Spring into Health!

total wellness

a ucla student wellness commission publication

spring into health!

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household plants that purify indoor air plus...

study techniques

what will (and won’t!) help you study keeping your life in check

quantified self-movement should you take

multivitamins? spring 13 | vol 13 | issue 4

editor’s note Spring is in the air!

And, for many, it’s the traditional time to get reorganized with spring cleaning. Certainly, throughout the year, a large amount of clutter can build up but devoting time to tidying up may lead you to discover things you’ve been trying to find for months, stuff you’ve never even known you had, or notes you’ve written long ago. Maybe you made a New Year’s resolution, jotted it down somewhere, misplaced the note, and completely forgot to follow through with your plans for the New Year. If you haven’t been staying on top of your resolution, don’t worry; you’re not alone. As mentioned in our issue on Healthy Living: From Head to Toe, only about eight percent of individuals who make resolutions are successful in carrying them out according to a 2012 study published in the Journal of Clinical Psychology.

total wellness ▪ spring 2013

If you’re looking for ways to spring into health!, Total Wellness is here to help you get back on track. Need motivation or want to monitor your progress along the way? The Quantified Self-Movement can help with quantifying your results and directing your efforts towards self-improvement. Explore the various ways to utilize these self-tracking tools on page 38.

Even if your resolution was to improve your performance in school, Total Wellness has also dug through the research to assist you with improving the effectiveness of your study sessions. Learn more about the myths behind common study techniques, what research has to say about them, and some alternatives that may help give a boost to your GPA on page 16.

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Or, did your goals involve following a healthy diet? To spice up your arsenal of quick and easy healthy snack options, check out page 18 for dips that you can make yourself with just a few simple ingredients.

If your resolution centered around exercise, Total Wellness has something for you too! With all the athletic apparel on the market, it may be difficult to navigate through all your options and understand which products are worth your investment. In this issue’s Get Active column (page 8), we provide an overview of the latest sports clothing and accessories on the market.

As always, we love to hear from our readers.

After all, Total Wellness is here to serve you and to make healthy living simple and enjoyable, so please give us an update on how you are doing with your resolutions and health goals and what you’d like to see in our future issues. Write to us at totalwellnessatucla@gmail.com and you may even be a featured reader on our website (www. totalwellnessmagazine.org) and Facebook page. We hope you take advantage of the spring cleaning mindset to declutter, embrace a fresh start, and spring into health!

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

karin yuen Co-Art Director

Julie EscobaR Copy Editor

barbara wong Co-Art Director

Brian Khoa Nguyen Co-Outreach Director

angela hao Assistant Finance Director

Judy Jeung Co-Outreach Director

total wellness â–Ş spring 2013

Nabeel Qureshi Finance Director

cindy la Managing Editor

Kevin Sung Webmaster

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words from the commisioner Hello, Bruins!

Spring Quarter at UCLA has by far always been my personal favorite, and I hope you are having an equally if not more enjoyable quarter!

It has been a busy few weeks for SWC, as we are gearing up for our annual Bruin Health Week (BHW), which features over a week of programs dedicated to improving the health of the UCLA community. The slogan we have been using these last couple weeks is, “Spring into good health this quarter with SWC!” and the upcoming BHW is a perfect avenue and motivator to help you prioritize your physical and psychological health!

We here at SWC believe that tending to one’s health and wellbeing is enjoyable and exciting, and should not be thought of as a dreaded obligation or task on a checklist.

That’s why our first BHW event is literally going to be an exciting party – an 80’s neon themed blogilates party that is! Youtube celebrity Cassey Ho will be leading a pop pilates class in the gorgeous outdoor venue of Wilson Plaza to kickstart our week focused on health and wellness.

total wellness ▪ spring 2013

In addition to some campus favorites like Super CPR!, Chillax to the Max and Iron Chef that will be returning to the BHW line up, we have added some novel programs that we know you will love. We are bringing a unique dining experience to campus with our mindful eating event “Dining in the Dark”, where attendees will be cutting out all the typical distractions including watching TV, studying and using computers, to focus solely on the experience of food. Be sure to also look out for our Stress Less Fair in Bruin Plaza, our workshop on how to make your own delicious and healthy dips, and for our suicide awareness and prevention events around campus. I am truly honored and excited to be a part of BHW this year, and I hope that you find our events to be enjoyable, informative and motivational!

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

Shannon Wongvibulsin Chalisa Prarasri Barbara Wong Karin Yuen Cindy La Julie Escobar Nabeel Qureshi Angela Hao Brian Khoa Nguyen Judy Jeung 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, Jocelyn Kupets, Coco Liu, Allison Newell, Keziah Pagtakhan, Catrina Pang, Kristen Sadakane, Mary Sau, Jessica Sun, Annie Theriault, Amanda Wong, 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 4

Cassarah Chu SWC Commissioner

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© 2013 by Total Wellness Magazine. All rights reserved. Parts of this magazine may be reproduced only with written permission from the editor. Although every precaution has been taken to ensure the accuracy of the published material, Total Wellness cannot be held responsible for the opinions expressed or facts supplied by authors. We do not necessarily endorse products and services advertised. The information in Total Wellness is not intended as medical advice and should not replace the advice of your physician. Always consult a health care provider for clarification.

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

DEPARTMENTS get active 8 Athletic Apparel: Ineffective or Advantageous? body in focus 11 Patrol Those Moles! mythbusters 16 Study Techniques eat right 18 When You Get the Nibbles: Dips to Pick (and Skip) 22 The Heat on Red Meat: A Guide to Red Meat consumption and Related Risks

ON THE COVER 26 Household Plants 16 Study Techniques 38 Quantified Self-Movement 29 Multivitamins

26 Living Air Purifiers: Improve Indoor Air with Household Plants!

29 Getting the Daily Dose 34 BMP: A Panel of Eight That Tells Your State: A Guide to Blood Tests and What They Can Tell You 38 Quantified Self-Movement: Tracking Your Life to Keep Your Life on Track 42 Nail Polish: The Toxic-Trio

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total wellness ▪ spring 2013

cover: tsokur/istockphoto; right: illustrated by keziah pagtakhan

FEATURES

in the news

what’s happening in health? by chalisa prarasri | design by barbara wong

RESEARCH AND NEW FINDINGS

HUMAN GUT BACTERIA MAY MAKE RED MEAT INHERENTLY UNHEALTHY

total wellness ▪ spring 2013

In a study published recently by Nature Medicine, researchers attempted to understand why red meat consumption has been correlated with increased risk of death by heart disease, regardless of fat and cholesterol intake. It turns out that consumption of L-carnitine (a compound found in red meat, dairy products, and certain dietary supplements) leads to increased blood levels of trimethylamine-Noxide (TMAO), a compound that may affect the metabolism of cholesterol and slow its removal from artery walls. Study participants who consumed L-carnitine supplements showed increased blood levels of TMAO, though vegetarians and vegans showed a much smaller increase in TMAO levels. Since faecal studies showed that vegetarians and vegans had gut flora that was very different from the flora seen in meat-eaters, scientists speculate that eating red meat regularly may encourage the growth of these detrimental bacteria that can convert L-carnitine into TMAO. Further, people who displayed high levels of both L-carnitine and TMAO were at higher risk for heart disease than people who did not. To learn more about red meat and health, check out The Heat on Red Meat on page 22.

NEW BIRD FLU DISCOVERED IN CHINA

According to Nature News, China announced earlier this month that two people were killed by a new avian influenza virus called H7N9. This virus has never been observed in humans before. Preliminary analyses of the viral DNA suggest that the virus may be able to infect birds without causing serious illness. This is a cause for concern because it may allow the virus to spread undetected among flocks of poultry, giving

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PSYCHOLOGY PROFESSOR DESIGNS RELATIONSHIP-HELP WEBSITE

Andrew Christensen, a UCLA psychology professor, and colleague Brian Doss have made a free website designed to help couples with their relationships. Using decades of relationship research, the website uses the concept of “The O-U-R of Our Relationship”. Each partner observes a problem in the relationship, the two partners analyze the problems in order to understand them, then each partner tries to respond to the other in a way that can better resolve the dispute. Couples that participate in the program as part of research to help the development of the website can earn $180 to $250. People can also participate in programs without their partners. To find out more about the six-hour program, visit www.

OurRelationship.com.

LIVING NEAR A PARK MAY INCREASE PHYSICAL ACTIVITY IN TEENS

According to a new policy brief from the UCLA Center for Health Policy Research, nearly 45% of teens who live near a park (within a quarter mile of a small one, or a half mile of a large one) reported to exercising for at least one hour per day, at least five days per week. In contrast, only one-third of teens that do not live near a park reported as much physical activity. Since physical activity is a huge determinant for obesity and other chronic health conditions like diabetes, this finding may be helpful for solving inactivity problems among teens living in urban areas with few parks. t w

29 percent of adults 18 years or older live with hypertension

21.5 percent of Americans with untreated dental cavities

3.5 percentage of Americans aged 20 to 59 who get enough exercise to meet public health recommendations cdc

/

AT UCLA

NUMBERS

left (in order): robyn mackenzie/istockphoto; joshua hodge istockphoto; right: robbi akbari kamaruddin/istockphoto

it time to evolve so that it can more easily infect humans. So far, close contacts of the people infected have tested negative for the virus, indicating that it is not currently very infectious to humans.

q&a

Q: A:

What are parabens? by ryan babadi | design by jocelyn kupets

Most everyone goes through a preparatory morning routine involving the use of multiple personal care products. What isn’t commonly understood, however, is that these gels, bars, and liquid formulas often expose us to chemical compounds that may be of consequence to more than just our personal hygiene. Concern over chemicals known as parabens has sprouted as scrutiny over ingredients of ubiquitous products like makeup and lotion has increased.

The word “paraben” is a general term for a class of chemicals that are the most commonly used preservatives in cosmetic and pharmaceutical products. Chemically speaking, parabens are esters of p-hydroxybenzoic acid. An ester results from a reaction between an acid and an alcohol.

where are parabens found?

According to the U.S. Food and Drug Administration (FDA), there are usually many different parabens alongside other types of preservatives in any single product, so as to provide broad microbial protection. Cosmetics that commonly include parabens are makeup, hair care products, and moisturizers.

The majority of deodorant and antiperspirant manufacturers no longer add parabens to their products.

health outcomes, researchers warn, namely in terms of female breast cancer incidence and male reproductive dysfunction.

According to a 2012 article published in the same journal, researchers found parabens in almost all of 40 human breast tissue samples from primary breast cancer mastectomies, which are surgical operations to remove a breast.

Another 2012 study published in Epidemiology, from the University of Michigan’s Department of Environmental Health Sciences, implicates parabens in human oxidative stress. At the cellular level exist naturally present groups of reactive oxygencontaining molecules known as reactive oxygen species (ROS). When the human body is exposed to certain stressors, ROS activity spikes. High ROS levels equate to oxidative stress, promoting chemical reactions that can structurally damage cells. Researchers in the aforementioned study examined urinary paraben levels alongside blood markers for oxidative stress and inflammation, concluding that changes in these markers could be related to increased paraben exposure.

tips for avoiding paraben exposure For those who wish to take a precautionary approach to the issue, paraben-free alternatives of common products are widely available. This is especially apparent at health-oriented markets and pharmacies. To assess whether a product contains parabens, inspect the ingredients label. Note, however, that the term “paraben” will likely not be featured on its own. Instead, one of many forms may be listed. Researching individual manufacturers for their unique formulations and ingredients is recommended. Some common names for parabens are methylparaben, butylparaben, propylparaben, isobutylparaben, ethylparaben, polyparaben, and isobutylparaben.

the verdict?

Recent years have shown increasing research interest in parabens and their associated health risks. A 2008 review published in the Journal of Applied Toxicology showcased the ability of intact paraben esters to penetrate human skin. The researchers presume this occurs through application of topical cosmetic products, from which parabens are then systemically absorbed. Once inside, parabens have displayed a capacity for androgen and estrogen modulation, enzyme inhibition, and gene toxicity. These processes are associated with adverse

got a question? We love curious readers. Send

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

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total wellness ▪ spring 2013

what are the health risks associated with parabens?

While the above research and similar studies provide clues regarding potential health risks associated with paraben exposure, they are not conclusive in determining causation between exposure and adverse health outcomes. So until industry, regulatory agencies, and the scientific community comes to more of an agreement on paraben use, it may be wise for consumers to carefully examine the contents of the cosmetic and pharmaceutical products they consume, and avoid exposure to parabens when possible. t w

get active

athletic apparel: ineffective or advantageous? by leslie chang | design by catrina pang

The sports clothing and accessory industry is a

growing field that is expected to reach $126 billion by 2015. Lifestyle changes, increased female participation in sports, and a demand for stylish, functional, and versatile sports apparel are driving this expanding market. In addition, an emphasis towards healthy lifestyles and activities is instrumental to the high demand for sports apparel. This is a hyper-competitive marketplace with ongoing promotional battles and innovative ideas. However, false advertising is also an ongoing problem because these corporations tout amazing results from their products to consumers who are often easily misled. Companies advertise the positive effects of compression by claiming that using their products improves endurance and strength through the reduction of muscle vibration, which is linked to muscle fatigue.

Have you wondered whether metal fibers woven in socks actually improve foot odor?

claim: Companies with this product describe how copper

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works to eliminate 99.9% of the bacteria and fungi in the socks to help control odor. In fact, Copper Sole™ technology is a patented copper compound in fabric.

research: The odor from our feet is a result of microbes that

live there and break down the sweat that we release, which results in that foul smell. In fact, studies have found that copper does have antibacterial properties. In a 2004 study published in the Journal of the Federation of American Societies for Experimental Biology, researchers found that copper has strong antimicrobial properties without skin sensitizing effects, meaning that they don’t irritate the skin. In addition, the American Podiatric Medical Association has given awards to several brands with “copper technology” for their usage in eliminating foot odor.

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bottom line: Copper socks are a great way to reduce stench from feet for people who suffer from that affliction.

However, foot and shoe hygiene are also important factors that contribute to smelly feet, so hygiene should also be closely monitored when trying to reduce foul odors.

left (in order): joshua hodge photography/istockphoto; anthony rosenberg/istockphoto; right (in order): maridav/istockphoto; ehstock/istockphoto

copper socks

compression textiles Have you seen the strange calf socks currently gracing many dedicated athletes? In addition to showing off their amazing bodies, this clothing may also serve a purpose.

claim: Companies advertise

the p ositive effects of compression by claiming that using their products improves e ndurance and strength by reducing muscle vibration, which is l inked to muscle fatigue. In addition, they claim that the use of their product improves circulation, reduces cramping, and hastens recovery after workouts.

research: Despite the benefits

espoused in product descriptions, the studies on this topic have varied results.

A study published in 2010 in the Journal of Sports Science compared participants who wore compression clothing with those that did not and found no difference in muscle pH, muscle soreness, the time it takes to become exhausted, oxygen uptake, or lactate concentration (the acid which results in soreness after exercise). Yet, this data contrasts with other studies on compression technology.

dry fit technology A study published in 2013 in the International Journal of Sports Physiology and Performance has found that compression clothing may have small to moderate effects such as increased maximal strength and power, reduced muscle swelling and pain, and increased blood lactate removal. All of these effects indicate that compression clothing could assist athletic performance. Compression textiles have been found to increase blood flow in the venous system, which improves circulation. Therefore, increasing compression area from the ankles and thighs to whole body compression could positively influence the physiology of the athletes by improving oxygen uptake and arterial lactate (acid that creates the burning feeling in muscles) release. This can in turn enhance running. Currently, more research is being done on the topic in order to clarify the actual benefits of this technology.

bottom line: Although the jury

is still out on whether compression clothing affects the workout experience, at most the benefits are minimal. Therefore, compression clothing is not necessary for the casual workout but may be of use for competitive athletes.

Ever wonder why the fabric of most athletic clothing isn’t made of cotton but instead it is made of synthetic polymers?

claim: Many companies such as Under Armor

claim that Dry Fit Technology eliminates sweat by moving it away from the body, allowing for easy evaporation. When the body perspires, the evaporation keeps the body cool as the heat from the body escapes when the sweat evaporates. In a regular cotton t-shirt, sweat is absorbed into the fabric and does not have time to evaporate before it accumulates.

research: Polyamide, the polymer used

in these fabrics, was invented by DuPont scientists in the 1930s. These textiles are excellent at absorbing sweat and pulling the water through the fabric, allowing it to evaporate. This is called ‘wicking’ and is caused by the chemical properties of the polymers.

The ends of the polymers have polar groups which are negatively and positively charged.

These ends attract the polar water molecules in sweat, much like how magnets are attracted to each other. This forces the sweat to move in one direction. Because the water in sweat is polar, it is attracted towards the polar fabric and therefore pulled through the fabric and cannot be pulled back towards the skin.

bottom line: If heavy sweating is a common side effect of your exercise regime, spending money on clothing with this kind of material might be well worth it in the end.

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minimal running When you are walking around campus, do you see shoes that look like glorified toe socks? These are a new trend in running shoes called minimalist runners.

claim: Popularized by recent books (Natural Running and

The Barefoot Running Book), this emerging footwear trend is believed to reduce stress on the legs and lower the incidence of running injuries. This kind of footwear is reminiscent of running barefoot with minimal cushioning.

toning shoes Have you seen the advertisements for “Shape-up” sneakers by Skechers, EasyTone shoes by Reebok, and Truebalance by New Balance?

claim: These companies promise to help people lose

weight as well as strengthen and tone the muscles in their abdominals, legs, and buttocks when walking with this particular shoe style. They say that these shoes work better than regular fitness shoes because their “rocking sole” forces wearers to focus on balance, therefore activating muscles and shaping their bodies.

research: Unfortunately, these claims have been proven fore-foot or mid-foot strike that has less impact force than traditional running shoes. In traditional running shoes, that force lands on the heel, which can lead to pressure on the lower leg and an increase in injuries sustained there. A landmark study published in Nature in 2010 compared Kenya’s famous Kalenjin distance runners who ran barefoot with those who did not and found that the Kalenjin runners had fewer lower leg problems because force was placed on the fore-foot as opposed to on raised heel. These researchers suggested that the change in running style might have allowed these runners to run for long distances with minimal injury. However, a study published in 2012 in Foot and Ankle International has found that experienced runners that transitioned from traditional footwear to minimalist footwear all sustained injuries during or shortly after their transition. The majority of these injuries are stress fractures on the metatarsal, which are particular bones of the feet. This may be because of the cumulative microtraumas that the runners experienced.

bottom line: Before you invest in minimalist running shoes, make sure that you understand the risks that are involved with changing any aspect of your running regimen.

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false, and the Federal Trade Commission has recently announced that Skechers has to pay $40 million to settle charges for deceiving their customers with false advertising.

Reebok and New Balance have also been charged with falsifying claims. Some of the clinical studies made by Skechers were from a chiropractor married to a senior marketing associate of Skechers, therefore resulting in a blatant conflict of interest. In addition, data was missing or doctored in studies to show a large weight loss in participants wearing shape ups.

In fact, Elisa Terry, UCLA’s FITWELL Services Program Director warns that toning shoes may be dangerous and should not be worn at all for any type of activity.

bottom line: The toning footwear market was worth close to one billion dollars in 2010, so these sales are an important segment of the athletic footwear economy. However, next time you see an ad claiming amazing results without going to the gym, look twice at the “clinical studies” that back up these claims. t w

left: david freund/istockphoto; skechers.com; right: fotowizje/istockphoto

total wellness ▪ spring 2013

research: Minimalist runners typically land with a

body in focus

patrol those moles! written & designed by allison newell

Spring has arrived. And this translates to warmer weather and more

total wellness â–Ş spring 2013

excuses to be out in the sun, whether it is hitting the pools at Sunset Recreation, engaging in outdoor activities, or simply tanning at the beach.

However, such activity comes with the usual precautions related to skin protection and cancer. One type of skin cancer, melanoma, develops out of melanocytes. Melanocytes are skin cells that produce melanin, a protein that gives skin its natural color. When these skin cells become damaged, they can multiply quickly to form a cancerous tumor. According to a 2012 study published in Dermatology Clinics, rates of melanoma are rising more than that of any other cancer in the United States, making prevention, early diagnosis, and detection more important than ever. It is the second most common cancer in people 15 to 29 years of age, with factors such as UV exposure, tanning, and family history playing a role. Moles are one of the leading indicators in assessing one’s risk for melanoma. Melanoma may be detected when a change in the shape, color, size, or texture of an already existing mole occurs.

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Euphemized as a “beauty mark” by popular culture and scientifically regarded as a nevus (nevi for plural), a mole is a spot on the surface of the skin, usually tan, brown, or pink in color. It develops when melanocytes cluster together. Usually melanocytes are evenly distributed throughout the skin, but sometimes they become concentrated in one area to form a cluster (what we call a mole).

Most moles emerge in early childhood and throughout the first 30 years of life. Moles may grow slowly or change slightly in color during this time frame. Some may even disappear over time, while others may not change at all. During times of hormonal changes (like

the common mole

Moles typically appear on areas of the skin exposed to sunlight, but they can also be found in more obscure areas like the scalp, ears, buttock, breasts, genitals, and toes. There are different types of moles, with each type possessing specific characteristics and risks for skin cancer. The majority of moles are harmless, but there are specific characteristics to be wary of. Here's a simple breakdown of the two main types of nevi (the common mole and dysplastic nevus), how to distinguish between them, and how to take an active role in monitoring them.

the dysplastic nevus

size: A common mole is typically less than five millimeters (1/4 inch) in diameter. Think of the size of a pencil eraser as a reference.

size: A dysplastic nevus, otherwise known as an atypical mole, is often greater than five millimeters in diameter.

color: It is evenly pigmented, meaning the color is

color: The pigment of a dysplastic nevus is varied and may contain mixed shades of a particular color.

consistent throughout the mole. It is typically tan, pink, brown, or black in color. The color of the mole usually depends on skin type. For example, fair-skinned individuals tend to have moles that are light colored (tan or pink).

shape: It is round or oval and has a distinct edge that

shape: The edge of a dysplastic nevus is irregular and the

border may fade into the rest of the skin. The distinction between the mole and the rest of the skin is more blurred compared to a common mole.

separates it from the rest of the skin. It is symmetrical, which means the shape of one half of the mole matches the shape of the other half.

texture: The surface of a dysplastic nevus is smooth but slightly scaly, rough, irregular, or pebbly.

texture: A common mole is smooth in texture, and it

College of Dermatology, one out of ten Americans has at least one dysplastic nevus.

may either be flat or slightly raised (looks like a small bump). It is normal to find hair growing from a mole.

how common? Most adults have common moles on their skin, typically between ten to 40 common moles. cancerous or not? Rarely do common moles turn into

total wellness ▪ spring 2013

puberty, pregnancy, birth control use), moles may darken.

Some people have more moles than others, due to either genetic makeup and/or frequent, unprotected sun exposure at a young age.

a cancer; they remain relatively stable and harmless over the lifespan. However, if an individual has more than 50 common moles, this may be associated with a greater potential for skin cancer. Make sure to apply sunscreen, self-examine your body, and visit a dermatologist if you notice any changes. If you have a large number of moles, but don’t notice any distinct changes, visiting a doctor annually (or more often) is still recommended.

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how common? According to the American Osteopathic

cancerous or not? Dysplastic nevi are not cancerous by

definition, despite their close resemblance to melanoma.

Also, most do not develop into cancer. However, dysplastic nevi are “markers” for those who may be at risk and need frequent check-ups with a doctor. Furthermore, the more dysplastic nevi one has, the greater the risk for skin cancer.

According to a 2012 study published in Dermatology Clinics, dysplastic nevi are reported in 34 to 56% of melanoma patients and the presence of dysplastic nevi can confer up to a ten-fold increase in risk for melanoma. But no need to fear!

Having dysplastic nevi does not mean you will automatically get melanoma; they just indicate an increased risk for skin cancer. See a dermatologist or doctor for routine skin exams if you have more than five dysplastic nevi.

all moles: photographs by national cancer institute/istockphoto right: photographs by dean bertoncelj/istockphoto

what is a mole?

the self-examination how to check moles for melanoma The ABCDE Guide One of the first indicators of melanoma is a change in the shape, size, texture, and color of an already existing mole. Other times, melanoma may arise “out of the blue” as a new colored area on the skin. Here is the “ABCDE” checklist for detecting melanoma, recommended by the American Academy of Dermatology:

Whether you have common moles or dysplastic nevi, it is important to perform a full-body self-examination and to be aware of changes over time. When performing a selfexamination, look out for the characteristics listed in the ABCDE guide. The best time to perform an examination is after a shower or bath. It is ideal to perform the examination with no clothing on. Place yourself in a room with good lighting, a fulllength mirror, and a hand-held mirror. Jot down notes about what you observe and when the observation was made. Taking pictures is recommended to help track changes. According to the National Cancer Institute, these are some places to inspect carefully:

›

Examine the face, neck, scalp, and even ears. In addition to using a comb or hairbrush, it may be helpful to use a blow dryer to move hair when examining the scalp, or have a friend or family member check your scalp for you. When looking at the back of the neck and ears, use a hand-held mirror for better viewing.

›

Look at the front and backside of your body (head to toe), as well as the sides of your body (make sure to lift up your arms when checking the sides).

›

Look closely at your fingernails, palms, and all angles of the arm.

The color is uneven and there may be shades of white, gray, red, pink, or blue.

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Check the buttocks, breasts, and genital regions using a hand-held mirror.

D= Diameter

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Closely examine your feet, including toenails, the soles of the feet, and the spaces between the toes.

A= Asymmetry The shape of one half of the mole does not match the shape of the other half.

B= Border The border is irregular, ragged, blurred, or fading into the surrounding skin area.

C= Color

The diameter changes (usually increases in size) and exceeds six millimeters in width.

E= Evolving

important note: In men, the most common location for melanoma is the back, whereas in women, it is the lower leg.

Therefore, it is important to pay close attention to the moles in these regions.

The mole is changing in size, color, or texture. The mole may become scraped, lumpy, or hard. It may also bleed, ooze, itch, and/or cause pain and discomfort. According to Cameron Chesnut, MD, and Chief Resident of UCLA Dermatology, this “is the most important item on the checklist. If a mole is changing, it should be considered guilty until proven otherwise.”

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what to do if you notice changes

prevention

Whether it’s a common or dysplastic mole undergoing some change as described, it is important to consult a dermatologist.

Even if you perform a self-examination, it’s ideal to refer to the doctor for a second, more thorough examination.

According to Dr. Chesnut, “self examinations are important, but they are no substitute for seeing a dermatologist, even if done diligently.” According to a 2007 literature review published in the Journal of the American Academy of Dermatology, physicians were better at detecting early stage melanomas compared to patients, spouses, or family friends. Dermatologist examination of the skin was also found to be highly sensitive and specific in detecting melanoma. In addition, a 2008 meta-analysis published in the British Journal of Dermatology revealed that dermoscopy, the noninvasive technique used by clinicians to perform microscopic skin examinations, is more accurate in diagnosing melanoma than naked-eye examinations.

Melanoma can turn deadly and spread if left unmonitored or untreated. Therefore, careful surveillance of the skin and early detection are key to maximizing prevention and minimizing serious effects. In addition to keeping an eye on your moles, it’s important to take the following precautionary measures:

what the physician will do

› Apply sunscreen daily.

›

For a shave biopsy, a surgeon’s blade is used to remove a fragment of the suspected mole. This sample is then sent to the pathology lab for a biopsy. A biopsy is a close examination of tissue and is performed to achieve a diagnosis.

›

In an excisional biopsy, the whole mole is cut out and the skin is stitched back together due to the deepness of the excision. Scarring may occur, but it depends on how big the mole is initially and how long the skin is left to heal. Excisional biopsies are rarely performed. They are typically performed when cancer is found after a shave biopsy.

total wellness ▪ spring 2013

›

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It’s critical that a professional carry out these procedures. Removing a mole at home can cause skin disfigurement and infection, and if the mole is cancerous, the cancer may remain or even spread to other areas of the body.

Use UVA/UVB sunscreen with an SPF of 30 or higher every day. Apply 15 minutes before heading outside and reapply every two hours. “Most people apply 1/4 of the amount of sunscreen that is used when measuring SPF, thus anything lower than SPF 30 is diluted to the point of not being effective” says Dr. Chesnut.

› Avoid tanning beds.

Tanning beds are major sources of UV radiation, making them one of the main culprits for rising melanoma rates.

According to the World Health Organization, those who use tanning beds before the age of 30 increase their lifetime risk of melanoma by 75%! In a 2005 metaanalysis published in Cancer Epidemiology, Biomarkers, & Prevention, exposure to a tanning bed was found to significantly increase the risk of melanoma. And believe it or not, tanning beds are listed by major cancer societies to be as carcinogenic as cigarettes. According to Dr. Chesnut, “the idea of a ‘base tan’ is very false – there is no such thing as a good tan. Any tanning is a sign of photodamage to your DNA. Making pigment is the way our body tries to shield our DNA from the sun like an umbrella, but it does not occur unless damage has been done.” If you do have a history of tanning and have any moles, you should see a dermatologist regularly.

left: onur kocamaz/istockphoto; .shock/istockphoto; art-4-art/istockphoto; rouzes/istockphoto

When visiting your doctor or dermatologist, expect to receive a head-to-toe examination. The doctor may inquire about family history of melanoma as well as your own medical history.

Using a dermatoscope, a magnifying device that provides an up-close inspection of the skin, the doctor will assess any moles that could be potentially harmful. If a mole is suspected, removal may be the best option, since melanoma can only be diagnosed if the tissue has been closely examined under a microscope. There are two ways to remove the mole: shave biopsy and excisional biopsy.

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Love what we do?

Join us!

› Avoid deliberate tanning. › Limit unprotected sun exposure,

especially between 10 AM to 4 PM when the sun’s rays are the strongest.

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Total Wellness is now recruiting:

› Understand family history of melanoma and/or unusual moles.

Writers Designers Web Programers

› Perform self skin-examinations monthly.

Visit http://www.totalwellnessmagazine.org/ to learn more.

› See a dermatologist every year for a professional exam.

Frequent, regular check-ups may be necessary for those with higher numbers of common moles and for those with dysplastic nevi.

the bottom line

Questions? Contact totalwellnessapplication@gmail.com

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total wellness ▪ spring 2013

The vast majority of moles are harmless and should not be a cause of further stress and worry. Only moles that look different from others or those that are undergoing noticeable changes should raise a red flag.

If changes are caught early, melanoma will have less time to progress, leading to better outcomes overall.

The bottom line: get to know your skin. The best recipe for managing your health is being actively vigilant and aware of your body. t w

Applications due midnight May 3, 2013.

mythbusters

study techniques by josephine liu | illustration and design by kristen sadakane

One of the most common study techniques used by college students is highlighting. But just how effective is highlighting, underlining, or bolding important details when half of the text is marked or when professors want a recount of the big picture? A study recently published in Psychological Science reveals that some of the most popular tools students use may actually hinder rather than help performance. Read on to discover the truth behind study myths and to find out about habits that students may want to adopt instead. myth #1: highlighting and underlining help the brain to process information Two of the most widely accepted methods used for memorization are highlighting and underlining text, as any student borrowing a course reserve from Powell could point out.

However, the aforementioned study revealed that while highlighting and underlining can draw attention to individual concepts, students using these methods were less likely to make connections across concepts and were prone to overmark. In addition, the study showed that the two techniques could actually hurt performance on higher-level tasks that require inference making, or drawing conclusions from given data.

myth #2: keyword mnemonic devices are efficient From learning PEMDAS (Parenthesis, Exponential, Multiplication/Division, Addition/ Subtraction) in elementary school to Sohcahtoa (Sin=opposite/hypotenuse, cosine=adjacent/hypotenuse, tan=opposite/adjacent) in middle school, most students store tons of mnemonic devices to help them remember a variety of things, from the most simple of operations to the most complex foreign language vocabularies. But how useful are these fun phrases when students have to take the time to create their own? In a 2007 study published in Applied Cognitive Psychology, researchers found that inventing mnemonic devices is not efficient in terms of the time required for generating and memorizing keywords to fit into the devices. In foreign-language vocabulary tests, students who used mnemonic devices received significantly lower scores than students who took practice tests instead.

pedmas sohcahtoa artkou???

In a 2009 Memory study, researchers found that rereading was the most frequently used technique by 55% of students at one university. Naturally, rereading should increase the total amount of information digested. However, two different studies published in 1993 and 2009 in Contemporary Educational Psychology failed to find significant differences in results between students who read the given text once and students who read the same text twice when tested on application or inference-based questions. Although there were some benefits when students were tested on recall-based memory measures, students utilizing this technique may not show improvement in comprehension.

myth #4: studying in the same place everyday is the most effective Many students seem to have a special study spot that they prefer to go to – the back of the reading room in Powell or the window seat at that café in Westwood – where they spend several hours cramming in material for an impending midterm. However, in a 1978 experiment published in Memory and Cognition, psychologists discovered that when given a list of 40 vocabulary words, college students who studied the list in two different rooms varying in cleanliness and location scored far better on a test than those who studied the list twice in the same room.

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original illustrations by kristen sadakane

total wellness ▪ spring 2013

myth #3: rereading allows the student to digest the material better

techniques to adopt instead: alternative #1: teach the subject to peers “To teach is to learn twice,� revealed a 1998 study published in the Archives of Pediatric and Adolescent Medicine. Pediatric residents who were randomly assigned to teach about oral rehydration retained nearly two times as much of the information on the subject six weeks later as compared to those who were assigned to self-study or to attend a formal lecture. The researchers discovered that preparing to teach motivated the students to actively engage with their material rather than just reading and listening to it passively.

alternative #2: practice testing Although most students prefer to take as few tests as possible, practice tests have proven to enhance learning and retention. A study published in 2008 in Memory and Cognition revealed that undergraduates studying Swahili-English translations who continued to take tests without additional studying scored substantially higher on a final test after one week (80%), than those who continued to study with no further testing (36%). Practice testing could involve a number of methods: using actual or virtual flashcards, completing practice problems or questions included at the end of textbook chapters, or completing old exams handed down from previous students.

alternative #3: distribute learning over time Though many college students have fallen prey to pulling all-nighters and cramming in material before an 8 AM final, extensive research has proven that spreading out studying of content typically benefits long-term retention more than does massing learning opportunities back-to-back or in relatively close succession. In 1979, a study in the Journal of Experimental Psychology revealed that Spanish language learners who participated in six sessions in addition to an original lecture spaced one to thirty days apart tested superior to students who had six review sessions all in one day (Journal of Experimental Psychology). So while cramming the information the night before may get a student through a test, the material will quickly fade from memory. Thus, it may be more effective to study the material at intervals over time.

S M T W TH F S

study

study study study

study study

alternative #4: stay focused with StayFocusd

total wellness â–Ş spring 2013

Believe it or not, a summary by the American Psychological Association in 2006 explains that there is actually no such thing as multi-tasking. So people who are scrolling their Facebook newsfeed, listening to music, and watching Youtube videos while studying are actually serialtasking. Rather than engaging in these tasks simultaneously, the brain is working overtime to switch from one task to another in rapid succession and cannot actually entirely focus on any of them. Eliminate distractions by downloading apps and extensions on your laptop such as StayFocusd, a free, popular Google Chrome Extension that blocks different websites after a certain allotted period. For example, the program can limit Facebook usage one hour a day or Youtube to thirty minutes a day, thereby taking away the option of multitasking altogether. t w

f You Tube

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eat right

when you get

the nibbles: dips to pick (and skip) by julia duong | design by jessica sun

total wellness â–Ş spring 2013

main image: sf foodphoto/istockphoto; top right: dmitry naumov/ istockphoto; bottom right: vitalina rybakova/istockphoto

When the munchies hit you, what better way to snack healthily than to eat more fruits and vegetables?

While dips and spreads are great ways to enjoy juicy fruits and crisp vegetables, it is often too easy to select dips with unhealthy saturated fats and unnecessary calories. In this article, you’ll find recipes for some fantastic dips that your taste buds will enjoy.

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pick: yogurt skip: sour cream Yogurt can be a low fat dip alternative to sour cream, while still retaining that tangy, creamy texture. What are the health benefits of yogurt? First, the digestive tract contains plentiful “good” bacteria that aid in digestion and support the immune system.

Yogurt contains these “good” bacteria, also known as “probiotics.” Another benefit, which was published in 2006 by the Journal of the American Dietetic Association, reported that consuming yogurt relative to fruit drinks or dairy-based fruit drinks resulted in higher satiety ratings, meaning that yogurt can make you feel more full than those types of drinks. This means that you can eat less yogurt (and consume less calories), while still feeling satisfied. In comparison, sour cream is high in saturated fat and calories: 93% of sour cream is fat calories, giving it a relatively high number of calories per bite.

Therefore, yogurt can serve as a healthier alternative. Try mixing fresh herbs and seasonings into your dip to flavor it without adding too much sodium.

cucumber yogurt dip with dill 2 cup low fat plain yogurt 1 finely chopped fresh cucumber 1 tbsp finely chopped fresh dill 2 cloves minced garlic 1 tbsp olive oil freshly ground black pepper Whisk ingredients to combine. Chill for up to four hours and serve with vegetables.

fruit yogurt dip 1 cup low-fat vanilla yogurt 1 tbsp ground cinnamon sprinkling of brown sugar 2 tbsp honey Whisk and chill for one to two hours. Serve with desired fruits. livestrong.com

pick: cottage cheese skip: regular cheese horseradish and cottage cheese dip 16 oz small-curd wholemilk cottage cheese 1/4 cup (or more) preserved horseradish 1 tsp fresh chopped dill 1/2 tsp sugar kosher salt and freshly ground black pepper to taste

total wellness ▪ spring 2013

Cottage cheese is often a staple in health conscious diets because of its high protein content and healthy fatty acids content.

While there are some benefits associated with eating regular cheese, cottage cheese is lower in calories: 100 g of cottage cheese contains 98 calories, whereas 100 grams of cheddar cheese contains 403 calories. However, consider eating fat-free cottage cheese, because full fat cottage cheese can increase blood cholesterol. Cottage cheese can also be high in sodium, but there are low-sodium varieties available if sodium intake is a concern.

Combine first five ingredients in a medium bowl. Cover dip and chill for at least two hours and up to two days to let the flavors meld. bonappetit.com

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pick: white beans skip: refried beans Beans are an easy way to get an adequate amount of veggies into your daily diet – white kidney beans, in particular, are excellent sources of vegetables. These beans have a high fiber content, which helps to slow down the digestion of high-glycemic, complex carbohydrates like bread and pasta.

Eatting too much carbohydrates can cause that energy to be stored as fat.

Refried beans can also be healthy, but they are often prepared with animal fat (e.g. lard) that are high in cholesterol. If you really have the craving for refried beans, a suggestion is to cook them in a little bit of healthy oil, like olive or canola (two tablespoons at the most).

white bean dip 1 can (15 oz) white (cannellini) beans, rinsed and drained 8 garlic cloves, roasted 2 tbsp olive oil 2 tbsp lemon juice In a blender or food processor, blend beans, roasted garlic, olive oil and lemon juice until smooth. Enjoy with vegetables. mayoclinic.com

pick: hummus skip: store-bought

total wellness ▪ spring 2013

be wary of store-bought hummus.

The USDA Nutrient Database notes that commerciallyprepared hummus has about 25 calories and 1.4 g of fat per tablespoon. Many people pile on tablespoons of hummus with each vegetable or cracker, which results in excess and unnecessary calories. Homemade hummus can be a much healthier alternative because the ingredients can be customized to reduce the calories. For example, a typical hummus recipe calls for about three tablespoons of tahini; while tahini is simply ground sesame seeds containing unsaturated “healthy” fat, omitting it or reducing the amount used can eliminate up to 267 calories and 24 g of fat. As long as the other flavors are strong and present, you shouldn’t even notice the skipped tahini.

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In a blender or food processor, add the garbanzos and puree.

2 cans (16 oz each) reduced- Combine the olive oil, lemon sodium garbanzos juice, garlic, pepper. Blend well. (rinsed and drained except for Add the reserved liquid, one 1/4 cup liquid) tablespoon at a time until the 1 tbsp extra-virgin olive oil mixture has the consistency of a 1/4 cup lemon juice thick spread. Serve immediately 2 garlic cloves, minced or cover and refrigerate until 1/4 tsp cracked black pepper ready to serve.

homemade hummus

mayoclinic.com

top left: kaan ates/istockphoto; bottom left: robyn mackenzie/ istockphoto; top right: marek mnich/istockphoto

Hummus is a classic Middle Eastern and Arabic food dip or spread favored by dieters and the health-conscious. It is an excellent source of protein and vitamins and is made from ground chickpeas, ground sesame seeds (tahini), olive oil, lemon juice, salt, and garlic. Chickpeas are rich in fiber and protein, and contain folic acid (an important antioxidant), zinc, and magnesium. According to a 2011 analysis published in Journal of Inherited Metabolic Disease, folate, when incorporated into diet, can reduce the risk of developing colon polyps and colon cancer. Folate, which can also be found in dark, leafy vegetables, is also known as vitamin B9 and aids in the body’s daily cell production. A folate deficiency can accelerate carcinogenesis by disrupting the normal processes of DNA biosynthesis and repair.

bonus: eggplant baba ganoush 1 bulb garlic (about 8 cloves) 2 eggplants, sliced lengthwise 1 red bell pepper, halved and seeded juice of 1 lemon (about 4 tbsp) 1 tbsp chopped fresh basil 1 tbsp olive oil 1 tbsp black pepper or to taste Prepare grill by spraying cold grill with cooking spray.

Slice top off garlic bulb, wrap in foil and place on cooler part of grill. Roast for 20 to 30 minutes. On hot part of grill, place eggplant slices and bell pepper. Grill for two to three minutes a side. Squeeze roasted garlic out of bulb and place in food processor. Add grilled eggplant and red bell pepper. Add lemon juice, basil, pepper and olive oil. Pulse until smooth. Place dip in serving bowl. mayoclinic.com

eggplants can be an unexpected base ingredient in your dip.

Not only is eggplant fiber-rich, but it also contains antioxidants, including nasunin and chlorogenic acid. According to a 2000 study published in Toxicology, nasunin, an antioxidant found in the eggplant peel, helped prevent cellular brain damage in rats.

Nasunin’s main function is to act as a potent oxygen radical scavengaer, which protects cells from lipid oxidation. Chlorogenic acid, a plant compound known for its high antioxidant activity, has been associated with the ability to lower bad cholesterol (LDL) levels. Eggplant also contains no fat, cholesterol, and sodium.

total wellness â–Ş spring 2013

These dips are excellent complements that help you to eat more fruits and vegetables and serve as an alternative to unhealthy baked goods and sugary beverages. However, remember to eat mindfully – snacks should not be meal replacements. Taken in moderation, these delicious dips pack great flavor and nutrients. tw

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eat right

the heat on red meat

a guide to red meat consumption and related risks by halee michel | design by karen chu

Many individuals enjoy and even crave red meat daily.

total wellness â–Ş spring 2013

left: ugurhan /istockphoto; right (in order): markgillow/ istockphoto; nicholas sutcliffe/istockphoto

Meatless Mondays? Heck no. Some people might head straight to the prime rib line at a buffet. Others might eat at restaurants where red meat is the dish of choice or even the only dish. Although red meat can contain an abundance of protein, (a porterhouse steak contains 40 g of protein, according to the Harvard School of Public Health), a wide range of research exists that investigates the negative health effects of the regular consumption of red meat. When deciding what type of protein to eat, it’s important to consider the whole package: the nutrients, fats, and potential health effects that accompany it.

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what is considered red meat?

Myoglobin, the protein in meat that holds oxygen in the muscle, determines the color of the meat. The U.S. Department of Agriculture uses myoglobin content to establish whether a meat is in fact considered a red meat.

Under these guidelines pork, veal, beef, and lamb are classified as red meats.

risks associated with the daily consumption of red meat Red meat contains a high amount of cholesterol and saturated fat, both of which are thought to contribute to cancer and heart disease. The type of iron found in red meat, called heme iron, may produce cell-damaging compounds that can lead to cancer, particularly colon cancer. According to the American Institute for Cancer Research, heme iron appears to damage the lining of the colon. In addition to this, carcinogens, substances capable of causing cancer in living tissue, are released when red meat is cooked. A meta-analysis published in Cancer Prevention Research in 2011 analyzes the intake of heme iron from meat and the risk of colorectal cancer. The study included data on 566,607 individuals and 4,734 cases of colon cancer. Three out of the five meta-analyses illustrated that the intake of red meat and processed red meat was associated with a significant risk of colon cancer.

research linking red meat to cancer and shorter lives: Harvard researchers investigated the effects of the regular consumption of red meat and published their results in the Archives of Internal Medicine in 2012. To analyze the effects of red meat, they examined the diets of 37,698 men from the Health Professionals Follow up Study (1986-2008) and 83,644 women from the Nurse’s’ Health Study (1980-2000).

The researchers found that unprocessed and processed red meat consumption was associated with an increased risk of cardiovascular disease and cancer mortality in men and women.

benefits of red meat Despite the negative attention that red meat sometimes receives, it contains several essential nutrients.

›

According to the Office of Dietary Supplements, a federal organization part of the National Institute of Health, a three-ounce serving of ground beef provides 12% of the daily value of suggested iron. Within the body, iron transports oxygen and aids in cell growth. However, the iron that it does provide, known as heme iron, has been associated with a risk of colon cancer, which is discussed in Risks Associated with the Daily Consumption of Red Meat.

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processed red meats

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Another nutrient that red meat contains in abundance is zinc, a nutrient that helps the immune system fight off bacteria. A three-ounce serving of beef chuck, a type of beef commonly used in pot roasts, contains 47% of the suggested daily serving of zinc, according to the FDA. Although red meat contains a sufficient amount of zinc, the zinc found in red meat may actually be associated with a greater risk for cardiovascular disease. The MESA (Multi-Ethnic Study of Atherosclerosis), published in the Journal of Nutrition in 2012, and initiated in 2000 with 5,285 participants, found a correlation between consumption of zinc in red meat and an increase for the risk of cardiovascular disease. Interestingly enough, the zinc from red meat, but not from other sources, expressed this trend.

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total wellness ▪ spring 2013

Processed meats encompass red meats preserved by curing, salting, smoking, and/or the addition of preservatives (think salami, bacon, hot dogs, ham, and sausages). The process of preserving red meat in these ways can enable carcinogens to form. The addition of salt increases the sodium content, which may contribute to high blood pressure. According to the American Institute for Cancer Research, cancer risk increases with the consumption of any portion of processed meat. In order to reduce one’s cancer risk, this institute recommends that people limit themselves to 18 oz. or less of red meat per week. As for processed red meats, the American Institute for Cancer Research recommends avoiding them.

According to the Office of Dietary Supplements, beef is one of the best sources of vitamin B12. Vitamin B12 aids with the formation of DNA and supports the health of nerve and blood cells.

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giving it up?

It is important to understand that dieticians are not suggesting that you avoid red meat entirely, but rather that you eat red meat in moderation and choose lean cuts when doing so. Christine Rosenbloom, PhD, RD, and a nutrition professor at Georgia State University, suggests that people focus on making better selections when it comes to the portion size and the type of red meat. She emphasizes that they do not necessarily need to give it up. When selecting a red meat, good options include those without marbling or visible fat. Lean beef options include sirloin, chuck, and trimmed loin. Lean pork options include pork tenderloins and loin chops.

Vitamin B12: The Office of Dietary Supplements recommends that adults ingest 2.4 mcg of B12 daily. Although, red meat ranks high among the leading sources for B12, with three ounces of liver providing 70.7 mcg and three ounces of top sirloin steak providing 1.4 mcg, alternative sources also provide sufficient amounts. In fact, three ounces of cooked clams tops the charts, providing a whopping 84.1 mcg. Other types of fish and dairy products are also known to supplement decent amounts of B12. Three ounces of salmon provides 4.8 mcg, one cup of lowfat milk provides 1.2 mcg, and eight ounces of lowfat yogurt provides 1.1 mcg. Look for fish, dairy, and breakfast cereals fortified with B12 when trying to boost your consumption of this vitamin.

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Zinc: The Office of Dietary Supplements recommends that adult men consume 11 mg of zinc daily and adult women consume eight mg of zinc daily. Oysters, a leading source of zinc, provide 493% of one’s suggested daily value. Other sinkholes for zinc include a three-ounce serving of crab (43% of one’s DV), half a cup of baked beans (19% of one’s DV), and one ounce of dry roasted cashews (11% of one’s DV).

These suggestions serve as just a few alternatives, amongst a plethora of other options.

alternative sources for red meat nutrients Although red meat contains some adverse substances, which may be linked to cancer, it also contains several hearty nutrients. Fortunately, these nutrients can be found in alternative meat, vegetable, and grain based foods.

Iron: The Institute of Medicine of the National Academy of Sciences recommends eight mg per day of iron for males between the ages of 19 to 50 and 18 mg per day of iron for females between the ages of 19 to 50. The iron dosage recommended for females is higher than that recommended for males because of the iron lost every month during menstruation. These daily iron requirements can be met by consuming beans and leafy greens. A list of foods containing substantial amounts of iron can be found on the Vegetarian Resource Group website. Some examples of foods high in iron include one cup of cooked soybeans (8.8 mg of iron), one cup of cooked lentils (6.6 mg iron), and one cup of cooked spinach (6.4 mg iron).

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the bottom line While regularly consuming red meat has been associated with an increased risk of certain types of cancers and cardiovascular disease, it’s important to realize that occasionally consuming a portion of red meat isn’t going to shave days off of one’s life. At the same time, value is found in moderation, healthy choices, and variety. So next time meatless Monday comes along, consider embracing some alternative, meatless dishes. tw

left: jerryhat/istockphoto; shuchun ke/istockphoto; alina solovyova-vincent/istockphoto; right: illustrated by keziah pagtakhan

total wellness ▪ spring 2013

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total wellness ❯❯ on the cover

total wellness ▪ spring 2013

"The best things in life are nearest: Breath in your nostrils, light in your eyes, flowers at your feet, duties at your hand, the path of right just before you.”

– robert lewis stevenson

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feature

living air purifiers: improve indoor air with household plants!

total wellness â–Ş spring 2013

Ever been in an office or room and felt nauseated, fatigued, or had difficulty concentrating? This may be a result of the sick building syndrome (SBS), an acute condition with no obvious cause.

It is characterized by symptoms such as headaches, eye and nose irritation, fatigue, nausea, and other ailments that appear to be linked to the amount of time workers or occupants spend in a building. In the late 1970s, efforts to maximize energy efficiency by alleviating the rising energy costs for heating and cooling systems resulted in the manifestation of SBS. Superinsulation and a reduction in fresh air exchange was introduced into many building designs, creating tightly sealed rooms with increased concentrations of many indoor pollutants, known as volatile organic compounds (VOCs). So how was the problem of stuffiness resolved?

To the delight of many workers and homeowners, in 1989 a study by National Aeronautics and Space Administration (NASA) and the Associated Landscape Contractors of America (ALCA) reported that common indoor plants could provide natural ways of combating the VOCs that caused SBS. Indoor plants have built in filtration systems that can reduce the health risks of inhaling unhealthy particles including mold spores, dust, animal dander, and harmful VOCs.

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left: illustrated by keziah pagtakhan; right: (top icons) browndogstudios/istockphotos ; (plant icons) illustrated by keziah pagtakhan

by lillie luu nguyen | design by keziah pagtakhan

volatile organic compounds Three of the most common household VOCs and their sources are the following:

❯ ❯ ❯ ❯

BENZENE Tobacco smoke Stored fuels Paint supplies Automobile emissions

FORMALDEHYDE Particle board Plywood, paneling Pressed-wood products Urea formaldehyde foam insulation ❯ Combustion ❯ ❯ ❯ ❯

TRICHLOROETHYLENE ❯ ❯ ❯ ❯

Paints Adhesives Spot removers Degreasers

how do plants clean the air?

In addition to basic photosynthesis, which removes carbon dioxide and returns oxygen to the air, there are several ways plants remove toxicants not only from air, but from soil and water in the pot. Plants can metabolize toxic chemicals like formaldehyde into harmless by-products. Additionally, plants can incorporate toxicants such as heavy metals, like the lead found in paints, into their tissues, thus isolating them. Houses built before 1978 are also more susceptible to lead poisoning from paints as a result of deteriorating paints on walls, doors, and windows. In addition, a 2007 study published in Ornamentals and Flowers stated that plants can purify the air by absorbing volatile organic compounds from the air into their leaves. They then translocate these compounds to their root zone, where microbes break them down. Given that air also reaches plant roots, uptake by root tissues is another means by which air can be purified.

helpful household plants With an estimated 400,000 plant species throughout the world, which plant would be the most suitable air purifier? Based on the 1989 NASA study, the following plants have shown to ameliorate the concentration of VOCs in buildings and homes.

PEACE LILY (Spathiphyllum wallisii)

SPIDER PLANT (Chlorophytum comosum)

Targets: benzene, formaldehyde, and trichloroethylene

Targets: formaldehyde

GERBERA DAISY (Gerbera jamesonii) Targets: benzene and trichloroethylene This plant requires a lot of sunlight and well-drained soil.

This plant is easy to maintain because it does not need a lot of upkeep and thrives in almost any condition. The plant will even survive being neglected at times.

total wellness ▪ spring 2013

This plant does best when placed in a shady spot. It should be watered approximately once per week, and only when the soil is dry. It is poisonous, so keep it out of the reach of children and pets.

ENGLISH IVY (Hedera helix) Targets: formaldehyde and fecal particles from the air This plant flourishes in cool, moist air with partial shade to bright indirect light. It is poisonous, so keep it away from children and pets.

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BAMBOO PALM (Chamaedorea sefritzii)

RED-EDGE DRACAENA (Dracaena marginata)

Targets: formaldehyde

Targets: benzene and trichloroethylene in addition to other VOCs like xylene and toulene

This plant’s soil should be kept moist and the plant needs to be placed in indirect sunlight.

This plant is best suited for a temperature of about 75°F. For water and sunlight requirements, a small dose of each is preferred.

CHRYSANTHEMUM (Chrysantheium morifolium)

GOLDEN POTHOS (Scindapsus aures)

Targets: benzene and formaldehyde This plant requires high maintenance because it likes bright, but indirect sunlight, good air circulation, and being watered with warm water. Allow the soil to dry in between watering.

Targets: formaldehyde This plant can be placed virtually anywhere in a home and requires a thorough watering, about once a week.

MOTHER-IN-LAW’S TONGUE (Sansevieria trifasciata ‘Laurentii’)

AZALEA (Rhododendron simsii)

Targets: formaldehyde

This popular plant does best in a cool environment (around 65°F) and should be kept out of direct sunlight.

Targets: formaldehyde

This plant does not require a lot of maintenance.

build a community!

To establish an effective plant-based air-pollution control system, a variety of VOC filtering plants could make a difference in the air quality. The 1989 study by NASA also recommends using one potted plant per 100 square feet of home or office space. It is recommended that each plant be in containers with diameters of six to eight inches.

Aside from their usefulness as efficient energy sources and quiet filtration systems, plants can increase the relative humidity and decrease the amount of particulate matter (e.g. dust) in the room. This is useful because low humidity and too much dust can induce indoor healthrelated conditions. Plants are also a great addition to the home or office for their aesthetic beauty. With an abundance of species, a plant’s color, shape, and size can even be used to elicit positive psychological effects. According to a 2005 study published in Evolutionary Psychology, flowering plants were shown to induce positive emotions in people. With so many rewarding aspects to keeping plants indoors, going green is a noteworthy idea to consider! t w

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left: (plant icons) illustrated by keziah pagtakhan; (lower icons) browndogstudios/istockphotos right: dušan zidar/istockphoto

total wellness ▪ spring 2013

other uses of household plants

feature

getting the

daily dose

by pavan mann| design by amanda wong

Behind the scenes of the body’s essential functions are micronutrients —

total wellness â–Ş spring 2013

relatively small quantities of vitamins and minerals that run the stage when it comes to wellbeing. Despite a balanced diet, some of these may not be present in adequate amounts, making a mark on overall health. Taking multivitamin/ mineral (MVM) supplements is one way to ensure a sufficient supply of these teeny-tiny showstoppers.

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and vegetables, including strawberries, broccoli, potatoes, and spinach. The research revealed that the amount of iron, calcium, phosphorus, riboflavin, and ascorbic acid available in these foods decreased significantly over the course of the 49-year study period. This decline in nutrient concentration was attributed to industrial farming techniques such as artificial fertilization, irrigation, and genetic plant breeding.

These practices are popularly implemented in farming because they trade-off nourishing content for a more profitable, higher crop yield size. MVMs, which contain varying amounts of the aforementioned ingredients, can be added to any wellbalanced diet to ensure that the body is getting enough of the nutrients it needs.

why might MVMs be needed?

Vitamins and minerals play critical roles in boosting the immune system, promoting growth and development, and aiding proper organ function. They are particularly important for bones, teeth, and blood and can cause serious illnesses if deficiency persists. MVMs cannot substitute for a healthy diet, which should consist of foods that provide more than just vitamins and minerals, like essential fats, proteins, and fiber. However, dietary restrictions from allergies or food absorption and digestion problems can prevent adequate consumption of necessary nutrients, which are alternatively available in MVMs. Vegetarians and vegans, as well as people with poor appetites or on low calorie diets, should consider taking a multivitamin/mineral supplement to satiate their micronutrient needs. The Office of Dietary Supplements at the National Institute of Health recommends that women who are pregnant, planning pregnancy, breastfeeding, or postmenopausal take a daily MVM, as well as people over 50.

who takes MVMs? A National Health and Nutrition Examination Survey conducted from 2003 to 2006 revealed that 33% of the U.S. population over one year of age took at least one MVM supplement in a given month. As shown in the figure below, daily MVM usage was lowest in 14 to 18-year-olds, with only 14% of males and 19% of females taking them. In ages 19 to 30, usage increased to 25% in males and 30% in females.

This trend continued, so that more than 40% of people 71 and older consumed MVMs regularly. Although young adults are statistically least likely to consume dietary supplements, it is crucial that they receive all of the elements necessary to support their continuing development and to sustain their busy lifestyles and minds.

Additionally, produce from large, industrial farms may not be as nutritious as it was when food was grown in smaller, more organic farms. According to the Agriculture Factbook by the United States Department of Agriculture, the number of farms fell from seven million in 1935 to just 1.9 million in 1997 and is still slowly declining due to the steady increase of larger corporate farms. A study published in 2004 by the Journal of the American College of Nutrition examined the amount of nutrients in a group of 43 foods between the years 1950 and 1999. The sampled foods contained mostly fruits

Use of MVMs by Age, NHANES 2003-2006 50 48 40

43 38

28 25

32

25

23 19 14

10

0 1-3

4-8

graph adapted from office of dietary supplements

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9-13

14-18 Age (years)

19-30

31-50

51-70

males

females

71+

right: matejay/istockphoto

Percentage

27

30

18

total wellness â–Ş spring 2013

40

35

30

20

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are there any risks in taking an MVM? MVMs are not likely to pose a hazard to health, unless the user is also consuming additional supplements or vitamin/mineral-fortified foods such as cereals and drinks.

Overdosing on vitamins A, D, E, and K can be toxic because they are fat-soluble and are stored in the body. High doses of these antioxidant-rich vitamins were found to increase adult mortality in a review published by The Cochrane Library in 2012. Other vitamins, such as vitamin C and the B vitamins, are water soluble and can usually be excreted via urine if taken in excess. Surplus nutrients can be hazardous to health; too much vitamin A increases the likelihood of lung cancer in smokers and of birth defects in developing fetuses, and extra vitamin K can decrease the effectiveness of medications that reduce blood clotting. Adult males and postmenopausal women taking unprescribed, unnecessary amounts of iron supplements may develop hemochromatosis (iron overload), because these groups need significantly less iron than menstruating women who regularly lose blood.

what is in most MVMs?

MVM usage is generally safe because most supplements do not exceed the daily recommended values of the contained minerals and vitamins. Overdose is unlikely unless an MVM consumer is taking additional, individual supplements. Many MVMs account for the intake of common nutrients such as vitamin D (obtained from dairy products and sunlight) by decreasing the amount present in the supplement.

People considering MVMs should take one that caters to their age or gender, as these have adjusted concentrations to suit to the needs of different groups. For example, pregnant women are recommended to take prenatal supplements, which provide extra folic acid to prevent neural defects in the fetus. However, in a 2006 Nutrition Reviews study, excess folic acid taken by postmenopausal women was correlated to a 20% increase in the risk of breast cancer. Therefore, to avoid potential health hazards, it is imperative that someone considering multivitamins takes the one that is best suited for his or her current dietary needs.

The following is a table of vitamins and minerals that can be found in most MVM supplements.

Minerals Calcium Iron Phosphorus Iodine Magnesium Zinc Selenium Copper Manganese Chromium Molybdenum Chloride Potassium Boron Nickel Silicon Tin Vanadium

Vitamins Vitamin A Vitamin C Vitamin D Vitamin E Vitamin K Thiamin (Vitamin B1) Riboflavin (Vitamin B2) Niacin (Vitamin B3) Vitamin B6 Folic acid (Vitamin B9) Vitamin B12 Biotin (Vitamin H or B7) Pantothenic Acid (Vitamin B5)

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how can deficiencies be prevented?

Though multivitamin/mineral supplements can be beneficial, they are not necessary. Some of the most common deficiencies can be corrected by eating foods that are rich in that specific nutrient or taking only a specific supplement upon a physician’s approval. The Office of Dietary Supplements (ODS) at the National Institute of Health has compiled information about widespread deficiencies in the U.S. to combat them and to promote balanced diets. According to the ODS, here are a few nutrients that some Americans might need more of in their diets, symptoms of deficiencies in these nutrients, and where to find these nutrients besides in an MVM.

magnesium

Magnesium participates in over 300 biochemical reactions in the body. It is essential to muscle and nerve function, keeping a steady heart rhythm, strengthening bones, and supporting a healthy immune system. It maintains steady pressure and sugar in blood and is involved in energy metabolism and protein synthesis. deficiency signs: The early signs of magnesium deficiency are appetite loss, nausea, and weakness. The later signs are numbness, irregular heartbeats, high blood pressure, muscle cramps or twitching, and anxiety. food sources: Spinach, dark green vegetables, legumes, nuts, seeds, and whole, unrefined grains are all sources of magnesium.

vitamin B12

deficiency signs: Inadequate B12 induces tiredness, weakness, constipation, and loss of appetite. A more severe deficiency may cause weight loss, nerve problems (numbness and tingling in the hands and feet), loss of balance, depression, confusion, poor memory, soreness of the mouth/tongue, and megaloblastic anemia (abnormally large red blood cells). food sources: Vitamin B12 can be obtained from beef liver, clams, fish, meat, poultry, eggs, other dairy products, fortified cereals, and yeasts.

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calcium

Calcium is known to support the structure and hardness of bones and teeth, but it also helps the communication between brain and body, the movement of blood, as well as the release hormones and enzymes. Though it is a widely known and recognized nutrient, many people do not get the recommended value of calcium. According to the ODS, groups who have inadequate calcium intake include boys and girls aged nine to 13 years, girls aged 14 to 18, women between 51 to 70 years, and men and women over 70 years. Causes of calcium deficiency include veganism, insufficient vitamin D intake, and the natural decrease of calcium absorption with age. deficiency signs: Symptoms do not typically occur in the short term, because the body will reabsorb calcium stored in the bones. However, in the long term, numbness or tingling in the fingers, convulsions, abnormal heart rhythms, and osteoporosis may occur. food sources: Aside from milk, yogurt, and cheese, calcium can also be found in kale, broccoli, Chinese cabbage, sardines, and salmon.

right (in order): macida/istockphoto; ga161076/istockphoto ; sezeryadigar/ istockphoto; left (in order): bedo/istockphoto; yasonya/ istockphoto; ajt/istockphoto

total wellness â–Ş spring 2013

This nutrient helps make DNA and keeps blood and nerve cells healthy. Vitamin B12 is one of several important vitamins in the water soluble B-complex, which also includes thiamin (vitamin B1), riboflavin (vitamin B2), vitamin B6, vitamin B12, folate, biotin, niacin, and pantothenic acid. Though most Americans get enough through food, 1.5% to 15% of the population develops deficiencies due to problems absorbing B12. This may be because of decreased hydrochloric acid production in the stomachs of older adults, which slows and weakens digestion. Deficiency can also be due to vegetarianism, veganism, digestive disorders, or pernicious anemia, which is a B12 absorption disorder. Folate and B12 deficiencies often coexist, and the two can have confounding symptoms.

bottom line

zinc

Zinc is found throughout the body, fighting off invading bacteria and viruses, making proteins and DNA, healing wounds, and helping us properly taste and smell. It also facilitates growth and development of babies during pregnancy up until early childhood. Zinc deficiency is most prevalent in vegetarians, vegans, older infants still breastfeeding, alcoholics, and those with sickle cell disease or digestive disorders. deficiency signs: Absence of zinc from the diet causes hair loss, diarrhea, eye and skin sores, loss of appetite, loss of taste, weight loss, lower alertness, slower wound healing, delayed growth in children, delayed sexual development, and impotence in men. food sources: Oysters, red meat, poultry, seafood (crab and lobsters), fortified cereals, beans, nuts, and whole grains provide zinc.

Depending on diet and availability of certain foods, other deficiency risks are possible, but are rare in the United States. A healthy, well balanced diet (with or without the addition of MVMs) is beneficial to wellbeing. MVMs are in no way substitutes for the nutrients obtained from a balanced diet and cannot reverse the effects of excess sugars and fats or lack of exercise. However, a multivitamin/mineral supplement can ensure that the body is getting what it needs to function properly. MVMs are generally daily doses and do not exceed the daily recommended intake values. Too much of a good thing is possible, and overdose of some nutrients can cause adverse effects. Overdosing on iron, for example, can lead to liver damage and heart failure.

The addition of any supplement to your diet should be discussed with a physician or health professional, who can elaborate on possible side effects or interactions with other medications. If you think a nutrient deficiency is affecting your health, it is crucial to get properly diagnosed by a physician, as the symptoms of a deficiency can be confounded with similar symptoms of other medical issues. t w

iron

total wellness â–Ş spring 2013

The World Health Organization estimates that over 30% of the world’s population is iron-deficient anemic. This type of anemia is increasingly prevalent in menstruating and pregnant women. Iron helps to transport oxygen in the blood throughout the body and plays a part in regulating cell growth and development. deficiency signs: Symptoms include anemia (fatigue, poor endurance, shortness of breath, headache, dizziness, pale skin, leg cramps, and insomnia), brittle nails, loss of appetite, coldness in hands and feet, swelling or soreness of the tongue, cracks in the sides of the mouth, frequent infections, and pica (cravings for nonfood items like ice, dirt, paint, or starch). food sources: Iron intake can come from red meats, fish, poultry, lentils, beans, and spinach.

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feature

BMP: a panel of eight that tells your state a guide to blood tests and what they can tell you by samantha

fong | design by karin yuen

total wellness ▪ spring 2013

left: oliopi/istockphoto.com; illustrations by karin yuen

Blood tests are extremely useful tools in informing about a person’s health.

One common lab test that physicians order is called the Basic Metabolic Panel (BMP). Also known as a Chemistry Panel, the BMP is taken to obtain information about a patient’s metabolism (the sum of all physical and chemical processes that use energy in the body). Results from a BMP can also provide information about how a certain medication is working. Other times, the test is administered in an emergency situation so that an overall picture of the person’s health can be acquired. The BMP consists of eight tests that provide information about a person’s kidneys, electrolyte and fluid balance, and blood sugar levels. Read on to learn what the eight tests are, what normal levels look like, and what abnormal levels may mean about your health.

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kidney tests

sugar metabolism

1. blood urea nitrogen (BUN)

3. glucose

Normal levels: 6-20 mg/dL

Normal levels: 70-100 mg/dL (with fasting) and 80-125 mg/ dL (without fasting)

Why it’s in the blood: When proteins that have been used by the body are broken down by the liver, ammonia is formed.

Ammonia contributes to the formation of urea, a nitrogenous chemical waste product. Kidneys that are functioning properly will filter the blood and excrete the urea through the urine.

High Levels: Above-normal levels reveal that the kidneys may not be functioning properly. A high protein diet, kidney failure or kidney disease, urinary tract blockage, dehydration, or heart failure are some conditions that can contribute to high BUN levels.

Low Levels: BUN levels that are lower than normal may be caused by a low protein diet, liver disease, liver damage, overhydration, or malnutrition.

2. creatinine Normal levels: 0.7-1.3 mg/dL for men and 0.6-1.1 mg/dL for women

Why it’s in the blood: Carbohydrates are broken down in the body into molecules called glucose, a main source of energy for the body. Insulin, a hormone produced by the pancreas, is released in the blood to allow glucose to be used by muscle, liver, and fat cells in the body.

High Levels: High glucose levels may mean that not enough insulin is being produced and/or that there is a decrease in sensitivity to insulin, resulting in diabetes. Too much glucose in the blood can cause damage to blood vessels, affecting blood supply to important organs in the body. Other possible reasons for high glucose levels may include pancreatitis, pancreatic cancer, or an overactive thyroid gland.

Low Levels: Lower than normal levels indicate hypoglycemia, or low blood sugar. Hypoglycemia may be due to an underactive thyroid, the secretion of too much insulin, liver disease, kidney failure, malnutrition, or Addison’s disease, a condition in which the adrenal glands do not produce enough hormones.

total wellness ▪ spring 2013

Why it’s in the blood: After food is metabolized into energy that the body can use, a protein derivative known as creatine is formed in the muscles. When the body metabolizes creatine, a chemical waste product known as creatinine forms. Normal kidneys will filter creatinine out of the bloodstream and dispose of it in the urine. Muscle mass affects the amount of creatinine in the blood, which is why men usually have higher creatinine levels than women.

High Levels: Creatinine levels above the reference range indicate that the kidneys may not be filtering properly. Some reasons for high levels may be a high protein diet, kidney failure or disease, urinary tract blockage, severe dehydration, heart failure, muscular dystrophy, or low blood volume.

Low Levels: Levels lower than the reference range may indicate a low protein diet, liver disease, or muscular dystrophy.

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6. sodium Normal Levels: 135-145 mEq/L Why it’s in the blood: Sodium is both an electrolyte and mineral. It helps balance the amount of fluids inside and outside of cells and is important for nerve and muscle function. The hormone aldosterone communicates to the kidneys whether or not to store sodium or release it in the urine.

electrolytes 4. carbon dioxide (bicarbonate) Normal Levels: 23-29 mEq/L Why it’s in the blood: Carbon dioxide is a waste gas formed in the body from metabolic processes. It is carried by the blood to the lungs and exchanged with oxygen. Since more than 90% of carbon dioxide in the blood exists in the form of bicarbonate, this test measures the concentration of bicarbonate in the blood. Bicarbonate acts as a chemical buffer in the blood to maintain the blood’s pH balance. If the blood becomes too acidic or basic and the pH deviates from its optimal level, the blood cannot carry out its proper function. Healthy kidneys and lungs keep the bicarbonate, carbon dioxide, and carbonic acid levels balanced. This test is important in testing for kidney and lung diseases.

High Levels: High levels of sodium may indicate high blood pressure, dehydration, diabetes, kidney disease, a high sodium diet, high levels of aldosterone, or Cushing’s syndrome.

Low Levels: Low levels may be caused by kidney disease, improper functioning of the adrenal or thyroid gland, heart failure, sweating, burns, dehydration, ketonuria, severe diarrhea or vomiting, cystic fibrosis, Addison’s disease, or cirrhosis (when the thyroid or adrenal glands are not functioning properly). Low sodium blood levels may also indicate abnormal brain function and increased cerebral pressure, leading to possible seizures if levels get below 125 mEq/L.

High Levels: Reasons for high bicarbonate levels may be, but are not limited to, fluid in the lungs, heart disease, dehydration, blood transfusions, overuse of antacids, breathing disorders such as chronic obstructive pulmonary disease, high levels of the hormone aldosterone, Cushing’s syndrome (when high levels of cortisol are in the blood), or anorexia.

5. chloride

total wellness ▪ spring 2013

Normal Levels: 96-106 mEq/L Why it’s in the blood: Chloride is a type of electrolyte that balances the amount of fluid inside and outside the body’s cells. Fluid balance is important in providing a proper environment for maintaining cell function. The electrolyte also works to control blood pressure, blood volume, and pH levels.

7. potassium Normal Levels: 3.7-5.2 mEq/L Why it’s in the blood: Potassium, another important electrolyte and mineral, plays a role in maintaining acid-base balance in bodily fluids, in the functioning of our muscles and nerves, and in moving nutrients and waste into and out of cells. The hormone known as aldosterone is responsible for controlling the levels of potassium in our blood. This test goes hand in hand with the serum sodium test because in general, as potassium levels increase, sodium levels decrease and vice versa.

High Levels: High chloride levels may be caused by dehydration, high salt intake, kidney disease, metabolic acidosis, or an overactive parathyroid gland.

High Levels: Abnormally high levels may be caused by medicines that reduce blood pressure and may also indicate kidney damage or injury, a heart attack, metabolic acidosis, or a high potassium diet.

Low Levels: Low levels of chloride may indicate Addison’s disease, the secretion of too much aldosterone, congestive heart failure, burns, dehydration, or metabolic alkalosis (a condition in which the pH of the blood is raised above normal).

Low Levels: Low potassium levels may be caused by high aldosterone levels, cystic fibrosis, severe burns, alcoholism, dehydration, malnutrition, chronic diarrhea, kidney disease, and diuretic medicines.

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illustrations by karin yuen

Low Levels: Low bicarbonate levels may indicate hyperventilation, shock, dehydration, diarrhea, an overdose of aspirin or alcohol, liver or kidney disease, a heart attack, ketoacidosis, hyperthyroidism, diabetes, or Addison’s disease.

healthy living

made simple 8. calcium

total wellness

a ucla student wellness commission publication

Normal Levels: 8.8-10.4 mg/dL for adults and 6.7-10.7 mg/ dL for children Why it’s in the blood: In addition to being stored in bones, calcium serves many functions in the blood. The mineral aids in muscle contraction, nerve signaling, and blood clotting.

Calcium levels are normally kept constant in the blood. When levels are low, calcium is released from the bones into the bloodstream. Conversely, when levels are high, calcium is either eliminated in the urine or stored in the bones.

High Levels: Some reasons for high calcium levels may be, but are not limited to, tuberculosis, cancer in the bones, Paget’s disease (a disorder where there is abnormal bone growth), or hyperparathyroidism (when the parathyroid glands are overactive).

Low Levels: Low calcium levels may indicate low levels of the blood protein albumin, hypoparathyroidism, high phosphate levels due to kidney failure, malnutrition, or soft bones due to vitamin D deficiency.

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Read our previous issues online at http://issuu.com/totalwellnessmagazine

total wellness ▪ spring 2013

The Basic Metabolic Panel, which measures the levels of eight different substances flowing through our blood, helps doctors better understand the current state of how a person’s body is functioning. Being informed about these eight blood chemical tests and understanding the importance of monitoring these substances in the blood enables one to better care for one’s body. It’s also important to note that doctors may pick and choose individual tests when a specific problem may be detected or to monitor a patient’s specific health situation, such as checking sodium levels when a person has high blood pressure. While this summary of the BMP includes various reasons for abnormal levels, it is not limited to those reasons, as higher or lower-than-normal results can arise from a variety of problems in the body. The reference ranges for normal results alter slightly for different laboratories, so be sure to check with a professional about what specific levels mean. t w

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feature

quantified self-movement: tracking your life to keep your life on track by anahit poturyan | design by annie theriault

Benjamin Franklin did it. 35 million Americans do it. Occasionally, you might do it too.

So what do so many Americans and you have in common with

total wellness â–Ş spring 2013

Self-tracking, also known as self-quantifying, has been around for centuries. Franklin’s personal documentation of his progress with the 13 virtues (frugality, moderation, silence, order, etc.) is one of the earliest examples. Every day of the week he would log his advancement towards the 13 virtues of morality on a chart.

More recently, self-tracking has become one of the trends from the health-conscious community to emerge into a worldwide movement. Gary Wolf and Kevin Kelly officially created the Quantified Self Movement (QS) in 2008, unifying a worldwide community of health enthusiasts and self-trackers.

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left: joshua hodge photography; right: sĂĄndor kelemen/istockphoto; anton snarikov/istockphoto

Ben? The answer is: self-tracking.

The QS has taken self-improvement to a radically new level. This newly formed group utilizes microchips, biometric devices, and smartphone apps to track anything that is quantitative about the human body or mind. QS consists of three divisions, each allowing members to communicate together. The blog and community site are the main sources of contact, where individuals can post questions, swap information, offer tips, etc. The second part of QS are the Self Show&Tell meetings, offering direct contact with members and innovators. Lastly, people in QS “gather, inspire, and learn from each other as [they] share and collaborate on self-tracking projects” at their annual conference.

what is it for?

The purpose of collecting personal data is to analyze it and make it useful for your life.

While you can do it on your own, QS creates a community of self-trackers to better enhance the tracking process. This can be extremely beneficial, because it enables people to take better care of their bodies and to modify their habits. Self-tracking is utilized by individuals to help achieve health and fitness goals or manage diseases, which can consequently improve quality of life.

how is it done, and what do people use it for?

A 2012 study published in the Yearbook of Medical Informatics surveyed tools (devices and social media platforms) used by self-trackers. Researchers concluded that there is presently a trend of individuals monitoring and supervising themselves, mainly within the health and fitness categories. Surprisingly, there is also a group of people using self-tracking for the management of chronic diseases. In 2012, the Research Center’s Internet and American Life Project reported that 69% of adults track (for themselves or for others) with technological and non-technological methods. And among that group of individuals, 34% use a journal or a notebook to track rather than using devices or apps. Expensive gadgetry and apps are available for individuals to track anything that is quantitative about the body. This can range from measuring calories, curiosity, sleeping cycles, microbiome, and the list continues with interesting possibilities. Of interesting ways to self-track, most notable is the personal QS “research” of Eric Alm, PhD, a microbial researcher at MIT. Over the course of a year Dr. Alm experimented by self-tracking his microbiome by analyzing stool samples daily and later presented his findings at the Genomes Environments Traits (GET) Conference in 2012.

This is one example of how curious people can quantify their lives and find patterns within themselves.

is it beneficial?

However, due to the newly formed nature of this movement, not much research has been conducted on the efficacy of other self tracking methods for improving quality of life. The aforementioned study from the Yearbook of Medical Informatics notes that the “efficacy and effectiveness [of self-tracking] is limited to date”.

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total wellness ▪ spring 2013

Step tracking may be beneficial to health. A 2007 study published in the Journal of the American Medical Association found that adults who regularly used a pedometer experienced an increase in their physical activity by 2,183 steps per day.

This may have improved the overall health of participants because researchers noticed an average overall decrease in body mass index (BMI) among the participants.

the guide ❯❯ self tracking tools Interested in self-tracking and self-improvement?

Here are some apps to get you started.

runkeeper

mint

This mobile phone app is advertised as “The Personal Trainer in Your Pocket,” and is used by 14 million people to track hikes, walks, runs, and bike rides. This interactive app allows individuals to record the time, pace, speed, and distance traveled while using your phone’s GPS to map your trail. This app documents average minutes per mile and heartbeat along with calories. It even offers a “goals” feature allowing you to enter and track your progress over a course of time. However, RunKeeper does not limit you to outdoor activities. You can use this in the Wooden Center when working out on a treadmill, stationary bike, elliptical, or row machine.

This app has accounted for 37 million runs, 17.3 million walks, and 6.7 million bike rides, according to Runkeeper’s activities database powered by Google Analytics.

Self-tracking is not just limited to one’s body and health. Mint, pitched as “the best free way to manage your money,” helps individuals manage money by compiling all financial accounts onto one platform. Mint will automatically sync and categorize your expenses into a specific category (i.e. shopping and dining) and arrange the data into graphs, while also calculating the average amount spent within each separate category. This free program is ideal for students learning to manage money.

If you are interested in sharing ideas or becoming involved with QS, you can join 266 other trackers in the Los Angeles group. Check out www.quantifiedself.com.

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left icons: itunes.com; right: moodscope. com; josé luis gutiérrez/istockphoto

total wellness ▪ spring 2013

Alternative: FitBit ($50-100) and Nike Runner

moodscope

don’t want to use apps to self-track? here are other options for you: ❯ pen and paper The classic pen and paper method can track anything within the limits of these two materials.

Here are a few ideas of things to track: hours spent on leisurely reading, record of daily vitamin intake, hours spent on social media websites, hours spent commuting, and the list can go on. ❯ simple pedometer Track the number of steps using a pedometer. A simple pedometer can be purchased for just a few dollars at any drugstore. For a few more dollars, a more advanced digital pedometer can record heart rate, calories burned, distance, and speed. The Surgeon General suggests that people take at least 10,000 steps daily. tw

total wellness ▪ spring 2013

Moodscope offers users a platform to measure and track moods using an online card game. This card game is based on the supposed psychological phenomenon known as the Hawthorne Effect - the positive change in the behavior of subjects as a response to being observed. Once you have made a free account using basic information, you are presented with 20 cards on your computer screen. Consecutively, each card will represent a single mood, such as “inspired”, “distressed”, “active”, “hostile”, etc. Four options are available to classify your current state, they are: “very slightly or not at all”, “a little”, “extremely”, and “quite a bit”. After answering all 20 cards, a graph is charted to display the visual representation of your mood. Percentages for your “vital stats” are analyzed along with your daily score, and this information is then automatically emailed to personally selected friends. In 2012 an article published in Psychological Medicine assessed the effectiveness of Moodscope; investigators concluded that Moodscope may be a useful supplement for users already in therapy. Moodscope could also potentially become useful for health professionals to identify low-mood-causing influences and patterns.

Alternative: MoodPanda. MoodPanda allows users to measure their mood daily and share on social media sites using a mobile phone.

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feature

nail polish: the toxic-trio

by tiffany lin | design by karin yuen

left: jens utzt; right: simone andress/istockphoto; kasiam/istockphoto

total wellness ▪ spring 2013

Have you ever wondered what’s in your nail polish? The bright pinks, mint greens, and rusty oranges may be hiding chemicals that are harmful to your health. According to the Department of Toxic Substance Control (DTSC), the toxic-trio of dibutyl phthalate, toluene, and formaldehyde are the three most harmful chemicals found in nail polish. They are commonly linked to negative health effects. A lab study performed by California’s Environmental Protection Agency in 2011 found that these chemicals can often still be found in nail polishes, despite some manufacturers’ claims to have removed them. Read on to learn more about the purposes and effects of the toxic-trio in nail polishes, as well as for tips on how to limit the harm from these chemicals.

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formaldehyde

dibutyl phthalate (DBP) What is it? DBP is a colorless, oily liquid with a weak, aromatic odor. It is used to make flexible plastics and is a constituent in cosmetics and fragrances.

Purpose in Nail Polish: DBP is a plasticizer, an additive that contributes to the flexibility of nail polish by increasing the fluidity of the material; this prevents chips and cracks in the polish after it is dried. This chemical also acts as a solvent for pigments.

Health Effects: DBP is known to the state of California as a developmental toxin that disrupts function of the endocrine system. It can alter hormone levels or disrupt the way the body handles its response to hormones. Although it is still permissible in the U.S., the use of this substance in cosmetics has been banned in the European Union. According to a study in 2000 from Reproductive Toxicology, DBP can cause birth defects and reproductive problems in rats. Studies about the effects of DBP in humans are ongoing, but consumers should still be wary.

What is it? Formaldehyde was first used as a biological preservative. It is also used as a disinfectant, as well as in a wide variety of industrial products, such as wood and carpeting, as a bonding agent.

Purpose in Nail Polish: Formaldehyde is a nail hardener and helps products dry faster. It is not often found in nail polishes, but is commonly used in nail strengthening products or treatments.

Health effects: Formaldehyde is a known human carcinogen, a chemical that causes mutations that can lead to cancer. It is an irritant to the eyes, nose, and throat, and it can lead to skin irritation and allergic rash if exposed to the skin in high concentrations. Formaldehyde can cause respiratory problems and exacerbate these problems in people with asthma and/or other breathing issues.

toluene What is it? Toluene is mostly used as an additive to gasoline.

It is also used as a solvent in paints, fragrances, adhesives, and inks. It has the typical “paint thinner” odor, which can be detected in nail polishes.

Purpose in Nail Polish: In nail polishes, toluene is used to suspend the color and form a smooth finish across the nail.

It allows the color particles to be evenly distributed in the solution.

total wellness ▪ spring 2013

Health Effects: A study from 2004 in the Journal of Neuropathology and Experimental Neurology, suggested that long term inhalation of the neurotoxin toluene may result in tissue damage to the central nervous system; evidence of impairment in the brain can appear as early as after two years of toluene abuse. In cases of chronic abuse, this chemical can lead to more serious disorders, such as dementia. Effects of inhalation include headaches, dizziness, fatigue, and irritation of the upper respiratory system. In addition, toluene can cross through the placenta to reach a fetus, which may result in developmental defects.

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case study by DTSC

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Surprisingly, toluene and DBP were found in higher concentrations in the polishes with toxic free claims than in those without. The goal of this study was to address health and safety concerns for nail salon workers, who are exposed to these chemicals for prolonged periods of time. However, it also warns us as consumers to be wary of products that claim to be “three free” and to do thorough research before buying nail polishes.

In addition to this, there have been various other studies conducted on nail salon employees. The American Journal of Public Health published a study in 2011 in which personal air monitors were used to determine the concentrations of toxins in the work environment of nail salon workers. They found that the levels of chemicals in the air were higher than recommended to prevent headaches, irritations, and breathing problems, which are conditions often reported by workers in this industry.

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recommendations to limit the harmful effects of nail polish ❯ Look for true “three free” polishes. ❯ Bring your own “three free” nail polish to salons. ❯ Apply and remove polish in well-ventilated areas to minimize inhaling fumes. ❯ Limit use near children and pregnant women, who are more vulnerable to the negative effects. ❯ Try water-based polishes, which don’t give off fumes like solvent-based polishes. ❯ Avoid gel manicures, which contain chemicals that allow the polish to adhere to your nail for prolonged periods of time and require soaking your nails in acetone for 30 minutes for removal.

be on the lookout for safer cosmetics In recent years, major nail polish brands have been changing their formulas to eliminate the presence of toxic-trio chemicals due to increased pressure from Campaign for Safe Cosmetics, a campaign that started in 2002 by a coalition of public health, educational, environmental, and consumer groups trying to protect people from the health risks of chemicals in beauty products. To look up product safety before purchasing, you can use the Skin Deep Database by the Environmental Working Group, an environmental advocacy organization focused on human health and toxic chemicals. t w

left: studio21214 /istockphoto

In May 2011, the Department of Toxic Substance Control sampled 25 nail products for sale in the San Francisco Bay Area to determine the validity of the claims made by the manufacturers that some or all toxic-trio chemicals had been removed from their products. About half of these samples were nail polishes, and the other half was comprised of topcoats and basecoats. Out of the 25 samples, 12 claimed to be free of at least one toxic-trio chemical, and of these, seven claimed to be free of all three. The other 13 products made no claims regarding the toxic-trio. It was found that ten of the 12 products claiming to be toluene free actually did contain the chemical, and five of the seven “three free” products contained high levels of DBP, toluene, or both.

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decoding the nutrition label

MSG (monosodium glutamate) by chalisa prarasri | design by valerie fong

Have you ever wondered what all of the controversy surrounding MSG is about?

You may have heard that this mystery ingredient is used in many restaurants and packaged food items to enhance flavor. You may also have heard that MSG is associated with a complex of adverse reactions commonly known as “Chinese Restaurant Syndrome” and that it contributes to obesity. Read on to learn what MSG is, and find out what science has to say about the allegations against MSG.

up well by an article aptly named “Monosodium glutamate ‘allergy’: Menace or Myth?” published in 2009 by Clinical & Experimental Allergy. This article states: “Despite concerns raised by early [anecdotal] reports, decades of research have failed to demonstrate a clear and consistent relationship between MSG ingestion and the development of these [Chinese restaurant syndrome] conditions.” This conclusion is corroborated by review articles published in Food and Chemical Toxicology (1993), The Journal of Nutrition (2000), and the Journal of The American Academy of Nurse Practitioners (2006).

what is MSG?

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“chinese restaurant syndrome” In 1968, a man writing to the New England Journal of Medicine described a variety of symptoms that he claimed was caused by something he ate at a Chinese restaurant. He proposed that this complex of symptoms be called “Chinese Restaurant Syndrome”. Today, Chinese Restaurant Syndrome (a.k.a.

MSG symptom complex) describes some combination of headaches, palpitations, skin flushing, tightness of the chest (in people with asthma), nausea, drowsiness, and weakness.

Decades and many scientific studies later, reviews of the evidence accumulated regarding MSG symptom complex come to one fairly unanimous conclusion, which is summed

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MSG and obesity The evidence implicating MSG as a causative factor for obesity is controversial and not well supported with scientific research. In 2008, a study published by Obesity (Silver Spring) seemed to show that, among Chinese adults, MSG consumers were significantly more likely to be overweight than non-consumers. However, the following year, this same journal published a letter to the editor which presented evidence that contradicted these claims and noted that the study might contain design flaws. In 2010, The British Journal of Nutrition published a similar study with a larger sample size that found no evidence for a link between MSG consumption and obesity in Chinese adults. More confusion came in 2011 when The American Society for Nutrition published yet another article with a vastly larger sample size that implicated MSG in weight gain. To contradict this, a comment was published in the same journal, in the same year, arguing that the design and statistical methods of the study were not properly rigorous and noting that parts of the study were “unclear or questionable”.

The Food and Drug Administration has recognized MSG as a generally safe ingredient since 1959, for good reason. Decades’ worth of research has failed to find reliable, reproducible scientific evidence to implicate MSG as the “menace” many believe it to be. tw

left: doug cannell/istockphoto; right: beata becla/istockphoto

MSG is the most commonly known food additive source of glutamate, a form of the non-essential amino acid glutamic acid. Like other sources of glutamate such as hydrolysed vegetable protein, hydrolysed plant protein, hydrolysed soy protein, and autolysed yeast extract, MSG is used as a flavor enhancer in food. When in water, MSG and other glutamate sources release “free glutamate”, which activates distinct glutamate receptors on the tongue, causing the perception of “savory” or “umami”. Food additives only contribute a portion of the total free glutamate consumed, however. People ingest an average of about 1 g per day of “natural” glutamate from dietary sources such as tomatoes, meat, parmesan cheese, mushrooms, and soy sauce, with food additives contributing an additional 0.3 to 1 g. This makes sense because there exist savory foods that do not contain glutamate food additives.

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

athletic apparel: ineffective or advantageous?

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

patrol those moles!

Cameron Chesnut, MD, Chief Resident in Dermatology, David Geffen School of Medicine at UCLA

study techniques

Melissa Magaro, PhD, Clinical Psychologist, Affective Disorders Program Coordinator, UCLA Counseling and Psychological Services

when you get the nibbles: dips to pick (and skip)

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

Alona Zerlin, MS, RD, Dietitian II, Department of Medicine, Center for Human Nutrition

living air purifiers: improve indoor air with household plants!

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

nail polish: the toxic-trio

Alona Zerlin, MS, RD, Dietitian II, Department of Medicine, Center for Human Nutrition

Cameron Chesnut, MD, Chief Resident in Dermatology, David Geffen School of Medicine at UCLA

bmp: a panel of eight that tells your state: a guide to blood tests and what they can tell you

decoding the nutrition label

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

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

copy-edits and review

Julie Escobar, Chalisa Prarasri, & Shannon Wongvibulsin

layout revisions quantified self-movement: tracking your life to keep your life on track Elisa Terry, NSCA-CSCS FITWELL Services Program Director, UCLA Recreation

Barbara Wong, Shannon Wongvibulsin, and Karin Yuen

cover & table of contents

Designed by Barbara Wong & Karin Yuen

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total wellness ▪ spring 2013

the heat on red meat: a guide to red meat consumption and related risks

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