Health TO YOUR
March 2013
Mid-Valley Newspapers M
A guide to welln wellness and healthy living in the Mid-Willamette mette Valley
STAT Quick reads about health topics in the news
Americans’ behavior killing them off
Maridee Nye, 94, gardens a patch on the corner of 14th and Lincoln in Albany. MARK YLEN | TO YOUR HEALTH
Planting well-being OSU Extension’s Janice Gregg to teach classes on ‘Gardening for Healthy Aging’ By MIKE MCINALLY
O
T I PS FO R H E A LT H Y GARDENING
lder citizens looking for an activity that will help bolster whole-person health — physical and mental — might want to start by getting their hands dirty.
That’s the message from Janice Gregg of the Oregon State University Extension Office in Linn County, who’s planning to teach a pair of classes this month on “Gardening for Healthy Aging.” “What can gardens contribute to our health and our quality of life?” Gregg asked in a recent interview as she prepared to teach the free two-hour classes. (See the box for class dates and times.) The answer: Plenty, regardless of whether the gardener is working on a big plot of land or smaller sites. Gregg said the benefits of gardening can be useful even if participants are tending to a simple raised bed or even just a handful of pots. The gardening work can be great for the body. But it also has plenty to offer the mind and soul as well, she said. She noted, for example, studies that show “if you work in a garden, you’re better able to cope with stress and life’s challenges.” “Gardening can contribute to all of these aspects of health and wellness,” she said. And gardens also give outlets for creativity and social interaction with others. One of
MARK YLEN/DEMOCRAT-HERALD
OSU extension’s Jancie Gregg talks about healthy gardening activities.
Like any physical activity, gardening can involve some exertion. Here are some tips on how to avoid injury: • Use raised beds or pots so you don’t have to bend your back so much. • Use tools with long handles. • Garden early in the morning or later at night so that you’re not working in the heat of the day. • Just as you would before any physical activity, warm up before and after. Your muscles don’t have to be sore after a day of gardening. • Carry a whistle or a cellphone with you just in case you need assistance.
the keys to the success of the long-running Master Gardeners program, Gregg said, is its social component. But you don’t need to be a Master Gardener to start enjoying the activity. Beginners, for example, could start planting herbs in pots or a small raised bed. Rosemary, Two free “Gardening for Healthy Aging” classthyme, sage and oregano can be good choices es will be offered this month. A session in Benton — and, she said, they smell great as they grow. County will be held from 9:30 to 11:30 a.m. With flowers, Gregg advised, plant the Tuesday, March 26, in the Sunset Building, 4077 kinds you like — but be sure to do a little reS.W. Research Way in Corvallis. A Linn County search beforehand to make sure you have a session will be from 9:30 to 11:30 a.m. Thursday, location suitable for growing those kinds. March 28, at the Lebanon Senior Center, 80 Then, of course, it’s about paying attention Tangent St. Call 541-967-3871 to register. to what you’ve planted and tending to it. And the rewards can be great. “It’s about the fact that I planted that,” watched it grow. And there are the real reGregg said. “I paid attention to that plant. I sults of my attention to that plant.”
I F YO U G O
Calcium: Get it from food, not pills Evidence suggests supplements may damage heart while helping bones BY GISELA TELIS THE WASHINGTON POST
When a 2012 study in the journal Heart found that calcium supplements might raise your risk of a heart attack, I was more than a little alarmed. Might the overthe-counter supplements I’d been taking to strengthen my bones be damaging my heart? The answer: Maybe. “Over the last five years, there have been some studies to suggest that taking a calcium supplement raises blood calcium levels and could precipitate into the arteries,” says Felicia Cosman, senior
clinical director of the National Osteoporosis Foundation and author of “What Your Doctor May Not Tell You About Osteoporosis.” “But this whole line of evidence is very controversial, and I think the jury is still out.” What isn’t controversial is calcium’s important role in overall health: Your body needs it to maintain heart and nerve function and to build and keep strong bones. The Institute of Medicine recommends that most adults get 1,000 to 1,200 milligrams a day. But as for meeting your daily requirement in whole or in part by taking supplements, there’s a lot of conflicting evidence. The 2012 Heart study and an earlier study in the journal BMJ both suggested links between calcium intake and heart attacks, but the latter study also found that getting too little
calcium can contribute to heart disease. The same ambiguity goes for kidney stones, another side effect of calcium supplements. A large 2006 study in the New England Journal of Medicine found that women taking a 1,000-milligram calcium supplement were more likely to develop kidney stones than women taking a placebo. But an even larger study in 2004 found that overall dietary calcium intake actually reduced kidney-stone risk. It’s confusing, even for doctors. But there’s a common thread: None of the heart or kidney risks was associated with calcium from food. That has changed how many physicians advise their patients, Cosman says, and it has brought their focus back to what their patients eat. “We want people to concentrate
on modifying diet wherever possible,” Cosman says. “Most of the data show that dietary calcium is better for you and your bone integrity, so if you can get the calcium you need through your diet, you shouldn’t take a calcium supplement.” Considering the abundance of calcium-rich and calcium-fortified foods out there, getting enough calcium from diet alone isn’t hard. Some breakfast cereals offer as much as 1,000 milligrams in a single serving. Unless you have a medical condition (such as celiac disease) that impairs your ability to absorb nutrients, eating a varied, healthful diet that includes calcium-rich foods such as milk and yogurt should do the trick, Cosman says — no supplements required. SEE CALCIUM | A4
The three leading causes of death among Americans in 2000 were all behaviorrelated (tobacco use contributed to 18.1 percent of deaths that year, poor diet and exercise habits played a role in 16.6 percent of deaths, and alcohol was a factor in 3.5 percent of deaths), according to data from the Centers for Disease Control and Prevention. Two health policy experts from Harvard University wanted to find out how the public was responding to what they called “new frontier” public health initiatives aimed at changing consumer behavior, such as New York City’s ban on super-sized sodas. Stephanie Morain and Michelle M. Mello conducted an online survey of 1,817 Americans, asking them about a variety of policies. Overall, 75 percent said the CDC was doing a “good” or “excellent” job, and more than half gave the same ratings to their state and local public health agencies. When it came to assessing the government’s public health agenda, there was broad support for preventing cancer (89 percent were in favor), preventing heart disease (86 percent), preventing obesity in children (81 percent) and adults (76 percent), preventing and reducing tobacco use (76 percent) and reducing alcohol consumption (70 percent). In addition, 84 percent agreed that the government should help people with diabetes control their disease. — Los Angeles Times
Safer oysters possible with less bacteria Oregon State University has improved an old method of making oysters safer to eat so that more bacteria are removed without sacrificing taste and texture. The improved process nearly clears their digestive tracts of the bacteria Vibrio parahaemolyticus, which can cause gastroenteritis, an infection marked by severe abdominal pain, vomiting and diarrhea. Each year in the United States, more than 40,000 cases of Vibrio parahaemolyticus infection are linked to the consumption of seafood. “This bacteria is a huge safety concern,” said YiCheng Su, an OSU professor of seafood microbiology and safety. “Cooking oysters easily kills it, but many consumers want to eat raw shellfish without worrying about foodborne illness.” To make oysters safer, processors place the mollusks in tanks of clean seawater at room temperature, a method known as depuration. The shellfish filter clean water through their system and excrete most bacteria from their digestive tracts into the water. Seeking a better alternative, Su and his colleagues tweaked the depuration method. — Oregon State University
HIV: Progress made, but not enough A 20-year-old diagnosed with HIV or AIDS today can expect to live 50 years, due to groundbreaking advances in treatment since the discovery of the virus 30 years ago. Despite the progress, troubling trends remain: 47,500 new cases of HIV infection are diagnosed each year in the U.S. — The Record (Hackensack,N.J.)
A4
To Your Health
Tuesday, March 12, 2013
8 tips for hiring a personal trainer Experts can help with technique, goals — and accountability BY JOE MILLER THE CHARLOTTE OBSERVER
CHARLOTTE, N.C. — Trying to get in better shape? Maybe it’s time you asked for help from a personal trainer. “If you’re in need of a personal trainer, it’s probably because permanent changes are overdue and need to start happening immediately,” says Taylor Carpenter, with TaylorCarpenter Personal Training in Charlotte, N.C. A personal trainer can fill several vital roles — tailoring a workout regimen to your needs, making sure your form and technique are good. Perhaps the biggest advantage: a personal trainer provides accountability. Here’s some advice, from personal trainers and those who employ them, on how to hire a trainer of your own.
1. Qualifications. A trainer with athletes tweak their performance a four-year degree in a related field and you simply want to lose some is preferable. “A person with an ac- weight and increase your mobility, tual degree in exercise science or maybe it’s not a good fit. physiology carries a better under4. Curiosity. During your interstanding of how the body works, view, the trainer should ask you how muscles work,” says Melanie more questions than you ask the Dean with Gateway to Health & trainer. “A big part of the process is Performance in Cary, N.C., who listening to where they are right holds a Master of now, what limitaScience. Look for tions there are, ‘I needed someone what their goals personal training certifications; esto listen to me and are,” says Dean. pecially look for Knee issues work with the goals forced Pamela certifications that require continuing I wanted to achieve.’ Bennett of Chareducation, which lotte to abandon PAMELA BENNETT helps keep a trainer her long-standing TRAINING SUCCESS STORY current on trends martial arts pracand research. tice. She’d fallen 2. Experience. While formal ed- out of shape but wasn’t a fitness ucation is important, experience novice. She was skeptical when she with clients is vital as well. Ask to first met Michael Anders, a perspeak with a couple of clients for sonal trainer and owner of Shape references. Up, because she wasn’t sure he’d 3. Area of focus. Some trainers pay attention to her goals. focus on specific types of clients. “I needed someone to listen to If, for instance, a trainer special- me and work with the goals I izes in helping high-performing wanted to achieve, not try to define
goals for me,” says Bennett. That was seven years ago; she continues to work with Anders. “You should feel a comfort level immediately,” says Jessica Bottesch with Empower Personal Training in Durham. “Are they taking my goals seriously and not just prescribing a cookie-cutter program?” 5. Commitment. Most trainers suggest working with a trainer two to three times a week, at least initially. This is especially true if one of your problems has been motivation. The frequent visits can help establish a routine. Once you fall into that routine, you can cut back your visits. 6. Team player? Because healthy living isn’t simply about working out in the gym, check to see if the trainer works with and will refer you to other health care professionals. If you’re diabetic, for instance, the trainer should bring in a nutritionist or dietician to consult. If you have muscular dystrophy or fibromyalgia, you might want a masseuse. “A good trainer
should have no problem crossing over lines,” says Dean. 7. Cost. The trainers we spoke with said to avoid anyone who requires a long-term commitment. “I work on a month-to-month basis with a 30-day money-back guarantee,” says Anders. Most personal trainers charge by the session. A one-hour session in a gym will run $45 to $65. (Less experienced trainers may charge less.) A trainer with a related degree will run more, perhaps $60 to $65. And if the trainer comes to you, expect to pay $60 to $100 or more. 8. Flexibility. “Maybe you don’t need three times a week,” says Empower’s Bottesch. “Maybe once a week or even once a month is good. The trainer should be willing to show you things you can do on your own.” Another option: group fitness. “It’s not quite the same tailored approach, but it is a much lower price point and you still have access to a trainer.”
Calcium Binge drinking: Not just for coeds Continued from A3
But what about other supplements for bone health? Vitamins D and K have also gained favor lately. Vitamin D is crucial to bone health; without it, you wouldn’t be able to absorb or use the calcium you consume. But again, there’s some controversy. Experts disagree about how much you need and how well it prevents osteoporosis or bone fractures. Although the U.S. Preventive Services Task Force — an independent group of national experts that issues recommendations on preventive care — last week reported insufficient evidence that taking 400 international units daily does anything to prevent bone fractures, studies of higher Vitamin D doses have shown a reduced risk of fractures. The K vitamins — particularly K2, found in organ meats, eggs and certain fermented foods — have also drawn attention for their potential benefits to bone health, says integrative medicine physician Ariane Cometa, founder of the Cometa Wellness Center in Cockeysville, Md. Studies have shown that Vitamin K2 may sustain bone density and protect against heart disease, and these have been enough to turn Cometa into a K2 convert. She now recommends K2 supplements to her patients and takes them herself. But because most Vitamin K2 studies have been relatively small, many physicians don’t yet feel the case for the nutrient is strong enough, Cosman says. “It looks like people with high Vitamin K intakes have better bones,” she says. “There is some evidence, but it’s not enough for us to go out and recommend it for bone health.” It’s worth noting that Vitamin K can be tricky if you take blood thinners, because it promotes blood clotting. So if you are on anticoagulants, check with your doctor before increasing your intake of Vitamin K through food or supplements.
Behavior much more widespread than thought among adults, elderly BY KATIE LESLIE THE ATLANTA JOURNAL-CONSTITUTION (MCT)
There’s nothing quite like a story about alcohol abuse to harsh a buzz, but consider these scenarios as you head into any upcoming festivities: A lady walks into a party and has one glass of champagne. She’s what public health experts call a moderate drinker. A gent enjoys same party and has two glasses of wine. He, too, is defined as a moderate drinker. But should either of them reach for another glass, they’ve just poured themselves into excessive drinking territory, by medical standards. And if she hits four drinks or he reaches five, they’re on a binge. Binge drinking — a behavior oft-ascribed to college kids — is more widespread than you might think, public health and medical experts say. One in six American adults report binging about four times a month, according to the Centers for Disease Control and Prevention. Here’s the surprise: Roughly 70 percent of those episodes involve adults ages 26 years and older. And elderly binge drinkers report the most frequent episodes, an average of five or six a month. The average binge involves eight drinks. But all that over-indulgence is according to the standards of the medical profession. Ask the average person, and they may have a different formula altogether. Steve Power, of Conyers, Ga., jokingly defines binge drinking this way: “When I drink liquor and get drunk trying to forget the day that I had.” Drew Costanza not only quibbles with the doctors’ definition — he disputes the assumption that
THE WASHINGTON POST
Here are some of the top sources of calcium in food: • Yogurt, plain, low-fat, 8 ounces: 415 milligrams • Mozzarella, part-skim, 1.5 ounces: 333 mg • Sardines, canned in oil, with bones, 3 ounces: 325 mg • Cheddar cheese, 1.5 ounces: 307 mg • Milk, nonfat, 8 ounces: 299 mg • Soymilk, calcium-fortiMilk, reduced-fat (2 percent milk fat), 8 ounces: 293 mg • Orange juice, calcium-fortified, 6 ounces: 261 mg • Salmon, pink, canned, solids with bone, 3 ounces: 181 mg • Cottage cheese (1 percent milk fat), 1 cup: 138 mg • Ready-to-eat cereal, calciumfortified, 1 cup: 100-1,000 mg • Kale, raw, chopped, 1 cup: 100 mg • White bread, 1 slice: 73 mg — Source: Office of Dietary Supplements, National Institutes of Health
Roughly 70 percent of adult binge-drinking episodes involve people ages 26 and older. Elderly bingers average five or six episodes a month. getting hammered from time to time is necessarily a problem. “I feel the phrase ‘binge drinking/drinker’ is pejorative in that it alludes to drinking excessively as being necessarily bad, when that isn’t always the case,” said Costanza, a 30-year-old salesman in Atlanta’s Buckhead neighborhood. Costanza considers himself a “weekend warrior,” one who reserves most hard-core drinking for the weekend. He also walks to his watering hole or takes a cab, he said. Did we mention that Costanza also writes a blog about his outings titled “Drew Distilled”? He thinks the five-drink-per-man definition discounts variances in drinkers’ size and tolerance. “I doubt Andre the Giant would think five drinks a night is a binge,” he said in a Tweet to this reporter. Dr. Bob Brewer, an epidemiologist and head of the CDC’s alcohol program, is accustomed to such push-back. “A lot of people are surprised by that and taken aback and say ‘Wow, that is really strict,’” he said. But medical and public health
experts, who get paid for this kind of thing, are sticking to their numbers: For men, a binge is five drinks in roughly two or three hours; for women, four drinks. There’s actual science behind those sobering figures: That’s roughly the amount it takes for a woman or man to reach a 0.08 blood alcohol level. And “it’s the statistical threshold at which the risk of significant harm goes up,” explained Aaron White, a neuroscientist with the National Institute on Alcohol Abuse and Alcoholism. Research shows that at those levels, people are at greater risk of all kinds of bad outcomes, such as motor vehicle accidents, violence and contracting sexually transmitted diseases. And that’s not accounting for what alcohol does to your liver and how it increases your risk of heart disease and high blood pressure, doctors note. “It doesn’t mean at that threshold you are guaranteed to suffer some consequences,” White said. “It means if you go past it, it’s dangerous territory.” Experts interviewed for this
Worried about your alcohol consumption? DeKalb, Ga., Medical Center’s Paul Olander points to the CAGE Questionnaire as a widely used alcohol abuse screening tool. 1) Have you ever felt you should cut down on your drinking? 2) Have people annoyed you by criticizing your drinking? 3) Have you ever felt bad or guilty about your drinking? 4) Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (eye opener)? An answer of one yes or more indicates alcohol abuse issues should be explored. — American Psychiatric Association
story acknowledged a vast gap between their cautionary approach and the messages that pervade American culture. “We market drinking as a social lubricant,” said Paul Olander, director of behavioral health services at the DeKalb Medical Center. “As a way of celebrating, it goes along with dates and with romance, and wining and dining, and watching sports and all kinds of things. It’s to the point that it can seem like without (alcohol), those activities aren’t quite as good.” Face it, drinking games aren’t nearly as fun if the limit is one. The medical professionals say they’re not trying to make anyone feel bad about imbibing — just aware of the potential risks and consequences. “One binge does not an alcoholic make,” said Olander. “But if you keep binging, and running in circles where that happens, you’re upping the odds that you will deepen your relationship with alcohol.”
Hospitals growing less forgiving of angry doctors BY SANDRA G. BOODMAN
TO P FO O D SO U R C ES O F CA LC I U M
D O YO U D R I N K TO O M U C H ?
KAISER HEALTH NEWS
At a critical point in a complex abdominal operation, a surgeon was handed a device that didn’t work because it had been loaded incorrectly by a surgical technician. Furious that she couldn’t use it, the surgeon slammed it down, accidentally breaking the technician’s finger. “I felt pushed beyond my limits,” recalled the surgeon, who was suspended for two weeks and told to attend an anger management course for doctors. The 2011 incident illuminates a long-festering problem that many hospitals have been reluctant to address: disruptive and often angry behavior by doctors. Experts estimate that 3 to 5 percent of physicians engage in such behavior, berating nurses who call them in the middle of the night about a patient, flinging scalpels at trainees who aren’t moving fast enough, demeaning co-workers they consider incompetent or cutting off patients who ask a lot of questions. “We’re talking about a very small number of physicians, but the ripple effect is profound,” said Charles Samenow, an assistant professor of psychiatry at George Washington University School of Medicine, who evaluates doctors
with behavioral problems. to answer pages or attend meetFor generations, bad behavior ings. The commission has called by doctors has been explained away for a “zero tolerance” approach. as an inevitable product of stress or Such behavior is not unique to tacitly accepted by administrators doctors; researchers have found reluctant to take action and risk that nurses act out, too, mostly to alienating the medical staff, partic- other nurses, but that their behavularly if the offending doctors gen- ior is less likely to affect patients. erate a lot of revenue. Recently at Growing attention to the probone Virginia hospital, according to lem has spawned a cottage indusUniversity of Virginia School of try of therapists who provide Nursing dean Dorrie Fontaine, a anger management counseling, veteran operating-room nurse with which is sometimes billed as “ex30 years’ experience walked into ecutive coaching.” Programs are her supervisor’s flourishing at Vanoffice and quit derbilt, the UniExperts say that after a surgeon of Virginia, doctors’ bad behavior versity screamed at her — the University of is not merely his usual reaction California at San to unwelcome and, most unpleasant; it also Diego news — when she recently, GWU. told him that a has a corrosive effect Most doctors routine count re- on morale and poses a who enroll are vealed that an inmiddle-aged men strument was significant threat to sent by hospitals or missing. Hospital state medical patient safety. a d m i n i s t ra to rs boards that have shrugged off the episode, saying, ordered them to shape up. “Well, that’s the way he is.” Experts say that doctors’ bad But that tolerance is waning, behavior is not merely unpleasant; Samenow and other experts say, as it also has a corrosive effect on a result of regulations imposed in morale and poses a significant 2009 by the Joint Commission, the threat to patient safety. A 2011 surgroup that accredits hospitals. vey of 842 hospital administrators These rules require hospitals to in- for the American College of Physistitute procedures for dealing with cian Executives found widespread disruptive behavior, which can concern: 71 percent said disruptive take passive forms such as refusing behavior occurs at least monthly at
their hospital, while 11 percent said it was a daily occurrence. Ninetynine percent said they believed such conduct negatively affected patient care, while nearly 21 percent linked it to patient harm. Those findings mirror a 2008 study of more than 4,500 doctors and nurses, in which 71 percent tied it to a medical error and 27 percent to the death of a patient. Laura Sweet, deputy chief of enforcement for the Medical Board of California, has said that the licensing body has investigated several maternal or fetal deaths resulting from the failure of nurses to contact doctors about a worrisome reading on a fetal monitor “for fear of being chastised or ridiculed.” “Hospitals can no longer afford to look the other way,” said California internist Alan Rosenstein, who has written extensively about the issue, beginning with an influential 2002 study that found that bad behavior by doctors drove nurses from the profession. Bad conduct, notes Rosenstein, former West Coast medical director of the VHA hospital network, can have expensive consequences in the form of lawsuits by employees alleging the existence of a hostile workplace and an exodus of experienced nurses who are expensive to recruit and difficult to replace.
To Your Health
Tuesday, March 12, 2013
A5
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Hearing DifďŹ culty? Attend the March meeting of the Oregon Association for Better Hearing This month’s Topic:
Invisible hearing aids: Opportunities and pitfalls Join us as we show a history-making hearing aid we’ve developed at our clinic (patent in process). You will also see the presentation we will give on this hearing aid at the American Academy of Audiology’s international conference in April in Anaheim, CA.
Monthly meetings are always FREE to the public, no registration, no personal information required Ron Leavitt, Au. D. Panel Moderator
Thursday, March 14th, 3:30-5 PM Good Samaritan Regional Medical Center 3600 NW Samaritan Dr., Corvallis, OR Conference Room B (near cafeteria)
541-754-1377 for more info www.betterhearingus.com Please pass this notice on to someone you know who could beneďŹ t from this informational seminar