DECEMBER 2015 | VOL. 8 — ISSUE 12 | COMPLIMENTARY
Getting
Asthma
on the Run PLUS 7 New Year Challenges Baking without white flour Importance of vitamin D
O regOn H ealtHy l iving . cOm
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Healthy Food 4 Less Sherm’s Food 4 Less has over 2,500 square feet dedicated to healthy lifestyles which includes our organic produce and bulk food section. This area features the best of locally grown fruits and vegetables at hard to beat prices.
Natural Organic Gluten-free Bulk whole grains Compare our large selection of natural and organic products offered at the lowest possible prices.
A complete health care store within a store. Sherm’s Food 4 Less • 2230 Biddle Rd. • Medford
SAUSAGEWHITE STUFFED PEPPERS CHILI
Buy these ingredients at Food 4 Less Ingredients • 1 pound ground white meat Ingredients 10 oz Lean ground turkey or chicken 2/3 Cupturkey sour cream, reduced fat • 1 tablespoon olive oil
sausage, cooked and crumbled • 2 (15.5-ounce) white beans 8 Wedges light cheese, cans chipotle queso • 1 medium onion, diced such as cannellini, preferably 2 Tsp olive oil, extra virgin1 1/2 cups) fresco, (laughing cow brand) (about low-sodium, 1 Small onion, chopped 1/4 Tsp chili powder drained and rinsed • 2 stalks celery, diced • 4 cupsdried low-sodium chicken broth (about 1/2 cup)chopped 1 Large green or red bell pepper, 1 Tsp parsley, • 3/4 teaspoon dried oregano • 3 medium poblano peppers 12 Medium 2 Cloves garlic, minced sweet or mild chili peppers, • 1 (15.5-ounce) can hominy, (about 4 ounces 1 Cup corn, fresh or frozen, cooked each), seeded(cubanelle or anaheim) and rinsed and white ribs removed, finely3/4 Cupdrained reduced fat shredded mexican or Sea salt and pepper to taste • Salt diced (about 1 1/2 cups) cheddar cheese 1/3 Cup fresh cilantro, chopped • 1/4 cup nonfat plain Greek-style • 1 clove garlic, minced
yogurt • 2 tablespoons chopped fresh 1. Preheat oven to 375.teaspoon Line two baking Add salt, pepper, chili powder, cilantro leaves • 1/4 cayenne pepper, mixture. sheets with foil.more Cut peppers parsley and, stirring • Lime wedgesuntil well combined to tastein half and remove ribs and seeds. Place halved pepand cheese is incorporated. Gently fold in pers, cut side done, on prepared pans. Bake chopped fresh cilantro (at this point you Directions for 8-10 minutes, or until slightly softened may refrigerate the mixture up in an air and starting to brown. tight container for a day or two). Heat the oil in large pot or Dutch oven over moderate heat. Add the onion, celery, poblanos, and cook, stirring occasionally, until 2. Over medium high heat, saute turkey 4. Sprinkle the inside of the roasted pepper the vegetables are soft, about 8 minutes. Add the garlic, cumin, cayenne stirring, until sausage in a coriander large skillet and sprayed with and cook, halves with salt andfragrant, pepper. Spoon even cooking spray, until browned, about 6-7 amounts of sausage filling into each and about 30 seconds. minutes; remove from pan and set aside. sprinkle tops with the shredded cheddar In the same skillet, cook onion and green cheese. Add the ground turkey and cook, breaking up the meat with a spoon, until the meat is no longer pink about 2 minutes. pepper in olive oil for 4-5 minutes until Bake peppers for 10-12 minutes at 350 softened. Add stirring garlic andoccasionally, corn, cooking 1-2 Add the white beans, broth and oregano. Cook, partially covered, for 25 minutes. degrees, on foil lined pans. Broil for 2-3 additional minutes. Remove from heat and additional minutes, if desired, to brown add cooked sausage to the vegetables. Add the hominy and salt and more cayenne pepper, to taste, and continue cooking, partially covered, 10 minutes longer. Ladle into tops. Garnish with fresh cilantro or parsley. 3. In a large mixingand bowl1 combine all 8 lightof cilantro. Serving size: 1 pepper half individual bowls and top each serving with 1 tablespoon of yogurt 1/2 teaspoons Garnish with a lime wedge. cheese wedges (unwrapped of course) Makes 12 stuffed pepper halves and light sour cream to the warm sausage • 1 teaspoon ground cumin
Directions:• 1/2 teaspoon ground coriander
Recipe courtesy of Ellie Krieger
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Table of Contents DECEMBER 2015 | VOLUME 8, ISSUE 12
PAMPER
SPECIAL
FITNESS
HEALTH
FOOD
Let the Sunshine in: Vitamin D New Year Challenges: 7 achievable resolutions
5
20/20 in a Day: The latest on LASIK
12
Short of Breath? Don’t let EID sideline you
15
A Bunch of Flours: Which alternatives work?
18
20
Spot-on Radiation: New LINAC machine
14
CALENDAR
Local Events Calendar: Find out what’s happening in your community
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ADVERTISER INDEX
The editor’s desk It is rainy outside as I write this, not so unusual in Oregon in winter. After reading the doctors’ advice about vitamin D, I see I’m clearly not getting enough, particularly since I avoid dairy products. Looks like I — and maybe you — need supplements in our stockings! Next month, we are dedicating the magazine to the topic of chronic pain. An astounding number of our neighbors suffer every day, so we’ll be highlighting the current thinking about how to effectively cope with chronic pain. crose@mailtribune.com
Abdill Career College.............. 17 Allcare Management Services.................................. 11 Ashland Food Co-op .............. 14 The Blue Giraffe Day Spa Salon.......................... 4 Grins4Kidz................................ 4 Medford Food Co-op................ 9 Medicap Pharmacy................... 9
OHL Contributors
Oregon Advanced Imaging....... 3 Oregon Retina Specialist........... 7 Providence Medford Medical Center........................ 24 Sherm’s Food 4 Less.................. 2 Shop’n Kart............................. 21
Cathleen Cole
Margaret Battistelli Gardner
Rebecca Scott
STAFF EDITOR: Cheryl P. Rose
ADVERTISING DIRECTOR: Dena DeRose DESIGN & PRODUCTION: Bret Jackson CONTRIBUTING PHOTOGRAPHERS: Brian Prechtel
4
Cindy Quick Wilson
CONTRIBUTING WRITERS: Cathleen Cole Margaret Battistelli Gardner Rebecca Scott Cindy Quick Wilson
Southern Oregon Foot & Ankle........................... 23 Southern Oregon Subaru........ 10 Oregon Healthy Living Magazine is published by the Southern Oregon Media Group Advertising Department, 111 N. Fir St., Medford, OR 97501. General information: 541.776.4411 To advertise: 541.776.4422 Submissions and feedback: crose@mailtribune.com
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SPECIAL
7
Healthy Challenges Achievable New Year resolutions
L
ooking for a resolution you can actually keep? Though about 40 percent of Americans make annual resolutions, most of those lofty goals have crashed by Valentine’s Day. Fewer than 10 percent of resolutions are kept for the entire year, according to one study. Here are some challenges that aren’t too hard or too expensive that may improve your wellness if you give them a try.
GROW OR RAISE YOUR OWN FOOD “There is nothing like serving a salad and knowing you grew it,” says Kelly Brainard, owner of Ashland Greenhouses in Ashland. “Nothing beats homegrown and ripened on vine for flavor, and you know what went into it – what kind of fertilizer, what kind of water.” Container gardening offers an option for everyone, whether you have a yard or not. A sunny spot on a patio or balcony will do. Brainard suggests choosing varieties that grow well in containers and that produce a lot of fruit. “Lettuces, spinach, kale, microgreens, strawberries and herbs do well,” she says. “Choose patio tomatoes over other varieties and bush beans instead of pole beans.” Another option is to join a community garden, of which there are several in the Rogue Valley. For those tempted by livestock, it’s possible to rent chickens, including the coop, feed and handling instructions. Check out rentthechicken.com if you want to experiment, but with limited commitment.
Degree of Difficulty: Moderate
For fruits or vegetables, Brainard emphasized choosing a container large enough to accommodate root size and investing in good potting soil. “The common mistake is overplanting and trying to shove too much in one container,” she says. “Then the roots are stressed and it affects the yield. Of course, you do have to take care of your plants, but it’s rewarding. It’s possible to produce a lot of vegetables in a small space.”
Cost: $$
In planting, there are startup costs for soil, containers and plants that may reoccur if planting for multiple seasons or expanding. Community garden memberships may require a fee to join and/or a designated amount of service hours.
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SPECIAL
SWITCH OFF REFINED SUGAR
GET MORE SLEEP
Sugar is not inherently evil. It’s bad when we consume massive quantities of it, which Americans tend to do. Over the past 30 years, according to the American Heart Association, Americans have steadily consumed more added sugar in their diets, contributing to the obesity epidemic. Most Americans eat about 20 teaspoons of added sugar a day. “We have become accustomed to added sugar to the point where our cravings run deep, from our palate to the microbiology of our gut,” says Tyler Giles, general manager of HealthWay Nutrition Center in Medford. He suggests limiting foods and beverages with excessive added sugar, but also warns of refined starches, such as white flour.
Getting sufficient, good-quality sleep is critical for many reasons, according to Michael Presti, medical director at the Providence Medford Center for Sleep Medicine. First, chronic insufficient sleep shortens lives. Studies have shown that less than seven hours of sleep a night significantly reduces one’s life span, and this effect becomes exponentially worse with average sleep times of less than six hours. Next, quality of life is powerfully influenced by sleep quality. Insufficient or poor-quality sleep can induce or exacerbate conditions such as depression, anxiety, impulsivity and chronic pain. It erodes cognitive abilities such as attention, problem solving and creativity, often limiting work performance and productivity. “In short, good quality sleep of adequate duration is imperative to feeling your best and realizing your potential across a long, healthy life,” Presti says.
Degree of Difficulty: Moderate
One tip is to wean yourself off sugar slowly – not a cold-turkey, zero-tolerance approach. “It would be foolish to think we should have a zero-sugar diet, as glucose is our primary cellular fuel,” Giles said. “A zero-added sugar diet, meaning the vast majority of sugar comes from whole foods, now that’s worth considering,” Giles says. “We need to do it wisely and with moderation. Please keep in mind that reducing your dietary sugar intake is best done slowly, especially with diabetics and athletes, as they may have unique requirements for sugar intake.” One sugar substitute is stevia, a natural sugar derived from a plant. It has zero calories and is said to be sweeter than refined sugar. Pure Via and Truvia brand products, among others, contain stevia.
Cost: $$
Sweetener substitution products often cost more by comparison.
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Degree of Difficulty: Easy
If you don’t have an underlying physical issue, such as gastro reflux disease, or a sleep disorder, such as sleep apnea, getting quality sleep can just mean practicing good sleep habits. Set a wake-up time and stick to it. Lay off the stimulants, such as coffee, and get some physical activity in each day. Keep the bedroom at a comfortable temperature and quiet. Put down the blue-light emitting device well before bedtime. The normal approximate sleep times per day are 16-plus hours for newborns, 12 to 14 hours for children aged 1 to 3, 11 to 13 hours for children aged 3 to 5, 9 to 11 hours for children aged 5 to 18 and 7 to 9 hours for adults.
Cost: Free
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SPECIAL
MAKE YOUR OWN HOUSEHOLD CLEANERS For Libby VanWyhe, there are multiple reasons to convert to making your own cleaners. “They are cheaper and safer than brand-name cleaners, plus they have a lower environmental impact,” says the nature center manager of North Mountain Park in Ashland. “The antibacterial annihilation you get from store-bought products has the unintended consequence of making microbes more resistant. The stronger the antibacterial solutions press the organisms to evolve to beat them and we end up with supermicrobes that then become very difficult to kill with anything on the market.”
Degree of Difficulty: Easy
Keep it simple, VanWyhe recommends. “If you look on the Internet, there are so many ways to make cleaners, but what all of them have in common is some combination of baking soda, borax and an acid, such as lemon or vinegar.” She recommends buying the base ingredients in bulk. VanWyhe will add essential oil, liquid soap, salt or another simple ingredient to a base multi-purpose powder depending on how she wants to use it.
Multi-Purpose Powder Recipe
1 cup baking soda 1/4 cup borax Essential oil (add drop by drop until you achieve the aroma you want) Combine ingredients in a mixing bowl. Stir well. Sprinkle mixture onto surface and scrub. Store in a labeled and sealed container. This powder can be used as a base for several other cleaning solutions.
Cost: $
Start-up costs involve storage containers, spray bottles and ingredients. After the initial investment, replacement supplies are less than the cost of multiple bottles of brand-name cleansers.
continued on page 8
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SPECIAL
continued from page 7
TAKE A TIME-OUT ON SOCIAL MEDIA Social media can be an addictive time waster and taking the occasional time-out is a healthy habit. When you’re tied into social media too much, it can lead to depression and anxiety, according to Sandy Newsome, a licensed psychologist with Wellness Psychology in Medford. Adults and teens who spend a lot of time on social media, such as Facebook or Instagram, often see others posting wonderful life events that make their own lives look dull. Many get depressed thinking their lives aren’t as good. People can become compulsive about checking social media, fearing they will be left out.
Degree of Difficulty: Moderate
Though deleting the apps is easy, like any addiction, it’s the temptation to backslide that makes this challenge moderately hard. Newsome noted obstacles that interfere with an intended time-out as the accessibility (always at hand in smartphones and with unhelpful alert notifications), job demands that require the technology and peer pressure. During the time off, plan more face-to-face occasions or phone calls to connect with friends.
Cost: Free
MOVE EVERY 20-30 MINUTES Prolonged sitting is tough on muscles, joints and metabolism. “If you do more than 20 to 30 minutes of sitting or stay in any position too long, you begin to lose postural control,” explains Brian Saling, a doctor of physical therapy at Providence Eagle Point Physical Therapy. “We tend to get in habitual positions, but that puts wear and tear on the joints and muscles. The benefit of moving periodically is to put a little challenge on those muscles that would normally shut down during low activity. Stand up and rotate through hips. Swing the shoulders side to side. A couple of seconds of movement is not very much effort at all.”
Degree of Difficulty: Easy
Standing, walking and stretching aren’t difficult for people without impairments, but willpower is. “The hardest part to changing body positions is developing a system when you’ll do it,” Saling says. For those with an office job, Saling suggests setting alarms on a computer or a personal device as reminders. Another idea is to stand every time you take a phone call. At home, he suggests getting up every time there is a commercial break on television or creating other cues to regularly change posture.
Cost: Free continued on page 10
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SPECIAL
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SPECIAL continued from page 9
GO GLUTEN-FREE If you don’t have a physical imperative to give up gluten, there may still be reasons to give going without a try. Angela Lounsbury, the vitamin manager at Natural Grocers in Medford, identifies three top reasons to sacrifice gluten: resolve digestive issues, reduce inflammation and lose weight. “Many people are unable to digest gluten because of how it’s grown and processed these days,” she says.
Degree of Difficulty: Moderate
“It’s much easier to eat gluten-free than ever before,” Lounsbury says. “Nearly every restaurant and grocery store has options. It’s difficult in the beginning, because gluten feeds receptor sites in our brain, making it so addictive. However, once your system is clean, you don’t crave it and it gets easier.” As with any selective diet, it can make eating a bit more of a high-maintenance task and can leave you having to turn down the muffin tray at the office or the pasta dishes at the potluck.
Cost: $$
Gluten-free substitution products often cost more by comparison.
Cathleen Cole, Cheryl Rose and Margaret Battistelli Gardner contributed to this story.
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PAMPER
Foresight is
20/20
If you’re tired of wearing glasses or contact lenses, LASIK can help
TEXT BY CATHLEEN COLE • PHOTOS BY BRIAN PRECHTEL
J
ennifer Hite of Medford was near-sighted and wanted to improve her vision. She’d worn contact lenses for 20 years, but they were often inconvenient for the active outdoorswoman. “I thought it would be nice to be free of them,” she recalls.
Hite researched LASIK surgery and was impressed with the improvements that have been made over the years. “The technology is so much better now,” she says. Last June, Hite had LASIK surgery at Medical Eye Center in Medford performed by Paul Imperia, an ophthalmologist and refractive surgery specialist. During the surgery, she felt only pressure on her eyes. “But not in a way that hurt,” she says. “It’s not painful at all.” Her recovery following the surgery was quick and painless. “I took the following day off from work but I could have worked,” she confirms. “I had zero complications. Within 48 hours I was fully healed.”
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Hite says she couldn’t be happier with her outcome – 20/15 vision. “The results were exactly what I’d hoped for,” she says.
Health and age factors
The latest in LASIK (laser-assisted in situ keratomileusis) is blade-free LASIK – all laser, customized and accurate. The surgeons at Medical Eye Center have been performing blade-free LASIK, utilizing a system approved by NASA for its astronauts, for more than six years. In Imperia’s opinion, anyone 18 or older without serious eye disease who depends on glasses or contacts is a good candidate for the surgery. He believes it’s rare for a patient not to be a
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PAMPER
Dr. Paul Imperia, at right, performs a LASIK procedure at Medical Eye Center in Medford. The results from the procedure typically last the person’s lifetime. “Rarely, a person’s vision can change over time, and we can fine tune it with another laser procedure,” Imperia says. “Also, when people hit their 40s, they will need reading glasses like everyone.”
The surgery
good candidate for laser vision correction. “However, we do extensive testing before the procedure and occasionally find factors that make someone not an ideal candidate,” he says. “These folks sometimes are candidates for other procedures like lens implants. Anyone with serious eye disease, like advanced glaucoma, would also not be a good candidate.” There’s no age limit for the procedure. The ophthalmologist has done LASIK in patients in their 80s, he notes, mostly to fine tune the results of cataract surgery.
Lasting results
LASIK corrects nearsightedness, farsightedness and astigmatism. According to Imperia, the majority of patients achieve 20/20 or better uncorrected vision. As with any surgery, there are risks. “However, the risk of a vision-threatening complication, like an infection, that would result in a loss of vision is extremely rare,” the surgeon says. “Nobody in my practice and, as far as I know, nobody in the USA, has ever gone blind from LASIK.”
Imperia says that 99 percent of his patients choose to have both eyes done at the same time. There is no preparation other than the preprocedure examination and testing. The eyes are numbed with drops and the patient will feel some mild pressure but no pain. The recovery period is fast. “Patients will experience some mild discomfort and blurred vision the day of surgery,” Imperia says. “By the next day, typically, patients can see well and have no discomfort.” Patients should not rub their eyes, wear eye makeup or swim. They should also avoid hot tubs and saunas. They should wear eye shields to protect their eyes, use their prescribed eye drops and go to their follow-up appointments.
The cost
LASIK is an elective procedure and isn’t covered by health insurance plans. At Medical Eye Center, the cost is $4,800 for both eyes, which includes the pre-procedure exam and testing, the procedure itself and follow-up care for one year. “We partner with CareCredit, a medical credit card, that offers many options,” Imperia says. “We strive to make the procedure affordable.”
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HEALTH
Imaging Accuracy Key to New Radiation Technology
T
TEXT BY CINDY QUICK WILSON
he New Year will bring improved radiation therapy for cancer patients at Providence Medford.
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“This is a $3.5 million installation,” says Joe Hellman, chief radiation physicist. “It’s the first of its kind in the Rogue Valley.” The device is called a linear accelerator, or LINAC machine, which provides beam radiation treatments. The sophisticated features of the Versa HD allow conformal beam-shaping of X-rays to destroy cancer cells with less damage to surrounding tissue “This technology has been available, in one form or another, for about six years,” Hellman explains. “The difference is that the LINAC has an onboard CT scanner that lets us check patient positioning, more accurately locates the tumor, and provides more precise localization that our current technology does not allow.” Traditional radiation therapy uses mega-voltage or high energy, which can distort images, but with the new technology, the imaging accuracy will be improved, Hellman says. “That means the physician can draw tighter tumor volumes and could potentially go to a higher dose, knowing that the normal tissue around it is being spared. The treatment plan can be better tailored to the patient’s needs.” In some cases, treatment regimens may be shortened, Hellman notes. “There are treatments called stereotactic body radio therapy, or SBRT, which is a way of treating smaller tumors in five treatment fractions. Our traditional treatments typically run anywhere from 20 to 44 daily treatments. This would be an opportunity for select patients to be treated in only five.” For the patient, the experience will be virtually the same as before, but because the treatment fields can be smaller, side effects will be reduced. “It’s scary, no matter what kind of cancer treatment it is,” says Hellman. “Patients hear all the horror stories and wonder about losing hair and getting sick, but after a couple of treatments, they start to relax and that reduces the anticipation and worry about how the treatment will affect them. The worst that most people get from radiation is that they feel tired, which is normal. Most patients become more comfortable once they come here because we have a very caring team.”
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Get Exerciseinduced Asthma
FITNESS
on the Run Doctors say it is not an excuse to sit on the sidelines
TEXT BY CINDY QUICK WILSON
Y
ou decide it’s a great morning for a run. The sun is shining, the air is crisp and refreshing. But after a few short minutes, you find yourself doubled over, gasping and struggling to catch your breath. You could have exercise-induced asthma (EIA), a respiratory affliction that can affect people who may have no other asthmatic symptoms.
“Anywhere from seven to 20 percent of the general population is affected by this in some way, whether they realize it or not,” says Aaron Williams, family and sports physician with Providence in Central Point. “That’s actually a significant portion of the population when you think about it as a whole.” During normal breathing, the air we inhale is warmed and moistened by the nasal passages. But during exercise, the increased need for oxygen causes us to breathe through our mouths, drawing in higher volumes of colder, drier air. With exercise-induced asthma, the muscle bands around the airways
can be sensitive to these changes in temperature and humidity and react by contracting and narrowing the airway. This results in symptoms that include coughing, wheezing, shortness of breath, tightening of the chest and unusual fatigue. “Cold weather, dry air and intense physical activity that requires rapid breathing are the main components that bring out symptoms in those who are susceptible,” confirms Kevin Molteni, pediatrician with the Grants Pass Clinic. “Most people who suffer from chronic asthma do experience some symptoms during exercise, however, those normally unaffected by asthma can experience exercise-induced symptoms that generally
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FITNESS
“Someone who is not asthmatic but who has these symptoms may have EIA.” — Aaron Williams, family and sports physician with Providence in Central Point
appear between five and 20 minutes after the start of exertion, or sometimes become evident after exercise stops.” No particular age group seems more inclined than another, although in his practice, Williams says he most often sees EIA in school-age athletes. “I see it more in adolescents who are trying to get into sports,” he says. “Maybe they’ve had a little bit of asthma or they have allergies, so they are more sensitive and they notice coughing and shortness of breath when they start to exercise.” While involvement in sports may bring it to light for some, the Mayo Clinic reports it’s not uncommon for EIA to go undiagnosed in children. Parents may not realize kids are having difficulty breathing after physical activity because they tend to hide how they feel due to peer pressure or embarrassment, and the symptoms may not happen consistently during physical activity. Molteni says some children outgrow the condition, but not most. “The majority will experience symptoms as adults if they exert themselves to the same degree,” he says. “Most adults become couch potatoes, so the symptoms disappear into the La-Z-Boy.”
Diagnosing EIA—a process of elimination
Aside from exertion, other factors may contribute to inflammation and the production of mucus in the airways, like air pollution, chemical sensitivity, respiratory infections and lung disease. “In naturopathic medicine, we always treat the person, not the illness, so we take into account the total picture of health,” explains Lissa McNiel, naturopathic physician at Arbora Natural Medicine Solutions in Medford. “We determine whether there are environmental or food allergies, underlying inflammation or other triggers, especially during exercise. We try to pinpoint and remove as many external factors as possible.” As a diagnostic tool, Williams sometimes uses a treadmill equipped with an ergonometer, which measures the work performed by the person exercising, to monitor FEV1, which calculates the patient’s forced expiratory volume of air. “If that drops within the first 10 minutes, 10 percent below what they were doing before, that’s suggestive of EIA,” he says.
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FITNESS
People who start coughing and have shortness of breath when they exercise also have to be aware of other things that might be the root cause, especially in the older population, Williams continues. “Someone who is not asthmatic but who has these symptoms may have EIA, but it can also be an airway obstruction, acid reflux or a vocal cord defect, which is one of the bigger causes that a lot of people miss. It can also indicate coronary artery disease, heart failure or parenchyma pulmonary disease.”
Don’t take the easy (chair) way out
Doctors say having exercise-induced asthma is not an excuse to sit on the sidelines. “That’s the worst thing you can do,” says Williams. “There are Olympic athletes who have won gold medals with this condition and many people who still participate in sports. Even general asthmatics need to be exercising so they keep the airway open. Usually, once you educate people about that, they’re much better, but some people want to use that as a crutch and to say ‘Oh, I can’t exercise, so I’m just going to be lazy.’” McNiel offers some suggestions from a naturopathic viewpoint. “Eliminating allergens, when identified, will certainly help,” she says. “I sometimes suggest a humidifier, but it has to be well-maintained and kept very clean. Try reducing environmental contaminants by using a HEPA filter to help clean particulate and contaminates out of the air. As for natural supplements, there is a laundry list, but one of my favorites is fish oil, which can reduce inflammation in the lungs.” Experts suggest using inhaled medications before exercising, warming up and cooling down properly and avoiding outdoor activities when poor air quality or high pollen counts are a factor. In cooler weather, Williams suggests covering the nose and mouth with a handkerchief or face mask to warm the air as it’s breathed in during exercise. “They’ve done studies where when they heated the air to near body temperature, it reduces the body’s reaction,” he notes. “I think it’s important that if your general practitioner is not comfortable treating asthma, you need to find a specialist,” McNiel concludes. “I find that some of the patients who come to me have been prescribed an inhaler but they haven’t had proper diagnosis. While an inhaler works well for opening airways, it treats only the symptoms and not the underlying causes.”
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FOOD
Baking Bonanza
From grains to nuts, alternative flours provide flavor and nutrients TEXT BY REBECCA SCOTT
A
t one time grocery stores sold only bleached and unbleached white flour. Now choices range from grain to nut flours and several others. With so many options, how do you choose the right flour? You won’t fear the baking aisle anymore if you learn the facts about specialty flours. You’ll know which healthy flours to use in your recipes, and eventually, create your own.
Not all flours are created equal
“White flour is refined with few vitamins and minerals, and increases blood sugar,” says Terry Johnson, the natural and specialty foods manager at Sherm’s Food 4 Less in Medford. “Whole grain flours are high in vitamins, proteins, minerals and fiber. The grains sprout before making the flour which increases antioxidants and other nutrients.” If you desire gluten-free goodies, nut-based flours are the optimal alternative. “Nut flours are nutrient-dense and made by grinding nuts into a flour-like consistency,” says Jaena Barrera, the NHC regional director for Natural Grocers. “Of all the nut flours, almond flour is the most popular because of its sweet, buttery taste and it’s readily available in stores. Most almond flour recipes are simple to follow if you’ve baked with white flour before.” Grain, nut, rice and other flours return fiber and minerals to food. While specialty flours are healthier, they have a higher price tag. According to Johnson, “White flour averages 40 to 50 cents per pound whereas gluten-free specialty flours are anywhere from $2 to $11 per pound.” But you needn’t sacrifice healthier flours because of price. “Most people use white flour because it’s cheap, but it has no nutritional value,” says Barrera. “Flour blends, or companies like Bob’s Red Mill, sell affordable alternative flours.”
COMMONLY USED FLOURS • Whole wheat flour: Made by grinding the whole grain of wheat. More absorbent than white flour and requires additional liquids, resulting in extra sticky dough. Use in cookies, breads and other baked goods. • Coconut flour: High in protein, fiber and healthy fats, and low in sugar. It’s made from the pulp of the coconut. Use in quick breads, cakes, muffins and other treats. Very absorbent, so most recipes require several eggs. • Almond flour: Usually made with blanched almonds (no skin), with a consistency similar to corn meal. It adds moisture and a rich nutty taste. Use in cakes, pastries and pancakes.
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FOOD
PUMPKIN PIE WITH GRAIN-FREE CRUST Courtesy of Natural Grocers
Crust Ingredients: 3/4 cup coconut flour 1/2 cup toasted pecan halves 8 tablespoons chilled butter or coconut oil 2 tablespoons coconut sugar 1/4 teaspoon sea salt 3 large eggs
A flour for every occasion
As its name implies, all-purpose flour has a variety of uses in cooking and baking. Specialty flours are made from a wide-range of ingredients, so their specific purposes are equally diverse. “Don’t use nut flours for a roux or gravy,” explains Barrera. “Tapioca or arrowroot flours are better for a roux because they’re finely ground and similar to cornstarch in texture. These flours would not be good for baking.” Nut flours are a good white flour substitute in baking, perfect for everything from fluffy pancakes to crispy cookies and breads. However, be wary of attempting a 1:1 substitution in your regular recipes. “Almond flour is the best for that, but it has more fat so you may need to reduce the amount of liquid,” says Barrera. “You need to experiment with your recipes.” You can bake organically, too. “Many flours have ‘no GMO’ stickers on them. If something is 100 percent organic, it’s GMO-free,” explains Johnson.
Alternative flour awareness
Specialty flours open up new worlds of tastes and textures, but can create problems for people with allergies. Coconut flour brownies are delicious to one person and dangerous to another. “Most people with allergies are already careful,” Johnson says. “Tell guests what the ingredients are or label food before serving.” An open dialogue diffuses potential problems.
Never fear, flour is here
Whether you’re gluten-free or want healthier baked goods, there’s an alternative flour for you. Review your old recipes and try new ones. “Use new mixes for different foods you’re making,” says Johnson. “Many people have their own special mixtures.”
Crust Directions: Toast pecans in small skillet over medium heat until fragrant, 10 to 15 minutes, stirring frequently. Remove from heat. Combine coconut flour, pecans, butter (or coconut oil), coconut sugar and salt in food processor. Pulse until combined and pecans are finely chopped. Add eggs. Pulse until a dough forms. Press dough into the bottom of a 9-inch pie pan. Set aside. Filling Ingredients: 2 eggs 1/3 cup honey 1 teaspoon vanilla extract 1/4 cup coconut milk 1 15-ounce can pumpkin 1 teaspoon pumpkin pie spice 1 teaspoon cinnamon Filling Directions: Whisk together eggs, honey, vanilla and coconut milk. Stir in pumpkin, pumpkin pie spice and cinnamon. Mix until well-combined. Pour into crust. Place on baking sheet. Bake at 350 degrees for 45 minutes to one hour. A toothpick inserted into the pie should come out clean. Cool before serving.
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HEALTH
Vitamin D Does a Body Good When it comes to keeping you strong and healthy, vitamin D gets an A+ TEXT BY CATHLEEN COLE
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re your bones aching? Do you feel tired all the time? Do you get sick a lot? If the answer is yes, yes and yes, it’s time to get your vitamin D level checked. Vitamin D functions as both a vitamin and a hormone. Karen Harris, a physician with Providence Medical Group – OB/GYN Health Center in Medford, explains that vitamins are nutrients that cannot be synthesized by the body and must be acquired through the diet (ideally) or via supplements. “Vitamin D is technically considered to be a pro-hormone because the body can synthesize it, but it requires the exposure of sunlight on the skin,” she says.
The benefits of vitamin D
Vitamin D has long been known to help the body absorb and use calcium, which is required for strong bones. It helps to prevent softening and thinning of the bones that can lead to fractures. According to Harris, more recent research suggests that adequate vitamin D is also incredibly important as an immune modulator and can lower the risk of colon, breast, prostate, skin and pancreatic cancers. It also helps fight infections, both viral and bacterial, including influenza. “It has a tremendous amount of benefits,” agrees Angela Carlson, a physician with Bear Creek Naturopathic Clinic in Medford. In addition, low levels of vitamin D have been associated with an increased risk of developing asthma, elevated blood
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pressure, diabetes, heart disease, multiple sclerosis, rheumatoid arthritis, Crohn’s disease, dementia, obesity and depression – particularly seasonal affective disorder. “The evidence doesn’t prove that too little vitamin D causes these conditions, but it does show that people with higher levels of vitamin D are less likely to get these diseases, often much less likely,” Harris confirms. “Finally, people with lower levels of vitamin D have a higher mortality overall, a higher risk of dying from any cause.”
Shedding light on vitamin D
Sunshine on the skin starts the body’s process of making vitamin D, but with the fear of skin cancer, many people avoid the sun, cover up completely or slather on sunscreen to ward off the rays. In Carlson’s opinion, we’re overusing all kinds of skin products. Certainly people with fair skin who sunburn easily should use sunscreen, she notes, but some natural sun exposure each day is necessary. “Having a healthy relationship with the sun is important,” Carlson says. According to Harris, the amount of sun exposure needed to produce vitamin D depends on a person’s skin color and weight, on the season and on the latitude where they live. It may take a fair-skinned person about 45 minutes of sunlight a week during the summer exposing arms and legs and most of the torso to get enough vitamin D, she explains. A person with dark skin may need up to three hours per week. Obese people have lower levels of vitamin D with higher sun requirements. “In the winter, people who live above a latitude line running
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HEALTH from Los Angeles to South Carolina, which certainly includes us in Oregon, can basically not make enough vitamin D from about November through March and need supplementation,” Harris confirms. A Centers for Disease Control and Prevention study found that 32 percent of children and adults throughout the United States were vitamin D deficient. Another federal health study estimated closer to 50 percent of the population is at risk. “I have been checking vitamin D screening levels for the last 12 years, and it is rare – even in the summer in an individual who is active outdoors – to find someone with a normal level,” Harris says.
Carlson says. If a patient is symptomatic and shows a low level, she advises taking 10,000 IU a day for one month and then drop to 5000 a day. “I put almost everyone on it,” she says. “I personally feel that people need vitamin D year-round. It makes a lot of people feel better.”
Are you getting enough vitamin D?
A blood test measuring 25-hydroxy D, the calcidiol form made by the liver, determines if a patient is low in vitamin D. The normal lab range is 30 to 100 nanograms per milliliter with a general goal of 40 to 60 nanograms per milliliter according to the Endocrine Society Clinical Practice Guidelines. If you are below the normal level, you can carefully increase your sun exposure, eat more foods with vitamin D such as dairy products, fatty fish and eggs and start taking a supplement. “Depending on the patient’s blood level and history, I often suggest an over-the-counter vitamin D3 in a gel form, because vitamin D is oil soluble, in a dose varying from 2000 to 5000 IU (International Units) daily, or I may prescribe a much larger dose of 50,000 IU of either D2 or D3 once per week for about 8 weeks,” Harris says, adding that she then rechecks the blood level. The doctor recommends an extra vitamin D supplement to maintain a healthy level, especially in the late fall, winter and early spring. “I usually suggest a minimum of 2000 IU and more ideally 3000 to 4000 IU a day of vitamin D3,” she says. For patients with low vitamin D levels, Carlson recommends 5000 IU a day, possibly for a year. When the level is in the normal range, the maintenance dose can go to 2000 IU a day during the summer months. “It really takes a long time to get vitamin D levels up,”
VITAMIN D-RICH FOODS • Fatty fish such as salmon, herring, tuna and sardines • Milk • Fortified foods • Mushrooms • Eggs • Beef liver • Cod liver oil
SYMPTOMS OF LOW VITAMIN D • Aching muscles, bones and joints • Bone fractures • Fatigue, feeling tired all the time • Feeling sad, depressed • Problems with immune system, getting sick a lot • Excessive sweating, especially of the head
December 7, 2015 • Oregon Healthy Living 21
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DECEMBER
EVENTS CALENDAR
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SOMATICS, YOGA & RELAXATION 5:30 P.M. TO 6:30 P.M. • ORENDA ENERGY ARTS, 617 EAST MAIN ST., MEDFORD CONTACT INFO: 541.210.1952 This class incorporates techniques from yoga, qi gong and somatics to help alleviate stress, chronic pain, anxiety, depression and trauma. Emphasis on breathing and mindfulness throughout class with guided relaxation at the end. Cost: Drop-ins—$12; Four-class card—$40. Sliding scale available. Oregon Health Plan Members pay only $5.
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TH THE MEDFORD UGLY SWEATER 5K 9 A.M. • 101 S BARTLETT ST., DOWNTOWN MEDFORD CONTACT INFO: www.medforduglysweater5k.com The Medford Ugly Sweater 5K encourages participants to proudly wear the most “ornamental” holiday sweaters they can find. A family race devoted to fun, everyone gets to burn a few calories and enjoy some laughs. A portion of the proceeds benefit the Jackson County Foster Parents Association. Register online and pick up your packet on December 18 from 11 a.m. to 6 p.m. at Sports Authority in the Rogue Valley Mall.
MOROCCAN CHRISTMAS COOKING PARTY 6:30 P.M. TO 9 P.M. • ASHLAND FOOD COOP COMMUNITY CLASSROOM, 300 N PIONEER ST., ASHLAND CONTACT INFO: 541.482.2237 $30 Co-op owners $35 general public In this class, instructor Tiazza Rose will host a Christmas cooking party like no other: a Christmas party in Morocco! Moroccan food has been enriched for over two thousand years by surrounding cultures to become a unique mix of sweet, salty and earthy spice flavors. A variety of wines and beers will be available throughout the evening for $5.
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TH LOW COST PET VACCINATIONS 11 A.M. TO 1 P.M. • JACKSON COUNTY ANIMAL CONTROL, 5595 SOUTH PACIFIC HWY., PHOENIX CONTACT INFO: 541.210.1952 All dogs must be on leash, and all cats must be in carriers. $10 (cash only) per vaccination. Nail trims also available for $5/pet (cash only).
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DECEMBER
EVENTS CALENDAR
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EVERY
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WEDNESDAY
ASHLAND YMCA BALLROOM DANCE 2 P.M. TO 4 P.M. • ASHLAND FAMILY YMCA, 540 YMCA WAY, ASHLAND CONTACT INFO: 541.488.77813 The Alan Berman Trio will perform a variety of popular numbers for dancers and listeners every third Sunday afternoon through spring 2016. Tickets at the large dance studio door are $7 for adults: $5 for teens and youth. Children under 14 must be accompanied by an adult.
EVERY
CRATER LAKE RANGER-GUIDED SNOWSHOE WALKS 1 P.M. • RIM DRIVE, CRATER LAKE CONTACT INFO: 541.594.3100, www.craterlaketrust.org Free park entrance, free tour and snowshoes provided free! Take a one-mile walk through snow-covered forests and meadows at Crater Lake. No previous snowshoeing experience needed, but space is limited and reservations are recommended. Tour takes about two hours.
SATURDAY & SUNDAY
TODDLER TIME WEDNESDAYS! 10:15 A.M. TO 11 A.M. • ASHLAND’S LITTLE MAKERSPACE, 310 OAK ST., ASHLAND CONTACT INFO: www. ashlandslittlemakerspace.com Smoosh, splat, laugh tactile play for curious toddlers! In this class, your young artist will explore several activities that focus on the elements of art color, texture and shape! Dress for a mess and they take care of the rest! Class fee is $12 for the first child; $20 for 2 children.
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We’re here for you with award-winning stroke care. Providence Medford Medical Center is recognized for exceptional stroke and heart care by the American Stroke and Heart Associations. Providence receives the highest ratings for stroke care and emergency cardiac care in southern Oregon. Feel confident in our hands. Top-ranked stroke and cardiac care in your community Providence.org/Medford The American Heart Association and American Stroke Association recognize this hospital for achieving 85% or higher compliance with all Get With The Guidelines® -Stroke Achievement Measures and 75% or higher compliance with five or more Get With The Guidelines® -Stroke Quality Measures for two or more consecutive years and achieving Time to Intravenous Thrombolytic Therapy ≤ 60 minutes in 50% or more of applicable acute ischemic stroke patients to improve quality of patient care and outcomes.
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