: Everyone knows the physical advantages of moving and grooving. Being around all ages, I see that dancers have better balance. Being able to shift your weight in different directions definitely helps a person’s balance. Good balance means fewer chances of falling and less broken bones.

Q: Are there any other benefits? JR: Besides having better flexibility and coordination physically, dance also brings that to you mentally. More flexibility in your brain in remembering your dance steps is helping to keep away Alzheimer’s disease. Dance uses your brain and moves your body to keep them in good working order — and it’s fun!

Q: How can a person prevent dance-related injuries? JR: It’s the same as in life — pay attention to what you are doing. This is your time for yourself, not the cell phone or the latest text, not thinking of running your errands after class. Longs and Home Depot aren’t going anywhere. Take care of yourself. The strong survive!

Q: Are there any age requirements to join Judy’ s Gang? JR: There are over 100 dancers in Judy’s Gang from ages 3 to “seasoned citizens.” You cannot max out in Judy’s Gang. I even have exercisers who are in their ’90s who live an independent, full life, traveling to the Mainland by themselves because they are smart enough to keep exercising to stay in shape. So many of the “seasoned citizens” say they wish they had started 20 years ago, sending that message to their younger friends and family.

Q: What would you say to someone who wants to dance but isn’ t sure if it’ s right for them? JR: You really don’t know until you try. So come on down and experience a fun hour, whether you just want to be a “dancer for an hour” or a performer. I strive for fun first! Your first class is not the time to take life too seriously. This is an hour you don’t have to think about work or that eternal list of things to do. Come and escape, whether it is dance or exercise. You feel so good afterwards because you did something good for yourself. A new session begins on Feb. 11 at Judy’s Gang, Inc. after our big show on Feb. 2. It’s perfect time to start! A Supplement of THE MAUI NEWS – Wednesday, January 30, 2013 – Page T6


Outside of dance, Judy says she is lucky to teach weight lifting and stretch classes which in turn supplement her workout. Check out the schedule below to find which of Judy’s classes are right for you. Some of her classes include: > Motown weights and stretch bands > Children’s tap/jazz > Adult jazz > Adult tap > Strength training > Nordic pole walking > Slo-Robics > Supertappers > “Have a Ball” (stability, BOSU ball, hula hoops and more) > Stretch and stretchy bands

Judy teaches a total of Judy’s Gang, Inc. is located in Wailuku Industrial Park, at 811 Kolu St., #104. Children’s dance classes cost $22 per four-week session. Adult dance classes cost $29 per four-week session. Exercise classes are $84 per eight-week session. Judy also teaches 12 dance and exercise classes at Kaunoa Senior Center. For more information about those classes, call 270-7308.

ANNUAL SHOW TO ‘SALUTE OUR SOLDIERS’ Before you put on your own dancing shoes, perhaps you want to check out what all the talk is about. Now’s your chance, as Judy’s Gang will present its annual all-ages show beginning at 7 p.m. Feb. 2 at the Maui Arts & Cultural Center’s Castle Theater, featuring more than 100 dancers. This year’s performance will take on a “SOS — Salute Our Soliders” theme, complete with patriotic dances and festive attire. “It’s just a small step, but the Gang is going to honor the brave soldiers and veterans who have given so much to our country,” says Judy. “I want to reach as many veterans and soldiers as I can to come to the show. It is designed just for them and their families.” In addition to the dancers this year, Judy has brought in Jimmy C on drums and Al Scheck on guitar to open the second half of the show with some special numbers with the dancers. “Tap dancing is like having little drummers on your feet,” says Judy. “Now we have a real drummer — in person! It has been something I have wanted to do for a long time, and now is the perfect time and a bonus for us all.” Another special guest will be Melatia Cabrera singing a song for the soldiers and veterans with her back-up group. Melatia has been dancing with Judy

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Dance instructor Judy’s Ridolfino (left) will lead more than 100 dancers in spirited dance during Judy Gang’s annual show Saturday at the Maui Arts & Cultural Center. since she was three years you didn’t get the welcome old and has sung in some of you deserved on your her previous plays and homecoming, you sure are shows. going to get it that night.” Judy welcomes everyone Cost is $14 for adults, to this annual dance frenzy, $10 for seniors, students and adds a special invitation and children 6 and older. to all the veterans out there. Ages 5 and younger are “Join the fun from the free. Tickets are available at ‘Boogie Woogie Bugle the MACC box office, by Boy’ to a ‘Ball of Confu- calling 242-7469, at Judy’s sion,’ safely through the Gang, Inc. or through any of ‘Danger Zone,’ all tied up the dancers. For more inforwith a yellow ribbon to wel- mation, call Judy at 879come you,” she says. “If 8742.

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Hawaii senators propose tax on sugary beverages HONOLULU (AP) — Four Hawaii senators have proposed a statewide tax on sugar-sweetened beverages. The Democratic senators said the consumption of sugary drinks contributes to obesity. Hawaii ranks second-to-last for adult obesity compared to other states. The senators want to charge 1 cent per teaspoon of sugar in each drink and use the revenue to fund community health centers and help trauma victims. They say the tax would translate to about 10 cents per 12-ounce soda. Sen. Russell Ruderman, who co-sponsored the bill, said he anticipates opposition from consumers. Despite the title of the bill which includes the word “taxation,” Ruderman said the bill is a fee, not a tax, because Hawaii residents can choose whether or not to buy sugary drinks. The bill is a

way to fight childhood obesity while providing much-needed funding for health care, he said. Senate Minority Leader Rep. Sam Slom, the only Republican in the state’s 25-person Senate, said he opposes the bill. “It has nothing to do with obesity,” he said. “It’s a money grab by the state government.” Slom said obesity isn’t a major problem in Hawaii, adding that the bill diverts attention from more pressing fiscal and economic issues. He said the bill imposes on individual choice and that parents are responsible for deciding what their children drink. Hawaii House Majority Leader Scott Saiki said he isn’t sure the bill will find support in the House. While sugary drinks carry health risks, the House will be cautious about enacting broad-based taxes this session, he said.

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You may have seen Konomi Dance Works performing at local events including the Maui Fair, the Maui Korean Festival and at Queen Ka‘ahumanu Center, but now it’s time take a closer look at the personalities behind Wailuku’s newest dance studio. Katerina “Konomi” Dominguez has been dancing since she was 6 years old. Now, at

Katerina Konomi Dominguez began dancing when she was 6 years old at the Maui Academy of Performing Arts. She fell in love with tap and jazz and soon became a protege of local Tap icon Jill Okura of Heart Dance Studio. Dominguez quickly discovered the joy and freedom that comes with dancing and soon decided that she wanted to pursue her love for dancing and the arts as a career. She looks forward to sharing her passion and excitement with Maui and hopes to establish a friendly and active tapping community here.

Starting at the age of 6, Alex “Kid Karma” Hutaff-Bautista found the passion for dance through his uncle Tobby “Lukani” Hutaff. The early passing of his uncle made him want to follow in his footsteps. Since then, Hutaff-Bautista has dedicated his life to performing and dancing. His credits include World of Dance 2012 2v2 champion, Maui Hip-

age 20, she has realized her dream of opening her own studio: Konomi Dance Works LLC, located at 70 Kanoa St. in Wailuku. Along with local battle champions Brandon Haros and Alex “Kid Karma” HutaffBautista, she hopes to introduce Maui’s talented keiki and adults to the various modern styles of hip hop. Brandon Haros discovered his natural gift of dance in 2008 at the age of 15 when he entered a high school competition. What started out as a momentary muse became a passionate pursuit. Lacking a place and money for classes, he practiced wherever he could — in his kitchen or garage, sometimes using the screen door as a mirror. Inspired by YouTube videos of dancers such as Mike Song and Poreotics, he developed his unique style of hip hop featuring his dexterity in “popping,” “tutting,” “isolation” and “animation.”

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442-6856 A Supplement of THE MAUI NEWS – Wednesday, January 30, 2013 – Page T8


Start to finish: 40 minutes (20 minutes active) Makes 32 toasts

BAKED SESAME SHRIMP TOASTS

INGREDIENTS 32 diagonally sliced 1/2-inch-thick baguette slices Cooking spray 1/2 pound raw shrimp, peeled and deveined 1 large egg white 2 1/2 teaspoons sake, Chinese rice wine or dry sherry 2 teaspoons finely grated fresh ginger 1 large garlic clove, minced 1 1/2 teaspoons hot sauce 1 1/2 teaspoons toasted sesame oil, divided Heaping 1/4 teaspoon kosher salt 1/4 teaspoon sugar 4-ounce can water chestnuts, drained and finely chopped 2 scallions, finely chopped (about 1/4 cup) 1/4 cup low-fat mayonnaise 2 teaspoons sesame seeds

DIRECTIONS 1. Heat the oven to 400 F. By SARA MOULTON The Associated Press

Chinese New Year is the sort of new year celebration I love. Because unlike the Western tradition of big blowout parties, Chinese New Year is a time to get together with family, to give thanks for what you have, to retire your grudges, and to look forward to a year of peace and happiness. In that way, I think of it much as I do Thanksgiving. It’s in the spirit of Chinese New Year (which this year starts Feb. 10) that I’ve reconfigured one of my favorite dim sum dishes — shrimp toasts. Traditionally, shrimp toasts are made of chopped or ground shrimp seasoned with soy sauce, sesame oil, scallions and rice wine. This mixture then is mounded onto little toasts and deep-fried. The result is creamy on top, crispy on the bottom, and richly flavorful through and through. Like everyone else on the planet, if it’s fried, I love it. In this case, though, I was hoping to get the crunch of frying without the fat.

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2. On a rimmed baking sheet, arrange the baguette slices in a single layer. Spritz the bread slices on both sides with cooking spray. Bake them on the oven’s middle shelf for 4 minutes. Remove them from the oven, turn over each slice, then set aside. Reduce the oven to 350 F. 3. In a food processor, combine the shrimp, egg white, sake, ginger, garlic, hot sauce, 1/2 teaspoon of the sesame oil, the salt and the sugar. Puree until smooth. Transfer the mixture to a bowl and stir in the water chestnuts and scallions. 4. In a small bowl, stir together the mayonnaise and remaining 1 teaspoon sesame oil. Mound a rounded tablespoon of the shrimp mixture on top of each toast and spread evenly over the toast. Brush the top of each mound with some of the mayonnaise mixture, then sprinkle with sesame seeds. 5. Bake on the oven’s middle shelf for 12 to 14 minutes, or until the shrimp mixture is just cooked through. Serve hot. Nutrition information per toast: 120 calories; 20 calories from fat (17 percent of total calories); 2 g fat (0 g saturated; 0 g trans fats); 10 mg cholesterol; 19 g carbohydrate; 1 g fiber; 1 g sugar; 5 g protein; 260 mg sodium.

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UP IN SMOKE Study: Women have caught up to men on lung cancer risk (AP) — U.S. women who smoke today have a much greater risk of dying from lung cancer than they did decades ago, partly because they are starting younger and smoking more — that is, they are lighting up like men, new research shows. Women also have caught up with men in their risk of dying from smoking-related illnesses. Lung cancer risk leveled off in the 1980s for men but is still rising for women. “It’s a massive failure in prevention,” said one study leader, Dr. Michael Thun of the American Cancer Society. And it’s likely to repeat itself in places like China and Indonesia where smoking is growing, he said. About 1.3 billion people worldwide smoke. The research is in New England Journal of Medicine. It is one of the most comprehensive looks ever at long-term trends in the effects of smoking and in-

cludes the first generation of U.S. women who started early in life and continued for decades, long enough for health effects to show up. The U.S. has more than 35 million smokers — about 20 percent of men and 18 percent of women. The percentage of people who smoke is far lower than it used to be; rates peaked around 1960 in men and two decades later in women. Researchers wanted to know if smoking is still as deadly as it was in the 1980s, given that cigarettes have changed (less tar), many smokers have quit, and treatments for many smoking-related diseases have improved. They also wanted to know more about smoking and women. The famous surgeon general’s report in 1964 said smoking could cause lung cancer in men, but evidence was lacking in women at the time since relatively few of them had

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smoked long enough. One study, led by Dr. Prabhat Jha of the Center for Global Health Research in Toronto, looked at about 217,000 Americans in federal health surveys between 1997 and 2004. A second study, led by Thun, tracked smoking-related deaths through three periods — 1959-65, 198288 and 2000-10 - using seven large population health surveys covering more than 2.2 million people. Among the findings: ■ The risk of dying of lung cancer was more than 25 times higher for female smokers in recent years than for women who never smoked. In the 1960s, it was only three times higher. One reason: After World War II, women started taking up the habit at a younger age and began smoking more. ■ A person who never smoked was about twice as likely as a current smoker to live to age 80. For women, the chances of surviving that long were 70 percent for those who never smoked and 38 percent for smokers. In men, the numbers were 61 percent and 26 percent. ■ Smokers in the U.S. are three times more likely to die between ages 25 and 79 than non-smokers are. About 60 percent of those deaths are attributable to smoking. ■ Women are far less likely to quit smoking than men are. Among people 65 to 69, the ratio of former to current smokers is 4-to-1 for men and 2-to-1 for women. ■ Smoking shaves more than 10 years off the average life span, but quitting at any age buys time. Quitting by age 40 avoids nearly all the

AP photo

A woman smokes a cigarette during a break from work in downtown Chicago. New research published in the New England Journal of Medicine finds that women who smoke today have a much greater risk of dying from lung cancer than they did decades ago compared to those who never smoked. That is partly because they are starting younger and smoking more than women used to.

excess risk of death from smoking. Men and women who quit when they were 25 to 34 years old gained 10 years; stopping at ages 35 to 44 gained 9 years; at ages 45 to 54, six years; at ages 55 to 64, four years. ■ The risk of dying from other lung diseases such as emphysema and chronic bronchitis is rising in men and women, and the rise in men is a surprise because their lung cancer risk leveled off in 1980s. Changes in cigarettes since the 1960s are a “plausible explanation” for the rise in non-cancer lung deaths, researchers write. Most smokers switched to cigarettes that were lower in tar and nicotine as measured by tests with machines, “but smokers inhaled more deeply to get the nicotine

they were used to,” Thun said. Deeper inhalation is consistent with the kind of lung damage seen in the illnesses that are rising, he said. Scientists have made scant progress against lung cancer compared with other forms of the disease, and it remains the leading cause of cancer deaths worldwide. More than 160,000 people die of it in the U.S. each year. The federal government, the Canadian Institutes of Health Research, the Bill and Melinda Gates Foundation, the cancer society and several universities paid for the new studies. Thun testified against tobacco companies in class-action lawsuits challenging the supposed benefits of cigarettes with reduced tar and nicotine, but he donated his payment to

A Supplement of THE MAUI NEWS – Wednesday, January 30, 2013 – Page T10

the cancer society. Smoking needs more attention as a health hazard, Dr. Steven A. Schroeder of the University of California, San Francisco, wrote in a commentary in the journal. “More women die of lung cancer than of breast cancer. But there is no `race for the cure’ for lung cancer, no brown ribbon” or highprofile advocacy groups for lung cancer, he wrote. Kathy DeJoseph, 62, of suburban Atlanta, finally quit smoking after 40 years - to qualify for lung cancer surgery last year. “I tried everything that came along, I just never could do it,” even while having chemotherapy, she said. It’s a powerful addiction, she said: “I still every day have to resist wanting to go buy a pack.”


Dr. Steven Birnbaum works with a patient in a CT scanner at Southern New Hampshire Medical Center in Nashua, N.H. The American Cancer Society says there now is enough evidence to recommend screening certain older, heavy smokers for lung cancer.

CHECKING IN Lung cancer scans backed for older, heavy smokers (AP) — After decades of qualms about lung cancer screening, the American Cancer Society says there now is enough evidence to recommend it, but only for current and former heavy smokers ages 55 to 74 and after a frank talk about risks and benefits. The new guidelines are a cautious but exciting step against the world’s most deadly cancer, doctors who wrote the advice say. It is based on a big study in 2011 that found annual, low-dose CT scans — a type of X-ray — could cut the chances of dying of lung cancer by 20 percent and from any cause by nearly 7 percent. The study only included older people who smoked a pack of cigarettes a day for 30 years or the equivalent, such as two packs a day for 15 years. Whether screening would help others isn’t known, so scans were not advised for them. “We’re trying to make sure we restrict harm that might come from screening,” such as unneeded biopsies and follow-up procedures when scans falsely suggest cancer, said Dr. Richard Wender, family medicine chief at Thomas Jefferson University in Philadelphia. Lung cancer is fairly rare before age 55,

so “the benefits of screening are going to be less if you start at a younger age.” Wender, a former Cancer Society president, led the guidelines panel. Three of its 20 members have ties to companies that make cancer treatment or imaging products. The scans cost $100 to as much as $400 and are not covered by Medicare or private insurers. “We believe insurance companies should cover this test for the right people — not for everybody,” Wender said. More than 160,000 people die of lung cancer in the United States alone each year, and the vast majority are diagnosed after the disease has spread. Cancer screening has provoked great argument in recent years, especially over when and how often women should get mammograms and whether men should have PSA blood tests to look for prostate cancer. Some of the most influential guidelines come from a government-appointed panel — the U.S. Preventive Services Task Force — but it hasn’t considered lung cancer screening since 2004, when it said there wasn’t enough evidence to recommend for or against it. An update is in the works

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now. The Cancer Society used to recommend screening with chest X-rays but withdrew that advice in 1980 after studies showed they weren’t saving lives. Since then, the CT scans have come into wider use, and several medical groups backed limited screening with them. Many private companies also market CT scans directly to the public, including for some who are at lower risk for lung cancer than the people in major studies have been. WellStar Health System, a network of hospitals and private doctors in suburban Atlanta, has screened nearly 900 people since 2008. Less than 3 percent were referred for lung biopsies because of suspicious findings, and of those, 70 percent turned out to have lung cancer, said screening coordinator Vickie Beckler. The system generally follows the advice of the National Comprehensive Cancer Network, a group of top cancer centers, but eligibility for scans is “a very fluid area” that’s being refined, she said. Patients younger than 50 need a doctor’s referral for a scan, but if they want one and have major risk factors, “it should be their prerogative

AP photo

to have access to screening as long as they understand the risks and benefits involved and come to that decision with their physician,” she said. Kathy DeJoseph, 62, of suburban Atlanta, is glad she was screened as part of a study at WellStar. Several years of scans found nothing but last year, one detected cancer. “I’d have been dead had I not had that scan,” she said. “I was very, very lucky.” She also finally quit smoking after 40 years to qualify for lung cancer surgery. Having a scare from a scan “is a great motivator for people to quit smoking — fear that they might have had lung cancer, that they dodged a bullet, really causes people to change and take a look at their behavior,” Wender said.

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CHOICE IS YOURS? Hospitals crack down on workers refusing flu shots (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won’t get flu shots, with some workers losing their jobs over their refusal. “Where does it say that I am no longer a patient if I’m a nurse,” wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot. Hospitals’ get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is wide-

spread in most states, and at least 20 children have died. Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports. In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation. Why would people

whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients. Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes. “We would all like to see stronger data,” she said. “But other evidence shows

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Bill Staples, a Mississippi Department of Health employee, is given a flu vaccine shot by registered nurse Rosemary Jones, also with the health department, in Jackson, Miss.

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among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes “the injustice of being forced to put something in my body.” Medical ethicist Art Ca-

plan says health care workers’ ethical obligation to protect patients trumps their individual rights. “If you don’t want to do it, you shouldn’t work in that environment,” said Caplan, medical ethics chief at New York University’s Langone Medical Center. “Patients should demand that their health care provider gets flu shots — and they should ask them.” For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000. A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

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