Health Perspective

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health PERSPECTIVE

Copyright 2015 The Valley News & The Herald-Journal January 2015

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HEALTH How to prevent the flu PERSPECTIVE

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Influenza has already been reported in Iowa, so Shenandoah High School Nurse Linda Laughlin is sharing tips to help prevent influenza and respiratory illness outbreaks. “The number one thing to stop the spread of the flu is to get immunized. It’s not too late to get a shot,” Laughlin said. Those with health problems, like asthma, should especially get a flu shot, she said. “The Iowa Department of Public Health and the Center for Acute Disease Epidemiology reported on Dec. 12 that three strains of flu were already circulating in Iowa. That means that without a vaccination, anyone has the potential to become sick three different times,” Laughlin said. The Centers for Disease Control reports that the timing of flu is unpredictable and can vary from season to season. Flu activity in the U.S. most commonly peaks in January or February. However, seasonal flu activity can begin as early as October and continue to occur as late as May. School absence rates are increasing across the state, as are the number of influenza-associated outbreaks. Once rates of absence reach 10 percent, an outbreak may be occurring, and the public health department should be contacted. Some schools have reached over 25 percent of students absent on a single day due to influenza. To help stop the spread of germs, Laughlin offered the following tips: Sing the ABCs while washing hands – and do so often. “The number one line of defense in the spread of germs is always hand washing. Wash your hands often with soap and warm water for 20 seconds…always sing the ABC song to know how long is long enough – if you’re a fast singer, sing it through twice,” she said. Teach and encourage children and staff to wash hands regularly with warm water and soap…and then be a good example of that. Thoroughly clean your environment every day. Include stair hand rails, doorknobs, telephones, sink faucets knobs, and other commonly touched surfaces. “Use any type of antibacterial wipe, or mix ¼ cup of bleach to 1 cup of water for cleaning,” she said. “And that bleach mixture should be made fresh daily. If disinfectant is not available, soap and hot water can be used.” Do not cough or sneeze into your hands. Cover your mouth and nose with a tissue when you cough or sneeze, then wash your hands; put your used tissue in the waste basket. If you don’t have a tissue, cough or sneeze into your upper sleeve or elbow. Try to avoid touching door handles with your hands. “My rule that I tell kids at school has always been, ‘You can use hand sanitizer, but if your hands are visibly soiled with saliva or something, always use soap and water,” said Laughlin. Most experts agree that viruses spread mainly by droplets made when people with an illness cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might also get the flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or nose. Get enough sleep. “Teens should get nine and a half

2 u Health Perspective - The Valley News (1/21) & Herald-Journal (1/22)

hours,” said the school nurse. “I know that’s easier said than done with teens, but it’s a good rule in order to stay healthy.” Drink lots of fluids and eat proper nutrition. “That’s important for all of us, but for school children, it’s very important, because they’re exposed to so much more,” she said. If you are sick, stay home. “Consider wearing a facemask and keep your distance from others to protect them from getting sick too,” Laughlin said. “School attendance is important, so save sick days for the times when you really need to stay home. Change your towels. “Viruses can live on the towels, so they should be changed often,” Laughlin said. “But if you’re sick, paper towels are better for drying hands.” Avoid sharing. “Avoid the sharing of utensils, glasses, toothbrushes, telephones, and computer keyboards, if you can help it – and keep them clean,” said Laughiln. “My pediatrician told me that if you’re having problems with an on-going sickness, throw your toothbrushes away or at least put them in the dishwasher to clean them.” Laughlin said all health care workers are required to have a vaccination, or wear a mask if they are within six feet of a patient, even if they’re not sick. “You can be a carrier of the influenza virus one day before symptoms occur and ten days after being sick,” she said. Visit the influenza web site here http://www.cdc.gov/ flu/protect/habits/index.htm or http://www.idph.state.ia.us/ Cade/Influenza.aspx?pg=FluHome for fact sheets, updated information and more.

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How to reduce your risk for diabetes Eat like you already have diabetes to reduce your risk for the disease. That’s the advice offered from Shenandoah Medical Center (SMC) Dietician Kay Wing. “Managing diabetes is like flying an airplane. You need both wings to keep balanced. One wing represents physical activity, and the other wing is healthy eating. Both of those things have to come into play,� Wing said. Diabetes is a disease affecting nearly 10 percent of Americans, according to diabetes.org. The disease affects how the body uses glucose, the main type of sugar in blood. Glucose, which comes from the carbohydrates in the food we eat, is the major source of energy needed to fuel the body. The body needs the hormone insulin in order to use glucose. But bodies with Type 2 diabetes can’t produce enough insulin or the insulin doesn’t function properly. However, a healthy lifestyle can help prevent or delay the onset of type 2 diabetes, even though some cases cannot be prevented. Therefore, health expert Kay Wing is offering more advice on how to stay healthy: Know your numbers. “I encourage people to have regular check-ups,� said Wing. “When diabetes is caught in the early stages, it’s like cancer - early detection can pre-

vent complications. So, getting that regular blood test is important.� Lighten up. Wing offered this tip to determine diabetes risk: “People can look on a website and determine what their body mass index is. If it’s greater than 27 they might consider a weight loss of 10 to 20 pounds. Usually the weight loss needs to occur in order for the blood sugar to return to normal,� said Wing. Being overweight increases the risk for type 2 diabetes and scores of other health problems such as heart disease and stroke. That said, Wing discourages losing weight via a fad diet plan, “...because they usually don’t teach you a moderate and healthy way of eating. The ones that provide a balance of all the food groups and fewer calories are the ones you want to choose,� Wing said. “I don’t put people on diets. I recommend people cut back by 100 calories a day. That can be as simple as substituting fruit for a brownie or chips. The thing that’s made the most difference in some of my clients with gestational diabetes is eliminating sugary drinks,� Wing said. “Instead, drink flavored or unflavored water, coffee, or unsweetened tea. If your favorite food is a Snickers candy bar, then you tell yourself you’re never go see DIABETES, Page 4

Health Perspective - The Valley News (1/21) & Herald-Journal (1/22) u 3

DIABETES

Continued from page 3

ing to eat another one, it stresses out the body. Just eat them in moderation, in smaller portions (the snack size versus a king size - less often.” Factor in fiber. Adding more fiber to your diet is another way to prevent or delay the onset of type 2 diabetes. Many foods include fiber; that includes beans, fruits, nuts, and vegetables. “A cup of berries has about eight times the fiber of a piece of fudge,” Wing said, adding that berries are a healthier choice also because the calories are less than fudge or salty foods. Fiber also makes the stomach feel fuller which reduces the likelihood of overeating. Fiber helps the body control its blood sugar levels and can lower the risk of heart disease. Increase fruit and vegetable intake; avoid refined carbohydrates. Diets high in refined carbohydrates have been shown to increase a person’s risk of diabetes, while additional studies have stated that diets rich in

whole grains protect the body against diabetes. Get moving. Physical activity can be increased easily, said Wing. “Even for older adults, increased activity can be as simple as finding a route to walk around your house; walk during commercials if you’re watching TV. Use soup cans as weights to move your arms around in different ways while you’re watching TV. Any extra activity helps,” Wing said. Type 1 diabetes can’t be prevented. No one knows for sure what causes type 1 diabetes - nor do they know with certainty who will get Type 1 diabetes. But Wing said genetics AND environmental triggers, like a serious illness, can prompt the gene to go into diabetes. “Type 2 has a strong genetic component, but can be delayed. If you live long enough, anything can happen; the 80 year olds who are getting diabetes could have had it at age 50, but kept it down by maintaining a healthy weight and with exercise,” she said. There’s no reliable way to predict who will get type 1 diabetes, said Wing, but blood tests can detect early

signs of Type 2 diabetes. “We always want two numbers in the diabetic range before we give people a diagnosis of diabetes in case there was a stress on your body. It’s like gestational diabetes - the body is under a lot of stress. But when the woman delivers the baby, their body goes back to normal in 90 percent of the cases,” Wing said. “It’s such a complex disease –it’s not just about the sugar- seek out a health care professional for help...especially a registered dietitian for a healthy eating plan. Wing has been serving as a dietician at SMC since 1975. Wing was instrumental in establishing the SMC Diabetes Self Management Program in September 2000. The program recently received an Education Recognition Certificate from the American Diabetes Association. Since starting the Self Management Education Program, this is the fourth time the ADA has awarded SMC the certificate. For more information, visit diabetes.org.

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Explaining the gluten-free diet Dietary fads come and go, but the glutenfree movement is one nutritional trend that seems to have staying power. The gluten-free diet was once largely exclusive to sufferers of Celiac disease; a condition that damages the lining of the small intestine, preventing it from absorbing parts of food the body needs to stay healthy. That damage is the byproduct of the body’s reaction to gluten, a term used to describe proteins found in specific grains. But while the gluten-free diet remains a necessity for those who cannot tolerate gluten, nowadays-even non-sufferers are embracing the gluten-free diet for a variety of reasons. “A gluten free diet is prescribed for someone with Celiac Disease, an autoimmune disorder caused by sensitivity to gluten, a protein found in wheat, rye, barley and sometimes oats,” said Molly Gilmore, dietitian at Clarinda Regional Health Center. “According to the Celiac Support Association, approximately 1 in 133 people have Celiac Disease, although most are not diag-

nosed,” Gilmore said. Another reason people choose a glutenfree diet is due to non-Celiac gluten sensitivity, or NCGS. Though NCGS is not as severe as Celiac Disease, research has suggested that a gluten-free diet can relieve NCGS symptoms, which include abdominal pain and headaches. Allergies are another reason some people may opt for a gluten-free diet. Unlike Celiac Disease or NCGS, both of which are digestive system responses to gluten, wheat allergy is an immune-system response and, like other allergies, can be outgrown. But until a wheat allergy is outgrown, it’s best to avoid foods, including those with gluten, that might trigger an allergic reaction. “It is important to know that Celiac Disease is not a food allergy. True wheat allergies are actually very uncommon in both adults and children,” Gilmore said. “When these grains are consumed by someone with Celiac Disease, it can cause damage to the intestines and in some cases, triggers severe gastrointestinal distress, including vomiting

and diarrhea.” While a gluten-free diet is a necessity for people with Celiac Disease, NCGS or wheat allergies, according to Michell Nacouzi, MD, a primary care physician at Duke Primary Care Brier Creek, it may provide little health benefit to those without such conditions. But that doesn’t mean the popularity of the gluten-free diet is about to wane. Those without a preexisting medical condition who are considering a gluten-free diet anyway should know a few things about this diet before making such a drastic change. Gluten-free is not easy. Unlike eliminating sugary soft drinks or cutting back on fried foods, going cold turkey on gluten can be very difficult. Many people who adopt a gluten-free diet find it extremely challenging, as gluten proteins can be found in additives, making something as seemingly simple as reading labels a lot trickier than it looks. “Grains containing gluten include wheat, barley, rye, malt and oats. Some oats have see DIET, Page 7

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DIET

Continued from page 5

been processed to be gluten-free and should be stated on the package,� Gilmore said. Though labels may not list gluten among a product’s ingredients, men and women must be aware of all additives that contain gluten proteins in order to avoid gluten entirely. And while supermarkets are stocking more gluten-free products, shopping for groceries while on a gluten-free diet can be tedious. Certain foods and drinks must be avoided. Though people considering a gluten-free diet are aware that such a diet requires some sacrifices, they may not know which foods and beverages they will need to avoid until they have instituted the diet. For example, a gluten-free diet excludes any beverages that contain barley, meaning beer cannot be part of a gluten-free diet. Though many gluten-free beers are now on the market, beer aficionados may find such alternatives cannot compare to the real

thing. Rye and wheat products also must be avoided, and these include products whose labels list bulgur, durum flour, farina, graham flour, kamut, semolina, and spelt among their ingredients. Unless labels say gluten-free, the following are a handful of products that should be avoided: Breads, cakes and pies, cereals, croutons, French fries, pastas, salad dressings, soy sauce and soups. Many doctors also recommend men and women on a gluten-free diet avoid oats, as they can easily be contaminated with wheat during the growing and processing stages of production. Be mindful of the dangers of cross-contamination. Cross-contamination can occur during the manufacturing process when gluten-free foods come into contain with foods that contain gluten. Manufacturers typically include the phrase “may contain� on labels as a warning to consumers looking to avoid gluten and other ingredients. When labels include this phrase, there’s a strong chance that cross-contamination has occurred, and such products should be avoided by men

and women on gluten-free diets. “For people with Celiac Disease, the best treatment is to avoid gluten-containing foods for the rest of their lives,� Gilmore said. Cross-contamination also can occur when gluten-free foods are prepared on the same surfaces as foods containing gluten. For example, toasting gluten-free bread in the same toaster as regular bread can easily lead to contamination. Preventing crosscontamination can be a difficult task, and that difficulty merits consideration by people who want to adopt a gluten-free diet. A gluten-free diet may lead to a vitamin and nutrient deficiency. Grains are often rich in vitamins, and avoiding grains as part of a gluten-free diet can deprive men and women of these vitamins, weakening their bodies as a result. When adopting a glutenfree diet, speak with a dietitian to ensure your diet has enough iron, calcium, fiber, thiamin, riboflavin, niacin, and folate. If the diet is lacking, you will need to make adjustments.

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8 u Health Perspective - The Valley News (1/21) & Herald-Journal (1/22)

Ms. Sitzman recently completed her medical rotation at Clarinda Regional Health Center under the direction of Dr. Autumn Morales. Whooping cough, also known as pertussis or the “100 day cough,� is a respiratory illness caused by the bacterium Bordetella pertussis. Pertussis causes a severe cough that produces a loud “whoop� as the affected person takes a deep breath in following a long spell of coughing. Hence the name— “whooping cough.� What other symptoms does it cause? The typical course of pertussis involves 3 different stages: 1. Catarrhal stage: Pertussis starts like a common cold and is highly contagious at this point. It may last 1-2 weeks. Symptoms to look out for: a. Runny nose b. Low grade fever c. Occasional cough 2. Paroxysmal stage: As pertussis progresses, the coughing gets dramatically worse. This stage is what comes to mind when most people think of pertussis. This stage can last anywhere from 1-10 weeks! These are the standard symptoms: a. The traditional fits of cough with the “whoop� b. Severe coughing to the point of vomiting c. Extreme exhaustion from using so much energy to cough These cycles of vomiting and exhaustion are called “paroxysms� 3. Convalescent stage: This is the recovery stage that usually lasts 2-3 weeks. a. Coughing spells become less severe and less frequent b. Unfortunately, any common cold virus that a person is exposed to at this stage can

cause the return of severe whooping cough symptoms Why is it so important to be vaccinated? Since infants under 12 months of age are the most at-risk humans for pertussis complications and even death from pertussis, vaccination of everyone, especially those in frequent contact with infants, is crucial. What do I need to know about the vaccine? The DTaP vaccine is included the regularly scheduled vaccines for children. It provides immunization against Diphtheria, Tetanus, and Pertussis. Today, children receive 5 doses of the DTaP vaccine—at ages 2, 4, 6, and 15-18 months and 4-6 years. Since 2005, the tetanus booster Tdap that adults receive every 10 years includes a booster for pertussis. Prior to that, pertussis was not included in the tetanus booster. Additionally, it is now recommended that expecting mothers receive a Tdap booster during each pregnancy. The use of upper and lower case letters in the vaccine names is a reflection of the dosage strength in the vaccine. Tdap, the booster, has a high dose of the tetanus vaccine and a lower dose of the diphtheria and pertussis vaccine. The DTaP vaccine contains high doses of each of the vaccines. The “a� stands for “acellular�—only a part of the Bordetella pertussis bacteria is in the vaccine. What else can I do to stop the spread of pertussis? 1. Check with your doctor to make sure you are up to date on your pertussis vaccine. a. Vaccinated individuals are less likely to contract pertussis and if they do, they have a shorter, less severe course of disease. 2. WASH YOUR HANDS! 3. If you or anyone you know has a persistent cold and develops the symptoms discussed above, go see your doctor. For more information, check out: http:// www.cdc.gov/pertussis/

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Immunizations important for adults, too Influenza According to the CDC, roughly 226,000 people are hospitalized in the United States due to influenza, while thousands more die from the flu and its complications. Flu vaccines protect against various strains of the flu virus, and the vaccine is recommended for just about everyone between the ages of six months and older, including middleaged adults. People age two and older are now advised to get the nasal mist version of the vaccination. However, adults age 50 and older should not get the mist. Individuals who are severely immunocompromised, not feeling well or those who have an allergy to eggs should speak to their doctors before getting a flu vaccination. Pneumococcal disease Pneumococcal disease is an illness caused by bacteria that can spread from the nose and throat to the ears or sinuses. If the bacteria spreads to other areas of the body, like

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the lungs, it can cause pneumonia. Pneumococcal disease also can cause meningitis if it affects the spinal column. Adults 65 and older need one dose of the pneumococcal conjugate vaccine followed by the pneumococcal polysaccharide vaccine.

ease, as it rarely produces symptoms. However, certain types of HPV can cause cervical cancer, genital warts and cancers of the penis, anus and throat. The HPV vaccine is recommended for both males and females between the ages of 17 and 50.

Shingles Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. Individuals who have had chickenpox are at risk for developing shingles later in life. The virus can cause a painful skin rash and blisters. Other symptoms include chills, pain, fever, and even loss of vision. Because shingles most often occurs in people age 50 and older, the shingles vaccine is recommended for those in this age bracket. People who have medical conditions that weaken the immune system or those who take immunosuppressive drugs also may benefit from the shingles vaccine. Pertussis (whooping cough) The CDC estimates that there are between one and three million pertussis cases in the United States each year. All adults between the ages of 19 and 64 need a onetime whooping cough booster vaccine, particularly if they will be in close contact with infants younger than 12 months. Adults are the most common source of pertussis infection in infants. Whooping cough for adults can last for several weeks or even months, causing unnecessary discomfort and leaving sufferers gasping for breath. HPV Human papillomavirus, or HPV, is a common virus spread mostly through sexual contact. Few may know they have the dis-

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New parents can easily become overwhelmed by the number of pediatrician visits their children need. By the time a child celebrates his or her fifth birthday, he or she has seemingly been administered dozens of immunizations. But even though people get the majority of their vaccinations while they are very young, that does not necessarily mean they can’t still benefit from immunizations later in life. The Centers for Disease Control and Prevention notes that humans never outgrow their need for vaccinations. Although certain vaccinations may no longer be necessary, others may be necessary into adulthood. Certain vaccinations, which can safeguard individuals from long-term illness, hospitalization and even death, are now recommended for all adults. The following are some of the immunizations you may need as you age.

Quitting smoking and losing weight consistently top New Year’s resolutions lists. In an effort to stop smoking, a growing number of smokers are turning to electronic cigarettes, or e-cigarettes, to help them quit once and for all. Although e-cigarettes are not currently regulated, the U.S. Food and Drug Administration is weighing regulations in a market that estimates suggest could be as big $5 billion in 2015. But are these devices safe? Or even effective? There is mixed information regarding the efficacy of e-cigarettes to help a person quit smoking. Some studies point to e-cigarettes as a good method of smoking cessation, while others say there’s limited evidence to support those claims. E-cigarettes typically contain liquid nicotine, which is inhaled as vapor. The vapor resembles smoke and can mimic the look and feel of smoking traditional cigarettes. But e-cigarettes typically do not contain any of the additional chemicals, such as tar and other potentially toxic ingredients, found in traditional cigarettes. Nicotine cartridges for e-cigarettes also come in various concentrations and flavors, and smokers can even purchase nicotine-free replacement cartridges. Much like users of nicotine patches or chewers of nicotine gum, e-cigarette smokers can gradually lower their nicotine doses over time. The American Lung Association currently has not approved any e-cigarette as a safe or effective method to help smokers quit. They cite a study that estimates there are nearly 500 different e-cigarette brands today with varying levels of nicotine and the possible presence of other chemicals. These e-cigarettes are unregulated. The ALA says there is a great deal more to learn about these products before they can be recommended as a safe and effective way for smokers to wean themselves off of smoking. E-cigarettes may contain additional chemicals besides nicotine. Studies have

found detectable levels of chemicals used in antifreeze in two leading brands of ecigarettes. Formaldehyde and benzene have been detected in some e-cigarette emissions. Other studies have found secondhand emissions from e-cigarettes can prove harmful to nonsmokers. While some organizations do not endorse e-cigarettes, others state that they shouldn’t be ruled out just yet. A 2014 study by British researchers and published in the journal Addiction found people were 60 percent more likely to succeed in quitting smoki n g using ecigarettes compared to would-be quitters who tried a nicotine patch or gum. Background information in the report suggests that, since the e-cigarette vapor only contains nicotine and not tobacco smoke, e-cigarettes may help reduce cravings and withdrawal symptoms. Although some e-cigarettes may contain harmful byproducts, toxicity tests indicate they are safer than regular cigarettes. Some health experts believe the benefits of quitting traditional cigarettes outweigh the risks posed by e-cigarettes. The American Heart Association agrees. In a policy statement released in August 2014, the American Heart Association said physicians shouldn’t discourage e-cigarette use as a last resort to stop smoking. “If people cannot quit at all and have tried everything in the field, we would not discourage them,” said Aruni Bhatnager, the statement’s lead writer. “It’s not something we would suggest.” The AHA recommends e-cigarettes only if smokers refuse or are intolerant of other options. People who desire to quit smoking may look to e-cigarettes to help their fight. Although the safety and efficacy of e-cigarettes remains open to debate, cannot be proven, many former smokers feel e-cigarettes played a significant role in helping them to quit smoking once and for all.

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Health Perspective - The Valley News (1/21) & Herald-Journal (1/22) u 11

Some side effects of obesity may surprise you According to the Centers for Disease Control and Prevention, nearly 40 percent of the United States population is now considered obese, while an additional 34 percent are considered overweight. In Canada, 25 percent of the population is classified as obese and 41 percent are overweight. These figures illustrate a potentially grave future for Canadians and Americans alike, as the consequences of being overweight or obese include diabetes, heart disease and even death. Obesity can have a very real and lasting impact on individuals and future generations. Here are some health effects that can be the result of carrying around too much weight. Cancer The National Cancer Institute says each year thousands of new cases of cancer in men and women can be linked to obesity. Some researchers feel that excess fat cells increase hormonal activity, which can lead to tumor growth.

causing it to work less efficiently, and may lead to aneurysm, heart failure or stroke. Infertility As with cancer, the potential correlation between obesity and infertility requires further study. But there is some evidence that points to obesity as a contributing factor to infertility. Overweight women tend to have a harder time getting pregnant, and some researchers feel that is because fatty tissue may cause hormonal changes that impact conception.

High blood pressure Overweight or obese people have a greater chance of developing high blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries while the heart pumps blood. High blood pressure can weaken the heart over time,

Type 2 diabetes When a person has type 2 diabetes, his or her body cannot use insulin properly. Over time, the body cannot make enough insulin to regulate blood sugar level. About 80 to 90 percent of people who are obese also have type 2 diabetes, and it’s believed that being overweight places extra stress on the body’s ability to maintain proper glucose levels in the blood, creating a greater need for insulin. This can create a vicious cycle, as insulin use itself can lead to weight gain.

Osteoarthritis Overweight individuals frequently develop pain in the joints of their knees, hips and lower backs. The condition occurs as tissue that protects the joints wears away. Extra weight also can wreak havoc on the feet that are forced to bear those extra pounds. Premature birth A study published in the Journal of the American Medical Association found that overweight women are at a greater risk of having a preterm delivery. Too much fat can weaken uterine and cervical membranes. Trouble sleeping Obese and overweight people can have problems sleeping, says the American Sleep Foundation. Obesity can be linked to sleep apnea, a condition in which a person gasps for air or momentarily stops breathing while asleep. This condition can result in frequent interruptions in sleep and an overall poor quality of sleep.

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12 u Health Perspective - The Valley News (1/21) & Herald-Journal (1/22)

12 Iowa Locations: www.asiaudiology.com

The benefits of weightlifing for women Many women steer clear of the freeweight areas inside their gyms, opting instead for treadmills and other cardio machines. Some women may not know how to use weights correctly, while others simply don’t want to add any bulk to their frames. But research shows that women who adhere to moderate strength-training programs two to three times per week can benefit in a variety of ways. n Burn more calories: Many people exercise to burn calories and shed fat, and weight training is an efficient way for women to do just that. Resistance training is a great way to burn calories, as after a heavy weight-training session, the body continues to use oxygen, which increases a person’s basal metabolic rate. In addition, as you increase lean muscle mass, your body burns even more calories as its muscles contract and it works to repair and build new muscle. n Reverse metabolic decline: Lifting weights can help reverse the natural slowing down of metabolism that begins in middle age. Keeping your body working out and your metabolism elevated for as long as possible can help keep you in top shape.

n Build stronger bones: Lifting weights does more than just build muscle. Weightlifting also builds bone density. After menopause, women may lose up to 20 percent of their bone mass, and the United States Surgeon General estimates that, by 2020, half of all Americans could have weak bones due to bone loss. Women can look to weightlifting to help increase bone density and reduce their risk of fracture and osteoporosis. n Reduce risk for heart disease: Cardiovascular disease claims the lives of 5.6 million women worldwide each year. Women are more likely to get heart disease than cancer. A study in The Journal of Strength and Conditioning found that women who lift weights are less likely to develop heart disease risk factors, such as large waist circumference, high triglycerides, hypertension, and elevated glucose levels. The American Heart Association lists weight training as a healthy form of exercise for those at risk for heart disease. n Combat back pain: Weight training can help strengthen the core muscles of the abdomen and back, which may help alleviate lower back pain. It’s important to use

proper form when lifting weights to avoid exacerbating existing back pain or developing new injuries. n Boost mood and combat depression: Lifting weights is not just good for the body, it’s also good for the mind. Women who strength train regularly can improve their feelings of well-being and may be able to reduce episodes of depression. A study from researchers at Harvard University found that 10 weeks of strength training was effective at reducing symptoms of clinical depression. n Relieve stress: Any form of exercise can help to relieve stress, but according to the 2009 study “Psychological Aspects of

Resistance Training,” those who regularly strength train tend to manage stress better and experience fewer adverse reactions to stressful situations than those who do not exercise. n Increase energy levels: Lifting weights can boost mind power and provide a long-term energy boost. Working out in the morning can be an especially effective way to maintain high energy levels throughout the day. Women should not shy away from lifting weights. In addition to creating a trimmer, healthier body, resistance training offers many other health benefits.

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Health Perspective - The Valley News (1/21) & Herald-Journal (1/22) u 13

Foods that pack a nutritious punch A healthy diet is essential to long-term health. When coupled with routine exercise, healthy diets can be an effective way for men and women to reduce their risk of contracting a variety of diseases, not to mention the positive impact that such a healthy lifestyle can have on an individual’s quality of life. The following are a handful of easily found foods that pack a nutritious punch. n Whole wheat and multigrain pasta: Once difficult to find, these low-calorie alternatives to traditional pastas are now available in many large chain grocery stores as well as organic marketplaces. That’s good news, as a typical two-ounce serving of whole wheat or multigrain pasta typically includes about seven grams of protein and six grams of fiber. n Nonfat Greek yogurt: Nonfat Greek yogurt is a great low-calorie source of protein, making it a great snack option for men and women who want a snack that can boost their afternoon energy levels without compromising their waistlines. Single serving containers of Greek yogurt tend to be right around six ounces, and that six ounces can include 120 grams of protein or more.

n Russet potatoes: If baked potatoes are a side dish you typically only enjoy in restaurants, you might want to consider eating more of them at home. One medium-sized Russet potato is roughly 170 calories and

includes three grams of fiber, five grams of protein and 25 percent of your daily recommended dosage of potassium. Russet potatoes also are high in vitamin C and iron. n Fresh spinach: Popeye was on to

something, as a four cup serving of fresh bagged spinach is just 20 calories and loaded with vitamins and nutrients. Just one serving of fresh bagged spinach can provide 160 percent of the recommended daily value of vitamin A and 40 percent of the daily value of vitamin C. Spinach is also a great source of folic acid, which can help prevent heart disease, stroke and certain types of cancer. n Dried lentils: Dried lentils make great additions to salads, soups and stews and pack a nutritious punch despite their relatively small serving size. A single serving of dried lentils is 1/4 cup, and that serving includes 10 grams of protein and 11 grams of fiber. n Brown rice: A single 1/4 cup serving of brown rice has roughly 20 less calories than a similar serving of traditional white rice, and brown rice is also a much greater source of dietary fiber (1.8 grams) than white rice (0.4 grams). Brown rice also is rich in selenium, which can reduce a person’s risk of developing arthritis, certain cancers and heart disease.

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“Even when you’re dying there can be a lot of living to do- special life moments made possible by Heartland Hospice.�

By Jeanne Franson Rn/Agency Director

2 Hospice is not a place or a person. It is a way of providing end of life medi-

cal and supportive care where a client lives, whether at home, in a nursing facility or hospital. We provide a compassionate presence and specialized medical knowledge to clients and their loved ones as death draws near. Hospice Care begins when a terminally ill person chooses care options based on comfort and symptom relief rather than a cure.

2 Our team works together to relieve pain, control symptoms, provide support and enhance the quality of life through a range of services. 2 The clinical members of the team the clients

Physician, Dietitian and Registered Nurse work together to alleviate pain and other symptoms, educate the client and loved ones on medications, medical equipment, diet , disease management and care needs of the patient.

2 Our Hospice Spiritual Coordinator assists clients on their spiritual journey providing comfort and support. 2 Our experienced Medical Social Worker may provide guidance on legal matters, community resources, funeral planning, emotional support and counseling to clients and their loved ones.

2 Certified Nursing Assistants provide care needs such as bathing, hair and skin care. Left to Right: Jeanne Franson RN Agency Director, Jenny Herzberg RN, Aimee Mauderly RN, Ashley Barnes C.N.A, Val Ramsey RN, Celeste Westgaard RN, Jacque Baxter Office Manager, Daphne Bix RN, Ashley Lindburg C.N.A. Not Pictured: Dr. William Butz Medical Director, Christie Welter Hospice Social Worker and Martha Freeman Spiritual Counselor

2 Trained Volunteers are available for additional support or respite care.

2 The Hospital Comfort Suite is available, if criteria are met.

The Heartland Hospice Mission

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Phone

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2To provide care for terminally ill clients and their loved ones using extraordinary sensitivity, heroic compassion and aggressive symptom control. 2 Our practice emphasizes meeting the physical, emotional spiritual and bereavement needs of those we serve. “We are here to surround you with caring and to walk beside you for as long as you need us.� Heartland Hospice- neighbors caring for neighbors. A department of Montgomery Memorial Hospital.

Health Perspective - The Valley News (1/21) & Herald-Journal (1/22) u 15

Save the Date for the SMC

FAMILY HEALTH FAIR

3ATURDAY -ARCH TH s AM AM 3HENANDOAH .ATIONAL 'UARD !RMORY EARLY BLOOD DRAW DATES Fasting 8 - 12 hours prior to having blood drawn recommended. Drinking water before the blood draw will not affect your results. You choose the tests you want. No insurance claims ďŹ led.

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16 u Health Perspective - The Valley News (1/21) & Herald-Journal (1/22)

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