Even a crumb of gluten can have a serious impact on those who have sensitivities or celiac. (Courtesy Spectrum Health Beat)
By Jessica Corwin, Spectrum Health Beat
Just one-sixteenth of a saltine cracker is enough to cause damage in someone with celiac disease—mere crumbs.
This means that any of us hoping to serve meals free from gluten must pay attention to much more than our ingredients alone. We must consider the entire kitchen as we begin any gluten-free cooking adventure, everything from food storage to kitchen appliances.
Read on for six simple and effective tips to help you dish up 100 percent gluten-free meals with peace of mind.
1. Wash Up
Registered dietitian McKenzie Hall, co-founder of Nourish RDs, suggests beginning any gluten-free food preparation with hand washing. As even a crumb of gluten-containing food is enough to cause a negative reaction, the need to wash your hands every time you come across a gluten-containing ingredient or surface cannot be stressed enough.
2. Separate your storage
Food storage is not something that typically comes to mind when considering gluten-free safety, yet it is an essential component. Designate a specific cupboard, drawer and perhaps even the top pantry shelf as gluten-free zones to be sure no gluten containing crumbs are introduced. As a separate freezer may not be an option, prevent contamination by sealing ingredients securely within a zip-top freezer bag.
3. Manage your mise en place
Before you begin cooking, gather all your ingredients and identify whether or not hidden sources of gluten may be present. Sneaky sources include bouillon, artificial bacon bits, malt vinegar, wonton wrappers, dressings, sauces, seasonings, yogurt, and even colors or flavorings if they have been produced outside of North America. If you are uncertain, call the manufacturer to determine whether or not gluten is a concern.
4. Stock up on spatulas
If you are able to, purchase a separate set of utensils solely for the use of gluten-free food preparation. Please do as this will greatly reduce the risk of cross-contamination. Incorporating clean and separate utensils, cutting boards, pots into your kitchen, while avoiding the use of porous equipment such as wooden or plastic cutting boards are key to kitchen safety. Kim Koeller, founder of Gluten Free Passport, recommends designating a separate toaster and fryer for gluten-free cooking, as well as separate pots and strainers for gluten-free pasta.
5. Consider your condiments
Hall advises any gluten-free cook to buy separate condiments for gluten-free cooking to prevent cross-contamination of gluten. Consider doing so for condiments such as peanut butter, jam, jelly, cream cheese, mayonnaise, hummus and butter. Label each item with a ‘gluten free’ sticker or a red rubber band to let friends and family know not to dip a gluten-covered utensil inside, because once a gluten-drenched knife enters the peanut butter jar, it is no longer gluten-free.
6. Clean up the crumbs
While you most likely clean and sanitize your kitchen counters on a daily basis, when was the last time you cleaned your cupboards, pantry, or drawers? If gluten-containing foods, bread in particular, are being served in your kitchen, then crumbs should be a concern. Each time you reach into your silverware drawer, which is often, you are presenting the opportunity for crumbs to fall in and pollute knives, forks, spoons and other utensils with gluten.
Don’t eat fat. Use less salt. Stay away from sugar. No processed foods. On and on these ‘Do not eat’ signs flash before our eyes.
But how about we stop looking at what to take out of our diets and more at what to put into our diets?
Herbs are one of the most power-packed foods out there and they often fall under the radar when it comes to giving your body a boost.
Want to use less salt, have more flavor in your dishes, and provide a dose of antioxidants to your meal? Add herbs.
Herbs are one of the highest ranked foods for antioxidants and they pack a punch of flavor to boot.
Antioxidants help fight free radicals that damage cells and cause cancers and heart disease. The ORAC scale measures the antioxidant levels of foods and, right at the top of the list, you will find various herbs. Among the best are oregano, rosemary, thyme, parsley and basil.
Get started with these 7 top tips:
Buy or cut fresh herbs a few days before or the day you are going to use them.
Store them in an open bag in the refrigerator crisper drawer.
Wash and pat dry your fresh herbs just before using them.
Use three times as much fresh herb if a recipe calls for dried
herbs. For example, if a recipe includes 1 teaspoon of dried parsley,
use 3 teaspoons of fresh parsley.
Use 1/3 the amount of dried herbs if the recipe calls for fresh. For
example, if the recipe includes 3 tablespoons of fresh dill, use 1
tablespoon of dried dill.
Add fresh, freshly ground, or leafy dried herbs (basil, parsley, oregano, dill) at the end of cooking.
Add hardy dried herbs (thyme, bay leaves, anise, caraway, fennel) near the beginning of cooking.
Diabetes is a far too common disease, and unfortunately, it is on the rise.
The statistics are sobering: Diabetes is the seventh leading cause of death among Americans. Sadly, 1 in 11 (29 million) Americans suffer from diabetes, and 1 in 3 (86 million) have pre-diabetes.
The good news is that some forms of diabetes can be prevented, and the best way to prevent this disease is to become educated about what it is and how you can avoid it.
First, let’s be clear about the definitions.
Type 1 diabetes is typically diagnosed in kids or young adults. In Type 1 diabetes, the body (specifically the pancreas) does not make insulin and, therefore, cannot process sugar. The sugar then stays in the blood and can’t get in the cells to be used as energy. Symptoms of this type of disease include weight loss, fatigue, thirst, frequent urination and extreme hunger, even after eating. Type 1 diabetes does not tend to run in families, and diagnosis is done with a simple blood sugar test.
Type 2 diabetes does tend to be hereditary, by both genetic risk factor for insulin resistance and health habits (physical activity and diet). Type 2 diabetes is preventable and is caused by high blood sugar from insulin resistance. Symptoms of this disease include those listed for Type 1 diabetes, plus blurred vision and headaches.
What exactly does insulin resistance mean? Here’s how it works: Insulin is the key to getting blood sugar into the cells—brain cells, liver cells and muscle cells. If someone has insulin resistance, it takes more insulin to get the door of the cell to open. Therefore, while waiting for the pancreas to make more insulin, the blood sugar rises and not only gets pushed into fat, but also causes the many complications of diabetes. As the belly fat increases, it leads to more insulin resistance.
Here’s a simpler way to think about it: When someone with pre-diabetes says they are “craving carbs,” or they are a “carbaholic,” I like to say that they aren’t actually craving carbs; instead, their fat is craving sugar. Unfortunately, when they eat the sugar, it goes straight to their fat, instead of going to their muscles, brain or liver. When people with pre-diabetes eat sugar, they are starving themselves and feeding their fat. To stop the craving, they must stop the sugar for 10 days and tell the fat to “shut up.”
Not all carbs are bad
Now let’s focus on carbs.
Carbohydrates are necessary fuel for our bodies—especially our muscles and our brain. Our liver needs to store a little bit of carbs as glycogen for when we need a boost, like after walking at a good pace for 40 minutes. However, there is a difference between healthy and unhealthy carbs.
Complex (healthy) carbs raise the blood sugar slowly and allow the pancreas to make insulin slowly and push the sugar into the right cells—not into the fat on your body. We need complex carbs at breakfast, morning snack, lunch and afternoon snack, and then not so much for the rest of the day. Healthy carbs include whole grain whole wheat bread, brown rice, sweet potatoes, quinoa, oatmeal (cooked—not the sugary packets), beans, peas and green vegetables.
Simple (unhealthy) carbs raise your blood sugar quickly, overwhelm the insulin in your body and get pushed into your fat. Think of simple carbs as a treat—white rice, white tortillas, baked goods, candy, many cereals, and anything made with mostly white flour.
Unfortunately, too many people think they are doing the right thing by staying away from all carbs. That is the wrong tactic.
When my patients (all women, of course) tell me they don’t eat any carbs, I let them know that’s the wrong approach to good health. The goal is to achieve an even blood sugar with minimal insulin spikes. High insulin can make us hungry for sugar and then pushes the sugar into fat. A healthy diet only contains one small treat per day—a piece of chocolate, a serving of alcohol, or a white flour tortilla.
Think of these types of carbs like a budget—you can have some carbs, but you can’t have them all at once.
Blood sugars and Type 2 diabetes can cause many complications—kidney disease, hypertension, stroke, skin problems, neuropathy, foot problems, infections resulting in loss of toes, eye issues (glaucoma and blindness), and impotence in women and men.
High blood sugars damage and clog small blood vessels, and if organs, including the eye, heart, kidney and sex organs, do not get blood, the various organs can’t work properly and problems occur.
Risk factors to know
It’s important to know the risk factors associated with this disease. Family history of diabetes, being overweight (especially with belly fat), and inactivity are all serious risk factors. In addition, women have two other factors that can work against them: having diabetes during pregnancy and menopause.
Menopause increases the risk by causing insulin resistance, and menopause can also make things worse by causing poor sleep from night sweats. The cycle continues because poor sleep makes it more difficult to have the energy to exercise and make good food choices. Menopause can definitely wreak havoc for women and diabetes.
I see many menopausal women in my office each year, and so many of them tell me about their struggle with weight. I remember one patient in particular I’ll call Sue.
Sue came to see me for heavy bleeding around the time her menopause had started. We did an ultrasound, which showed a thick uterine lining, so I scheduled a dilation and curettage.
During her exam, I also asked her what was the No. 1 struggle in her life. She started crying and told me her weight was her biggest struggle. Over the years, she had managed to keep her weight at a “tolerable” level, but in the past six months (around the time she started menopause), her weight continued to climb and she was giving up.
I couldn’t let Sue leave my office without trying to see what she could change to help with her weight struggle. We went through her diet, and she mentioned that she was avoiding carbs most of the day. She would eat some protein throughout the day and try to starve herself by eating little else.
By the time she began preparing dinner, she was extremely hungry and tired. As a result, she would eat the same meal she had just made for her family—some type of meat and a potato or pasta.
Even though Sue limited her portions throughout most of the day, she was actually causing herself to put on more weight. Her body was so hungry that whatever food was being consumed was being pushed into belly fat. Sue was surprised to learn she was making it worse, but I helped her develop a simple and easy plan to incorporate complex carbs into her diet.
By the time I saw her for her dilation and curettage several weeks later, she was feeling better, had more energy, and had lost six pounds for the first time in years.
It’s important for all of us to know as much as we can about diabetes in order to avoid falling victim to this disease.
Knowing the risk factors plus ways to avoid diabetes (exercise and diet) are imperative.
For the past two years, Jorge Gonzalez, 46, had done all kinds of things to improve his health.
He lost 60 pounds. He trained to run a 5K race. He focused on his health in matters big and small.
So imagine his bafflement when, one day at work, he suddenly began to feel particularly unwell. Even his colleague noticed it.
Gonzalez himself had to admit—the pounding in his chest couldn’t be ignored.
His new fitness watch noticed a problem, too. Gonzalez had bought the smart watch to help him monitor his vital signs. On that day, it showed alarming blood pressure numbers: 241/118.
“I didn’t think I was having a heart attack,” Gonzalez said. “But I did feel, well, out of tune.”
A short walk
Gonzalez is a director at Start Garden, a Grand Rapids, Michigan, company that helps entrepreneurs start new businesses. He always enjoyed helping others in his community, but when it came to helping himself he’d been reluctant to pick up the phone and call his doctor.
When he finally did—not in small part because a colleague nudged him into action—he learned he’d have to wait two months for the next available appointment.
But his blood pressure showed no signs of dropping. And two months was a long time.
Then, his colleague reminded him of something.
“Hey, Jorge,” his coworker had said. “Do you remember that presentation we had here a while ago by someone from Spectrum Health? It was about that new medical clinic down the street, STR!VE.”
Gonzalez remembered. The presentation showcased a new type of medical office aimed at developing a whole-body, preventive approach to long-term wellness.
For Gonzalez, it would require just a short walk down the street, onto Ottawa Avenue in downtown Grand Rapids.
He decided to take a short stroll.
Whisked to surgery
The STR!VE office has an inviting and comfortable ambiance, unlike many medical clinics. People can visit for same-day or next-day appointments.
Photo by Katy Batdorff
Gonzalez arrived and met with family nurse practitioner Melissa Wilson, MSN, BS, FNP-C, who checked his vital signs. On gauging his blood pressure, Wilson grew alarmed.
“I waited a moment, thinking it might be a false read, then took his blood pressure again,” Wilson said. “It was not going down. I put in a call to the emergency department at Spectrum Health Butterworth Hospital.”
Gonzalez saw the nurse practitioner’s concern and realized he may be in trouble.
“I told her she couldn’t play poker,” he said. “She didn’t have a poker face. I could tell by looking at her that this wasn’t good.”
Gonzalez was rushed to Butterworth Hospital. Doctors and nurses at the emergency department waited for his arrival.
“They immediately did an EKG,” Gonzalez said. “A young guy read the report. I could see his face turn red.”
Things happened very quickly after that, Gonzalez said. It’s something of a blur in his memory, but he recalls a physician calling out to his staff: “All hands on board!”
Then someone shaved his chest in preparation for surgery. A second EKG confirmed Gonzalez had suffered a heart attack. His artery had become 100 percent blocked.
Doctors placed a stent in his artery to restore blood flow to his heart.
Walking man
Three months later, Gonzalez feels like a new man. He is grateful for the quick actions of STR!VE medical staff and the medical team that met him at the emergency department at Butterworth Hospital.
“I wouldn’t be alive today if it wasn’t for STR!VE,” he said.
Gonzalez now repeats that walk down the street from his office to STR!VE on a weekly basis. He can take care of his follow-up appointments and meet with a dietitian to monitor his diet.
“Two years ago, I weighed 240 pounds,” he said. “Today, I weigh 182. I lost the weight because there was a day I tried to put on my shoes and couldn’t.
“I learned, though, that it’s not just about calorie reduction,” he said. “It’s what you eat. My cardiologist told me the blockage in my artery was probably because of years of a bad diet, and he recommended the Mediterranean diet. Now I eat whole foods, less processed, and a lot more fruits and vegetables.”
Wilson believes Gonzalez has recovered so quickly because he changed his sedentary habits and his diet.
STR!VE continues to help him work not just on nutrition, but his health maintenance overall.
Photo by Katy Batdorff
“Many people come here for our weight management program, but we are also a full-service, primary care medical office,” Wilson said. “Some of the people who come here keep their primary care physician but come to STR!VE to treat illnesses, when they need to see a doctor same day or next day. Others use us as their primary care.”
Wilson smiles when she sees Gonzalez visit. She encourages him to keep up his appointments.
“I tell him it’s all about the follow-up,” she said. “He tells me I sound like his wife.”
“Most water-related trauma is preventable,” she said. “If I can help families take steps to avoid the devastating results of water accidents, I’m going to do it.”
Practice home water safety
While it’s not just a summertime thing, we have to start by saying that for families with kids younger than 4, water risks start at home, with the bathtub.
“Of course a parent isn’t thinking it’s risky to run to the kitchen from the bath for just a minute,” Dr. Michiels said. “But even one minute can be too long. My No. 1 rule is that there must be 100 percent supervision of every child from 0 to 4, every time there is water that goes beyond a Dixie cup.”
The greatest risk for kids under 4 is accidental water entry. If a child can get to water of any kind, there is significant risk. Swimming pools and spas must be securely covered and kept off limits with fencing and secure gates around a pool. A small child can slip under many pool covers.
Check gate latches to make sure unsupervised children can’t access the area. And treat a shallow kiddie pool with the same deference.
“If a toddler slips in unsupervised, it might as well be an ocean,” she said.
Beach and open water safety
The Centers for Disease Control and Prevention report that 10 children die per day from water-related incidents in America. Families living near the Great Lakes and other inland lakes may be at even higher risk.
Enjoying the beach is fantastic family fun. Practicing a few safety precautions will make sure the day stays fun.
“Make it easy by keeping kids in personal flotation devices all the time,” Dr. Michiels advised. “They can still play in the sand while wearing a (life jacket). And it gives you time if something goes wrong.”
That said, Dr. Michiels stresses that a life jacket is not a substitute for supervision. A designated responsible adult should be assigned to specific children within the group.
“There are lots of examples of children who drowned when handfuls of adults were nearby, but no one was specifically assigned to watch the kids,” she said. “Designating certain children to certain adults adds protection from a child being overlooked.”
Creeks, rivers and boating
Creeks and rivers add a potentially dangerous element. The current
can sweep a child out of reach and out of sight quickly. Never allow
play on the banks without a watchful adult for every child.
Properly fitting life jackets, barricaded play areas and even the controversial toddler leads can prevent a tumble into the water.
As kids get older and become stronger swimmers, it’s easy to overlook ongoing risk. Additionally, teens may have opportunities to participate in boating and personal watercraft activities.
Dr. Michiels offered more smart talk for water safety and teens:
A personal flotation device must be worn, even if you are a good swimmer.
Complete a boating safety course.
Only allow the number of riders for which the personal watercraft or boat is designed to carry.
No horsing around, whether on piers, docks, boats, rafts or personal watercraft.
Discuss the dangers of alcohol and drugs with boating. Many boating fatalities involve drinking or drugs.
In case of emergency
Dr. Michiels said the best practice to assist a child (or any person) who is pulled from the water has changed in recent years.
“If you pull a child from the water and they cough, sputter but are awake, call 911 and stay with them,” she said. “The child may not be able to catch his or her breath, but we no longer advise trying to pump or extract inhaled water. If the child is limp and not breathing, call 911 and start CPR compressions immediately.”
Previously the medical community advised the rescuer to determine if the child was breathing and try to extract water. Today, rescuers are advised to start compressions immediately only if the victim is limp and unresponsive.
Don’t want to risk it? Splash Pad it!
To enjoy water when you don’t have enough supervision to ensure the safety of multiple tykes, check out splash and sprinkler parks near you.
These are often free, and offer crazy fun water play without drowning risk. That said, if the area is concrete, scrapes, stitches and even bone breaks are possible. Many splash parks feature rubberized surfaces.
Just use common sense and take a minute to assess when you arrive.
A possible warning sign that your asthma is out of control: You’re using a quick-relief inhaler more than twice a week. (Courtesy Spectrum Health Beat)
Summertime can bring asthma sufferers a lot of misery, but lung experts say watching for warning signs of breathing trouble can guard against serious complications.
“As the leading organization working to save lives by improving lung health, we think it’s crucial for people with asthma to know as much as they can about the disease,” said Dr. David Hill, volunteer medical spokesperson at the American Lung Association.
“This includes the fact that changing seasons have a major impact on asthma. Being prepared for the summer and understanding warning signs can help prevent serious complications,” he said in a lung association news release.
Summer can bring increased pollen in the air, hot temperatures and associated ozone and particle pollution—all of which can trigger asthma symptoms.
There is no cure for asthma, but it can be controlled and managed.
Key warning signs that asthma may not be in control include needing to use a quick-relief inhaler more than two times a week, waking at night with asthma symptoms more than two times a month and having to refill a quick-relief inhaler more than two times a year.
If you have any of these warning signs, you should see your health care provider to improve management of asthma symptoms, such as reducing exposure to asthma triggers, the lung association advised.
Asthma affects about one in 13 people in the United States, including more than 6 million children, according to the U.S. Centers for Disease Control and Prevention.
It is the most common childhood disease but can start at any age. The rate of asthma nearly tripled between 1980 and 2010.
Research shows that rising temperatures due to climate change are leading to longer and more intense allergy seasons, according to the news release.
The lung association offers a free, online learning course about asthma triggers, how to identify and reduce them, action plans for flare-ups, how to respond to a breathing emergency, asthma medication education, and an asthma management plan outline.
A restless night may be the result of poor habits before bedtime. A helpful hint: Leave the cell phone out of the bedroom. (Courtesy Spectrum Health Beat)
Sleep is everything. It needs to be a high priority for all of us to be happy and healthy.
It is truly the basis of good health, because it gives our brains a chance to rest and process the events of the day and then make brain chemicals for the next day.
Do you have trouble sleeping? If so, you’re probably dealing with a host of negative side effects.
Without sleep, we may experience bad moods and perform poorly at work, at school or at home with our families. A lack of sleep also puts us at risk for heart disease, diabetes and depression.
Researchers have spent years analyzing sleep patterns to learn why sleep is so important to our overall health and wellness. Their observational studies of people with and without good sleep patterns show a strong effect on chronic disease.
People who get less sleep have a higher risk of being overweight, developing diabetes, experiencing high blood pressure and having a heart attack. Overall, these people have a lower life expectancy than those who get a consistent eight hours of sleep each night.
Typically, those who consistently sleep less than six hours a night are plagued with the highest weight, while those who sleep eight hours or more have the lowest weight.
Is it really that simple? For the most part, yes.
Less sleep leads to a rise in cortisol—our stress hormone—and also causes a rise in insulin, which promotes belly fat storage. Decreased amounts of sleep also cause an increase in ghrelin—a brain hormone that stimulates appetite—and a decrease in leptin, which signals when we feel full.
Of course, it goes without saying that when we don’t have enough sleep, we don’t feel like exercising and we often gain weight due to inactivity.
Unfortunately, sleep (or a lack of it) can have a strong effect on our moods and coping skills. Lack of sleep puts people at a greater risk for depression, anxiety and mental stress. All of this makes it difficult for these people to remain optimistic and thrive in social situations.
The bottom line? To be happy, sleep is a prerequisite.
We know we should be getting our sleep, but what really happens when we are having trouble sleeping?
There are several different types of sleep problems that can cause us to sleep less than we should at night.
Sleep disorders
Chronic insomnia, narcolepsy, sleep apnea and parasomnias are some of the more common sleep issues my patients experience.
Insomnia can be a result of too much overstimulation from watching TV or working on a computer late at night. Consumption of alcohol, sugary foods or caffeine before bed can also interfere with the ability to fall asleep easily.
Insomnia can be caused by taking certain medications such as antidepressants, oral steroids or allergy pills. Medical conditions that cause pain—arthritis, for example, or breathing problems such as asthma—can also be underlying causes of insomnia.
The good news is that insomnia can be improved.
The best treatment starts with awareness, which begins with a close examination of our habits and rituals around bedtime. Turning off the computer or TV several hours before going to bed can help you fall asleep more quickly. Sometimes, prescription medications or over-the-counter remedies can also be helpful.
Narcolepsy, associated with excessive daytime sleepiness, can be genetically linked. A diagnosis of narcolepsy can be determined with a sleep study.
Medications aimed at improving sleep quality and stimulating daytime wakefulness are typically prescribed to help with this condition.
Sleep apnea, typically linked to obesity and heart disease, is also diagnosed by completing a sleep study.
Treatments for sleep apnea range from changing sleep positions to using a Continuous Positive Airway Pressure machine to keep airways open.
Weight loss is also an effective treatment for sleep apnea.
Parasomnias occur when people are fearful of going to sleep because they are afraid of what might happen to them during sleep. Night terrors, sleepwalking or sleep eating without memory are common things they may fear.
Sleepless nights
Many women come to see me because they are having trouble falling asleep or staying asleep during the night.
A woman I’ll call Jane is one of those patients.
At age 49, she began experiencing irregular periods, night sweats and disturbed sleep around the time of her period. She led a very busy life with teenagers, a husband who traveled for work and parents who required more care.
Her sleep issue was causing problems in her life.
Jane would have difficulty falling asleep and, if she woke up during the night, she had trouble getting back to sleep because her mind would start racing and she couldn’t turn it off.
As a result, she was chronically tired and unmotivated to exercise. She began to gain weight. She felt irritable and crabby most days and she just didn’t know how to get off the roller coaster.
Jane had tried to fix her sleep problems by herself, but it wasn’t working.
She tried every tea and over-the-counter medicine she could find, including melatonin. She had recently resorted to drinking a glass of wine in the evening, but that just made her feel even less rested.
It was time for a new plan for Jane.
Simple changes
We started by discussing what she probably already knew: Lack of good sleep made her very unhealthy and caused her bad moods.
I then explained the correlation between hormones and brain chemicals.
We worked on deconstructing her nighttime routine. I asked her how she could structure her day so she wouldn’t have so many chores to complete at night, leaving her more time to prepare for the next day.
As Jane talked out loud to me, she realized she could make some simple changes—packing lunches and doing a load of laundry at night—that could help her be more efficient in the morning.
I then pressed Jane about making time for herself before bed.
I also made some suggestions.
I recommended that she write down her worries or duties on paper and then make a list for the next day (or several days), detailing how she would conquer these obligations.
Other suggestions I made: Avoid screen time 30 minutes before bed, refrain from alcohol in the evening, write in a gratitude journal before going to sleep.
And, finally, I suggested that Jane practice metered breathing every night before going to bed.
Metered breathing is a technique I discuss with many of my patients to help them fall asleep at night or get back to sleep if they wake in the middle of the night.
Here’s how it works:
Find a quiet place in your home and sit in a comfortable chair.
Begin staring at a spot somewhere in the room and focus on the sound of your breathing.
Continue breathing like this for five minutes, uninterrupted.
I felt confident Jane’s plan would be effective if she followed it.
After tracking her progress, we would consider menopause hormone therapy
to treat her night sweats if they continued to be an issue.
Jane took my recommendations seriously and changed her routine. She began to sleep again and she started exercising, lost some weight and improved her overall mood.
A surefire route to healthy grilling: Toss some fresh fruits and vegetables on the grill and drizzle on some olive oil. (Courtesy Spectrum Health Beat)
Tired of the same old barbecue? Looking for healthier options that transcend those humdrum hot dogs and banal burgers?
It doesn’t matter if you’re a vegetarian or a meat-lover, or even something in between—there are plenty of ways to add variety and flavor to your summer grilling plans.
And the best part is, you can keep it healthy along the way.
Healthier hot dog
At a ball game or barbecue, hot dogs just seem to call your name. And
they appear so innocent because they’re so small and simple.
But don’t be fooled. Done wrong, a single hot dog can pack on the calories.
If you get a dog with all the fixings—cheese, chili, ketchup, mustard, mayo and baked beans—and you add coleslaw, macaroni salad or potato salad as a side, you’re looking at anywhere from 750 to 2,000 calories. Not to mention all the fat.
But you don’t need to avoid hot dogs altogether. You just need to choose wisely.
Look for a hot dog that has less fat than its original version.
For example: A Hebrew National standard beef frank has about 150 calories and 13 grams of fat, but the “97 percent fat-free” version has 45 calories and 1 gram of fat. The better-for-you version has 105 fewer calories and 12 grams less fat.
It’s simple math.
You can also get turkey, chicken or veggie franks as a healthier option to make at home. It’s also recommended you choose a whole wheat bun for added fiber.
If you trade in your pork brat for a turkey brat, you’ll cut your calories in half and drastically lower your fat intake. A pork sausage has anywhere from 290 to 455 calories and 23 to 38 grams of fat per link. A turkey or chicken sausage, on the other hand, has about 140 to 180 calories and 7 to 12 grams of fat.
If you’re vegetarian, opt for veggie sausages made of soy, bean or tofu protein. Just about every grocery store offers delicious gourmet chicken sausages that are additive-free and they have great flavors such as sun-dried tomato, gouda and apple, and spinach feta. (For the sake of comparison, the typical chicken sausage has about 180 calories and 12 grams of fat.)
As a side, meanwhile, fill up on grilled veggies and veggie-and-bean salsas (sometimes called “cowboy caviar”). Or choose fruit salad instead of pasta and macaroni salad.
It’s truly all about making healthy substitutions that suit your taste.
Meat mythology
Somewhere along the way, you’ve probably heard that ground turkey is a
healthier option than ground beef, particularly if you’re looking for
fewer calories and less saturated fat.
But that’s not always the case.
Turkey breast is lean, but dark turkey meat is not. And some ground turkey contains both.
A quarter-pound of regular ground turkey contains 3 grams of saturated fat, but the same amount of extra-lean ground turkey has just 0.5 grams of fat. The right cut of turkey offers a sizable difference.
A few tips for ground beef:
With ground sirloin, always opt for
the 90/10 ratio over the 80/20 or 85/15. Just 4 ounces of 90/10 contains
190 calories and 11 grams of fat.
Beware of 80/20 ground chuck. About 4 ounces has 280 calories and 20 grams of fat.
For juicy, grilled burgers that are good for you, don’t just look to beef to satisfy you.
Try veggie burgers with guacamole topping for good fats, or try grilled salmon patties. These are easy to find in your local grocery store. You can also try ground lamb with spinach and feta if you’re looking for a Greek twist.
Marinate your protein
Kansas State University researchers found that using herbs and spices in marinades can reduce carcinogenic compounds in grilled meats by up to 88 percent.
Other research has found that oils, vinegar and even beer can cut down on carcinogens in meat. The marinade could create a protective barrier between the meat proteins and the heat of the grill, or the antioxidants in the marinade may combat the carcinogens.
If you want to reduce charring, use a George Foreman Grill. It works beautifully for salmon, flank steak, burgers (veggie and meat) and pork tenderloin. Smaller, 1-pound tenderloins are great, and flank steak is an excellent lean meat for grilling.
Go beyond the bun
You don’t have to rely on mainstays like burgers and hot dogs for your outdoor cooking. A few quick examples of some creative alternatives:
Pizza. Grill a pizza and make it caprese by topping it with fresh-sliced mozzarella, tomato slices, basil and a drizzle of garlic olive oil and fig balsamic.
Fajitas. Grill your chicken strips, onions and peppers and top it with fresh salsa and guacamole in a corn tortilla.
Portobello. You can make a vegetarian burger by grilling portobellos, red peppers, goat cheese and basil pesto.
Tacos. Grill up fish tacos and add your favorite slaw, or try a Korean taco made with flank steak and guacamole. There are so many great recipes for this on the internet.
Veggies. Toss them with olive oil, and use sturdy ones that won’t fall through the grill. Asparagus, sweet potatoes, onions, multicolored peppers, zucchini and eggplant are all great options. They can take just five to 10 minutes depending on the heat. Toss with pesto or garlic for added flavor.
Grill your dessert
With all these healthy grill options, you’ll of course need to leave a little room for a fun dessert.
Grill a slice of pound cake and serve it with grilled pineapple with chipotle olive oil and Persian lime olive oil, or grilled peaches with a little olive oil and a cinnamon pear balsamic and your favorite gelato.
These tips are bound to brighten up your grilling this summer. They’ll also keep you healthy while you still get to enjoy great-tasting food.
Flip-flops and sandals may look lovely, but are they the best choice for foot health? Not really, according to research. (Courtesy Spectrum Health Beat)
Every spring, they emerge in droves from their winter hibernation. Their unmistakable sound heralds the arrival: flip, flop, flip, flop, flip, flop.
From the beach to the mall and environs in between, flip-flops are the go-to warm-weather footwear for many a person.
And while these same folks will tell you they wear flip-flops for comfort, research suggests this type of footwear is often a big source of discomfort.
And not just that—it can also cause serious problems.
Studies have shown that flip-flops can alter your gait pattern—essentially the way you walk. This alteration affects not only the biomechanics of the foot and ankle, but the knee, hip and back.
In a normal gait cycle, the action begins with the foot making contact with the ground on the outside edge of the heel.
As the forefoot comes to the ground in the stance phase of the gait cycle, the foot begins to pronate, or flatten, to provide shock absorption. The foot adjusts to the surface on which you’re walking.
The foot then becomes more rigid, serving as a lever for the muscles of the lower leg as they contract. As the foot leaves the ground, it enters the swing phase of the cycle.
If the moment of pronation here is too pronounced or too drawn out, it can affect the entire lower extremity.
Excessive foot pronation increases the stress at the knee and hip joints, which can create problems in the foot, ankle, knee, hip and lower back.
A big problem with most flip-flops is the lack of support they provide at the arch on the innermost part of the sole. This allows excessive pronation, which may contribute to dysfunction and pain in the lower extremity.
Under pressure
Flip-flops also affect more than just the kinetic chain of events.
Research has shown that people will experience more pressure on the bottom of their feet when they wear flip-flops, as compared to those who are barefoot or wearing shoes.
Flip-flops can be insufficient for dissipating ground reaction forces. A greater amount of force travels through the lower extremity of someone wearing flip-flops, placing more stress on the ankle, knee, hip and back.
Flip-flops can also cause a shorter stride length and an inefficient gait, leading to increased stress on the lower extremities.
Much of this arises from the flip-flop wearer’s need to hold the flip-flop on with the toes.
Scrunching the toes to maintain the position of the flip-flop activates muscles toward the back of the leg and the sole of the foot, which moves the toes and foot downward.
When walking, we’re supposed to move the toes and foot upward as the foot clears the ground.
Flip-flops hamper this motion, as well as compromising the normal function of the plantar fascia (a ligament on the bottom of the foot). The normal tightening of the plantar fascia allows for improved function of the foot as a propulsive lever.
The reduced function with flip-flops contributes to more force through the lower extremity and decreased stride lengths during the gait cycle.
But here’s the all-important question: What might all of this lead to?
Well, a variety of discomforts, imbalances and overuse injuries, some of which include plantar fasciitis, stress fractures, arch pain, bunions, shin splints, tendonitis in the tendon connecting your kneecap to your shinbone, knee and hip dysfunction or pain, bursitis of the knee and hip, low back pain and more.
It’s not hard to see how flip-flops can cause some serious problems.
The good news? Summer style and optimal foot comfort are still within reach.
“When looking for a sandal, look for one with a contoured foot bed with arch support, as opposed to flat-soled flip-flops,” said John Harris, DPM, FACFAS, a Spectrum Health Medical Group orthopedic foot and ankle surgeon. “In addition, pick a sandal that does not require you to scrunch your toes to hold them on. Perhaps a sandal with a heel strap.”
If you must wear flip-flops, you should limit use to short distances and a short amount of time.
“Parents, be leery of allowing your kids to use flip-flops as their go-to summer shoe gear,” Dr. Harris said, explaining that many of the summer injuries he sees are attributable to flip-flops.
Also, be sure to replace your footwear frequently—it can help ensure a pain-free summer for your feet, knees, hips, legs and back.
Even though many moisturizers now contain sunscreens, people may not put them on their faces as carefully as they do sunscreen lotions, new research suggests.
“Moisturizer is not as well applied as sunscreen,” said lead author Kevin Hamill, a lecturer in eye and vision science at the University of Liverpool in England.
“Therefore, if planning prolonged sun exposure, we advise sunscreen be used,” he added. “If using moisturizer, we advise one with SPF (sun protection factor): any SPF is better than none but it should not be considered the equal of sunscreen.”
For this study, researchers exposed 84 volunteers to ultraviolet radiation and photographed them using a UV-sensitive camera on two separate visits. The photos were taken before and after participants applied SPF30 sunscreen to their face on one visit or moisturizer on the other visit.
Coverage was worse for the moisturizer (nearly 17% missed) than the sunscreen (11% missed), the findings showed. This difference was mostly due to less coverage of the eyelid regions—21% missed with moisturizer and 14% missed with sunscreen.
Most participants were unaware they had worse coverage with moisturizer than with sunscreen, according to the study published online April 3 in the journal PLoS One.
The study authors noted that particular attention should be paid to the eyelid area when applying any SPF cream.
In addition, other methods of protecting eyelids, such as UV filter sunglasses, should be considered, they suggested in a journal news release.
The growing season is here—and that means it’ll be easier than ever to get your fill of fresh fruits and vegetables.
But only if you keep seasonal fare top of mind.
Spectrum Health dietitian Caren Dobreff has plenty of tips to help you and your family make the most of summer produce.
It could pay off in your waistline and your wallet.
During the off season, fresh fruits and vegetables are often harder to find and more expensive, given the steeper costs for transportation and logistics.
“Buying fresh fruits and vegetables in season and locally is much more cost effective,” Dobreff said.
Local food pantries and community and government organizations also run programs that make fresh items accessible to everyone, regardless of income.
Also, consider yourself fortunate if you live in a state that values the agriculture industry and local farmers markets.
“(You’re) able to capitalize on those nutrient-rich fruits and vegetables as we go into the growing season,” Dobreff said.
That’s good news all around, as the list of the health benefits from a diet rich in fruit and vegetables is long, Dobreff said. It includes lower risk of high blood pressure, heart disease, some cancers, diabetes and digestive problems.
An added benefit to eating fresh: slimming down.
“Weight management can be an outcome without it being the primary goal,” Dobreff said.
Under the current guidelines, the typical 2,000-calorie-a-day diet calls for about 2 1/2 cups of vegetables and 2 cups of fruit. For children ages 13 and younger, the guideline varies by age—anywhere from 1 to 1 1/2 cups of vegetables and the same for fruit.
Dobreff’s 5 tips to highlight the summer bounty:
1. Keep it in sight
Make bowls of fresh fruit visible in your kitchen and keep prepared, chopped vegetables easily accessible in the refrigerator.
“We eat with our eyes and we are cued or prompted with foods that are ready to eat and easily in reach and visible,” Dobreff said.
2. Tweak recipes
Substitute traditional, all-meat dishes with vegetables.
Make a meatloaf using lean beef or ground turkey and replace half the meat with diced, cooked vegetables such as onions, mushrooms, zucchini or bell pepper. Substitute half the pasta in macaroni and cheese with broccoli, or half the ground beef in spaghetti sauce with mushrooms.
3. Prioritize plant-based
How about meatless Mondays? Try a new plant-centered recipe each week, such as broccoli salad with balsamic vinegar, nuts, diced red onions, garbanzo beans and diced apples. Another option: veggie burger with lettuce, tomato and sliced red onion on a toasted whole grain bun.
The U.S. Department of Agriculture offers a simple tip: At every meal, fill half your plate with fruits and vegetables.
4. Involve the kids
Drum up excitement in your kids by getting creative with fruits and vegetables.
Visit local farms where you can pick your own strawberries, blueberries, cherries or other produce. Make trips to the local farmers market so your kids can talk to area growers about their foods.
Help your kids plant a garden or, even easier, put together some patio pots.
“Bell peppers, tomatoes, green beans and peas are great patio growers and are easy to maintain,” Dobreff said.
Find a local cooking class to take with your family. At home, have the little ones pick out a new recipe that features fruits and vegetables—and then involve them in meal preparation.
“If your kids struggle with eating whole fruits and vegetables, remember that kids’ palates are sensitive and it can take over nine or 10 times of trying a new food before it’s accepted,” Dobreff said. “Don’t give up. Let a little time pass and try again.”
5. Get closer to the land
Join a community supported agriculture organization—a CSA—or take advantage of local farmers markets.
By getting closer to the land, you learn more about what’s in season. You can then incorporate these findings into your meal planning.
In Michigan, for example, asparagus is an early arrival in May and June, followed by lettuce and greens, sugar peas, radishes, beans, peppers, tomatoes and more. Some vegetables, like Brussels sprouts, potatoes and squash, are available well into the fall.
Sage advice: Get outside and start enjoying the benefits of the growing season.
“Successful healthy eating patterns are sustainable, easy to incorporate into the long haul and have stood the test of time,” Dobreff said. “Equally important is that they are backed by research and evidence.”
Menopause can be tough enough to handle, but when hot flashes and weight gain are accompanied by dry, scratchy, irritated and red eyes, it’s time to take action.
This condition actually has a name associated with it—dry eye of menopause—and it is a common complaint of women over 50.
Many women talk about it, ask their physician about it, and don’t like it, but there are no clear answers as to why women suffer from this condition. And, unfortunately, we don’t really know what to do about it. Is dry eye really associated with menopause, or is it a product of aging? We aren’t completely sure.
A patient I’ll call Rhonda suffered from several symptoms during menopause, including dry and irritated eyes. The 54-year-old finally decided to call our office for help.
She had been period-free for about 15 months, and her menopause symptoms were not going away. She started with night sweats and irritability roughly six months before her last period, but soon after her final period (not knowing it was her last one), the hot flashes started with a vengeance.
And the symptoms just kept coming. Rhonda didn’t sleep well, her moods became erratic, and she gained weight without changing her diet or exercise plan. For many months, Rhonda thought she could just handle everything, but after blowing up at a lady who left her cart in the middle of the aisle in the grocery store one day, she knew something had to change.
Rhonda took her first step by seeing her family practice physician. Although helpful, Rhonda wasn’t sure about her doctor’s recommendation to start taking hormone supplements.
So, instead, her doctor started her on the medicine Lexapro for the hormone-related mood changes. Lexapro increases the brain chemicals lost with poor sleep and lower estrogen levels. The medicine quickly helped with her mood swings and also cut her hot flashes in half.
Unfortunately, the weight gain continued, and she started having really scratchy eyes. She went back to her doctor thinking she had something stuck in them. After a thorough examination of her eyes with a special lamp, the doctor concluded they were clearly red and irritated despite having no foreign particles in them. She told Rhonda she had seen many women with dry eyes when they started menopause and perhaps it was time to consider hormone medication.
Rhonda left the office determined to take the next step in getting relief for this annoying symptom. She made an appointment at the Spectrum Health Medical Group Midlife and Menopause Offices with Natasha Peoples, a nurse practitioner and certified menopause practitioner. Peoples walked her through our menopause symptom and lifestyle assessments, also known as SEEDS (Seven Essential Elements of Daily Success).
The assessment confirmed that Rhonda had many of the symptoms, even though some of them were better with the Lexapro. Rhonda’s No. 1 goal was to get help for her dry eye issue, and she hoped Natasha could give her some advice. Her job required her to sit at a computer screen for several hours each day, and her eye symptoms made it difficult to concentrate.
After listening to Rhonda’s concerns, Natasha explained how the body changes with menopause, focusing specifically on the dry eye problem. We know that dry eye of menopause in women is common, no matter what age they experience menopause—at 30, 45 or 55. And, for many women, the symptoms of dry, scratchy eyes get better with estrogen. Testosterone is thought to possibly play a role in tear formation as well, and, without good studies to help us, testosterone in low doses added to estrogen could also help.
There are also some other options that may help dry eyes if a woman either can’t (because of medical reasons) or simply won’t add hormones to her daily routine. Dry eye of menopause is thought to be from quicker evaporation of tears and lower-quality tears (tears that are watery and don’t have much oil to coat the eye surface). Conversations with patients tell us that over-the-counter medications such as artificial tears and lubrication ointment can be effective for some, as well as adding fish oil or flax seed supplements to their diet. Even the basic habit of drinking water and staying hydrated can also play a positive role in eliminating this symptom.
Peoples thought Rhonda would benefit from taking hormones, but she first needed to make sure Rhonda was a good candidate. Natasha asked many questions about Rhonda’s medical history and lifestyle habits, and determined she was very healthy, except for being overweight. They talked about getting back to the basics and incorporating the SEEDS into her daily routine. And, they also worked out a plan to start menopause hormone therapy, deciding on the patch and FDA-approved progesterone capsules called Prometrium-bioidentical.
Three months later, Rhonda returned to see Peoples for her checkup and happily reported she felt better. She added one more walk to her week, started doing a DVD with weights, added yoga once a week, and began a routine of daily stretching. In addition, she drank more water, got better sleep and took a multivitamin, Vitamin D and fish oil.
Two weeks after starting the hormones, her hot flashes disappeared, and although her dry eyes weren’t completely back to normal, they were only a minor nuisance and no longer bothered her at work. Even her friends and family members noticed she was acting and feeling better.
Women, including Rhonda, do not have to suffer during menopause. Sometimes even the most basic habits can make all the difference in helping us feel better. And, even though Rhonda’s health care providers aren’t completely sure which change helped her eyes improve the most, Rhonda enjoyed feeling better than she had in a long time.
Berries are nature’s natural sweetener and they come loaded with benefits. Fiber, vitamins and antioxidants sweeten the deal.
Fresh strawberries are a plentiful spring and summer fruit, so load up on them at the farmer’s market. One cup contains 100 percent of your daily vitamin C needs and has just 46 calories.
Here are two great ways to turn a basket of berries into sweets. The first is a simple, low-sugar refrigerator jam that you can use in many ways, from a tasty topping for toast to a sweetener in smoothies.
Low-sugar strawberry jam
4 tablespoons cold water
1-1/2 teaspoons unflavored gelatin
1 pound strawberries, chopped
1 tablespoon honey
Place two tablespoons of cold water in a small bowl. Sprinkle the gelatin over the surface. Do not stir. Set aside to soften.
Meanwhile, place the strawberries in a heavy saucepan, along with the other two tablespoons of water. Bring to a boil, reduce heat and simmer until berries are softened, about five minutes. Stir in the gelatin and the honey. Chill at least one hour before serving.
Yield: About 2 cups
Strawberry trifle
A fresh trifle is a tasty way to showcase seasonal berries, but most traditional recipes are heavy in fat and sugar, mostly from the lemon curd. By lightening up homemade curd and using yogurt instead of cake layers, this dessert is guilt-free.
2 large lemons, zested and juiced
1/4 cup sugar or sugar substitute
3 large eggs
3 tablespoons butter, cut into bits
4 cups assorted berries, stemmed and halved
2 cups plain 2 percent Greek yogurt
Whisk the lemon juice and zest, sugar and eggs in a 2-quart heavy saucepan. Stir in butter and cook over moderately low heat, whisking frequently, until curd is thick and clings to the whisk, about six minutes.
Transfer lemon curd to a bowl and press a piece of plastic wrap on the surface to prevent a skin from forming. Chill in the fridge until cold, at least 60 minutes.
When chilled, layer half the curd in the bottom of a glass bowl. Add a third of the berries, then top with 1 cup of the yogurt. Repeat with layers of curd, berries and yogurt and finally top with a layer of berries. Cover with plastic wrap and chill at least 60 minutes before serving.
Vitamin D is the healthy “sunshine” vitamin, but it can have a dark side, one Canadian man discovered.
A team of Toronto physicians reported on the case of a 54-year-old man who developed kidney damage after taking extremely high doses of vitamin D.
It’s a cautionary tale for consumers, medical experts say.
“Although vitamin D toxicity is rare owing to a large therapeutic range, its widespread availability in various over-the-counter formulations may pose a substantial risk to uninformed patients,” said study co-author Dr. Bourne Auguste. He’s a clinical fellow in home dialysis at Toronto General Hospital and the University of Toronto.
As reported recently in the Canadian Medical Association Journal, the man was seen by doctors after he returned from a holiday in Southeast Asia, where he spent much of his time sunbathing. Vitamin D is naturally synthesized by the skin upon contact with sunlight.
Testing showed that the man had elevated blood levels of creatinine, a marker for kidney damage or malfunction. The patient was then referred to a kidney specialist and underwent further testing.
Doctors learned that the man had been prescribed high doses of vitamin D by a naturopath—even though he did not have vitamin D deficiency and no history of bone loss.
Over 30 months, the man had taken eight to 12 drops of vitamin D—a total of 8,000 to 12,000 International Units, or IUs—per day.
The typical recommended daily allowance of vitamin D is 400 to 1,000 IU, with a higher amount (800 to 2,000 IU) recommended for adults at high-risk of osteoporosis, and for older adults.
The patient far exceeded those dosages, however, and that led to extremely high levels of calcium in his blood. It’s those high blood calcium levels that triggered his kidney damage, Auguste’s team said.
“Patients and clinicians should be better informed about the risks regarding the unfettered use of vitamin D,” the study authors concluded.
Dr. Maria DeVita directs nephrology—kidney medicine—at Lenox Hill Hospital in New York City. Reading over the case report, she said that “overuse of the vitamin, as is true of many supplements, may have dire adverse effects.”
DeVita said, “Vitamin D is necessary for the development and maintenance of strong bones, (but) the take-home message is too much of a good thing is not good.”
Research suggests yoga may impart a multitude of health benefits, including reduced blood pressure and lower stress levels. (Courtesy Spectrum Health Beat)
For years, aerobic exercise has been touted for its numerous health benefits, including improved cardiovascular health, better mood, increased energy and stronger bones and muscles.
But there’s another form of physical activity that’s grabbing headlines—yoga.
Some studies suggest the mind-body practice may be good for heart health, from reducing blood pressure and cholesterol to lowering stress and body mass index.
While yoga often is associated with images of limber practitioners, it is more than just stretching and handstands.
Originated in India, yoga includes physical poses (asana), breathwork (pranayama) and meditation. There are many yoga styles, including Hatha, Iyengar, restorative and hot yoga, each with a specific emphasis such as alignment or relaxation.
Recently, more Americans are stepping onto the mat.
According to the Centers for Disease Control and Prevention, 14.3 percent of U.S. adults—or 35.2 million—practiced yoga in 2017, up from 9.5 percent in 2012.
Many take up the practice as a holistic approach to health and wellness and for its stress-busting effect.
“There’s a huge body of literature that says psychosocial stressors such as work and marital stress, as well as anxiety and depression, are associated with increased risk for cardiovascular disease,” said Dr. Puja Mehta, an assistant professor of medicine in the division of cardiology at Emory University School of Medicine in Atlanta.
“With chronic stress, the sympathetic nervous system is in overdrive,” which can lead to inflammation and increased blood pressure, Mehta said.
Yoga may help put the brakes on the body’s stress response by activating the parasympathetic nervous system, or the “rest and digest” system, through deep breathing and relaxation, Mehta said.
Cultivating mindfulness also may encourage participants to engage in other habits that boost cardiovascular health by promoting self-awareness and self-care behaviors.
“(This) can have a profound effect on supporting the engagement of healthy behaviors of diet and physical activity,” said Dr. Gloria Yeh, associate professor of medicine at Harvard Medical School and director of mind-body research at Beth Israel Deaconess Medical Center in Boston.
Research also shows yoga may lower cardiovascular risk factors.
Yeh coauthored a 2014 review of clinical research published in the European Journal of Preventive Cardiology that found yoga had a significant impact on cardiometabolic risk factors compared to doing no exercise at all.
For example, yoga decreased total cholesterol by 18.48 mg/dl and triglycerides by 25.89 mg/dl more than the change seen in the control group. Blood pressure improved too. Systolic and diastolic blood pressure decreased 5.21 mmHg and 4.98 mmHg, respectively.
The benefits also extend to people with heart disease.
Among people with paroxysmal atrial fibrillation, in which symptoms come and go, doing 12 weeks of yoga combined with deep breathing resulted in a lower heart rate, lower blood pressure and higher mental health scores compared to those who didn’t do yoga, according to a 2016 study published in the European Journal of Cardiovascular Nursing.
Mehta said although these and other scientific studies show promising results, there are some limitations, such as a small number of participants.
In addition, because yoga encompasses a variety of elements, there isn’t a standard dose of yoga, which makes comparisons across studies difficult, she said.
Both Yeh and Mehta said more research is needed, including more randomized clinical trials and a better understanding of the exact mechanism behind yoga’s cardiovascular benefits.
“We need to better understand for whom yoga may be more beneficial and how,” Yeh said. “Because yoga is so heterogeneous with many different styles and emphases, we’d like to be able to match the right exercises with the right people at the right time. We need to understand how best to integrate yoga with other lifestyle measures.”
And the biggest research question remains, Mehta said: “Are you going to live longer and not have cardiovascular events like heart attack or stroke?”
For older adults and people new to yoga, Mehta recommends looking for gentle, restorative or chair-based classes.
People with heart disease or high blood pressure may need to modify some poses and avoid postures that place the head below the heart, she said. Experts also suggest pregnant women in particular steer clear of “hot yoga,” or yoga classes that take place in a heated room, because of the risk of overheating and dehydration.
The bottom line, Yeh said, is that yoga is exercise and “any exercise is better than no exercise, so the activity that someone will do—and enjoy doing—will be the one that provides the most benefit.”
Reprinted with permission from Spectrum Health Beat.
Simple table salt ought not trouble you at mealtime. The real concern is how much salt went into processing and preparing the meal itself. (Courtesy Spectrum Health Beat)
If you’re like most people, you won’t have any trouble identifying the usual suspects. (French fries, chips and pretzels—we’re looking at you.)
The leading sources of excess sodium in the average American diet are less obvious.
Packaged foods such as bread, desserts and even canned vegetables—vegetables, for Pete’s sake!—can be prepared with alarmingly high salt levels.
That should be a cause for universal concern.
While there’s been some debate about precise levels, current guidelines call for an intake of 2,300 milligrams of sodium a day.
| The American Heart Association goes even further, recommending all American adults try to limit themselves to 1,500 milligrams per day. This is also the level recommended for people with high blood pressure and heart disease.
African Americans are also advised to stick to the lower level.
The reality? The average American eats well over twice that amount, or about 3,400 milligrams a day, and sometimes more.
“Most people don’t realize that the problem isn’t using their salt shaker, but all the foods they eat with those hidden sources,” said Caren Dobreff, RD, projects dietitian at Spectrum Health.
Such as? “Toast and cereal,” Dobreff said. “Because sodium is widely used for flavor, as a leavening agent (think baking soda), as a preservative, it turns up in places you don’t expect.” Portion sizes can add to the confusion since few people limit themselves to a single slice of bread or a half cup of cereal.
The immediate impact of too much salt can be a bloated feeling due to water retention.
“Water retention can make your socks or shoes or waistband feel snug,” Dobreff said.
Over time, too much sodium may increase the risk of high blood pressure, stroke and heart failure, as well as osteoporosis, stomach cancer, kidney disease and headaches.
The best defense: Tune up your sodium radar.
Restaurant foods contribute to about a quarter of the typical American’s dietary sodium. Meals prepared at home account for another 10 percent. Surprisingly, less than 5 percent of dietary salt is added at the table.
This means the worst offenders—about 65 percent, reports the American Heart Association—are foods we buy at the store.
Here’s how to protect yourself from sneaky salt attacks:
Read the label
Manufacturers of packaged foods must list nutritional information on the label. This includes listing sodium content.
The fine print will help you discover, for example, that 3 ounces of deli meat such as ham or turkey can contain up to 1,050 milligrams of sodium. A cup of chicken noodle soup packs 940 milligrams, a slice of American cheese has 460 milligrams and a piece of bread has 230 milligrams. That’s pretty salty.
Check chicken labels, too, especially if the package notes, “Contains broth.” Meat processors often plump the chicken by injecting it with sodium, improving moisture retention. This enhanced chicken can increase sodium content as much as 440 milligrams.
Most red meat cuts have 100 milligrams or less, but processed meat—think cold cuts, sausages and hot dogs—can have hundreds of milligrams of added salt.
Research your restaurant favorites
While it’s harder to learn what’s in your favorite restaurant foods,
most national chains have nutrition details on their websites.
A little digging before you get there will help you discover that a slice of pizza at your local shop may well have 760 milligrams of sodium, while a cheeseburger has a whopping 1,690 milligrams. At some fast food joints, just 3 ounces of breaded chicken strips contain 900 milligrams of sodium.
And don’t be fooled when restaurants label something low- or reduced-sodium. Reduced-sodium soy sauce, for example, can still have as much as 500 milligrams per serving.
Cook from scratch
Cooking from scratch offers the most control over how much salt winds
up on your plate. A tomato, for example, contains a mere 6 milligrams
of sodium. But half a cup of canned low-sodium diced tomatoes has
already more than tripled to 20 milligrams.
A helping of regular canned tomatoes is 10 times saltier, at 220 milligrams.
“Look for ways to create flavor explosions,” Dobreff said. She recommends high-impact seasoning like citrus, vinegar, herbs and spices, such as cumin and chili powder.
Don’t get duped
As appealing as some popular gourmet salts sound—pink Himalayan,
Hawaiian black lava, grey sea salt, kosher salt and even dusting
salt—they’re still just sodium chloride.
“Some people like to experiment with them for flavor and some are prepared more naturally,” Dobreff said. “But the sodium is roughly the same.”
Plan a counterattack
When you’ve got a major salt craving, play nutritional offense. Keep
whole fresh fruits and vegetables and unsalted roasted nuts and seeds on
hand. We tend to snack on what we can see and what our arms can reach.
“Buy a lower-sodium type of pretzels or chips, for example, and count out the amount of a single serving,” Dobreff said. “Then enjoy them. But be careful to balance them out with foods that day that are high in potassium, such as bananas, citrus fruits, papayas, avocados or potatoes.”
A black-legged tick poses on a leaf, waiting for an animal to brush up against it, so it may crawl on its new blood host. (Courtesy Spectrum Health Beat)
“Many of us have heard about the tick boom,” said Rosemary Olivero, MD, a pediatric infectious disease specialist with the Spectrum Health Medical Group. “It’s important to remember that we always expect a dramatic increase in the presence of all types of ticks during this time of year.”
The Michigan Department of Community Health has reported an increase in black-legged ticks along the Lake Michigan shorelines during the past seven years. The black-legged tick was formerly referred to as the deer tick.
Brian Hartl, an epidemiologist at the Kent County Health Department’s Communicable Diseases division, said the tick boom has been a multi-year trend.
“In terms of ticks, we don’t do any surveillance, per se, but we know the tick habitats are spreading eastward,” Hartl explained. “Historically, black-legged ticks—those that carry Lyme disease—have been on the lake shore. But they’re expanding inland from the lakes.”
But there’s more trouble to ticks than just Lyme disease, Dr. Olivero said.
“The black-legged tick can transmit Lyme disease, which is the most common tick-borne infection in Michigan,” she said. “The same tick can also transmit Anaplasmosis and Babesiosis, which almost never occur in Michigan. Other ticks (such as the American Dog tick, Lone Star tick, Woodchuck tick and Brown Dog tick) can transmit other diseases: Rocky Mountain spotted fever, Tularemia, Ehrlichisos, Anaplasmosis and Babesiosis. Luckily these infections are quite rare in Michigan.”
This arrived on the tails of the agency sharing news about a new, formerly rare tick-borne illness—the Powassan virus. Seventy-five cases of Powassan were reported in the United States in the past 10 years, but that number is expected go up as the ranks of mice and the ticks that carry the disease increase.
Symptoms of this serious infection can include fever, headache, vomiting, weakness, confusion, seizures and memory loss. Long-term neurologic problems may occur. The CDC notes there is no specific treatment, but some people need to be hospitalized to receive respiratory support and intravenous fluids or medications to reduce swelling in the brain.
Hartl said the best defense against ticks is to make it tough for them to latch on in the first place.
“Really it’s just being cognizant of your environment,” he said. “If you’re camping or hiking, wear pants or long socks to keep from getting ticks. They like to hang out in long grass and grab hold of you as you walk by.”
And if you do find a tick attached to your body, properly remove it. There are some videos online for how to do so. Dr. Olivero recommended this video for the proper way to remove ticks. For Lyme disease to be transmitted, ticks need to be attached for 24 to 48 hours.
“If you can remove it quickly enough you can keep from getting Lyme disease,” Hartl said.
Dr. Olivero agreed.
“There are two effective ways to prevent tick bites: wearing long sleeves, and using insect repellents,” she said. “Doing daily tick checks to remove any attached ticks can help prevent contracting Lyme disease from a tick. Important areas to check for ticks include the hairline and behind the ears. Carefully, using pointed tweezers, is the most effective way to remove a tick.”
An ounce of prevention truly is worth a pound of cure: A severe sunburn in your youth can nearly double your chances of developing melanoma later in life. (Courtesy Spectrum Health Beat)
Only half of Americans routinely protect themselves from the sun when outdoors, a recent American Academy of Dermatology survey found.
Those who don’t practice sun safety put themselves at increased risk for skin cancer, which is the most common cancer in the United States, despite being one of the most preventable cancers.
One in 5 Americans will develop skin cancer at some point in their life, the AAD estimates.
Just one serious sunburn in childhood or the teen years can nearly double a person’s risk of developing melanoma, the deadliest form of skin cancer, later in life.
“Exposure to the sun’s harmful UV rays is the most preventable risk factor for skin cancer, and there are many simple things you can do to protect yourself from the sun,” AAD President Dr. George Hruza said in an academy news release.
Seek shade when possible, especially between 10am and 2pm when the sun’s rays are strongest.
Wear protective clothing, such as a lightweight, long-sleeved shirt, pants, a wide-brimmed hat and sunglasses.
Apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher to all skin not covered by clothing. Reapply every two hours or after swimming or sweating.
“It’s also important to remember to protect parts of your body you think might not be getting any sun,” Hruza said.
“Areas like the tops of your hands, bottoms of your feet or the part in your hair may not immediately come to mind when it comes to sun protection, but they are still vulnerable to dangerous sun damage,” he explained.
Skin cancer is highly treatable when caught early, so it’s important to do regular skin self-exams and look out for ABCDEs—the warning signs of melanoma:
Asymmetry: One half of the spot is unlike the other half.
Border: The spot has an irregular, scalloped or poorly defined border.
Color: The spot has varying colors from one area to the next, such as shades of tan, brown or black, or areas of white, red or blue.
Diameter: Melanomas are usually greater than 6 millimeters (about the size of a pencil eraser) when diagnosed, but they can be smaller.
Evolving: The spot looks different from the rest or is changing in size, shape or color.
“If you find any new or suspicious spots on your skin, make an appointment to see a board-certified dermatologist,” Hruza said. “Spots that are changing, itching or bleeding could be a sign of skin cancer, and the earlier skin cancer is detected, the easier it is to treat.”
Too much sugar is never good for you. Combine it with extra stress, and you have a recipe for disaster.
There are certain times of the year we know we will indulge in extra sweets: holidays, birthdays, graduations and work outings. These are also times when we might feel more stressed.
But is it possible to enjoy sugar in moderation and be healthy at the same time? Absolutely.
If you can master the basics of healthy eating, despite the extra stress you may be feeling, you can keep your eating in check during any occasion.
Belly up and listen
What I’m really talking about is belly fat. I take this topic very
seriously because belly fat can kill you. It can happen to any of us,
and it’s something I discuss with nearly all of my patients at one time
or another.
Shelly is one of those patients. She came to see me for her physical, and she was upset because her favorite jeans did not fit.
She was just 50 years old and still having periods, and she began to notice her metabolism changing. She had gained her usual 5 pounds over the summer because of numerous summer parties, backyard barbecues, fruity cocktails and beer.
She typically didn’t drink during the week, but it was just too easy to crack open a cold beer when she was doing yard work under the summer sun. When friends would stop over, she’d mix up some drinks. I’m sure we can all relate to these same situations.
In the past, Shelly would go back to her normal routine when fall arrived. The 5 pounds would come right off. She would only drink on the weekends and she’d begin a better routine of regular exercise and sleep.
This year, however, something was different: She didn’t lose the 5 pounds and she actually started gaining weight.
Knowing that the holidays weren’t far off, she was worried her weight would get out of control and she would have even bigger issues.
Shelly was smart to be worried.
Once belly fat starts, it gets a mind of its own and can get out of control quickly. That’s exactly what was happening to Shelly—she was gaining all of her weight in her belly. I knew she was concerned and disappointed.
She said she always had a flat belly, but now that was changing.
Icky, sticky
A recent study in the Annals of Internal Medicine proves what we already know: Belly fat leads to early death in men and women by increasing our risk of heart attack and stroke—up to 10 years earlier than it might have happened if we didn’t have any belly fat.
The reality is most of us will die of heart attack or stroke at some point. But belly fat makes it happen sooner.
How? Belly fat is deep on the inside, wrapped around your bowels and liver, and craving sugar. As belly fat grows, your liver uses it to make bad cholesterol, and then the belly fat produces inflammatory chemicals to make your blood vessel linings sticky.
At the same time, the fat makes your body insulin-resistant, raising insulin levels and keeping blood sugar high by making you crave sugar.
This combination—sticky blood vessels, high blood sugar, and high cholesterol—causes plaque to build up in the blood vessels, blocking blood flow to your brain and heart muscle. All of this can lead to heart attack and stroke, and once the belly fat gets going, it doesn’t give up easily.
Bottom line: We can’t let the belly fat start.
Back to basics
Another factor that makes belly fat grow is stress—both good stress and bad stress.
Added stress can raise insulin levels and use up stress hormones such as cortisol and DHEA. It can cause our sleep to be interrupted, leaving us sleepy and fatigued. We know that sleep deprivation leads to insulin resistance, causing us to crave and store more sugar. It’s a vicious cycle.
During Shelly’s physical, I asked if I could measure her waist circumference. Measuring waist circumference is easy, but it can feel more personal than a pelvic exam.
Here’s how it’s done: Take a tape measure and wrap it around the small of your back, over your hip bones and around your belly.
We measured Shelly’s belly and it was 39 inches. Healthy is 35 inches.
After seeing that number on the measuring tape, Shelly made it a goal to lose 4 inches of belly fat.
After hearing what I had to say about belly fat, Shelly knew she needed to get off the sugar, reduce stress in her life, and change her sleep habits.
In other words, she needed to get back to the basics.
Grow with SEEDS
By having a plan, you can succeed even during the toughest of times.
When you adopt these habits and work hard to follow them every day, it is easier to get back on track if you have a stressful day or have a sleepless night.
When I talk about the basics, I am referring to the SEEDS—Seven Essential Elements of Daily Success—concept as a way of life.
Here are the seven basic things I discussed with Shelly:
Drink plenty of water (eight glasses a day). Add one more for each cup of coffee or for each serving of alcohol.
Get plenty of sleep (seven hours a night). Take power naps if necessary to be sure you are getting enough sleep.
Take your vitamins daily, including Vitamin D and a multivitamin.
Eat a balanced diet, including plenty of healthy carbs and protein, with only one sugar treat (including alcohol).
Eat plenty of fiber (think vegetables) and take a fiber pill if needed.
Exercise regularly (30 minutes a day, with a mix of walking, aerobic activity, strength training and stretching).
Start a gratitude journaland do metered breathing each night before going to bed.
You may have noticed that alcohol is mentioned more than once in the list of SEEDS.
Beer, wine and liquor are all forms of alcohol, and they all contain sugar. Since alcohol is often a part of a celebration or party, it’s important to limit your other forms of sugar (pasta, white bread, cookies, etc.) if you will be consuming a drink (or two or three) that same day.
And remember to add an extra glass of water for each drink consumed.
Shelly may not have been excited to see that her waist circumference was 39 inches, but she was happy with our discussion.
The end of the school year is fast approaching. The warm-weather days are finally here. You’ve penciled in your must-see, must-do events for the summer.
Boating. Amusement parks. Local festivals. Pretty much anything that gives you an excuse to soak up the sunshine.
But few things rival the all-time summer classic: picnics and potlucks.
And while those grand gatherings of food and friends may seem like they’re free of worry and strife, they’re actually a golden opportunity to contract foodborne illness—particularly if you don’t pay attention to food preparation and handling.
How many people really stop to think about the safety of the food that has been sitting in the sun all day? Foodborne illnesses happen more often than you’d expect.
You can smarten up your food safety by following these sensible tips on preparation, handling and storage.
Keep it cold
Place cold items into a cooler with ice or frozen gel packs. The temperature should remain below 40 degrees. Frozen meats should also be placed into a cooler to ensure they stay cold longer.
Once the cold food is served, it should not be left out for more than two hours. If the outdoor temperature exceeds 90 degrees, this time frame drops to one hour. If your cold food has been out longer than this, you need to throw it away. To help cool food when it’s out, you can place dishes such as chicken salad or potato salad directly onto a bowl of ice.
Rule the cooler
Your cooler should be in tip-top order, with everything organized
according to accessibility, use and safety. This avoids spillage,
contamination and overexposure to the warm temperature.
If you place an in-demand food item at the bottom of the cooler, for example, you will repeatedly expose other top-level, lesser-used items to the outdoor temperature. This is unwise.
For starters, consider placing beverages into a separate cooler, so your food cooler doesn’t need to be opened as frequently. This will keep the temperature down on your cold foods. And place your lesser-used items toward the bottom of the cooler.
The trick is to limit the number of times the coolers are opened, so you keep your food cold as long as possible.
Avoid cross-contamination
Keep raw meat, poultry and seafood securely wrapped to prevent any
juices from contaminating prepared dishes and raw foods. Consider using a
separate meat cooler, in fact, or placing raw meat below the prepared
dishes.
Prep your produce
When you’re packing things up at home, take time to rinse fresh fruits and vegetables under running water. Scrub any firm-skinned produce with a vegetable brush, and make sure you cut and prep all your servings so that you’re not messing with it at the picnic.
Grill it right
If you want to use a marinade, do it while the meat is in the refrigerator at home. Don’t re-use the marinade after the meat is cooked!
Also, if you are partially cooking the meat before grilling, do so immediately before leaving the house. Meat should be cooked thoroughly and kept hot until served.
Hot foods should be kept above 140 degrees when holding for serving and they should not be left out for more than two hours.
Avoid re-using platters or utensils that were used with raw meats.
The U.S. Food and Drug Administration offers a handy chart that details safe cooking temperatures. The U.S. Department of Agriculture offers seven tips for safe picnics, including this time-tested truth: “When in doubt, throw it out.”
Looking for a better way to bounce back from a sports injury or orthopedic surgery? The solution may be as close as your fork.
Experts say choosing the right foods—and avoiding the wrong ones—can help bones, muscles, tendons and ligaments repair faster, getting you off the couch and moving again.
“There are two things to keep in mind,” said Kristi Veltkamp, RD, who counsels Spectrum Health patients on eating well. “First, make sure you are managing inflammation. And second, get the nutrients needed to help you heal and repair.”
Inflammation after any injury is normal.
“There’s often heat, swelling or redness,” Veltkamp said. “To calm that inflammation, look for foods that are rich in omega-3 fatty acids, like those found in salmon, walnuts and flax seed. Olive oil also helps. And try to eat plenty of fruits and vegetables.”
If that all sounds familiar, it should. It’s the basis of the Mediterranean diet, which is shown to reduce inflammation, Veltkamp said.
Also avoid foods that are high in sugar, refined flour or trans fats. Alcohol, which slows healing, should be avoided as well.
Building blocks
Alongside managing inflammation, you should focus on getting plenty of the nutrients required for healthy rebuilding.
Start with protein.
“The majority of our tissues are made up of protein,” said Matthew Axtman, DO, a sports medicine specialist with Spectrum Health Medical Group Orthopedics. “So even though protein is part of your normal diet, look to increase healthy sources, like chicken, fish and nuts.
Dr. Axtman recommends getting plenty of vitamin C.
“It helps build collagen, which is the basis of tendons and ligaments,” he said. Look for it in citrus fruits, kiwi, peppers and tomatoes.
Calcium is also essential, especially if you’ve injured a bone. You can find it—along with Vitamin D, which aids in absorption—in dairy products and dark-green, leafy vegetables.
Avoid salt and caffeine during your recovery because they cause you to urinate more. This makes your body lose calcium, Dr. Axtman said.
Meanwhile, those deep-green vegetables are also a great source of fiber.
“If you’re sitting around more and moving less, it can affect your gut,” Dr. Axtman said. “Fiber-rich foods will help.”
Mind and body
During the rebuilding process, it may help to take supplements for
about two to four weeks. This holds true even if you typically prefer to
get all your nutrients from a balanced diet.
“While you’re healing, consider adding vitamin A, naturally found in many orange vegetables, at 10,000 IUs a day,” Veltkamp said.
Look for a multivitamin that contains 2 to 4 milligrams of copper and 15 to 30 milligrams of zinc, which is shown to help with wound healing.
Veltkamp also recommends HMB, a protein that can help prevent muscle wasting. It’s found in sports supplements such as Myoplex Muscle Armor.
Finally, give a little thought to the emotional aspects of eating. Recovery can be as tedious as watching grass grow, so it’s easy to fall into the trap of eating from boredom instead of hunger.
“Have a list of things you can do when you feel like reaching for food for the wrong reasons,” Veltkamp said. “Like knitting, taking a bath, anything soothing and distracting.”
It’s normal to have food cravings during recovery, but that’s because food can make us feel better. Don’t be afraid to treat yourself now and then.
“Just look for healthier alternatives,” Veltkamp said. “Like chocolate-banana smoothies.”
The most effective defense against hepatitis A is vaccination, but the most vulnerable populations typically remain unvaccinated. (Courtesy Spectrum Health Beat)
The number of Americans infected with hepatitis A has grown nearly 300% in just three years, health officials reported recently.
The staggering increase has come despite an effective vaccine and is seen mostly among drug abusers and the homeless, according to the U.S. Centers for Disease Control and Prevention.
Hepatitis A virus can linger in feces and be spread hand-to-hand, with infection occurring when a hand contaminated by the virus touches the person’s mouth.
“In the previous decade, large outbreaks of hepatitis A were rare and mostly attributed to contaminated commercial food products,” noted lead researcher Dr. Monique Foster, an epidemiologist in CDC’s Division of Viral Hepatitis.
Although 2016 saw two outbreaks of hepatitis A caused by contaminated food, the main culprit of outbreaks has been the living conditions of drug addicts and the homeless, Foster said.
The vast majority of the thousands of U.S. cases between 2016 and 2018 involved person-to-person transmission, Foster added.
“Since the hepatitis A outbreaks were first identified in 2016, more than 15,000 cases, 8,500 hospitalizations and 140 deaths have been reported,” she said.
Although hepatitis A can make you very sick, it usually goes away by itself in about six months, after which you become immune, explained Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City.
Hepatitis A attacks the liver, he said. Those most likely to develop serious liver illness are those with other conditions like cancer or those whose immune systems are not functioning normally.
The most effective defense against this potentially deadly infection is vaccination, which is also the best way to prevent outbreaks, Foster said.
“Since the widespread availability of the hepatitis A vaccine and recommendations to vaccinate children, the overall rate of hepatitis A infections has decreased dramatically in the U.S.,” she said.
But a large population of susceptible, unvaccinated adults who were not infected during childhood remain vulnerable to infection, Foster said.
This includes people who use drugs, homeless people and gay and bisexual men, she said.
“Vaccination is the most powerful tool we have to stop these outbreaks now and prevent similar ones in the future,” Foster said.
To this end, the CDC recommends that those at the highest risk get vaccinated.
“Transience, economic instability and limited access to health care among the affected populations have made the outbreaks more difficult for states to control,” Foster said.
Siegel believes, however, that the only way to contain the epidemic and prevent future outbreaks is to solve the social problems that feed it.
“This is really not a hepatitis A problem and it’s not solvable by giving everybody a vaccine,” he said. “We have to realize it’s a public health issue and it’s a matter of cleaning up places where the virus breeds.”
Only by improving sanitation can outbreaks among the most vulnerable be prevented, Siegel said. “It’s more an issue of sanitation, public safety and cultural problems than it is one of public awareness.”
The report was published recently in the CDC’s Morbidity and Mortality Weekly Report.
Warm weather activities seem custom-made for flip-flops.
But even Jimmy Buffett sings about how he blew out his flip-flop when he stepped on a pop top and cut his heel, then cruised on back home.
John Harris, DPM, FACFAS, a foot and ankle specialist with Spectrum Health Medical Group, certainly agrees with Buffett’s iconic lyrics. He would tell you not to wear the flip-flops in the first place. Then you wouldn’t have to worry about cutting your heel.
That’s not all Dr. Harris said about flip-flops, which he considers the scourge of the footwear world.
Top 3 reasons to throw out the flip-flops:
1. Ouch! Heel pain.
The lack of suitable, or any, arch support in flip-flops can cause plantar fasciitis—heel pain or pain across the bottom of the foot.
Anyone with this lingering condition will tell you to avoid it at all costs.
2. Pain in the … ball of the foot
Not having adequate cushioning and arch support can cause soreness on the bottom of the foot.
Treatment requires more supportive shoes with effective arch support.
3. Avoid ‘flip-flop heel’
This condition is caused by walking around barefoot or wearing shoes that don’t have a back.
A thick callus rim forms around the edge of the heel when wearing shoes like flip-flops that don’t have backs to act as heel counters. This creates a situation in which your heel is constantly being exfoliated while walking. That creates a callus.
Aside from being unsightly, the cracked rim of the callus is painful.
Other flip-flip concerns
Less common, Dr. Harris said, but equally concerning are injuries from activities while wearing flip-flops.
Doctors often see ankle sprains from someone playing basketball or other sports in flip-flops, skin abrasions from a child riding a bike while wearing flip-flops, or cuts on a foot when a person wears flip-flops into a river and they slip off and float, exposing the barefoot to sharp rocks and river debris.
In addition, a study by Auburn University points out that wearing flip-flops causes you to take shorter steps and changes the way you walk compared to your gait while wearing sneakers. This can cause muscle strain.
“Instead of flip-flops, wear activity-specific shoe gear,” Dr. Harris suggested.
He pointed out that the child riding a bike should wear sneakers, the basketball player should wear basketball shoes or sneakers, and the person in the river should wear something like Keen shoes for walking in a lake or river, unless it is a sandy-bottomed lake.
“For daily wear in the summer, I’ll wear a pair of shoes similar to flip-flops,” Dr. Harris conceded. “But, I choose a shoe or sandal that has a more substantial sole and significant arch support compared to the inexpensive and flimsy flip-flops you find at stores all over town.”
There are many brands that fit this category, he said, suggesting people look for something like Chaco, Keen, Teva or Vionic.
“They’re designed to protect your foot while allowing you to engage in activities,” he said.
All in all, Dr. Harris encourages everyone to look for summer sandals that have a more substantial sole compared to those that feature a couple millimeters of foam, often found in common flip-flops, and to look for sandals with arch support rather than just a flat surface for the foot bed.
“No matter what brand you select, you still should never play basketball or mow your lawn in flip-flops,” Dr. Harris warned. “It’s just too risky.”
For many women, cardiovascular disease is personal because they have lost their mom or sister to a heart attack or stroke.
They get how heart disease is the No. 1 killer of women, and that too many women are robbed of happy years with family and friends. They have experienced firsthand a loss that could have been prevented.
Women’s heart disease is more common than thought, and especially increases after menopause if women do not take estrogen medication.
There are other risk factors, which include belly fat, pre-diabetes or diabetes, lack of exercise, sleep deprivation, and a diet high in processed foods, unhealthy carbohydrates and saturated fats.
Prevention of heart attacks and strokes is possible, but has to start with a goal and a plan.
Once a woman decides to not have heart disease, or if she survives a heart attack and wants to prevent another, she needs a team. On that team, at minimum, should be a preventive cardiologist and a certified menopause specialist. This team will put the patient in the middle, and partner with her to help her achieve her wellness goals.
An example of how such a team collaborates might be best told by a patient I’ll call Laura.
Laura came to see our menopause specialists because her hot flashes would not go away and interfered with her life.
She had been told hormones might not be safe because she was overweight, had high cholesterol and took blood pressure medication. Her family had a history of cardiovascular disease and her loved ones had suffered heart attacks.
Her biggest concern? To not have a heart attack herself. She was also desperate to get the hot flashes to stop.
As menopause specialists, the first thing we do after understanding a woman’s story and risk factors is to consider treatment options.
We always start with the SEEDS and Laura definitely had room for improvement in this area. She realized she needed to drink more water, cut the sugar, and get more restful hours of sleep each night.
These lifestyle habits alone could significantly ease her symptoms, but since she was only two years out from her last period, we also had the option of considering hormones. We know that FDA-approved hormone medications used the correct way can actually help reduce risk factors for heart disease and could definitely help her feel better.
In reviewing her history, I saw she had enough risk factors that I wanted the opinion of preventive cardiologist Thomas Boyden, MD. After an evaluation, testing and suggestions for how to prevent heart disease, Laura was cleared to proceed with our treatment plan.
The end result? Laura felt more informed, had the tools to be successful from her care team, and she could start taking hormones because they would be a safe option for her.
Laura now had hope for how she could age differently than her relatives.
Amid a tight budget and high prices, what steps can you take to ensure you and your family eat healthy, great-tasting food?
Planning is the name of the game, Spectrum Health registered dietitian Kristi Veltkamp said.
“Lack of planning is the biggest deal-breaker,” Veltkamp said.
Does your after-school or after-work routine involve the question, “What’s for dinner?” Do you rummage through the refrigerator or pantry at the last minute, hoping to whip up something suitable for dinner?
It may be time to sit down and think carefully about how you’re spending your food money. It can help you avoid the desperate, late-evening runs to fast-food restaurants or pizza parlors—or pricey restaurants—and it’ll keep your wallet and your waistline in top shape.
Veltkamp’s 5 tips to keep your food budget under control:
1. Plan your meals
This is the No. 1 solution to save money. Planning your meals ahead of time allows you to build according to your budget. It sets you up for success each week, Veltkamp said.
It’s not just about dinner, either. “You can pack your lunch so you don’t have to go out at work,” Veltkamp said. “And you can plan to use the leftovers.”
You should also aim for more vegetarian meals—they’re cheaper and healthier. “Meat tends to be the most expensive item,” Veltkamp said.
With a creative mind, you can find new and innovative ways to use items such as beans and rice, which are cheaper and preserve longer, she said. Tacos made from rotisserie chicken and all the fixings, for example, make for a quick, cheap and easy meal.
2. Get Crocking
If you plan your meals ahead at the start of each week, the Crock-Pot can prove to be a lifesaver not only in money but in time, too.
“When you’re doing the cooking yourself, you’ll save more money,” Veltkamp said.
The tacit message here: Stay away from restaurants as much as possible—they eat up your budget. (They also increase your salt intake.)
Generally, Crock-Pot meals can be healthy. “It depends on what you’re putting into it,” Veltkamp said. Canned goods are OK, but you should rinse them first to cut down on the sodium.
“One of the ways it saves on money is when you use more ingredients that haven’t been prepared—raw products like rice, potatoes, beans or even frozen veggies,” Veltkamp said.
3. Buy in season
Items that are local, fresh and in season should be on your list each week.
“They’re higher in nutrients and they haven’t been delivered across the globe,” Veltkamp said. “And if you buy a lot at once, they’re cheap. You can can them or freeze them and save them for later.”
This includes berries, greens, tomatoes and much more. Veltkamp said some people will toss their herbs in water and freeze them into cubes, then throw them into soups once they’re needed.
One tip: Buy in-season items fresh, then buy them mostly canned or frozen when they’re out of season. Some fresh produce can get pricey when it’s out of season.
4. Buy in bulk
Bulk food stores are sometimes hard to come by without a membership—Costco, Sams Club and the like.
But if you can manage to pick up some essential items in bulk, you can truly save a bundle.
What should you buy in bulk? “Things that aren’t going to spoil fast,” Veltkamp said. “Nuts, grains, rice, beans, flour—non-perishable items.”
5. Shun the junk
This is a big one. Junk foods may sometimes appear like the cheap way to go, but in the long run you’re only setting yourself up for trouble.
“Your body doesn’t need the empty calories,” Veltkamp said. “If you eat healthy, you crave less.”
Healthy foods are simply more filling.
Think about it: A bag of chips is a few bucks, but there are many people who can sit down and make that bag disappear in one evening. A bag of apples may cost slightly more.
“But who sits down and eats a bag of apples?” Veltkamp said. One or two apples will satisfy hunger cravings and also deliver much-needed nutrition.
“Healthier foods tend to fill you up more and make you more satisfied,” Veltkamp said. “You don’t have the cravings you get with those processed foods.”
Bottom line: You’re eating less food and getting more nutrition.
Repeat exposure to harmful cleaning agents can cause serious health problems later in life. To reduce risk, wear protective clothing and properly ventilate your work area. (Courtesy Spectrum Health Beat)
While it’s a regular ritual, spring cleaning can become a dangerous chore for your health, experts warn.
Some cleaning supplies—air fresheners, rug cleaners, bleach, oven cleaners and floor polish—have dangerous chemicals such as volatile organic compounds.
These chemicals become vapors that can irritate the nose, throat, eyes and lungs, said Dr. Timothy Craig, an allergist and immunologist at Penn State Health.
“The nose provides a helpful warning signal,” he added in a health system news release. “If someone’s nose becomes irritated while cleaning, it’s safe to assume his or her lungs will be irritated, too.”
“For most people, using chemical cleaners occasionally would not create clinically significant reductions in lung function,” Craig said.
“But repeated exposure to harmful chemicals over a lifetime could lead to significant disability later in life, especially for people with asthma, chronic obstructive pulmonary disease (COPD) or Alpha 1 antitrypsin deficiency, a genetic disorder that may cause lung or liver disease,” he warned.
“We all clean with bleach and other chemicals from time to time,” said Dr. Ann Bogdan, a family health physician from Penn State Health Medical Group-Mechanicsburg. “But I encourage my patients to be careful when doing so.”
The doctors offer these six safety precautions while spring cleaning.
Don’t combine chemical cleaners. “In particular, never mix ammonia and bleach,” Bogdan said. This can result in dangerously toxic vapors.
While cleaning, be sure to have proper ventilation by opening a window or running a fan.
Wear rubber gloves. “Without them, you run the risk of developing redness or rashes on your hands,” Craig said.
Try using old-fashioned cleaners. “Diluted vinegar works well to clean windows and baking soda gives you scrubbing power,” Bogdan said.
Read labels and look for volatile organic compounds and other potential irritants, even in products labeled as “green” or “healthy.”
Look for products with the “Safer Choice” logo, which the U.S. Environmental Protection Agency deems as “safer for human health and the environment.”
And their final advice: If you develop coughing, wheezing, throat soreness or eye watering while using chemical cleaners, step into another room or walk outside. If the symptoms persist even after leaving the room, call a doctor.
Less than 10 minutes a day of brisk walking can help prevent disability in people with arthritis pain in their knee, hip, ankle or foot, researchers report.
Just one hour a week of brisk physical activity “is less than 10 minutes a day for people to maintain their independence. It’s very doable,” said lead study author Dorothy Dunlop. She’s a professor of preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago.
“This minimum threshold may motivate inactive older adults to begin their path toward a physically active lifestyle with the wide range of health benefits promoted by physical activity,” Dunlop added in a university news release.
She and her team analyzed four years of data from more than 1,500 older adults in Baltimore, Pittsburgh, Columbus, Ohio, and Pawtucket, R.I., who had pain, aching or stiffness in their lower joints from osteoarthritis but were initially free of disability.
The participants’ levels of physical activity were monitored using a wearable device.
An hour a week of moderate-to-vigorous physical activity reduced their risk of disability, the study found.
Specifically, the activity reduced the risk of walking too slowly to safely cross a street by 85 percent. It reduced their risk of not being able to do daily living activities—for example, morning routine tasks such as walking across a room, bathing and dressing—by nearly 45 percent.
By the end of the four years, 24 percent of participants who did not get a weekly hour of brisk physical activity were walking too slowly to safely cross the street and 23 percent had difficulty performing their morning routines, according to the study.
About 14 million older Americans have symptomatic knee osteoarthritis, the most common type of osteoarthritis. About 2 in 5 people with osteoarthritis—most of whom have it in their lower joints—develop disability.
Federal guidelines recommend low-impact physical activity for older adults with arthritis and recommend that older adults do at least 2.5 hours a week of moderate-intensity activity.
But that amount of activity can be too much for inactive older adults with lower extremity pain, according to Dunlop.
“We hope this new public health finding will motivate an intermediate physical activity goal,” she said. “One hour a week is a stepping stone for people who are currently inactive. People can start to work toward that.”
The study was published recently in the American Journal of Preventive Medicine.
Earlier diagnosis of Alzheimer’s means patients and families can plan for the future, including safety, care, legal and financial issues. (Courtesy Spectrum Health Beat)
Brain scans can improve diagnosis and management of Alzheimer’s disease, a new study claims.
“The good news is that there are no side effects from any of these recommendations,” said Dr. Thoits, the division chief of neurology with Spectrum Health Medical Group.
Researchers assessed the use of PET scans to identify Alzheimer’s-related amyloid plaques in the brain. The study included more than 11,000 Medicare beneficiaries with mild thinking impairment or dementia of uncertain cause.
This scanning technique changed the diagnosis of the cause of mental impairment in more than one-third of the participants in the study.
The brain scan results also changed management—including the use of medications and counseling—in nearly two-thirds of cases, according to the study published recently in the Journal of the American Medical Association.
“These results present highly credible, large-scale evidence that amyloid PET imaging can be a powerful tool to improve the accuracy of Alzheimer’s diagnosis and lead to better medical management, especially in difficult-to-diagnose cases,” said study co-author Maria Carrillo, chief science officer of the Alzheimer’s Association.
“It is important that amyloid PET imaging be more broadly accessible to those who need it,” she added in an association news release.
Funding for the study came from Avid Radiopharmaceuticals Inc., General Electric Healthcare and Life Molecular Imaging.
“We are impressed by the magnitude of these results, which make it clear that amyloid PET imaging can have a major impact on how we diagnose and care for patients with Alzheimer’s disease and other forms of cognitive decline,” said lead author Dr. Gil Rabinovici. He’s a professor of neurology at the Memory and Aging Center at the University of California, San Francisco.
There is no cure for Alzheimer’s disease, but early diagnosis means that patients can receive treatment to manage symptoms and be directed to clinical trials for new drugs.
Early diagnosis also means that patients and families can plan for the future, including safety, care, legal and financial issues, and access resources and support programs, the researchers said.
In this study, the PET scans revealed that about one-third of patients previously diagnosed with Alzheimer’s had no significant amyloid buildup and their Alzheimer’s diagnosis was reversed.
But in nearly half of patients not previously diagnosed with Alzheimer’s, the PET scans revealed significant amyloid plaque buildup, resulting in a new diagnosis of Alzheimer’s.
One-third of the study participants who had previously been referred to Alzheimer’s clinical trials showed no sign of amyloid buildup based on PET scans. Based on those results, doctors were able to ensure that nearly all (93%) of patients referred to Alzheimer’s trials were amyloid-positive, which is critical to these trials’ success.
“Accurate diagnoses are critical to ensure patients are receiving the most appropriate treatments. In particular, Alzheimer’s medications can worsen cognitive decline in people with other brain diseases,” Rabinovici said.
“But perhaps more fundamentally, people who come into the clinic with concerns about memory problems want answers. An early, definitive diagnosis may allow individuals to be part of planning for the next phase of their lives and to make decisions that otherwise would eventually need to be made by others,” he said.
If you’re like most women, you have a tough time getting back into a workout routine once you get out of the habit of exercise.
We think we are active enough with weekend activities, yard work and the occasional jog or bike ride. But as we get older, we realize this type of exercise routine isn’t quite enough, and we start to gain a few pounds each year.
Worse still, if we become more relaxed about our diet, the weight gain is even greater.
We might not notice until our clothes are suddenly a little too tight.
This may be the wake-up call we need to get our exercise mojo back.
So where do we begin? Let’s start with the basics of exercise.
Aerobic, strength, stretching
I like to focus on three types of activity: (1) aerobic exercise,
where we get our heart rate up and keep it sustained for a given time;
(2) strength training, to maintain and build muscle; and (3) stretching,
to prevent injury and fatigue.
All three aspects are important to help maintain a healthy and strong body.
All three also play a vital role in helping you fit into the clothes you love.
Strength training is especially important for women as we age, because if we allow muscle mass to be lost, fat moves in between the muscle fibers, leaving muscles weak and flabby. When muscle mass drops, weight gain starts.
Men don’t often have the same issues as women when it comes to weight gain. They tend to keep weight off more easily for many years because they start with more muscle mass and naturally express more testosterone.
Women who keep their muscles toned by doing interval training, weight lifting, resistance training and incline training can keep the weight off more easily as well.
You may be shaking your head and thinking all this exercise sounds way too difficult, but it’s much easier than it sounds.
Choose it
First, make sure whatever type of workout you pick is something you
like to do. For example, I like to swim—I participated on the swim team
in high school. I also like to lift weights, and I learned the proper
way to lift from my roommate in college.
One of my other favorite forms of exercise is yoga. I do it twice a week at home. As you can see, if you find something you enjoy doing, you can make it work. If I’m pressed for time, I lift weights and do yoga without ever leaving my home.
Fortunately, there are many different forms of exercise—you just need to find the right one for you and your lifestyle.
If you don’t like yoga, try a Zumba, body pump, or kickboxing class. Pilates, Tai Chi, or aquafit classes are also good options. Even better, mix it up and try several types of workouts each week.
To help build muscle, add in some weight-lifting exercises either at a gym or in the privacy of your own home if you have some weights.
If you need a little help getting started, check out one of my favorite health books, Body for Life for Women by Pamela Peeke, MD.
You’ll find some simple strength-training workouts for the upper and lower body in the back of the book. Even if you do the book’s lower-body workout two or three times per week, you can maintain—and possibly even increase—muscle mass. I think you’ll find the exercises and the entire book helpful.
Schedule it
In addition to the type of exercise you choose, you also need to
determine a time when you’ll actually do the exercises each day, or at
least several times per week.
I prefer to do my workout at night, when I’m too drained to do other work such as paying bills or writing.
When I have finished helping my kids with their homework and my kitchen is cleaned up after dinner, I head to the exercise bike or yoga mat—usually around 9pm. This allows me to get in a good workout, clean up and head to bed before it gets too late.
This routine works well for me and allows me to de-stress from the day. I know I don’t have time to exercise in the morning, so I don’t plan on it. Many women, however, see morning as the best time to do their workout—they’re then done for the day, and they know there’s no way they would do it at night.
After you’ve chosen an exercise and a time frame, you need to put it on your calendar. You may think you don’t need to schedule your workouts, but it really does help you stick to your plan.
Here’s what I recommend: On Sunday night, plan out your week. Start by listing your priorities: work, kids’ events, appointments, exercise. The rest of your day should be planned around these scheduled priorities.
As I look at each day, I plan a longer workout, such as swimming, when I have more time. On days when I’m pressed for time, I schedule a shorter workout, such as the legs and core session from Dr. Peeke’s book.
There is usually one day each week when I simply have no time to fit in a workout, and that becomes my day off. So when the day comes, I have already planned to take it off—no guilt.
Do it
So what are you waiting for? Create your exercise plan today!
Usually by day five of my routine, I’m feeling so good that I’m choosing to exercise instead of making myself do it.
If you can get into a regular routine, add some strength training, and cut down on your carbohydrates intake—especially after 3 p.m.
Of all the reasons to visit a hospital, childbirth may be the absolute best.
The goal is to have mom and baby return home as soon as possible, happy and healthy.
Unfortunately, even in the 21st century, this isn’t always the case. Risk is inherent in the birth process.
Would you be surprised to learn that maternal mortality rates in the U.S. are headed in the wrong direction? It’s true.
According to the CDC, the rate of pregnancy-related deaths in the U.S. has been worsening for some time, jumping from 7.2 deaths per 100,000 live births in 1987 to 18 deaths per 100,000 live births in 2014.
To improve birth outcomes, hospitals have turned to 21st century innovations.
Precision measurement
In childbirth, there is always some blood loss on the part of the mother, not just during delivery but during postpartum recovery, too.
This can sometimes become a major concern, given that hemorrhaging is a leading cause of pregnancy-related death in the U.S.
Consequently, it’s vital to get detailed information about the volume of blood loss during vaginal deliveries and during C-sections, as it helps providers take quick and appropriate action when the moment demands.
Gauss Surgical, a Silicon Valley-based company, has developed technology to improve this process.
The company’s Gauss Triton system pairs artificial intelligence with a readily available iPad to give providers highly precise measurements of a mother’s blood loss.
The Triton app, downloaded directly to the iPad, can analyze visually and materially.
In instances of vaginal delivery, the Triton system can calculate for blood loss by weighing the blood-absorbent items that are used during delivery. The software effectively analyzes the weight of the used items and compares this to the pre-surgery weight of the items. With each hospital system using specific brands and sizes of sponges or swabs, it allows the software to make highly detailed assessments.
In C-section deliveries, the technology is all the more fascinating.
The doctor or nurse can point an iPad camera at the sponges or swabs used to clean blood and snap a photograph, allowing the system to scrutinize the image for hemoglobin and blood content.
The AI at work in this case is much like the AI used in facial recognition, only instead of analyzing faces, the system analyzes a blood-soaked swab or sponge.
Providers can immediately assess that data, helping them accurately monitor blood loss volume.
Altogether, the system is a tremendous upgrade from the approaches of yesteryear.
“Traditionally, we have weighed blood-soaked items to estimate how much blood has been lost,” said Carolyn Leja, CNM, director of women’s and infant services at Spectrum Health.
That approach had its obvious weaknesses, particularly in overestimating or underestimating blood loss. (It’s difficult, for example, to visually distinguish blood from other fluids on a sponge.)
The response to blood loss during delivery can depend on timing—how far along in the delivery process things have progressed if a problem arises. Where one response mandates medication as a method to slow delivery, another may require a blood transfusion.
More accurate measurements at the right time can lead to more precise responses, something the Gauss system helps providers achieve at critical moments.
By quickly identifying instances of hemorrhage, for example, the technology can reduce the need for blood transfusions and shorten a patient’s length of stay.
“The scanning technology helps assure that we are intervening at the right point,” Leja said. “This tells us within a few CCs how we are doing.”
Smarter AI
Spectrum Health Butterworth Hospital has been using the Triton technology since December. The weight system is used in normal deliveries and the optical system is used in C-sections. It’s the first hospital in Michigan to use the new technology.
Spectrum Health Ventures is one of 10 investors in Gauss Surgical’s Triton artificial intelligence technology.
The larger plan is to incorporate the technology into all labor and delivery rooms.
“We worry about blood hemorrhages,” said David Colombo, MD, chief of Spectrum Health Maternal Fetal Medicine. “Young healthy people giving birth don’t consider risks, but we treat every case with potential risks in mind. When you talk about a patient hemorrhaging, well, this is the stuff we lose sleep over.”
As with many things involving today’s species of artificial intelligence, it is nothing short of remarkable.
Any technology that enhances the delivery process and improves outcomes—particularly by perfecting data collection and reporting—is a useful addition to the health care environment.
“There are lots of steps we can take,” Leja said. “We just want to be prepared for every delivery.”
With measles, mumps and other outbreaks making headlines, one local expert said we should set our sights on another adults-only ailment making a comeback:
Shingles.
“I just know I’ve seen a lot of it lately,” said Christina Leonard, MD, an infectious disease specialist at Spectrum Health. “Because of that, I certainly encourage the vaccinations. You see these cases, and they’re often preventable. People can be really devastated by shingles.”
Here are seven things Dr. Leonard believes you should know about the shingles:
1. Cases are on the rise
The Centers for Disease Control and Prevention estimates that one million people will get shingles this year, and one in three people will get shingles in their lifetime.
“The baby boomers are getting into their twilight years,” Dr. Leonard explained. “They were all people who didn’t get the (chickenpox) vaccine that were exposed to the virus. As you age, your immunity wears off.”
2. Blame it on chickenpox
Shingles are caused by the varicella zoster virus, the same virus that causes chickenpox.
According to the CDC, “after a person recovers from chickenpox, the virus stays dormant (inactive) in the body. For reasons that are not fully known, the virus can reactivate years later, causing shingles.”
3. Remember, shingles start with tingles
Shingles start with a tingling sensation, Dr. Leonard said.
“The onset is you get a tingling or an itching,” she said. “That’s usually one of the first symptoms. The rash doesn’t usually come on until later. If you have that tingling or itching, and see these little red spots, you should get to your doctor right away and get on antivirals. You want to get evaluated right away.”
4. It’s often more serious than chickenpox
“Pain. That’s the thing that really bothers people the most, the exquisite pain of this rash,” Dr. Leonard said. “You don’t think it can be that bad. You think, ‘Chicken pox wasn’t that bad.’ But the second time around can bring nasty, nasty pain. It’s really debilitating.”
5. It can leave long-lasting effects
Shingles sufferers run the risk of developing post-herpetic neuralgia, which is the persistent nerve pain that lingers after you’ve had shingles.
“Most people don’t realize that this can stick around forever,” Dr. Leonard said.
6. Luckily, it doesn’t spread easily
“One of the other questions we get a lot is, ‘Am I contagious?’” Dr. Leonard said. “You can go to work. You just want to keep it covered. If you keep it covered, it’s not a big deal. If you’re around someone with a weak immune system, such as someone who’s pregnant, you should be extra cautious.”
7. There is a vaccine
Dr. Leonard said the shingles vaccine is often 100 percent covered by insurance, and recommended for anyone age 50 or older. It used to be age 60, but many younger people are getting shingles and the age was reduced by the CDC to 50.
“It gives you enough of a boost,” she said. “Even if you get the shingles vaccine, you can still get the shingles, but it decreases the severity and decreases the likelihood of long-term nerve pain.”
It’s possible that a simple conversation between parents and their children is all it would take to stop the cycle of some diseases.
If parents would discuss their own health problems with their kids, things like heart disease and diabetes might occur much less often.
Diabetes, heart disease and even breast cancer are preventable by following a healthy lifestyle. A well-timed conversation—before another generation suffers—could make all the difference.
When people say, “Everyone in my family has diabetes” or “Everyone has heart disease,” the underlying reason is usually a sensitivity to sugar.
What does this mean? Some families have a predisposition to belly fat weight gain and get diabetes earlier in life. Anyone can get diabetes if they eat enough sugar and gain enough weight, but some people get diabetes at lower weights.
Examples of this include the Freshman 15, gaining 30 pounds after having a baby, or the 15 pounds many women gain at menopause. More belly fat means more sugar cravings for foods like white bread, white potatoes, white rice and sweets.
Once ingested, the sugar then goes straight from the stomach to the belly fat. It’s a vicious and very unhealthy cycle.
Unfortunately, high blood sugars typically mean high cholesterol as well, especially if your diet is also high in fats like butter, lard, bacon and red meat. Sugar and fat together are a bad combination because high blood sugars make blood vessel walls sticky, the fat sticks to the walls, and plaque or blockages are formed. When enough blockages form in blood vessels, enough blood cannot get through to your vital organs (heart and brain), which would lead to a heart attack or stroke.
Tackle your risk factors
I have discussed the topic of risk factors in previous blogs, and I
believe the topic is important enough to mention again here. We all have
risk factors we can’t change—family history, age and timing of
menopause. But there are risk factors we can change (exercise, sleep
habits, and food choices), and it’s not as difficult as you may think.
The first step is to make a goal toward better health.
To create your goal, look at how well your mom, dad, or grandparents aged.
Hopefully, they were able to be a good example of how to lead a healthy life. Sadly, many women have not grown up in households with parents who were positive examples of how to eat right and exercise.
Many parents never talked to their kids about eating a healthy diet or maintaining an active lifestyle in order to avoid diabetes or heart disease. If you were lucky enough to have a mom or dad who talked with you about the importance of being healthy, use that positive example to create your own goals.
If not, create a clear picture of yourself and how you want your own life to be, and use that picture to set some goals for your future. How do you want to look and feel in three months, one year, or when you are 50 years old?
A patient I’ll call Leonica is an example of someone who grew up with several family members who suffered from a variety of health problems.
They had heart disease, diabetes, obesity and cancer, but they never talked about their health issues. The memories continued to haunt her, and she decided she did not want to suffer in the same way. Leonica respected that her family was strong and independent, however, she wished her family could have talked about their health problems to help her and others from her generation lead better lives.
For example, Leonica had no idea about the connection between craving sugar and eating simple carbs. She didn’t realize that eating things like white bread, white rice and potatoes would make her feel tired.
Things to know (and remember)
By educating herself, Leonica learned how eating more complex carbs
like sweet potatoes and brown rice, and having a protein and vegetable
for dinner would help her lose weight—without giving up her favorite
foods. She continued making diet changes to reverse early diabetes and
became more active in her everyday life.
As a result of her changes, Leonica became an example for her children, nieces and nephews. She also became the voice to get others talking about how to change their lives for the better. By passing on this knowledge to her extended family, Leonica hopes to stop the cycle of the diseases that have plagued her family for years.
Here are a few key points to remember:
See your doctor—If your family members have heart disease, diabetes or obesity, it doesn’t mean you will have the same fate. However, you are more likely to suffer from these issues, so see your doctor, get tested early for diabetes, and learn how you can avoid the same health problems.
Talk with your family about their health—Ask your parents, aunts, uncles, grandparents and siblings about their health. Learn from them what you should and shouldn’t do to be healthy. Women who cope best ask for help and get educated so they can develop a goal and a plan. It’s OK to talk about bad moods, depression and anxiety; sharing can help others and take away the fear associated with these issues.
Know your numbers—Find out your waist size, blood sugar (A1C) level, cholesterol levels and blood pressure. It can be scary to know you have pre-diabetes, but knowing gives you power and can be motivating to get a plan in place—before it’s too late.
Know how close you are to menopause—Being healthy gets harder after menopause, so you want to know how close you are to being there. As estrogen hormone levels fall, the body craves sugar and stores it in belly fat. And belly fat raises insulin and insulin factors, which increase the risk of breast cancer. Everything is tied together.
Cut back on the simple carbs—These are the same as sugar, and, if you want to avoid diabetes and heart disease, you need to have only one simple carb serving per day. Examples of simple carb foods include white bread, white potatoes, white rice, white flour tortillas, sweet treats and alcohol. Remember—only one per day.
Eat a good breakfast—Include a complex carbohydrate (whole wheat bread, cooked oatmeal, whole wheat bagel), a protein (eggs, low-fat cheese, turkey bacon), and a healthy fat (olive oil, avocado, nuts). Eating a healthy breakfast will keep your blood sugars stable and curb your cravings all day long.
Warmer weather has a way of getting us off the couch and into more active pastimes—biking, yard work, tennis and spring cleaning.
If you’re feeling the urge to get up and get active, take a minute to prepare yourself with these tips from Jason Lazor, DO, a specialist in sports medicine and musculoskeletal injuries with the Spectrum Health Medical Group Sports Medicine.
What you learn here may help you steer clear of tennis elbow, golfer’s elbow, shoulder injuries and other forms of tendonitis, which can all result from overuse.
“In the springtime, I see a lot of overuse injuries,” Dr. Lazor said. “People have deconditioned a little bit over the winter, and they jump out expecting to go and perform their sport or activity at the level they were pre-winter.”
So before you get up and go, hit pause and read an orthopedic pro’s suggestions for easing your body into spring and summer.
Dr. Lazor’s Top 12 Tips:
1. Set realistic expectations.
“If you have been more sedentary over the winter, then slowly evolve back into your sport,” Dr. Lazor said. Pushing your muscles too hard too fast isn’t worth the risk of injury.
2. Stretch and warm up.
Do this before any physical activity, whether it’s golfing or working around the house. Stretching your joints for five minutes can do a lot to prevent acute muscle or tendon injuries.
For athletes, Dr. Lazor recommends warming up with sport-specific exercises and drills rather than just, say, jogging to get the blood flowing. But he cautions against “bouncy stretching.” Keep movements slow and controlled.
3. Take a break.
Yes, take a breather when you feel muscle tightness setting in. Then do some more light stretching to loosen up before resuming the activity.
4. Stay hydrated.
This is good advice anytime, but especially when you’re engaged in sports. Dehydrated muscles and tendons are less flexible and less resilient, Dr. Lazor said.
So if you’re a coffee drinker, reduce your risk of muscle strain by drinking more water than coffee. And avoid excessive alcohol, another cause of dehydration.
5. Avoid smoking.
In addition to its other downsides, nicotine impairs the healing process for tendons and muscles.
6. Vary your activities.
To prevent muscle imbalance, you should mix it up. The shoulder, for example, has more than 20 muscles attached to it.
If you keep repeating the same overhead motion, “certain muscles will get overworked and others will decondition,” Dr. Lazor said. That throws off the shoulder’s balance, resulting in tendon damage.
Resistance training is a good way to prevent overuse injuries because it makes the muscles and tendons more resilient. Dr. Lazor emphasizes the essential part of resistance training—the slow, controlled downward motion of a biceps curl, for example, which lengthens the muscle and protects it from injury.
7. Use proper form.
When lifting and carrying heavy items, make sure your body mechanics
are correct. Keep an upright position to help protect your back. And if
you’re doing overhead work, use a ladder or step stool to put the work
at eye level and reduce stress on the shoulders.
8. Eat well.
If you play endurance sports such as tennis, eat well so your muscles
have the nutrients needed to stay healthy and heal if they become
strained.
Plus, eating well makes you feel better. “If you eat junk, you are going to feel like junk,” Dr. Lazor said.
9. Use proper sports equipment and footwear.
Avoid injury by wearing shoes meant to support your particular foot anatomy.
Also, make sure to have the equipment that fits your body and experience level. For example, tennis players should use a racquet that matches your size and skill level.
10. Practice cross-training.
Keep your muscles in balance with variety. Don’t spend all of your time on one sport, Dr. Lazor said.
“You want to incorporate other sports—swimming, biking, running—because that works the muscles differently. It gives some of those muscles that are getting overused a break and works them in different ways.”
11. Build your core.
This means focusing on your abdomen, back, glutes and pelvis—because
many sports injuries are related to deficits in core strength.
“I like planks for core work,” said Dr. Lazor. “When you do planks, whether it’s prone planks or side planks, you have to focus on utilizing your core—squeezing your butt cheeks together and, for both males and females, using the Kegel muscles.”
12. Stretch again at the end.
“I’m a big fan of doing your deep stretching after your activity,” Dr. Lazor said.
Again, using tennis as an example, this means stretching the shoulder, pectoral and back muscles, as well as the hamstrings and quads. Stretching after a workout, whether around the house or on the courts, will help your muscles rebound faster.
Preventing spring and summertime strains and muscle pains isn’t hard. It just takes a little patience, insight and common sense.
More U.S. veterans are at increased risk for heart disease, a looming public health problem, researchers say.
They analyzed data from more than 153,000 people who took part in the National Health Interview Survey, conducted by the U.S. Centers for Disease Control and Prevention, in 2012, 2013, 2014 and 2015.
Vets between the ages of 35 and 70 reported significantly more heart conditions than non-veterans, the data showed.
After age 70, non-veterans reported more, but the study’s author suspects that might be because fewer vets survived into old age due to heart disease.
“I think it’s sort of the first indication of a coming public health crisis for veterans,” said study author Ramon Hinojosa, assistant professor of sociology at the University of Central Florida.
“Because of the wars in Afghanistan and Iraq, we have a relatively large, new younger generation of veterans who are going to survive for 30 or 40 years after their war experience,” he said in a university news release.
The study suggests that what’s known as the “healthy soldier effect” is no longer guaranteed. That’s the tendency for members of the military to be more fit and less overweight than same-age civilians.
Hinojosa said the change could be due the nature of modern warfare, changes in diet, leisure and exercise, more obesity among younger vets and higher rates of drinking, smoking and mental illness.
“It’s concerning to know that the physical benefits of military service seem to be not holding as well for the younger veterans,” he said.
“This suggests the health protective benefits of military service are not what they used to be,” Hinojosa said. “I think that should cause us to really look at what’s going on among the veterans after they leave military service.”
Being aware of this emerging problem can help health care providers offset the likelihood of early onset heart disease, Hinojosa noted.
The study was recently published in the Journal of the American Board of Family Medicine.
Sweet potatoes are an excellent source of potassium, calcium, and vitamins A, B and C. Sweet potatoes are also a source of antioxidants, which are important to reduce cancer and heart disease risk. (Courtesy Spectrum Health Beat)
Midlife and menopause are stages of life when weight gain happens fast and weight loss can be very slow.
Let me share a secret that can help: sweet potatoes.
Many people are surprised to learn the sweet potato is a healthy food that can to be added to any meal and help us all keep a healthy weight and get daily vitamins and fiber at the same time.
The sweet potato qualifies as a superfood—a weapon against weight gain, belly fat and diabetes. It can be enjoyed for breakfast, lunch, dinner and even as a snack.
The sweet potato has so many health benefits. For weight control, it is a low glycemic index food, meaning that while it contains carbohydrates, the carbs are slowly broken down in the blood and can be used by the brain, muscles and liver and not sent straight to the belly to become fat.
Low estrogen levels, which define the life stage of menopause, cause cravings for sugar or any simple carbohydrate, such as what is found in white potatoes, white rice or white bread. Our body’s response to stress or sleep deprivation can include a rise in insulin surges and insulin response, which can result in an increased waistline.
Including foods such as sweet potatoes in your diet can help slow weight gain and add many good vitamins and fiber.
Sweet potatoes are an excellent source of potassium, calcium, and vitamins A, B and C. Sweet potatoes are also a source of antioxidants, which are important to reduce cancer and heart disease risk. Manganese is also in sweet potatoes and can help with your metabolism.
Being healthy is about using small tips and tricks in daily life. The sweet potato can be used in fast and easy ways. They can be roasted, boiled, steamed, or even eaten raw.
The vitamins are best preserved when steamed, but I tend to roast my potatoes because it is easier. I wash the sweet potatoes, poke holes in the skin to avoid explosions in the oven, and put them on a cookie sheet for an hour at 350 degrees. Once they are cooled, I use the cooked sweet potatoes in a variety of ways to make satisfying and tasty recipes.
For breakfast, especially on the weekend when I have more time, I love to make one of my favorites—sweet potato hash.
Sweet potato hash: 1/2 cup chopped onion, 3 cloves chopped garlic, 1 tablespoon extra virgin olive oil, 1 cup of greens such as spinach or Swiss chard, 1-2 cups cubed roasted sweet potato, and optional meat of 1/4 cup cooked sausage or cooked bacon. These ingredients are sautéed together and then topped with a fried egg. Maple syrup added around the edge of the plate makes a tasty treat.
Here are some other ideas:
Sweet potato snack: Cooked sweet potato mashed with a fork, covered with a tablespoon of real maple syrup, chopped nuts such as walnuts, almonds or pecans, and warmed in the microwave.
Fast lunch with sweet potato: Cubed sweet potato with 1-2 teaspoons of olive oil, warmed in the microwave and tossed with salad greens and leftover cold chicken or sautéed tofu. This is tasty, filling, and helps avoid sugar spikes.
Sweet potato french fries: For dinner, my kids prefer sweet potato fries, simply made by cutting the raw sweet potatoes into whatever shape works—sliced to be round (fastest) or cut into traditional fry shape. Simply place the pieces on a cookie sheet with 1-2 tablespoons of olive oil and 1 teaspoon of Kosher salt, and bake at 400 degrees until brown or about 30 minutes, flipping the pieces halfway through for evenness.
Sweet potato custard: Mash 2 cups of roasted sweet potato and add 1 beaten egg, 1/2 cup almond or cow milk, 2 tablespoons of maple syrup, and spices such as cinnamon, ground ginger, cloves and nutmeg. Place in a small baking dish or ramekins, placed on a cookie sheet and baked at 350 degrees for 30 minutes. Yum!
