Get Ready, Get Set, Refresh! by Total Wellness Magazine

total wellness

a ucla student wellness commission publication

get ready, get set,

refresh!

how to conquer bad breath

tips for a

healthier heart bathe your way to

better health contacts in focus

winter 13 | vol 13 | issue 3

editor’s note Time to refresh! At any stage of life, it can be difficult to keep our health in focus in the midst of all our activities, whether it be school, work, extracurriculars, sports, or just life in general. Especially in college (the time to explore, excel, and develop academically as well as make new friends and have life experiences), maintaining the balance necessary for our wellness can seem like a secondary task or sometimes even an unrealistic goal with midterms, papers, and finals on top of everything else.

total wellness ▪ winter 2013

In fact, I remember that during Freshman Orientation, one of the peer counselors informed us that in college, there are three S’s: sleep, socialize, study, but you can only choose two. As a junior now, I certainly realize how this simple statement captures the struggle to find balance between these three important aspects of college. Yet, this lack of balance can lead to a damaging toll on health. Certainly, with finals just around the corner and the quarter coming to an end, most of us are probably drained, stressed out, and ready for some time to refresh. But, we don’t have to wait until Spring Break vacations to recharge ourselves. Instead, doing small things to refresh during our daily routines can help keep us relaxed and energized enough to continue thriving in this fast-paced world without getting burnt out. In this issue of Total Wellness, we highlight some unique ways to refresh under the constraints of limited time and hectic schedules. Striving to gain from the refreshing boost and health benefits that exercise can provide, but don’t want to or can’t afford to spend an hour at the gym? Try out a Tabata workout, which lasts only four minutes, but has the potential to provide you with better results than an hour of moderate intensity exercise. Learn more about

the workout plus some examples you can try on page 23. Even as we work or study, we can utilize methods to refresh ourselves. Undoubtedly, for most of us, using the computer or other electronic devices is a part of our daily lives. In fact, according to The Vision Council, more than a third of U.S. adults spend approximately a sixth to a fourth of the day in front of electronic devices. However, prolonged use can result in many discomforting side effects, such as eye strain. As a result, it’s not a surprise that there’s a rise in the number of individuals suffering from latent computer vision syndrome (CVS). But, even with all the studying to do, papers to write, or Facebook posts to browse, you don’t have to be afflicted with this syndrome. Discover how to refresh your eyes and avoid CVS on page 8. Although life may seem busy and health can often times fall to the bottom of our never ending to-do lists, we challenge all our readers to Get Ready, Get Set, Refresh! as an effort towards improving overall wellness and wellbeing. 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

Chalisa Prarasri Assistant Editor-in-Chief

Julie EscobaR Copy Editor

cindy la Managing Editor

barbara wong Co-Art Director

Brian Khoa Nguyen Co-Outreach Director

Judy Jeung Co-Outreach Director

Nabeel Qureshi Finance Director

angela hao Assistant Finance Director

Fritz Batiller Webmaster

Kevin Sung Assistant Webmaster

total wellness â&#x2013;Ş winter 2013

karin yuen Co-Art Director

words from the commisioner Hello Bruins! This latest issue of Total Wellness focuses on freshening up for the sake of your health, and it reminds me of the fresh new things that SWC has been working on this year! Recently, a new week of programming that SWC had never taken on before took the campus by storm, and left an impact on the campus’ culture surrounding body image. SWC’s inaugural I <3 My Body Week included new and exciting events the campus hadn’t experienced before, like the Silent Disco in Powell Library, the True Beauty by True Bruins art exhibit, and a talk with sociologist and author Kjerstin Gruys about her year without looking into mirrors. Wonderful new events like these are what SWC strive to host, because each new event or program provides a refreshing and new approach to incorporating healthy choices into students’ lives. Looking forward to the Spring Quarter, SWC has its flagship “week” of the year: Bruin Health Week, in which we hope to continue providing exciting events and opportunities to increase the information, resources, knowledge and motivation necessary for the UCLA community to have a sound mind and body. Throughout Bruin Health Week, each of the 12 committees and task forces within SWC will be hosting events that bring attention to different facets of health, including mental, sexual, environmental, academic, emotional, and physical health.

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These are some of the things SWC are up to, but what’s more important is focusing on what you have been up to. If you made resolutions this new year to take better care of yourself and prioritize your health, have you stuck to them? Have you started integrating the information and tips in our magazine into your life, or better yet, been sharing them with others? Have you attended any of our events and increased your wellness? I hope that your responses to these questions include at least a couple yeses, but if not, it is always a great idea to take a fresh look at your health, integrate healthier living practices, and recommit yourself to being a healthier you! 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! Stay happy and stay healthy, Bruins! Warm Wishes,

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

Shannon Wongvibulsin Chalisa Prarasri Barbara Wong Karin Yuen Cindy La Julie Escobar Nabeel Qureshi Angela Hao Brian Khoa Nguyen Judy Jeung Fritz Batiller Kevin Sung

Staff Writers Ryan Babadi, Savannah Badalich, Leslie Chang, Julia Duong, Julia Diana Feygelman, Samantha Leslie Fong, Sally SooHyun Kim, Harini Kompella, Sofia Levy, Lawrence Liem, Tiffany Lin, Josephine Liu, Pavan Mann, Halee Michel, Samantha Mojica, Allison Newell, Lillie Luu Nguyen, Jaclyn Portanova, Anahit Poturyan Design Karen Chu, Valerie Fong (intern), Kelsey Kong (intern), Jocelyn Kupets (intern), Coco Liu, Allison Newell (intern), Keziah Pagtakhan, Catrina Pang, Kristen Sadakane, Mary Sau, Jessica Sun (intern), Annie Theriault, Amanda Wong (intern), 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, publication and is supported by advertisers, the Arthur Ashe Student Health and Wellness Center, the On Campus Housing Council (OCHC), the Student Wellness 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 3

Cassarah Chu SWC Commissioner

© 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 body in focus 8 iStrain: Rise of Latent Computer Vision Syndrome 11 Hocus Pocus Halitosis! 15 Understanding Your Stool eat right 19 Fishing for Your Health get active 23 The Tabata Workout mythbusters 25 Cracking Down on the Truth

total wellness

ON THE COVER

a ucla student wellness commission publication

get ready, get set,

11 41 28 38

refresh!

how to conquer bad breath

tips for a

healthier heart bathe your way to

better health

Bad Breath Heart Disease Epsom Salts Contact Lenses

28 Bathe Your Way to Better Health with Epsom Salts 32 Health Coaching 35 Beat the Burn 38 Seeing Eye to Eye With Contact Lenses 41 Don’t Miss a Beat: Understand the Risks for Heart Disease and How to Step up Your Cardio Health!

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cover: annaomelchenko /istockphoto; right: kasiam/istockphoto

FEATURES

contacts in focus

winter 13 | vol 13 | issue 3

in the news

what’s happening in health? by jaclyn portanova | design by karin yuen

AT UCLA The New UCLA Healthy Campus Initiative

Psychological traumas can change gene expression

Recent research (conducted by scientists from the University of Zurich and Swiss Federal Institute of Technology) published in Biological Psychiatry found that major life events such as psychological traumas can actually change the DNA of the people involved in a way that can be passed on to their children. Cross-generational effects have been documented in many cases, such as in the children of Holocaust survivors. These changes (called epigenetic changes) do not alter DNA sequences; they alter gene expression in response to environmental factors. When alterations occur in the germ cells (sperm or eggs), the changes can be passed to the next generation. A parent’s epigenetic reactions to specific environments can help prepare his or her offspring for similar environments. However, these epigenetic changes may be problematic if the environment changes, or if the reaction is maladaptive.

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Diet soda with alcohol can raise you over the legal limit

According to a recent study published in Alcoholism: Clinical & Experimental Research, mixing alcohol with diet soda may not be a wise choice. In fact, researchers at Northern Kentucky University found that college students who drank the equivalent of four drinks of vodka with diet soda registered over the legal limit for blood alcohol content while those who drank the same amount of vodka with regular soda registered below it. At each study visit, the drink was consumed in about ten minutes. Those who drank the diet soda were slower to react during computer tasks that tested their reaction times. Participants in the study reported feeling the same level of intoxication despite tests showing that those who drank diet soda were one-fifth more intoxicated than those who did not.

In an effort to support a culture of mental and physical health and wellness on campus, the UCLA Healthy Campus initiative is providing resources for students, staff, and faculty to live healthier lives. Philanthropists Jane and Terry Semel are supporting this initiative in the hope of reducing preventable diseases. UCLA experts in nutrition, physical activity, mental health, and environmental health have been chosen to lead this program within their areas of expertise. Healthy events are already taking place. The four-day “I <3 Walking” project, for example, encourages the UCLA community to exercise and socialize on campus and in Westwood. Fourteen student groups have been awarded $1,500 to improve overall health at UCLA. Their exciting new projects are being unveiled during the winter and spring quarters.

Discovered: New Protein blocks HIV and other deadly viruses

In a recent study published in Immunity, researchers at UCLA describe a protein with a novel antiviral property. Cholesterol-25hydroxylase (CH25H) is an enzyme that converts cholesterol to a molecule called 25-hydroxycholesterol (25HC). 25HC, which can permeate the cell membrane and block viruses from getting in, may be a key to inhibiting the growth of aggressive viruses. This has implications for fighting human pathogenic viruses such as HIV, Ebola, and Rift Valley Fever. Preliminary findings that show that 25HC can inhibit HIV growth in vivo has prompted further research in this area. Other viruses have not yet been tested with 25HC in vivo. t w

NUMBERS

156 the number of pounds of added sugar an average American consumes every year

million the number of new sexually transmitted infections (STIs) in America each year

1 9 in

women between ages 15 to 44 who have used the morning-after pill medicinenet.com; cnn; yahoo

left (in order): mohamed sadath/istockphoto; henrik jonsson/ istockphoto; right: roel smart/istockphoto

RESEARCH AND NEW FINDINGS

q&a

Q: A:

How does using hand sanitizers compare with hand washing? by tiffany lin | design by coco liu

Washing your hands with soap and water and using hand sanitizer serve two different functions. Water and soap removes the germs from your hands; on the other hand, the alcohol in hand sanitizer is able to kill bacteria and inactivate some types of viruses. If your hands are visibly soiled, it is recommended that you wash your hands because hand sanitizer cannot cut through grime, while water and soap can remove oil and dirt.

is there harm in overusing hand sanitizers? Yes. A 2009 study from Northwestern University found that “ultra clean” children tend not to have fully developed immune systems. Underdeveloped immune systems can lead to a wider range of diseases in adulthood. Additionally, there is a potential danger of exposure to triclosan, an unregulated and widely used antibacterial ingredient. Triclosan breaks down when exposed to chlorinated water and forms toxic chemicals, including chloroform. According to a 2012 study published in Proceedings of the National Academy of Sciences, animals exposed to triclosan experience problems with muscle activity (impaired muscle and heart function), which could contribute to cardiovascular problems. However, the research is based on tests on mice and fish, and the effects of triclosan on human muscles have not been tested.

how effective are hand sanitizers in killing germs and bacteria?

got a question? We love curious readers. Send

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

This claim made by producers is based on tests they perform on inanimate objects in a laboratory setting. It is difficult to carry over the claim and be certain that it applies to hands as well. Hands are much more complex, with pits and grooves that can hide and trap germs. Additionally, people may wear jewelry or watches, which have bacteria on them as well. Hands also come into contact with many surfaces and transfer germs from one place to another.

what are the different types of hand sanitizers?

› triclosan-based gels These hand sanitizers work because they contain triclosan, an antibacterial agent. However, this compound has been increasingly linked to negative health and environmental effects, and it kills bacteria in a manner that promotes bacterial resistance. For more information on triclosan, read the answer to the question: Is there harm in overusing hand sanitizers? › alcohol-based gels Most hand sanitizers sold in stores belong to this category. However, many types sold in stores have a lower alcohol content than the 60% that is necessary for hand sanitizer to effectively kill germs. › essential oil-based sanitizers This is an option for those who would like to avoid triclosan and complications with alcohol content. These hand sanitizers are based on essential oils such as rosemary and eucalyptus, which have antimicrobial properties. However, these are much more expensive than the alcohol-based gels. how to use hand sanitizers properly 1. Remove the grime from your hands first because hand sanitizers cannot get rid of this. 2. Vigorously rub all sides with enough hand sanitizer to get hands wet. 3. Rub hands until they’re dry. 4. If they are dry within ten to 15 seconds, you did not use enough, so apply more. t w

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To effectively eliminate bacteria and viruses, you should use an alcohol-based hand sanitizer. The alcohol content in a hand sanitizer must be over 60% in order to effectively kill bacteria. Alcohol kills bacteria by softening the bacterial membrane. Be careful of some hand sanitizers sold in stores that have less than 60% alcohol content, and make sure to check the active ingredients before purchasing. If the alcohol content in a hand sanitizer is under 60%, bacteria will not only survive, but the hand sanitizer gel will increase their mobility, which may increase bacterial growth. Also, any grime on the hands must be wiped away before alcohol can be effective. According to the Centers for Disease Control and Prevention, the use of hand sanitizers (with an alcohol content of 60% or more) on hands that aren’t visibly soiled can help curb the spread of stomach and intestinal bugs.

is the claim that hand sanitizers kill 99.9% of all bacteria true?

body in focus

iStrain:

rise of latent computer vision syndrome Time flies when surfing through the web, texting with friends, or watching television. Ever looked at the clock and wondered how an hour had already past when it felt like only five minutes have gone by? It is no question that people spend a significant amount of time using technology, especially digital media. What constitutes digital media? Digital media are forms of electronic content that can be transmitted through television, the internet, or computer based networks. High-definition televisions, desktop and laptop computers, smartphones, e-readers, tablets, and gaming systems are among the most popular digital media devices used today.

In college, the use of these items is inescapable since students use them not only for school-related work but also for leisure and for a way to keep in touch with friends and family. As seen in a 2012 survey conducted by The Vision Council, more than a third of U.S. adults reported spending four to six hours a day with digital media or related electronic devices. About 14% of those surveyed, young adults (ages 18 to 34) reported an average use of more than 12 hours daily. All that time spent staring at various digital screens puts a real strain on oneâ&#x20AC;&#x2122;s eyes, which can cause vision problems as well as other medical conditions such as dry eyes and headaches. Such uncomfortable and debilitating problems are not necessarily inevitable, as it is easy to prevent them from happening.

left: tobias helbig/istockphoto; right: dan wilton/istockphoto,

total wellness â&#x2013;Ş winter 2013

by sally soohyun kim | design by kelsey kong and barbara wong

›

what exactly is “computer vision syndrome”?

According to a 2005 review published in Survey of Ophthalmology on Computer Vision Syndrome, the most common ocular complaints due to the use of digital devices include eye strain, eye fatigue, burning sensations, irritation, redness, blurred vision, and dry eyes. You may also experience an aching sensation in your head, neck, or shoulders. These symptoms are collectively known as Computer Vision Syndrome (CVS). The American Optometric Association defines CVS, also known as digital eye strain, as the combination of eye and vision problems associated with the use of computers. However, the causes of this syndrome are not limited to computer use. Using other kinds of digital media can also cause the various symptoms of CVS.

›

who’s at risk for cvs?

The Vision Council states that more than 70% of Americans do not know or do not believe that they are susceptible to digital eye strain. However, anyone who is in front of a digital screen is at risk. In a society where smartphones and computers are needed to complete a student’s or worker’s tasks, it is hard to escape from these useful and ubiquitous inventions. It is no wonder then, that CVS is very common. According to a 2011 review published in Ophthalmic and Physiological Optics: The Journal of the British College of Optometrists, between 64% and 90% of computer users experience uncomfortable visual symptoms listed under CVS. But there is no need to scurry back to papers and pens. Currently, there is no evidence that CVS causes any permanent damage to our eyes.

tips for avoiding cvs Although the symptoms of CVS are not severe or irreversible, they are uncomfortable and can influence work and study performance requiring computers and other digital media. The good news is that it is easy to alleviate or even prevent CVS. The simple solution is to limit the use of digital media, but that may be impractical for both students and adults. Fear not, there are multiple quick and easy ways to lessen the impact of digital media on one’s eyes.

try using the 20-20-20 rule:

The Centers for Disease Control and Prevention recommends that for every 20 minutes of near work, take a 20 second break and look at something at least 20 feet away.

reduce glare: Adjust the brightness of your

screen to a comfortable level by adjusting its settings. Changing the background color from bright white to a cooler gray may help reduce glare and associated eye strain.

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get comfortable: Place yourself at a comfortable distance so that you do not need to lean forward or strain your eyes to focus to see text. The Occupational Safety and Health Administration, under the United States Department of Labor, states that generally, the preferred viewing distance is between 20 and 40 inches from the eye to the front of the computer screen.

Adjust the font size for the best view while writing a long paper or reading digitally by changing the viewing percentage. Remember that you can zoom in on your smartphones and tablets. This will decrease the need for squinting or looking too closely at hand-held devices during prolonged use. In addition, researchers from the Vision Ergonomics Research Laboratory in the United States reveal that the Verdana font is the safest for the eyes, in that it allows viewers to read more comfortably and prevents the need to lean forward and strain one’s eyes. According to a 2011 study published in The American Journal of Medical Sciences, tested subjects ranked Verdana, in 14 size font, as the best font type and size combination in comparison to other common fonts (Times New Roman, Georgia, Courier New, Arial, and Tahoma). However, it is important to note that it really comes down to personal preference. The study measured subjects’ opinions by asking a series of questions that asked how the fonts affected their overall mental workload (mental demand, performance, effort, frustration). Thus, just be sure that the combination of font style and font size allows you to read easily without fixing yourself in an uncomfortable position. Play around with the different style options offered to find the best viewing for you.

blink often! Most individuals blink on average between ten and 15 times per minute. A 2005 study published in Survey of Ophthalmology has shown that the blink rate at the computer is significantly less than normal. People blink about five times less in front of a computer screen than they would regularly, which contributes to dry eyes. Remind yourself to blink more often, and consider the use of over-the-counter lubricating eye drops to help refresh and refocus your eyes.

use a stand for your additional work material: To avoid having to constantly look

consider the most optimal location:

Change the lighting surrounding the computer screen. Try closing the blinds or moving the device until the glare disappears. If possible, dimming the surrounding lighting can also help reduce glare and strain.

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back and forth between your computer screen and the printed material on your desk, try putting the printed matter on a stand next to your computer monitor or laptop. This will help lessen neck pain and the strain of having to refocus your eyes for each glance.

visit your eye doctor regularly: Be sure

to tell your doctor about your computer usage if you have symptoms of CVS. Doctors can determine whether you need prescription computer glasses to help increase contrast perception and filter out glare and reflection to reduce symptoms of eye strain.

It is important to pay attention to your body’s signals. Significant eye, neck, head, or shoulder pain are important warning signs of strain and fatigue. Try one or more of the tips listed above to help prevent CVS. tw

left: nicole blade/istockphoto; mattjeacock/istockphoto; right: grimgram/istockphoto

personalize it: Change it up and Zoom in!

body in focus

hocus pocus halitosis! by chalisa prarasri | design by annie theriault

A guide to combating the unfortunate dis-odor of bad breath

Bad breath, often referred to as

total wellness â&#x2013;Ş winter 2013

halitosis in the scientific world, is surprisingly common. Based on a number of studies conducted between 1991 and 2006, scientists estimate that 30 to 50% of the population has bad breath, which means that in a room of ten people, three to five of them are likely to have bad breath (and one of them could be you!). To help prevent this embarrassing incident, here are six things you may not know about the smell of your mouth, along with ways to keep it under control.

Other possible origins of halitosis include the respiratory and gastrointestinal tracts. Oral halitosis cases are generally caused by gingivitis, periodontitis, dental cavities, or poor oral hygiene. When food or other particles are not effectively removed in a timely manner, they can get stuck in spaces between the teeth or attach to the surface of the tongue. Over time, these particles are broken down by the bacteria in the mouth to form smelly substances.

The smells emanating from people with bad breath are hypothesized to be caused by some nasty compounds.

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This occurs primarily in the back portion of the tongue, where the majority of food particles and anaerobic bacteria build up and create odorous compounds. If you look at the back of your tongue in the mirror, you can see a white film coating it. You may think that this film represents the halitosis-causing bacteria, but that is not always the case. Some of the odor-causing bacteria found in your mouth may actually be transparent, so how your tongue looks may not be an accurate indicator of how your breath smells.

There is such thing as bad-breath phobia.

These substances, produced from processes discussed in #1 and 2, include hydrogen sulfide, methyl mercaptan, skatole and putrescine, cadaverine, and isovaleric acid, which are responsible for the smells we associate with rotten eggs, feces, decaying meat, rotting corpses, and sweaty feet, respectively.

Halitophobia, also known as pseudo-halitosis, is an exaggerated fear of having bad breath. People with this condition go to great lengths to keep people from smelling their breaths, such as covering their mouths when they speak, keeping their distance from people, and maintaining meticulous oral hygiene. Despite these actions, halitophobics continue to believe that they have bad breath even when they do not.

We can’t objectively judge our own breath.

According to a study published by The Journal of the American Dental Association in 2001, how we perceive our oral odors is actually more strongly correlated with self-image than truth. That is, if you’re afraid that you have bad breath, you will tend to smell your breath and think it smells bad, regardless of how it actually smells. Similarly, if you don’t think you have bad breath, you will tend to smell your breath and think it’s fine, even if it smells awful to an impartial judge.

There are two reasonably good ways for you to find out if you have halitosis:

1. Have someone close to you judge your breath (after all, it’s how other people perceive your breath that matters!). 2. Lick the back of a spoon (or otherwise get your saliva on something), allow it to dry, and then judge the smell. According to the study mentioned in #5, the participants were able to achieve partial objectivity in assessing the smell of their breath by smelling their saliva when it was removed from their mouths.

right(in order): darja tokranova/istockphoto; roccomontoya/istockphoto

80-90% of bad breath cases are localized in the mouth.

The degree of bad breath is related to the quantity of bacteria present on the tongue.

tips for avoiding halitosis Commonly used breath management solutions (like chewing minty gum) may not be enough to keep halitosis at bay. According to a review article published by Oral Diseases in 2012, mint, parsley, clove, and fennel seed concoctions only mask mouth odors without eliminating them. To really get rid of that bad breath, try changing either your habits or your diet.

HABITS: keep good oral hygiene.

gently clean the back of your tongue.

It may seem obvious, but great oral hygiene is one of the best ways to keep halitosis at bay. Since such a large portion of bad-breath cases are localized to the mouth, it makes sense that keeping that area clean and disease-free with regular brushing and flossing will help with breath issues. Brushing your teeth twice a day helps remove the biofilm produced by the oral bacteria that develops in the mouth. The initial buildup of this biofilm is not harmful and can easily be removed on a daily basis. It’s when this biofilm is allowed to accumulate longer that it becomes more harmful, causing dental caries and periodontitis – two very common sources of halitosis. Visiting your dentist on a regular basis is also important for maintaining good oral health. Your dental professional can give you objective feedback on your breath and provide advice to help combat halitosis.

Gently removing some of the bacteria on the back of the tongue while brushing may be helpful in achieving better breath. Removing plaque and bacteria from the back of your tongue can be done with a toothbrush or tongue scraper. Be careful with tongue scrapers, however, as they may provide too much stimulation and cause gagging.

stay calm and happy. According to a study published in Life Science in 2006, anxiety is linked to an increased amount of volatile sulfuric compounds (like hydrogen sulfide, responsible for the smell of rotten eggs), which play a large role in bad breath. Additionally, in a 2008 study published in Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, depression was related to patient complaints of halitosis.

avoid smoking and alcohol. Tobacco contains volatile sulfuric compounds, which have been linked to bad breath. Additionally, tobacco is a risk factor for hyposalivation and gum disease, which may also lead to halitosis. Alcohol drinking has been linked to bad breath as well. According to a 2007 study published in the Journal of Dental Research, chronic alcohol drinkers were more likely than non-drinkers to have bad breath, possibly because alcohol in the mouth breaks down into smelly compounds and because alcohol can lead to a dry mouth.

avoid odorous foods, such as onions, garlic, cabbage, cauliflower, and radish when you want good breath. This tip speaks for itself. Smelly foods will very likely create a smelly mouth. Additionally, some of these odorous compounds might enter your bloodstream to be secreted out of your mouth and nose through your lungs. Don’t avoid these foods altogether though, since they all have their own health benefits.

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DIET:

complement garlic with milk. According to a study published in the Journal of Food Science in 2010, adding milk (especially whole milk) to garlic was able to help deodorize the smell of garlic in the mouth.

stay hydrated. Hyposalivation, or having too little saliva in the mouth, is a factor linked to bad breath. Since saliva performs the function of washing out the mouth, too little saliva leads to an accumulation of food particles and other matter which decomposes and causes bad breath.

chew some eucalyptus or cinnamon gum. In a 2010 study published in the Journal of Periodontology, gum containing eucalyptus extract was found to reduce bad breath, probably because eucalyptus has antibacterial properties against certain bacteria that cause bad breath. Additionally, in a 2011 study published in the Journal of Clinical Dentistry, gum containing cinnamon extract and sugar was able to temporarily kill bad-breath bacteria in the mouth just as well as sugar-free cinnamon gum.

eat some licorice. In a 2012 study published in the Journal of Breath Research, a compound found in licorice was able to reduce the amount of smelly compounds produced by three strains of bacteria that are associated with halitosis.

drink green tea.

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left: ana vujosevic/istockphoto; right: david morgan/istockphoto.

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In a 2008 study published in the Journal of Nutritional Science and Vitaminology, green tea was found to inhibit the production of smelly compounds in saliva. According to a 2012 study published in The Archives of Oral Biology, green tea may even be able to counteract bad breath caused by smoking. Be careful, though, because green tea extract-containing chewing gum was also found to cause discoloration of the teeth. t w

body in focus

understanding your stool by lawrence liem | design by karen chu

are aspects of the human body that can serve as indications of whether a person’s body is in good condition. However, one important indicator of health that may be overlooked is the stool.

Stool (also known as feces) is waste eliminated from bowel movements. People often delay seeking treatment even after they detect abnormal stool because doing so can lead to embarrassing, awkward conversations. However, if the abnormalities are due to serious medical conditions such as colorectal cancer, early detection can be essential and even life-saving. Excretion is a natural part of any living organism, but abnormal feces can be an indication of a serious health condition. Understanding one’s stool is a useful tool one can utilize to detect and to prevent any potential medical conditions.

total wellness ▪ winter 2013

The color of fingernails, the strength of one’s hair, or the lines under one’s eyes

COLOR OF STOOL Noting the color of one’s stool is one of the easiest ways to tell if there are any problems. According to Bernard Aserkoff, MD, a physician in the GI Unit at Massachusetts General Hospital in Boston, the product of bowel movements is generally brown in color because of bile, a compound produced in the liver that is important to the digestion process. Usually, shades of brown and green are considered normal colors for feces. Here is a chart that details different stool colors and what they can mean:

pale-yellow, greasy, foul-smelling stool When these conditions appear, there is probably excess fat in the bowel, which means the fat is not being properly absorbed in the body. It can indicate a serious medical condition and one should seek a physician immediately.

red but not bloody stool This can come from food items that contain red coloring. These items include beets, strawberry ice cream, red velvet cake, chili peppers, and many more. However, it is difficult to be certain whether the red coloring is a result of food colorings or blood without a professional medical opinion. Contact a physician if stool looks like it may contain blood.

bloody stool This warrants concern as it can be a sign of cancer or an injury to the digestive track. A doctor should be contacted immediately.

brown stool This is the expected color of stool!

pale grey stool This can suggest that something is wrong with the digestive tract. Since bile gives stool its natural brown color, a blockage of it may leave the feces pale in color.

This can be dried blood that results from bleeding in the esophagus or stomach. A visit to the doctor is recommended if this occurs. Black stool may also be a result of ingesting iron supplements.

green stool Normally, green stool is caused by food items that are rich in chlorophyll (such as spinach). Taking certain medications can also result in this coloring. Thus, for the most part, green stool is not a cause for concern. Note: Food coloring can affect one’s stool, so if one were to eat a blue cake or drink blue Kool-Aid, blue stool can emerge. After a few days, it should return to normal.

center: petek arici/istockphoto.

total wellness ▪ winter 2013

black stool

HARD VS. SOFT According to Robynne Chutkan, MD, an assistant professor of medicine at Georgetown University Hospital, stool should come out in one large piece instead of many small pieces. Common causes for breakage in feces include lack of fiber in diet, bowel spasms, and excessive straining. Bodily waste that does not come out in one piece can cause additional stress during elimination. Moreover, excreted stool should have a certain density. It should be dense enough to sink but not so hard that it causes painful elimination. Here is what happens when it is on either end of this spectrum: too watery (diarrhea) Diarrhea occurs when the colon is not absorbing enough water from the waste materials. This leads to watery, loose stool. Most diarrhea is caused by a virus that infects the gut. Other causes of watery stool can be adverse reactions to certain foods. For instance, this condition can be caused by lactose intolerance. In rare cases, illnesses like Celiac disease can also create watery stool.

too dry (constipation) Constipation is defined as infrequent movement of the bowels, leading to difficulty in elimination. Consuming a diet high in fat or processed foods can increase stool transit time, allowing more water to be absorbed from the stool, further exacerbating constipation. Fiber when combined with fluid will create bulk and help soften stool. On the other hand, lack of fiber combined with dehydration hardens the stool and can lead to painful excretion.

WHAT CAN BE DONE? to address diarrhea The most common cause for diarrhea is a viral infection of the gut received from unclean foods or water. It is better known as the stomach flu or food poisoning. Though medications such as Imodium can be used to alleviate the symptoms, most cases of diarrhea will go away in a few days. Since diarrhea often leaves a person dehydrated, it is recommended that people drink plenty of fluids and make certain the food consumed is clean. Proper hygiene such as frequent hand washing is also highly recommended.

Constipation is often caused by lack of fiber in diet, lack of physical activity, or dehydration. If constipation persists, stool will become larger and harder to pass. This can cause a tear in the anus and result in an anal fissure. For this condition, it is suggested that one eats plenty of fiber-rich foods and drinks plenty of fluids. Additionally, regular exercise can promote healthy bowel movements. If needed, a stool softener can be used, but always consult a doctor before starting any medication or supplement use.

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to address constipation

TO KEEP A HEALTHY GI TRACT IN GENERAL To keep a healthy GI tract, consume a high-fiber diet combined with plenty of water and regular exercise. Additionally, practicing food safety and proper food hygiene can help with digestive health. high fiber Fiber provides bulk to waste by absorbing water. Whole grain foods, fresh fruits, and fresh vegetables can provide an easier trip to the restroom. The American Academy of Family Physicians recommends eating at least nine servings (about two cups) of fiber-filled fruits a day.

water Plenty of water is needed to help move feces throughout the body at a regular pace. Water provides bulk and prevents the stool from becoming too hard.

exercise Exercise can stimulate peristalsis, the rhythmic contraction in the digestive tract, which helps to propel feces through the colon and alleviate constipation.

cleanliness

Stool is a natural part of daily living and can be used as a simple preliminary measure to determine whether one has any digestive problems. However, certain medical conditions may escape the untrained eyes. It is therefore important to consult your primary care provider if you notice any abnormalities in your stool. To catch potentially serious problems in their early stages, attend your routine annual physical exam and pay attention to the quality of your stool. The hardness, color, and shape are all clues to the simple, yet crucial characteristics of human wastes. A healthy diet, routine exercise, high fiber intake, and proper hydration can lead to a healthier lifestyle and easier trips to the restroom. t w

right: juliĂĄn rovagnati/istockphoto

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Foods should be cleaned, cooked, and stored at the proper temperatures to prevent bacterial or viral infection. When traveling to underdeveloped countries, drink only bottled water and freshly cooked foods. Frequent hand washing can also prevent digestive problems.

eat right

fishing for your health

by anahit poturyan | design by barbara wong

total wellness ▪ winter 2013

How many times have you heard the phrase “you should eat more fish”? Do you know why? The American Heart Association (AHA) suggests that you eat two servings of fish per week for the most advantageous results in overall health. Fish offers you protein and omega-3 fatty acids in addition to various vitamins and minerals. Read on to learn about the other benefits fish can offer, along with the risks associated with consuming fish or fish oil supplements, the wild versus farmed fish debate, the top five fish consumed in the United States, and an app that can help you decide which fish to eat.

Omega-3s Fish contain omega-3 fatty acids, which aid in the proper functioning of the cardiovascular system. This fatty acid is essential, meaning that it needs to be consumed through food because our bodies cannot produce this substance. There are three different types of omega-3s: Docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and alpha-linolenic acid (ALA). DHA and EPA are found in marine animals, while ALA is found in plant sources like kale and spinach. EPA and DHA promote brain and retina health and also help with the reduction of arrhythmias (irregular heart rhythm) and triglycerides (a type of fat that clogs and thickens heart arteries). However, if you are a vegetarian or vegan, eating foods such as walnuts, flaxseed, and soy can be a good alternative to intake of DHA and EPA omega-3s from fish.

Risks

total wellness ▪ winter 2013

Especially for pregnant and nursing women and young children, mercury contamination should be of concern because it is a neurotoxin for developing fetuses and brains. The key to eating healthily is balance; it is important to eat in moderation and follow the guidelines set forth by the Food and Drug Administration (FDA) and the American Heart Association (AHA). Additionally, choosing fish low in mercury, such as salmon, canned light tuna, pollock, catfish, and shrimp, can help decrease the risk for mercury poisoning.

Fish Oil Supplements Don’t like the taste of fish? Fish oil supplements may be a good alternative. Each manufactured supplement varies in doses of omega-3s; some offer a combination of EPA and DHA, and some contain only ALA omega-3s. Your physician can help you choose which supplement ratio is best for you. However, take fish oil supplements with a grain of salt. Just like actual fish, these supplements can be contaminated with mercury and PCBs. If you are curious about the purity of your supplement, you can check out the Environmental Defense Fund’s 2008 report evaluating 75 fish oil manufacturers. As long as you are careful, fish oil supplements can offer many benefits. Interestingly enough, a 2013 article published in Current Opinion in Psychiatry found that fish oil can help improve mood disorders. Also, a 2011 article published in The Journal of Clinical Psychiatry reported a minor tendency for major depressive episode (MDE) patients to experience decreased depressive symptoms with the intake of omega-3 supplements.

Seafood Watch App The Monterey Bay Aquarium offers a free PDF guide and an iPhone/Android app for consumers to help them make conscious and sustainable choices when it comes to eating seafood. Check out mobile.seafoodwatch.org for more information. The website suggests the best fish to eat based on availability, which depends on how environmentally friendly the methods of farming or catching the fish were. The fish are classified under three categories: “best choice”, “good alternatives”, and “avoid”. These classifications help you decipher which fish are the best to eat (farmed or wild, local or imported) depending on your location in the United States. They have broken down the United States into six regions and organized guides specifically for fish common in those states.

left (in order): andra cerar/istockphoto; antimartina/istockphoto recipe source: eatingwell.com, hechurchcookblog.com

Although eating fish can be beneficial, contaminants such as mercury, dioxins, and polychlorinated biphenyl (PCBs) may pose health risks. These chemicals enter the fish food-chain because of human industrial activity, mainly from incineration, farming, and manufacturing goods. A rule of thumb to follow when eating fish is to remember that fish at the highest end of the food chain, mainly predators, contain the highest levels of contaminants, especially mercury. That is why the FDA strongly suggests limiting swordfish, shark, tilefish, and king mackerel. While fish have wondrous health benefits, eating too much fish can increase your chance of accumulating high levels of mercury in your body. The symptoms of mercury poisoning include: headache, weakness, loss of coordination, vision impairment, and skin rashes.

wild versus farmed Eat this! No, eat that! Be careful of this! Be careful of that! We can hardly go a day without hearing something like this. How is one to know what to eat? When it comes to wild and farmed fish, there isn’t a definite answer to the debate about which is better. As a consumer, you must weigh out the pros and cons yourself in order to make careful and conscious decisions.

pros of farmed fishing

cons of farmed fishing

Aquaculture – farmed fishing – was created to meet the high demand of consumers and the decreasing food-fish populations. People for the Ethical Treatment of Animals (PETA) reported that more than 40% of consumable fish now come from these aquacultures. The main advantages of farming fish are related to the environment. Farming aquacultures eliminates the risk of over-harvesting wild fish from the oceans. Additionally, farmed fish tend to have lower levels of mercury than wild fish.

Farmed fish have a different diet compared to their wild counterparts; they are fed on grains and soy, which may contain traces of herbicides and pesticides. Land farmers use these pervasive chemicals on conventional crops to kill unwanted bug and plant life growing in the fields. Exposure to these chemicals through the consumption of fish that were fed diets containing these compounds could lead to allergies, asthma, change in mood or behavior, and, in severe cases, hormone disruption or cancer. Although this controlled diet eliminates most of the mercury contamination in wild fish, farmed fish may still absorb mercury from the water, since most farms are positioned in the ocean. A 2012 study published in the book The Swimming Physiology of Fish reported that 20% of captive fish die because of lack of exercise due to their cramped and overpopulated living conditions. Condensed living spaces in conjunction with poor diets give rise to disease. For this reason, farmed fish are shot with constant doses of antibiotics. This is problematic for humans because some chemicals used in antibiotics may cause cancer with too much exposure.

recipes

Looking for quick and easy ways to incorporate fish into your meals? Here are a few wallet friendly, tasty, and nutritious recipes.

pan-seared salmon with fennel

tuna sandwich

ingredients:

1 large tomato 1 cup of finely chopped fennel 2 tbsp of minced red onion 2 tbsp of minced dill 1 tbsp of red-wine vinegar ½ tsp of salt 1 pound of salmon fillet freshly ground pepper 2 tbsp of extra-virgin oil

instructions:

1. Open two cans of tuna and drain water completely. Transfer tuna into a medium size bowl and pat dry with a few sheets of paper towels. 2. In a small microwave safe bowl, combine grated onion and olive oil and heat for 45 seconds. Cool. 3. Using a fork, toss onion mixture with tuna and add lemon juice and mayo. Add any optional ingredients if using. Season well with salt and pepper. 4. Assemble the sandwiches or use it to top a bed of greens.

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1. Chop tomato, fennel, onion, and dill. 2. Combine tomato, fennel, onion, dill, vinegar, and 1/4 teaspoon salt in a medium bowl. 3. Cut salmon into four equal portions, sprinkle with the remaining 1/4 teaspoon salt and pepper. 4. Heat oil in a large nonstick pan over high heat until shimmering but not smoking. 5. Cook the salmon, skinned-side up, until golden brown, three to five minutes. 6. Turn the salmon over and remove the pan from the heat. 7. Allow the salmon to finish cooking off the heat until just cooked through, three to five minutes or more.

2 (5 oz.) cans tuna 2 tbsp grated onion 1 tbsp olive oil 1 tsp fresh lemon juice 1/4 cup mayonnaise salt and pepper to taste 4 slices of bread 2 pieces of lettuce leaves

Canned Tuna

Physicians and health enthusiasts deem salmon a “super-food”, because of its opulent levels of omega-3. However, the omega-3 fatty acid is not the only superstar nutrient found in salmon. This pink-colored fish also provides protein and vitamins D, B2, and B12. It is also low in fat. Vitamin D promotes healthy bone and cell growth and may reduce inflammation. Vitamin B2 (riboflavin) and B12 collectively aid in the proper functioning and growth of organs. Wild Alaskan salmon is the best choice for consumers because it has the lowest level of mercury.

Canned tuna is a classic lunchtime staple liked by many because of its quick and easy preparation. It is great for many diets because it is low in calories and high in protein. Additionally, it contains plenty of omega-3’s and vitamin B12.

Tilapia

Cod

Pollock

Although tuna is advertised as the “chicken of the sea” due to its popularity, tilapia is dubbed the “aquatic chicken” because of its ability to grow in various environments and reproduce easily. This makes the native African fish ideal for the American aquaculture market. Tilapia offers protein as its main nutritional benefit.

Cod, a cold-water fish, is naturally low in calories and high in protein. It is packed with vitamin A, D, K, selenium, niacin, vitamins B6 and B12, and tryptophan. Vitamin K builds proteins for properly functioning tissues and bones while vitamin A maintains retina and skin health. Niacin (vitamin B3) supports the function of nerves, skin, and the digestive system. The amino acid tryptophan is used to make niacin and the healthy sleep-promoting neurotransmitter serotonin. Also, cod is popular for its liver oil, which is used to lower triglyceride levels and can be applied topically to heal wounds.

Pollock, a mild tasting cold-water fish belonging to the cod family, is most commonly used to make fish sticks and fillets. There are two types of pollock, Atlantic and Alaskan, both of which are high in protein. Alaskan “walleye” pollock has been given the green light by both the Alaskan and United States governments as a safe fish for its low toxin levels. Pollock is also used to make the gel layer of surimi, known as “imitation crab” in grocery stores. t w

top

total wellness ▪ winter 2013

consumed fish in the united states from the national marine fisheries service

left (in order): floortje/istockphoto; floortje/istockphoto; nikolay suslov/istockphoto; aga & miko materne/istockphoto; edward westmacott/istockphoto; right: mistikas/istockphoto

Salmon

get active

the tabata workout by savannah badalich | design by karin yuen

Feel too busy to make time for an hour-long workout? How about a short workout that improves multiple body systems in less than 60 minutes? Or even less than 30? Tabata interval training is a four minute high intensity exercise method that yields more effective results than an hourlong moderate intensity workout.

the history The Tabata was first developed in 1996 by Japanese scientist Dr. Izumi Tabata (a former researcher at the National Institute for Health and Nutrition and a current professor and researcher at Ritsumeikan Universityâ&#x20AC;&#x2122;s newly established Faculty of Sport and Health Science) and his team of researchers from the National Institute of Fitness and Sports in Tokyo. According to their original 1996 article published in Medicine and Science in Sports and Exercise, the team conducted research on two

groups of athletes; one group trained at moderate intensity, and the other trained at high intensity. Moderate intensity athletes exercised five days a week for six weeks with each workout lasting an hour. The high intensity athletes worked out four days a week for six weeks with each workout lasting four minutes. The results showed the moderate intensity group had an increase in the capacity of their aerobic - cardiovascular - system, but little results in the capacity of their anaerobic muscle - systems. The high intensity group showed a greater increase in their aerobic systems than the moderate intensity group and a 28% increase in the capacity of their anaerobic systems. Ultimately, high intensity interval training proved to be more beneficial on both the aerobic and anaerobic systems of the athletes.

what is the tabata workout? The Tabata is comprised of 20 second periods of maximum intensity cardiovascular work, punctuated by ten seconds of rest over eight cycles to comprise four minutes. The key is the intensity. The 20 seconds require maximum effort, with no shortcuts or slacking. Without the intensity, the results will not follow.

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benefits

cautions

› Increase Aerobic & Anaerobic Capacities: As stated in Dr. Tabata’s 1996 article published in Medicine and Science in Sports and Exercise and in the 2011 article from Journal of Obesity, the Tabata workout increases aerobic capacity – the body’s maximum oxygen intake – and anaerobic capacity – the maximum energy the body produces in the absence of oxygen – far more than a longer duration moderate intensity workout. › Time Saving: With an incredibly effective workout that is merely four minutes long, even the most busy of individuals can find time for this quick workout.

› Ease Into It: The Tabata is, as stated previously, a high intensity exercise. Therefore, good cardio and strength conditioning – especially cardio – prior to trying the Tabata is advised. Try your best, but don’t overexert yourself. › Body Form/Technique: Unfortunately, with exhaustion comes inconsistent form. Be careful not to lose your form or technique when performing specific exercises or moves during your Tabata workout. Quality repetitions and consistent form prevent injuries.

› Fat Burning: The Tabata interval method is a form of highintensity intermittent exercise, which, according to a 2011 article published in the Journal of Obesity, is shown to be more effective at reducing subcutaneous fat (fat located just beneath the skin) and abdominal body fat than other types of exercise. It also results in a number of skeletal muscle adaptations that result in enhanced skeletal muscle fat oxidation.

example workouts

Pick one or two of the following moves to perform during the 20 seconds of maximum intensity: sprints:

jumping squats:

Whether on a track, trail, or treadmill, sprint at full-speed during the 20-second interval. A similar option that may put less stress on the knees is bike sprints.

Descend into squat position, then jump straight up as high as you can go. Land with both feet firmly on the ground, descending into a squat. Repeat.

jumping rope: Options include: both feet together, high knees, the boxer shuffle with heels in front, alternating feet, and buttkickers.

The ultimate non-impact exercise, swimming offers all the cardio benefits of running and cross-trains your upper body. According to a 2010 study published in The Journal of Physiological Sciences, intervals of high intensity swimming caused an increase in the level of the GLUT-4 protein (the protein responsible for insulin regulation) in the skeletal muscle of rats. Increased levels of GLUT-4 improves glucose tolerance and help prevent the onset of diabetes. Pick whichever stroke you are most comfortable with and swim away. t w

mountain climbers Get into the pushup position. Bring one knee toward your chest as high as you can go. Keep your hands firmly planted on the ground and jump to switch legs. Options include: bringing the knee to alternate elbows.

right: baris simsek/istockphoto

total wellness ▪ winter 2013

Step your right foot forward and descend into a lunge – until your right thigh is parallel to the ground – then jump; During the jump, switch your feet beneath you, bring your left foot in front of you and right foot back, landing in a lunge position. Repeat.

left (in order): don nichols/istockphoto, nicola pavone/istockphoto, bsani/ istockphoto; right: vika valter/istockphoto

swimming:

jumping lunges:

mythbusters

cracking down on the truth by lillie luu nguyen | design by keziah pagtakhan and barbara wong

How many of us have typed for hours on end and found that the only way to release the strain from our fingers is to give each knuckle a nice little tug? Depending on the research source, between 25% and 54% of people crack their knuckles. People may do this because it can loosen up the knuckles, allowing for more mobility. However, can this excessive knuckle cracking be a long term detriment or worse yet, a cause of arthritis? A closer look into the science behind popping oneâ&#x20AC;&#x2122;s knuckles will provide more insight into this old wives tale.

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what really happens when the knuckles are cracked?

possible harms in knuckle cracking

Between each joint is a lubricating fluid called synovial fluid. This fluid contains dissolved gases such as carbon dioxide and nitrogen. As the spaces between the joints are manipulated to move away from each other, the dissolved gases cause microscopic bubbles in the fluid to aggregate. Known as cavitation, this bubble formation creates an air-filled space between the joints that continues to expand as the joint is being pulled and eventually leads to the “pop” heard when knuckles are cracked. After this occurs, approximately 15 minutes must pass before the knuckles can be popped again because the gases have to reenter the cavity.

Even if there is no current evidence for a direct correlation between knuckle cracking and arthritis, a 1990 article in Annals of the Rheumatic Diseases discovered that knuckle cracking can lead to hand swelling and lowered grip strength in habitual knuckle crackers. It was reported that 84% of long term habitual knuckle crackers experienced hand swelling later on in life compared to six percent of non-habitual knuckle crackers. In addition, since the ligament (the tough, flexible tissue that connects bones together) loosens with each pop, the joint itself becomes more loose when knuckles are cracked, making it more difficult to retain a firm hold on objects without applying additional force; as a result, this can lead to soft tissue damage in the joints.

research behind knuckle cracking

what is arthritis?

It is only natural to believe that constantly having bubbles burst between the joints could have a negative effect on the health of one’s fingers and toes. However, Donald L. Unger, MD and Northwestern University graduate, set forth to debunk the myth by cracking the knuckles of his left hand for 60 years while avoiding cracking the knuckles on his right hand. As the 19th recipient of the Ig Nobel Prize in Medicine, an honor that is awarded to those who achieve the goal of “first making people laugh, and then making them think,” Unger demonstrated through experimentation on his own hands that there was no increased risk of arthritis in the hand that he regularly cracked. Furthermore, there were no discrepancies in the physical features of his two hands.

It is a painful inflammation and stiffness of the joints, and is categorized by two major types. Degenerative arthritis, also known as osteoarthritis, is caused by “wear and tear”, and inflammatory arthritis results from improper regulation of the immune system. Examples of inflammatory arthritis include rheumatoid arthritis, lupus, and psoriatic arthritis.

In addition, a 2011 study in the Journal of the American Board of Family Medicine has noted that the total duration and cumulative exposure to the loosening of the phalangeal joints did not have any significant correlation to osteoarthritis. This can be seen in the group study results, where the prevalence of osteoarthritis was similar amongst both habitual knuckle cracking and non-knuckle cracking participants.

The main causes of both major types of arthritis are not well known, but both genetic and environmental factors play a role. While knee osteoarthritis can happen as one ages and inflicts excessive mechanical stress on the joints over time, genetics are known to be a particularly important contributing factor to hand osteoarthritis. It is possible that rheumatoid arthritis is triggered by exposure to some unknown environmental stimulus. Although it is true that those with arthritis often experience a popping of their joints as a result of damage to the surfaces of their cartilaginous joints, this is more likely to be a consequence of arthritis rather than a cause.

The research behind knuckle cracking has not firmly established this practice to be beneficial or disadvantageous. While one may continue pulling or bending the fingers in whichever way one pleases to release the tension, one can clear out the discomfort in the joints through safer and healthier means. Hydrotherapy and aromatherapy mixed with slow massages using essential oils such as lavender, rosemary, and eucalyptus during a warm relaxing bath are some alternatives one can try. For those with more severe aches within the joints, hot paraffin baths are known to provide relief. Natural remedies such as herbal teas, exercise, and getting plenty of rest are all possible treatments to reinvigorate the joints as well. t w

right: silvia jansen/istockphoto

total wellness ▪ winter 2013

bottom line

total wellness ›› on the cover

"Sometimes the most urgent thing you can possibly do is take a complete rest” total wellness ▪ winter 2013

– Ashleigh Brilliant

feature

bathe your way to better health with epsom salts

total wellness â&#x2013;Ş winter 2013

The simple relaxing nature of a warm bath is naturally appealing to many. But, could baths serve as a beneficial agent for the body beyond relaxation? They may indeed, particularly if they are drawn up with Epsom salts. If you take baths with Epsom salts, you will not only come out of the tub smelling good and feeling refreshed, but you may also be taking advantage of Epsom saltsâ&#x20AC;&#x2122; numerous possible health benefits.

left: svetl/istockphoto; right: foremniakowski/istockphoto

by harini kompella | design by barbara wong

what are epsom salts? Epsom salts are not actually salts. Epsom salts are named for a bitter saline spring at Epsom in Surrey, England, and are actually a naturally occurring pure mineral compound of magnesium and sulfate. These compounds can help individuals make up for the magnesium deficiency found in many Americans. According to the Journal of the American College of Nutrition, 68% of U.S. adults get less than the recommended dosage of magnesium, and furthermore, 19% consume less than half of this recommended daily allowance (RDA). Soaking in these Epsom “salts” may be an easy way to increase the body’s levels of magnesium and sulfate, both of which are essential for many biological processes, including regulating enzymes and maintaining nerve activity. Epsom salts have recently gained more attention, particularly in regards to their incorporation into consumer products, such as bath salts. Yet, research on the use of Epsom salts baths is still fairly new. According to a 2012 review article published in the International Journal of Cosmetic Science, one-third of all the body’s enzymes may require the presence of metal ions, such as magnesium, for faster activity. This review further explains that Epsom salts can be used in bath water to increase skin softening and exfoliation, as well as relieve muscle tension and to promote relaxation. However, there is little evidence-based research available in the medical literature to back up these claims.* In general, however, magnesium and calcium may play a key role in these processes, as is further discussed in the Health Benefits section of this article.

health benefits reduces stress and relaxes the body*

relieves pain and muscle cramps* Epsom salts may ease pain and relieve inflammation helping in the treatment of sore muscles, bronchial asthma, and migraines. A 2012 study published in the Journal of Immunology suggests that these magnesium sulfate salts decrease the production of compounds associated with inflammation. These inflammatory-based molecules are linked with different diseases, including autoimmune diseases which can consist of pain conditions. Therefore, lowering the production of these molecules may help with inflammation relief. Furthermore, a 2003 study from the Journal of Nutritional and Environmental Medicine found that people with chronic conditions such as chronic fatigue syndrome, migraines, and fibromyalgia, may have lower levels of sulfate, and suggests that Epsom salt baths may help increase sulfate levels and thus, improve any pain (including pain in the muscles) associated with these conditions.*

helps maintain proper muscle and nerve function* Epsom salts can help regulate the body’s electrolytes and help maintain the proper function of muscles, nerves, and enzymes. Magnesium is important for the ability of the body to use calcium as a conductor of electrical impulses - the main method by which information is transmitted between the brain and body. As the aforementioned Archives of Biochemistry and Biophysics review notes, a sufficient level of magnesium maintains calcium levels to prevent inflammation, which may otherwise occur if too much calcium is present. Since the immune and nervous systems interact with each other, enough magnesium in the cells helps calcium carry out its role as a conductor of electrical activity. Also, this review suggests that this balance between magnesium and calcium levels allow for proper smooth muscle function.

total wellness ▪ winter 2013

Stress has been found to drain the body of magnesium and increase the body’s adrenaline levels. Adrenaline is a hormone released in times of greater stress to prepare the body for the ‘flight or fight’ response. According to a 2007 review article published in the Archives of Biochemistry and Biophysics, research findings show that an inadequate intake of magnesium activates a bodily pathway that is involved in stress and inflammation, and suggests that higher magnesium levels may allow the body to better handle stress. It has been suggested that Epsom salts dissolved in warm water may lower stress hormones, although this is yet to be tested in studies. People who have taken these baths have found them to be relaxing and calming, which may be because the magnesium from the Epsom salts gets absorbed through the skin. In turn, the replenishment of magnesium levels in the

body from this absorption can contribute to normal regulation of stress hormones.* Though there have not been any studies exploring the relationship between Epsom salt baths and relaxation, these baths have been a suggested therapy for both stress reduction and better sleep. This is primarily based on individuals’ positive experiences while taking these baths.

In addition, the Journal of Immunology study cited above points out that a sufficient amount of magnesium reduces inflammation, facilitating improved functioning of the nervous system. Thus, magnesium may allow for more normal muscle and nerve function. Also, the study from the Journal of Nutritional and Environmental Medicine explains how lower levels of sulfate may lead to neurotransmitter imbalances – imbalances in the chemical messengers of the nervous system. As a result, low sulfate levels may lead to nerve-related medical conditions; Epsom salts may help counteract these effects by increasing the body’s sulfate levels.

helps prevent artery hardening and blood clots* Epsom salts may improve heart health and help prevent heart disease by improving circulation, lowering blood pressure, protecting the elasticity of arteries, preventing blood clots, and reducing the risk of sudden heart attack deaths. A 2012 study published in the American Journal of Physiology – Heart and Circulatory Physiology suggests that if the magnesium concentration found in mammalian cells is low, fatty acid accumulation in cardiovascular tissue and cells occurs. This buildup of these fatty acids is a major contributor to heart problems, including hypertension. The researchers of this study further explain that their results may explain why magnesium helps lower blood pressure, along with its role in promoting vasodilation – the widening of the blood vessels and decreasing of the workload on the heart’s muscular tissue. According to a 2012 study published in Neurological Research, magnesium sulfate therapy may prevent vasopasm - the narrowing of blood vessels, restricting blood flow - in artery smooth muscle cells, as demonstrated with rabbits in this particular study.* In addition, a 2013 study from the Journal of Clinical Anesthesia found that magnesium sulfate can regulate blood pressure in hypertensive patients, provided an overdose isn’t administered.*

*taking epsom salts with a grain of salt Epsom salts are thought to be possibly helpful in regulating one’s health, due to its composition of magnesium and sulfate. However, there is no widely accepted, unbiased research suggesting that Epsom salts are absorbed through the skin when one takes a bath with these bath salts. A 2004 study, conducted by the School of Biosciences at the University of Birmingham and published in the Epsom Council’s Report on Absorption of Magnesium Sulfate Across the Skin, did show that prolonged soaking in an Epsom salt bath raised magnesium levels. The post-bath magnesium levels were compared to earlier measured urine and blood magnesium levels, and the researchers suggested that this may show that the amount of the magnesium found in Epsom salts can get absorbed through the skin. However, this source may be biased because it has only been published through the Epsom Council, which advertises Epsom Salts as one of its products. Since Epsom salts are pure mineral compounds of magnesium (and sulfate), studies exploring their health effects are often looking at the impact of magnesium itself, which has been outlined in much of this article. Any observed improvement with Epsom salt baths may be correlated with possible absorption of the salts’ magnesium, but science has not reliably shown that this absorption occurs.

Epsom salt baths may provide a simple, stress-free way to receive the benefits of magnesium, which may improve the overall health. Hopefully, in due time, the research increases on Epsom salt baths specifically, so we can better understand how they directly affect us. There have been some observations that people find Epsom salts useful, including for skin softening, stress relief, and overall muscle relaxation. The intake of magnesium through diet and supplements has been found to help make up for magnesium deficiencies and thus enhance one’s health. Perhaps, then, Epsom salt baths can prove to be a soothing, fun way to enhance one’s health.

left: matka_wariatka/istockphoto; right: katie molin/istockphoto

total wellness ▪ winter 2013

Conclusion

the guide ›› epsom bath salts never used epsom/other bath salts before? here’s a quick how-to guide

Fill a drawstring cheesecloth bag with several teaspoons to two cups of bath salts. To make your own cheesecloth bag, pour the salts into the middle of a square of cheesecloth that is at least six inches, then draw the corners of the cloth up, and tie a piece of string around them to seal the salts in. If you don’t have any cheesecloth handy, you can use any porous or loosely woven cotton material, poking a few holes if needed that are just small enough to let the water in, but not the salt out. Alternatively, you can dissolve the salts in a jug of water.

Fill the tub with water – ideally enough to just cover your body when lying down in the bath – of desired temperature. Add the salts into the tub while it is still filling up with water to ensure proper mixing. This can be done either by letting the salts out of the jug of water or dropping your bag of salts into the water – swirling it around to allow it to dissolve.

note

When you get out of the tub, vigorously rub your entire body. If you have used a bag for your salts, rinse it out with fresh water and drape it over the faucet or shower rod to dry.

3 Relax for about 12 minutes in the bath. So far, a suggested concentration of Epsom salts in baths is about 500 g, or two cups, in a filled up standard sized tub (15 gallons of water), and the ideal time to spend soaking is 12 minutes a day, two to three times a week.

› Avoid becoming chilly after you are done with the bath. › Those with heart or kidney conditions should get their doctors’ permission before

taking Epsom salt baths, since magnesium is excreted by the kidneys. Taking this precaution helps avoid a possible magnesium overdose. › If you have arthritic joints, move them as much as possible after the bath to prevent aggravated pain from congested joints. › If frail, you should start with a smaller quantity of salts – about half a cup to one cup – and gradually increase the amount as you become better able to tolerate the bath. t w

total wellness ▪ winter 2013 31

feature

by leslie chang | design by catrina pang

total wellness â&#x2013;Ş winter 2013

To get better acquainted with the rising popularity of health coaching and what it entails, Total Wellness obtained an inside look from Julie Skrupa, an American Association of Drugless Practitioners boardcertified health coach. Skrupa completed the Health Coaching Training Program with the Institute for Integrative Nutrition (IIN) in New York City, a school whose holistic approach to health coaching focuses on lifestyle factors that create optimal health. She has been employed at UCLA since 2007 and now works with the UCLA Center for Healthier Children, Families & Communities. The following features her answers to a few questions that Total Wellness had regarding Health Coaching.

left: joshua hodge photography/istockphoto; right: daniel bendjy/istockphoto

health coaching

what is health coaching? A health coach is a wellness authority and supportive mentor who motivates individuals to cultivate positive health choices by educating and supporting them as they work towards achieving their health goals through lifestyle and behavior adjustments. Health coaches understand how to work with diverse groups of people and how to mentor and motivate individuals to make positive and healthy lifestyle changes. By enrolling in a health coaching program (which often integrates Eastern and Western medicine to promote holistic healing), students have the opportunity to learn from experts in the fields of nutrition, health, wellness, and medicine. In addition, students are introduced to all of the dietary theories; they learn how problematic diseases with chronic symptoms such as diabetes, high blood pressure, and obesity may have underlying causes in nutrition and mental health, and they are given the tools to build their health coaching business. Currently, preventative health care is in high demand. Individuals that are able to make healthy lifestyle choices have a reduced risk of developing certain debilitating diseases.

what separates health coaching from related fields like nutrition or medicine? Health coaches are not medical practitioners like doctors, nutritionists, or registered dieticians. A health coach training program is a certification program, much in the same way that a personal fitness trainer is a certified trainer with knowledge and expertise in certain areas. A school like IIN is partnered with some universities and colleges (for example, Goddard College in Vermont and SUNY Purchase in New York) to offer students who successfully complete the coaching program eligibility to earn college course credits. A coaching program is different from a traditional academic program that offers degrees like PhD, MD, ND, or RD, because it does not offer the same in-depth curriculum as a formal degree program. Health coaches can also collaborate with doctors, nurses, nutritionists or dieticians to help create individualized plans for patients that may include a variety of healthy living choices including medication, food, and lifestyle changes. Since doctors may only have a few minutes to spend with patients, having a resource such as a health coach in the doctorâ&#x20AC;&#x2122;s office can be beneficial. Health coaches do not have a professional license to prescribe drugs. Instead they use their expertise to review the prescriptions,

lifestyles, and dietary habits of patients and offer suggestions after learning about past and current living situations. Unless a health coach also has formal medical training qualifying them to examine a patient, make a medical recommendation, or write a prescription, he or she will refer the client back to their medical practitioner for more serious medical guidance.

what are possible jobs associated with a health coaching degree? Health coaches can pursue a number of careers. They can work as mentors and counselors to people who need support and guidance regarding making healthy lifestyle and nutrition choices. Many have private coaching practices and work with individuals or groups, while other coaches offer their services to corporations, universities, alternative healing centers or medical offices. Coaching can also serve as a stepping stone for other health related avenues like writing books or blogs on health-related topics, public speaking, running cooking and baking classes or workshops, leading grocery store or health food store tours, and creating specialty health, wellness, and food products. By learning the basics of nutrition and understanding the importance of relationships, career, spirituality, and physical activity, students can use their knowledge to pursue the ventures that they are most passionate about.

total wellness â&#x2013;Ş winter 2013 33

what are important topics from health coaching that you want readers to know?

Primary Food: This is IIN’s philosophy and it is rooted in the concept that everything we consider a source of nutrition – actual food – is a secondary source of nourishment. The food we eat is secondary to other aspects of life that feed us and satisfy our hunger for life. While food can fill you, it cannot fulfill you. These other parts of life include healthy relationships, regular physical activity, a fulfilling career, and spirituality (while this can be religious, it can also be something that brings you comfort and makes you feel refreshed and at ease, such as meditation, writing, or playing music).

Bio-individuality: This term means that each person is unique with individualized nutritional requirements. No single way of eating works for everyone, and personal differences in anatomy, metabolism, body composition, and cell structure can all influence a person’s overall health and determine the foods that make them feel their best. This also means that the best food for each person depends on a variety of factors including body type, age, sex and lifestyle. Two of the main factors influencing bio-individuality are ancestry and metabolism; these determine how the body breaks down food products. Understanding these factors can allow people to choose foods that support their bodies.

total wellness ▪ winter 2013

There are a variety of resources available. Finding information from experts in their respective fields can be one of the best ways to learn about cutting edge research and new and innovative ideas. Here are just a few experts: Neal Bernard, MD (founder and president of the Physicians Committee on Responsible Medicine), Mark Hyman, MD (pioneer of functional medicine), David ‘Avocado’ Wolfe (author of Naked Chocolate), Cory Reddish ND, (a naturopathic physician), Andrew Weil, MD (pioneer of the Integrative Medicine field), John Douillard (chiropractor and Ayurvedic physician), Walter Willett, MD (chair of nutrition at the Harvard School of Public Health), and David Katz, MD (founder of the Yale University Prevention Research Center). There are also a number of websites that provide excellent information about current health, wellness, science, and nutrition topics. Here are two: CSPI (Center for Science in the Public Interest) (http://www.cspinet.org) and MindBodyGreen: Your Guide to Wellness (www. mindbodygreen.com). t w

left: silvia boratti/istockphoto; right: ikramraghuvanshi/istockphoto; isaac koval/istockphoto; right: r_mackay/istockphoto;

what are some resources that are important to health coaches?

feature

beat the

burn

by anahit poturyan | design by jessica sun

total wellness ▪ winter 2013

Do you sometimes get that uncomfortable burning feeling in your chest right after eating? It’s infamously known as heartburn. Everybody, young or old, probably has experienced heartburn at least once during his or her lifetime. In fact, 42% of Americans experience heartburn yearly according to research from the University of California, Irvine. Let’s take a look at what heartburn is, its causes, dietary and non-dietary triggers, symptoms, and methods for alleviating heartburn.

what is heartburn?

what are the symptoms?

Anatomically speaking, there is a muscular valve in between the esophagus and the stomach known as the lower esophagus sphincter (LES). This valve helps keep stomach acid inside the stomach. Heartburn occurs when the LES does not properly close. A reflux of stomach acid can enter the esophagus and cause a burning sensation when the LES does not close tightly or if it opens frequently. This can happen in two ways: when overeating fills the stomach to its capacity, or when the stomach is under pressure from pregnancy, tight fitting clothing, or obesity. Although this condition is named heartburn, it has absolutely nothing to do with the heart. The only connection between the two is the fact that the sensation of heartburn is very similar to that of a heart attack.

Some symptoms of heartburn are obvious, such as the classic burning feeling in the chest and throat right after eating a meal. Others include chest pain - usually after exercising, while bending over, or while lying down. Another symptom is the sensation of having food “stuck” in the middle of your throat. If heartburn is consistent and there is serious irritation on the esophagus, this could be gastroesophageal reflux disease (GERD). GERD, commonly known as acidreflux disease, is a digestive disorder of the esophagus and the stomach. Some symptoms of GERD that may go unnoticed include coughing and sore throat. If left untreated, heartburn and GERD can sometimes lead to development of cancer.

total wellness ▪ winter 2013

fruits and vegetables: The fiber in fruits and vegetables can help aid digestion.

› Bananas: The potassium and fiber in bananas help the stomach break down the extra food in the stomach.

› Papaya: An enzyme called papain found in papaya can help with digestion.

› Pineapple: Bromelain, an enzyme found in pineapples,

pairs up with pepsin and trypsin, digestive enzymes, to break up protein in the stomach for digestion. › Other that can aid in digestion fruits include: pears, melons, berries, apples, and peaches.

whole grains are also a great way to ease the symptoms

of heartburn. Just like fruits, these grains possess fiber, which aids in digestion. Additionally, whole grain can absorb surplus acid from the stomach. Some whole grains include oatmeal, brown rice, and whole wheat bread.

left(in order): okea/istockphoto; somchaisom/istockphoto; right: jusun/istockphoto

foods that alleviate heartburn

how to prevent & alleviate

heartburn? Minor and major lifestyle changes can reduce your chances of developing serious problems or worsening your heartburn.

›

Physicians suggest changing one’s eating habits. Try to refrain from exercising right after eating. Also, avoid lying down within three or four hours of eating. Lying down right after eating is not suggested because it causes food inside the stomach to be pushed up harder against the LES.

›

Reducing stress, smoking, and food portions can help your esophagus function better.

›

Raising the position of your head six inches above the shoulders while sleeping can drastically help avert acid reflux, because digested food will not climb up the esophagus.

›

Using antacids can help relieve heartburn by neutralizing acidity of the stomach. Over-the-counter antacids include: AlkaSeltzer, Tums, Milk of Magnesia, and Pepto-Bismol.

Dr. Malcolm Taw, MD, FACP, assistant clinical professor at UCLA David Geffen School of Medicine, comments: “When I discuss treatment and prevention of heartburn with my patients, I find that it is important to address not only ‘what’ they eat, but ‘how’ they eat. Some of my patients have a fairly decent diet, but they often multi-task and rush through their meals, which is not conducive to optimal digestion and assimilation of food. Ideally, one should set aside time to eat in a relaxed environment free of work or study. Another therapeutic modality to consider is acupuncture, which has helped several patients seen in our clinic [UCLA Center for East-West Medicine].”

non-dietary causes of

heartburn

Food is not the only cause of heartburn. Some medications (such as ibuprofen for pain, anticholinergics prescribed for sea sickness, sedatives for insomnia and anxiety, and theophylline used for asthma) can lead to the burning feeling in the esophagus.

food that can contribute to heartburn: Generally, acidic, spicy, oily, high-fat, and fried foods as well as caffeinated and alcoholic beverages are triggers for heartburn because these foods and beverages relax the LES and prevent it from closing correctly.

when should you

see a doctor? total wellness ▪ winter 2013

› When your heartburn becomes

consistent or if the pain intensifies.

› When medications, such as antacids, do not offer you relief.

› When you cannot fall asleep, or when

you wake up constantly because of pain. › If heartburn causes vomiting or if you have a painful time swallowing food t w

feature

seeing eye to eye with your contact lenses by sofia levy | illustration and design by kristen sadakane

s oft lenses

h ard (rigid) lenses

These lenses are typically made of flexible, soft, hydrophilic plastic and water. The water helps oxygen pass through the contact and into the eye, maintaining comfort and eye health. Silicone-based soft contacts are especially breathable because they allow oxygen to get to the eye. These contacts are known to be more comfortable and have a lower chance of causing infection than other lens types. They can even provide UV protection. However, soft lenses are also more fragile and can absorb pollutants more easily. Soft lenses can come in several types:

› Rigid gas-permeable lenses are stiffer and more durable than soft lenses, provide sharper vision, and allow enough oxygen to the cornea. Gas-permeable lenses thus tend to last longer and therefore be less expensive than other lens types. Furthermore, some can be extended-wear and can be worn overnight and/or for up to a week. Rigid gas permeable contact lenses are known to be the best for correcting severe nearsightedness, farsightedness, and astigmatism. However, because they are more rigid lenses, gas-permeable lenses can take longer to get used to than soft lenses.

› Daily-wear lenses are removed and cleaned at night and then worn again in the morning and throughout the day. Most daily wear lenses are two-week or monthly disposable lenses and must be replaced according to the manufacturer’s and doctor’s recommendations. They can be purchased in packs of six that normally last for three to six months depending on their replacement schedule. › Extended-wear lenses can be worn during the day and night and for up to a week. However, wearing contacts for an extended amount of time can cause discomfort and increase risk of damaging the eye. › Daily disposable lenses are worn once and then disposed. 38

original illustrations by kristen sadakane

total wellness ▪ winter 2013

Approximately 36 million people in the U.S. wear contact lenses – those little clear disks that individuals put in their eyes to correct eyesight problems such as nearsightedness, farsightedness, astigmatism, and presbyopia. There are many types of contact lenses, each with pros, cons, and required maintenance. Take a look at the many options for contact lenses and see which one might be right for you, or find out how to take care of the ones you are currently using.

o ther types of lenses Bifocal lenses, like bifocal glasses, are meant for individuals who are nearsighted and have presbyopia. Bifocal lenses are great for solving the two vision problems at once and they can come as soft lenses or rigid-gas permeable lenses.

Monovision involves wearing a different contact for each eye, correcting each eye’s vision individually. However, this can make binocular vision difficult and therefore disrupt depth perception. Modified monovision consists of wearing a contact lens only in one eye, which can make driving easier.

Ortho-k lenses, short for orthokeratology lenses, reshape the cornea to improve vision. Ortho-k lenses are worn at night or every other night and allow the user to see clearly during the day without any corrective lenses. Ortho-k lenses are most effective for mild nearsightedness. However, these contact lenses are not suitable for people over the age of 40 and are not incredibly popular because laser vision correction can fix the same vision problem in less time.

Colored and/or decorative contact lenses have been very popular recently as they can change the color of the eyes (or make them look like cat’s eyes). However, it is incredibly important to obtain and purchase these lenses properly. It is imperative that one gets decorative contact lenses like they would get other types of contact lenses: one should get an eye exam by a licensed professional, get a valid prescription, and purchase the contacts from a legitimate vendor that requires a valid prescription. Also, it is important to clean and take care of the lenses appropriately. If non-prescribed decorative contacts are used, it can cause complications that include vision impairment, corneal abrasions, and even blindness.

c ontact lenses are good for those who: › have trouble seeing distant objects. › need vision correction all the time. › will be able to take care of the lenses carefully and properly.

› only need vision correction for part of the time. › are physically unable to take care of the lenses and put them in properly. lenses.

› have uncontrolled conditions such as diabetes, hyperthyroidism, asthma, or allergies.

› have chronic dry eye or cornea problems.

vision problems: The problems listed below are all refractive errors where the eye fails to properly direct light onto the retina. This can occur depending on the eye’s shape, length, curvature, and/ or asymmetry.

› Nearsightedness (myopia) causes difficulty in seeing

distant objects, but allows one to clearly see objects that are near. › Farsightedness (hyperopia) causes difficulty in seeing nearby objects and sometimes even distant objects as well. › Astigmatism is defined as an asymmetry in the cornea. This asymmetry causes blurry vision. › Presbyopia usually begins to affect individuals around the age of 40 as a normal part of aging. It causes one to have difficulty focusing on nearby objects. Presbyopia is not the same as hyperopia, as presbyopia typically eventually affects everyone, but only certain people have hyperopia. Also, presbyopia is caused by the lens becoming less flexible, whereas hyperopia occurs due to the shape of the eyeball causing light rays to focus incorrectly.

total wellness ▪ winter 2013

c ontact lenses may not be suitable for those who:

› cannot commit to taking good and adequate care of the

Toric lenses are specifically for people with astigmatism and can also correct nearsightedness or farsightedness. They can come in soft, rigid-glass permeable, extended-wear, and even tinted types.

r isks of wearing contact lenses: Dry eye, deposits in the lenses (rare in rigid lenses), allergic reactions to the lens solution, eye and eyelid inflammation, irritation and redness, corneal problems such as hazy vision, scratches, and swelling. The likelihood of these risks, however, can be reduced with proper care and cleaning of the lenses. If you experience these complications and/or any sign of infection, stop using the contact lenses and see your doctor immediately.

a t what age can one start wearing contact lenses? Infants and children don’t usually wear contact lenses except to treat certain medical conditions. Many teenagers wear contact lenses, but they must frequently change lenses as their eyes continue to grow until they are in their late teens or early 20’s.

c ontact lens care A 2011 study in Contact Lens and Anterior Eye: The Journal of the British Contact Lens Association showed that complete compliance in properly taking care of contact lenses is rare, although slightly higher (15%) in those who wear daily disposable contact lenses. The compliance was lowest in hand-washing, case-cleaning, rubbing and rinsing, and correct lens replacement. Here are the steps to properly caring for your contacts:

1. Wash hands with a non-cosmetic mild soap before handling the contacts and dry them with a clean, lint-free towel.

soap

5. Use the appropriate eye drops, solutions, etc. recommended by your doctor for the lenses.

6. Never run tap water directly on the contact lenses or put the lenses in your mouth to clean them. Tap water and saliva have germs that can cause infection.

2. Use hairspray before putting in

contact lenses, because hairspray residues in the air can adhere to the contacts and cause discomfort and/or infection.

3. Keep nails short and smooth to avoid

scratching the eye or damaging the lenses.

4. Put on makeup carefully once the contacts are in your eyes and take the contacts out before removing makeup. This will prevent makeup from getting onto the lenses.

7. Clean the contacts by lightly rubbing your index finger in the lens in the palm of the other hand. This will get rid of buildup on the lens. 8. Clean the contact lenses with every use and replace their storage case every three months.

h ow to wear your contacts safely › Do not wear the contacts longer than recommended by a doctor and longer than the lens type allows.

total wellness ▪ winter 2013

› Never share contacts with someone else.

› Keep your eyes lubricated with the proper method (such as eye drops or even nutritional supplements) recommended by a doctor. › Do not let the tip of the solution bottles touch other surfaces like hands, eyes, and contact lenses. t w 40

right: baris simsek/istockphoto

› Contacts can make your eyes more sensitive to the sun, so when in sunlight, wear sunglasses with UV protection.

feature

don’t miss a beat: understand the risks for heart disease and how to step up your cardio health!

by julie escobar | design by keziah pagtakhan

This total includes the cost of health care services, medications, and lost productivity. These enormous consequences indicate the importance of placing emphasis on improving cardiovascular health. Read on to learn how to recognize the symptoms and risk factors for heart disease and what you can do to keep your heart healthy.

total wellness ▪ winter 2013

Did you know that heart disease is the leading cause of death for men and women in the United States? According to the Centers for Disease Control and Prevention (CDC), approximately 600,000 people die of heart disease in the U.S. every year – that is one in every four deaths. The CDC also reports that coronary heart disease alone costs the U.S. $108.9 billion each year.

what is heart disease?

symptoms

Heart disease – also called cardiovascular disease and coronary heart disease – is a simple term used to describe several problems related to plaque buildup in the walls of the arteries, or atherosclerosis. Other types of heart disease include heart failure, an irregular heartbeat – or arrhythmia – and heart valve problems. In coronary heart disease (CHD), plaque is caused by the accrual of fatty deposits and other substances along the walls of the coronary arteries, which bring blood and oxygen to the heart. As the plaque builds up, the arteries narrow, making it more difficult for blood to flow and creating a risk for heart attack or stroke.

››

There are many risk factors that may increase your chances of developing heart disease. Certain conditions and lifestyle factors can contribute to individual risk for developing heart disease and should be addressed in order to alleviate the symptoms.

diabetes

alcohol

According to the CDC, about three-quarters of those with diabetes die of some form of heart or blood vessel disease. If a person has diabetes, it means their blood glucose, or blood sugar, is too high. Glucose, produced by the liver and muscles and consumed from the food you eat, is meant to supply energy to all the cells in your body. Insulin is a hormone made from the pancreas that is released into the bloodstream in order to regulate glucose levels. If the body does not produce enough insulin (Type I) or does not use insulin efficiently (Type II), then glucose cannot get into your cells and stays in the bloodstream. This eventually leads to diabetes Type I and/ or Type II.

Excessive alcohol use leads to an increase in blood pressure and a higher level of triglycerides in the blood, which can lead to atherosclerosis and a higher risk for heart disease. According to experts at the University of Maryland Medical Center, having more than three drinks a day can contribute to high blood pressure. Why? Because alcohol has been shown to raise blood pressure by interfering with the flow of blood to and from the heart. Further, when alcohol is present in the bloodstream, it pushes blood rich in nutrients away from the heart. Research from the National Institute on Alcohol Abuse and Alcoholism, or NIAAA, states that alcohol intake also reduces the liver’s ability to oxidize compounds correctly, which as a result, may lead to an increase in the process by which free fatty acids are transformed into triglycerides.

diet Diets high in saturated fats and cholesterol raise blood cholesterol levels and promote atherosclerosis. Other aspects of dietary patterns linked to heart disease include those high in salt or sodium which raise blood pressure.

physical inactivity Physical inactivity is linked to the development of heart disease and other major risk factors. These include obesity, high blood pressure, high triglycerides, lower levels of HDL cholesterol, and diabetes.

left (in order): jarsolaw miszcak/istockphoto; evgeny karandaev/istockphoto; andrey armyagov/istockphoto; ginosphotos/istockphoto; right (in order): inkit/ istockphoto; okea/istockphoto; stepan popv/istockphoto; joe potato photo/ istockphoto; dtimiraos/istockphoto

total wellness ▪ winter 2013

the guide

Chest pain, also known as angina, is the most common symptom of heart disease. While pain varies between individuals, it is felt when the heart is not getting enough blood or oxygen. Individuals may experience heavy chest pain near the heart, or may also feel it under the breastbone (sternum), or in their neck, arms, stomach, or upper back. Pain may be brought on by exertion through physical activity or strong emotion. Other symptoms of heart disease include shortness of breath, fatigue, and general weakness.

obesity Obesity refers to an excess amount of body fat. Many who are overweight and obese suffer from an energy imbalance, in which case individuals tend to eat and drink more calories than the body uses or needs, therefore causing them to gain weight. Energy imbalance and weight gain may be the result of genes, eating habits, how and where people live, attitudes and emotions, life habits, and income. The tool most commonly used to measure overweight and obesity in children and adults is the Body Mass Index (BMI). For adults, the height and weight of each individual are used to calculate their BMI. However, due to the changing growth rates of children, BMI charts for children compare their height and weight to others of the same sex and age. According to the National Health and Nutrition Examination Survey (NHANES) conducted by the Centers for Disease Control and Prevention (2009-2010), more than two-thirds (68.8%) of adults (aged 20 and older) are considered to be overweight or obese. Obesity is not only a risk factor for heart disease, but it is also a precursor to high cholesterol, high blood pressure, and diabetes.

blood pressure High blood pressure is a condition where the pressure of the blood in the arteries is too high.

While there are no symptoms that will tell individuals they have high blood pressure, lowering blood pressure through the use of medication or by changes in lifestyle can reduce the threat of heart disease or heart attack. Individuals are recommended to eat a heart-healthy diet, exercise regularly, quit smoking, limit their alcohol intake, reduce the amount of sodium (salt) in their diet, reduce stress, and maintain a healthy weight.

Smoking and/or using tobacco is one of the biggest risk factors for developing heart disease. Chemicals in tobacco can damage your heart and blood vessels, leading to narrowing of the arteries. Nicotine, a chemical in cigarettes, constricts the blood vessels, obstructing blood flow and causing blood pressure to rise. In addition, carbon monoxide reduces the amount of oxygen the blood can carry to the heart.

cholesterol Cholesterol is a waxy substance naturally produced by the liver or ingested by certain foods. Cholesterol is carried in the blood by special carriers called lipoproteins. A high level of high-density lipoprotein, or HDL, is often considered “good” cholesterol and may give some protection against heart disease. This is because HDL’s are believed to carry cholesterol away from the arteries to the liver, where the body can eliminate it. Higher levels of low-density lipoprotein or LDL, is considered “bad” cholesterol and can lead to heart disease. At higher levels, LDL combines with other substances to form plaque in the arteries and slow the blood flow to the heart, brain, and other vital organs. Triglycerides are another form of fat found in the blood. They are produced by the liver and come from the foods we eat. A high triglyceride level in conjunction with a low HDL or high LDL level is also associated with the buildup of fat in the blood, a good reason to monitor your level of triglycerides and keep them low.

heredity An individual’s risk for heart disease may be due to genetic factors. It is likely that those with relatives who have experienced high blood pressure, heart disease, and other vascular conditions may be more prone to the same illnesses. Those with a family history of heart disease may also share common environments or have the same unhealthy lifestyle that make them more prone to developing heart disease, such as smoking, lack of exercise, and excessive drinking.

total wellness ▪ winter 2013

Blood pressure readings are usually given as two numbers written as a fraction. If an individual has high blood pressure (hypertension), one or both of these numbers may be too high. The top number represents systolic blood pressure, while the bottom represents diastolic blood pressure. Normal blood pressure is usually below 120/80 mmHg, while high blood pressure is at or above 140/90 mmHg most of the time. If your blood pressure is at or above 120/80 mmHg but below 140/90 mmHg, then this is called pre-hypertension.

smoking

how can you prevent heart disease?

123456

stop smoking

steps to increase your cardio health!

No amount of smoking is safe. Additionally, exposure to secondhand smoke can increase the risk of heart disease even for non-smokers.

reduce alcohol intake

Drink alcohol in moderation, before it becomes a health hazard. Experts from the Mayo Clinic suggest no more than two drinks a day for men, and one a day for women.

eat a heart healthy diet

total wellness â&#x2013;Ş winter 2013

Cut back on fatty fried foods and foods high in saturated fats. Major sources of saturated fat include: red meat, dairy products, and coconut and palm oils. Equally unhealthy are foods rich in trans-fat, including: deep-fried fast foods, bakery products, packaged snack foods, margarines, and crackers. As a general rule, avoid foods high in fat, cholesterol, and salt. But make sure to eat foods rich in fruits, vegetables, whole grains and low-fat dairy products, which can help protect your heart.

left (in order): serghei platonov/istockphoto; marcela barsse/istockphoto; right (in order): ivanmateez/istockphoto ; dra_schwartz/istockphoto

exercise regularly

Regular physical activity can improve risk factor levels. This will help you boost circulation and improve cholesterol levels, as well as reduce stress and help you maintain a healthy weight. Try doing 30 to 60 minutes of moderate physical activity most days of the week. If that is too much of a time commitment, try breaking up your workout into ten-minute sessions. The important thing to remember is to never give up. Even short amounts of exercise at a low intensity offer health benefits if you remain consistent. However, you will see and feel more dramatic results by increasing the intensity, duration, and frequency of your exercise routines.

maintain a healthy weight

Excess weight can contribute to the development of high blood pressure, high cholesterol, and diabetes, and lead to increased risk for heart disease. Tip: Calculate your BMI to determine whether you have a healthy or unhealthy percentage of body fat. An individual’s Body Mass Index is defined as the individual’s body mass divided by the square of his/her height [BMI = weight (kg) / (height (m))^2]. Underweight

below 18.5

Overweight

25.0-29.9

Normal

18.5-24.9

Obese

30 and above

Since BMI does not discern between muscle weight and body fat, measuring your waist circumference is another useful tool to measure abdominal fat. According to the National Heart Lung and Blood Institute, “If most of your fat is around your waist rather than your hips, you’re at a higher risk for heart disease and type 2 diabetes.” Women with a waist circumference of 35 inches or more and men with a waist circumference of 40 inches or more have an increased risk of heart disease and/or diabetes. This is why it is of special importance to remember to measure your waist circumference in order to screen for possible health risks that come with being overweight or obese.

regular health screenings

total wellness ▪ winter 2013

Don’t Put Your Heart on the Line – Have an Emergency Action Plan

Make sure to see your doctor to monitor your blood pressure, cholesterol levels, and predisposition to diabetes.

Make sure that you have an emergency action plan in case you or someone in your family or circle of friends suffers from a heart attack or stroke. This may be especially important if an individual is at a high-risk for a heart attack or has suffered from a heart attack previously. Talk to your doctor about signs and symptoms and when you should call 9-1-1. t w

DECODING THE NUTRITION LABEL

high fructose corn syrup by julia duong | design by mary sau

High fructose corn syrup (HFCS) is synthesized from the starch in corn to which natural enzymes and heat are added to break the starch down into corn syrup. Although the name “high fructose corn syrup” suggests a composition of pure fructose, HFCS is actually only 42 to 55% fructose, with the remainder being glucose and other sugars. HFCS has nearly the same chemical composition as table sugar, which is 50% fructose and 50% glucose. Thus, both can be considered, in scientific terms, metabolically equivalent. However, HFCS is more regularly used because unlike its relative, HFCS is resistant to crystallization (allowing it to blend well with other goods during the manufacturing process), has a longer shelf life, and is less expensive (due to government subsidies on corn).

is HFCS itself harmful? The mainstream usage of HFCS is often associated with high levels of obesity and increased rates of other health related problems like diabetes. In 2012, a study published in Global Public Health indicated that the prevalence of type II diabetes was higher in countries where there was greater accessibility to HFCS in the food supply (20%) when compared to countries with less accessibility to HFCS (6.7%). However, evidence suggests that HFCS itself is not the culprit causing these problems:

› A 2007 study published in American Journal of Clinical Nutrition showed that cola beverages sweetened with HFCS had no significantly different effect on “hunger, satiety, and short term energy intake” when compared to the same drinks sweetened with sucrose.

total wellness ▪ winter 2013

› In 2011, a study published in The Faseb Journal demonstrated that the risk of obesity was more significantly associated with lifestyle and dietary fat intake than HFCS consumption. Overweight/obese individuals were given a reduced calorie diet and regular exercise, but still ingested either HFCS or sucrose at levels typical of the 25 to 50th percentile of populations. For both groups, decreases in weight circumference, body mass, and fat mass were noted. the underlying problem: too much sugar leads to too many calories In general, health professionals voice the opinion that when it comes down to it – a sugar is a sugar. HFCS is no more “natural” than table sugar, which in itself is also highly refined. Natural sweeteners such as honey and agave are subject to some industrial refinement before being sold as well. In 2012, a study published in Nutrition Journal demonstrated that a diet containing a significant number of calories provided by HFCS yielded the same obesity rates when

WHERE IS IT FOUND? Foods with HFCS include certain soft drinks, ice cream, canned fruits, and baked goods.

compared to diets with equivalent calories provided by table sugar. Overweight human participants were given one of four low calorie diets, with caloric intake composed of either ten percent or 20% HFCS or sucrose. Results showed that among the four diets, there was no significant difference in BMI, weight, waist circumference or overall body mass. Barry Popkin, PhD, a nutrition professor at the University of North Carolina, stresses that the real problem is not due to HFCS, but rather, the availability and prevalence of sugars in general that are found in the food supply. “I don’t care whether something contains concentrated fruit juice, brown sugar, honey or HFCS. The only better sweetener option is ‘none of the above.’”

moderation is key According to Susan Bowerman, MS, RD, CSSD, Assistant Director of the UCLA Center for Human Nutrition, ingesting too much sugar through sweetened beverages and “hidden calorie” foods (e.g. baked goods) leads to greater calorie intake, which in turn, leads to weight management problems such as being overweight and obese. Weight gain has been associated with diabetes and heart disease. “What it boils down to is this: HFCS is an inexpensive source of sugar, and since it is found in so many foods, our total calorie intake from added sugars has gone up as a result. It’s not the source of the sugar that’s the problem -- it’s the excess calories we’re consuming from all this added sugar in the food supply.” The American Heart Association recommends that women get no more than 100 calories a day from added sugar from any source, and that most men get no more than 150 calories a day from added sugar. That’s about six teaspoons of added sugar for women and nine teaspoons for men.” Note that one teaspoon is about four grams of sugar, which is approximately the size of a sugar cube. A 12-ounce can of Coke, for example, has 39 grams of sugar (or about ten sugar cubes/teaspoons). Today, high fat and high sugar foods are made more available compared to any other time in human history. Fast foods and snacks are pleasurable, but eating more calories than you burn can become a habit that promotes weight gain. According to Mayo Clinic, if you are concerned about maintaining your health, the best strategy is to minimize added sugar, no matter what type of sugar it is. t w

left: pederk/istockphoto; right: chris bernard/istockphoto

what is it?

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

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

iStrain: rise of latent computer vision syndrome

Gavin Bahadur, MD, Comprehensive Ophthalmology, Clinical Instructor of Ophthalmology, UCLA Jules Stein Eye Center

hocus pocus halitosis!

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

understanding your stool

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

fishing for your health

Eve Lahijani, MS, RD, Nutrition Health Educator, UCLA Bruin Resource Center

the tabata workout

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

Ben Artzi, MD, Assistant Clinical Professor, Division of Rheumatology at UCLA

bathe your way to better health with epsom salts

Lorraine Young, MD, Clinical Professor of Medicine and Dermatology, David Geffen School of Medicine at UCLA

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

beat the burn

Malcolm Taw, MD, FACP, Assistant Clinical Professor, UCLA Center for East-West Medicine, David Geffen School of Medicine at UCLA

seeing eye to eye with your contact lenses

Gavin Bahadur, MD, Comprehensive Ophthalmology, Clinical Instructor of Ophthalmology, UCLA Jules Stein Eye Center

decoding the nutrition label Susan Bowerman, MS, RD, CSSD Assistant Director, UCLA Center for Human Nutrition

copy-edits and review

Julie Escobar, Chalisa Prarasri, and Shannon Wongvibulsin

layout revisions

Barbara Wong, Shannon Wongvibulsin, and Karin Yuen

cover & table of contents

total wellness â&#x2013;Ş winter 2013

cracking down on the truth

health coaching

donâ&#x20AC;&#x2122;t miss a beat: understand the risks for heart disease and how to step up your cardio health!

Srinivasa Reddy, PhD, Adjunct Associate Professor of Medicine and Molecular and Medical Pharmacology Clinical Medicine at UCLA

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