Healthier You Spring 2017

spring 2017

fraser health region

photo courtesy: Jennifer Speer

born to run Social connections, travelling, and fun all part of the love of running page 6

Stopping the scourge of fentanyl page 16

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contents

spring 2017

fraser health region

on the cover

Jennifer Speer celebrates her first ever trail race at the Loop the Lakes Race in Squamish. photo courtesy: Jennifer speer

www.glaciermedia.ca

Publisher

Alvin Brouwer director of advertising

Michelle Bhatti

manager of specialty publications

Keshav Sharma ksharma@glaciermedia.ca | 604-619-2933 creative director

Marina Rockey

contributing writers

Ian Jacques, Alison Taylor, Emily Stewart, Dr. Paul Martiquet

volume 3, number 1, spring 2017

6 10 14 16 18 19 20 21 22

Born to run Social connections, travelling, and fun all part of the love of running Alison Taylor breastfeeding–there's no single solution Province tops country in breastfeeding numbers; resources abound for mothers and babies in B.C. Alison Taylor Putting a halt to HPV Province doubling spending on HPV vaccine; Grade 6 boys to be offered vaccine for the first time in September Alison Taylor Stopping the scourge of fentanyl Use of synthetic opiod continues to be a growing health crisis Ian Jacques Helping kids kick the sugar habit Sugary drinks are not the best choice for good health Dr. Paul Martiquet toward intuitive eating The Food Exchange System Emily Stewart burnaby hospital foundation Agents of care for the community Ian Jacques eagle ridge hospital foundation Serving the hospital with the big heart Ian Jacques royal columbian hospital foundation Building on a tradition of care & support Ian Jacques

Published by glacier media. Copyright Š2017.

All rights reserved. Reproduction of articles permitted with credit.

Advertisements in this magazine are coordinated by Glacier Media. Glacier Media does not endorse products or services. Any errors, omissions or opinions found in this magazine should not be attributed to the publisher. The authors, the publisher and the collaborating organizations will not assume any responsibility for commercial loss due to business decisions made based on the information contained in this magazine. Speak with your doctor before acting on any health information contained in this magazine.

No part of this publication may be reproduced or transmitted without crediting Glacier Media. Printed in Canada. Please recycle.

fraser health region spring 2017

3

Tim Shoults Editor, Healthier You fraser Health Region

Time to get moving!

where can you find healthier you?

After a winter that felt like it might never end for B.C.’s South Coast, it feels good to get outside and enjoy the sunshine!

In doctors’ offices, walk-in clinics, pharmacies and other community settings, we will be waiting there, too – keeping you company, and sharing stories and insight into healthrelated issues that matter to you.

Wherever you live in this beautiful region of ours, healthy and active living is right at your feet — and it starts by getting them moving.

That’s why we’re dedicating this edition’s cover to the love of running.

Of all the activities that can do you good, it’s the most accessible to all.

There’s no membership to buy, no specialized equipment beyond a pair of comfortable shoes, and it can be done from literally anywhere you are.

That said, there are plenty of ways to make it a social activity as well, from joining a local run club or clinic to participating in one of the many community-based run events across the Lower Mainland, Sunshine Coast, Sea to Sky Country and Fraser Valley this spring and summer.

While the runners and organizers featured in “Born To Run” are veterans of the scene, don’t let that stop you.

The journey to a better you begins with just one simple step — and then the next one.

I remember one particularly passionate run club leader telling me once: The hardest part of running is showing up.

4

spring 2017 fraser health region

Every single step you take after that gets easier — and the rest of your day after a run gets better. You feel more refreshed, more alert and simply happier in every way.

See you on the trail, at the Sun Run or just on the street this spring!

••• This edition of Healthier You also shines a spotlight on the resources available to new mothers when it comes to breastfeeding — and no, it’s not about forcing a “breast is best” doctrinaire approach. We take a look inside the continuing fentanyl crisis in B.C., check out the efforts being made to expand HPV prevention efforts to Grade 6 boys in B.C. this fall, offer you some exercises to promote relaxation, look at ways to help your kids kick the habit of sugary snacks, and help you find a path towards more “Intuitive Eating”.

As ever, we’d love to hear from you about what a Healthier You means for you and your family. Send us your thoughts, comments, questions or ideas for stories in future editions by email to tshoults@glaciermedia.ca.

Have a healthy and happy spring!

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Born

Social connections, travelling, and fun all part of the love of running

Alison Taylor contributing writer

“For 2017, my goal is to not register for a race!” says 25-time marathon runner Jenn Black.

“It’s been super hard and there have been many times where my fingers have been twitching on the keyboard and I just made myself back away.”

This is the first time since 1997 that Black hasn’t been running with a clear goal in mind.

“I always had a race on the horizon my whole running career,” she says.

It’s nice, she adds, just to be running for the love of running.

Black began running when she was 26 years old — a boyfriend broke her heart and she decided to stop being an “out of shape victim on the couch.”

She ran her first marathon a year and a half later, training with a running group at the YMCA in Vancouver, and she hasn’t stopped. Running has helped her navigate some of her darkest times in life. It has made her feel strong, and be strong.

But more than that, it has been the people she has met along the way.

Whistler runner Jennifer Speer on the Valley Trail that runs through Whistler. photo: david buzzard, www.media-centre.ca

6

spring 2017 fraser health region

“I just fell I love,” she said of running. “And I fell in love with it because of the community around it.”

to run That running community has grown by leaps and bounds in the last few decades.

Olympic marathon Carey Nelson, who ran for Canada in the 1996 Atlanta Games, has been putting on run clinics for decades with Forerunners. The store first opened in 1986, one of the first in Vancouver to offer running clinics.

“More people are running, the events are bigger, so there’s more participACTION,” says Nelson, using the buzz word from the 1970s when the government launched the national non-profit of the same name to promote healthy living and physical fitness.

Forerunners follows the three run per week program to train people for full and half marathons — one long run, one speed work out and one race-pace tempo work out.

“It gets you to the start line and gets you to the finish line and maybe even gets you the time you want,” says Nelson, of the training program.

Forerunners will be opening a new store on Main Street this spring.

It will offer a “Learn to Run 5 km Clinic,” recognizing this one of the fastest growing events in the running community.

“You don’t have to run a marathon; if you run a 5 km that’s a good achievement as well,” says Nelson.

Lara Penno, manager of runner services & RUNVAN Ambassador Program for the Vancouver International Marathon Society, sees the growth in the shorter race distances first hand.

The BMO Vancouver Marathon now has six different events, including an 8 km run and 5 k run.

In 2015, it also added a marathon relay. Those changes are reflected in the weekly training sessions at the RUNVAN Club.

“We have various pace groups so no one is left behind,” says Penno. “The club started two and a half years ago and has about 20 to 30 runners out each week.”

This is just one of the running clubs she involved with in Vancouver.

Penno has also overseen another club called “The Right Shoe” for about 15 years.

Whistler runner Jennifer Speer with her medals from the races she's run. photo: David Buzzard

“We used to call it a run clinic,” she says. “I changed it to call it a run club because it really spoke better to how we operated year round.”

There is a huge social component to the club — the brunches after long Sunday runs, the pub nights a handful of times each year, and the friendships forged on the road.“Everyone really enjoys that,” she says. “They like that community. I’ve seen my run club itself become richer as a result continued on page 8

fraser health region spring 2017

7

continued from page 7

of that and relationships have deepened. People have stayed in the run club longer because of that social component.”

Dave Clark, founder of the Whistler Half Marathon, has seen the running community in Whistler flourish of late due in no small part to his event, now in its seventh year.

“We didn’t really think about how this event would impact the community as far as healthy living goes until after the first GranFondo,” says Clark, referring to the annual road race from Vancouver Whistler runner to Whistler, Jennifer Speer with which had a her medals from the races she's run. hand in the photo: David Buzzard explosion of

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“As soon as that registered with me it was like ‘That’s what I want to do here,’” he says.

"...they feel like they’re part of something.” dave clark The Whistler Half Marathon is tracking 10 per cent ahead of last year’s participants, on target to host 2,000 runners in June, up from the 800 people who registered that first year. It has come a long way in a few short years. You can tell when the Whistler Half is fast approaching by the number of runners out on the Valley Trail.

Like one-third of the participants in the BMO Vancouver Marathon who come from other countries, Whistler is also a destination event for some of the participants, who travel to the ski resort specifically to run.

Clark says there is so much more conversation about the experience of running than there has ever been before and that goes a long way in getting someone to put on their shoes and get out on those cold and rainy days.

“When we have those conversations it drives us to continue or to push harder or to increase our distance or to run a little faster or just get out the door,” says Clark. “People get inspired by it and excited about it and they feel like they’re part of something.”

Jenn Black has travelled the world running — the London Marathon, New York Marathon, Paris Marathon.

Over the years, her own personal running community has been there along the way as she met her husband, had two children.

They’ve helped each other through illnesses and the loss of parents.

On those long four-hour training runs, conversations can get gritty and real.

“It’s very safe territory,” she says. “We come from such varied backgrounds and different family set ups and different work choices but we have this common love of running.”

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breastfeeding There’s no single solution

Province tops country in breastfeeding numbers; resources abound for mothers and babies in B.C. Alison Taylor contributing writer

was quietly nursing Oliver in a small, private room at the centre.

Seventeen-day-old Oliver has had trouble gaining weight in his first two and half weeks of life.

“When you’re home and breastfeeding, it’s so isolating when you’re struggling,” she says.

It’s been a whirlwind worrying time for his parents.

They took him to see their family doctor, who recommended supplementing with formula; next they visited a lactation consultant who noticed Olivier was tongue tied; then they had surgery to fix that problem.

“So these resources, especially these clinics, are just like gold.”

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spring 2017 fraser health region

The Vancouver Breastfeeding Centre Dr. Verity Livingstone started the Vancouver Breastfeeding Centre more than 30 years ago after the birth of her son. At the time she was on faculty at UBC and her original research area focused on how women returned to work and combined breastfeeding. continued on page 12

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“I became quite interested in the way that different women managed to do this, and in my interest, my eyes were open to the breadth of what breastfeeding medicine could encompass and how little we had been taught in medical school and how much need there was,” she recalls.

“I think we all recognized that were were promoting the wonders of breastfeeding. Mothers were running into difficulties and nobody knew anything about it so we thought ‘Well, we better start and educate ourselves and see if we can offer our service to moms that needed it.”

Dr. Verity Livingstone, of the Vancouver Breastfeeding Centre at UBC, with new mother Agnieszka Kurowska and her eight week old son Jamie. photo: David Buzzard

She’s seen mother/ baby pairs like Margaret and Oliver thousands of times over. There are so many factors that can play a role in breastfeeding challenges.

Remember, says Livingstone, there are two patients to consider. Babies may be tongue tied or have a cleft palette, they may be premature or have small mouths, they may be twins. Mothers may have had breast augmentation surgery, or nipple piercings, they may have mastitis, or something else may be interfering with the production of their milk.

Livingstone’s challenge is to get to the underlying root of the problem.

“Breastfeeding is a learned skill,” she adds. “Suckling, which is what the babies do, is instinctive. But a mother doesn’t know how to breastfeed... She has to basically be taught.”

For some it comes easily: A few pointers in the hospital after birth and they’re ready to go. For others, is can be a long, hard, often painful journey, fraught with angst and feelings of failure.

12

spring 2017 fraser health region

Livingstone is one of five family physicians at the centre with a special interest in breastfeeding.

“We are what is known as as a rapid access clinic,” says Livingstone, of the centre which is a medical referral clinic. “I’ve decided that breastfeeding issues are considered emergency and that we must see these mothers and babies as quickly as possible.”

Many are like Margaret and Oliver, who were at their doctor’s office at 10 in the morning, referred to the centre, and calmly nursing at the Vancouver Breastfeeding Centre two hours later.

“He’s doing better,” says Margaret. “We got some tips here. It really builds your confidence.”

The stats — B.C. tops country in breastfeeding The World Health Organization (WHO) recommends exclusive breastfeeding to begin within one hour after birth until six months of age. Nutritious complementary foods should then be added while continuing to breastfeed up to two years and beyond. Breastmilk provides nutrients to help the baby grow and antibodies to protect the baby from infections and diseases.

In Canada, 89 per cent of mothers initiate breastfeeding soon after birth, according to the 201112 statistics from Statistics Canada. That number rises to 96 per cent in B.C. Mothers in B.C. also had the highest rate of breastfeeding exclusively for six months or more.

While most provinces saw increases in this area from the previous decade, B.C. also had the largest increase from 28 per cent in 2003 to 41 per cent in 2011.

“We’re the best because I think we’ve focused on it for so long and we’ve got community resources,” says Livingstone.

The Vancouver Breastfeeding Centre is just one resource. Among other things, the public health nurses can provide support, there are breastfeeding clinics, lactation consultants, and La Leche League groups.

There is help.

And yet, Statistics Canada shows that across the country 26 per cent of women breastfeed for six months or more. While that’s up from 17 per cent the previous decade, it’s still just one quarter of the population following the WHO recommendations.

B.C. again leads the charge in this area with 41 per cent breastfeeding for six months or more, up from 28 per cent the previous decade.

Among mothers who breastfed for less than six months, about 44 per cent stopped because they felt they had insufficient breast milk, while 18 per cent said they have difficulty with breastfeeding technique.

Margaret, like so many mothers, really wants to breastfeed Oliver.

But with all the difficulties throughout the first two and half weeks of his life, she was getting “to the point where I don’t want to do formula but I’m considering it.”

“There’s so much ‘breast is best’ and I totally believe in breastfeeding and breast milk, but I think for many women, we feel guilty for doing formula or anything else than breast milk and... that can be hard,” she says.

Livingstone is clear however that there is not a “one size fits all” solution. Each mother/baby pair is unique.

Part of the process at the Vancouver Breastfeeding Centre is to inform mothers and help them explore their own beliefs and attitudes towards breastfeeding, help lay to rest any misconceptions and then help give them the skills to do what they choose to do.

“We’re not making mothers breastfeed,” says Livingstone. “What we’re trying to do is make sure babies are fed the best way possible and help the mothers do what it is they’re trying to do.

“Vancouver is getting better and better in having resources available. That’s the important thing. We’ve recognized there’s a problem and we’re now trying to meet the needs.”

w w w. b h f o u n d a t i o n . c a

Putting a halt to

HPV

Province doubling spending on HPV vaccine; Grade 6 boys to be offered vaccine for the first time in September Alison Taylor Contributing Writer

The province of British Columbia has committed an extra $2.2 million in 2017 as it expands its human papillomavirus (HPV) vaccination program to Grade 6 boys for the first time ever.

“Cancer is costly,” says Stacey Berisavac, manager of health promotion for the Canadian Cancer Society, BC and Yukon Division, as it can lead to serious forms of cancers.

In 2016, the province spent $2.2 million on the vaccine for girls. According to the B.C. Ministry of Health, approximately the same amount is budgeted for Grade 6 boys, who will be offered the vaccine in school this September. That brings the total cost of the HPV vaccination program to $4.4 million annually, as part of B.C.’s publicly funded immunization program.

HPV is one of the most common sexually transmitted infections. It is estimated that about 75 per cent of sexually active men and women will have at least one HPV infection in their lifetime. It is a group of more than 100 different types of viruses and more than 40 of those are transmitted through sexual intercourse, genital skin-to-skin contact and oral sex. High-risk HPV can cause infected cells to change or become abnormal or precancerous.

And that is money well spent, according to the Canadian Cancer Society, one of about 25 stakeholders who lobbied for the change for boys in B.C.

“Some of them can lead to serious cancers: anal, penal, mouth, cervical, vagina, vulva, mouth and throat,” adds Berisavac.

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“The Canadian Cancer Society sees that providing the HPV vaccine to all genders now through a schoolbased program is a significant positive move in public health policy... It will have an enormous impact in reducing the future of HPV related cancers in all genders now.”

At the time of the announcement to extend the program to boys, Health Minister Terry Lake said: “The HPV vaccine is most effective when administered before a child is first exposed to the virus and will help protect them from HPV-related cancers and other serious health problems.”

The province also hopes to promote herd immunity by extending the coverage to boys; herd immunity occurs when enough people have immunity through vaccination or previous exposure which then prevents the spread of the disease.

According to statistics from the BC Centre for Disease Control, 70.3 per cent of Grade 9 female students were up to date with HPV immunizations in 2015.

Vancouver Coastal Health — covering Richmond, Vancouver and the North Shore/Coast Garibaldi — was at 76.7 per cent. The Fraser Health Authority was at 64.2 per cent, although some schools were not

represented in that number. Those numbers needs to be higher for herd immunity to work.

It is not clear why immunization coverage rates have not reached levels originally projected. Berisavac says there is misunderstanding and misinformation in the community. People, she adds, should go to their trusted sources of information and make decisions that are factbased and not fear-based.

“We are that source that people should definitely look at,” she adds of the Canadian Cancer Society.

The vaccine, which will be used in this program, is called Gardasil 9. It will be administered in two doses, given at least six months apart.

“Vaccine safety monitoring continues to show the safety of the HPV immunization” said Dr. Perry Kendall, B.C.’s provincial health officer. “It’s just as effective in preventing HPV-related cancers in males as it is in females, and the benefits are long lasting.”

The decision to provide the vaccine to Grade 6 boys is also seen as evening the playing field.

“The HPV virus does not discriminate based on gender,” says Berisavac.

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Stopping the scourge of fentanyl Use of synthetic opiod continues to be a growing health crisis Ian Jacques Contributing Writer

Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine, but is 50 to 100 times more potent. It’s a silent killer that does not discriminate between age, gender or race.

Since April 2016, Fentanyl has been responsible for thousands of deaths across the province.

Health authorities, including Vancouver Coastal Health and Fraser Health, along with municipal, provincial and federal governments, paramedics, police and firefighters, have worked literally around the clock to bring awareness to this health crisis.

Many programs and initiatives and funding has been put towards this crisis, but the numbers of people dying due to drugs being mixed with this deadly cocktail continues to alarm.

The number of illicit drug deaths in B.C. did decrease slightly in February — the second month in a 16

row — but it is still far higher than for the same period last year.

Provisional data from the BC Coroners Service showed that a total of 102 persons died as a result of illicit drug use during the month of February, an average of more than seven deaths every two days. In contrast, there were 59 illicit drug-related deaths in February 2016.

Individuals aged 30 to 39 and 40 to 49 years have accounted for the largest percentage of illicit drug overdose deaths during the first two months of 2017.

Consistent with last year's data, males accounted for 83.1 per cent of these suspected illicit drug overdose deaths.

Chief coroner Lisa Lapointe continued to urge extreme vigilance by those using illicit substances.

“While I'm very relieved to see that the numbers have not continued to increase over the last two months, we are still losing cherished members of our communities at a terrible rate,” said Lapointe.

“People are dying in far higher numbers than we've ever seen, and a slight decrease in fatalities from the previous month should not be seen as any indication that the risk has decreased.”

spring 2017 fraser health region

Lapointe also noted that 89 per cent of illicit drug overdose deaths occurred inside (the majority in private residences) and that there have been no deaths at a supervised consumption or drug overdose prevention site.

“This is evidence that these sites are saving lives. People need to be encouraged to visit these sites as the majority of deaths are occurring when people use illicit substances without medical attention or assistance nearby,” she said.

The Province is providing approximately $13 million to health authorities to help ease financial pressures resulting from the actions taken to respond to the overdose crisis over the past year. This includes costs related to overdose prevention sites, preparing for additional supervised consumption services, enhanced surveillance, and expanding opioid substitution treatments.

The BC Centre on Substance Use hosted 20 training events with more than 1,000 health care providers on how best to treat patients who have an opioid addiction.

More than 20 overdose prevention sites across the province have had more than 66,000 visits and reversed more than 480 overdoses, with zero deaths.

The province's Mobile Medical Unit stationed in the Downtown

Eastside has treated more than 2,100 patients, since December of last year, including more than 500 patients for overdose, relieving pressure on local emergency departments and paramedics and providing patients with quick, easy access to opioid substitution therapy such as Suboxone.

The RCMP and municipal police departments have used naloxone in nearly 100 overdose reversals since the beginning of the program.

In February, mayors of Canada's largest cities and federal cabinet ministers pledged to work together on the overdose crises.

This collaboration led to a number of initiatives to target this crisis.

The Ministry of Health distributed guidelines to providers of supportive housing and homeless shelters to help guide them in the preventative actions they can take to reduce overdose fatalities in their facilities: The Michael Smith Foundation for Health Research issued an RFP as part of its work to support B.C.'s Joint Task Force on Overdose Prevention and Response with an ongoing evaluation of the province's response to the opioid overdose crisis. The first phase of

Health is where we live, learn, work and play.

For further details, please contact Keshav Sharma, Manager of Specialty Projects at 604-619-2933 or ksharma@glaciermedia.ca extending your reach with

this work includes a review of how other jurisdictions have responded to opioid overdose deaths — particularly those jurisdictions that have experienced fentanyl.

“We must continue to work together as a health and publicsafety system, as a province and as a society to do everything in our power to prevent as many of these deaths as we can,” said Health Minister Terry Lake. “The overdose crisis is taking a great toll on the families and frontline workers who are directly affected.

We will continue to do everything we can here in B.C to combat this crisis.”

Helping kids kick the

sugar habit

Sugary drinks are not the best choice for good health Dr. Paul Martiquet Medical Health Officer, Sunshine Coast/Powell River

How many cubes of sugar are in a large (1 litre) slushy drink? If you guessed 24 cubes, you’re right.

If you think that’s much too large a serving, just watch kids coming out of the corner convenience store and see how often they’re carrying a giant drink.

Sip Smart! BC Program Sip Smart! BC was created to help educate kids and families about consuming sugary drinks.

The program, originally tested in 2008 with grade 4 students in 20 schools around BC, has been updated by a partnership of the BC Pediatric Society and the BC Government and funded by Provincial Health Authorities. Sip Smart! BC is being rolled out now for students in grades 4, 5 and 6.

Water is the best choice Most sugary drinks provide little or no nutrition, they are a poor option against healthy drinks like water and plain milk. Need to satisfy a thirst? Water is the best choice and is a sugar-free way to stay hydrated, energized and alert.

Most purchased drinks contain added sugar Sugary drinks abound in store coolers everywhere. They include

18

the usual and obvious like pop or slushies, but also sitting on the shelf are ‘fruit punch’ and ‘you-name-it-ade’. In fact, almost anything that is not labelled 100% fruit juice will contain added sugar, and maybe little or no juice!

Sports and energy drinks and even flavoured waters are all culprits containing added sugar.

...almost anything that is not labelled 100% fruit juice will contain added sugar...

4 grams = 1 sugar cube But how much sugar are we talking about? To find out, read the ingredients label and for every four grams of sugar, count a teaspoon, or one sugar cube. That means the average can of pop contains 10 cubes’ worth (40 grams) of sugar! Bubble tea? 21 cubes in a 500 ml serving.

Family resources While the Sip Smart! BC program provides information for teachers in the classroom, it also has materials for families to use at

spring 2017 fraser health region

home. Even if your child does not receive instruction at school, the parents’ handbook is a rich source of information. All materials are available online via the Sip Smart!

BC website.

Classroom resources for teachers The program’s handbook for teachers is available online along with multiple supporting handouts, overheads and other classroom materials. There are fact sheets, lesson plans and handouts, indeed, everything you might need to teach kids about drinking sugar.

The first lesson in the program, called ‘Drink Detective’ is a delightful introduction to the subject. It provides three activities starting with ‘Sugar Shocker’ and is followed by ‘Drink Check’ and ‘Drink Diary.’ Other lessons build on this opening by discussing how to use Canada’s Food Guide, how water is most beneficial, and how it’s not just sugar we should watch for in our drinks.

The goal of the Sip Smart!BC program is to help kids make healthy choices. Specifically, that “when kids are thirsty, they reach for healthy thirst-quenchers.

Sugary drinks are everywhere, but healthy drink choices are better for a child’s health.”

Toward

Intuitive Eating

The Food Exchange System Emily Stewart contributing writer

While 1960’s-era unabashed undereating is now clinically recognized as being harmful to health, today’s media is still obsessed with dieting. One day carb-free diets are all the rage; the next, vegetarianism. As their clients fluctuate between diets and weights, more nutritionists are advising a surprisingly obvious eating plan: Intuitive Eating.

According to Evelyn Tribole (M.S., R.D.) and Elyse Resch (M.S., R.D., F.A.D.A.), intuitive eating banishes the idea of “good food”, “bad food”, and any food limitations.

“The more you go to external sources to ‘judge’ if your eating is in check, the further removed you become from intuitive eating.”

These nutritionists believe that our diet-obsessed culture has limited our awareness of biological hunger cues.

By continuously restricting certain foods, we swing between periods of feast and famine. To combat this (and diet-associated weight changes), we must accept, listen to, and honour our perfectly normal eating desires.

Whether or not they realize it, most people decide what to eat based on socially accepted rules: eat cake on your birthday; do not eat after 7 p.m.; chicken is better than beef. These rules cause most people to think about their food choices, rather than feel them.

After so many years following food rules, many people cannot discern food hunger cues, control portions and eat without guilt. The process for returning to truly intuitive eating is not easy. Hence the reason many nutritionists employ the Food Exchange System as a stepping stone.

The Food Exchange System was first used to ensure adequate nutrition and insulin regulation within diabetic populations. The system makes choosing balanced meal items easy in any situation. All food is analysed as a ratio of proteins, fats, and carbohydrates (macronutrients). Then, foods are categorised into

exchange groups: starches, fats and meat/ meat substitutes. The ratio of one macronutrient to another determines which of the food exchange groups that items belongs to. So bread is a starch and olives are a fat, although both bread and olives contain carbohydrates and fats.

Each item on the list is approximately equal to the others in calories. The items can be substituted in meal planning. For instance, ½ cup of breakfast cereal is nutritionally equal to 1/3 cup of cooked rice, or one cup of canned pumpkin. There are subgroups like milk products and combination foods. Combination foods comprise multiple categories. For instance, casseroles equate to two starches and two meats per serving.

To begin, an individual Food Exchange eating plan is assigned by a registered dietician, who evaluates a client’s goals and health. Then, one can begin to explore unique food combinations to achieve their nutritional daily requirement of food exchanges.

There is no “bad” food. If your meal requirement is two starches and two fats, then you’re welcome to eat a slice of cake. Or, you can eat olive tapenade bruschetta for the same exchange. By controlling portions based on macronutrient values, there is less temptation to overeat or to skip meals, and a more enjoyable eating experience. While the Food Exchange system isn’t a completely intuitive way of eating, it does manage portion control, detract food rules and sustain a healthy body.

As Tribole and Resch state, “Making peace with food means allowing all foods into your eating world, so that a choice for chocolate becomes emotionally equal to the choice for a peach.” The idea that we can actually allow ourselves to eat whatever we want is the antithesis of dieting. “When you know the food will be there and allowed, day after day, it doesn’t become too important to have it,” says Intuitive Eating. “Food loses its power.” And, you gain yours!

Quotes from this article are sourced from Intuitive Eating: A Revolutionary Program that Works by Evelyn Tribole (M.S., R.D.) and Elyse Resch (M.S., R.D., F.A.D.A.) For information on the Food Exchange System, see the Eating Exchange Booklet at Summit Nutrition: www.summitnutrition.us/resources/ ED-exchange.pdf fraser health region spring 2017

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burnaby hospital foundation Agents of care for the community Ian Jacques Contributing Writer

The Burnaby Hospital Foundation is the fundraising arm of Burnaby Hospital dedicated to community partnerships to purchase vital medical equipment and technology, improve patient care, and support innovative and educational community programs.

The Foundation prides itself on being the agents of care for the hospital.

A community hospital is an essential resource for everyone living in its surrounding neighbourhoods.

The hospital's role is important to the health and wellbeing of every family and is pivotal to the vibrancy of the community.

generations that will help maintain the vibrancy of the entire community.”

There is not a hospital in B.C. that is fully governmentfunded. Hospitals are expensive to operate, but crucial for medically necessary services.

Donations fund approximately 47 per cent of the cost of Burnaby Hospital's new medical equipment. In fact, since 2002 Foundation donors have given close to $19 million to purchase new equipment, and that doesn't include the dollars raised for clinical education, hospital programs or community-wellness initiatives, which also rely on donations to exist.

“I think people are really starting to think about these things now as the conversation focuses on the range of things that goes into good health care,” she said.

“Hospitals are not the only answer, and in order to operate facilities and manage a growing population, we need to think of new ways to do things.”

Over the last several years, the Foundation has been building its community health and wellness fund, which has now surpassed half a million dollars.

“It’s an effort that the community at-large is increasingly excited about as the public becomes more aware of the discussion around sustainable health care and serving diverse populations with a variety of needs,” adds Becir.

“The Burnaby Hospital Foundation connects people to what matters to them, whether that’s going home to their family after an illness or injury, or helping them find a focus Photo submitted for their charitable interests,” said Foundation president and CEO Cheryl Becir. “We bridge the gap between what government provides and what our community needs, but more than that, we believe our role goes beyond raising awareness and funds.

Dr. Warner proudly stands beside some of the equipment that generous donors have helped purchase through their donations to the Burnaby Hospital Foundation.

“Our purpose is to ensure that Burnaby Hospital is equipped in every way to advance the health of all

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The Foundation has been instrumental in raising funds for a $4.85-million MRI suite, and a new endoscopy unit, which was more than $600,000.

“Those projects came together in part from large donations from individual donors, but they also happen because of all the individual donations that people send — every single dollar makes a difference,” she said. “We have people who donate $10, $20, kids who bring in their piggy bank money and it is so rewarding to see that add up and make such a huge impact here for us.”

The Foundation has been raising money for equipment, education and technology since 1982.

“We really have been built on the partnerships with people in our community,” she added.

eagle ridge hospital foundation Serving the hospital with the big heart Ian Jacques Contributing Writer

From the moment Eagle Ridge Hospital (ERH) opened its doors 33 years ago, it has provided the community with timely, compassionate, quality health care in an environment that is constantly described as welcoming, special and conducive to healing.

ERH is situated within the City of Port Moody and serves five communities comprising the Tri-Cities (Port Moody, Coquitlam, and Port Coquitlam), Anmore and Belcarra.

“Our expert, dedicated staff consistently goes above and beyond the call of duty to help patients and their families navigate urgent and emergent medical needs ranging from lifesaving diagnosis and injuries to living with cancer,” said Eagle Ridge Hospital Foundation executive director Charlene Giovannetti-King. “Eagle Ridge Hospital is truly at the heart of our community.

When ERH was built in 1984 it served a population of 120,000. Today that population has grown to more than 226,000. And with the draw of more affordable housing and expansion of public transportation, the community is expected to grow to more than 320,000 residents within the next 20 years.

mission is to enhance the delivery of health care services to the community through philanthropy and advocacy. The Foundation has been supporting the acute care site and health care services in the TriCities area since that time and has raised more than $24 million.

“The philanthropic gifts of our donors both transform the services offered at ERH and impact the health of all the residents of the Tri-Cities Communities,” Giovannetti-King said. “On average Eagle Ridge Hospital Foundation purchases between 60 to 70 percent of the new equipment ordered annually for the ERH. That is an outstanding impact on a hospital the size of ERH.” A significant milestone project for the Foundation was the recent purchase of a Spy Medical Imaging Camera. This camera enables surgeons to work collaboratively to perform a mastectomy and reconstruct the breast in one surgery.

The emergency department opened in 1988 and was built to serve 20,000 patients annually. Today that number has grown to almost 52,000 patients — 20 per cent of which are children.

“With demands for enhanced services at the hospital coupled with unprecedented growth in the area, we must continually evolve to meet the emerging health care needs of the region so that residents can continue to receive the care they need and deserve in their own community,” she said. “The hospital and its partner, Eagle Ridge Hospital Foundation, have an unwavering focus to transform the hospital strategically and thoughtfully to a fully functioning community hospital. Eagle Ridge Hospital Foundation is working with ERH to plan the next leap in this direction with the expansion of the emergency department that, should the project be approved would benefit thousands of patients throughout the region.”

The Foundation began raising money for the hospital in 1982, two years before the hospital opened. Its

Donors can support Eagle Nurses at Eagle Ridge Hospital say thanks to the Eagle Ridge Ridge Hospital Foundation Hospital Foundation for their by www.erhf.ca/donate. efforts in raising funds for Gifts large and small are much-needed medical equipment welcomed and can be to allow the hospital to provide quality care to its patients. directed to the Foundation photo: Snap’d Tri-Cities through gifts to one of their direct mail campaigns, make a major gift to buy a piece of equipment, sponsoring a rider in the annual Wheel to Heal event or paying it forward with a gift in their will. fraser health region spring 2017

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royal columbian hospital foundation Building on a tradition of care & support Ian Jacques Contributing Writer

Building on a strong tradition of caring and community support, the Royal Columbian Hospital Foundation was established in 1978 to raise funds for the hospital’s first CT Scanner.

Fast forward to today the Foundation is one of the largest in the province serving a hospital that a third of British Columbians rely on for critical care.

The New Westminster hospital is the only one in the province with trauma, cardiac, neurosciences, highrisk maternity and neonatal intensive care on one site.

Norris said the Foundation focuses on four priority areas: equipment, patient care, research and education.

“Health care is constantly evolving, and the pace of technological innovation is rapid,” he said. “Donors to the Foundation can help the hospital stay ahead of these changes. By funding new technologies or supporting compelling research, donors to the Foundation can make a lasting difference and help the hospital with its needs sooner than would otherwise be possible.”

A major redevelopment of the hospital is in the works and the Foundation is supporting Fraser Health’s multi-year, multi-phase vision for the project.

“This project provides unique opportunities to make deep, direct and long-lasting impacts on patient outcomes and the quality of care,” he said. “We have committed to working with donors to support the various phases of redevelopment.” Construction is starting on a new building for patients who need mental health care. The Foundation will raise $9.1 million dollars in support of this much-needed facility.

Their most recent fundraising campaign helped support critical care for those who have suffered heart attacks or cardiac arrest.

Donors to Royal Columbian Hospital Foundation have recently helped to bring the latest imaging and monitoring technology to the hospital’s cardiac catheterization lab, where patients from throughout the health region are rushed for emergency care after suffering heart attacks or cardiac arrest.

It only stands to reason that because of vast services that the hospital provides, it is critical to have a Foundation that is committed to raising money to help the hospital save lives, restore health and provide comfort to seriously injured and ill patients of all ages.

“Philanthropy in health care goes back a long time. For Royal Columbian Hospital, it dates back to even before Canada existed as a country,” said Foundation president and CEO Jeff Norris. “Donors helped fund construction of the hospital in time for its original opening in 1862.”

Photo submitted

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The $3.3 million cath lab upgrade allows our interventional cardiology team to continue to provide exceptional care, added Norris.

Norris said there are many worthwhile causes, and they are always grateful when a donor chooses to support their Foundation.

“Royal Columbian has a unique role in the province as the only centre in B.C. with trauma, cardiac, neurosciences, high-risk maternity and neonatal care all on one site,” Norris said. “No other hospital in B.C. delivers this range of services at this high level of care. Through their generosity, donors to the Foundation are truly helping save the lives of family, friends, neighbours and colleagues.”

The Foundation welcomes donations online at www. rchfoundation.com, by phone at 604-520-4438 or in person by visiting their office on the main floor of the hospital’s Health Care Centre building.

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