FITNESS
TECHNOLOGY
NUTRITION
MEDICAL
FAMILY Fall 2015
the doctor is in Dr. Martin Senicki with Wilson Regional Orthopedics talks sports injuries and how to help prevent them
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contents FITNESS
4 SWEAT IT OUT Change up your workout routine to help reach your goals faster 6 DOES IT WORK? Ask these questions to find out of the office wellness group is right for you 8 MAKE TIME Busy schedules don’t always allow for working out and eating healthy
TECHNOLOGY
10 BETTER HABITS Wearable devices are all the rage but are they the right option for you? 12 A DECEPTIVE HEALTH WEB Don’t believe everything you read online
FEATURE 14 THE DOCTOR IS IN Protecting yourself from sports injuries is crucial
the doctor is in Dr. Martin Senicki with Wilson Regional Orthopedics talks sports injuries and how to help prevent them
14
NUTRITION 18 THE GREAT VEGGIE-STARCH SWAP Out with the starches and in with the veggies! 20 EATING BETTER Letting kids explore their food can pave the way for less picky eating
MEDICAL 22 PUT YOUR HEART TO THE TEST Simple tests and measurements can easily gauge the health of your heart 24 PUFF NO MORE Quitting isn’t easy, but it’s necessary to maintain your health
FAMILY 28 ITCHY SITUATION The dreaded “L” word is back. Here’s how to be prepared 30 IT TAKES A VILLAGE Work together as a family to form healthier habits 32 BRINGING UP BABY Being a parent isn’t easy. Here are some tips to help ease your worries
Even if you’re a gym pro, you’re
probably looking for new ways to maximize that sweat time or keep the exercise excitement alive. With “52 Brilliant Ideas to Pump
Up Your Workout” (Penguin, 2008), author Steve Shipside offers, you guessed it, 52 ways to fend off boredom and boost results. Here are a few examples:
On the rowing machine: If you’re starting to get this down, then it’s time to throw down the gauntlet to others. Try pitting yourself against times recorded online.
sweat it out! Elevate your workouts for better, faster results
WILSON WELLNESS
By Jessica Abels CTW Features
4
Changing up your workout can reinvent your exercise goals. Here are a few ideas to help get you started.
FITNESS See how you rate against other people around the world and try to improve. Or take part in a rowing marathon. On the stepper: Most people looking to push themselves simply up the resistance, but here’s another approach. With the resistance fairly low, try pumping the steps faster, running, or pedaling on the spot. Imagine a world in which Tour de France riders compete on unicycles and you are now
sprinting against the world’s best for the title of King of the Mountains. Now watch those calories burn off. Stretching: The three-way stretch is so called because it stretches your back, arms, and hamstring all in one. Sit on the floor with one leg straight out in front of you. Bend the other leg, pulling your ankle as far up into your groin as you can with the sole of your foot resting on the
upper thigh of the other leg. Now with both hands reach down the straight leg as far as you can. If you can reach your toes, then hold them; if not, don’t strain yourself. Try not to tense the straight leg. You should feel the stretch right across your back and down the back of your leg (hamstring). Hold for 30 seconds, gently release, and switch legs. © CTW Features
Your employer may be offering a variety of wellness programs, such as weight loss, smoking cessation, stress management and other similar interventions for employees. Cash or other incentives may be dangled to encourage your participation. Are these programs effective? “Some work, some don’t, some work for a short time,” says Thomas Lenz, director of the Healthy Lifestyle Management Program, Creighton University, Omaha, Nebraska. A company may measure success by how well a program benefits its insurance rates or reduces employee sick days.
does it work? Employers are starting to offer wellness groups to help keep their employees healthy. Ask these 5 questions to see if it’s worth it for you
WILSON WELLNESS
By Bev Bennett CTW Features
6
Being sedentary for eight hours a day can take its toll on your body. Employers are taking notice and offering ways to get you moving.
FITNESS
But, if you’re wondering whether your employer’s program could meet your own needs, here are five questions to help you decide.
1 Do the company’s strategies engage you? That’s vital to your success, according to Jeff Brizzolara, Ph.D., chief clinical officer, Viverae, a corporate health management provider, Dallas, Texas. “The ultimate goal is participation – engagement – in your health. Any programs that don’t get you up and moving, eating healthier or at the very least working toward a wellness goal, probably aren’t very effective,” writes Brizzolara, in an email interview.
2 Does the company ask for your input? “We can’t assume we know what each individual needs for good health. Unless we ask we don’t know what people need,” Lenz says. You may share that you’d like grocery shopping tips or a safe place to walk.
3 Does the company offer ongoing support? “If it’s just a six-month program and it’s over, people backslide,” Lenz says. “Even
though it’s very time consuming, data shows the stronger you can make the relationship with the employee, addressing all aspects of health, the better the outcome will be.” He adds that in the Creighton program health professionals meet with employees once a month on an ongoing basis.
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4 Does the company’s environment support your health? Positive cues include healthy food in the cafeteria and/or vending machines, a walking area around the campus and a stress-free zone, according to Brizzolara. Some companies go the next step by providing on-site fitness and health centers and subsidizing healthy food choices in their cafeterias, Brizzolara writes.
5 Does the program suit your personality? If you share the personality traits of a hermit crab can you find a compatible program? As apps, personalized texts and wellness webinars become more available, you’ll be able to find a fit, Brizzolara writes. And, if you’re an outgoing type, you may find your comfort zone in a company team competing with colleagues. © CTW Features
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Being physically active and eat-
ing home-cooked meals may help reduce the risk of becoming obese. But when schedules are hectic, one of the two health-promoting actions may be shortchanged, according to research.
When adults make time to exercise during a given day, they’re likely to do so at the expense of preparing food, according to a 2013 study by Rachel Tumin and colleagues at The Ohio State University College of Public Health, Columbus, Ohio.
However, you don’t have to substitute one beneficial habit for another. “It doesn’t have to be either, or,” says Darryn S. Willoughby, associate professor, health, human performance and recreation, Baylor University, Waco, Texas.
make time Cooking healthy food and exercising both take time, which is always in short supply. Here’s how to conquer both.
WILSON WELLNESS
By Bev Bennett CTW Features
8
Incorporating time to exercise and eat healthy into your already busy schedule takes practice.
FITNESS You can incorporate exercise and nutritious home-cooked meals into your busy life if you take advantage of small chunks of free time and don’t require perfection, health experts say. Take cooking, for example. If you think every dinner has to double as a tryout for the next chef competition, you may be overlooking the appeal of plain cooking, according to Suzy Weems, registered dietitian and professor of family and consumer sciences, Baylor University. “Everything doesn’t have to have multi-mega ingredients. Get back to those simple, stripped-down 30-minute meals, “ says Weems, mother of four. One tip you can take from professional cooks is to prepare ingredients in advance, the nutrition expert says. For instance, chop extra vegetables in the food processor and save for the next night’s dinner. Sauté a double batch of chicken strips and refrigerate half for another meal.
Exercise doesn’t have to be all consuming to be beneficial either. Look for easy ways to move more. It doesn’t have to be structured exercise. Standing every day will improve your health risk profile. Get out of the chair and stand once an hour. If you need a reminder, set a buzzer to go off once an hour to spur you to walk around the office. Although efficiency is good to get everything accomplished, a little intentional inefficiency can boost your health. Try to do things less efficiently so you’re moving around more. Your office, or your home, can give you a workout. Take the stairs at work. “Skip a step [going up] which turns the stairs into a lunge exercise. You can condition your lower body muscles,” Willoughby says. Do squats while you’re in the kitchen waiting for the water to boil. Partner with your spouse or chil-
dren for a rowing exercise, Willoughby suggests: Form a large towel into a U-shape. Grab the ends and have someone else grab the U as you “row” back and forth. After a while you’ll find a number of “mindless” exercises you can fit into the day without thinking about it, the experts say. In addition, it’s important to get the most muscle for the moves. Two exercises, push-ups and squats, provide maximum benefits for the time spent, according to Willoughby. “If you can’t do regular push-ups, do a modified one with knees on the floor. Push-ups work muscles in the chest, shoulder and back of the upper arm with one exercise,” he says. For your lower body, try squats, which work muscles in the thighs, hips and buttocks. If you prefer lunges for the lower body, you’ll be strengthening your thighs, hamstrings and buttocks. © CTW Feature
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Thanks to new wearable de-
vices, it may be easier than ever to take charge of your health. That gizmo on your wrist or waistband knows even more
about your exercise routine than your spouse does. However, devices are easy to tune out or leave on the dresser and may be challenging to use ef-
fectively, according to Dr. Mitesh S. Patel, MBA, assistant professor of Medicine and Health Care Management, University of Pennsylvania, Philadelphia.
better habits Technology is advancing and wearable devices continue to surge in popularity. Using them to your benefit, however, takes practice
WILSON WELLNESS
By Bev Bennett CTW Features
10
Being unplugged might not be the best option for you. Popular new devices can take your workout to a whole new level.
TECHNOLOGY
In fact, more than half the people who purchased wearable devices stop using them, onethird within the first six months, according to Dr. Patel. “These tend to be helpful to people who are very motivated to start with. But for most people with chronic health conditions, the devices alone aren’t enough to change behavior,” says Dr. Patel, who recently co-authored an opinion piece on the relative merit of these devices to drive health behavior change for JAMA online. Even so, Dr. Patel doesn’t suggest that technology can’t help you develop better habits. Instead he and other health experts recommend you look for technologies that suit your lifestyle and provide feedback to help you set goals. Before buying anything, figure out “what motivates you and choose something that matches your exercise style,” says Alissa Rumsey, registered dietitian nutritionist, Academy of Nutrition and Dietetics Spokesperson. Decide whether you prefer “ease of use and simplicity or are into tech, looking for something with more bells and whistles,” says Rumsey, certified strength and conditioning specialist (CSCS), New York City. Smartphones, which a majority of adults have, may be even more effective than tracking devices for improving health, according to Dr. Patel. If you’re already use a smartphone and download free or low-cost apps for it, turning the phone into a “health coach” with
appropriates apps isn’t much of a stretch. It’s not like getting used to a new device, Dr. Patel says. You can even find a smartphone app that links you to friends, allowing you to see what they’re doing to improve their health, Rumsey says. “If they’re doing 70,000 steps and you’ve only done 30,000 you’re motivated to do more,” Rumsey says. When shopping devices, look for ones that are interactive, not passive. “The majority of devices just tell you information. You took 5,000 steps today or slept 4 hours. Now there’s a push to find devices that are more interactive,” says Rumsey. She recommends devices that have a social interaction component, sending emails or texts alerting you to move more, for example. Low-tech strategies can be effective, too. Wearable devices may cost hundreds of dollars. Factor in occasional change of batteries and repairs if necessary
and you may be making a pricy investment in your health. A step counter may provide the incentive you need at a fraction of the price, according, Rumsey says. “I use step counters to get people to move during the day. Set a timer and get up and move once an hour,” she says. Although a step counter may not be totally accurate, accuracy isn’t that important, according to Rumsey. “It should make you move more. That’s the goal,” Rumsey says. © CTW Feature
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When it comes to post-holiday weight loss, you may have to dig deep to find credible advice on the Internet. “When you do a Google search you may think the top [listed] sites are the best, most accurate. Not so,” says François Modave, Ph.D., associate professor and department chair, Department of Computer Science, Jackson State University, Jackson, Miss. Your search will get you to the most popular sites, according to Modave. However, if you limit yourself to those first sites, you’re more likely to come across weight loss information that doesn’t come from credible sources or doesn’t provide sound advice. Instead, you may have to wade through one or more pages before finding what you need. That’s what Modave discovered when he and colleagues conducted a study of the accuracy of weight-loss information in search engine results on the Internet.
The researchers evaluated content quality, such as nutrition, physical activity or behavioral strategies for weight loss, accessibility and author credentials for more than 100 sites consumers are likely to check. The study covered commercial, government-, medical- or universitysponsored sites, those from news media as well as blogs. The highest scores went to blogs and to medical, government or university sites. The lowest scores were for commercial sites, according to the study recently published in the American Journal of Public Health.
The mixed results don’t mean you should discount every diet tip you read online. Beneficial information is available, but it often appears lower in search engine listings, according to Modave, who is working to help make Internet health information accessible to more people. Rather than take what pops up first, put a little more thought into your online search, says Wesley Delbridge, registered dietitian, Academy of Nutrition and Dietetics Spokesperson.
a deceptive health ‘web’ Not all information found on the internet is accurate, especially when it comes to health
WILSON WELLNESS
By Bev Bennett CTW Features
12
Don’t believe everything you read on the internet. Sometimes it can do more harm than good when it comes to your health.
TECHNOLOGY His tips: • Look for sites that end with “.gov” for government or “.edu” for a college or university. • Look at the writer’s credentials. RD for registered dietitian or LD for licensed dietitian, are good signs. • If reading diet studies published in journals, see whether the information is peer-reviewed for accuracy. Just as important as what to look for, are the things to avoid, says Delbridge in the Phoenix area. Words or phrases that should steer you away include miracle, revitalize, purify, detox, special secret, “research currently underway” or “eat what you want and still lose weight,” according to Delbridge. Be aware that social media can be magnet for commercial diet programs.
Tweet about your diet with likeminded followers and you may find weight loss supplement companies following you, Delbridge says. Blogs scored better than researchers anticipated in a recent study of online diet advice. “We didn’t expect blogs to perform that well,” Modave says. The reason may be that “people maintaining blogs tend to do more research,” he says. However, the study also points out that blogs contain “far more unsubstantiated claims than medical, government or university sites,” which also rated high. The researchers noted whether unsubstantiated claims were made but those claims did not affect the scoring. In addition, the researchers decided to look only at the first
page of a site for consistency’s sake, Modave says. “That artificially lowers scores for universities or [health or medical] association websites. A blog tends to have all the information one page.” Resources: Wesley Delbridge recommends the following sites. The Academy of Nutrition and Dietetics’ link to weight loss: http://www.eatright.org/Public/ landing.aspx?TaxID=6442451978 The U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion: http://www.healthfinder.gov/ © CTW Features
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Dr. Martin Senicki knows –
whether you’re a weekend warrior or a year-round athlete –you’ll more than likely suffer an injury. That’s why he’s interested in all aspects of
sports medicine care – prevention, treatment and long-term healing. Dr. Senicki is Wilson’s newest orthopedist, and he is practicing at Wilson Regional Orthopedics across from
Wilson Medical Center. Dr. Senicki is also the only orthopedist in Wilson who’s a D.O. – a doctor of osteopathy. DOs complete four years of medical training, complete intern-
the doctor is in Sports injuries are happening more and more but there are ways you can help prevent them
WILSON WELLNESS
By Connie Rhem
14
“Listen to what your body says. Your body knows what it needs and it will tell you. But you have to be listening.”
FEATURE ships, residencies and fellowships and choose a specialty just as any other medical doctor does. The primary difference in a medical doctor and a doctor of osteopathy is the approach the physician takes in treating their patients. DOs practice a whole person approach to medicine – a more wellness oriented approach. The American Osteopathic Association (AOA) notes that DOs are specifically trained to treat patients and their bodies as an integrated whole rather than focusing on and treating specific symptoms and illnesses. The AOA notes that DOs focus on preventive care and receive extra training in the musculoskeletal system of nerves, muscles and bones. “This training provides osteopathic physicians with a better understanding of how an illness or injury in one part of your body can affect other parts,” according to the AOA website. Osteopathic manipulative treatment (OMT) is also part of the training and practice of DOs. “With OMT, osteopathic physicians use their hands to diagnose illness and injury and to encourage your body’s natural tendency toward good health,” the website explains. Dr. Senicki uses his DO training in all aspects in his practice of orthopedics, including his focus on sports medicine – especially knee and shoulder. Although his patients usually see him after a new injury or as the result of an improperly
healed old injury, his interest is in ensuring that young athletes start out practicing those habits that make them less likely to be injured. The first recommendation Dr. Senicki makes is to ensure that athletes – especially young athletes – eat nutritionally balanced meals. “People just think yeah, yeah, eat right, but it’s really important,” Dr. Senicki says. “I can’t say enough how important a diet in whole foods is to a person’s body. Preparing those foods fresh from the grocery store to your table is important as well.” Dr. Senicki says he often tells his patients to focus on the perimeter of their grocery store, where they
can find produce, high-protein meat, fish and poultry and grains. “You should really avoid processed foods, which are typically high in sugar and sodium “Your body needs the right fuel, and that fuel comes from the natural ingredients found in whole food,” he says. Dr. Senicki recommends working closely with your family physician on what you or your child needs nutritionally to both perform at your best and keep your body healthy.
Adding insult to injury “Children start playing sports now at an early age,” Dr. Senicki says.
WILSON WELLNESS
“Children are particularly vulnerable because they are still growing and an injury can affect that growth if not dealt with properly.” Dr. Senicki says he would like for young athletes to start early on with good habits. Stretching, warming up, cooling down are all part of keeping your body healthy and less likely to suffer an injury, he says. Dynamic stretches benefit the body most by warming up the muscles for your more rigorous activity later, says Dr. Senicki. Starting slowly and then working into your workout or sports activity is the best option for decreasing the
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Martin Senicki, D.O. and his team are ready to assist you. Pictured left to right are Barbara Flora, LPN; Dr. Senicki; Krista Shay, Radiologic Technologist; and Faye Bissette, PFS Financial Counselor
opportunity for an injury. One of the most important aspects of playing sports is using the appropriate protective gear. Use an approved helmet, pads, shoes or cleats, eyewear, mouthpiece or any other protective gear appropriate for your sport, he says. “The most prevalent information in the media today is about football players and concussions,” Dr. Senicki says. “I think that awareness is important. Athletes who suffer concussions early on in their careers may suffer brain damage that can affect them as
adults. So it’s important to make sure they have the best protective equipment technology has to offer. It’s important as well that they follow standardized guidelines for dealing with a concussion. What is crucial is that an athlete should never return to play until an evaluation from a physician who is comfortable with concussion evaluations.” Wilson Medical Center CEO Bill Caldwell is a licensed coach through the United States Soccer Federation. “Wilson loves soccer,” Caldwell says. “As a former soccer coach, I’ve seen a number
FEATURE of soccer injuries. And they can be serious and long lasting. There is now that push to work through the pain, but that’s not the best option for the team as a whole or the amateur athlete as an individual.” Dr. Senicki agrees. Attention is growing on female soccer players and ACL injuries. He noted recent studies and articles in the media about ACL injuries in girls and women. The anterior cruciate ligament (ACL) is located deep in the middle of the knee and connects the thighbone to the shinbone. Why girls and women suffer this injury more often than boys and men is up for interpretation. The ACL is most often sprained or torn
as the result of changing direction rapidly, stopping suddenly, slowing down while running, landing from a jump incorrectly or colliding with someone else, according to the website of the American Academy of Orthopedic Surgeons (AAOS). Other causes may be the difference in physical conditioning, muscular strength and neuromuscular control, the website notes. The differences in a man’s and woman’s pelvic and lower extremities and the effects of estrogen on women may also increase the risk of an ACL tear, the AAOS notes. Dr. Senicki says all of these might contribute to the issue. Women can’t change some things like es-
trogen levels or the different build of their bodies. But all athletes can learn the correct way to condition their bodies so that sudden movements and landings do not have such a dramatic effect on them. “In my practice, I’m not seeing professional athletes,” Dr. Senicki says. “Those athletes have to play injured sometimes. But amateur athletes need to listen to their bodies. When your body hurts, you’re probably injured. When you go back in the game after a week after you’ve had a concussion, your brain is still rattled. Listen to what your body says. Your body knows what it needs and it will tell you. But you have to be listening.”
At first glance a head of cauliflower bears
no resemblance to a bowl of cooked couscous. But, you can transform the vegetable into a look alike for the granules of durum wheat with a brief turn in a food processor. Serving vegetables in traditional starch roles is popular among people who avoid gluten-containing foods, such as wheat pasta. However, the concept has broader health appeal, according to nutrition experts. “Most Americans need to get more variety [in their diets], says Jennifer Stack, MS, registered dietitian, certified diabetes educator, associate professor, The Culinary Institute of America, Hyde Park, New York. Replacing some “refined whites” with vegetables is a move in the right direction, according to Stack. Eating more vegetables disguised as starches has several advantages: You may consume fewer calories without reducing the volume of food you eat, which is an advantage if you’re dieting; lower your risk of an insulin spike if you have diabetes,
great veggie-starch swap Cut down on carbs and increase your veggie intake in one fell swoop? It’s as easy as rethinking the versatility of vegetables.
WILSON WELLNESS
By Bev Bennett CTW Features
18
Adding veggies into your diet couldn’t be easier. Sometimes you just have to think outside the box.
NUTRITION
and come closer to eating the daily 2 1/2 to 3 cups of vegetables the government recommends (depending on your gender and age). “Enjoying vegetables in place of some starches can be a good way of adding nutrition for a lower calorie bang,” writes Vandana R. Sheth, registered dietitian nutritionist, spokesperson for the Academy of Nutrition and Dietetics. Your calorie savings depend on the starch you’ve been eating, the vegetable you substitute and how you prepare it. For example, a cup of plain, cooked white rice has about 205 calories; a cup of plain, cooked cauliflower crumbles is about one-fourth of that.
Top a mound of cauliflower crumbles with a vegetable and chicken stir-fry and you have a substantial meal with a modest calorie count. In addition to helping with weight loss, cutting your starch intake may be a benefit if you’re managing diabetes. “When you have diabetes it is important to monitor and enjoy a consistent carbohydrate intake throughout the day for better blood sugar control management,” writes Sheth in an email interview. “Substituting non-starchy vegetables for some of the carbohydrates at meals can allow people with diabetes to not only meet
their carbohydrate-specific goals, but also enjoy more food,” writes Sheth, Los Angeles. The nutrition experts aren’t recommending people without specific dietary concerns forego starches, but moderate their intake instead. Keeping some starches in the diet is important for children, who need these foods, according to Sheth. “Growing children need the calories and nutrients that come from grains and other starchy foods. If they fill up on a lot of vegetables, they may not be able to adequately meet their calorie needs,” Sheth writes. © CTW Features
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eating better Letting a child explore food can sometimes lead to healthier food choices and a broader palate
WILSON WELLNESS
By Bev Bennett CTW Features
20
Got a picky eater? Use these helpful tips to broaden your little one’s palate.
NUTRITION
Feeding a toddler can be challenging, upending your perceptions about how children should eat. But, this is a time when children are just learning about foods and allowing them to explore is valuable, according to Tamara S. Melton, registered dietitian nutritionist and mother of a 2-year-old and 3-year-old. Here are some tips that work in her family: 1 Make a range of foods available at
mealtime. “My 2 year old doesn’t like any wet food on her hands. She has a texture aversion. She likes to eat anything dry, like crackers. Putting different types of food in front of her and letting her put her hands on fruits and vegetables allowed her to expand her diet,” Melton says. 2 Mix up preparation techniques
Your child might not like boiled cabbage but will approve of the taste and texture of raw shredded cabbage. 3 Allow children to have their own preferences. “They will have some things they do like and that they don’t like. That’s OK, “Melton says. 4 Focus on the family at mealtime.
This means putting away the tablet, says Melton, director of LaCarte Wellness, a corporate wellness consultation firm in Atlanta. 5 Relax. Your children won’t starve to
death, Melton says. “Just eat together healthfully as the whole family. It does work.”
© CTW Features
If you are heading to the doctor’s office for a routine physical and blood test, and you are over the age of 20, the following four screenings will likely be part of the exam and for good reason. According to the American Heart Association, 2,150 Americans die from cardiovascular diseases every day – that’s one every 40 seconds. While the following tests don’t diagnose disease, the results, along with age, weight, lifestyle and genetic factors, can predict a person’s risk of heart disease. “The bottom line is that we want to detect heart disease risk early, so we can do something about it,” says Barbara Fletcher, registered nurse, president of the Preventive Cardiovascular Nurses Association and clinical associate professor at the Brooks College of Health School of Nursing, at the University of North Florida in Jacksonville, Fla. “For the most part,” she adds, “all of these risks can be impacted by diet and exercise and, if needed, stress management.”
put your heart to the test Want to gauge the health of your ticker? Know where you stand with these key measurements to keep you in tip-top shape
WILSON WELLNESS
By Ann Burkley CTW Features
22
Simple tests and measurements can easily gauge the health of your heart.
MEDICAL 1 Resting Heart Rate
Today, resting heart rate is used as much more than an indicator of fitness level; it is used as a risk factor for early death from heart disease and other conditions. A 2013 Danish study reported that those who have resting heart rates of 80 beats per minute die four to five years earlier than those who have pulses of 65 beats per minute. Pulse measurement is routine, but for many sitting in a doctor’s office isn’t relaxing. A more accurate resting heart rate can be determined by measuring the heart rate first thing in the morning before getting out of bed. 2 Blood Pressure
“High blood pressure can
lead to heart disease, heart failure, stroke and kidney failure, so it’s very important for it to be controlled,” Fletcher says. A normal adult blood pressure is below 120/80. The systolic pressure, the top number, measures pressure in the arteries while the heart beats. The diastolic pressure measures the pressure in the arteries between heartbeats. Without diagnostic testing, the first symptom of hypertension may actually be a heart attack or stroke. 3 Cholesterol Cholesterol levels that are too high or low, depending on the type of cholesterol, coupled with other risk factors, can predict the risk of heart disease and stroke.
A typical blood panel provides levels for both high-density lipoprotein (HDL, “good” cholesterol) and low-density lipoprotein (LDL, “bad” cholesterol) cholesterol levels. An HDL level less than 40 mg/dL is considered low and an LDL level less than 100 mg/dL is optimal. 4 Triglycerides Triglycerides are a common type of fat in the body. High triglyceride levels, particularly when combined with low-HDL or high-LDL levels can speed up atherosclerosis, the buildup of fat deposits on artery walls, which increases risk of heart disease. Triglyceride level should be 150 mg/Dl or less. © CTW Features
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WILSON WELLNESS
By Marla R. Miller CTW Features
24
Quitting is usually frowned upon, but in this case being a quitter can save your life.
MEDICAL
The addictive power of nicotine can have such a grip on smokers, it takes an average of 14 attempts to quit for good. Smokers serious about stopping have a better chance at success when combining the patch, which provides a small but steady dose of nicotine, with immediate-delivery nicotine lozenges or gum to fight urges after eating or in social settings, according to smoker cessation experts. While researchers continue to test various treatment methods for kicking the habit, the biggest breakthrough in recent years has come in the way of studies supporting two types of nicotine replacement are better than one. “There’s not much new with medicine, but using two forms of nicotine replacement – like the patch and gum – is most effective,” said Dr. Daniel Seidman, a member of the Columbia University Behavioral Medicine Faculty and author of “Smoke-Free in 30 Days” and contributing author of “Helping the Hard-Core Smoker: A Clinician’s Guide.” Nicotine replacement therapies like the patch work by giving smokers a small amount of nicotine, but without the dangerous effects of inhaling tobacco smoke. The nicotine lozenge comes in the form of a small, candy-like tablet that dissolves over the course of 20 to 30 minutes and delivers nicotine to the bloodstream, relieving short-term cravings to smoke. Proven medications such as the antidepressant bupropion and varenicline work for many, but in slightly different ways. Numerous studies show that bupropion substantially reduces the severity of nicotine cravings and withdrawal symptoms.
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Varenicline has fairly high cessation rates. It binds at nicotine receptor sites in the brain, reducing cravings for cigarettes and making people less likely to smoke, says Paul Cinciripini, cancer prevention expert at the MD Anderson Cancer Center and director of its Tobacco Treatment Program. The University of Texas MD Anderson Cancer Center is home to one of the largest tobacco research programs in the nation, and Cinciripini also encourages people to consider participating in tobacco research studies and clinical trials if available in their area.
Cinciripini says people should be leery of unregulated products and claims on the internet, including nicotine water, herbal supplements, home remedies, eye movement desensitization and reprocessing (EMDR) and hypnosis. On the other hand, he says, studies support mindfulness meditation can help when combined with medication. The experts agree a good smoking cessation treatment plan includes medication and behavioral and psychological therapy, including support groups, cessation classes or specific behavioral change techniques.
Another newer treatment option, the prescription nicotine inhaler, delivers nicotine vapor to the mouth and upper airways, but not as much of it reaches the lungs. Other methods that deliver medicine to the lungs – metered dose sprays, dry powder inhalers or nebulizers that create a fine mist – do not replicate the natural inhalation used by smokers when drawing on a cigarette. The good news is current pharmacological methods approved by the Food and Drug Administration have been successful for many, Seidman says. “A lot of people who could quit easily, have quit,” he says.
MEDICAL
“It used to be about half the population smoked. Now, it’s about 19 percent and half of those people have other problems that make it difficult [to quit].” Seidman’s research interests include developing innovative approaches to assist underserved and highly addicted smokers. He says rates of smoking among depressed people are twice as high and they have a much harder time quitting. Seidman believes social media and new smartphone applications could help provide support and encouragement to smokers throughout the day. “You can download it and work on it on your phone to help with the behavior of smoking,” he says. “With something like the patch, you’re not really dealing with the person’s overall adjustment or emotional dependency on smoking.” Seidman, also a practicing psychotherapist and clinical professor at Columbia, says it is important to set a specific date to quit and prepare for it – from how to handle being around other smokers to dealing with stressful situations and triggers. Cinciripini reminds smokers who want to quit not to beat themselves up over a failed attempt or to get discouraged. Rather, they should try to learn from it – what worked and what didn’t – and take time to learn about themselves. He also says there is no set time to win the battle over cigarettes. Long-term cessation requires dedication and a plan, rather than relying on willpower alone, because nicotine is a psychoactive drug and quitting is about a permanent lifestyle change.
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You’ve read the headlines – so-
called “super lice” or mutated lice are infesting schoolchildren nationwide, and over-the-counter treatments are useless against them. But
the truth is, “There’s really nothing super about them,” says Dr. Jillian Parekh, a pediatric physician at Montefiore Health System’s Family Care Center in New York.
Size-wise and otherwise, they’re pretty much the same old pests, but as insects are known to do over time, they’ve developed a resistance to the chemical that’s most com-
itchy situation It’s a bird, it’s a plane, it’s ‘Super Lice’. Think twice about toxic treatment of treatment-resistant head lice.
WILSON WELLNESS
By Dawn Klingensmith CTW Features
28
Now that the kids are back in school, the dreaded “L” word is back. Here’s how to get prepared.
FAMILY monly used to kill them. It’s a “classic resistance story” that’s at least 15 years in the making, and this is not a surprise ending, says researcher Kyong Yoon, whose latest tallies of permethrin-resistant lice populations likely made headlines because the media were seeking back-to-school news hooks. But though these flightless insects did not sprout wings or undergo any such sci-fi transfiguration, their widespread permethrin resistance could mean that your best weapon against them is no longer at your corner drugstore. Over-the-counter permethrin or pyrethrin treatments (RID or Nix) are still “a reasonable first choice for primary treatment” of lice infestations “unless resistance to these products has been proven in the community,” according to the American Academy of Pediatrics. Where resistant lice have taken hold, “Doctors can prescribe new formulations that are very efficacious” at least for the time being, says Yoon, an assistant professor of biological and environmental sciences at Southern Illinois University in Edwardsville. However, you may not need to resort to mildly toxic drugs at all. The strongest weapons in our arsenal against this adaptive insect may be natural or decidedly low-tech. Essential oils have long been used in traditional medicine to get rid of
head lice, but their constitutions and concentrations are so variable that home concoctions typically aren’t recommended. There are pesticidefree hair products on the market, including the Fairy Tales and Ladibugs brands, that contain a mix of citronella, rosemary and peppermint oils “that, for whatever reason, are flat-out offensive to lice,” says Jim Cohn, a product sales and development consultant for Snip-its childcentered hair salons. Some of the leave-in products also provide a coating “which makes it difficult for lice to attach to the hair shaft,” says Risa Barash, founder and CEO of Fairy Tales Hair Care. The shampoos, sprays and gels can be used preventatively, she adds. Certain home remedies are anecdotally effective at eliminating head lice, including liberal applications of mayonnaise or petroleum jelly left on overnight. An uncontrolled, nonrandomized 2004 study reported a 96 percent “cure” rate with Cetaphil cleanser applied to the hair, dried on with a handheld hair dryer, left on overnight, and washed out the next morning and repeated once a week for three weeks, according to the American Academy of Pediatrics. Perhaps the best weapons against lice are your own two hands. Good old-fashioned nit-picking, or manual removal of lice and nits with a finetooth comb, can effectively eradi-
cate head lice, Parekh says. While there is little peer-reviewed literature, the academy notes that “the inherent safety of manual removal relative to the minor toxicity of the pesticides” is an obvious benefit and creates an opportunity for “a parent and child to have some close, extended time together.” Or not. The process can be so tedious and time-consuming that an industry of third-party providers has sprung up around it. “You can hire companies to help do it for an hourly rate. It’s a whole business, these Nit Fairies.” Parekh says. When removing lice and nits by hand, “Pay close attention to ‘hotspots’ behind the ears, the back of the neck and at part lines, and after each run through the hair, wipe the comb clean in a disposable towel,” Barash says. As prescription drugs are increasingly used to treat lice infestations, it’s important that steps are taken to avoid continued exposure that “triggers selection pressure” among the lice to develop resistance through mutation, Yoon says. “If resistance management is not implemented, these insect do have the ability to adapt,” he warns. And then the next generation of “super lice” will be rearing their heads and dominating headlines.
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When Cathy Egbert decided to
take advantage of her employer’s health incentive offer in her effort to lose weight, she didn’t go it alone.
“I brought my husband into it as well,” says Egbert, who joined Weight Watchers and received a 50 percent reimbursement for her monthly fee.
With her husband’s support Egbert recently reached her goal of losing 47 pounds. “I went from a tight [size] 16 to a comfortable 6,” says Egbert.
it takes a village Forming healthier habits is easier when your loved ones join you
WILSON WELLNESS
By Bev Bennett CTW Features
30
Working together as a family towards a healthier lifestyle is beneficial for everyone.
FAMILY She returned the encouragement and her husband lost 93 pounds, making significant improvements in his health. Their experience isn’t unique. A growing body of research shows that you’re likely to have greater success meeting your wellness goals if you include your spouse and even your family in your efforts. The couple’s experience also reflects what was found in a recent study in England – people are more successful in swapping bad habits for good ones if their partners make a change as well. And, there’s a good chance that will happen. New research led by the Johns Hopkins Bloomberg School of Public Health indicates that if one spouse improves his or her exercise regimen the other spouse is “significantly more likely” to join in. What’s more, employers may be encouraging spouses to join in, with discounts and other incentives. No wonder Egbert and others are taking advantage of opportunities to involve their spouses and families in wellness programs at work. “When spouses do it together they end up doing it better,” says Laura Ritzer, co-director, ProMedica Wellness, Toledo, Ohio. “If I’m having a bad day, he’s right there to support me, and I am there for him,” says Egbert, an employee of ProMedica, a nonprofit health system that provides healthcare services in northwest Ohio and southeast Michigan. “All the time I said ‘this is hard.’ We stood by each other, had cheat days and had to pick ourselves up,” Egbert says. But along with the support, being health partners has practical benefits.
ingsland, referring to the migrant “It means we only have to make farm workers health educators one meal,” Egbert says. are trying to reach in Immokalee, With healthier meals at home, Florida. their 15-year old son, who isn’t Although childhood obesity is a on the program, managed to lose concern in the region, weight loss 15 pounds as well, according to isn’t the message. Egbert. “We wanted to have fun, get Your community may offer both enjoyable and beneficial opportuni- more families involved, “ she says. The lure of car-free bike and peties for your family to partner for destrian paths, information booths, better health. health screening bus and free One lively example is Ciclovia drinking water is a major draw, Immokalee, monthly healthy living especially for fathers. festival, in a Florida community, “Not a lot of dads come to [nutriwhich brings families together to bike or walk, learn about nutritious tion education] classes but they do come to ciclovia,” Fundingsland food choices and jump rope. says. “We see dads learning “We’ll see entire families walkto jump rope.” ing along with a stroller and their baby,” says Suzanne Fundingsland, © CTW Features MS, registered dietitian nutritionist, Family Nutrition Program, Collier County Extension Service, University of Florida, Naples. Ciclovia, a Spanish term for a cycle path or cycleway that’s blocked off from cars or trucks, is popular in Columbia and rapidly spreading to other countries. “We thought the closed street – ciclovia – would con4100 Raleigh Rd. Pkwy., Wilson nect on a cultural point,” says Fund-
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Lots of parents joke about that
moment when it’s time to leave the hospital with a newborn: Not only are the medical professionals going to allow you to go, they require you to take the baby home, where you’ll be responsible. Many an otherwise capable, confident adult has felt a stomach quiver at this moment – and lived to tell about it (obviously) – but what about all the moments after that?
Everything from infant behavior to developmental milestones to sleeping patterns to eating to general health can create questions and cause concerns. In fact, pediatrician Dr. Jennifer Shu, medical editor of the American Academy of Pediatrics’ healthychildren.org website, says these subject areas – along with growth and nutrition – are where most of the questions she receives originate.
“There’s something about [a baby’s] sleeping and eating,” adds Dr. Jodi A. Mindell, a clinical psychologist specializing in pediatric sleep medicine and professor of Psychology and Director of Graduate Psychology at Saint Joseph’s University in Philadelphia. “Those are the two that worry and stress parents the most.” Whether they’re panicked about how much their infant is eating or concerned that
bringing up baby Confidently finding your way through your child’s first year
WILSON WELLNESS
By Jessica Royer Ocken CTW Features
32
Being a parent isn’t easy and can be downright scary. Here are a few helpful hints from the experts to ease your fears.
FAMILY their child’s strange sleep habits will affect brain development, parents may find their minds spinning. And, this, in turn, affects how parents function, notes Mindell. “Exhausted parents can’t function.” So if you have questions or worries about what’s normal for baby behavior, know that you’re not alone. Take heart and read on for some expert suggestions on reliable resources and strategies to get the information you need to parent at the top of your game. First, be assured that the vast majority of infants fall within the range of “normal” for any given behavior or development process. Anne H. Zachry, assistant professor of occupational therapy at The University of Tennessee Health Science Center, says she sees children on the autism spectrum in her Memphis OT practice, as well as those with learning or coordination disabilities, but she remains confident that most infants do not have any disability at all. “The most important point about ‘normal,’” she says, “is that it is a range.” Looking at growth charts or development calendars can sometimes make you “falsely alarmed,” she explains. Keep in mind what’s generally expected in the first year – a baby who can hold his head up while on his tummy and start to push up on all fours, for example – but don’t pin yourself to exact dates. “The ‘norms’ reported in magazines are just that: norms,” Mindell adds. “They don’t reflect the high variability [among individual babies]. We know from the data that sleep is highly variable, especially in first six months to year of life.” If the baby is growing and developing, “don’t worry,” she says. Further, one of Mindell’s studies found that “sleep is a small contributor to intellectual development,” she reports. So your baby may be queen of
information out there (more on that the 15-minute nap right now, but in a moment), but your most essenthere’s no reason she can’t be a tial resource in the first year is your star in kindergarten when the time child’s pediatrician, these experts comes. report. So select one you trust and “Try not to compare your child to cultivate a good, open relationother children except as a rough ship. “Some pediatricians are more guide,” Shu says. “Rather, look for comfortable in their knowledge forward progress or regression in about sleep than others,” Mindell your own child.” says. And this also may be true of That said, if something seems off other subjects you’re interested in, to you, or you just have a question, don’t be afraid to ask. Though such as breast-feeding or baby-led weaning. So it’s important to ask if your baby may seem like an alien your child’s doctor feels comfortable being sometimes, you know him giving advice on a particular topic, best. “Call your pediatrician for any Mindell suggests. If she doesn’t, concerns at all,” Shu says. be sure to ask whom she’d recom“Most parents have an instinct mend you consult with instead. and can tell when something isn’t Now, about those other resources right,” Zachry adds. “Go with your available. The key is to choose gut feeling, and it never hurts to wisely and avoid overload. As ask a professional.” tempting as it can be to Google As for when to ask, Zachry suggests keeping a list of questions you’d like to discuss at your baby’s next check up, and for guidance on more poten• Fast & Reliable Service tially urgent matters, Shu • FREE Local Delivery recommends the “symptom • Drive-Thru Window checker tool” • Most Insurance Plans on healthychildren. Accepted org, which • Easy Prescription tells parents whether to Transfers call 911, Michael Warren, RPh contact their pediatrician within 24 hours, or contact the doctor during the next office day. There’s lots Wilson Medicap Pharmacy and lots of
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away on all your questions and concerns, you’ll serve yourself best by being discerning. Look carefully at who is providing the information you read, these experts suggest. Make sure it’s a medical professional and a reputable website or publisher. “I like dot-gov websites and nonprofit organizations,” Shu says. And take what you’ve read with you to discuss with your child’s pediatrician at the next visit, she adds. Remember that information written by hospitals, professional medical organizations, and other experts (and backed by science) is often more accurate than opinions and blogs. “Be careful about what is opinion versus evidence-based,” Mindell says. “A lot of the voices on the Internet are those with the strongest opinions. You’re looking for middle-ground advice that fits what you’re comfortable with as a
parent. And beware of fear mongering,” she adds. “As parents, that’s what touches our core. The minute someone says you’re going to cause your child permanent damage, they have your attention.” Whatever you choose, find a reputable source you like and stick with it. Don’t survey the entire library or Internet every time you have a question, as that’s a great way to make yourself crazy. “I always defer to the American Academy of Pediatrics and healthychildren.org rather than trying to go to a variety of websites and pull in info,” Zachry says. “It has everything on there, and it’s backed by pediatricians.” Also, check out the sidebar for additional resource suggestions from these experts. Finally, know that you’re likely better prepared than you think. You got this. Seriously. You do!
“Confidence is key, and this comes with time,” Shu says. (Again, here’s where a good relationship with your child’s pediatrician in the early weeks and months can help, she adds.) Just take a deep breath and focus on your baby. There’s pressure to have the latest and greatest gear and gadgets, Zachry says. But remember that babies often prefer the box the gift came in to the item itself. “Parents are prepared. Their instincts kick in. Just focus on holding and interacting with your baby,” as that’s what promotes development, she says. In fact, many parents are overprepared, Mindell adds. Step away from the computer, and pull your head out of that book! “Read a few reputable sources, then put them aside and enjoy your baby.” © CTW Features