Healthy Living from Head to Toe by Total Wellness Magazine

total wellness

a ucla student wellness commission publication

healthy living from head-to-toe

+ sleeping positions

microwave uses beyond heating your food

and your health

tips for a

healthier smile

your guide to

shoes

winter 13 | vol 13 | issue 2

editor’s note Happy New Year! With the end of a year and the start of a new one, it’s the traditional time for resolutions. Since a large number of resolutions center around health improvement, we’ve dedicated this issue to Healthy Living: From Head-to-Toe. Working on this issue and thinking about New Year’s resolutions, I wondered about the success rate of these resolves on making a fresh start at the year’s beginning and dug deeper into the actual statistics behind these plans for a new year. Unfortunately, what I discovered was that while 45% of Americans generally make resolutions, only about eight percent are successful in carrying them out according to a 2012 study published in the Journal of Clinical Psychology. This same publication also reported that of the top ten resolutions, three are health related.

total wellness ▪ winter 2013

Why is there such a low success rate? Many factors could be involved. Anything from low motivation to setting resolutions that are too broad, such as “I’m going to be healthier this year”, “I’m going to get more exercise”, etc., can impede the way to success. With such an extensive objective and no concrete steps on how to reach the end result, after making the resolution one can become entirely overwhelmed, not even know where to start, and abandon the prospect entirely. If you’re like 36% of individuals, by the end of January, your resolution is already out the door. But, don’t give up hope. After all, you don’t have to wait until another new year arrives before you embark upon a new resolution or give yourself a second chance at your initial goal. Instead of being discouraged, we invite you to make defined, manageable goals for healthy living. Whether you hope to Get Active, Eat

Right, or keep your Body in Focus, this issue has something for you. Working on improving your dental health? Learn how in Ways to a Healthier Smile on page 26. Looking for ways to take better care of your feet? Check out Finding the Perfect Fit: Your Guide to Shoes on page 33. Searching for a new exercise to spice up your workout? Discover what a rowing machine has to offer on page 9. If your resolution falls within the realm of healthy living, Total Wellness is here to help make your goals manifest. Whatever your New Year’s health ambition is, we’d like to give you the resources to achieve them. Something you’re dying to read about in Total Wellness but you weren’t able to find it in this issue or in our previous issues (available at http://issuu.com/ totalwellnessmagazine)? Write to us and let us know at totalwellnessatucla@gmail.com! Your topic suggestion might even appear in a future issue with you as the featured reader. Even if health isn’t a New Year’s resolution for you, we hope to inspire you to make it a priority for a healthy, happy, and prosperous 2013! Cheers to your health,

Shannon Wongvibulsin Director and Editor-in-Chief

Total Wellness is a division of the Student Wellness Commission that is dedicated to spreading awareness of and sharing knowledge on issues of student health and health care. By providing an understanding of health and lifestyle issues, elucidating health concepts, providing recommendations for physical, mental, and social well-being, and making visible and accessible various health resources, programs, and events occurring at UCLA, Total Wellness seeks to empower students with up-to-date and accurate knowledge on the appropriate management of their health.

leadership

karin yuen Co-Art Director

barbara wong Co-Art Director

Nabeel Qureshi Finance Director

angela hao Assistant Finance Director

Judy Jeung Outreach Director

Fritz Batiller Webmaster

Kevin Sung Assistant Webmaster

total wellness â&#x2013;Ş winter 2013

cindy la Managing Editor

words from the commisioner Welcome to 2013, UCLA! Every

new year gives us a fresh start and a jolt of refreshing energy. This closing of the old year and ushering in of the new provides the perfect opportunity to refocus our efforts on our health.

Whether you are the type to make a flurry of resolutions, only a few dedicated ones, or none at all, having a sound body and mind is always a good idea, and SWC is here to help you do just that. Our primary mission is to help students integrate healthy choices and habits into their daily lives, and turn these behaviors into a lifestyle. This quarter, in addition to the recurring events we host all year like Bruin in the Kitchen, Food Trucks for Finals, free fitness classes, yoga classes, stress management workshops, CPR and first aid classes, we are excited to host a few very special weeks full of programming. In addition to co-hosting the annual Campus Safety Week, SWC presents its annual Mental Health Week and UCLA’s inaugural I Love My Body Week. Threats to our safety can have significant effects on our physical, mental and emotional health, and we are excited and honored to bring safety resources to the campus alongside the USAC Facilities Commission and USAC Internal Vice President’s Office. From erasing the stigma of mental health problems to introducing new and more effective ways of managing stress to ensuring that students make healthy choices even in exam season, the events during Mental Health Week will not only be applicable but useful for all students.

total wellness ▪ winter 2013

I Love My Body Week will include a student produced art gallery featuring true beauty through the eyes of true Bruins, and speakers, performances, workshops and programs dedicating to helping students create and maintain positive body images. All too often, we fall victim to pressures from the media, society, family, and peers to pursue body “ideals” that are detrimental to our health and create body dissatisfaction which impacts all aspects of our lives negatively. The newly created SWC Body Image Task Force is dedicated to helping change the way students think about and feel in their bodies and is eager to bring I Love My Body Week to campus. I hope that as you enjoy this latest issue, you give kudos to the amazing writers and designers who put it together as well as find the inspiration and knowledge you need to lead the healthiest lifestyle possible! Warm Wishes,

Cassarah Chu SWC Commissioner

total wellness Director and Editor-In-Chief Co-Art Director Co-Art Director Managing Editor Finance Director Assistant Finance Director Outreach Director Webmaster Assistant Webmaster

Shannon Wongvibulsin Barbara Wong Karin Yuen Cindy La Nabeel Qureshi Angela Hao Judy Jeung Fritz Batiller Kevin Sung

Staff Writers Savannah Badalich, Leslie Chang, Julia Duong, Julie Escobar, Harini Kompella, Sofia Levy, Lawrence Liem, Tiffany Lin, Jennifer Miskabi, Samantha Mojica, Brian Khoa Nguyen, Lillie Luu Nguyen, Jaclyn Portanova, Anahit Poturyan, Chalisa Prarasri, Nabeel Qureshi, Nicole Tu Design Karen Chu, Coco Liu, Keziah Pagtakhan, Catrina Pang, Kristen Sadakane, Jennifer Shieh, Annie Theriault, Rebecca Wang, Barbara Wong, Shannon Wongvibulsin, Karin Yuen Advisory & Review William Aronson, MD

Professor, UCLA School of Medicine

Susan Bowerman, MS, RD, CSSD

Assistant Director, UCLA Center for Human Nutrition

Leah FitzGerald, RN, FNP, PhD

Assistant Professor, UCLA School of Nursing

Dena Herman, PhD, MPH, RD

Adjunct Assistant Professor, UCLA School of Public Health

Eve Lahijani, MS, RD

Nutrition Health Educator, UCLA Bruin Resource Center

Melissa Magaro, PhD

Clinical Psychologist, UCLA Counseling and Psychological Services

Lilia Meltzer, RN, NP, MSN

Lecturer, California State University, Long Beach

William McCarthy, PhD

Adjunct Professor, UCLA School of Public Health

Rena Orenstein, MPH

Assistant Director, Student Health Education

Allan Pantuck, MD, MS, FACS

Associate Professor, UCLA School of Medicine

Raffi Tachdjian, MD, MPH

Assistant Clinical Professor, UCLA School of Medicine

Elisa Terry, NSCA-CSCS

FITWELL Services Program Director, UCLA Recreation

Alona Zerlin, MS, RD

Research Dietitian, UCLA Center for Human Nutrition

Total Wellness is a free, student-run, biquarterly publication published 7 times a year and is supported by advertisers, the Arthur Ashe Student Health and Wellness Center, the On Campus Housing Council (OCHC), the Student Welfare Commission (SWC), UCLA Recreation, and the Undergraduate Students Association (USAC). Contact 308 Westwood Blvd., Kerckhoff Hall 308 Los Angeles, CA 90024 Phone 310.825.7586, Fax 310.267.4732 totalwellnessatucla@gmail.com www.totalwellnessmagazine.org www.swc.ucla.edu Subscription, back issues, and advertising rates available on request Volume 13, Issue 2 © 2013 by Total Wellness Magazine. All rights reserved. Parts of this magazine may be reproduced only with written permission from the editor. Although every precaution has been taken to ensure the accuracy of the published material, Total Wellness cannot be held responsible for the opinions expressed or facts supplied by authors. We do not necessarily endorse products and services advertised. The information in Total Wellness is not intended as medical advice and should not replace the advice of your physician. Always consult a health care provider for clarification.

contents IN EVERY ISSUE 2 Editor’s Note 4 Words From the Commissioner 6 In the News 7 Q&A 46 Decoding the Nutrition Label 47 Credits

DEPARTMENTS get active 9 Row: Rock the Stroke body in focus 13 What’s Your Good Side? Sleeping Positions and Their Effect on the Body 16 Putting Health in Your Hands: Your Guide to Self-Examinations for Early Detection of Breast and Testicular Cancer eat right 19 To Can or Not to Can? 22 Fruity Favorites

ON THE COVER 26 38 33 13

Healthier Smile Microwave Shoe Types Sleeping Positions

26 Ways to a Healthier Smile 30 The Benefits and Controversies of the New HIV Prevention Pill: Truvada 33 Finding the Perfect Fit: Your Guide to Shoes 36 Fighting Dandruff Head-on 38 Surprising Uses for Your Microwave 41 Unraveling the Mystery of Invisible Illnesses

total wellness ▪ winter 2013

cover: casarsa/istockphoto; right: fanelie rosier/istockphoto

FEATURES

in the news

what’s happening in health? by shannon wongvibulsin | design by karin yuen

RESEARCH AND NEW FINDINGS

Food Allergies? Test Your Meal with Your Phone

Study Suggests a New Role for Blinking

A recent study published in the Proceedings of the National Academy of Science found that after the onset of a blink, cortical activity decreases momentarily but activity increases in the default-mode network, which is involved in internal reflections (such as recalling memories or having daydreams). The researchers had 20 volunteers view Mr. Bean videos and scanned the brains of the participants with functional magnetic resonance imaging (fMRI) while also monitoring blinking. Afterwards, the investigators compared the subject’s brain activity during times of blinking with times of non-blinking and found that eyeblinks can actively cause attention disengagement. Furthermore, this finding is consistent with the idea that turning off sensory inputs temporarily can help the brain in its cognitive processes.

total wellness ▪ winter 2013

Disease Forecasting

Health scientists are working on incorporating weather data into their attempt to forecast disease outbreaks. Using a computer model that factors in rainfall, temperature, and other weather conditions, researchers have recently reported their ability to predict when the flu season would peak in New York City more than seven weeks before it would occur. Nevertheless, since disease outbreaks are not dependent only upon weather, some are skeptical about these predictions and believe that much more work still needs to be done in this field of disease forecasting. Nevertheless, more advanced data processing programs, improved satellite technology for weather-tracking, and other developments have resulted in successful predictions in some models for conditions such as Rift Valley fever.

With the iTube (an innovation of UCLA Henry Samueli School of Engineering and Applied Science), it’s now possible to detect allergens (such as peanuts, almonds, eggs, gluten, and hazelnuts) in food using the cell phone’s built-in camera and smart-phone application and obtain the same sensitivity as that of a laboratory test. Not only does the iTube allow one to determine whether the allergen is present, but it can also quantify how much is present in parts per million.

Pesticide May be Linked to Parkinson’s Disease

Even though the U.S. Environmental Protection Agency has banned the use of the pesticide benomyl over ten years ago, the toxicological effects of this chemical are still being observed. In fact, researchers at UCLA had found that benomyl exposure begins a series of events at the cellular level that may lead to the development of Parkinson’s disease. Because it is known that exposure to benomyl leads to the accumulation of DOPAL (a naturally occurring toxin in the brain) due to the lack of proper functioning of the enzyme aldehyde dehydrogenase (ALDH), investigation of ALDH activity is now a focus for researchers attempting to fight Parkinson’s disease. t w

NUMBERS

percent of U.S. adults have nodded off or fallen asleep behind the wheel

nations rank higher than the U.S. in terms of life expectancy

million the number of plastic bottles Americans throw away every hour

cdc; cia: the world fact book; dosomething.org

left: vitor costa; sándor kelemen/istockphoto; cactusoup/istockphoto; right: macida/istockphoto

AT UCLA

q&a

Q: A:

Does eating eggs really increase my cholesterol levels and my risk for cardiovascular disease?

Not necessarily. If you are not diabetic, then research seems to solidly indicate that you can safely eat eggs without increasing your risk for cardiovascular disease. But the answer is more complicated than that. Eggs are not entirely off the hook, since researchers are still divided about how egg consumption can affect your blood cholesterol and overall health. Eggs contain an extremely high amount of cholesterol. At between 175 and 275 mg of cholesterol per egg, they contain more cholesterol per serving than most other foods. Early studies on egg consumption appeared to show a linear correlation between egg consumption and high blood cholesterol levels. Thus, it isn’t surprising at all that people so strongly associate them with high blood cholesterol. The truth is that those early studies may have had serious design flaws (such as lumping cholesterol with saturated fat and inaccurately estimating fat consumption) that could have caused the researchers to over-exaggerate how dietary cholesterol in eggs can contribute to heart disease risk. Several more recent studies, which are generally considered to be more accurate than earlier ones, seem to suggest that eggs in moderation can be part of a healthy diet.

by chalisa prarasri | design by barbara wong

suggest that there are two types of people – those whose blood cholesterol is highly sensitive to dietary intake of fat and cholesterol, and those whose blood cholesterol is entirely insensitive to diet. Cholesterol-sensitive people apparently make up about 30% of the population, but have not yet been shown to be at increased risk for heart disease, especially in light of studies like the Harvard Egg Study, which would have inevitably included people in the highly-sensitive group. Confusingly, other studies seem to suggest that eggs have almost no effect on blood cholesterol levels whatsoever. the bottom line While eating any number of eggs may not appear to increase your risk for cardiovascular diseases unless you are diabetic, research is still inconclusive enough that it is probably a good idea to stick to the Harvard Egg Study’s recommended safe limit of one egg per day until a conclusion is agreed upon. And, if you think you might be highly sensitive to dietary cholesterol, it might be a good idea to be wary of your dietary cholesterol in general. t w

The Harvard Egg Study (Journal of the American Medical Association, 1999)

complications The problem is that the Harvard results are specific to CHD. Some other studies have been conducted on the role of egg-based dietary cholesterol on blood cholesterol, but the conglomeration of evidence is confusing. Some studies

total wellness ▪ winter 2013

Though it was not the first of its kind, this study conducted by the Harvard School of Public Health was the most highly publicized. 37,851 healthy men and 80,082 healthy women were followed for eight and 14 years, respectively. After adjusting for other potential risks for coronary heart disease (CHD) such as age and smoking, the researchers found that eating any number of eggs per week did not increase the risk for stroke or developing CHD in both men and women. These results were different for diabetic patients, however. Eating more than one egg per day doubled the risk for CHD in diabetic men, and increased the risk for CHD by 50% for diabetic women. The researchers concluded that an otherwise healthy person could probably eat one egg per day without increasing his or her risk for CHD. Many other studies published over the last 50 years, including one published in 2011 by the European Journal of Clinical Nutrition, have yielded almost identical results.

got a question? We love curious readers. Send

your question over to totalwellnessatucla@gmail.com and the answer may appear in a future issue.

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get active

row: rock the stroke

by savannah badalich | design and illustration by coco liu

sports, rowing – also known as crew – provides both a cardiovascular and strength workout encompassing the upper and lower body. However, you don’t need a boat to take advantage of this compound exercise. The rowing stroke can be mimicked on a rowing machine known as an ergometer or

total wellness ▪ winter 2013

As one of the original modern Olympic

erg for short. Focusing on fast movements for cardio or slow, powerful movements for strength, erging is an intense training exercise utilized by professional rowing teams, athletes, and programs such as Crossfit. Here, we will discuss the proper stroke technique to prevent injury and ensure an intense total body workout.

the machine The Handle mimics the oar handle.

The Slide: The rail on which the seat “slides” to mimic the movement and stroke whilst on the boat. Overall, rowing – when the stroke is done correctly – is a total body workout meant to improve cardiovascular health and muscle strength. Try it out; ergs are located at the John Wooden Center and Kinross Recreation Center (KREC). Rowing classes and club teams are offered at the UCLA Marina Aquatic Center and appointments can be made online at http://www.recreation.ucla.edu/.

total wellness ▪ winter 2013

the stroke

the drive phase The Catch: Your body should be compressed like a spring. Knees bent, arms straight, remembering to keep your upper body tall and abs engaged at all times. Your shins should be perpendicular to the slide, with arms straight and hands holding firmly to the handle. Remember to lower your shoulders as well.

The Screen provides an interface to select a preprogrammed or customizable workout. You can simply row in order to start the machine without selecting a workout. Each number on the screen provides important information:

setting up the workout! (on the screen) ❯ Press Menu/Back ❯ Press the button next to “New Workout” ❯ Decide between a “Single Distance”, “Single Time”, “Time Interval”, or “Distance Interval” ❯ Adjust time/distance to your desired number and press the checkmark in the lower right hand corner ❯ Begin rowing

Split Time: This is the time it will take you to travel 500m. The faster or harder you go, the lower the time. Stroke Rate: The number of full strokes you perform per minute. If you are working efficiently, the larger the stroke rate, the lower your split time should go. The larger the stroke rate, the faster and more cardio based your workout will be. The lower the stroke rate – while trying to keep a low split time – the more powerful your stroke must be and therefore, more strength based. Distance: The amount of meters you have traveled throughout your session. Calories: The amount of calories you have burned in your session. This is calculated by digitally converting the wattage (produced by spinning the erg fan) to calories.

the recovery phase Arms & Body Over: From the finish, extend your arms, then swing your body forward so your shoulders are past your hips and arms are reaching for your shins. This pose is important to take on BEFORE you go on to the next position in which you raise your knees. Your hands must be past your knees before your knees come up.

Legs Only: Keeping the body angled from the catch, thrust your legs as if you are attempting to stand up. Your arms should remain straight and reaching to your shins. Your shoulders should remain past your hips and abs should be engaged.

The Finish: Your body should swing back from legs only, upper body tall, and abs completely engaged. Only after your body swings back, pull your arms back to finish the “drive” cycle of the stroke.

Note: The entire recovery phase should take up three out of four beats of the entire stroke. In other words, the recovery should be a long, patient portion of the stroke to recover and gather energy before exploding into the drive.

total wellness ▪ winter 2013

Back to the Catch: Only after your hands are past your knees, you can now slide back to the catch position, bringing your knees up and compressing your body. As always, keep upper body tall and shoulders down.

common mistakes common technique mistake

correction

Hyperflexion (pivoting the body too far back at the finish, leaving the abs disengaged) at the finish

According to a 2005 article published in Sports Medicine, hyperflexion can lead to lower back strain.

Adjust your body angle backward – but not too far back – at the finish so that you feel your abs are still engaged with a slight burn from holding that position.

Tensed upper body and shoulders or raised shoulders

This mistake can lead to shoulder strain and inflexibility with the body angle throughout the stroke – ultimately, leading to a less efficient and intense workout.

Relax and lower your shoulders. Keep your upper body fluid – not too tense, but not flimsy either.

Bringing the knees up before the body is over the legs with the shoulders past the hips and the arms reaching over the shins

By moving the knees up prior to bringing the body and arms over the legs, the hands are thus blocked from returning to the catch by the knees. The hands and arms, then, compensate by maneuvering up and over the knees as the body returns to the catch, leading to inadequate technique and loss of time on the recovery phase.

From the finish, straighten your arms, swing your body over your legs so your shoulders are past your hips, and make sure your hands are straight and over your shins. You should feel a stretch in your hamstrings. Only after completing all of the above should you begin to raise your knees and compress your legs.

Hunching the upper body over the legs at the catch

According to a 2012 Sports Health: A Multidisciplinary Approach, at the catch, there is a rapid generation of force at the handle until mid-drive – most of the power coming from your legs. However, hunching your back at the catch can lead to a shift of force from your legs to your back which can lead to lower back strain. Not to mention, a tall upper body with abs engaged leads to a more intense ab exercise and better posture.

Keep a tall upper body with your abs engaged at all times throughout the stroke. Never hunch. t w

workouts

total wellness ▪ winter 2013

consequence

beginner

intermediate

erg workout – beginner (easy) #1 *

erg workout – intermediate (moderate) #4 *

row time

intensity

stroke rate

Rowing warm up 5 min 1 x 5 min Rowing cool down 5 min

1 2 1

20 22 20

1=Easiest 10=Hardest * from rowingworkouts.org

row time Rowing 5 min 2 x 15 min 5 min warm down

intensity

stroke rate

2 3–5 1

22 22–26 20

body in focus

whatâ&#x20AC;&#x2122;s your good side? sleeping positions and their effect on the body by lillie nguyen | design and illustration by karin yuen

How long does it take you to enter deep slumber? For the average person without sleeping problems, it takes about ten to 20 minutes. During this time, the snoozer will change positions multiple times until the perfect orientation is achieved. Many are naturally inclined to doze off on their sides, while others lie on their back or stomach, but which is the best area to sleep on?

total wellness â&#x2013;Ş winter 2013 13

STOMACH

SIDES

FREE FALL:

Known as the prone position, a sleeper’s stomach will face down, with the hands up around the pillow and head turned to one direction

FETUS:

Curled up like a baby in a mother’s womb

LOG:

Arms lie alongside the body

YEARNER:

Both arms are stretched in front of the body

benefits:

As the most common sleep position, the lateral state has few to no related health problems. Resting on the right half of the body takes off stress on the vital organs (liver, stomach, and lungs). But between the left and right sides, the left has a slight advantage in that it is better for circulation, helps relieve high blood pressure, and is the better side if heartburn relief is desired. According to a 2009 study published in the Journal of Sleep Research, this optimal sleeping position reduced mild snoring by more than 80% relative to the 20% decrease obtained by those in the supine position. If the head was rotated to 40o, the snoring rate could be reduced to approximately zero!

According to a 2004 study published in Swiss Med Weekly, those with acute respiratory distress syndrome can increase the amount of oxygen delivered to their blood by lying in the prone position. Reposing on the stomach is also helpful for digestion, but make sure to eat light or nothing at all two hours before hitting the hay.

problems:

Few to none.

This position not only obstructs the upper-airway, but puts additional pressure on the spine and chest throughout the night, which may cause a nasty back ache the next morning.

fixes:

To further enhance the sleeping experience, place a pillow between the knees and one under the head so that it lines up with the neck and spine. By mitigating discomfort, night time disruptions will decrease and in addition insomnia and sleep apnea will be alleviated.

To lessen the induced weight on the back, use a long body pillow to elevate one part of the body, or do not use a pillow at all to level out the sleeping plane and straighten the spine.

total wellness ▪ winter 2013

benefits:

BACK

SOLDIER:

Arms extend parallel to the sides of the body

STARFISH:

Arms and legs are splayed outwards

benefits: Allowing the back to make contact with the bed relaxes the back muscles and re-expands the spinal discs so that they can reabsorb fluids that were pushed out of them throughout the day.

We spend a third of our lives sleeping, so why not make the best of this time? Sleep quality plays a large role in mental and physical functions, but late night interruptions caused by unpleasant sleeping positions can lead to sleep deprivation. Mattresses that are worn out and/ or saggy in the middle can affect the bend and curvature of the lower and mid-back, which affects the passage of airflow. In addition, a 2011 article in Laryngorhinootologie found that nasal volume had decreased significantly in smokers who relaxed on their backs whereas nonsmokers did not develop nasal obstructions. Therefore, select mattresses that hug the body’s outline and use pillows to raise the head and body to different levels that allow maximal breathing capacity and comfort. tw

problems:

fixes: Rather than listening to a cacophony of snorts and wheezes, place a pillow underneath the knees and the back to restore the natural curves of the lower back, and enjoy a peaceful night of sweet silence instead.

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total wellness ▪ winter 2013

Due to the supine position’s unfavorable placement of the face up and back down, the tongue falls inwards, causing breathing difficulties. As a result, many sleepers suffer from obstructive sleep apnea and snoring. The difference between the two is that snoring is the sound heard when a snorer inhales during sleep. Obstructive sleep apnea, on the other hand, occurs when the soft tissue in a person’s throat repeatedly collapses and blocks the airway during sleep.

putting health in your hands:

total wellness â&#x2013;Ş winter 2013

your guide to self-examinations for early detection of breast and testicular cancer by jaclyn portanova | design by barbara wong

left: amanda rohde/istockphoto; right: anthony rosenberg/istockphoto

body in focus

Self-examination is a tool that can be used to detect cancer in its early stages. It is something that can be done at home by anyone who wants to

increase the chance for early detection of abnormal changes to the body. Early detection of cancer allows for more treatment options and better outcomes. By educating yourself about the early signs of cancer, you can take charge of your health. With self-examinations, it is possible to detect testicular and breast cancers in some cases. Read on for some facts about breast and testicular cancers and recommended instructions for selfexamination.

testicular self-examination

steps for testicular self-examination 1. perform TSE after hot shower or bath so your scrotum is most relaxed

total wellness â&#x2013;Ş winter 2013

Testicular cancer is the most common type of cancer found in men between the ages of 15 and 35 and is more common in Caucasians. According to a 2011 study published in Clinics, testicular cancer is easily diagnosable by self-examination and is 96% curable if detected early. In the same study, it was found that knowledge of testicular cancer was poor and young adult men were unaware of their risk for testicular cancer. Due to lack of patient education, opportunities for early detection are often missed. Physicians recommend that their patients try to perform a testicular self exam (TSE) once a month. A monthly TSE will make you more familiar with the size and shape of your testicles which will allow you to notice any changes from your normal condition. If you notice any changes or experience pain, you need to contact your physician. Changes in the testicles may or may not indicate testicular cancer. If testicular cancer is caught and treated early, it is almost always curable.

2. examine one testicle at a time looking for lumps or an enlarged swollen testicle 3. use both hands and roll your thumb over the top to stabilize the testicle and use your middle and index finger behind the testicle and roll it back and

Breast self-examination Many medical professionals agree that beginning breast self-exams (BSE) in your 20’s is ideal. This is a way that you can learn what your breasts normally feel like and notice any changes in the way your breasts look or feel. Your breasts will feel differently depending on where you are in your menstrual cycle. For this reason, it’s best to do your self-examination after your period. The benefit of self-examination is early identification of breast cancer. According to a 2012 study published in The Journal of Steroid Biochemistry and Molecular Biology, breast cancer incidence is the highest for women of European descent in the U.S. However, women of African ancestry have a higher incidence of breast cancer diagnosed before age 40 and have tumors with more aggressive features which limits therapies and leads to poorer outcomes. When breast cancer is identified early, there is a much greater chance of survival. If you notice any changes in your breasts, you should contact your physician for further examination. t w

checking under the arms The breasts are triangularly shaped and reach under the armpits, which is why you need to check under the arms. You need to check under the armpits for lymph nodes which are similar to the lymph nodes/glands in your neck that can become enlarged when you get sick with a cold or sore throat. Lymph nodes are approximately the size of raisins, so anything firm and bigger than a raisin needs to be reported.

for more information about cancers visit: http://www.cancer.org http://www.cancer.gov http://www.breastcancer.org

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for further instructions on how to perform a breast self-examination visit: http://www.nationalbreastcancer.org/breast-self-exam http://www.webmd.com/breast-cancer/guide/breast-self-exam

for further instructions on how to perform a testicular self-examination visit:

http://www.webmd.com/cancer/features/testicular-cancer-selfexams-at-home http://kidshealth.org/teen/sexual_health/guys/tse.html

“p”s

1. position

You should perform the BSE in both a standing up and lying down position.

2. perimeter

Look to see if your breasts are symmetric. While few women have perfectly symmetrical breasts, a 2006 study published in Breast Cancer Research, found that greater breast asymmetry was related to an increased risk for breast cancer. Nevertheless, keep in mind that one side is usually slightly different from the other and minor differences should not cause alarm.

3. palpation

Visualize the breast as a “clock”: 12:00, 3:00, 6:00 and 9:00. Using the flat parts of your fingers (the pads), apply firm, circular motions, palpate the breast tissue from the collarbone, all the way down to the bra-line and around to the armpits. However, just because you feel a lump does not mean it’s cancer. The breast is made up of fat which is often lumpy. You need to know where your normal lumps are and if they are changing.

4. pressure

Use light pressure on your breasts the first time around, then firmer pressure the second time. Avoid using the tips of your fingers and instead use the pads, which have many nerve endings and are very sensitive.

5. pattern

The smoothest skin on a woman’s body is over the breasts. There should not be any dimpling or retractions on the skin.

6. practice

Learning about what is normal and abnormal takes practice. Feel and learn what is normal for you so you can be aware of any changes.

7. planning

The best time to do your BSE is after your period. Before and during your period breasts tend to be more lumpy and painful. Wait until your hormones are at their baseline, which is usually after you finish your period, before checking your breasts. For women who are menopausal, use the calendar as a reminder to check your breasts once a month.

eat right

to can or

not to can? by leslie chang | design and illustration by kristen sadakane

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Many people donâ&#x20AC;&#x2122;t have time to make meals from scratch or go to the store to buy fresh ingredients every day. Instead, some rely on canned goods that have a long shelf life and often contain important ingredients for meals. Canned food can be quickly heated and added for flavor and nutrition. However, how healthy are these canned goods? It is important for consumers to make an informed decision about the health benefits of canned goods and to understand both the risks and benefits of eating out of the can.

quick guide for canned goods consumption: if you’re buying canned goods, look for: ❯ Labels that say “BPA free lining” and “Preservative free” ❯ Foods that are out of season and difficult to get fresh

do canned goods contain unhealthy chemicals? bisphenol A (BPA) The main harmful chemical found in cans is bisphenol A (BPA). This chemical lines metal cans and polycarbonate plastics like baby bottles. In studies with rodents, BPA is found to speed up sexual maturation, alter behavior and affect the prostate and mammary glands. In humans, BPA has connections with increased cardiovascular disease, diabetes and male sexual dysfunction. This chemical is fairly widespread as the Environmental Working Group (EWG) found trace amounts in nearly 57% of all cans ranging from canned meat to vegetables and soups. Although BPA has been linked to health problems, a 2011 study published in the Journal of Agricultural and Food Chemistry indicated that the amount of BPA in cans to be almost 1,000 times lower than the “tolerable daily intake” levels set by the US Environmental Protection Agency (EPA) and the European Food Safety Authority (EFSA). These levels are set at 0.5 mg per kg of body weight. However, some acidic canned goods, such as tomatoes and citrus, can cause BPA to leach into foods much faster, which can increase the amount of BPA consumed. Also, when metal is used to scrape the can, the metal on metal friction increases the likelihood of scraping off some of the chemical lining; therefore, it is suggested that scraping should be done with a wooden utensil. Overall, there is still little risk involved in buying canned and other packaged goods that might contain BPA because levels of BPA in canned goods are not anywhere near the amounts that are dangerous for human consumption. For those who are still worried about potential health detriments of BPA, there are many varieties of BPA-free canned goods available. In addition, many goods that are canned may also be bought in glass jars or other containers that do not contain BPA.

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preservatives Other common chemicals found in canned goods are preservatives. Preservatives are used to increase shelf life by preventing mold, yeast, and bacteria from growing in food products. However, this can also result in adverse effects for human consumption as chemical interactions within the body often turn these preservatives into carcinogens. Sodium nitrate, often found in pickled vegetables, has been linked to stomach cancer. A 2006 study published in World Journal of Gastroenterology reviewed currently published studies on gastric cancer and found that foods containing nitrate were significantly linked to this cancer. In addition, this chemical was found to be related to tumors in 40 different species of animals. A 2002 study published in the International Journal of Cancer discovered that nitrosamines, another preservative, might elevate the risk for esophageal cancer. Therefore, preservatives in canned goods could be detrimental for human health and thus, the use of canned foods should be limited to when fresh ingredients are not an option.

❯ Foods that need heavy processing like garbanzo beans, cranberry sauce, chicken stock etc. ❯ Foods that need to be preserved like olives

BPA when shopping for canned goods, avoid: ❯ Acidic fruits and vegetables ❯ Fresh foods that are always available ❯ Canned goods with high sodium content (The Dietary Guidelines for Americans recommends less than 2300 mg of sodium a day) ❯ Foods that can be bought in other containers, like jars

Na+

are fresh fruits and vegetables more nutritious than canned foods? Fresh and canned fruits have been found to be nutritionally similar for many common minerals and vitamins. In fact, for a few nutrients, canned goods were found to be superior to fresh fruits. A 2007 review published in the Journal of the Science of Food and Agriculture reported that fresh fruits and vegetables have been found to lose nutrients after harvest; for example, green peas have been found to lose 51.5% of their ascorbic acid during the first 24 to 48 hours after picking. On the other hand, canned peas had smaller losses of ascorbic acid, less than 15% compared to ripe peas. In addition, fruits and vegetables are often picked before being fully ripened and are either artificially ripened or naturally ripen in transport which results in lower nutritional value. Canned goods are picked fully ripened and quickly transported to canning facilities which results in higher nutrition. Unfortunately, some of those nutrients can be leached out of canned goods as they are stored on shelves. However, as most Americans do not eat enough total fruits and vegetables as recommended by the government’s Five-A-Day program, supplementing their diet with canned goods is a good alternative if fresh fruits and vegetables are not available. This by no means suggests that people should forgo fresh produce because often times, canned foods contain a lot of sodium which can lead to increased blood pressure. t w

easy canned recipe: hummus: This snack is easy and fast to make, not to mention incredibly nutritious. Also, it is perfect for busy students and professionals alike as it doesn’t require many ingredients and can be stored for a week, thus enabling people to make a bigger batch for consumption later. Not only is it great for dipping with fresh vegetables, but it can also work as a spread for a sandwich or pita bread. Chickpeas, the main ingredient, are high in fiber and can regulate blood sugar levels as well as lower cholesterol. Although this is a basic recipe, don’t hesitate to add in other condiments like sundried tomatoes or olives for a more personalized flavor.

ingredients:

1 clove of garlic

1 can of garbanzo beans, approximately 15 oz

2 tbsp of tahini

1 tsp of salt

2 tbsp of olive oil

4 tbsp of lemon juice

black pepper to taste

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directions: In a blender, first blend the garlic and then pour the garbanzo beans into the blender. Then, place the lemon juice, tahini and salt in the blender, and blend until everything is creamy and well mixed. Transfer the mixture to a medium serving bowl, sprinkle with pepper, and pour olive oil on top.

eat right

fruity favorites by jennifer miskabi | design by annie theriault

We often hear that the golden rule for maintaining

Water is definitely the first beverage that comes to mind when you think of healthy drinks. Although it may very well be the healthiest non-caloric beverage available, the recommended six to eight glasses of water a day can get quite boring and repetitive sometimes. Fortunately, it is not necessary to turn to sugary sodas or unhealthy milkshakes to quench your thirst. There are many refreshing fruit juices that can reduce the risk of cancer, boost immunity, and even help with dental hygiene. According to a 2008 study published in the Archives of Pediatrics and

Adolescent Medicine, regular consumption of fruit juice did not lead to weight gain in children, and was associated with good nutrient intake. This study found that children who consumed around four ounces of 100% fruit juice per day, compared to non-consumers, had lower intakes of total fat, lower intakes of added sugar, and consumed more servings of whole fruit. Thus, the researchers concluded that 100% fruit juice is correlated with better nutrient intake and is not associated with weight status or likelihood of being overweight. Further studies also affirm the health-benefits of fruit juices. For example, according

to the 2003-2006 National Health and Nutrition Examination Survey, consuming 100% fruit juice in moderation should be encouraged and integrated into oneâ&#x20AC;&#x2122;s diet, as it can improve diet quality. According to the survey, in addition to contributing greatly to an overall healthier diet, 100% fruit juice can improve nutrient adequacy. Choosing the right beverages can go a long way for your health. Here are a few examples of the healthy fruit drinks and their benefits.

left: magone/istockphoto; right (in order): macroworld/istockphoto; mycan/istockphoto;

total wellness â&#x2013;Ş winter 2013

wellness is regular exercise and healthy eating habits. While nutrition is often associated with daily meals, a healthy diet goes beyond the food that you eat. When thinking of nutrition, many do not consider beverages (which in addition to solid food contribute greatly to our diets). The average American gets about 20% of their daily calories from beverages alone. Many of these drinks, however, are not beneficial to our health. In fact, according to a 2009 study published in The American Journal of Clinical Nutrition, 37% of our daily liquid calories are from sugar-sweetened drinks. The study also found that the reduction of sugar-sweetened beverages is highly associated with weight loss in individuals.

orange juice Oranges are one of the richest sources of vitamin C, an essential antioxidant that protects the body from the harmful effects of free radicals. Vitamin C also helps in the production of collagen. Another benefit of orange juice is its flavonoid content, which has anti-inflammatory properties.

health benefits of vitamin C ❯ Prevents Free Radical Damage: Free radicals are unstable molecules that can damage all the cells and tissues of the body and can also damage genetic material. This creates oxidative stress on the body that can increase the risk of common forms of cancer and heart disease, cause damage to the immune system, and even impair cognition and brain functions. Antioxidants such as the vitamin C found in orange juice combat the formation of these free radicals.

health benefits of flavonoids ❯ Collagen Formation: Vitamin C is needed to produce collagen, which is important for healthy skin and supporting immune system function. The vitamin C content of a medium-sized orange is approximately 75 mg. Thus, according to a 2003 study in The American Journal of Clinical Nutrition, having at least two glasses (500 mL total) of orange juice a day increases plasma vitamin C concentrations by 40 to 64%! This increases the body’s ability to fight free radical damage. Fortunately, one cup of orange juice has 100% of the vitamin C recommended per day, so enjoy every sip to great health.

❯ Anti-inflammatory Properties: Furthermore, the flavonoids in orange juice help protect the body against inflammation. A 2010 study in The American Journal of Clinical Nutrition, suggests that the natural flavonoids in orange juice can counteract the pro- inflammatory effects that result from the consumption of an unhealthy meal. Inflammation can potentially lead to atherosclerosis (the hardening of the blood vessel wall), and increased insulin resistance (which can cause type II diabetes).

pomegranate juice The health benefits of a refreshing glass of 100% pomegranate juice include its antioxidant potency, cardiovascular benefits, and anti-cancer qualities.

health benefits ❯ Heart-Healthy Drink: Pomegranate juice has other benefits such as strong anti-atherosclerotic, anti-oxidative, and anti-aging properties. According to a 2011 study published in Complementary Therapies in Clinical Practice Journal, pomegranate juice is a heart-healthy drink that can lower systolic blood pressure. Additionally, a 2005 study published in the American Journal of Cardiology found that the daily consumption of pomegranate juice may be beneficial for patients with coronary heart disease and may improve their condition.

❯ Decrease Cancer Progression: Although there is no specific evidence that pomegranate juice can prevent cancer, there have been studies conducted, specifically on breast cancer and prostate cancer, that show this juice may slow down the reproduction of the cancer cells. For example, a 2006 study in the Clinical Cancer Research Journal suggests that there is evidence of pomegranate juice actually slowing the progression of prostate cancer recurrence in men who have been treated for the disease with radiation or surgery.

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❯ High Levels of Antioxidants: For starters, pomegranate juice has an extremely high antioxidant level. A 2008 study reported in the Journal of Agricultural and Food Chemistry measured the antioxidant content of different fruit juices. Of all the fruit juices tested, pomegranate juice had the greatest antioxidant level, beating all the others by at least 20%. Additional studies also found that the antioxidant level in pomegranate juice surpasses that of other beverages such as blueberry juice, cranberry juice, orange juice, and even red wine.

cranberry juice While cranberries are relatively small, they have big health benefits. Drinking cranberry juice can help prevent cavities and urinary tract infections from occurring. The caveat? These benefits are attributed only to unsweetened cranberry juice.

shopper’s guide ❯❯

quick tips on what to look for If you are choosing bottled juice, canned juice or even a juice box, there are some choices you can make for a healthier fruit juice experience. Keep these tips in mind when selecting your ideal healthy fruit juice:

❯ Prevention of Urinary Tract Infections: Bacteria such as E. coli can cause infections by invading the urinary tract. While E. coli is the most common cause of a urinary tract infection, studies conducted at Worcester Polytechnic Institute have demonstrated that cranberry juice can prevent E. coli from creating biofilms, which form on the lining of the urinary tract and permit the multiplication of bacteria. Since stopping the formation of biofilms is the first step in preventing urinary tract infections, this research suggests that consuming cranberry juice may be effective in protecting against these infections.

❯ Improvement of Dental Health: Research from the University of Rochester Medical Center indicates that cranberry juice may be effective in the prevention of cavities. Similar to its effects on the urinary tract, cranberry juice inhibits bacterial biofilm formation in the mouth, which inhibits plaque build-up on tooth surfaces, thereby decreasing the risk of developing cavities and gum disease. However, keep in mind that these benefits apply to unsweetened varieties of cranberry juice; therefore, you should try to look for ones with the least amount of sugar, or better yet, 100% pure juice. If it is too tart, try adding some water to it

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bottom line Although fruit juices can be beneficial to one’s health, you must keep in mind that they may also be very costly in terms of calories. In fact, when consumed in excess, high-calorie fruit juices may sabotage one’s efforts to maintain a healthy weight. Thus, one should try to consume fruit juices in moderation. Fruit juices are a great alternative to beverages such as energy drinks, sodas, and sugar-filled iced coffees, all of which offer much less nutrition. Unlike these drinks, 100% real fruit juice is loaded with vitamins and minerals and may contain fewer calories and sugar. If the option is available, always choose the whole fruit over the juice. That way, you gain all the health benefits discussed, as well as the fiber, which helps keep you full. t w

❯ Read the Label and Avoid Additives When reading the fruit juice label, avoid additives and flavors as much as possible. Read the ingredients list and look out for unexpected additives and flavors such as artificial flavors and sweeteners, colors and dyes, and high fructose corn syrup. It may be hard to avoid certain additives, such as preservatives and thickeners, but try to limit the amount of additives in your fruit juice. ❯ Puree and Pulp Puree and pulp are the crushed parts of the fruit that usually get tossed out, tossing out beneficial fiber along with it. Puree and pulp are actually desirable traits in a healthy fruit juice, and one should enjoy it for a healthy dose of their daily fiber. The thicker and creamier consistency of a fruit juice containing puree or pulp can also be quite enjoyable!

left: elenathewise/istockphoto; right: kataryna govorushcenko/istockphoto

health benefits

❯ 100% Fruit Juice Fruit juice is a great beverage, but fruit drinks may not be. Try to avoid fruit drinks that end with “ade,” “cocktail,” or “beverage” and instead look for “100% fruit juice” written on the label.

total wellness ❯❯ on the cover

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"The groundwork of all happiness is health.” – James Leigh Hunt

feature

ways to a healthier

smile by julie escobar| design by barbara wong

total wellness ▪ winter 2013

In fact, according to a 2007 article in the Journal of Clinical Microbiology and Infection (CMI), “oral infections have become an increasingly common risk-factor for systemic disease,” which indicates that taking care of your teeth and gums not only reflects a brighter smile, but also a healthier way of living.

left and right: samposnick/istockphoto

When a person smiles, they reveal more than just a toothy grin of pearly whites; a healthy smile is also a good indicator of overall wellbeing. For many, smiling can make people appear more attractive, portray individual moods, and relieve stress. While cleaner, whiter teeth are often associated with health and youth, people tend to subconsciously connect a dull smile with age, poor health, and poor hygiene.

why is oral health important? Studies suggesting that oral health can positively or negatively affect the entire body have reported how poor oral conditions may be risk factors or indicators of poor systemic health. According to the 2007 article from CMI previously mentioned,“The relationship between oral and general health has been increasingly recognized during the past two decades,” revealing how “epidemiological studies have linked poor oral health with cardiovascular disease, poor glycaemic control in diabetics, low birth-weight preterm babies, and a number of other conditions, including rheumatoid arthritis and osteoporosis.” Periodontal disease, a disease affecting the tissues that surround and support the teeth, is one of the major oral health conditions connected to other systemic illnesses. Periodontal diseases appear in the form of a chronic infection that ranges from a simple gum inflammation to a more serious disease, such as gingivitis and periodontitis. In a 2008 article from U.S. World News

& Report, “Three in four American adults have at least mild periodontal (gum) disease, or gingivitis. More severe disease, or chronic periodontitis, may affect as many as 30 percent.” The cause of periodontal disease is when the bacteria that reside in the buildup of plaque and tartar on teeth is not removed regularly with brushing and flossing. The longer the sticky residue or plaque remains on the teeth, the more resistant it will get to removal and, the more harmful it becomes. The growth and persistence of bacteria in the mouth eventually stimulates a local and systemic host response which affects and is affected by other conditions. According to a 2000 article published in Periodontology, the “possibility that morbidity and mortality from systemic diseases may be reduced by improving periodontal health, makes it imperative that this relationship be examined more closely.” Whether mild or severe, prevention and maintenance may depend on how well you care for your teeth. Individuals can improve oral health and reduce the chance of developing other systemic diseases by following simple oral health routines.

what do i need to know? In order to attain your best smile, there are a few things everyone should keep in mind. When the bacteria in plaque break down simple sugars in the food that you eat, they produce acids. With repeated and prolonged exposure to acids, tooth enamel can eventually erode or decalcify, resulting in dental caries (cavities). Foods that increase the flow of saliva neutralize acids in the mouth, protecting tooth enamel. The flow of saliva also washes food out of the mouth, limiting the amount of time it is in contact with teeth.

hygiene and diet 101

total wellness ▪ winter 2013

To prevent the buildup of plaque on teeth and prolonged exposure to acids, proper hygiene and a balanced diet can reduce the occurrence of common dental problems, including the number of dental caries that one develops. While regular brushing and flossing are the best protection against tooth decay and gum problems, approximately 17% of adults admit to never flossing, and about 25% of adults ages 35 to 59 have untreated tooth decay. Thus, adhering to a proper oral regiment and maintaining a balanced diet with adequate nutrition is necessary to promote healthy teeth and help overcome standing conditions. Many nutrients, including vitamin C, vitamin D, calcium and others, are essential to oral health.

tips & tricks

for a healthy smile 1. limit carbs to mealtimes – Have carbs at mealtimes rather than as a snack. Carb-based foods, like breads and crackers, have a sticky residue that allows them to easily get caught between teeth and under the gum line. When you eat a larger amount of food, you produce more saliva, which helps wash food particles away.

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3. increase your vitamin C intake – According to a study of more than 12,000 US adults at the State University of New York, University at Buffalo, individuals who consumed less than 60 mg per day of vitamin C were 25% more likely to have gum disease than people who took 180 mg or more. 4. drink tea – Antioxidants found in tea are good for your gums. Black and green teas contain polyphenols, antioxidant plant compounds that prevent plaque from adhering to your teeth and reduce the chance of developing cavities and gum disease. Many teas also contain fluoride which guards enamel from decay and promotes healthy teeth. 5. sip with a straw – Sipping acidic drinks through a straw aimed at the back of the mouth reduces the amount of contact it has with teeth and can help preserve tooth enamel. Drinking teas and other coffee beverages through a straw can also help minimize stain build up on teeth. Of course, caution should be used when drinking a hot beverage through a straw.

6. boost calcium consumption – According to researchers at the University of Buffalo, people who intake at least 800 mg of calcium a day are less likely to develop severe gum disease. Attributable to the fact that 99% of the calcium within the body is found within the bones and teeth. Dietary calcium, obtainable in foods such as cheese, milk, and yogurt strengthen the alveolar bone in the jaw, which helps hold teeth in place. 7. have an apple a day – Crunchy foods, such as apples, celery and carrots help scrub away stains when you chew them. Jeff Golub Evans, DDS, founding president of the New York Academy of Cosmetic Dentistry, states that “The mildly acidic nature and astringent quality of apples, combined with their rough, fiber-rich flesh makes them the ideal food for cleansing and brightening teeth.” 8. eat more whole grains – According to a study conducted by researchers from McMaster University in Canada, whole grains keep teeth healthier longer. Among 34,000 men studied for over 14 years, those who ate at least three whole grain servings a day, were 23% less likely to suffer from tooth-loosening gum inflammation than those who averaged less than one serving. Eating more grains also stabilizes blood sugar levels, an important factor in reducing periodontitis in diabetes.

9. chew gum – Chewing gum stimulates salivary flow. According to a 2010 study published in The Journal of the American Dental Association, “Chewing sugarless gum for 20 minutes after meals can help prevent tooth decay.” 10. perfect your stroke – Irwin Smigel, DDS, and president of the American Society for Dental Aesthetics states, “Many adults never learned to brush and floss properly.” What’s the key? Remember to brush twice a day using a soft toothbrush with rounded nylon bristles in gentle circular motions at the gumline and then vertical sweeping movements of the toothbrush between teeth. Make sure to hold the brush at a 45° angle to the gum line, and to floss between the teeth daily. 11. stay away from smoking – Sally Cram, DDS, a periodontist in Washington, D.C. and a consumer for the American Dental Association states that, “smokers get periodontal disease at two to three times the rate of non-smokers.” Other oral health impacts from tobacco products include stained teeth and tongue, a dulled sense of taste and smell, and an increased risk of lung and oral cancers. 12. book your appointments – The mouth is a gateway into your body's overall health. Taking care of your teeth and gums can also mean preventing other serious illness. See your dentist regularly to keep your smile and yourself healthy.

left: samposnick/istockphoto

2. don't drink acidic drinks and brush – According to Mary Hayes, DDS, a spokesperson for the Chicago Dental Society, “Acid in an acidic drink or beverage combined with the abrasive action of brushing, can erode your tooth enamel.” Instead of brushing your teeth first, try sipping water or chewing gum to activate acid-neutralizing saliva, and then brush your teeth afterwards.

foods to avoid for healthy, white teeth

foods to choose for healthy, white teeth

1. SUGARY DRINKS such as soft drinks and fruit juices.

1. WATER

2. CANDY AND HIGHLY-SWEETENED SNACKS, especially sticky and gummy candies which stick to teeth and are not easily washed away by saliva.

2. SUGAR-FREE DRINKS

3. SOME STARCHY FOODS including, but not limited to, breads, pastas, rice, and potatoes. 4. SUGARY BREAKFAST CEREALS such as ready to eat breakfast cereals, pastries, and many processed foods. 5. COFFEE, SWEET TEA, AND RED WINE Which are drinks that tend to stain teeth.

3. SUGAR-FREE CHEWING GUM Look for the American Dental Association (ADA) Seal of Acceptance when choosing a sugarless gum, this means it has met the ADA’s criteria for safety and effectiveness. This includes providing evidence that the components of the product are safe for use in the oral cavity, and whether or not the sugar free gum contains an active/therapeutic agent intended to help reduce cavities. For example, Xylitol containing mints/gums can be useful in reducing the acidity in the mouth after eating by stimulating salivary flow. 4. CITRUS FRUIT

Certain foods, like chewing gum, citrus fruit, and cheese and milk, increase the flow of saliva, which neutralizes acids in the mouth protecting tooth enamel. Note: Although fruits are good for you, some fruits when consumed in excess can result in erosion of the enamel due to the acidic nature of certain fruits – such as lemons, oranges and even apples.

5. CHEESE AND MILK Minerals including protein, calcium, and phosphorous found in cheese and milk also buffer acids protecting enamel. 6. FISH AND FLAX, especially those high in omega-3 fatty acids, a strong anti-inflammatory nutrient. 7. COCOA Try choosing dark chocolate over milk chocolate since dark chocolate contains less sugar.

All of the above mentioned foods and drinks increase acid levels in the mouth. Acid is produced not only by bacteria that reside in the mouth, but from the acidic nature of the foods and drinks themselves. This increased flow of acids can erode tooth enamel, creating pits in the teeth where cavities can form.

All of the above mentioned foods and drinks help wash away acid-producing foods and bacteria from the mouth. Additionally, substances found within fish, flaxseed, and cocoa can help reduce inflammation and protect against erosion and decay. t w

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did you know? There are over 600 types of bacteria in the mouth.

While some are considered protective from other more harmful bacteria, the majority of bacteria can cause real damage to your teeth and gums. 29

feature

the benefits and controversies of the new HIV prevention pill: truvada by samantha mojica | design by mary sau

total wellness â&#x2013;Ş winter 2013

because not many people knew what the virus was or how it was transmitted. Many people who contracted HIV at the time considered it a death sentence because there were no medical treatments. Over the past 32 years, scientists have identified the virus along with the ways in which it is transmitted and as a result, social stigma associated with the virus has significantly

decreased. Scientists have also developed antiretroviral therapies (ART), which use a combination of pills that reduce the rate at which the virus multiplies. Although ART allows HIV positive individuals to live normal, healthy lives, the potency of the combination of pills has negative side effects on individuals. However, in the last decade, scientists have been working on a single pill called Truvada, which has recently been approved as an HIV prevention pill. While the development of this medicine may seem like a breakthrough in HIV prevention, some experts are concerned that the public may be misinformed about the medication. This article provides a description of what Truvada is, how to use it correctly, and common misconceptions most people have about Truvada.

left: levent ince/istockphoto; right: mac99/istockphoto

When the human immunodeficiency virus, commonly known as HIV, was first discovered in 1981, it was stigmatized

myths and misconceptions truvada: what is it? Truvada is a fixed-dose combination of the two antiretroviral drugs known as tenofovir (300 mg) and emtricitabine (200 mg). Combining these two drugs into one pill makes the process of taking medication easier and more convenient. Marketed by Gilead Sciences, Truvada was first approved by the FDA in August 2004 as a treatment for HIV. Recently, it was approved in July 2012 as a method of pre-exposure prophylaxis (Pr-EP), which is the prevention of HIV transmission in individuals at high risk of infection.

controversial approval: will the security of truvada encourage risky sexual behavior? Although Truvada will help reduce HIV transmission, public health experts are worried that the public may be misinformed about Truvada and therefore be inclined to engage in riskier sexual behavior. However, at approximately $13,000 a year, Truvada is not an over-the-counter drug. Additionally, Truvada should not encourage teenagers and adolescents to engage in riskier behavior because most would not be able to afford it. Instead, this drug is designed for “discordant couples”, which are committed couples where one partner is HIV-positive and the other is HIVnegative. Truvada is also well-suited for discordant couples who want to have children. Some discordant couples decide to pay for the expensive medical procedure of “sperm-washing”, where scientists separate the HIV from the sperm, combine the disinfected sperm with the egg, and implant the embryo back into the woman. Instead of struggling through this process, taking Truvada properly could help discordant couples conceive children with less hassle and less money spent. The benefits of Truvada outweigh the disadvantages because it can help reduce the number of people infected with HIV and ultimately prevent the transmission of HIV.

myth: HIV negative individuals do not have to worry about using condoms or practicing safe sex as long as they are taking Truvada. truth: Although Truvada can reduce the risk of HIV transmission up to 90%, part of the Pr-EP process involves using Truvada along with proper condom use, regular HIV testing, and screening for and treatment of other sexually transmitted infections (STIs). Taking Truvada does not make people invincible to HIV. It is important to use Truvada properly and continue safe sex practices. myth: Truvada cures HIV/AIDS. truth: Truvada does not cure HIV/AIDS. For

HIV negative individuals, Truvada serves as a precautionary measure that can reduce the risk of contracting HIV. For HIV positive individuals, Truvada - in combination with other HIV medication - serves as a treatment for individuals to manage their levels of HIV. However, both groups of people should still use condoms and limit their number of sexual partners.

myth: For HIV positive individuals, missing a dose of Truvada is acceptable as long as he or she is taking other ART. truth: Missing a dose of Truvada is risky because HIV can adapt and develop a resistance to the drug. If an HIV positive individual consistently misses his or her dose of Truvada, the HIV virus in his/her body may develop complete immunity from the drug, rendering Truvada ineffective for that individual. Truvada works best with other antiretroviral drugs such as protease inhibitors (PI) and non-nucleoside reverse transcriptase inhibitors (NNRTI). However, it has a negative reaction with Atripla, Emtriva, Viread, Hepsera, and Epivir.

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Annual Conference for

Integrative Medicine Dr. Hung Dinh Pham, PhD is a professor at UCLA who teaches many science courses including Life Science 3, Life Science 4, Molecular, Cell, and Developmental Biology (MCDB) 40, and MCDB 60. His MCDB 40 class focuses particularly on HIV and the negative effects of the social stigma associated with HIV. Below is an interview with Dr. Pham concerning his beliefs on AIDS awareness.

Q: What do you think about Truvada? Is it helpful or harmful in preventing the transmission of HIV? A: “I believe that Truvada is ultimately helpful in preventing

the transmission of HIV, but people still need to be careful and make informed decisions when using it. It is extremely risky to use Truvada when one is uninformed. For example, for a couple where one partner is HIV positive, the HIV negative partner may think that he or she is immune from the virus after taking Truvada, but Truvada does not provide immunity. It is crucial to continue using condoms even when taking Truvada. Another risk is missing a dose of Truvada. If the virus is already in your system and you miss a dose, the virus can develop a resistance to the drug and mutate into a stronger strain of the virus.“

Q: What is your Molecular, Cell, and Developmental Biology (MCDB) 40 class about and why do you feel it helps contribute to HIV awareness and prevention?

Nut ritio n

There is a community service aspect of the class where students volunteer for Aids Awareness Organizations and get to experience how important it is to educate youth about HIV itself as well as the social stigma surrounding HIV. Although the stigma surrounding HIV is not as prevalent today as it was in the 80’s, some stereotyping towards certain groups of e icin people still occurs. One ofMedthe movies that is part of the class e nes i h is Philadelphia, where Cstudents can learn about how so many • h c sear • Re were mistreated because society did not HIV positiveeapeople Care H lth Wellness • know how contagious the virus was. It is important to continue educating people so that we can move towards eradicating not only HIV, but also the discrimination associated with HIV.” t w •M ind -Bo dy •

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A: “The MCDB 40 class here at UCLA can be broken down into two components: the education of HIV and the elimination of the social stigma surrounding HIV. The class does not focus only on the biological aspect of how the virus works, but also the social and historical context in which the virus occurred. Yes, knowing how the virus is transmitted and knowing how to avoid it is important, but it is also important to be aware of the stigma and discrimination associated with HIV and why it is necessary for society to be accepting towards HIV positive people.

Date: Saturday, 02/02/13 Time: 9AM-3PM Place: UCLA NRB Auditorium Featuring: • John Weeks The Integrator Blog • Ping Ho, MA, MPH UCLArts and Healing • Lawrence Taw, MD UCLA Center for EastWest Medicine • And many more! If interested in attending or volunteering, please visit http://studentgroups.ucla.edu/ncam or http://exploreIM.ucla.edu.

Annual Conference for

Integrative Medicine

Int

left: valentín garcia rodriguez/istockphoto; right: skip odonnell/istockphoto

an inside perspective on truvada

Int

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finding the perfect fit: your guide to shoes by tiffany lin | design by keziah pagtakhan

Pain. Soreness. Blisters. After a full day of walking up and down the hills of a college campus, running errands around town, and hitting

the gym for a workout, how do your feet feel when the shoes finally come off? Our feet undergo a lot of pressure, stress, and physical toll on a regular basis, and many types of foot pain and injuries can be attributed to ill-fitting shoes or wearing the wrong type of shoes for the activity.

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❯❯

Minimize the negative effects of shoes on your feet by knowing how different types of footwear can cause changes in feet muscles and what to look for in an optimal pair of shoes.

buyer’s guide: what to look for

❯

Ankle and arch support

❯

Thick, firm cushioning

❯

Materials that allow the foot to breathe

minimalist shoes A popular trend recently has been to run barefoot; in 2010, a study published in Nature found evidence that athletic shoes may weaken foot muscles and encourage runners to strike the ground with their heels forcefully. Minimalist, low-tech shoes are lightweight with thin soles and are supposed to mimic the barefoot experience, but still provide protection for the foot for harsh environments. Potential Problems: According to a study conducted by the American Council on Exercise in 2011, these minimalist, low-tech shoes can actually increase the impact and stress on the foot if the runner continues to land on the heel. Additionally, these shoes are usually worn without socks, which may cause foot odor and fungal infections due to the sweating of the feet during highly physical activities like running. When to Wear: If the runner is able to adapt to landing on the balls of the feet, these shoes decrease stress and impact on the foot.

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Potential Problems: In 2008, Auburn University researchers presented research at the meeting of the American College of Sports Medicine indicating that wearing flip flops can cause sore feet, ankles, and legs. This type of footwear causes people to take shorter steps, makes the heel hit the ground with less vertical force, results in a larger ankle angle when walking, and forces the toes to grip the shoe all of which are unnatural movements. When to Wear: Though flip flops are worn often on college campuses, they are not designed for long-term wear. They do not have proper support for the feet and ankles and expose the toes, but they can be worn in moderation without serious negative effects. Wear flip flops when you’re walking around the dorms or visiting the beach, but try to avoid these as an everyday default shoe or when walking long distances. Additionally, the APMA recommends flip flops made of soft natural materials, such as leather, to minimize the potential for blisters and irritation.

left (in order): david freund/istockphoto ; lee pettet/istockphoto; right (in order): oliver blondeau/istockphoto; maxim malevich/istockphoto

flip flops

the professional take athletic shoes Potential Problems: Ideally, an athletic shoe buffers impact forces and does not change foot movement too far from the natural barefoot state. A study published in the Journal of Athletic Training in 2006 recommends thickly cushioned shoes for decreased impact on the foot. However, not all athletic shoes meet these ideal characteristics.

When to Wear: These are the shoes of choice whenever a highly physical activity is involved. Wear these to the gym or whenever you will be spending a lot of time on your feet. More expensive shoes made with higher quality materials and better design may be worth the investment for someone with an extremely active lifestyle.

high heel shoes

Wearing any type of shoe will affect foot muscles, since it deviates from the barefoot condition. Here are some things to keep in mind before walking out the door:

›

Make sure the size and width of the shoe fits your foot.

›

Wear the appropriate shoe for the activity to minimize the risk of muscle fatigue and injury.

›

Try not to wear any one type of shoe for an extended period of time to prevent the development of chronic muscle problems.

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Potential Problems: A 2011 study published in the Journal of Applied Physiology discovered that chronic high heel wearing leads to altered muscle geometry, which compromises muscle efficiency in high heeled and barefoot walking, even when the shoe is not being worn. This type of footwear also causes discomfort, muscle fatigue, and increases the risk of strain injuries. Long term wear may also result in the development of Morton’s neuroma, a nerve injury between the third and fourth toes, since high heels tend to have a narrow shape that squeezes the toes together.

Podiatrists emphasize assessing the “foot-type” of their patients, making observations about arch height and the biomechanics of the foot during activity. Individual recommendations are madex based on their evaluations, since it is difficult to recommend one shoe that will benefit all types of feet.

When to Wear: Since most of the severe negative effects of these shoes stem from chronic wear, they can be worn at special occasions for a short period of time without too many problems. tw

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fighting dandruff head-on by sofia levy| design by catrina pang

total wellness ▪ winter 2013

Psoriasis is a common autoimmune disease that affects the skin. In individuals with psoriasis, their autoimmune systems send out signals that speed up the production of skin cells. With the skin making too many new cells, this can affect the scalp causing it to be itchy, be sore, and/or shed brittle, loose flakes.

Remedies/Treatments:

Psoriasis can be treated with shampoos containing tar and salicylic acid and steroid creams. There are also ultraviolet light therapies for psoriasis and injection treatments for severe psoriasis.

Seborrhea is a type of dandruff that is a common form of eczema. It effects five percent of the population and generates waxy, yellowish-brown, greasy scales along with a very oily scalp. It can start at birth (known as “cradle cap”) and affect many areas of the body, even though it is not very itchy. Seborrhea can occur in people who have weak immune systems such as those on chemotherapy or those who have HIV. It can also result as a reaction to a yeast that can grow on the scalp Remedies/Treatments:

Seborrhea can be treated with frequent and vigorous shampooing with dandruff control shampoos. Adults treating seborrhea should part their hair into small sections, apply the shampoo to each small area at a time, and scrub for five minutes to loosen the flakes. Babies with cradle cap should receive a similar routine with frequent shampooing. However, they should be treated carefully with gentle massages and soft brushes.

left: sharon dominick/istockphoto; right: upper right: steve cukrov/istockphoto; lower right: antagain/ istockphoto; middle left: dragan trifunovic/istockphoto; middle right: diane labombarbe/istockphoto

Does your scalp frequently itch or do you find little flakes of skin on your dark clothes? If so, you may have dandruff! Dandruff is a common scalp condition that affects 15 to 20% of the total population and over 50% of the adult population of any ethnicity and both genders. Dandruff is characterized by scaling and shedding of the skin on our scalp. However, “dandruff” is often mistaken for a specific condition when it is actually an umbrella term for several possible conditions that lead to scalp flaking. Scalp skin cells shed every 27 days, so mild and rather unnoticeable flaking of the scalp is normal. On the other hand, dandruff is classified by a prominent, high turnover of the scalp’s epithelial cells that is apparent with larger, oilier, and/or clumped flakes. This scaling can be due to several conditions. Fortunately, there are many easy ways to deal with these problems.

anti-dandruff shampoos If there is excessive, heavy scaling, scalp oiliness, severe scalp itching, and/or lesions on the scalp, then a physician should be seen.

If using regular shampoo does not adequately solve the dandruff issue, you can use an over-the-counter dandruff control shampoo. These are the primary ingredients to look for in shampoos that help stop the itching and flaking: ❯ Selenium sulfide slows skin cell turnover on the scalp, has antifungal activity, and relieves itching. ❯ Zinc pyrithione has antibacterial and antifungal properties and relieves itching. According to a 2012 study in Dandruff Research Today, zinc pyrithione treatment significantly improved dandruff. ❯ Coal-tar base slows skin cell turnover, controls excessive skin oiliness, removes psoriatic scales, and relieves itching. ❯ Salicylic acid slows skin cell turnover, reduces excessive skin oiliness, and relieves itching, and it probably looks like a familiar ingredient since it is also used in acne treatments. ❯ Ketoconazole has antifungal properties, but is stronger and requires a prescription.

regular shampooing Many of the mild to moderate dandruff conditions can be relieved simply by using regular shampoo! Flaking and itching can be controlled using normal shampoo every one to three days, depending on what frequency works best to control these moderate dandruff symptoms.

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It is important to note that the shampoos containing these ingredients may work better than others. Some shampoos may cause scalp dryness, and/or scalp irritation. Therefore, if you have skin allergies, you may want to consult a doctor before using a dandruff-control shampoo. So in general, you may need to try more than one and see which one fights your dandruff best! tw 37

total wellness â&#x2013;Ş winter 2013

surprising uses for your microwave by julia duong | design by karen chu

Chances are that you have a microwave sitting in your kitchen or

dorm room. The microwave is a versatile invention that has many more uses than just defrosting TV dinners. Here are a few surprising, unexpected uses for your microwave.

left: geoffrey holman/istockphoto; right: caracterdesign/ istockphoto; zocha_k/istockphoto; scantynebula/istockphoto

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COOKING warm up citrus fruits

make sun窶電ried tomatoes

Microwaving lemons and oranges for a few seconds in the microwave will help emit more juice. Moreover, the skins will emit an aromatic fragrance in your home! Cut tomatoes in half and scoop out the seeds. Place the tomato halves (cut-side down) on a microwave-safe plate large enough to hold them individually. Microwave, uncovered, on high for 15 minutes. Pour out excess liquid, and turn the tomatoes over. Microwave on high for an additional ten to 15 minutes, until dry.

froth milk for your latte

Add milk to a jar up to the halfway point. Cover with a lid and shake the jar until the milk has frothed (about 30 seconds). Then take off the lid and microwave for about 30 seconds. The foam will rise to the top, with the heat stabilizing the rise. Pour the milk into your coffee (hold back the foam), then spoon the foam on top.

proof your dough

Dough rises best in a warm, moist place. While bakers have a contraption to create these ideal conditions, a closed microwave can keep in moisture. Heat a cup of water in the microwave until steaming, and then place the dough inside. Shut the door, allowing dough to rise.

HOME & PERSONAL salvage dried mascara

A quick pop in the microwave can make mascara usable again.

warm up a homemade heating pad

Add some dried beans or rice in a sock, then warm it in the microwave. The result is a great heating pad to ease aching pain.

warm up creams and lotions before putting them on

As the weather gets chillier, warmed up cream after a bath or shower can be soothing.

CLEANING Toss a kitchen sponge into the appliance and microwave it for a few seconds. The heat will disinfect the bacteria residing in the sponge.

warm plates before eating

Have warm plates ready for serving by spritzing a few drops of water on the plates, then stacking them in the microwave to warm them up.

steam窶田lean your microwave

Slice a lemon in half, and place it in a bowl of water. Microwave on high for two minutes. Any stuck-on food should come right off, and the sides can be wiped down with a sponge.

total wellness 笆ｪ winter 2013

kill the bacteria in a sponge

SAFETY NOTE Microwaves are convenient appliances, but it is important to know how to properly use and maintain your microwave. Microwaves cook by producing electromagnetic waves that cause water molecules in food to vibrate. The vibrations then produce the heat that cooks the food. In a 2010 study published in the European Journal of Oncology, the Ramazzini Institute found that 2.4 GHz radiation (the frequency of radiation emitted by WiFi routers and microwave ovens) affects the heart by creating heart palpitations, in which the heart beats irregularly. Moreover, in 2003, a study in The Journal of the Science of Food and Agriculture discovered that broccoli cooked in the microwave with a little water lost up to 97% of its beneficial antioxidants. By comparison, steamed broccoli lost 11% or less of its antioxidants. However, the Food and Drug Administration (FDA) strictly regulates the manufacture of microwaves, enforcing rules in which the levels of radiation emissions should not pose a hazard to public health. The limits that the FDA set are well below the threshold for risk.

Remember to keep the following in mind: ❯ Follow the instruction manual for recommended operating procedures and safety precautions. ❯ Use microwave-safe containers. Refrain from using metal pans or aluminum foil, for microwaves reflect off of them, causing food to cook unevenly and possibly damaging the oven. ❯ If water is super-heated (hot beyond its boiling temperatures), water eruption can occur. The water will show no signs of boiling, and a slight movement can cause the water to explode out of the cup. To prevent such a phenomenon, add materials such as instant coffee or sugar. While microwaves are safe appliances in general, it is advised to not solely rely on microwaves for cooking purposes, as there are much more healthy ways to cook (e.g. steaming). However, if one has very little time or is looking for alternative uses for microwaves, this nifty apparatus can save time and money. t w

In general, most injuries related to microwaves are due to thermal burns, exploding liquids, and overheated foods.

SOUTHWEST EGG SCRAMBLER

BERRYLICIOUS MUFFIN

ingredients:

egg beaters (99% egg whites) diced bell peppers and onions 1/4 cup black beans salt & pepper to taste

1/4 cup quick oats 1 beaten egg (substitute 1/4 egg beaters for less calories) small handful of blueberries little bit of brown sugar/stevia (optional) 1 tablespoon soymilk or regular milk

directions:

total wellness ▪ winter 2013

1) In a microwave safe bowl, combine egg whites, veggies, beans, and spices. 2) Microwave covered until eggs are cooked solid. Take a fork and stir. Microwave more if needed.

directions: 1) In a coffee mug, combine ingredients and mix. 2) Microwave for 2 minutes, making sure it does not overflow. Add an extra 30 seconds if muffin needs to firm up. recipe source: usatodayeducate.com, myfitnesspal.com

left: porcorex/istockphoto; right: gerenme/istockphoto

FROM THE COOKBOOK

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unraveling the mystery of invisible illnesses by harini kompella | design by karin yuen

Is it possible for people to have illnesses that are not paired with any observable symptoms? Could it be that many individuals who look completely healthy deal with continuous symptoms on a daily basis? Behold, invisible illnesses, a group of chronic conditions that significantly alter one’s day-to-day living, but consist of symptoms that cannot be seen. The variety of symptoms one experiences is literally hidden from an observer. Is it truly possible that someone may have an illness that others fail to notice at all? The answer may surprise you.

2013 total wellness ▪▪ winter 2013

Invisible disabilities, which can consist of both mental and physical conditions, clearly exist. Considering a major portion of our population live with these illnesses, perhaps it is time we better understand what it means to have an invisible syndrome. There are a plethora of individual types, but some common ones include chronic fatigue syndrome, temporomandibular disorders, and fibromyalgia.

temporomandibular disorders Temporomandibular disorders (TMJD, commonly called TMJ), are a complex and poorly understood set of conditions characterized by pain in the jaw joint and surrounding tissues, along with limitation in jaw movements. Symptoms include: ❯ Pain in the jaw muscles ❯ Pain in the neck and shoulders ❯ Chronic headaches ❯ Jaw muscle stiffness and limited movement or locking of the jaw ❯ Ear pain and pressure ❯ Painful clicking, popping or grating in the jaw joint when opening or closing the mouth ❯ Bites that feel abnormal Other less common symptoms are ringing in the ears, dizziness, and vision problems. Although, the causes of most TMJ disorders are not known, there are some known contributing factors to the development of these disorders, including: ❯ Autoimmune diseases ❯ Infections ❯ Injuries to the jaw area ❯ Dental procedures that cause stretching of the jaw, such as what happens when a breathing tube is inserted before surgery ❯ Various forms of arthritis

chronic fatigue syndrome Chronic fatigue syndrome (CFS) is defined as a complicated disorder characterized by extreme fatigue that does not improve with bed rest. Also, it may worsen with physical or mental activity. CFS is characterized by: ❯ Intense fatigue occurring over six months, and is associated to other related symptoms, including asthenia and easily induced tiredness which cannot be resolved by a night’s sleep ❯ Widespread muscle and joint pain ❯ Cognitive difficulties ❯ Chronic, often severe, mental and physical exhaustion The majority of cases actually starts in a sudden manner in a previously healthy and active person and is usually accompanied by a flu-like illness. In turn, the onset of CFS is more likely to occur in winter, but also within several months of severe adverse stress. According to a 2009 review published in BMC Psychiatry, CFS is usually associated to systemic, physical, and neuropsychological manifestations. However, the review’s authors acknowledge that CFS still needs to be better medically understood. As of now, CFS is: ❯ A complex, chronic disorder of unknown cause, clinically appearing as intense and disabling fatigue (both physical and mental) without any apparent cause ❯ A condition which interferes with daily activities by as much as 50% ❯ A condition which does not decrease with rest and does worsen with exercise There are currently no curative treatments for CFS patients. Regardless, CFS is a prevalent condition; according to the Centers for Disease Control and Prevention (CDC), an estimated half a million people in the U.S. have a CFS-like condition. CFS has been found to affect two to three times as many women as men, and affects mainly young adults from 20 to 40 years old.

Most TMJ patients have relatively mild or periodic symptoms which may improve with the help of simple home therapy. Self-care practices, from eating soft foods to avoiding extreme jaw movements, may be useful in easing symptoms. However, there is no standardized treatment for TMJ, particularly for the more severe cases. TMJ is the most prevalent source of orofacial pain, accounting for 12% of the adult population in the U.S. For every one man, nine to ten women have TMJ, with the majority being between 18 and 45 years of age. Due to this widespread prevalence and the fact that the temporomandibular joint acts as a “ball and socket” model, allowing for over 2,000 hinge and sliding motions per day (including, talking, swallowing, and kissing), TMJ alloplastic replacements have been considered for treatment. However, as a 2011 review published in the McGill Journal of Medicine suggests, there is room for improvement, in regards to engineering and the materials used.

left: rouzes/istockphoto

total wellness ▪ winter 2013

It may also be possible that genetic, hormonal, and environmental factors (such as habitual gum chewing) can increase the risk for TMJ.

fibromyalgia

methods of treatments

Fibromyalgia (also called myalgic encephalopathy, fibromyositis, and fibrositis) is a complex chronic pain disorder that affects people physically, mentally, and socially. It is characterized by chronic widespread pain, multiple tender points, abnormal pain processing, sleep disturbances, fatigue, and often psychological distress. Those with fibromyalgia experience: ❯ Pain in tendons and ligaments, along with tender points throughout the body; even slight pressure on tender points can cause pain ❯ Fatigue ❯ Chronic widespread pain and tenderness for at least three months (one of the criteria for diagnosing fibromyalgia)

While these illnesses are not completely understood, there are a variety of ongoing treatments that are getting tested and proving to have some effect. These range from the more standard types of care, such as Western medication, to less conventional types of treatments, referred to as either complementary or alternative health treatments. The National Center of Complementary and Alternative Medicine (NCCAM) states that conventional medicine is medicine practiced by medical doctors (MDs), doctors of osteopathic medicine (DOs) and by allied health professionals, which is why it is also called Western or allopathic medicine. NCCAM defines complementary and alternative medicine (CAM) as a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Complementary medicinal treatments consist of using CAM with conventional medicinal treatments, while alternative medicine consists of using CAM in place of conventional medicine

Other common symptoms of fibromyalgia include irritable bowel syndrome (IBS), dizziness, and concentration difficulties. As with other invisible illnesses, no one knows the exact cause of fibromyalgia; however, growing research and clinical observations suggest that possible triggers and causes include: ❯ Physically traumatic or stressful events ❯ Emotionally stressful events ❯ Illnesses or immune disorders ❯ Bacterial or viral infections ❯ Decreased blood flow to the muscles ❯ Neuroendocrine/neurotransmitter dysregulation ❯ Possible genetic predisposition According to a 2012 study published in The Journal of Nuclear Medicine, an increased blood flow may be occurring in the brain region known to discriminate pain intensity. There is no single treatment that will relieve all fibromyalgia symptoms. Using medicinal treatments, along with sleep management, psychological support, and/or physical therapy, massage, water therapy, acupressure/acupuncture, yoga, diet changes, and stress reduction techniques can help one better manage his/ her symptoms. Fibromyalgia has now been recognized as one of the most common chronic pain conditions, affecting around ten million people in the U.S. and around three to six percent of the world population. The condition is prevalent in women, with 75 to 90% of fibromyalgia patients being women, yet it can occur in men and children of all ethnic groups. Fibromyalgia is usually found in those between the ages of 20 to 50 years old.

mental disorders

Mind and body practices, or relaxation techniques, such as meditation, mindfulness, biofeedback, and visualization are also suggested techniques to help with the symptoms associated with invisible illnesses. It is suggested one talks to his or her doctor about different treatment modalities, as treatment to at least reduce the intensity of symptoms often involves an integrated approach, involving multiple types of treatment.

Ultimately, invisible illnesses cannot be seen, and that goes for medical professionals as well. As a result, diagnosis of an invisible condition relies strongly on a diagnosis of exclusion – other physical and psychiatric illnesses need to be ruled out. Due to the difficulty in pinpointing an invisible illness, a diagnosis is not always reached.

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? total wellness ▪ winter 2013

Mental illnesses are also considered disabilities. They too are invisible and can be completely debilitating to patients, and make performing everyday tasks very difficult, if not impossible. About one in four adults suffers from a diagnosable mental disorder in a given year. Invisible mental illnesses include depression, attention deficit disorder (ADHD), schizophrenia, anxiety, and agoraphobia. Mental illnesses need to be better understood, and due to its nature, twothirds of people living with serious mental illnesses do not receive treatment. To learn more about ADHD symptoms and how to cope with them, check out ADHD: Myths and Misunderstandings in Total Wellness’ Volume 13, Issue 1: What a Pain!

Some CAM treatment modalities include natural products, acupuncture, trigger point injections, yoga, music therapy, spinal manipulation, and massage therapy. Uncover more about CAM treatment modalities in Total Wellness’ Volume 11, Issue 2 Integrative Medicine.

misconceptions of invisible illnesses A 2004 John Hopkins University study, published in the book Chronic Care in America: A 21st Century Challenge, found that one in two Americans has a chronic illness that affects his or her daily life, and according to the 2002 U.S. Census Bureau, 96% of these Americans with a chronic illness have one that is invisible. However, there is still minimal understanding about what it means to have an invisible illness.

myth 1: is it a disease?

myth 3: “it’s all in their head”

A disease is a medical condition with a specific cause(s) and recognizable signs and symptoms. Many of these invisible conditions, however, consist of a collection of signs, symptoms, and medical problems that, while typically present together, are not related to a specific, identifiable cause. This is actually defined as a syndrome.

Many of those with invisible illnesses have to live with loved ones and acquaintances believing that this “so-called” illness is from one’s imagination. As it turns out, the term “invisible disabilities” refer to a whole spectrum of hidden disabilities or challenges that are primarily neurological in nature. Many of these syndromes exist as a dysfunction of the brain, and are due to an irregular nervous system. Therefore, these are real medical problems that are not imaginary but may literally be “all in one’s head.”

myth 2: “but they don’t look sick” This is the key reason these illnesses are called invisible. With these syndromes, afflicted people generally don’t use an assistive device nor show any outwardly sign of disease. In fact, 73% of Americans with severe disabilities do not use any assistive devices. Yet, according to the Americans with Disabilities Act (ADA) of 1990, an individual with a disability is a person who has “a physical or mental impairment that substantially limits one or more major life activities, has a record of such impairment, or is regarded as having such impairment.” At least the majority of those with invisible illnesses fall into this category. It then stands to reason that victims of invisible syndromes have a true disability that causes valid symptoms.

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? total wellness ▪ winter 2013

myth 4: people get an invisible illnesses because they do not take good care of their health

As stated earlier, there is often no clear cause of an invisible disability. It may then be technically incorrect to say it has to do with one’s health habits. In a 2009 survey study of scholars with invisible illnesses, published in Music Theory Online, the largest group of invisible illnesses was attributed to autoimmune diseases produced by an overactive immune system. With autoimmune diseases, the immune system attacks itself, including healthy bones, organs, tissue, skin, and other bodily functions and systems, for no controllable reason. This study similarly found another large group of invisible illnesses to be respiratory illnesses, which can actually overlap with autoimmune diseases. Additionally, one group consisted of medical syndromes that, while are not generally recognized as autoimmune diseases, or to have any understood medical cause, operate similarly to autoimmune illnesses, and result in comparable symptoms.

living with invisible illnesses Invisible illnesses are very real, incapacitating conditions. Those with invisible syndromes have to deal with a variety of unseen symptoms on a daily basis. The lack of support, understanding, and knowledge itself of these syndromes by surrounding friends and family can further contribute to the depression and related symptoms one experiences when living with these chronic conditions. Awareness is a must, and reaching out can make a much needed difference. There is hope for the field of invisible illnesses. Knowledge of such conditions is growing in the scientific community, and there are new treatments being tried out. Additionally, one with an invisible syndrome can use the following tips to cope:

1. let go of expectations of one’s self and others. People with an invisible illness need to remember

that no one is perfect, including themselves! They may not complete tasks in the timely fashion they would like to, but they should realize that it is okay. It is the body’s message to pace oneself. Additionally, as frustrating as it may be that others do not understand the victim’s symptoms, remember that the illness is invisible. They may not realize what a significant part this illness has become in one’s life. This is why increasing awareness through different ways, by talking, holding events, blogging, etc. can help out both involved parties.

2. find supportive friends. These illnesses may be

blessing in disguise since they allow one to realize who his or her actual friends are. Invisible illness victims should surround themselves with understanding friends, who are willing to learn more about the illness, or at least lend their shoulder. Furthermore, a circle of supportive friends and family leads to healthier relationships which can help ease some symptoms. As with any difficulty, one is better off with support from friends and family, and those with invisible syndromes are no exception. Yet, according to the results of a 2009 survey published in Heartnotes (conducted by Evercare Hospice and Palliative Care), while 82% of respondents knew someone with a chronic illness, only 34% were likely to suggest ways to help better manage their care. Furthermore, 15% did not offer advice because they did not think the matter was important. The matter is important; remember that one in two Americans has a chronic illness and the majority of those illnesses are invisible!

4. use your talents and skills for things you care about. Remember, those with invisible illnesses are

still valuable people of society.

invisible illnesses often serve as sources of inspiration for others. If you have an invisible illness, remember that you still have as much of a right to all life has to offer as others do, so do your best to not let your symptoms be a complete damper.

6. educate yourself. Educating one’s self may be the

best way to show one’s support for invisible illnesses and their involved difficulties. For more information, and access to organizations provided for specific invisible illnesses, visit: http://www.theacpa.org/56/Health%20Conditions.aspx Additionally, the Counseling and Psychological Services (CAPS) center on the UCLA campus offers both individual counseling and group therapy, including through what are referred to as Wellness Skill Groups. These groups include “Moving Beyond the Pain,” “Mindful Pathway to Wellness,” and “Biofeedback Training.” Such groups focus on reclaiming one’s life from pain, learning how to deal with difficulties, such as symptoms, through living in the present, and how to better manage one’s stress, as well as better understand the connection between stress and physical symptoms. Additionally, there are groups that work on dealing with the social fears and anxiety that may be associated with invisible mental illnesses (includes “Building Social Confidence” and “Break the Cycle of Anxiety”). Call CAPS at (310) 825-0768, or visit http://www.counseling.ucla.edu/ for more information. Also, invisible illnesses are not limited to the ones discussed in this article but they also include a number of other conditions, such as Asperger syndrome, inflammatory bowel disease, and narcolepsy.

As healthy as one may appear, if he or she claims to have an illness that is invisible, it may be fair to believe him/her. Invisible illnesses are, however, diagnosed by long-term symptoms, and doctors have specific criteria for diagnosis. Therefore, it is important to consult a medical expert if you have persisting symptoms that are interfering with your day-to-day life. Making assumptions or simply claiming you have an invisible illness may further contribute to the frustration felt by those actually affected by these syndromes. To those affected by invisible illnesses: Remember that there is hope, and it is important to work with a team of medical professionals. While there is still plenty not medically understood about these illnesses, research in the field is growing and, as a result, treatments are being found to better manage your symptoms. tw

total wellness ▪ winter 2013

3. search for the joy in your blessings. It takes time and efforts, but investing one’s time in things that make him/her happy can help relieve some of the mental tension that comes with having an invisible illness. Also, while an invisible illness is undeniably a difficult thing to live with on a daily basis, they are generally not fatal, allowing victims to live a day at a time and pace themselves.

5. encourage someone else. Stories of those with

decoding the nutrition label

maltodextrin by lawrence liem | design by karin yuen

Maltodextrin has a wide range of uses from an aroma carrier in cooking to a binding agent in paints to an absorbent in cosmetics. Often, this compound appears on ingredient labels, but what is maltodextrin and how does it affect us? what is it?

According to a Polycystic Ovarian Syndrome Association, Inc. (PCOSupport) article on maltodextrin, it is more rapidly absorbed than glucose as it has a high glycemic index. The higher the glycemic index, the faster the sugar is processed and absorbed into the body. Since maltodextrin is high on glycemic index, it will spike blood sugar like a simple sugar. Once ingested, it enters the bloodstream rapidly to be used for quick energy.

WHERE IS IT FOUND?

total wellness ▪ winter 2013

Maltodextrin is often used in processed foods as a thickener or as filler since it is fairly inexpensive. It gives food extra volume and bulk without added costs. Foods with this compound include puddings, cereal, salad dressings, etc.

Aside from allergic reactions and possible weight gain when consumed in excess, there have not been any major side effects to warrant concern for this substance. According to the Food and Drug Administration, maltodextrin is “generally recognized as safe” and does not have any adverse effects on human health. Essentially, it is just an elongated links of sugar units. While there is no conclusive evidence that this substance is of danger, it is best to stay informed with up-to-date information so that people can make the best choice possible. tw

possible benefits ❯ With fructose, it can stabilize blood sugar: According to Gene Bruno, MS, Dean of Academics in the Huntington College of Health Sciences, both sugars work together to prevent any drastic changes to the blood sugar level in humans. Fructose burns for quick term energy and maltodextrin burns for longterm energy. ❯ Great for sports drinks: Maltodextrin is often used in sports drinks because it is energy-rich, relatively cheap, and less likely to cause stomach problems. In fact, a 2006 article in the Journal of Sports Medicine and Physical Fitness (which studied the effects of maltodextrin on cross-country ski performance) found that those who were given maltodextrin had improved total performance times compared to those who did not take the substance. ❯ May increase overall mineral absorption in the body: According to a 2010 study published in the European Journal of Nutrition, mineral absorption was enhanced in rats given maltodextrin compared to those not administered the compound. ❯ Increases fecal bulk which eases elimination: According to a 2008 article in the Journal of the American College of Nutrition, when resistant-maltodextrin (short glucose polymer chains resistant to human digestion) was given to patients, it resulted in favorable fermentation in the bowel and altered the colonic bacterial population in the body, which both contributed to eased digestion and elimination.

possible dangers ❯ Since maltodextrin is made of long chains of glucose, it is digested like sugar. If eaten in excess, it can cause unnecessary weight gain and fluctuations in blood sugar level. According to Carol Chen MS RD, a dietitian at the UCLA Arthur Ashe Student Health and Wellness Center, though there may not be apparent side effects from this substance, consumers should still be aware of their consumption. Moderation is key to maintaining a healthy lifestyle.

left: robyn mackenzie/istockphoto; right: river albu/istockphoto

Maltodextrin is a nonsweet nutritive saccharide that is usually made from corn, potato, or rice starch. It is described as an odorless, slightly sweet white powder. It is essentially a long chain of simple sugars so it is often called a complex carbohydrate. Since it is less sweet than regular sugar, it is often used as an artificial sweetener.

credits We would like to acknowledge the following people for their contributions to this edition. We would also like to make special mention of the following UCLA physicians, professors and faculty members who donated their time and expertise to ensuring the accuracy of content published in the following articles:

q&a

❧

Alona Zerlin, MS, RD, Research Dietition, UCLA Center for Human Nutrition

row: rock the stroke

Elissa Terry, NSCA-CSCS FITWELL Services Program Director, UCLA Recreation

what’s your good side? sleeping positions and their effect on the body

David Fish, Associate Director for the Pain Medicine Fellowship Program, Physical Medicine and Rehabilitation, UCLA David Geffen School of Medicine

putting health in your hands: your guide to selfexaminations for early detection of breast and testicular cancer

Michele Hoh, MD, Associate Clinical Professor of Medicine, UCLA Family Medicine Practice, Iris Cantor – UCLA Women’s Health Center

to can or not to can?

fruity favorites

Susan Bowerman, MS, RD, CSSD Assistant Director, UCLA Center for Human Nutrition

ways to a healthier smile

Evelyn Chung, DDS, Clinical Associate Professor – Hospital Dentistry, Advanced Prosthodontics, UCLA School of Dentistry

unraveling the mystery of invisible illnesses

finding the perfect fit: your guide to shoes

decoding the nutrition label

Hung Pham, PhD, UCLA Professor in Life Sciences, Department of Molecular and Cell Development

Brenden Riley, DPM, Associate Attending of Podiatric Surgery, University Podiatry Group

fighting dandruff head-on

Lorraine C. Young, M.D. Co-Chief, Dermatology Clinical Services, Health Sciences Clinical Professor, UCLA David Geffen School of Medicine

surprising uses for your microwave

Raffi Tachdjian, MD, MPH, Assistant Clinical Professor of Medicine and Pediatrics, Division of Allergy and Clinical Medicine at UCLA

Carol Chen, MS, RD, Dietitian, UCLA Arthur Ashe Student Health and Wellness Center

copy-edits and review Shannon Wongvibulsin

layout revisions

Barbara Wong, Shannon Wongvibulsin, and Karin Yuen

cover & table of contents

Julie Skrupta, Board Certified Holistic Health Coach, UCLA Center for Healthier Children, Families and Communities

total wellness ▪ winter 2013

Alona Zerlin, MS, RD, Research Dietition, UCLA Center for Human Nutrition

the benefits and controversies of the new hiv prevention pill: truvada

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