REALHEALTH YOUR GUIDE TO BLACK WELLNESS
SUMMER 2014 $2.99 US REALHEALTHMAG.COM
Feet Hurt? Don’t Ignore The Pain!
Public Pools Look Before You Leap
What To Do When A Heatwave Hits
Safer Healthier Ways To Grill Meat
Reverend Run And His Wife JustineOvercame Simmons Fear And Got Tested To Learn Their Risk Of Diabetes (And So Can You!)
CONTENTS this month on REALHEALTHMAG.COM RH blogger Mona Ramsey used to be afraid to get her tresses wet, but now she knows how to protect her mane. Check out her tips here.
Health Basics A—Z
Want to lose weight, exercise smart, eat right, find good health care, sleep better or just get healthy? For tips, click on “Health Basics A–Z” on the realhealthmag.com home page.
Jazz Notes for You
Musician Alex Bugnon used to abuse his health. But when he realized he had to repair the damage he’d done, he made some very dramatic lifestyle changes.
The Ultimate Team Player
Former b-ball star Tamika Williams has traveled the world to talk to women and girls about HIV, which both empowers them and raises awareness.
Digital Real Health
Read Real Health magazine online exactly as it appears in print. Go to realhealthmag.com/ digital to view the current issue and the entire Smart + Strong digital library.
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editor’s letter
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Customizing weight loss: Just do what works for you!
18 COVER STORY
dream believer
For the past two years, Reverend Run and his wife, Justine, have learned a lot about diabetes.
buzz
Fat shaming doesn’t work; moods affect sexual risk-taking; how to handle a heatwave and stay safe; how clean are public pools?
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step lively
Too much bad bacteria in your vaginal tract can create issues that throw your sexual health off balance; Ask Doctor Dee
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smokin’ hot
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nutrition
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flake off!
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fitness
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thoughts
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sex
Just say no to food poisoning this summer; farting explained; more reasons to load up on vitamin C
Stop heel pain now; fast, easy ways to boost your endurance
Take a tip from this podiatrist: It isn’t normal for your feet to hurt, so don’t ignore the pain.
Yes, you can eat grilled meats, but cook up those steaks, chops and chicken how we show you.
Okay, so you know a lot about dandruff, but this news might be a surprise. Plus: Stuff We Love
If you live with chronic pain, try these tips to soothe the hurting.
Real Health Question of the Month
What do you love, and hate, the most about summer?
I love the warm, breezy days, walks in gardens and parks, BBQs, fresh salads, and fruity drinks at the beach or poolside. The only things I hate are the pesky mosquitoes. —Gerrie E. Summers
reach out & click!
At realhealthmag.com, you can read more articles; access exclusive, online-only special reports; meet other health-minded black singles; and subscribe ($9.97 for four quarterly issues; you can also call 800.973.2376). Plus, sign up for the Real Health email newsletter to get the latest black health news!
(COVER) COURTESY OF NOVO NORDISK AND “ASK.SCREEN.KNOW”; (MAN, BACTERIA AND MEAT) THINKSTOCK; (SUMMERS) COURTESY OF GERRIE E. SUMMERS
No More Hair Fear
EDITOR’S LETTER
Fitness Is All About You
REAL HEALTH
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hen I was a teenager, I was overweight. After puberty kicked in, my body began to react to food differently. I found I could no longer eat what I wanted when I wanted. To fit into the clothes I loved and to like the way I looked, I realized that I simply had to do one thing: lose weight. Of course, losing weight is easier said than done. At that point, trying to shed excess weight became my never-ending mission. When the weather would warm up, that was my signal to start preparing for a diet. I’d focus my thoughts on how slim and svelte I’d look, how cute in my clothes, how light on my feet I would feel. How happy I’d be! But the first hurdle was always hunger. Every diet I’d ever tried would find me starving for food—in particular something delicious. I have a sweet tooth (and, nope, things haven’t changed), so I’d psyche myself up to boost my willpower. At home, my mother would bake extra cakes for the holidays and store them in brightly painted, oversized round tins. Whenever she’d unseal the pans, out would waft the mouthwatering and delicious fragrance of liquored fruit and sweet spices. Saying no to that was almost impossible. For a while, I’d be good. I often made it past Defcon 4. That’s when the family
EDITOR-IN-CHIEF
Kate Ferguson MANAGING EDITOR
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Casey Halter ART DIRECTOR
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ADVISORY EDITOR
Sean Strub
ADVISORY BOARD
Lee SaintMartin, MS, IIPA, CN, ND, naturopath; Goulda Downer, PhD, RD, CNS, and Nutrition Services, Inc.; Yuan Wan, licensed acupuncturist and doctor of traditional Chinese medicine; Dr. Rachael Ross, MD, PhD, sexologist; Lovell Harris, MD, internist; Terrie Williams, mental health advocate; Xavier Artis, campaign creator, Stay Strong: Healing Starts With Us (HSWU)
SMART + STRONG PRESIDENT AND COO
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Here’s to your health,
JOAN LOBIS BROWN
Issue No. 38. Copyright © 2014 CDM Publishing LLC. All rights reserved. No part of this publication may be reproduced, stored in any retrieval system or transmitted, in any form by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the publisher. If you are an individual or organization and would like to subscribe to Real Health, go to real healthmag.com or call 800.973.2376. Send feedback on this issue to info@ realhealthmag.com or Real Health, c/o Smart + Strong, 462 Seventh Ave., 19th Floor, New York, NY 10018. Smart + Strong® is a registered trademark of CDM Publishing, LLC.
would gather for mealtime and pass around the table many morsels of temptation. If I lasted past the Easter festivities without blowing my diet, I’d rejoice at the miracle. For me, losing weight was much like having an unpaid full-time job. I found dieting very hard to do because I loved food. Still, I believed there must be a way to eat the foods I loved without getting punished for indulging. That’s when exercise came into my life. At first, I began jogging. Then I upped my pace. I lived near a park, so I’d run either inside that grassy urban oasis or around its tree-shaded, concrete perimeter. I’d carefully time myself because I was always pushing to shave additional minutes off my finish time. But the best part about my exercise regimen was that it helped me to lose weight. That’s when I became hooked. I started keeping a journal to record all the food I ate and the activities I did. Soon I learned what worked for me in terms of diet and exercise. Today, nothing’s really changed. Maddeningly, my weight still fluctuates. The only difference now is that I have a better understanding of how my body responds to the different foods I eat. As a result, I’ve been able to customize my weight loss and maintenance regimen so that they’re unique to me. If nothing else through the years of having my weight yo-yo up and down, I’ve learned a very important principle: Weight loss is purely an individual thing. What works for some simply won’t work for others. That means forget a one-size-fitsall approach to diet and exercise. Try out different programs to see what works for you.
Kate Ferguson, Editor-in-Chief katef@realhealthmag.com
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BUZZ
Body Language
Fat shaming won’t make a person lose weight. So what’s a better approach?
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hen media personality Kim Kardashian shared on The Tonight Show that she suffered fat shaming after packing on the pounds during her first pregnancy, many people could relate. Today, more than two-thirds of U.S. adults are overweight or obese. But the problem isn’t unique to Americans. According to 2012 statistics, in Canada, roughly 4.7 million adults reported a height and weight that classified them as obese. Also in 2012, more than 60 percent of Australians fit into the same category. Experts shudder at these statistics. Carrying extra body weight increases the risk of numerous illnesses, including diabetes, metabolic syndrome, coronary heart disease, high blood pressure, stroke and respiratory conditions, just to name a few. But given that so many people are tipping the scales, some believe being fat is becoming the new normal. What can we do? Public speaker, coach and author Marcia Meislin says in her Huffington Post blog that in the past, she would
heap verbal abuse on herself after each episode of binge eating. She thought this self-administered fat shaming would help her kick the habit. It didn’t. And when others do the fat shaming, the same results apply. “Shaming people only increases all sorts of negative effects,” says Edward Abramson, PhD, a clinical psychologist and author of the book Emotional Eating: What You Need to Know Before Starting Another Diet. “Fat shaming tends to make people withdraw, and that increases the likelihood that instead of having a moderate amount of the dessert or the ice cream or the chocolate, Link weight loss with or whatever, the person health to who has been shamed help loved will binge eat. They’ll ones shed pounds. gobble the food down and as a result tend to consume more than they would if they could just sit and eat a meal normally.” According to recent findings, fat shaming puts those who are overweight or obese at increased risk of
engaging in the very behaviors that most likely packed on pounds in the first place: excessive food intake and physical inactivity. “Overeating is a common emotionregulation strategy, and those who feel the stress of stigmatization report that they cope with it by eating more,” write the authors of one study conducted at Tallahassee’s Florida State University of Medicine. But when folks perceive of their weight as normal and they’re in fact overweight or obese, they do place themselves at risk of chronic diseases and poor health. Abramson agrees, but offers a less stigmatizing way to address the issue. “I like to talk about healthy eating rather than telling people, ‘You should go on a diet; you’re too fat,’” he says. “[We should] talk about eating healthy for health, which doesn’t include high-calorie, high-fat, processed foods, visits to McDonald’s and junky snack foods, especially sugary drinks. Sugared drinks are probably the single greatest cause of obesity in kids.”
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BUZZ
STILL MISUNDERSTOOD
Taking Chances
Engaging in safer sex may depend on your mood.
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rdinarily, if you’re in a good mood, most likely you wouldn’t do anything to sabotage your health. But, let’s say you’re depressed. Perhaps, depending on how badly you felt, you might not even care about your future. Similarly, according to recent findings, HIV-positive men who have sex with men (MSM) may engage in riskier sex when they suffer from black moods. For the study, scientists asked 106 sexually active, HIV-positive MSM in New York City to complete a survey each week, for a six-week period, regarding their sexual behavior, depression and well-being. Researchers found that the men who felt happier during a particular week were more likely to have safe sex. Conversely, those who said they felt more depressed than usual during a given week were more likely to engage in risky sexual behaviors. “We all have bad days and good days, and bad weeks and good weeks. That’s life,” says Patrick A. Wilson, PhD, an
associate professor of sociomedical sciences at Columbia University’s Mailman School of Public Health, and lead study author. “But it turns out that how moods change can be a big factor in influencing condom use.” Wilson and his research team couldn’t explain exactly how the men’s moods in each group led them to make either healthy or unhealthy choices. Most of the participants in the study group were poor, black and Latino men. Wilson suggests that the men who suffered from depression may have experienced severe social stresses, such as stigma, and might have gone through tough economic times. When compared to these men’s more immediate needs—a stable job, housing and support networks—the risk of HIV transmission may be of low concern, Wilson says. But he adds that other factors are likely at play: “It boils down to coping—recognizing your emotions and how to respond when they change.”
THE PERCENT OF ALL YOUTH WITH HIV WHO DON’T KNOW THEY’RE POSITIVE. Source: National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention
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Ask filmmaker Andrew Jenks why he thinks there’s so little media coverage of HIV/AIDS and he’ll tell you straight up that the virus “has a PR problem.” What’s more, Jenks feels that “guys like Magic Johnson are a double-edged sword” because people see him living healthy with the virus and believe HIV is all figured out. In addition, shame and stigma are still attached to acquiring the virus. These are the reasons Jenks partnered with the MAC AIDS Fund to make an as-yet-untitled documentary. He wanted to show the personal stories of three young people affected by HIV/ AIDS to give viewers a better understanding of what’s at stake if we let the matter rest where it currently lies. The three young adults Jenks profiles are an American college girl, age 19, who was born with HIV; an HIV-negative man, age 27, who feeds kids the HIV basics in a poverty-stricken South Africa township; and a 35-yearold, HIV-positive man who lives in Mumbai, the city formerly known as Bombay, in India. While in Mumbai and walking down Falkland Road, Jenks encountered an unexpected plot twist in today’s HIV tale. He saw little 13-year-old girls selling sex. Later, he visited an orphanage and met HIV-positive kids who were born into sex slavery. “I really wasn’t expecting it,” Jenks says. “Sex slavery is something that needs to be solved in order to eradicate HIV.”
Andrew Jenks (left)
(CONDOM) THINKSTOCK; (JENKS) COURTESY OF ANDREW JENKS
A new documentary takes a look at today’s HIV stories.
BUZZ Meds Madness Will a breakthrough hep C drug also break the bank? When the game-changing hepatitis C pill Sovaldi (sofosbuvir) garnered FDA approval several months ago, an outcry about its cost was heard ’round the world. A standard 12-week course of treatment for the liver disease rings up at $84,000, which breaks down to about $1,000 a pop. But the pill’s maker, Gilead Sciences, says the price tag is justified because Sovaldi offers patients the best of both worlds: greater convenience and a likely cure. What’s more, Gilead adds, in the long run Sovaldi would save money for health insurers; without the new treatment, people living with hep C would require long periods of care and expensive operations. As Gilead’s COO John Milligan put it: “When you talk to [health insurance payers] about the long-term benefits, they recognize they’re not going to have to worry as much about liver transplants and other care they’re going to have to give.” In general, the newest hep C treatments all ring up for more than $50,000 for each course of treatment. The good news is that these treatments often forgo interferon, an injectable that’s notorious for its flu-like side effects.
Last One In
Read this before making a splash in your public pool. When it’s hot and humid, a dip in a neighborhood swimming pool may seem like the move to make. But some very uncool behaviors by fellow swimmers can lead to health hazards, especially if the water’s pH and chlorine levels aren’t maintained. To “keep the poop, germs and pee out of the water,” the Centers for Disease Control and Prevention (CDC) suggests that people shower before jumping in the pool, take bathroom breaks every hour, wash their hands after using toilet paper or changing diapers, and stay out of the pool if they have diarrhea. Another bit of advice: Don’t swallow pool water, and do check chlorine and pH levels. (“Most superstores, hardware stores and pool-supply stores sell pool test strips,” the CDC advises.) Chat with the pool operator and ask how often the pool’s chlorine and pH levels are checked. Also inquire about the pool’s latest inspection score and its germ-killing technology. According to the CDC, local environmental health programs inspect public pools periodically to see if they’re complying with local and state health regulations. So check with your local health department before—not after—you get splashing.
THE NUMBER OF PEOPLE WHO DIE FROM HEAT-RELATED COMPLICATIONS EACH YEAR IN THE UNITED STATES.
Source: U.S. Army
ALL IMAGES: THINKSTOCK
Simmer Down Don’t become a hot weather statistic. Many people don’t realize how deadly heat can be. In 1995, Chicago witnessed the deadliest event in its urban history when more than 700 people died in a suffocating heat wave. Then, just eight years later, a record heat wave across Europe claimed an estimated 52,000 lives, by some reports. Weather emergency agencies define a heat wave as a period of excessive heat that lasts for three days or more. When the body can’t cool itself through sweating and evaporation, heat-related illness may develop.
What’s more, extreme heat can bring on dangerous conditions such as dehydration, sunburn, cramps, exhaustion and stroke. In addition, when body temperature rises above 103 degrees, the heat can damage cells and cause our organs to shut down. According to experts, we can follow simple steps to avoid these heat wave horrors: Slow down; stay out of the sun; dress in lightweight, light-colored clothing; drink plenty of water or other non-alcoholic beverages; and spend more time in air-conditioned spaces. realhealthmag.com
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SEX Ask Doctor Dee Dorothy Horton, PsyD, answers your questions.
The Proper Balance What happens when bad bacteria outnumber good microorganisms in the vagina? Many women suffer from bacterial vaginosis (BV), a mild vaginal infection often accompanied by a strong, unpleasant odor that some describe as “a fishy smell.” Some women complain that BV makes them feel “uncomfortable and self-conscious” as well as “disgusted, ashamed, dirty, annoyed and distressed,” according to findings published in a recent issue of the PLOS ONE medical journal. In addition, chronic episodes of BV affect women even more intensely, to the point where the condition may interfere with their personal and sexual relationships. In general, doctors don’t know what causes bacteria in the vagina to become imbalanced. But experts say women’s risk of developing BV rises with douching, smoking and having multiple sex partners or a new lover.
Besides restricting their number of sex partners, not smoking and not douching, women can lower their chances of a BV infection by practicing safer sex, says Hilda Hutcherson, MD, a gynecologist and author of Pleasure: A Woman’s Guide to Getting the Sex You Want, Need and Deserve. “Condoms may reduce the risk of developing BV,” she explains. Additionally, because bacterial vaginosis may be present without any noticeable symptoms, many experts suggest women get routine gynecologic exams that include a test of their vaginal discharge, a look at a sample of their vaginal tissue and a standard pelvic examination. The good news is if you do get a case of BV, the treatment is pretty simple and straightforward. Doctors usually prescribe an antimicrobial cream to get rid of the infection.
THE PERCENT OF ADULTS IN MIXED-FAITH MARRIAGES WHO SAY THEY SELDOM OR NEVER ATTEND RELIGIOUS SERVICES. Source: The“Many Americans Mix Multiple Faiths” poll, Pew Research Center’s Forum on Religion & Public Life, December 2009
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Unfortunately, for many couples who aren’t of the same faith, choosing the religion in which to raise their children can be one of the most difficult and stressful decisions of shared parenthood. Therefore, it is very important that couples make this choice together without allowing other family members to interfere. For a more harmonious relationship, a couple needs to approach the subject with sensitivity, open-mindedness and, most of all, with a deep respect for each other and each partner’s faith. Each person should take time to carefully listen and understand the beliefs, desires and concerns of the other. In addition, each partner must be honest about the specifics related to the issue on which they can and cannot compromise. At that point, they might want to consider soliciting advice from trusted religious representatives on each side. What’s more, the couple must be prepared to make a decision about how to raise their children regardless of what partner’s religion is chosen. A couple must also ask many tough questions. For example, is the issue a deal breaker, or do they sincerely believe they can negotiate this lifechanging choice without damaging their relationship? The answers a couple finds may not solve every aspect of the dilemma, but, at least, facing the issue head-on will start a dialogue that’s key to their future happiness as a family.
(BACTERIA) THINKSTOCK; (HORTON) COURTESY OF DOROTHY HORTON, PSYD
Vaginal bacteria is normal, but the good must outweigh the bad.
For a couple who are of different faiths, how should they decide what religion to raise their children in?
NUTRITION
Eating Outdoors?
Food safety rules always apply. Summer picnics, reunions, tailgate parties, camping trips, or maybe even a good ol’ backyard barbecue or cookout— these all offer us a chance to have fun and eat food with family and friends outdoors. But beware: According to the Centers for Disease Control and Prevention (CDC), warm weather gives bacteria more opportunity to contaminate food. In addition, says the CDC, salmonella illness is more common in the summer. This bacteria is a regular cause of food poisoning, and during the past 15 years salmonella infections have remained high. To avoid an episode of food poisoning, or some other nasty foodborne illness, experts from the Academy of Nutrition and Dietetics offer this advice:
Gassed Up
Everyone breaks wind, but why does it smell bad?
• Wash hands before, during and after food preparation. • Wipe down surfaces. • Defrost meats in the refrigerator or microwave. • Marinate steaks, chops and other meats in the icebox (boil marinades first if you’ll reuse them). • Separate raw and cooked foods as well as the plates and utensils used to hold and serve them. • Cook and refrigerate foods at the correct temperatures (usually below 40 degrees Fahrenheit). • Also, don’t leave foods (cooked or store-bought) unrefrigerated for longer than two hours, and if it’s 90 degrees or hotter, cut that down to one hour. • Unsure if it’s OK to eat? Just toss it!
ALL IMAGES: THINKSTOCK
C Ya!
THE NUMBER OF AMERICANS HOSPITALIZED EACH YEAR FROM FOODBORNE DISEASES. Source: Centers for Disease Control and Prevention
On average, we pass gas between 13 and 21 times each day, but some people fart much more—or less—than usual. This process, along with burping, or belching, is the body’s way of ridding itself of gases that build up inside us. Often, these gases are odorless and pass unnoticed. But, sometimes, flatulence is smelly because the gases in our bodies contain sulfur. Still, passing bad-smelling gas isn’t usually a health issue, or a crime. But when flatulence occurs exces-
sively (and this may be different for each of us), docs caution there might be an underlying health problem such as irritable bowel syndrome, a common digestive illness that causes bouts of stomach cramps, bloating, diarrhea and constipation. In addition, excessive flatulence might be caused by eating gassy foods, such as broccoli or cabbage, or eating and drinking too fast.
Another reason to eat foods rich in vitamin C
Many people know that antioxidants such as vitamin C are good for our bodies. But new findings show that foods rich in C, such as oranges, papaya, peppers, broccoli and strawberries, might also lower our risk of having an intracerebral
hemorrhagic stroke (ICH). ICH occurs when a blood vessel ruptures in the brain; it’s the most common type of hemorrhagic stroke. For a study presented at an American Academy of Neurology meeting, researchers compared 65
ICH sufferers with an equal number of healthy people. When scientists tested everyone for their vitamin C levels, they found that those who had ICH had depleted amounts of this antioxidant compared with those who didn’t suffer from this stroke.
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FITNESS
Put Your Foot Down Don’t let plantar fasciitis trip up your activities.
Endurance exercises aren’t only for iron men and women. Many of us participate in endurance exercises regularly without even knowing it— for example when we take a brisk walk, climb stairs, do yard work, play basketball or tennis, dance, jog and swim. Partaking in these activities makes it easier to walk farther and faster, to push uphill when we’re tired; it also helps us do gardening, shop nonstop or play a sport. Experts agree it’s better to build endurance gradually, especially if you’ve been physically inactive for years. “One of the simplest exercises someone can do to start building endurance is walking,” says Anthony Wall, the director of professional education at the American Council on Exercise. “Other activities can include swimming, jogging and group fitness classes.” Start by doing any of these moderate-intensity endurance activities for 5 or 10 minutes. Then, build up to 30 minutes. Try doing the activity for at least this amount of time on most or all days of the week, advises the National Institute on Aging. Also, be realistic: Set goals based on your health and abilities.
THE AGE OF FAUJA SINGH, NOTED AS THE WORLD’S OLDEST MARATHON COMPETITOR. Source: ESPN.com Endurance Sports
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BOTH IMAGES: THINKSTOCK
Staying Power
So you wake up one morning and try to stand up when—wham!—a lancing pain shoots through your heel and slices up the back of your leg. Chances are you have plantar fasciitis (pronounced plan-tar fash-ieye-tus), one of the most common causes of heel pain. The plantar fascia is a flat band of tissue that runs under your feet and connects your heel bone to your toes. When this tissue becomes inflamed, it hurts to stand or walk. For pain relief, many foot doctors suggest simple toe, calf and towel stretches (placing a rolled towel under the ball of your foot then holding both ends of the towel and pulling it toward you while keeping your knee straight). In addition, those who suffer from plantar fasciitis should cut back on activities that trigger the pain. Docs also advise taking over-the-counter meds for pain relief, icing the heel to reduce swelling, and investing in shoes with arch supports and cushioned insoles—or placing heel cups or inserts into footwear. But recovery from plantar fasciitis is slow. Treatment requires commitment and consistency.
(POGUE) DUSTIN FENSTERMACHER; (CHILDREN) COURTESY OF ERIC POGUE
Reverend Run and his wife, Justine, believe everyone should get screened for diabetes. 1 8 REAL HEALTH S P R ING 2014
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DREAM BELIEVER The call to action came to Reverend Run in his sleep. The vision convinced him to wake up the black community about a serious scourge in their midst: diabetes. By Kate Ferguson
(POGUE) DUSTIN FENSTERMACHER; (CHILDREN) COURTESY OF ERIC POGUE
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hen Reverend Run recalls the dream he had about diabetes, memories of people crying out to God for help flood his mind. “All these people that used to live in my mother’s neighborhood were in pain and screaming,” he says. “There was a very crazy part in my dream where all the old men were outside in broken-down cars, and there were wheelchairs, and I didn’t know why they were sick. It was almost like God was saying to me, ‘I hear these people crying to me, and they’re perishing for lack of knowledge.’” Reverend Run took the dream as the sign of a spiritual challenge to inform his community about the importance of diabetes screenings. His desire to spread the word is the main reason he’s a spokesperson for Novo Nordisk’s diabetes campaign called “Ask.Screen.Know.” For two years now, the hip-hop icon turned preacher has joined the pharmaceutical giant’s health awareness initiative. One goal is to shepherd community residents into their doctors’ offices to find out their diabetes status. “The dream blew me away,” he continues. “I could see all the people who had gotten on their knees, and I could hear them crying out, ‘My mom’s losing a leg,’ or whatever the case
was, so I feel like I have a responsibility to do this. I feel like I’m an agent for God.” Interestingly enough, Reverend Run’s birthday is November 14, World Diabetes Day. “I’m always looking for signs and wonders,” he says. “That blew my head off.” According to the latest statistics from the Centers for Disease Control and Prevention, an estimated 7 million Americans have undiagnosed diabetes and 18.8 million people have been diagnosed. In general, type 1 diabetes occurs when the body makes too little or no insulin, a hormone produced by the pancreas gland. Type 2 diabetes is when the body cannot use the insulin it produces to regulate glucose, a type of sugar in the blood. (Type 2 diabetes is more common and prevalent among African Americans.) Without insulin, glucose stays in the blood and can’t reach the muscle, liver and fat cells where it’s stored for use as energy. What’s more, complications of the disease can result in other illnesses, such as blindness, hearing loss, heart disease, hypertension, kidney failure and lower limb amputations. “Diabetes affects you from your head to your toes because that’s where the blood flows 24/7,” explains Jeannette Jordan, a registered dietitian and certified diabetes educator from realhealthmag.com
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Novo Nordisk. Jordan is also on the campaign team with Reverend Run and his wife, Justine. “We don’t need that extra sugar in the blood,” Jordan says. “We need blood sugars in their normal range so people can live a long, healthy life.” But if diabetes goes untreated, the disease becomes a killer. In fact, according to the American Diabetes Association, diabetes contributes to the deaths of almost 232,000 Americans each year. But if diabetes is detected and treated in its earliest stages, it’s possible to save lives. “If you already have diabetes, the good news is the disease can be managed,” Jordan says. “You don’t have to end up with all the complications.”
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ustine admits that when her husband first joined the campaign last year, she numbered among those who are unaware and uneducated about diabetes. “Some of the risks, such as being over 45 and overweight, African American with a family history of the disease, I was all those things at that time,” she reveals. “I was scared to take the diabetes risk factor test.” Reverend Run’s involvement in the campaign helped open his wife’s eyes to the truth about diabetes. She learned that people living with the disease can often control it by making healthy lifestyle changes. “And if you don’t have diabetes,” she says, “you can avoid it and stop the cycle.” The illness is a subject close to Justine’s heart. Her father had diabetes, her grandfather died of it, and her aunt fell into a coma because of the disease. As Justine can attest, diabetes is not confined to older adults. “It had slipped my mind, but my cousin died young of diabetes,” Justine says. “She didn’t take her insulin, and her diabetes got out of control.” But many people don’t understand the connection between insulin and diabetes. One of the key messages of the campaign is to educate folks about this aspect of the disease. “In diabetes, you really need insulin,” Jordan says. “Insulin is something that helps diabetics better control their blood sugar.” In Reverend Run’s family, his father had diabetes. “I heard about it around the house,” he recalls. “When my dad died, he was managing the disease, but I don’t know what else he had going on in his life, or if he died from the complications of diabetes. That’s what motivated me to become proactive instead of reactive. When you’re proactive, you can probably stop the disease before it gets to you.” In the Reverend’s book, when it comes to diabetes, confrontation—and screening—is everything. “Many people are scared to find out what’s going on in their lives,” he says. “But what you don’t know can hurt you, so confront it. I always tell people, ‘If you’re afraid, just take your little afraid self
straight to the doctor.’ The thing is, you’re going to be afraid, but when you find out your test result, at least you’ll be able to attack the disease more effectively.’” Reverend Run admits that he also had to confront his own fears. “I started believing I might have diabetes,” he says. “I didn’t know what was going on with me, so I went to the doctor.” Fortunately for Reverend Run, the tests showed he didn’t have diabetes. But based on everything he’d learned about the disease’s risk factors, Reverend Run decided to change his lifestyle. “I’ve lost some pounds; I’ve been working out; I weigh in every Wednesday—and I’m someone who’s always avoided scales,” he says with a laugh. “I’ve found that—and I preach this—what you don’t confront, you can’t heal.” To manage diabetes, lifestyle changes are key. Research shows that the disease—and in particular type 2 diabetes— responds almost magically to eating healthier foods along with getting moderate levels of physical activity. Jordan suggests that parents embrace healthier lifestyles and become better role models for their children. When she realized the role diet played in contributing to diabetes, Jordan switched from cooking fried chicken, rice and gravy, potato salad and mac and cheese— the foods she grew up on—and began serving healthier foods. As a result, her daughter also began to eat healthier. “What we want people to know is that making these changes isn’t as difficult as they might think,” Jordan says. “I still eat a lot of the foods that I enjoy, but I don’t eat as much and I’m preparing them differently.”
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t Reverend Run’s house, his family’s diet has also undergone a transformation. “Now, it’s fresh fruits and vegetables,” Justine says. “Our 18-year-old son, Diggy, he goes to the store to get spinach, or he gets mad because we don’t have any broccoli in the house, or he’s driving to the store to make sure he has lean meats, and he’s eating brown rice.” She pauses then adds, “And fortunately slash unfortunately, he’s also watching us like a hawk. He’s like the doggone police. But it’s all good!” Then Justine suggests readers visit AskScreenKnow.com to take Novo Nordisk’s diabetes risk factor assessment. (You can also take the American Diabetes Association’s Diabetes Risk Test on the next page, or at diabetes.org/risktest.) Justine wants readers to take the pharma company’s test because: “If you take Novo Nordisk’s diabetes assessment online, you’re eligible to come to Run’s house and take a little tour,” she says. “We’ll have a diabetes educator there to teach you a lot of different things about diabetes, healthy lifestyle and exercising. We’re really excited about that.” ■
(REV. RUN, JUSTINE) COURTESY OF NOVO NORDISK AND “ASK.SCREEN.KNOW”
MANY PEOPLE BELIEVE IF DIABETES RUNS IN THEIR FAMILY, THEY WILL GET IT. NOT TRUE.
ARE YOU AT RISK FOR
TYPE 2 DIABETES? Diabetes Risk Test 1 How old are you? Less than 40 years (0 points) 40—49 years (1 point) 50—59 years (2 points) 60 years or older (3 points)
Write your score in the box.
2 Are you a man or a woman? Man (1 point)
Woman (0 points)
3 If you are a woman, have you ever been diagnosed with gestational diabetes? Yes (1 point)
No (0 points)
4 Do you have a mother, father, sister, or brother with diabetes? Yes (1 point)
No (0 points)
5 Have you ever been diagnosed with high blood pressure? Yes (1 point)
No (0 points)
6 Are you physically active? Yes (0 points)
7
No (1 point)
What is your weight status? (see chart at right)
If you scored 5 or higher:
Weight (lbs.)
4’ 10”
119-142
143-190
191+
4’ 11”
124-147
148-197
198+
5’ 0”
128-152
153-203
204+
5’ 1”
132-157
158-210
211+
5’ 2”
136-163
164-217
218+
5’ 3”
141-168
169-224
225+
5’ 4”
145-173
174-231
232+
5’ 5”
150-179
180-239
240+
5’ 6”
155-185
186-246
247+
5’ 7”
159-190
191-254
255+
5’ 8”
164-196
197-261
262+
5’ 9”
169-202
203-269
270+
5’ 10”
174-208
209-277
278+
5’ 11”
179-214
215-285
286+
6’ 0”
184-220
221-293
294+
6’ 1”
189-226
227-301
302+
6’ 2”
194-232
233-310
311+
6’ 3”
200-239
240-318
319+
6’ 4”
205-245
246-327
328+
(1 Point)
(2 Points)
(3 Points)
You weigh less than the amount in the left column (0 points)
Add up your score.
You are at increased risk for having type 2 diabetes. However, only your doctor can tell for sure if you do have type 2 diabetes or prediabetes (a condition that precedes type 2 diabetes in which blood glucose levels are higher than normal). Talk to your doctor to see if additional testing is needed. Type 2 diabetes is more common in African Americans, Hispanics/ Latinos, American Indians, and Asian Americans and Pacific Islanders.
For more information, visit us at www.diabetes.org or call 1-800-DIABETES Visit us on Facebook Facebook.com/AmericanDiabetesAssociation
Height
Adapted from Bang et al., Ann Intern Med 151:775-783, 2009. Original algorithm was validated without gestational diabetes as part of the model.
Lower Your R isk The good ne
ws is that yo u can manag risk for type e your 2 diabetes. Small steps big differen make a ce and can help you liv healthier lif e a longer, e. If you are at high risk, yo ur first step see your do is to ctor to see if additional te needed. sting is Visit diabet es.org or ca ll 1-800-DIA information, BETES for tips on gett ing started, ideas for sim and ple, small st eps you can help lower take to your risk.
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STEP
LIVELY If your feet cause you pain, don’t try to walk it off. Instead, take the advice of this foot specialist. By Jeanette L. Pinnace, DPM
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Feet also help us maintain our balance, absorb the shock of movement and support our body weight. That’s why, if we suffer a foot injury, it can totally affect our quality of life. During my years in private practice as a podiatrist, I’ve seen many patients with a variety of conditions that caused their feet to hurt. In many instances, the foot pain they suffered either signaled an underlying condition or created other health problems in their lives. Mary was an active 80-year-old woman who arrived in my office one day complaining of difficulty walking. Mary said she felt pain in her right heel when she tried to put her foot down. After I examined the sole of her heel, I found a mole in its center. The mole was asymmetric, had an irregular border, variation in color (black to dark brown) and measured 4 millimeters in diameter. Mary’s diagnosis? Melanoma, a skin cancer that can be deadly if not treated early. Mary was perplexed she’d been diagnosed with cancer. She had been seeing an internist on a regular basis and always got a clean bill of health. But like many other people who visit their doctor for a physical exam, Mary didn’t get her feet checked. After my diagnosis, Mary underwent surgery. 2 4 REAL HEALTH S U MME R 2014
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Doctors removed half her heel and fitted her with a heel prosthesis. The surgery saved her life. Mary’s melanoma is an example of a foot problem that signaled a dangerous illness. But many of the stresses on our feet stem from everyday activities, such as standing and walking for long hours and wearing the incorrect type of footwear. One common foot problem is Morton’s neuroma, an inflammation of the nerve between the third and fourth toes. Th is condition can cause burning and pain that feels like electric shocks. If your job requires standing and walking for hours, Morton’s neuroma could lead to balance problems as you try to relieve the pain by transferring body weight from one leg to the other.
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ut while you may not be able to change jobs, you can address foot pain by fitting your shoes with pads and inserts to comfort the soles of your feet. Shoe inserts may seem like a minor fi x, but just this small change can allow you to do your job without wincing at every step. Remember the hot TV series Sex and the City? “Hello lover,” coos Sarah Jessica Parker’s character Carrie Bradshaw
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to a pair of Manolo Blahnik stilettos in an episode of the show. Indeed, many women who love high heels feel the same as Bradshaw. They’d absolutely kill for a pair of these famous designer shoes. But let’s face it, wearing beautiful shoes shouldn’t have to include putting yourself at risk of an ankle injury. “For 10 or so years, I literally ran in heels,” Parker told an interviewer for Net-a-Porter, an online fashion magazine. “I worked 18 hour days and never took them off.” Is it any surprise that the superstar developed foot problems? When Parker went to a doctor after the cheap, plastic-soled shoes she wore for a movie role caused her to slip and twist her ankle, she said he told her that she’d created a bone in her foot that shouldn’t have been there. (By the way, plastic shoes are always bad news. Unlike shoes made of leather, they don’t allow your skin to breathe.) Like Parker, many women suffer from foot problems because they wear high-heeled shoes. When Grace, a secretary friend of mine, told me she couldn’t switch from high heels to flat shoes, I was shocked to learn why. Grace had worn high-heeled shoes for so long that she’d shortened the muscle in the back of her leg. As a result, she
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lthough the foot is a complex structure made up of 26 bones, 33 joints and 200 muscles, tendons and ligaments, we often take this body part for granted. But the feet are our body’s main mode of transportation— according to the American Podiatric Medical Association, by the time we reach age 50 we’ve already logged 75,000 miles on our feet.
could never put her heels flat on the ground. But wearing high heels isn’t the only source of discomfort that can lead to foot deformities. Injuries also result when you jam normally square-shaped feet into pointytoed shoes. Crowding the feet into too-small shoes can cause hammer, claw or mallet toes. Th is happens when the toes bend into irregular shapes. What’s more, squeezing the feet into shoes that don’t properly fit can also result in corns, calluses and pain that will have you limping through life. In addition, ill-fitting shoes may also cause ingrown toenails, fungal infections, bunions, pain under the ball of the foot, stress fractures and pain under the big toe. Just kick this thought around for a minute: If your tootsies hurt, you will be unhappy too. Th is is why it’s especially important to protect the feet with well-fitting, supportive shoes when you exercise. High-impact activities such as jogging require really good shoes to avoid corns, calluses, blisters, muscle cramps and ankle injuries.
B
ut sometimes a foot disorder doesn’t cause the feet to hurt. Helen, another patient, came to see me for a pain in her lower back. After an examination, I learned one of her legs was shorter than the other. The difference was just enough to cause Helen back pain. To address the problem, I had Helen fit the shoe she wore on the shorter limb with a lift. Once she stood without any height difference, her back pain resolved. In addition, systemic diseases such as diabetes, peripheral artery disease, ulcers, gout, neuropathy and arthritis can also affect the feet. Also, because the feet are further away from the heart, circulation problems can occur. Over the years, I observed that older women seem to have a lot more foot problems than younger women. But a study done by the
PUT YOUR BEST FOOT FORWARD TIPS FOR MAINTAINING YOUR TOOTSIES ■
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Regularly examine your feet, and pay attention to any changes in how they look or feel. Treat yourself to regular pedicures at home; if you can afford to splurge, then visit a nail salon—but bring your own pedicure tools. Regularly eliminate thick, dead skin that can build up on your feet. These calluses usually form on the heel, ball and sides of the feet. Soak feet in warm water then use a pumice stone, exfoliating scrub or a file to remove the unwanted layers. Apply foot moisturizer to keep the skin soft. Just make sure the skin between your toes stays dry. When you’re in the sun, don’t forget to slather sunscreen on every part of your foot, including the top and front of your ankles. Reapply sunscreen after a dip in the water. Keep the blood flowing by exercising your feet whenever possible. Flex your ankles, wiggle your toes and stretch your calf muscles. Avoid fungal infections by drying out workout sneakers (in the sun when possible) and wearing socks made of material that wicks away sweat. Buy your shoes later in the day when your feet tend to be their largest. (And make sure your shoes fit properly as comfort is key.)
Of course, never ignore foot pain. Schedule an appointment with a podiatrist for a full evaluation of the problem.
National Institutes of Health on this issue couldn’t explain why. Still, you don’t need fi ndings to know that your feet must last a lifetime. That means like any other part of your body your feet need attention and regular examinations. Whenever you go for your annual physical, be sure the doctor checks your feet—it might very well alert you to an underlying health problem. In addition, if you have a systemic disease, such as diabetes, it is especially important to get your feet checked by a podiatrist. When it comes to your health, don’t take a chance by doing it yourself. Many common foot problems, such as nail fungus, can put you at risk of other serious infections, especially if your immune system is not functioning to provide maximum protection. For example, people with diabetes, leukemia and AIDS, or those who’ve received a transplanted organ, are particularly at risk of more severe illnesses if they have nail fungus or some other minor foot injury. A fungal infection of the nail or skin (athlete’s foot) creates cracks and other openings that may invite bacteria to invade the body and cause infections elsewhere. (Nail fungus is notoriously difficult to treat. But two promising new topical treatments—efinaconazole and tavaborole—are in various stages of the FDA approval process.) In general, you can take many steps to care for your feet that don’t require a visit to the doctor. Most important, always inspect your feet and don’t let them become a forgotten body part. Keep the skin of your feet hydrated (but make sure the area between the toes stays dry to avoid inviting a fungal infection); trim nails straight across; and wear sandals when in moist, warm areas such as at pools and showers located at the gym. Remember, for overall good health, treat your feet well. Simply put, this means don’t neglect your feet and allow minor foot problems to become major disabilities. ■
(POGUE) DUSTIN FENSTERMACHER; (CHILDREN) COURTESY OF ERIC POGUE
Char marks make foods look very appetizing, but it’s best to line the grill with foil before cooking anything. 2 6 REAL HEALTH S U MME R 2014
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(POGUE) THINKSTOCK DUSTIN FENSTERMACHER; (CHILDREN) COURTESY OF ERIC POGUE
SMOKIN’ HOT Before you fire up the barbecue, get informed about the connection between grilled meat and cancer. But don’t worry—you can lower your risk without losing any of the flavor or summer fun. By Kate Ferguson
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during the late 1940s and 1950s, many migrated to the suburbs with their families. In these spacious environments, they bought homes that came attached to big backyards and other open spaces ripe for outdoor activities. One of the pastimes families began enjoying was eating outdoors. People needed a portable way to cook. Enter wheeled brazier grills. But cooking food on brazier grills was iff y. The units were notorious for burning the food on the outside while leaving it uncooked inside. What’s more, when a stiff wind whipped up, charcoal cinders would fly everywhere. As you might expect, these grills were soon dethroned by more improved and efficient models—the predecessors of today’s modern gas and electric grills. But regardless of the type of grill used, when you ignite a flame under meat, or any other food on a grill, something interesting happens: A chemical reaction transforms that piece of raw meat into a lip-smacking treat. More specifically, the meat undergoes a phenomenon called the Maillard reaction, better known as browning. The heat of the fire causes amino acids and sugars in meat to interact and form a bonanza of new compounds. That’s when the surface of the meat becomes golden brown and crunchy. What’s more, the reaction affects the meat’s flavor, as does the amount of fat on the meat. The reaction is named after Louis Camille Maillard, a 20th century 2 8 REAL HEALTH S U MME R 2014
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Although findings show that HCAs and PAHs can cause cancer in animals, scientists aren’t sure these chemicals cause cancer in human beings. “One difficulty with conducting such studies is that it can be difficult to determine the exact level of HCA and PAH exposure a person gets from cooked meats,” says the National Cancer Institute (NCI). “Although dietary questionnaires can provide good estimates, they may not capture all the detail about cooking techniques that is necessary to determine HCA and PAH exposure levels.” In general, meats grilled at temperatures
above 300 degrees have high concentrations of HCAs, and smoking or charring the meat (as some devotees prefer), further contributes to PAHs forming. Right now, findings show an association for increased risk of colorectal, pancreatic and prostate cancers among those who consume large amounts of well-done, fried or barbecued meats.
EVER THOUGHT ABOUT USING BEER AS A MARINADE? CERTAIN BREWS CAN REDUCE CANCER-CAUSING CHEMICALS THAT FORM ON MEAT.
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When American soldiers returned home
French scientist. He discovered that when a mixture of sugars and amino acids was heated, it gradually turned brown. Meat, of course, is protein that contains amino acids and sugars (the carbohydrates in the feed the animal digests is converted into sugars its muscles need to burn for energy). When meat is cooked, its outside surface is hotter than the inside. This triggers browning and concentrates the strongest flavors on the meat’s surface. The result? Your mouth gets hit with tons of flavorful sensations when you bite into grilled meat. You can enhance this flavor boost by marinating meats in a mix of tasty spices and liquids before grilling them. Unfortunately, not all the chemicals produced by this cooking process are harmless. Some may increase your risk of cancer (though this will depend on the type of meat and cooking method you use). The chemicals to look out for are called heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs).
This is why the World Cancer Research Fund and the American Institute for Cancer Research (AICR) suggest limiting the consumption of red meat as well as processed or smoked meats. The good news, according to the NCI, is that cooks can stop these chemicals from forming. A few simple steps will cut the risk: Partially cook meat in a microwave before grilling or pan frying; reduce the amount of time the food is cooked; and line grills with foil so the meat isn’t directly exposed to an open flame or a hot metal surface. In addition, buy lean cuts or trim the fat before grilling meats; flip often; remove charred or burnt pieces; and don’t make gravy from the drippings. Also, cut back on grilling certain types of meat, such as the red and processed meats associated with higher risks for colon cancer. Another solution to healthier summer backyard grilling is to add fish and chicken to the menu. Also, use spices, herbs, hot peppers and sauces to marinate white meat. Indeed, studies show that marinating meat, poultry and fish for at least 30 minutes can reduce the formation of HCAs. “Using a mixture of vinegar, lemon juice or wine along with herbs and spices seems to be the key,” says the AICR. Scientists don’t know precisely how these marinades help lower HCAs, but researchers believe that compounds in these ingredients are responsible. And how about beer as a marinade? Recently, researchers found that brewskis could in fact help lower PAH formation in grilled meat. Pilsner and black beer are the beverages to reach for to mix up a marinade, say scientists from the American Chemical Society. Why? Because these beers, when used as a marinade, cut the amount of PAHs in half. For this study, researchers marinated samples of pork for four hours in pilsner beer, non-alcoholic pilsner beer or a black ale and then cooked them on a charcoal grill until the pieces of meat were well done. Findings showed black beer had the strongest effect and reduced the levels of eight major PAHs by more than half when compared with unmarinated pork. The scientists, whose results were
published in the Journal of Agricultural and Food Chemistry, concluded “the intake of beer-marinated meat can be a suitable mitigation strategy” for those concerned about grilling and cancer. Marinades are also a great way to flavor meats before you grill them. Elizabeth Karmel, author of Soaked, Slathered and Seasoned: A Complete Guide to Flavoring Food for the Grill, serves up these finger-lickin’ coatings among a variety of “flavor accessories” that make grilled foods unforgettable. Mop sauces, rubs and barbecue sauces can enhance the flavor of grilled meats, she suggests. According to Karmel, marinades are a
liquid mix of a fat and an acid—for example, an oil and a vinegar. A rub is a powder or a paste made from herbs, spices and other ingredients. Mop sauces are thin liquids made from ingredients such as tomato juice or beer, and a barbecue sauce is usually a thick, sweet sauce. Homemade barbecue sauce can double as a marinade. These concoctions are usually made from a tomato sauce and cider vinegar base loaded with a multitude of spices, splashes of hot sauce, and a dash of lemon juice. Many grill gods and goddesses swear by a slowly simmering mix over reduced heat. As the mixture simmers, you can add a variety of flavor enhancers to suit your taste. For a sweet barbecue sauce, the usual additions include brown sugar, honey or molasses—even agave nectar. And if you crave a fiery hot sauce, try cayenne pepper or chilies. But to steer clear of high levels of HCA formation on grilled meats, don’t add too much sugar to marinades, experts caution. Finally, one last way to avoid PAH forming on grilled or barbecued meat is plain common sense: Clean the grill after each use. Simply scrubbing down a dirty appliance can get rid of builtup, cancer-causing residues from previous grilling. The result? None of that gunk can get into your freshly grilled steaks, chicken breasts or pork chops and then into your body. ■
Unexpected Flavors Forget meat. You can grill so many other foods! Who says only slices of chicken, beef, pork and other meat can stand up to the searing heat of a grill’s metal bars? Not us! Practically any food you can think of is worthy of this cooking technique that acts as a flavor enhancer to boot. If you’ve never tried grilling veggies, you may not think to include fruit, bread, cheese and even cooked rice on a list of foods to grill. But that would be a real mistake. These everyday foods can become grilled favorites that might just bump meat off your plate. Ever heard of grilled pineapple, watermelon, apples, peaches and pears? Yup! All of these luscious fruits can take the heat. According to cuisine experts, when fruits are firm and barely ripe, soak them in liquor or drizzle them with a little honey, agave nectar, maple syrup or some other liquid sweetener—and then brush them with oil and grill ’em. (Note: Most, but not all, fruits should be peeled before you grill them.) But if you just prefer to tackle veggies for now, follow this general rule of thumb: Don’t peel the veggie; simply brush on some oil then place on the grill. To shorten the cook time for certain grilled veggies, you can pre-cook them by steaming or blanching (submerging them for a few minutes in furiously boiling water) until they’re a tad tender. But be aware that other veggies—especially eggplant, fennel, onions, mushrooms, peppers, sweet potatoes, summer squash and tomatoes—should be raw when you drop them on the grill. You can even grill ice cream—yes, you heard right. But first dunk a scoop of the stuff in egg batter and roll the ice cream in a tasty dry food (think: bread crumbs or shredded coconut) to form an outside shell before grilling. Hey, have fun. The idea is to open yourself to new taste sensations!
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FLAKE
OFF!
Although dandruff provides equal opportunity embarrassment for everyone, African Americans shoulder more of the problem. By Gerrie E. Summers
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(POGUE) DUSTIN FENSTERMACHER; (CHILDREN) COURTESY OF ERIC POGUE
to develop that can lead to yeast infections of the scalp, or conditions such as seborrheic dermatitis.” In general, washing the hair less often may cause product buildup and scalp itchiness and irritation, but cleansing is key. “Shampooing keeps bacteria and fungus under control underneath the extensions, soothes the symptoms associated with dry and itchy scalp conditions, removes odor
What Causes Dandruff When the scalp becomes irritated, the body’s response is to speed up cell turnover, which causes abnormal shedding of dead skin cells. The excess skin cells clump together into visible, fine, white flakes. One common irritant is malassezia, a fungus already present on the scalp. This fungus feeds on sebum (oils) on the scalp, and, in susceptible individuals, it can grow out of control and lead to dandruff. In addition, certain illnesses, such as eczema, psoriasis or autoimmune diseases, can cause dandruff. And dry weather, hard tap water, poor diet, dehydration, hormonal changes and overproduction of sebum can also contribute to the condition. What’s more, improper hair care and certain hairstyles and products can make matters worse.
HEAD-SCRATCHERS
Hairstyles Tight hairstyles such as braids and extensions can aggravate dandruff problems “by increasing stress to the scalp that results in additional dryness and inflammation,” says dermatologist Neal Bhatia, MD, an associate clinical professor at Harbor-UCLA Medical Center in Los Angeles. In addition, says Latoya Brown, the director of education for the Basic Hair Care product line, “The improper installation and use of hair extensions can cause a breeding ground for hair and scalp problems.” Infrequent Shampooing “Wearing extensions and braids without weekly or biweekly shampooing is also very hazardous for the hair and scalp,” Brown continues. “This creates a prime situation for fungi and bacteria 3 2 REAL HEALTH S U MME R 2014
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Don’t mistake these scalp disorders for dandruff. Seborrheic dermatitis Dandruff is often described as mild seborrheic dermatitis. But in seborrheic dermatitis, the flakes transform into greasy, yellowish patches of red, inflamed skin that can also appear on the ears, eyebrows, chest and other areas of the body that have oil-producing glands. (Plain ol’ dandruff appears as fine flakes but comes without the inflammation.) Scalp psoriasis This autoimmune disease causes skin cells to grow too quickly and appear as patches of thick, red scaly skin, silvery white scales or dandruff-like flakes that cause itchiness, a burning sensation or soreness. Psoriasis and seborrheic dermatitis often look similar (and some individuals can have both conditions at once) making it difficult to diagnose. The scales of scalp psoriasis are thicker than those of seborrheic dermatitis and can affect the skin surface on other parts of the body. Head lice These tiny wingless insects feed off blood in the scalp. Lice lay their eggs, a.k.a. nits, in the hair shaft close to the scalp. When the nits hatch and feed, this causes itching. The appearance of lice eggs, plus itching, is often mistaken for signs of dandruff.
caused by sweat and oil buildup, and also deeply moisturizes and refreshes the hair,” Brown says. “But in the end these hairstyles compound the problem to the point where it may become necessary to make a choice,” Bhatia says. “Dandruff versus fashion.” Hair Washing Tips If you have an active lifestyle or are exposed to higher levels of air pollution, Brown offers this advice. “Wash hair weekly with a well-balanced moisturizing shampoo and conditioning system,” she says. “Weekly shampooing also cuts down on dandruff, bacteria and fungi that are normally produced by excreted hormones, pollutants (internal and external), product buildup, oil buildup, skin infections and infrequent hair washing.” Brown also adds that some African-American women have hair that tends to be dry and requires more moisture; for healthy scalp and hair, they should choose moisturizing products that don’t cause additional problems. Bhatia notes that oils, pomades and other products made with similar ingredients might exacerbate dandruff and dryness that can result in more scaling. Dandruff-Relieving Ingredients To relieve dandruff and to moisturize the scalp, try coconut or olive oil. In addition, to reduce fungi, it’s helpful to spritz apple cider vinegar onto the scalp and then rinse it off. Another natural remedy for dandruff is tea tree oil (found in Basic Hair Care’s Carbon Tea Tree shampoo). But if dandruff is persistent despite regular shampooing, you may need to switch to a medicated dandruff shampoo containing one of the following ingredients: zinc pyrithione, tar (coal tar), selenium sulfide, salicylic acid or ketoconazole. When dandruff is very resistant, Bhatia recommends folks try Promiseb Scalp Wash. “The No. 1 error in dandruff treatment is that people forget that the disease starts in the scalp, not in the hair,” Bhatia says. “Many treatments fail because people do not leave over-thecounter or prescription meds on the skin long enough for the scalp to absorb the medication.” ■
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ll races and ethnicities get dandruff, but according to market research, the itchy, flaky and difficult-to-treat scalp disorder is more prevalent among African Americans than other population groups. What’s more, the condition can be particularly challenging for black women because treatment requires daily hair washing—a no-no for fragile, dryness-prone black tresses.
Hail Merry Macaroons (8-pack, $40, hailmerry.com) Bite into these luscious little mounds without one ounce of guilt! They’re big on strawberry, caramel sea salt and chocolate flavor, but gluten-free, organic and vegan.
Contents EarthSilk Glossifyer and Scalp Conditioning Cream ($35, $30, contentshaircare.com) These professional treatments promote hair growth, moisturize tresses, stop shedding and breakage, and protect hair from heat and sun damage.
Element Rice & Corn Cakes (from $23.94 to $47.88 for boxed packs, elementsnacks. com) Satisfy a snack attack with these crunchy, totally gluten-free discs. Topped with smooth chocolate or creamy fruit, they boast only 5 grams of sugar.
Stuff We Love
A ROUNDUP OF THE LATEST, MUST-HAVE FINDS FOR HAIR, SKIN, HEALTH, BEAUTY AND MORE. THESE PRODUCTS ARE WORTH EVERY CENT.
Honest Tea Heavenly Lemon Tulsi (16 fl. oz., $1.49 per bottle, honesttea.com) A great summertime thirst quencher, this light, refreshing tea is made from a naturally caffeine-free herb and infused with flavors from aromatic lemon peel, lemon myrtle and lemongrass.
OurSkinny The Easiest Diet Ever (About $10 per day, ourskinny.com) These satisfying high-protein shakes, bars and snacks are also low in fat, calories, sugar and carbs —perfect for dieters who crave simplicity. FitKnix (a hi-tech line of women’s underwear, $24 to $34, knixwear. com) Active women will love these undies made with FreshFix technology that wicks away moisture while eliminating odor.
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THOUGHTS
Soothing the Hurt Many people choose meds to manage chronic pain, but alternatives exist. Nearly 100 million Americans suffer from acute and chronic pain. They endure persistent pangs, stings, stiffness and any number of uncomfortable sensations for days, weeks, months or years. That said, besides dispensing a prescription, many doctors suggest treatments that physicians would have sneered at just a few years ago. Depending on the nature of the ailment and the kind of pain felt, some of the most common alternative treatments include acupuncture, medical marijuana, regular physical activity, yoga, relaxation therapy, music therapy, massage, hypnosis, chiropractic treatments and supplements. At the Burn Care Center at MetroHealth Medical Center in Cleveland, Ohio, doctors use music therapy to help distract burn patients from the often-agonizing pain they feel when their dressings are changed. Essentially, music therapists instruct the burn patients to hum along to a song, beat a tempo on small instruments, keep time verbally with a tune, sing lyrics or participate in some other way. “One of the things we realized,” says the burn center’s founder Richard Fratianne, MD, “is that music can have a calming effect on people.”
Finding Relief Mark Collen’s art gives voice to his pain.
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The Expert Says According to Richard Fratianne, MD, founder of MetroHealth’s Burn Care Center in Cleveland, Ohio, music therapy is ideal for those seeking pain relief. How does music therapy help burn patients deal with pain? While patients are concentrating on
participating in the musical experience, they can’t think about the pain and all the things that make them anxious. How do you measure a burn patient’s pain and anxiety levels during music therapy? To do this, we ask the patients to selfdescribe their level of pain and anxiety before, during and after their dressing change, while a nurse and the music
therapist also observe and evaluate the same things. And we measure their pulse and respiratory rates and the stress hormones their body produces before and after music therapy is used. Is music therapy used to alleviate the pain of other illnesses? Doctors have begun to use music therapy to treat patients receiving chemotherapy in cancer wards.
(“HAPPY PILLS”) COURTESY MARK COLLEN
In 1995 while placing a box in my car, I felt a sharp pain shoot down my left leg. I had a herniated disk in my lower back that stuck directly into the nerve root on the left side causing me severe nerve pain. This was the beginning of my life with chronic pain. Within a few months of the injury, I had back surgery. Unfortunately, it failed to provide adequate relief, and I began to search for a physician to help me. For years, I went from doctor to doctor seeking quality pain management but to no avail. The suffering became so intolerable that the only feasible solution I could envision was suicide. During a suicidal episode, I created a piece of art that reflected what I was going through. The piece is titled “Chronic Pain.” The act of making the art helped me get through the crisis safely by taking all the intense emotions from inside my body and placing them on the outside into the art. It was a true catharsis. —Reprinted with permission of the American Chronic Pain Association
READER SURVEY
SPEAK YOUR MIND! (And Win Free Stuff)
During the past decade, sexual attitudes about many issues have changed markedly in the United States and Britain, according to recent survey findings in each country. How do you feel about sex? Real Health wants to know what you think, so please take the survey below.
Achieve your workout goals now!
As a thank you, we’ll select two winners at random whose surveys we receive and send them a fitness DVD (suggested retail price $7.82 to $8.99). For official contest rules, visit realhealthmag.com/survey.
1. Do you approve of same-sex partnerships?
11. What is your household income?
❑ Yes
❑ Under $15,000
❑ No
❑ $15,000–$34,999 ❑ $35,000–$49,999
2. Is sex only for the young?
❑ $50,000–$74,999
❑ Yes
❑ $75,000–$99,999
❑ No
❑ $100,000 and over
3. Should sex only take place within marriage?
12. What is the highest level of education attained?
❑ Yes
❑ Some high school
❑ No
❑ High school graduate ❑ Some college
4. Do you believe the main purpose of sex is to have children?
❑ Bachelor’s degree or higher
❑ Yes
13. What is your ethnicity?
❑ No
❑ American Indian or Alaska Native ❑ Arab or Middle Eastern
5. Is masturbation part of a healthy sexual life?
❑ Asian
❑ Yes
❑ Hispanic or Latino
❑ No
❑ Native Hawaiian or other Pacific Islander
❑ Black or African American
❑ White
6. Is it OK to have multiple sex partners within a relationship?
❑ Other
❑ Yes
14. Where do you get Real Health?
❑ No
❑ I’m a subscriber ❑ My doctor’s office
7. Do you approve of one-night stands?
❑ My church
❑ Yes
❑ A community or college organization
❑ No
❑ It was mailed to me ❑ Other:_______________________
8. In general, do you consider yourself sexually adventurous?
15. Do you have Internet access?
❑ Yes
❑ Yes
❑ No
❑ No
9. What year were you born?_________
16. Name:___________________________________________ 17. Organization (if you represent one):______________________ 18. Street address:_____________________________________________ 19. City & state:_________________________________________________ 20. ZIP code:____________________________________________________ 21. Email:________________________________________________________ 22. Phone:_______________________________________________________
10. What is your gender? ❑ Female ❑ Male ❑ Transgender ❑ Other
Summer 2014
Gaining weight was easy. Losing it's a lot harder...
but very much worth the effort.
You have to work at losing weight. Every day. But with every step, you lower your risk for type 2 diabetes and heart disease. Because many of the nearly one million deaths each year from type 2 diabetes, heart disease and stroke could be prevented with a few lifestyle changes, including weight loss, regular physical activity and healthier food choices.
It’s not easy. But it is worth it.
Learn how you can help stop diabetes by losing weight, eating healthy and staying active. Visit checkupamerica.org or call 1-800-DIABETES.