To Your Health Oct 2011

Health TO YOUR

Midvalley M idvalley yN Newspapers

Quarterly October2010 2011

A guide to wellness and healthy living in the Mid-Willamette mette Valley

STAT Quick reads about health topics in the news

Concussion boom The number of athletic children going to hospitals with concussions is up 60 percent in the past decade, a finding that is likely due to parents and coaches being more careful about treating head injuries, according to a new federal study.

“It’s a good increase, if that makes any sense,” said Steve Marshall, interim director of the University of North Carolina’s Injury Prevention and Research Center.

Bicycling and football were the leading reasons for the kids’ brain injuries, but health officials said that could be at least partly related to the popularity of those activities.

See the report online at http://www.cdc.gov/mmwr.

— Associated Press

Texting danger

Jessica Stallings staffs a booth a the Beaver Community Fair that was held Sept. 30 at Oregon State University.

CONTRIBUTED PHOTO

Reaching out to fight cancer SCREEN program volunteers educate the public to promote early detection

By Jennifer Rouse ore than 300,000.

That’s how many women are diagnosed with breast cancer and cervical cancer each year.

But a new program aimed at early screening and detection aims to turn as many as possible of those 300,000 from patients into survivors. The SCREEN program is run through Samaritan Health Services and has already begun training volunteers, who are showing up at local events.

“There are many great people already doing wonderful work in this area, especially around breast cancer,” said program coordinator Emily McNulty. “But with many of them, the focus is on people once they have already been diagnosed. We are trying to promote screenings and early detection.”

The official name of the program is the MidWillamette Screening and Regional Education Network. Funded by a five-year, $310,000 grant from the Susan G. Komen Foundation, the Knight Cancer Institute, the OHSU Center for Women’s Health and Samaritan Health Services, the idea behind the program is twofold: that early detection increases the chance of survival, and that women’s own friends and neighbors are the best ones to educate them about that fact.

“It’s designed as a grass-roots effort,” McNulty said. “We’re recruiting passionate women in the local community to be lay educators, because we know that someone who is already a part of the community is going to be

M

TO GET INVOLVED Contact Emily McNulty at 541-451-6929 or emcnulty@samhealth.org.

FOR MORE INFORMATION Check out this website for more information: http://www.samhealth.org/communitysupport/com munitycollaborations/Pages/screenprogram.aspx more successful than, for example, me coming in as an outsider.”

For SCREEN volunteer Jessica Stallings, getting involved with the program was a way to expand her interest in health-related issues.

A recent graduate of Oregon State University with a degree in public health, Stallings was browsing HandsOn Linn-Benton, a local volunteer website, when she spotted information about SCREEN. “It just pulled on my heartstrings,” she said. “I really have a passion for women’s health, and this detection and screening program is such a great way to empower women.”

Simple signup Stallings said signing up to participate with SCREEN was simple. Using the HandsOn Linn-Benton website, she sent an e-mail indicating her interest, and soon received a return e-mail from McNulty. She went through an orientation that was about two hours long and gave basic information about breast and cervical health. Since then, she’s worked at

local events like the Corvallis Farmers Market and the Beaver Community Fair at OSU, engaging people in conversation and handing out information about detection methods, such as self breast exams, mammograms and PAP smears. “It’s been really fun,” she said.

McNulty said program organizers aim to make involvement as easy for volunteers as possible. They ask volunteers to commit to doing two events or activities per year — it could be working at an event, leading a discussion, or meeting with a community group.

“Maybe they only want to talk to their personal church group, so they do a spring event and a fall event,” she said. “That’s fine. You can make it as much or as little as you want.”

The goal, she said, is not for every volunteer to give big public speeches or work on the issue round the clock. Instead, they hope to get a large group of committed people all over the valley.

“We want people to use their own existing networks,” she said. One volunteer, she said, is a Mary Kay consultant who thinks she can reach out to her clients. Others are women who have seen family members or friends struggle with cancer and want to do something to help.

The program reaches to Linn, Benton, Lincoln and Lane counties and is funded for five years. After that, McNulty says, there will hopefully be a group of volunteers in place willing to keep it going.

“You don’t need a medical background or any experience at all,” McNulty said. “The only key is having a passion for women’s health.”

10 things to know about breast cancer

BY KAREN GARLOCH MCCLATCHY NEWSPAPERS

Check your expertise during Breast Cancer Awareness Month in October.

1. A lot of people talk about preventing breast cancer, but the correct term is risk reduction.

“We don’t really know how to prevent breast cancer. We know how to reduce people’s risks,” said Judith Swasey, a nurse practitioner at the University of North Carolina-Chapel Hill’s cancer hospital. The basics: Don’t smoke, exercise a lot, watch your diet, annual screenings.

2. There has been lots of controversy in recent years over the usefulness of annual mammograms for some women. Some re-

searchers suggest they aren’t needed until women reach 50 and that it’s OK for women not at high risk to have scans every other year.

But the American Cancer Society and many breast cancer centers continue to recommend annual mammograms starting at 40.

The cancer society also recommends clinical breast exams by physicians annually, beginning at the same age as mammograms.

For those at high risk for breast cancer because of family history, annual screening should begin before age 40. For example, if you have a sister who developed breast cancer at 45, the recommendation is to start mammograms at 35.

Monthly self-exams have also

been the subject of debate, but the cancer society recommends them for women starting in their 20s.

Mammograms are controversial partly because they produce both benefit and harm. Awareness and screening have led to more early detection. But critics say that some patients have been harmed by unneeded surgery, radiation and chemotherapy for small cancers that wouldn’t have been found without mammography and wouldn’t have caused problems.

3. Post-menopause weight gain is particularly dangerous when it comes to breast cancer risk. With extra body fat comes more estrogen, which can stimulate breast cancer growth. A normal body

mass index is less than 30.

To calculate BMI, multiply your height in inches by that same number; divide that total into your weight in pounds; then multiply the total by 703. A person who is 5-feet-5 (65 inches) and weighs 150 pounds has a body mass index of 25. (Or Google “BMI calculator” for an online tool.)

4. Many studies have looked for a link between diet and breast cancer risk, but results are conflicting.

Experts say it’s good advice to eat a diet high in fruits, vegetables and whole grains, and low in fat and red meat. “That’s what I tell SEE 10 THINGS | A6

New findings from a Texas study show texting while driving is more dangerous than previously thought.

Reading or writing a text message behind the wheel can more than double a driver’s reaction time, according to a study by the Texas Transportation Institute.

“Our findings suggest that response times are even slower than what we originally thought,” said researcher Christine Yager, a TTI researcher. “Texting while driving basically doubles a driver’s reaction time, and makes the driver less able to respond to sudden roadway dangers,” she said.

— Associated Press

Bedbug risk Worried about bedbugs?

Maybe you should be more concerned about the insecticides used to get rid of them.

A government study counted one death and 80 illnesses linked to bedbug insecticides over three years. Many were do-it-yourselfers who misused the chemicals or used the wrong product. Most of the cases were in New York City.

The study by the Centers for Disease Control and Prevention is the first to look at the issue. The CDC was able to only get data from seven states. (Oregon was not included in the study.)

See the report online at http://www.cdc.gov/mmwr.

— Associated Press

Subsidies for fat Billions in taxpayer dollars are going to support high fructose corn syrup and three other common food additives used in junk food, according to a report by the California Public Interest Research Group and the U.S. PIRG Education Fund, both consumer advocacy groups.

The report,“Apples to Twinkies: Comparing Federal Subsidies of Fresh Produce and Junk Food,” makes the case that federal farm subsidies are helping feed the nation’s obesity epidemic. The research shows that from 1995 to 2010, $16.9 billion in federal subsidies went to producers and others in the business of corn syrup, high fructose corn syrup, corn starch and soy oils.

— Los Angeles Times

Funny medicine Laughter may decrease the perception of pain, according to a study published in September in the Proceedings of the Royal Society of Biological Sciences.

This study looked at six experimental studies in watching videos and live performances, checking for responses to pain with and without laughter. The results showed that pain thresholds are significantly higher after laughter than in the control condition. That is, people who were laughing felt less pain with the same stimuli than those who weren’t laughing.

— McClatchy Newspapers

A6

Tuesday, October 11, 2011

To Your Health

10 things Continued from A5

AMANDA COWAN | TO YOUR HEALTH

Dr. Kristin Bradford, left, meets with patient Anthony Garcia Navarro, 4, of Corvallis and his mom, Sofia Navarro, Thursday afternoon at Benton Health Center.

‘Health home’ model puts patient in center Benton, Linn clinics use a team of caregivers to best meet health needs

be as simple as being acthe clinic reaches out to cessible when patients those in need. need care. Simple things like changing the way apPlugging the gaps pointments are scheduled As R.N. care coordinator can make a big impact. for Community Health “It’s no longer OK to call Centers of Benton and Linn

BY MARIA L. KIRKPATRICK in and find your provider Counties, it is Elicia TO YOUR HEALTH doesn’t have an opening in Miller’s job to plug holes so Imagine suffering a the schedule until three patients don’t fall through chronic illness and having weeks from now if what the cracks. your own medical team, all you have is an urgent Miller teaches chronic based in one location, to issue,” Dahl said. care patients how to be work with you on the path Follow-up appointments proactive instead of reacto wellness. also are closely monitored. tive to their care and Staff members are famil- If a patient misses schedulreaches out to those who iar with ing a follow-up appointhaven’t been in to check up your file and ment, their scheduler will on their condition and keep individuals call. them out of the emergency address Providers also work their room. your needs schedules to fit in schedShe works regularly with to ensure uled and same-day apthe same staff and payou underpointments. tients. This way, she exstand your In Benton County, the plained, patients can come diagnosis health center is located in in and know the medical and treatthe same building as the staff available on any given Elicia ment and Health Department, which day and that staff is familhave timely Miller includes iar with that appointmental and ments to come in regularly “We are working patient’s records. public health — even when nothing is better with Information services. This wrong. transfers facilitates indifferent levels of smoothly, she This is what happens to patients at the Community tegrated servstaff now that we said, espeices with the Health Centers of Benton cially in cases specialty are in teams. I and Linn Counties. where the health clinic For nearly two years, the know exactly who whole family as well as health centers have been is being seen. to go to for health proworking on a different memmotion and model for delivering health whatever needs a Staff bers are aware public health. care — patient-centered patient may have or of chronic illIn Linn “health homes.” includCounty, servthat I may have in ness, “It makes you think ing high blood about reorganizing care and ices may not order to meet a pressure and be under the putting the patient in the same roof but patient’s needs. It diabetes, that center and what their when present contracting needs are,” said Sherlyn is much more in one memwith specialDahl, executive director. ber may affect efficient.” ists allows for “And then it creates a another. the same team team-based approach to DR. KRISTIN BRADFORD Miller care. services.”

COMMUNITY HEALTH floats be“We are CENTERS OF BENTON Team-based means the tween the two AND LINN COUNTIES getting our care is delivered through a teams. This patients emrelationship between paway if one provider is out, bedded in a full range of tients and their teams. the patient can see the health care, not just acute Team care not only targets other and have Miller the treatment of one illness care,” Dahl said. present as part of their inAlso available is prevenor symptom, it incorpoformed team. tion and education through rates a very strong preven“It provides more of a the public health departtion and health promotion hands-on approach,” Miller ment. component. said.

“And lends a sense of Every patient who comes “This is about working in to the clinic and does not comfort and personalizawith the patient to imtion.” have a health home gets prove their health status That level of comfort exthis total treatment. Acand health outcomes,” tends from patient to tively targeting the special Dahl said. “We started and vulnerable population, provider. with envisioning what it would look like to put the patient at the center. You start with the patient and assign them to a provider, who has their own patient panel.”

The panel includes medical assistants, schedulers, registered nurse care coordinator and a behaviorist.

There are two complete teams at the Benton County center.

Care coordinators provide health education and follow up after hospital discharge. Behaviorists help patients change the way they live to incorporate exercise and reduce stress.

The intent is to help people get healthy and stay healthy and to help those who need help.

Accessible at right time Providing better care can

Dr. Kristin Bradford has been at the clinic for two years and has been a part of the program since its inception some 18 months ago.

“I feel like our patients are able to more often see their provider and get through to communicate with my team. There is a lot less waiting and a lot less people they have to go through.”

This program also makes a big difference in the way Bradford is able to provide care. She said it is easier to get information needed for a patient because results and reports that used to be messages or lost in somebody’s inbox are relayed much faster.

“We are working better with different levels of staff now that we are in teams,” Bradford said. “I know exactly who to go to for whatever needs a patient may have or that I may have in order to meet a patient’s needs. It is much more efficient.”

And it all ties into the goal of keeping people out of hospitals – which, in turn, should help reduce health care costs.

“The concept feels right, when you get it,” Dahl said. “What is really difficult is changing basic processes that are so ingrained in how we deliver health care in the traditional model.”

Why can’t all health care be provided in this way?

Because, Dahl said, in health care, the reimbursement process still drives how services are delivered and reimbursement is driven by procedures and diagnosis.

Focusing on patients’ whole health translates into staff salaries that may not be covered under insurance. This is where the center’s federally qualified designation helps to get grants that help support the center’s sliding-fee scale.

my patients,” Swasey said.

“Whatever diet is hearthealthy is probably the best one to follow.”

5. Evidence is growing that regular exercise lowers the risk of breast cancer. “It doesn’t have to be highintensity exercise,” said Rachel Burns, dietitian with Levine Cancer Institute at Carolinas Medical Center. “It can be as easy as just walking, being physically active 30 minutes a day.”

6. Avoid soy supplements, Burns said. Soy contains isoflavones, which can act like estrogen and stimulate the growth of certain types of breast cancer. Supplements usually contain more concentrated doses of isoflavones than whole forms of soy, such as soy milk, tofu or edamame, Burns said. “Three servings a day of those (whole) forms are OK.” 7. Smoking hasn’t been linked specifically to breast cancer risk, but a recent study of women at high risk for breast cancer found that, for those who smoked, the more they

smoked and the longer they smoked, the more their risk increased, Swasey said.

8. MRI scans are not recommended as regular screening tools for the general population. But they are used, in addition to mammography, for screening high-risk patients and for diagnosis after mammograms that detect suspicious masses.

9. Women with dense breasts are at higher risk for breast cancer, and mammograms aren’t as effective in detecting cancer in very dense breasts. Ask your doctor whether you have dense breasts and, if so, you might benefit from regular MRI scans or ultrasounds along with mammography.

10. Breast cancer risk goes up with age. The often-repeated statistic that “1 in 8” women will get breast cancer is calculated over a lifetime to age 95. The National Cancer Institute has created a Breast Cancer Risk Assessment Tool. Take the test at www.cancer.gov/ bcrisktool.

FINDING THE WORDS

What do you say to a friend who’s been diagnosed?

BY ALEXIA ELEJALDE-RUIZ

here to help in any way.”

• “Would you like to tell Even the best-inten- me more about it?” tioned person can become speechless or tongue-tied Not helpful when reacting to a loved • “You’ll be fine.” one’s breast cancer diagno• “You poor thing.” sis. What should you say?

• “I know how you feel.”

And what should you not • “I know someone who say? Several peer coundied from that.” selors at Y-Me National • “Call me if you need Breast Cancer Organization anything.” offered the statements they • “Will you be OK finanfound most and least help- cially since you won’t be ful to hear during their own able to work?” breast cancer battles.

• “I think you should ...”

CHICAGO TRIBUNE

Helpful

As for timing ...

• “I’m here for you, and we’ll see this through together.”

• “I’ll organize your friends to make dinners, drive car pools, shop, etc. — whatever would be helpful.”

• “I know this is difficult for you, but please know I will do all I can to support you.”

• “I’m so sorry you have to go through this, but I’m

Many friends and family members rush to offer support upon hearing news of a cancer diagnosis — but then the calls subside, even as the cancer treatment stretches on.

Stay connected for the long haul, checking in with periodic phone calls or emails to see how she’s doing or just to talk about something normal.

To Your Health

Tuesday, October 11, 2011

A7

NUTRITION QUIZ: B12

BY SAM MCMANIS MCCLATCHY NEWSPAPERS

CLIFF OWEN | AP PHOTO

First lady Michelle Obama takes part in Walmart’s announcement in Washington, D.C., in January of a comprehensive effort to provide healthier and more affordable food choices to their customers.

Salads are nice, but burgers sell Consumers say they want healthier options, but statistics from fast food chains show that not that many are actually buying them

Every red-blooded American — and people from other countries, too — needs to be properly dosed with vitamin B-12, in large part to hasten red blood cell formation. But there’s so much more to know about B-12. Take our quiz to find out.

1. Which of the following does B-12 not positively contribute to? a) Neurological function b) Reduced kidney CK levels c) DNA synthesis 2. According to the Mayo Clinic newsletter, a normal body will store how much B12 in the liver? a) Two days’ worth b) A few weeks’ worth c) Several years’ worth 3. Which serving of the following does not provide 100 percent of the daily value (listed at 6 micrograms) for B-12? a) 3 ounces of fried clams b) 3-ounce top sirloin steak c) Fortified breakfast cereal 4. Those who are anemic have difficulty absorbing B12 from the intestinal tract.

Which population is not at special risk for being B-12 deficient? a) Elderly b) Vegetarians c) Endurance athletes 5. In healthy people, how much of a 500-microgram oral supplement is actually absorbed by the body? a) 6 mcg b) 10 mcg c) 50 mcg

BY CHRISTINA REXRODE ASSOCIATED PRESS

ANSWERS: 1: b; 2: c; 3: b; 4: c; 5: b.

NEW YORK — Americans talk skinny but eat fat.

No matter that First Lady Michelle Obama has been on a crusade for a year and a half to slim down the country. Never mind that some restaurants have started listing calories on their menus. Forget even that we keep saying we want to eat healthy. When Americans eat out, we order burgers and fries anyway.

“If I wanted something healthy, I would not even stop in at McDonald’s,” says Jonathan Ryfiak, 24, a New York trapeze instructor who watches his diet at home but orders comfort foods like chicken nuggets and fries when he hits a fast-food joint.

In a country where more than two-thirds of the population is overweight or obese, food choices are often made on impulse, not intellect. So, while 47 percent of Americans say they’d like restaurants to offer healthier items like salads and baked potatoes, only 23 percent tend to order those foods, according to a survey last year by food research firm Technomic.

That explains the popularity of KFC’s Double Down, a sandwich of bacon and cheese slapped between two slabs of fried chicken. It’s the reason IHOP offers a Simple & Fit menu with yogurt and fruit bowls, but its top seller remains a 1,180-calorie breakfast sampler of eggs, bacon, sausage, ham, hash

RALF-FINN HESTOFT | AP PHOTO

In this file photo from March 13, 1991, McDonald’s Corp.’s thenPresident Ed Rensi shows off the McLean Deluxe Burger during a news conference at the company’s Oak Brook, Ill., headquarters.

The lower fat hamburger made with seaweed derivative never really caught on with customers.

DAN KREMER/KFC | AP PHOTO

KFC’s Double Down sandwich has two fried chicken filets taking the place of bread slices. In between are two pieces of bacon, melted slices of Monterey jack and pepper jack cheese and a zesty sauce. browns and pancakes. It’s also why only 11 percent of parents ordered apple slices as an alternative to fries in McDonald’s Happy Meals.

The mixed message hasn’t stopped many restaurants from offering healthier fare.

After all, the government has stepped up its oversight — and influence — over the industry that it blames for America’s expanding waistline. National rules about putting calorie information on menus are expected to take effect next year. And Mrs. Obama touts restaurants and companies that slash calories in foods.

But revamping a menu can be difficult and expensive, requiring months or even years. For example, it took Dunkin’ Donuts four years to figure out how to make its doughnuts without trans fat — which doctors say is one of the unhealthiest types of fat — without

altering the taste.

And efforts to curb unhealthy eating aren’t always fruitful. In 2009, a year after New York made chains start listing calories on menus, only 15 percent of diners ordered lower-calorie foods, according to a study in the British Medical Journal.

As a result, many chains have scaled back their efforts to roll out healthy foods. The number of health-related claims made on menus, like reduced fat or reduced carbs, fell 5 percent from 2008 to 2010, according to Technomic’s study of more than 1,200 restaurant chains.

Most restaurants won’t share specifics about how their salads and veggie omelets compete when they’re up against burgers and crepes. But the healthy stuff appears to be only a small proportion of revenue at most chains.

Lose weight by minding your own ‘danger zone’

BY ELLEN WARREN CHICAGO TRIBUNE

How’s this for some great news? By making one, tiny, almost painless change, you can lose 10 to 20 pounds in a year.

I just got off the phone with a Cornell University professor who has made a career of studying people’s real eating habits, and he’s given me new hope.

By making just a single change, we can put an end to that cycle of what the professor, Brian Wansink, calls “creeping calories.”

“The same levers that almost invisibly lead you to slowly gain weight can also be pushed in the other direction to just as invisibly lead

you to slowly lose weight — unknowingly,” writes Wansink in his eye-opening book, “Mindless Eating.”

For each of us, there is a single behavior change that can make all the difference and result in a weight loss with none of that deprived, angry feeling that we dieters know so well.

The catch? That one small change varies for each of us, depending on our special “dietary danger zone,” Wansink told me. You’ll have to experiment to find yours.

For Wansink, using a smaller dinner plate to make his portions look bigger was a key to mindless weight loss because his danger zone was

overeating at mealtime.

Another example?

Wansink found that snackers who had to walk 6 feet to the candy dish ate less than half as much as those who kept the dish in plain sight on their desk.

If eating meals at your desk or in the car is your danger zone, brown bag it from home or only eat when the car is in park.

Some other tips from Wansink: • Keep tempting foods out of sight.

• Set your fork down between bites.

• Ask the waiter not to bring bread.

• Alternate water every other drink.

Sources: National Institutes of Health, Office of Dietary Supplements (http://ods.od.nih.gov); Mayo Clinic (www.mayo clinic.com).