People First Health Magazine Volume 13, #4 PDM309

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PeopleFirst pleFi REDUCING YOUR RISK OF

Helping People Live Better Lives

OSTEOPOROSIS DR. HISTER ON

BREAST CANCER HEALTHY FOOD SHOPPING COMPANY’S COMING RECIPE

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People First contents

4

Breast Cancer Dr. Art Hister looks at a cancer that will unfortunately strike approximately one in eight women.

5

Healthy Savings Great savings on health and wellness products available at Peoples Pharmacy.

6

Osteoporosis Peoples Pharmacist Ian Lloyd provides helpful advice on the bone wasting disease.

7

Super selection of quality vitamins and supplements from Peoples Pharmacy.

Gummies For Adults Page 5 Who says kids have all the fun? Great tasting and easy to digest calcium.

Save On Vitamins

9

Pharmacist Recommended Helpful advice on preventing and managing seasonal allergies.

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A Healthy Shopping Primer Darlene Booth on how to make your weekly food shopping trip a healthy trip.

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Forgiving Egg Bake Brand new feature recipe From Company’s Coming Healthy Family Recipes.

Helping People Live Better Lives


BREAST CANCER According to some surveys, a surprisingly large number of women fear breast cancer at least as much (some even fear it more) than they fear any other medical condition. So, if you’re a typical clueless sports-stats loving guy like me who is terrified of discussing his health concerns or personal problems with his male friends but who will spend many happy hours with his buddies arguing over batting averages, field goal stats, and goalie save percentages, especially if beer or wine is shared, a question that pops into mind nearly instantly about why so many women are so afraid of breast cancer is: why is that? Because to a typical boomer guy who likes to believe that we should judge everything including what we should be afraid of simply by the percentages, the breast cancer numbers really don’t account for its overwhelming “fear index.” Yes, based on the most recent data, 12% of women will end up with breast cancer (about 1 woman in 8), but that’s only if a woman lives into her 80s and beyond. In other words, as with nearly all malignancies, the rate of breast cancer also rises with age, meaning that in the younger women that we know better and hang out with more frequently (and you should know that for me, “younger” once meant any woman under 30, then it was any woman under 40, then under 50, then 60 and below, and now, well, these days a “younger woman” to me is any woman still able to blow out the candles on her birthday cake without help) the rate of breast

Dr. Art Hister

cancer is far lower than 1 in 8. Thus, according to the US National Institutes of Health, at age 40, an average woman’s risk of breast cancer (the numbers are higher, of course, for women with genetic risks) is 1 in 68; at age 50, it’s 1 in 42; at age 60, it’s 1 in 28; and at age 70, it’s still “only” 1 in 26. And even better, of course, because of newer and far better breast cancer treatments and far greater use of mammography (which detects smaller and more easily-treatable cancers), the rate of death from breast cancer has come down significantly over the last 20-30 years. So in the completely rational numbers-are-everything world that so many of us guys like to pretend we inhabit, you would think that an average-risk woman should be at least equally afraid (and probably more afraid) of the deleterious effects of more common yet equally debilitating and deadly conditions – heart disease, for example, or a stroke, or diabetes, or dementia, or even osteoporosis – than she is of breast cancer. So in this column, I’d like to address that seeming inconsistency, although to be honest, I am not a great choice for that task since I readily admit to understanding very little (in fact, close to nothing at all) about women, an admission that my wife – and probably every woman I know – would be very happy to confirm, I’m sure. But that said, from the many emails I get, I do know a thing or two about the particular health issues that strike the most fear into people, and it Continued On Page 11

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OSTEOPOROSIS

Ian Lloyd Peoples Pharmacist

Osteoporosis is a health concern that causes bones to become thin and weak. While it is primarily a concern for women, men can also develop low bone density. While nobody dies from low bone density, it can cause loss of mobility and sometimes pain. Very few women - and men - know they have osteoporosis until it is too late. They might fracture a wrist, crack a rib or break a hip. This is why it is very important to have your bone density tested. Ask your Peoples Pharmacist if they will be conducting a bone density clinic. During a bone density clinic, your pharmacist can determine your bone density using a special, non-invasive ultrasound machine, and you are able to see the result in a few minutes. There has recently been news about the side effects from the drugs that help to treat osteoporosis. This news is related to the possibility that oral bisphosphonates (Fosamax and Actonel) may be linked to osteonecrosis of the jaw. Osteonecrosis is a disease caused by a reduced blood flow to the bones in the joints. With too little blood, the bone starts to die. and may break down. It is known that patients who received IV bisphosphonates for cancer have a higher risk for developing osteonecrosis. Despite the great flurry of news reports, its occurrence is still quite rare, less than 1 in 1000. Osteonecrosis has occurred in patients who have had recent dental surgery, 6 People First Join us on

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which exposed the bone. The bisphosphonates are believed to prevent bone turnover, which is needed for healing after dental surgery. The bisphosphonates or surgery might not be the only cause of osteonecrosis, as bacteria are also suspected for causing this problem. It is also not clear what should be done about it. If you are planning any dental procedures it is best to tell you dentist or dental hygienist that you are taking medication for osteoporosis. To further complicate matters, there are also questions about how long someone with low bone density should take a bisphosphonate. The current thought is that five years is the maximum length of time a person should take this medication. Women who have taken bisphosphonates for five years have the same risk of breaking a bone as women who have been taking this drug for 10 years. To make matters more confusing, there is doubt whether some women should be taking osteoporosis drugs at all. A recent report suggests that there is no benefit for bisphosphonates in women that have not broken any bones. Yes, this does make treating osteoporosis more complicated. But it does allow a discussion between patient and physician about treatment options for your health. Ask your Peoples Pharmacist if you have questions about osteoporosis, or any other health care topic. Continued On Page 8


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Ian Lloyd...Continued From Page 6

There has been recent news that calcium supplements might increase your risk of heart disease. While this is partially true, one must not forget that calcium is foremost in the prevention of osteoporosis. The study in question found that people who took high doses of calcium (>1000mg/day) experienced more heart attacks than those who did not take calcium. The real increase in risk was not that great, however it did cause health care professionals to recommend that people reduce their supplemental use of calcium. Health Canada recommends that an adequate intake of calcium is 1000mg to 1200mg from all sources. We generally get about 300-400mg of calcium in our diet without really trying, so we only need a slight top-up to meet our daily requirements. I often get asked which form of calcium is best. The best form of calcium is the kind that you remember to take. It is true that calcium citrate is slightly better absorbed than calcium carbonate,

but the difference is not very significant. There are also chewable calciums, effervescent tablets, powders and lozenges. Again, the best calcium is the calcium you remember to take. Adequate vitamin D intake plays an important role in bone formation. Your body needs vitamin D to absorb and use the calcium to make bone. Some people ask me if they still need to take vitamin D, since the body can make its own supply from sunlight. While this is true, do you get at least 15 minutes of direct sunlight every single day of the year? This might not be that case for everyone, especially during the winter months or for those who are shut-ins. I recommend taking about 1000-2000IU of vitamin D a day just to be sure. With a focus on non-drug treatments for osteoporosis, there are many things you can do to reduce your risk of developing this bone thinning disease. The first is to participate in regular weight bearing or resistance exercises. A weight bearing

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pharmacist recommended Health & Wellness Information From Your Peoples Pharmacist

Seasonal Allergies Allergies occur when your body has an unusual immune response to a common substance like pollen, dust, or mold. When these substances cause your immune system to overreact, they are called allergens. Allergens don’t directly create the symptoms you experience but they latch on to cells in your body, triggering them to release histamine and other “chemical mediators.” The allergy symptoms you feel are a result of your body’s reaction to these chemical mediators. The most common type of allergy is called allergic rhinitis. This happens when the allergens are inhaled through the nose, where they trigger the allergic reaction. Allergic rhinitis caused by pollens that are only present in a specific season is called hayfever. Signs and Symptoms of Allergic Rhinitis: Common nasal symptoms of allergic rhinitis include itchiness, sneezing, a dripping/runny nose, and stuffiness. Some people also get symptoms in their eyes. They get watery/teary eyes that are red, itchy, and swollen. Other general symptoms that may be present are ear pain or itch, sore & itchy throat, sinus congestion, headache, and postnasal drip. Postnasal drip is the name for when a runny nose drips “backwards” into the throat, this can cause a mild cough and contribute to the “itchy throat” feeling. Managing Allergic Rhinitis Three things to be considered when developing an allergy management strategy are awareness, prevention, and treatment. You must educate yourself about your allergies and what causes them, learn to minimize exposure to your triggers, and discover how and when to treat your symptoms. Awareness: The first thing to do in establishing your allergy awareness is to learn what causes your reactions. Is it pollen, animal dander, dust or something else? You might wish to consult an allergist if you are having trouble pinning down the source of your allergies. If you have seasonal allergies, get to understand what pollen is and learn about your local pollen seasons. Pollen from non-flowering plants is very small and easily airborne. This type of pollen is likely to be an allergen whereas pollen from flowers is more likely to be an irritant. An irritant can worsen your allergy symptoms if the nasal tissues are already inflamed, but will not trigger an allergic reaction on its own.

Prevention: Managing allergies is the same as managing any other condition. It is important to treat cause as well as the symptoms. Once you discover what it is that you are allergic to, you can decrease your symptoms by reducing and/or avoiding situations in which you are exposed to your allergens. Here are some tips to help you prevent your hayfever: • Shut windows and doors to keep airborne allergens out of your house. • Plan outdoor activities for later in the day because most plants pollinate in the morning. • Avoid outdoor activities on warm, windy days but enjoy them after a rainfall washes the pollens away. • Keep your distance from pollen producing trees. Most pollen stays within 10 meters of the tree. • Avoid pets, even if you are not allergic to them. Animals can bring pollen and dust inside on their fur. Treatment: Knowing what your allergens are and trying to avoid them will certainly help to improve your allergy symptoms, but are not likely to eliminate them. The last step in managing allergic rhinitis is to learn how and when to treat your symptoms. It is important for you to consult your doctor and pharmacist in this step. There are many allergy medications available, some are prescription-only and others are over-the-counter. Most cases of allergic rhinitis can be effectively managed with overthe-counter medications called antihistamines that your Peoples Pharmacist can help you select. Tell your doctor and Peoples Pharmacist about ALL of the medications you are taking (prescription & over-the-counter). Some drugs, antibiotics and heart medications especially, can interact with antihistamines and cause serious and dangerous drug interactions. Take the antihistamine before you will be exposed to an allergen to prevent or reduce the severity of your symptoms. If you have hayfever, begin taking your antihistamine just prior to the start of pollen season and continue taking it regularly during pollen season. Prevent your symptoms from ever becoming severe by anticipating them and treating them accordingly.

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an

o d...Continued From Page

exercise is one where the muscles work against gravity and include walking, stair climbing and dancing. While bicycling and swimming are excellent exercises to strengthen the cardiovascular system, they may not be as helpful for preventing osteoporosis. Resistance exercises include weight lifting or using elastic exercise bands. All of these exercises have been shown to prevent bone loss. Remember, it is best to talk to your physician before starting any new exercise program. You may also have read that vitamin K can help with osteoporosis. This is partially true. A special form of vitamin K (menaquinone) might be helpful for increasing bone mineral density. This is different from the form (phytonadione) found in some multivitamins, which might not be as effective. For now, just eat more fruits and green leafy vegetables; which coincidentally have been asso-

ciated with a lower risk of developing osteoporosis. Osteoporosis is a major health concern for both women and men. Early detection can lead to effective treatment and the prevention of future complications. Ask your doctor or Peoples Pharmacist about a bone density test. Many Peoples Pharmacists hold osteoporosis clinics, where you may be able to receive a bone density reading. The more you know about your health the better. Ask your Peoples Pharmacist for more information about osteoporosis. It is never too late to bone up on your health. Written By Ian Lloyd, Pharmacist & Chartered Herbalist, Peoples Pharmacy

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Dr. Hister...Continued From Page 4

seems to me that the fear of breast cancer is really not much different from the fears about any other type of cancer because I think we are all very afraid of cancer in general, especially people of my generation (and our elders) who were brought up in an era when a diagnosis of cancer was akin to a death sentence. Why was that? Well, for a start, until the last 20-25 years or so, our cancer screening and diagnostic tools were primitive, to say the least. For example, the only way to diagnose prostate cancer until about 20 years ago was through that dreaded digital rectal exam, which even in the best hands (a small prostate pun), is a rather imperfect diagnostic tool. So no wonder that when we were growing up, and indeed even into our early adulthood, most cancers in either our peers or our elders were not diagnosed until those malignancies were in an advanced stage, many not even until they’d metastasized, which greatly diminishes the chances of surviving any cancer, of course. Second and equally important, up until the last couple of decades, our treatment options for cancer were also very limited (and sadly, for some cancers such as pancreatic cancer, for example, they still are). So my generation (and our parents’ generation, too) grew up making these kinds of barters with our Maker, “Please, God, I’ll gladly take any diagnosis. Just don’t make it cancer.” But for breast cancer, there are added reasons for a special fear, I think, starting with the depressing fact that it’s likely that nearly everyone reading this knows at least one young woman – sometimes more – who hasn’t done well after a diagnosis of breast cancer, and who in fact, died quite prematurely from that malignancy. As well, despite all our advances in treatment, the battle with breast cancer is often not an easy one even if the ultimate prognosis turns out to be favorable, and that can leave a significant mark on anyone who’s ever had to help a mom, a sister, a friend, or a colleague, in their fight. So even for a number-cruncher guy like me, it’s

Helping People Live Better Lives

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Dr. Hister...Continued on Page 13

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Are your medications working effectively for you? Medication Review Service The Peoples Drug Mart medication review service was created to ensure medication therapy is appropriate and effective for those taking multiple medications. Your Peoples Pharmacist will ensure all your medications are compatible with each other and working optimally. Medication review includes: • Detailed analysis of all medications (prescription and over-the-counter), vitamins and supplements, to ensure safe and effective use. • In-depth consultation to improve health outcomes by helping resolve any issues that may have arisen due to your medications. A Peoples Drug Mart medication review provides an opportunity for you to sit down one-on-one with your Peoples Pharmacist to help identify and resolve common medication-related issues, so you can get the most benefit from your medication. This medication review can help you better understand your medication therapy, and ensure that medications are being taken as prescribed. Speak to a Peoples Pharmacist about scheduling a free medication review.

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Dr. Hister...Continued From Page 11

not really hard to understand the extra-intense fear many women have about breast cancer. That said, I always like to end my columns on an upbeat note. And besides, I’m a health columnist who believes that his most important duty is to point out what my readers can do to prevent the condition I’m discussing (or if they can’t prevent it, to at least minimize their chances of dying from that problem). So it’s very important for me to note to the women reading this that depending on which experts you choose to believe, up to 40 % of breast cancers can be prevented though healthy lifestyle practices. Thus, increased rates of breast cancer have been linked with • obesity, • smoking, • the use of some hormones for treatment of the symptoms associated with menopause (so if you do have to use hormones to treat severe menopausal symptoms, always try to use the lowest dose of the weakest medication for the least amount of time that you can get away with), and alcohol intake (a woman’s risk of breast cancer is said to rise directly with the amount of alcohol she drinks regularly). On the very important other hand, regular exercise lowers the risk of breast cancer significantly, especially if that regular exercise routine is started at a younger age. In other words, if you want to lower their risk of eventually developing breast cancer (as well as lots of other health problems), get your daughters and grand-daughters involved in regular exercise regimes when they’re still young – it’s at least as important for their future well-being (I’d say it’s even more important) than other habits that seem to take a greater priority in so many kids’ lives these days, such as learning a second language, for example, or playing an instrument or spending even more time on Facebook. And besides, if they spend more time playing sports, they’re more likely to grow up knowing enough about goalie save averages and filed goal percentages to be able to have heart-to-heart discussions with their grand-dads. Dr. Art Hister can be heard on CKNW and other Corus Radio Network stations on House Calls on Saturdays at 10 AM, as well as seen on Global TV news on Saturday mornings at 9:20.

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A HEALTHY SHOPPING PRIMER B

Healthy eating has become a popular topic as more people are beginning to link food choices to their overall sense of well-being. A quest to move toward optimal health and wellness spurred my own long-term study in nutrition and preventative health; this interest contributed greatly to the dietary framework on which I have built my life. I always strive for a less is more approach; the less it has been processed, the more likely it is going to be a healthier choice. For the most part, while I can still get excited about cookies and ice cream, the mainstay of my diet is built around wholesome, high quality foods. Yet even with the best of intentions, I have found that the supermarket can present a confusing cornucopia of choice. Shopping with health in mind means learning how to make the best choice available. The most important strategy for a health conscious shopper is to limit the time you spend in the middle aisles. This is an area where you want to get in and get out as quickly as you can; if you stop and browse, you are more likely to impulse buy. Remember, just because a product is labelled low in fat, does not mean it is healthy; you only have to read the sugar content to figure that one out. Marketing strategies are going to try to lure you in with promises of natural, no cholesterol and trans fat free; while these are important health issues you are also going to want to read the labels carefully to make sure you can pronounce the rest of the ingredients and that you actually know what they are. A large majority of the middle aisle foods are highly processed, low in nutrition and best kept to a minimum in the diet. The outside perimeter of the store is where you will find all the foods that do not need an extensive ingredients list. Fresh fruits and vegetables, meats, poultry, fish and dairy will be found along the outside walls. These are the foods that you want to form the core of your diet. Supplement these foods with a trip to the bulk section where you can stock up on beans, legumes, whole grains, nuts and seeds. Keep in mind

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R.H.N

that these foods are best when they still have a semblance to the form they hold in nature. For example - raw nuts and seeds are healthier than roasted; brown rice is more nutritious than white and steel cut oats are a better choice over quick oats. Spend your grocery dollars on the finest quality you can afford. Fresh is best and the fresher the better; many nutrients are lost during shipping and storage. Sometimes I buy organic and sometimes I do not. Organic is touted as the best choice, but if I have to choose between organic that has been shipped in from a far away place or fresh local produce, I choose local and seasonal. Shop the local farmer’s markets during the growing season; food in season is not only more nutritious it also tastes better. If fresh is not available or cost effective then the next best choice would be frozen because it has been frozen at the peak of ripeness and has not had all the nutrients processed out of it. I would also include dried foods as a healthy choice. Lean, quality proteins are preferable over fatty proteins and processed meats. Many toxins are stored in fat tissue so if you are not able to afford organic, free range or grass fed, trim the fat and throw away the skin before cooking. Keep in mind that vegetarian protein sources like beans and legumes are good quality proteins and they are also a source of beneficial fibres. The last factor for consideration when shopping for healthy food is how well it will fit with your lifestyle. Whole foods do take more time and preparation than convenience foods so you will want to anticipate meals and plan ahead. I will often cook up a pot of rice or quinoa and find a few different ways to use that during the week. The easiest approach is to find some quick and easy recipes that become your meal staples and do some of the food preparation when you have time during the week. Remember that change does not happen overnight so start where you are. In my own experience, baby steps are more sustainable than taking on too much change all at once. Good Health to You!


Forgiving Egg Bake

Forgiving Egg Bake

Ham and Swiss baked with whole grain bread and a shot of dill. With a little advanced planning, this recipe can be a lifesaver on a busy morning. Slap it together the night before and let it soak overnight, then pop it in the oven the next morning and leave it to work its magic. 1 tsp (5 mL) butter 1 loaf whole grain bread 1 ⁄2 lb (225 g) cooked ham, diced 11⁄2 cups (375 mL) diced green pepper 3 cups (750 mL) grated Swiss cheese 8 eggs 3 cups (750 mL) 2% milk 2 Tbsp (30 mL) chopped fresh dill 1 tsp (5 mL) hot pepper sauce 1 ⁄2 tsp (2 mL) cracked pepper 1 tsp (5 mL) red wine vinegar Lightly grease a 9 x 13 inch (23 x 33 cm) casserole with butter. Line bottom of dish with an even layer of bread. You may have to cut bread to fit snugly. For next layer, spread 1/4 lb (113 g) ham and 3/4 cup (175 mL) green pepper over bread. Repeat sequence, then sprinkle cheese evenly over top. In a medium bowl whisk eggs and gradually pour in milk. Add dill, hot pepper sauce, pepper and vinegar. Pour evenly over contents of dish and cover with plastic wrap. Refrigerate for at least 7 hours. To cook, preheat oven to 325ºF (160ºC). Remove plastic wrap and bake dish for 40 minutes. Remove from oven and allow to rest for 4 minutes before serving. 1 serving: 410 Calories; 24 g Total Fat (7 g Mono, 1.5 g Poly, 12 g Sat); 280 mg Cholesterol; 27 g Carbohydrate; 3 g Fibre; 28 g Protein; 760 mg Sodium

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