Tag Archives: Shawn Foucher

Attack of the dad bod

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If your cute and cuddly physique is an improvement from a year ago, then you’re on the right track. (Courtesy Spectrum Health Beat)

By Shawn Foucher, Spectrum Health Beat


For the sake of illustration, let’s pretend a man’s picture of good health falls someplace on a horizontal line.


On one end, you’ve got the late John Candy; on the other, you’ve got the very much alive Dwayne “The Rock” Johnson.


For the average guy, there’s probably going to be a comfortable middle somewhere along that vast spectrum.


You may, for instance, be content with a body type more akin to the one Leonardo DiCaprio had on display one recent summer when he was photographed vacationing someplace warm and expensive.


Always the picture of prepossessing boyishness, the Oscar winner looked, in this instance, more like a cuddly dad from Des Moines and less like a toned Titan of Tinseltown.


And if the Internet’s collective brilliance has the last word on the matter, that’s perfectly OK.


Sometime in recent years, folks began dubbing this look the “dad bod.”


Countless celebrities have been photographed unabashedly displaying their dad bods—an online search bears infinite entertaining results—and millions of fathers have been consigned to this body type ever since the developed world became less agrarian and more sedentary.


One college newspaper writer gained some notoriety for suggesting that the dad bod maintains, perhaps, a certain kind of appeal.


It’s a fleshy-but-not-obese physique that suggests, “Let’s skip the gym this weekend, because I’m down for DiGiorno and a Game of Thrones binge.”


Who could say no to that?


But here on the cusp of another summer, an important question lingers: Apart from the cringe-worthy moniker, is the dad bod an acceptable standard of health? Not aesthetically, but medically?


It all depends on you.


If you’ve got a body like Leo, Seth Rogan or Adam Sandler, a discerning doctor is likely to be less concerned with how you look today and more concerned with how you looked five years ago.


What matters is where you’ve been and where you’re headed, said Harland Holman, MD, of the Spectrum Health Family Medicine Residency Center.

BMI, waist circumference

To assess a guy’s overall level of fitness, you have to account for how his body has changed from past to present, Dr. Holman said.


“You can’t just assume from one single picture what their lifestyle is,” he said.


You need context.


Explained Holman: “So, if Leonardo had a six pack and all of a sudden he’s looking like that?”

Not so good.


“But somebody who looks like that—who had a BMI that was 50, and obviously over the last year they’ve made some pretty big changes?”


Pretty good.


Body Mass Index, or BMI, is a decent indicator of a person’s fitness.


“First thing is, we’d see where your BMI is,” Dr. Holman said. “We shoot for a BMI of between 20 and 25.”


Many online sites will calculate your BMI, which is your weight, in kilograms, divided by the square of height in meters. (A 6-foot-1 man who weighs 215 pounds, for instance, has a BMI of about 29—slightly over the recommended cutoff of 25.)


But BMI is not the Holy Grail.


“Depending on your BMI, another indicator could be your waist circumference,” Dr. Holman said.


A man of average height should have a waist circumference of less than 40 inches. Anything over that, Dr. Holman said, and it’s an indication of a possible risk for metabolic syndrome.


You could make the argument that a dad bod that’s heavy in the middle is simply cuddlier and more lovable, but that’d be the only argument you’ve got.


Excess fat around the waist indicates a higher risk for heart disease and type 2 diabetes, Dr. Holman said.


“Obviously that extra fat around the abdomen … if celebrities or media are promoting that, that’s a little concerning,” he said.

Genetics, circumstance

Substantial physical change may prove frustratingly elusive for some fellas, but that’s only because their genes are tight—so tight, they’re never letting go.


“To be honest with you, there are genetics behind weight,” Dr. Holman said.


“You don’t really have control over that,” he said. “Focus on what you have control over. What do you put in your mouth every day? What do you do every day?”


If you’re eating healthy and you’re exercising, there’s a fair chance, bad genes or good, your body will reap the benefits.


And, dad bod or not, be leery of any message that says beer and pizza are acceptable regular components of any diet.

“When people start saying that’s cool, maybe we’ve gone too much the other way,” Dr. Holman said.


Here he’s alluding to those opposing ends on that John Candy-Dwayne Johnson spectrum. There really is a happy middle. (You can have a piece of pizza and a beer once in a while; just don’t make them fixtures of your diet.)


“When everyone needed a six-pack, some people gave up trying for that,” he said. “Hopefully they would, in the media, kind of promote more healthy living instead of focusing on what the picture of the abs looks like.”

Write your history—and your child’s

There’s a good reason they call it the “dad bod.”


Once men and women procreate, those little people called children commandeer every aspect of their lives, leaving precious few moments for time-intensive exercise regimens.


“There is that weight gain that dads get,” Dr. Holman said. “It often goes along with moms gaining weight, too. You become more focused on caring for your kids than yourself sometimes.”


Dr. Holman’s advice to patients, and parents: Focus less on looks and more on healthy activities and healthy meals.

And promote the same things in your kids.


Because apart from genetics, how you look today has something to do with how you grew up.


“A lot of weight depends on what you were early on,” Dr. Holman said. “Your body kind of sets a standard weight by the time you’re a teenager.”


If a poor diet and sedentary lifestyle were hallmarks of your childhood, your journey to health in adulthood may be fraught with more pain and slower gains.


If, however, you were active as a kid—youth sports, a love of outdoors and the like—you may find it easier to bounce back as an adult, even in your later years.


“Some people feel like it’s always going to be hard work to get under that weight that your body has set as its baseline weight,” Dr. Holman said. “It’s not that you can’t overcome it. It’s just that it gets a little bit harder to overcome.”

Mind your body

So, really, do looks matter? To a degree, yes. More accurately, what matters is the measurement of your looks. Your BMI and waist circumference will play roles in what your doctor has to say about your health and fitness needs.


But your health history—your weight today versus a year ago, or two years ago—is just as important. You should celebrate steps toward better health, no matter how small, and also recognize when your health is slipping.


“If the BMI is above 30, usually I will order a blood test,” Dr. Holman said. “A common blood test checks cholesterol, diabetes and thyroid.”


That’s the introductory assessment.


“That shows how urgent it is for them to make some lifestyle changes,” he said.


If your BMI is 30 but your cholesterol level is great and you’re not diabetic, “it’s not nearly as urgent as someone whose BMI is 30 but they’re starting to get pre-diabetes,” he said.


A normal blood sugar level is typically lower than 100. Anything greater than 125 is considered diabetes. Pre-diabetes is the range in the middle.


“There’s that gray zone between 100 and 125,” Dr. Holman said, “when people can make a huge lifestyle change and prevent getting diabetes.”


And who knows—you might also prevent the complete onset of a dad bod.


Reprinted with permission from Spectrum Health Beat.


A shot at college

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If your child is headed to college for the first time, you can allay some of your worries by ensuring they’re up to date on vaccinations. (Courtesy Spectrum Health Beat)


By Shawn Foucher, Spectrum Health Beat


If you’re looking to help your burgeoning thinker prepare for the first year of college, you could do worse than start with a simple science lesson.


Think of the higher learning universe as a giant petri dish.


Your youngster will dive headlong into that glorious environment, seizing opportunities to broaden the intellect and test new ideas that challenge the status quo.


College is, however, a life-sized cauldron of cellular chaos, swimming with a frightening array of potentially deadly germs.


What important steps can parents take to ensure their college student is prepared for life on campus?


Above all else, make sure your child is properly vaccinated, said Mary Zimmerman, immunization program manager at Spectrum Health.


Does this mean you can’t spend this last month of summer scouting out the best deals on futons, bed sheets and mini refrigerators? No. It just means immunizations need to maintain their proper place at the top of the to-do list.


The CDC provides recommendations on the vaccinations children need at various ages.


Teens headed to college should be current on six vaccinations in particular—meningococcal serogroup B, meningococcal conjugate vaccine (serogroups ACWY), hepatitis A, Tdap, HPV and influenza.

Meningococcal serogroup B vaccine

Given their bustling social lives and close-quarter living, college students are uniquely prone to exposure of meningococcal disease, Zimmerman said.


And if there’s just one thing to remember about meningitis, it’s this: It is deadly serious.


“People who have had meningitis had flu-like symptoms and then they were dead within 24 hours,” Zimmerman said. “If you survive, it’s a long-term stay in the hospital.”


The disease kills 10 percent of its victims, she said. Of those who survive, 20 percent will suffer long-term consequences from infection, including brain damage, amputation or loss of hearing.


When the bacteria infect the brain and spinal cord, it’s known as meningitis. When it infects the bloodstream, it becomes septicemia. There are two different vaccinations for meningococcus—serogroup B vaccine and serogroup ACWY vaccine, also known as the conjugate vaccine—and they immunize against different groups of the disease.


The CDC requires children to receive the conjugate vaccination by age 12, with a recommended follow-up conjugate booster at age 16. It’s also recommended that children receive the serogroup B vaccine at age 16, when they get the conjugate booster, but it’s not required, Zimmerman said.


Only recently has there been growth in awareness about the serogroup B vaccine.


In Michigan, the family of Emily Stillman, a Kalamazoo College sophomore who died of meningitis in 2013 at age 19, has emerged as the vanguard in pushing for awareness about meningococcal serogroup B.


Stillman died within 36 hours of contracting bacterial meningitis. She had received the meningococcal conjugate vaccine in her youth and also the recommended conjugate booster at age 16.


She did not receive the serogroup B vaccine.


Why? In 2013, the serogroup B vaccine hadn’t been available in the U.S. Not until 2015 did it become available.


Zimmerman cautioned that parents may encounter circumstances, even today, in which a primary care provider doesn’t have immediate access to the serogroup B vaccination.


This should not discourage them from pursuing it further.


“Check first with your primary care provider,” Zimmerman said. “If they don’t carry the B shot, you can check with the local health department — they do have it.”


Don’t assume the serogroup B vaccination isn’t important simply because the CDC made it a recommended vaccination, as opposed to a requirement, said Mary Wisinski, immunization program supervisor at Kent County Health Department.


“Absolutely get the vaccine,” Wisinski said. “It’s a deadly disease.”

Meningococcal conjugate vaccine

All strains of meningitis are spread through secretions from the throat and respiratory system—coughing, kissing, sneezing, sharing cups and so forth. Simply living in the same environment as someone with the disease could put you at risk.


About 10 percent of people who carry the bacteria in their nose or throat won’t show symptoms of the disease. But they can spread it.


“That’s why it’s so scary,” Zimmerman said. “There’s no rhyme or reason as to who might get the disease and who might just be a carrier.”


This is why vaccinations are so critical, she said, especially for the age 16-to-24 group headed into socially rich environments such as universities.


While the CDC requires the conjugate vaccination by age 12, there are of course children whose parents may have opted them out of vaccines.


College is a great time to reconsider such views.


“A college student will think they’re just run-down, and then they have to be rushed off to the hospital,” Wisinski said. “There’s nothing they can do.


“People do survive it, but the infection can cause them to lose their arms or legs, or cause them to be deaf,” Wisinski added. “It’s not a pleasant thought. Especially when there’s a shot to protect against it.”


The Kent County Health Department follows the mantra, “Vaccinate before you graduate.”


“(Parents) are sending these kids off to college very unprepared and unprotected,” she said.


In recent years, there has been a grassroots push among certain parents to opt out of vaccinations, but that has only led to spikes in diseases that had virtually fallen off the threat radar.


In 2016 and 2017, for example, the CDC logged outsized jumps in the number of mumps cases—directly traced to university campuses. The two largest cases were in Iowa and Illinois.


A Michigan college hit with a recent mumps outbreak didn’t have the data they needed to tackle it, Wisinski said.


“They didn’t know the vaccination status of any of their students,” she said.


In respect to the meningitis conjugate vaccination, nearly half of all teens fail to get the follow-up booster shot recommended at age 16, Wisinski said.


“(In Michigan), 80 percent of our kids get the first meningococcal vaccine at age 12,” she said. “But they don’t come back. In Kent County, only 50 percent of the teens that are immunized with the first vaccine will get that second one. Nationally, it’s 30 percent.”

HPV vaccine

Stereotypes about college exist for a reason.


The Freshman 15 is a real thing. As is the student loan debt crisis. And the risk of sexually transmitted diseases among teens and young adults.


For about the past decade, the CDC has recommended children receive two HPV vaccinations starting at about age 11.


HPV is a sexually transmitted virus, with some strains causing various types of cancer. Much like other series of vaccinations, it’s important to have the complete series before any exposure, Zimmerman said.


HPV is a two-dose series if the first dose is administered before a child’s 15th birthday. If administered after the 15th birthday, three shots are required, Zimmerman said.


It’s important to remember the follow-up.


“Obviously, you get your best protection by completing the series,” she said.

Hepatitis A vaccine

The CDC recommends the hepatitis A vaccine for anyone traveling to other countries—and many a college student would fit this bill.


“So many college students are traveling abroad,” Zimmerman said. “It’s good just to be protected.”


Hepatitis A is a liver disease spread through contaminated food and water. The vaccination is a routine recommendation for children starting at age 1, but there are adults and older children who have never had it.


The hepatitis A disease rate has declined 95 percent since the vaccine became available in 1995, but don’t imagine for a second that it has magically disappeared in this country.


Southeast Michigan is currently battling a hepatitis A outbreak that has killed 10 people and infected nearly 200.


The disease incubates in the body anywhere from 15 to 50 days before manifesting itself, Zimmerman said. Adults who get the disease can be ill for up to six months, with symptoms including nausea, vomiting and jaundice.


“It’s a virus,” Zimmerman said. “You clear it from your system. If you have the disease, you then have immunity. But that’s the hard way to get it.”


The easiest route is vaccination.

Tdap vaccine

Babies and small children receive a series of shots called DTaP, which protect against diphtheria, tetanus and pertussis, also known as whooping cough.


As a child ages, the effectiveness of this vaccination wears off. Consequently, at about age 11 the CDC recommends children receive a Tdap vaccination, Zimmerman said.


It’s effectively a booster for the original shot.


“They get the maximum benefit from (receiving) doses at the proper time,” Zimmerman said.


Tetanus is caused by toxins from bacteria in the soil. Diphtheria and pertussis are spread through coughing and sneezing. According to the CDC, about 1 in 5 people who get tetanus will die and 1 in 10 who get diphtheria will die.


Pertussis is most dangerous for babies. They contract the disease from children or adults who haven’t been vaccinated.


“Pertussis won’t kill adults, but it does kill infants,” Zimmerman said.


Here again, the anti-vaccination crowd has given rise to pertussis outbreaks at levels not seen since the 1950s, according to CDC data. In 2012, more than 48,000 pertussis cases were reported—the most since 1955.


Researchers have blamed these developments on a reduction in herd immunity.

Influenza vaccine

A list of recommended vaccinations for any age group, infant to elderly, would be incomplete without the addition of the influenza vaccination.


“The annual flu vaccine is always recommended,” Zimmerman said.


Children from eligible families can receive free vaccinations through the Vaccines for Children program, Wisinski said. This applies to all vaccines, from birth to age 19. Children with medical insurance that does not cover certain vaccines can also receive vaccines, but they must get them at the health department or a qualified facility.


“If they have Medicaid or no insurance, or even insurance that doesn’t cover shots, they can get free shots,” Wisinski said. “It’s part of the VFC program.


“If someone from birth through age 18 has no insurance, or insurance that does not cover vaccines, the vaccine is free—but we do charge an administration fee on a sliding scale fee, from $0 to $23,” Wisinski said.


Reprinted with permission from Spectrum Health Beat.



Make sense of highfalutin’ diets

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Photo by Chris Clark

By Shawn Foucher, Spectrum Health Beat

Photos by Chris Clark


If you’re looking for a sustainable nutrition plan—something that’ll suit you 20 years from now—you should stop looking at high-protein diets.


They’re popular now for dropping pounds quickly but they’re simply not practical beyond the horizon, said Harland Holman, MD, medical director at the Spectrum Health Family Medicine Residency Center.


“You can pick the high-protein diet to lose weight, but what you want to think about is the long-term,” Dr. Holman said. “If you go back to normal dieting, you’d put all that weight right back on. I’d recommend picking a diet you can stick with that’s healthy.”


America is deluged with new diets from year to year—high-fat, low-carb, high-protein—but in the end it seems the basics are best: a plant-based diet with fruits and vegetables, whole grains, legumes, nuts, and lean meats and seafood.

Photo by Chris Clark

One diet in particular fits the bill: The Mediterranean.


“You’ll lose weight on it and you can also look at all the positive effects, even much later,” Dr. Holman said.


Ample evidence supports the benefits of a Mediterranean-style diet, including reduced risk of coronary heart disease, stroke and diabetes. Research also suggests that diet plays an outsized role in brain health, while a Mediterranean diet supplemented with olive or nuts is associated with improved cognitive function in older adults.


Calling it a Mediterranean “diet,” in fact, may be something of a misnomer.


“It’s not a diet—it’s not something you go on and quit,” said dietitian Jessica Corwin, a community nutrition educator at Spectrum Health Healthier Communities. “It’s a way of thinking about meals differently.”


Remember the old Clinton-era food pyramid, early 1990s or so? That majestic work of art featured bread, rice, cereal and pasta prominently at the bottom, recommending a carbtastic 6 to 11 servings per day.

Photo by Chris Clark

Some illustrations of the Mediterranean food pyramid, meanwhile, don’t even show food at the bottom. They feature families playing and people interacting.


Seriously.


“The very base of the pyramid is about having fun, living an active lifestyle, and enjoying your food,” Corwin said. “It’s a stark contrast to our culture’s habit of racing through a meal while standing, driving or watching TV.”


As for actual food, the diet places heavy emphasis on leafy greens, vegetables, fruit and whole grains, building out from there.


Said Corwin: “Those following a plant-based Mediterranean Diet plan their meals around the vegetables, rather than the meat. Instead of saying, ‘OK, Monday we’ll have beef with something else,’ the focus switches to, ‘We have a ton of leafy greens we need to use up tonight, so what should we do with that?’”


First add nuts, beans, legumes, seeds, herbs, spices and olive oil, then fish and seafood. Poultry, eggs, cheese and yogurt would come once every other day, or perhaps a few times per week, with red meat and desserts just once or twice a month.

Photo By Chris Clark

But the takeaway is not simply that the health benefits of a Mediterranean diet outpace any high-protein diets.


High-protein diets can increase your health risks. Research has shown that people who regularly consume high-protein foods—red meat, in particular—are effectively increasing their lifetime risk of chronic disease.


“Red meat, animal protein, has been linked to increased cardiovascular disease, cancer and diabetes,” Dr. Holman said.


A person with kidney problems, meanwhile, may see their condition worsen on a high-protein diet.


“When you have tons of protein, it’s harder for the kidneys to process and clear it,” Dr. Holman said. “Super-high protein levels can affect your kidneys. Most of the time, healthy people are OK, but if you’re predisposed to problems with your kidneys it can cause you to retain fluid.”


A predictable side effect of the diet craze: People are protein-crazy.

Photo by Chris Clark

“Sometimes people don’t think they’re getting enough protein, but they are,” Dr. Holman said. “Most people overestimate how much protein they need.”


Smart dieting is the first step to positive lifestyle change, but don’t feel pressured to make dramatic changes immediately. Dr. Holman said he’ll first ask his patients to maintain a 24-hour food journal, carefully documenting the foods they typically eat in one day.


“You have to think about lifestyle change,” he said. “They’ll pick one or two things they can change. Sometimes it’s just as simple as cutting out soda. And most people don’t realize how healthy nuts are—they should switch to nuts as one of their snacks.”


The payoffs are real: Studies have shown people who adhere to a Mediterranean diet are about 30 percent less likely to develop cardiovascular disease, Dr. Holman said.


Reprinted with permission from Spectrum Health Beat.

Sound mind: A matter of degrees?

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Earning a degree in your later years isn’t just a matter of career advancement or personal achievement—it’s another way to stay sharp. (Courtesy Spectrum Health Beat)

By Shawn Foucher, Spectrum Health Beat

 

Researchers have long held that a heart-healthy diet and an active mind are among your best defenses against dementia.

 

But evidence continues to mount that you should also strive for a life of learning.

 

Recent studies suggest that mental stimulation at any age—from teens to post-retirement—is apt to improve the odds of enjoying a sound, healthy mind well into your twilight.

 

JAMA Neurology recently published results from a Minnesota study that found people ages 70 and older could decrease their risk of developing mild cognitive impairment by engaging in activities such as books, crafts, computers, games and socializing.

 

Interestingly, crafts and computers were especially associated with a decreased risk, according to the study.

 

Perhaps more compelling, however, is a separate JAMA Internal Medicine study that found an increase in educational attainment when you’re young may lead to a healthier brain in later ages.

 

Helmed by professor Kenneth Langa, the study reinforces what other researchers have been noticing—an unexpected but encouraging decline in dementia rates among the aging population in the U.S.

 

Langa and his team uncovered the association between dementia and educational attainment.

 

They measured dementia rates in two groups, one with an average age of 75 in 2000, the other with an average age of 75 in 2012. They found the dementia rate at 11.6 percent in the first group, 8.8 percent in the second group.

 

While those in the first group had attained about 11.8 years of education, on average, those in the second group attained about 12.7 years—almost a full additional year.

 

Coincidentally, the increasing value Americans have placed on education is borne out in the historical data. Prior to World War II, about 38 percent of those ages 25 to 29 had completed high school. By 1960, more than 60 percent in this age group had completed high school.

 

In comparing earlier generations to subsequent ones, it may suggest a greater return than expected on education: brain health benefits.

 

The notion that education could promote longer-term brain health is certainly not lost on the legion of gerontologists and neurologists responsible for treating some of the 5 million Americans living with Alzheimer’s, and millions more suffering from various forms of dementia.

 

“We know from other studies that education does appear to be a protective factor, so folks with more education are less likely to develop dementia,” said Maegan Hatfield-Eldred, PhD, a neuropsychologist with Spectrum Health.

 

“The idea is that education, learning new things, stimulates the parts of the brain that produce new cells and grow connections between cells,” Dr. Hatfield-Eldred said. “So people with more education have more brain matter that they can lose, and still maintain normal functioning.”

 

The implication here, of course, is that this brain stimulation and development occurs in youth and continues to benefit people into old age.

 

The takeaway: Brain health isn’t something to ruminate post-retirement.

 

It’s something parents should keep in mind for themselves and their children from the get-go, with consistent emphasis on education and intellectual development.

 

“It really emphasizes the importance of thinking about brain health over your lifespan,” Dr. Hatfield-Eldred said. “This isn’t something you should think about when you turn 70. It’s really a lifetime thing. The things you do over your lifespan impact whether you may develop dementia down the road.”

Ponder it

A question remains: What can you do now, as an adult, to increase the chances you’ll have a healthy brain into your 70s, 80s and beyond?

 

While age is the biggest determinant in the development of Alzheimer’s and forms of dementia, genetic factors also play a substantial role. There is currently no cure for Alzheimer’s, although some medications can alleviate the symptoms.

 

“The No. 1 risk factor for Alzheimer’s disease is your age,” said Iris Boettcher, MD, chief of geriatrics for Spectrum Health. “The older you get, the higher the risk.”

 

You can’t change your genes, but you can change your lifestyle.

 

Activities that require mental concentration are all apt to help with cognitive function, Dr. Boettcher said.

 

“The advice I give, even once the diagnosis of dementia is made, is we know that regular mental stimulation is helpful in reducing the progression of the disease,” she said.

 

Dr. Boettcher is especially keen on discussions and activities that encourage higher-level thinking.

 

“People say reading, and reading is OK, but it’s really discussing what you have read,” she said. “You can read things over and over again, but it’s not necessarily constructive brain stimulation.”

 

While that’s no call to run out and enroll in the physics track at your local university, it is a call to challenge yourself mentally.

 

“It’s not a cure-all,” Dr. Hatfield-Eldred said. “But in general, we know that people who stay (mentally) active have lower (dementia) rates. It may prolong the onset of dementia if you are someone who was going to develop dementia. Maybe you’ll get it later than you would, or maybe it will progress more slowly than it would have without those activities.”

 

Drs. Hatfield-Eldred and Boettcher also emphasize the importance of regular exercise—at least three times a week, about 20 to 30 minutes each time—and a heart-healthy diet such as the Mediterranean diet.

 

“It’s been shown in multiple studies: It reduces the progression of dementia and it’s healthy for the brain,” Dr. Boettcher said. “You don’t have to be a marathon runner or work out in a gym. It’s very simple.”

 

The take-home message from these studies: “There’s no one magic activity,” Dr. Hatfield-Eldred said.

 

Just eat right, exercise and study hard.

 

Reprinted with permission from Spectrum Health Beat.