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FRIDAY, APRIL 24, 2015 SECTION B
DUBOIS COUNTY, INDIANA
Popular diets are not always best. Page 2. Help available for caregivers. Page 3. Swimming offers health, fitness benefits. Page 6. Be smart about the earbuds you use. Page 9.
Health & Wellness
PAGE 2 ■ HEALTH & WELLNESS
THE HERALD ■ FRIDAY, APRIL 24, 2015
Popular diets not always best way to lose By CHELLE CORDERO Creators.com Lately everything is about losing weight and exercising, and everyone is salivating to jump on several popular diet plans hoping for instant success. Many hopefuls wind up feeling terribly frustrated and disappointed. What do the professionals have to say about many of the popular fad diets and how do you decide which to follow? The primary focus is your overall health. John Young, a physician specializing in the treatment of chronic illnesses, says that everyone, dieting or not, would benefit from eating a healthy diet. Moderate the intake of sugar, get plenty of vitamin D, eat one gram of protein for every 2.2 pounds of body weight daily, get a good night’s sleep, exercise and manage stress. “One of the many cellular benefits of exercise is that it increases the oxygen in our bloodstream. Every cell in our body requires oxygen, so consider exercise another means of feeding your cells,” Young says. It’s true that the pounds you lose on fad diets are mostly water weight. “‘Five Skinny Habits’ is more of an ‘undiet’ — designed to change your habits, not your diet, so actual weight comes off and stays off for good,” says “Five Skinny Habits” creator and health/nutrition expert David Zulberg. “The secret is to make just one reasonable change to your routine every week for five weeks.” Zulberg’s steps are: 1) Have a light meal. Make one meal that has fewer than 250 calories. 2) Make one meal a concentrated meal -— lunch or dinner — of protein and veggies. A glass of red wine is also allowed. 3) Going in for seconds or thirds? Take only veggies. 4) Add in exercise, slowly. Start with just 10 to 20 minutes of cardio three days a week. Build up your exercise habits gradually. 5) Replace snacks with healthier options. Stick to water, veggies, low-fat dairy or fruit between meals. “Weight loss is one of the most important challenges health care professionals face together with their patients,” said Ivan Oransky, vice president and global
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If you want seconds, select vegetables and leave the other foods behind. editorial director of MedPage Today, a leading news organization serving health care professionals. MedPage recently conducted a survey of participating doctors to determine the best and worst of the popular weight-loss programs. “While 89.6 percent of survey participants recommend diet and exercise as the preferred weightloss method, only 32.7 percent of survey participants sometimes prescribe one of these popular commercial weight-loss diets in conjunction with said regimen,” explained Oransky, “The Atkins diet was the most controversial amongst our panelists, resulting in an almost split approval range, while Weight Watchers was the most popular, with nearly 80 percent having felt comfortable recommending (the program).”
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The top two diets based on the survey are Weight Watchers and South Beach.
Weight Watchers focuses on re-teaching people how to eat from a list of foods available in
any grocery or with its own line of products. The American Journal of Medicine found that people lost eight times more weight than those who tried to lose weight on their own. One panelist in the survey said, “South Beach Diet focuses on good macronutrient balance with emphasis on vegetables, fruit, good fat and protein.” Both diets reinforce healthier eating habits, a plan that makes maintenance easier once the goal weight has been reached. The rest of the top five diets recommended are Dash for Health, Jenny Craig and Nutrisystem. The most controversial diet among the MedPage panelists is the Atkins diet. One panelist said, “Although Atkins works, I’ve never met anyone who has (been) able to maintain it. I am also concerned that some folks who are predisposed to kidney stone formation or kidney disease (might) ... have complications.” The WonderSlim diet received the lowest ranking. Consumers can choose from three plans that offer up to seven portion-controlled meals per day. All meals are portioned for weight loss to reduce calories, carbohydrates and fats while providing ideal protein levels. The dieter eats every two to three hours. It’s possible to buy foods at the grocery, but many pay more to eat from more than 70 meal selections provided by the company. For the complete list of the ranking, visit http://www.thedailymeal.com/12-best-and-worstweight-loss-programs-accordingexperts/51414.
THE HERALD ■ FRIDAY, APRIL 24, 2015
HEALTH & WELLNESS ■ PAGE 3
Quality help available for stressed caregivers By MICHAEL MAZUR Special Section Writer JASPER — Our parents took care of us as we were growing up, making sure we were happy and safe. But as little people we probably never thought our future roles would reverse and it would be we who now make sure our parents are happy and safe, living a quality life the best they can. “We feel as children it is our responsibility and duty to take care of our ill and/or aging parents, no matter what,” said Amy Gehlhausen, executive director and coowner, with her husband Chris, of Qualicare, a family home care service. In today’s family dynamics, children may be spread across the country with families of their own to raise and trying to fulfill their obligation to take care of their parents becomes a stressful juggling act. Family situations are different. There may be only one chlld. One sibling may be the primary caregiver while the other siblings may share in the caregiving tasks. Sometimes the children may start to argue amongst themselves, fracturing relationships. Tempers rise and good decision making can be impeded. Sometimes children quit their jobs to become full-time caregivers and as stress begins to take its toll, they may withdraw and participate less in family gatherings, according to Gehlhausen. Their perspectives differ, the primary caregiver absorbs the day-to-day challenges that the long-distant siblings do not see and may make judgments about the quality of care being provided by the primary caregiver. And according to Gehlhausen, moms may not want their son(s) helping them with their personal care. It makes them, as well as the son(s), uncomfortable. A mom or dad suffering with Alzheimer’s disease or other dementia will go through a personality change, making them likely to lash out at their children, being mean and even biting them. Gelhausen says the children and friends need to understand that this is not them, it is the disease that is taking over. “They (parents) are just as frustrated (and) confused not understanding what is happening to them,” she said. Many children wait until their nerves are frazzled before admitting they need help and feel that they failed, Gehlhausen added. “Admitting you need help is not a sign of failure but one of strength.” Debbie Wilson who has been using the home care service the last few months said she waited too long to seek help with caring for her 82-year-old mother who was diagnosed with dementia seven years ago. “It was on my list, but I hesitated because I thought I should be able to take care of her. I did not want to admit that I couldn’t do it alone,” Wilson said. “To my surprise the guilt went away. I could be her daughter again and not the caregiver.” This is how a third, unbiased party can come into play. Home care professionals can take over or aid in the many daily tasks involved in caregiving, from transporting the parents to doctors’ appointments, grocery shopping, cooking, cleaning and personal hygiene care. Quailcare caregivers play mind-stimulating games like cards, solving crossword or putting together jigsaw puzzles. “When sons or daughters take care of any aging or ill parent, they have to remember to change hats,” Gehlhausen said. “They
have to take off the son or daughter hat and put on the caregiver hat, meaning if Mom stubbornly refuses to take her medicine the son or daughter may let it slide because they feel uncomfortable telling their mother what to, as they were told as children. But wearing the caregiver hat reverses that role where they become the parent and must be responsible and ensure their mother takes her medicine for her well being.” Gehlhausen says that Qualicare takes a holistic approach, looking at the wellness and welfare of the family as a whole. Sometimes the family as caregivers are more stressed than the ones they are taking care of, especially those who are not physical ill but suffer from Alzheimer’s or other levels of dementia, according to Gehlhausen. “I am an only child and because I also work and had an hour commute each way, I felt constantly stressed trying to live two lives, mine and my mother’s. I was trying to do too much, stretched too thin, not being able to do all things for her that I wanted to,” Wilson said. The initial meeting or conversation involves the entire family, getting better insight into what type of care the family member needs and wants. The client’s condition, what medications they are taking, their favorites foods and music are all taken into consideration. Music is good therapy, Gehlhausen said. They take in the whole spectrum to develop a program. Marie Weinel, director of health services and a registered nurse for 17 years, attends all initial meetings using her medical perspective to the help analyze the situation before she develops and oversees each program. “No two programs are alike,” Gelhausen said. “They are individualized and unique to the person and the situation.” The meeting is really an educational process, Weinel said, “many family members don’t know what help is out there.” She says their caregivers will also go to nursing homes and to the hospital to be with their clients if the client wishes, but making sure they stay within their scope of practice. Some caregivers may become a surrogate member of the cli-
ent’s family. Weinel remembers one client wanting his caregiver to be with him and his family before he died. The caregiver was able to spend some time with him before he passed away. Weinel also trains the caregivers. She is a certified CNA instructor. All caregivers are certified in CPR and first aid, licensed and bonded and covered under Workers Compensation, protecting the client in case of an injury to the caregiver and providing security and piece of mind to the client. And they all must pass extensive background checks. Qualicare maintains an A+ rating from the Home Care Standards Bureau Our caregivers must be compassionate and empathetic. After meeting the requirements, Gehlhausen and Weinel ask themselves if they would we feel comfortable having a potential caregiver take care of their own mother. If they answer is yes, they are hired. When setting up the programs, personalities and skills of the caregiver are matched as closely as possible to the needs and personality of the client, with changes made as needed. “So far we have been pretty good with the matching,” Weinel said. Qualicare caregivers cross all demographics: male or female, young or retired. Some are retired nurses, others cross many professions and some have experience taking care of a loved one. Some work full-time and others work only evenings or weekends. “We are extremely flexible in our staffing, Weinel said. “This allows us to be more flexible with our services.” Margie Andry has a caregiver be with her 83-year-old mother and likes the fact that the same caregiver sees her four to five hours Monday through Friday. “It allows her (mother) to be more comfortable knowing it is the same person every day,” Andry said. “it gives her an extra friend.” Services can be as singular as providing transportation to and from a doctor’s office or to a bingo game or just being a companion playing card games or it can involve a 24/7 live-in situation. The home caregivers do not want to take away the things Mom or Dad like to do. “If mom loves to cook, we don’t cook for her we just
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supervise making sure she is safe. We never take away but provide help where needed,” Gehlhausen said. For children who live long distance and their family and job obligations prevent them from giving the quality of care they want to, this service can be a facilitator or case manager. Staff will go to doctor and medical test appointments with their parent(s) and provide a report to the children. “We are unbiased,” Gehlhausen said, “and just give the facts and our observations for them (children) to make the decisions.” Gehlhausen says that many times it is better to get help at the early stages rather than waiting until things get more severe. “It allows the family to be a family as much as they can. The children can still be children.” It can also prolong the quality of life of a parent who is being the primary caregiver for his or her spouse. If dad is in his 80’s and has Alzheimer’s and mom who is a little younger, becomes the primary caregiver, as time goes on she starts to deteriorate physically and mentally with all the added stress shortening her quality of life, according to Gehlhausen. “I have never heard a client say they got help too early. Many said they wished they had done this sooner,” she added. With a third party, children don’t have to wonder if mom has wandered off or left the burner on or dad found a way to start the car. “It is such a burden lifted,” Andry said. “Anytime a burden is lifted if frees up time to do other things.” Andry was elated to find out that a caregiver will take her mother who doesn’t drive anymore to her doctors’ appointments and blood tests during the week rather than having to wait and plan everything for a Saturday. The caregiver also plays cards with her mother, does some light housework and takes her mother shopping and to hair appointments. Ninety to 95 percent of Qualicare’s caseload are Alzheimer’s
and dementia cases. Gehlhausen says that one in three people older than 85 will be diagnosed with Alzheimer’s or another type of dementia. She sees the need growing for services like hers with aging baby boomers, their children working longer and raising their own families. Not all long-term facilities are equipped with Alzheimer’s and dementia units and those that are have limited space, according to Weinel. More than 5 million Americans are living with Alzheimer’s and as many as 16 million will have the disease in 2050, according to the Alzheimer’s Association. Indiana alone, in 2015, has 110,000 people aged 65 and older with the disease which is projected to increase to 130,000 by 2025 and it is the sixth leading cause of death in Indiana. And in 2014 the number of Alzheimer’s and demential caregivers, hours of unpaid care and the costs of caregiving are staggering. Long-term health care policies cover many of the home-care services and Medicaid provides assistance. Indiana Medicaid pays for some home care, but what and how much is covered is determined on a case-by-case basis, according to Gelhausen. Medicare does not cover home health care if it is not a service provided by a skilled person such as a nurse. So cooking and cleaning would not qualify. For families who feel that they are in a vise with taking care of their aging and/or ill parents and raising their own family, there is help available through reputable home care services. Andry “absolutely recommends families who have similar situations to check the service out.” Wilson was to the point where she was starting to think she “would go before (her mother)” with worrying about her own health with all the stress. Her mother gets better care now, seems to be thriving and is happy now. “This help has been the light at the end of my tunnel,” Wilson said.
PAGE 4 ■ HEALTH & WELLNESS
THE HERALD ■ FRIDAY, APRIL 24, 2015
Study rules out link between autism, MMR vaccine By MELISSA HEALY Los Angeles Times At least a dozen major studies have found that early childhood vaccines do not cause autism. But one possibility remained: that immunizations could cause the disorder in a small group of children who were already primed to develop the disorder. Now, new research has ruled that possibility out too. A study of nearly 100,000 children found that toddlers known to have an elevated risk of autism were no more likely to be diagnosed with the disorder if they were vaccinated against measles, mumps and rubella than if they weren’t. What’s more, the diagnosis rate for high-risk children who were vaccinated was the same as for immunized children with no family history of the disorder, according to the report published Tuesday in the Journal of the American Medical Association. By hunting for — and failing to find — a link between the MMR vaccine and autism spectrum disorders, or ASD, in children with an older sibling who had the disease, the study leaves no doubt that the two are not connected, experts said. While “abundant” evidence demonstrates that the MMR vaccine does not lead to ASD in the general population, it was still worth investigating whether there might be a connection among the more vulnerable population of kids with an older sibling on the autism spectrum, said Dr. Bryan H. King, an autism specialist at Seattle Children’s Hospital who was not involved in the new research. “Could it be that if all the requisite genetic and other risks are present, MMR can lead to the development of autism?” King asked
in an editorial published alongside the JAMA study. “If so, the population in which there might be such a signal would be families already affected by autism.” By showing such fears to be unfounded, the study — and others before it — makes plain that “the age of onset of ASD does not differ between vaccinated and unvaccinated children, the severity or course of ASD does not differ between vaccinated and unvaccinated children, and now the risk of ASD recurrence in families does not differ between vaccinated and unvaccinated children,” he said. But the vocal minority of parents who contend that there is a cause-and-effect relationship between the MMR vaccine and autism aren’t likely to be swayed, said Dr. James Cherry, a pediatric infectious disease specialist at the University of California, Los Angeles, who wasn’t involved in the new research. “Eight million studies are not going to convince people,” he said. Autism is a neurological disorder that has become more common in recent years, though scientists don’t know why. In 2002, ASD affected about 1 in 150 children in the U.S., according to the Centers for Disease Control and Prevention; by 2010, the prevalence had risen to about 1 in 68. Symptoms can be relatively mild, as in the social difficulties of people with Asperger syndrome, or they can be so debilitating that individuals, as adults, can’t live on their own. The idea that vaccines cause autism goes back to a 1998 study in the medical journal Lancet that described 12 young children with autism-like symptoms. Eight of those children started having behavioral problems after they got the MMR vaccine, according to their parents. That study was retracted in
2010 after its lead author, Dr. Andrew Wakefield, was found to have falsified his research. Yet his claims continue to stoke the antivaccination movement. Epidemiologists say low immunization rates fueled the measles outbreak that began at Disneyland in December and sickened at least 157 people in the United States, Canada and Mexico. The outbreak prompted lawmakers in California and elsewhere to try to close loopholes that give parents wide latitude to refuse vaccinations for their children. Last week, protests by hundreds of parents derailed — at least temporarily — a measure
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making its way through the California Senate’s Health Committee that would have required vaccination of virtually all children as a condition for attending public and private schools. Public health officials in the state say low vaccination rates, especially in five geographical clusters, are almost certain to spur new outbreaks of vaccine-preventable diseases. For the JAMA study, Dr. Anjali Jain, a pediatrician and health policy expert at the Lewin Group in Falls Church, Va., and her colleagues mined the records of 95,727 children born into families covered by a large commercial health plan to see whether
they could find any link between vaccination and an autism diagnosis. All of the children had at least one older sibling, including 1,929 who had been diagnosed with ASD. When an elder sibling has autism, the risk for younger siblings is known to be increased. So if there is a weak association between the MMR vaccine and autism, it would show up clearly in this “risk-enhanced population,” the study authors reasoned. It did not. Indeed, a first pass at the statistics seemed to suggest that getting the MMR vaccine conferred some protection against development of ASD.
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THE HERALD ■ FRIDAY, APRIL 24, 2015
HEALTH & WELLNESS ■ PAGE 5
Quit cigarettes without quitting tobacco By BRAD RODU Creators.com It has been well-documented for 20 years that virtually all health risks associated with cigarettes stem from the smoke. As a scientist at a major cancer center, I have been dismayed as government health officials and other medical authorities continue to misinform smokers, insisting that chewing, dipping and using e-cigarettes is as dangerous as smoking. One egregious example of this unprincipled campaign was the demonization of smokeless tobacco as the cause of baseball star Tony Gwynn’s death from salivary gland cancer earlier this year. Brian King, scientific adviser in the Centers for Disease Control and Prevention’s office of smoking and health, told Fox News, “With smokeless use, it’s primarily in the oral region, (which is) why we’re seeing a lot of cancers associated with smokeless tobacco around the oral cavity.” This is simply false. The vast majority of mouth cancers are associated with smoking, alcohol abuse and HPV infection. Numerous epidemiological studies show that there is little to no mouth cancer risk associated with American chewing tobacco, moist snuff or Swedish snus (http://www. biomedcentral.com/content/ pdf/1741-7015-7-36.pdf ). Additionally, there is no scientific link between tobacco use and salivary gland cancer. This isn’t to say that smokeless tobacco is risk-free, but the health effects from its use are so small
that they can’t be measured with any precision. Statistically, using smokeless tobacco is no more dangerous than driving a car. In 1995, determined to share the facts with the nation’s smokers, I published a book, “For Smokers Only: How Smokeless Tobacco Can Save Your Life.” The e-book, with a fresh chapter on ecigarettes, is available at Amazon. com, Barnes & Noble and iTunes. There’s also a just-released audiobook version. You’ll find extensive scientific and medical evidence supporting a switch from smoke to smoke-free tobacco. My science-based advice is simple: You can quit smoking without quitting tobacco and nicotine. Twenty years ago, there weren’t a lot of smoke-free cigarette substitutes. But now there are numerous options at convenience stores and vape shops, so there’s no excuse not to switch. If you’re thinking that the idea of switching from cigarettes to smoke-free tobacco is an industry ploy, rest assured that it is not. This strategy, known as tobacco harm reduction, is supported by tobacco research and policy experts around the world. It’s been endorsed by the British Royal College of Physicians, the American Association of Public Health Physicians and the Canadian Non-Smokers’ Rights Association, among others. The Royal College, one of the world’s oldest and most prestigious medical societies, reported in 2002 that, “As a way of using nicotine, the consumption of noncombustible (smokeless) tobacco is on the order of 10-1,000 times
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Twenty years ago, there weren’t a lot of smoke-free cigarette substitutes. But now there are numerous options, so there’s no excuse not to quit cigarettes. less hazardous than smoking, depending on the product.” In 2007, the society concluded that “smokers smoke predominantly for nicotine, that nicotine itself is not especially hazardous, and that if nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.” The AAPHP in 2008 was the first U.S. medical organization to formally adopt a policy of “encouraging and enabling smokers to reduce their risk of tobacco-related illness and death by switching to less hazardous, smokeless tobacco products.” The NSRA in 2010 recommended snus, a Swedish smoke-
less tobacco product, as a far less harmful substitute for “smokers who are unable to quit or unwilling to make a quit attempt,” under the principle that “the public has the right ... to accurate information about the relative risks of using tobacco products and to make choices based on the facts.” To see the potential public health impact of smoke-free tobacco, look at Sweden. Twenty years ago, I noticed that rates of lung cancer, the sentinel disease of smoking, among Swedish men were the lowest in the world. In 2002, I published the first scientific analysis of the role of snus in replacing cigarettes and reducing disease.
Today, in addition to smokeless tobacco, smokers have the option of switching to e-cigarettes, battery-powered devices that deliver a vapor of water, nicotine, flavorings and propylene glycol. (The latter is used to produce artificial smoke in theater productions and rock concerts.) E-cigarettes are sold in a variety of styles, from small, single-use or rechargeable devices that look like cigarettes to larger models that can be modified to provide higher vapor volumes and custom nicotine levels and flavors. E-cigars and e-pipes are also available. E-cigarettes have rapidly emerged as the most popular of a range of smoke-free products. One tobacco analyst believes that e-cig sales could overtake traditional cigarettes in the next decade. Smokers are finally learning the truth and taking steps to avoid smoke-induced cancers, heart attacks and emphysema. Eliminate the smoke and you eliminate almost all of the health risks associated with tobacco. Smokers who thought they couldn’t quit can continue to enjoy tobacco satisfaction by joining the smoke-free revolution. For more information about e-cigarettes, visit the E-Cigarette Forum (www.e-cigarette-forum. com). This website contains an excellent Beginners E-cig Tutorial and recommendations for starter products.
Brad Rodu, DDS, is the first holder of the Endowed Chair in Tobacco Harm Reduction Research at the University of Louisville’s James Graham Brown Cancer Center.
PAGE 6 ■ HEALTH & WELLNESS
THE HERALD ■ FRIDAY, APRIL 24, 2015
Swimming offers health, fitness benefits By SHARON NAYLOR Creators.com When you were a child, you may have loved swimming. Whether in a backyard pool or in an ocean or lake, there was no getting you to stop splashing around, and you may also have been on a town or school swim team, doing laps on a regular basis in practice and revving into high gear for a swim meet. Now that you’re an adult and most likely not on a competitive swim schedule — nor is it likely that you have a summer with only leisure time — it may be time to get back into the pool and start swimming laps again. Swimming has numerous health and fitness benefits, especially as you age, so the fun of the backstroke, breaststroke, butterfly and freestyle can now add a fresh kick to your exercise regimen. According to the Centers for Disease Control and Prevention, swimming is the fourth-most popular sports activity in the United States, a top way to get regular aerobic exercise. The CDC reports that just two and a half hours of swimming per week can help decrease the risk of chronic illness. “Swimmers,” says the CDC, “have about half the risk of death compared with inactive people.” Swimming laps is a low-impact aerobic exercise that works out your heart and puts minimal stress on joints while building endurance and helping to reduce blood pressure and cholesterol levels. Plus, the resistance of the water (12 to 14 percent more resistance than air) forces your body to work harder, toning biceps, triceps and back, chest, stomach and leg muscles for all-over toning benefits. Exercising in the water has several benefits over exercising on land. When you swim, says the United States Water Fitness Association, 90 percent of your body is buoyant in the water, “so you are not hitting the floor as hard as you would on land. No pounding or jarring!” Flexibility improves, circulation increases, bone strength stays strong (important for postmenopausal women), endurance grows and you get the confidence charge of beating your prior lap times as you continue your swimming regimen. Also, the cooling effect of water disperses your body heat more effectively, which can make exercising more comfortable than it would be in a hot gym or workout room. Additional benefits of swimming include: ■■ Fitness. A swimming regimen can help strengthen your body and, of course, provides a great cardiovascular workout, provided you’re swimming at a good pace and not just gliding or floating. ■■ Therapeutic effects. If you’ve had a back or other bodily injury, your doctor may suggest swimming as a low-impact workout to help keep you in shape and help rehabilitate your injured body parts. ■■ Stress release. Fitness overall creates calming hormones and is a smart element of a wellness plan. And when you’re swimming, you can forget about work, home and money pressures in your daily life. ■■ You may have heard that swimming doesn’t burn many calories compared with running, biking and other exercises. But at a brisk pace, you can often burn the same number of calories as you do with a brisk walk, a medium-level
Consider pairing your lap swimming with one or more of the in-water exercises to keep your interest level high, add variety to your workouts and keep your enthusiasm up, and keep a journal of your lap times and other fitness goals to further motivate you toward better health.
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Swimming laps is the fourth most popular fitness method in the U.S. intensity aerobics class or a slow run. Everything you do for your health adds up. You’ll find online calculators projecting how many calories you’ll burn doing specific kinds of exercises, but keep in mind that calculators aren’t always accurate, and the number of calories you burn depends on your weight and gender and the intensity and duration of your workouts. In addition to lap swimming, you can add on benefits, such as toning and relaxation, with several in-water workouts, including: ■■ Water walking. Moving forward, backward or sideward to work your muscles differently. ■■ Water aerobics. If your knees can’t take on-land aerobics, do these fun exercises in water. Water’s buoyancy makes them easier. And some people claim that if no one can see their feet clearly beneath the water, their lack of coordination isn’t noticed! ■■ Water toning. If you use floatable hand weights and other in-water fitness equipment, muscles get strengthened and firmed. ■■ Flexibility classes. In-water classes led by a trained and licensed instructor can help you improve your flexibility, important as you age, and also help you heal from injuries.
■■ Water yoga. Relaxing yoga classes are now offered in the pool. ■■ Water running. Flotation devices are used to lift you, and you
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THE HERALD ■ FRIDAY, APRIL 24, 2015
HEALTH & WELLNESS ■ PAGE 7
Is giving up grains good for your health? By JESSICA VELDMAN Creators.com For Lent two years ago, I decided to jump on the bandwagon of hating on grains and gave them up. No bread, no cereal, no cake, no cookies, no pasta, no rice. The one exception I made was quinoa, which I later found out can technically be classified as a seed. For someone from a part Italian family in which bread is heavily featured, this was quite a daunting task. Yet I wanted a challenge and to see whether giving up grains would actually make a difference in my health. I also wanted to do something that did not involve my giving up biting my nails or chocolate. Giving up grains was the new health craze, and I wanted to see what it was all about. Lent proved the perfect opportunity, especially because people are generally much more accepting of those things when you say it’s for a religious reason. Of course, I was also living in Memphis, Tenn., at the time, so that could have something to do with it. I suppose that if I had been in California, people would have been much more open to my new endeavor. When I told my friends I was giving up grains, they didn’t understand and had no idea what I was going to eat. Surprisingly, finding foods to eat was never a problem. Instead of Cheerios or oatmeal in the morning, I would eat Greek yogurt or apples and peanut butter or eggs. For snacks, I brought carrots and hummus. Lunch was usually some vegetable medley. Dinners varied greatly, sometimes including salad, sometimes just cheese and olives. I found grain-free recipes all over Pinterest. My favorite was a recipe for granola bars that involved heating peanut butter in a pan with a bit of coconut oil and then adding in nuts or seeds or dried fruit. I would then spread it out on wax paper and freeze it. My friends all agreed they were delicious. They became a problem, really. I ate way too many of those granola bars. They also did not hold up very well, but that was
fine because I’d throw the extra bits in yogurt. I still make them from time to time — but only rarely, because I lack self-control and will eat them all in a day. I always am asked whether I lost weight or felt healthier or what happened when I tried this. I gave up grains (with a few cheats, but very rarely) for about five months. I started eating them again when I studied abroad in France. I was not about to pass up fresh baguettes. In the beginning, my weight stayed pretty regular, probably because I ate way too many homemade granola bars. I did start to see the weight come off after about two months, but I was also exercising heavily during that time. I ended up eating more fruits, dairy and nuts. My diet became fairly fixed. I never felt that I was held back by not eating grains. Though I felt lighter and more energetic, I was tired easily and seemed to always be sore from working out. My body never seemed to fully recover. I didn’t mind the feeling, but I did not feel that my body was being nourished properly. Now that I have incorporated grains — whole grains, rice, oatmeal — back into my diet, I do feel better. I have not seen an increase in my weight since going back on grains. I also feel fuller after eating a slice of toast with peanut butter than I did after eating two eggs for breakfast. Typical diets seem to center very heavily on grain products, and finding alternatives was exciting to me, as well as quite tasty. But I’m glad to have more of a balance back in my diet. I like being able to eat a slice of my sister’s freshly made focaccia without feeling guilty but will try not to eat solely that for my meal, although I could. My sister makes delicious Italian breads and desserts. Based on my experiment, my advice to people wanting to go gluten-free or grain-free is to try it. Everybody is different, and some people seem to benefit quite a bit from this experiment. My body feels healthier now, but I’m also quite glad I tried it. Overall,
Giving up grains is a lot easier said than done when there are fresh baguettes around. JULIE KERTESZ CREATORS.COM
the old advice of eating a balanced diet is key, as well as trying to eat
as naturally as possible. If a graduate student living on a stipend
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PAGE 8 ■ HEALTH & WELLNESS
THE HERALD ■ FRIDAY, APRIL 24, 2015
Get total-body workout with zero equipment By JACK NEWCOMBE Creators.com Go to almost any Starbucks in Los Angeles or New York and you will find people sitting on communal furniture, working on their laptops. It’s death, taxes and people on their laptops at Starbucks. Some write screenplays and others update resumes. Some surf Facebook and others have fallen far down the Wikipedia rabbit hole. All of them are together. Most people do not sit and stay at Starbucks for the free Wi-Fi and iced caramel macchiatos. They stay because life is meant to be a shared experience and they do not want to be alone. By sitting next to a stranger, they are creating an environment that energizes them and helps them be more productive and feel better about themselves. They overcome the mental hurdle of not wanting to feel alone by surrounding themselves with other people. Similarly, the biggest hurdle for people when it comes working out is their mind. Our minds are extremely powerful. They can come up with amazing excuses. “I don’t have the time. I don’t belong to a gym. I don’t own any equipment. I don’t like running.” There is a simple (not easy) way to get an amazing, full-body workout with zero equipment. But first, you must get your mind in the right state. Let’s start with space. If you’re climbing over baby toys, you’re not going to be mentally focused. Clear some space. You do not need a lot. At least the size of a beach towel or yoga mat. Next is sound. Get some music going. If you really want to get in the zone, put your ear buds in and crank the music loud. Our senses are related. If you are hearing high-energy music, your natural energy level will increase. Conversely, if you listen to a lecture on paint drying, your energy will decrease.
Another alternative to pumpup music is something that will distract you. Find a series on Netflix that you missed. Discipline yourself to only watch it while you work out. You’ll blow through “Breaking Bad” and fit into a smaller size before you know it. It’s a win-win. Look the part. Put on workout clothes as if you are going to the gym. It is like working from home. Yes, you could stay in pajamas, but forcing yourself to take a shower and put clothes on will help you get in the right frame of mind to do work. Once you have your space, your tunes and your threads, you are ready to work. There are four basic exercises that you can do with no equipment. First is the squat. This works the majority of the legs, especially the front (quadriceps). Keep your chest lifted. Stick your backside out. Go as far down as you can and come up. One trick is to stare up at the ceiling. This forces you to keep your head up and have proper form. Next is the lunge. This works the back of the legs, specifically the hamstrings, groin and glutes. When you step out, make sure that your ankle is in line with your knee. You want to create a 90-degree angle with your front knee and back knee. Working our way up the body, we have come to the core — specifically, the plank. Hands are directly underneath your shoulders. You want to create a flat, diagonal line with your body so that your hips are not too high or too low. Finally, we have the pushup. Starting in your plank position, lower your body all the way to the ground and push up. Elbows should go back (behind you) as you lower yourself down. You can drop down to one knee or two to take the pressure off your upper body. There are limitless variations and derivatives of those basic exercises that can be
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found with a quick Google or YouTube search. An easy tip is to add jumping to any exercise to make it harder. That’s the thing. It isn’t about
the workout. It never is. Everyone knows you could go for a jog or do pushups, and you will get tired eventually. It’s about getting the right mentality and getting your-
self psyched, but more importantly, focused on what you’re doing. Once your mentality is there, you can work out anywhere (except Starbucks).
RANDALL NORRIS, – MICHAEL S. LOVE, MD J. BLESSINGER, MD RANDALL G.G.NORRIS, MDMD – MICHAEL S. LOVE, MD – BRIAN Norris, Love & Blessinger Patient Care Orthopaedics & Sports Norris, Love & Blessinger Care Our doctors specializePatient in the treatment of bone and joint problems providing services that include:
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• Total Joint Replacement (Arthroplasty) and joint problems providing services that include: • Spine Care Dr. Norris, Dr. Love and Dr. Blessinger are Board Quality patient care is our passion. Everything we • Arthroscopic Surgery • Partial Knee Replacement Certified by the American Board of Orthopaedic do revolves around our desire to provide the best • Hand Surgery • Total Joint Replacement (Arthroplasty) possible care to our patients. Surgery. • Fracture Care (surgical and non-surgical) • Spine Care • Sports Injuries Our state-of-the-art facility includes: Quality patient care is our passion. Everything weTendon, and•Ligament • Muscle, PartialSprains Knee&Replacement • Physician Offices do revolves around our desire to provide theStrains best • Digital X-ray • Hand Surgery • Pediatric Orthopaedics possible care • Open-bore MRIto our patients. • Fracture Care (surgical and non-surgical) • Anterior Approach Hip • Physical and Occupational Therapy Replacement Surgery • Sports Injuries Our state-of-the-art facility includes: This technique allows the surgeon • Saint Charles Surgical Pavilion, • between Muscle,the Tendon, to work patient’s and Ligament Sprains & a• licensed Ambulatory Physician Offices musclesStrains and tissues without Surgery Center detaching them – sparing the • Digital X-ray We combine all of this with our • Pediatric Orthopaedics tissue from trauma and experienced staff allowing • Open-bore MRI us providing a more rapid • Anterior Approach Hip to be the premier provider recovery. of orthopaedic in Occupational Therapy • Physicalcare and Replacement Surgery southern Indiana. This technique allows the surgeon • Saint Charles Surgical Pavilion, to work between the patient’s a licensed Ambulatory O rthopa edics & S pine muscles and tissues without Surgery Center detaching them – sparing the Saint Charles Health Pointe We combine all of this with our from trauma and Surgical Rehabilitation tissue experienced Pavilion staff allowing us providing a more rapid to be the premier provider & Sports recovery. Dr. Norris, Dr. Love and Dr. Blessinger perform orthopaedic care in aof wide variety of orthopaedic procedures. Our experienced staff includes: southern All outpatientIndiana. procedures can be done on site.
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THE HERALD ■ FRIDAY, APRIL 24, 2015
HEALTH & WELLNESS ■ PAGE 9
Consider professional help when planning diet By CHELLE CORDERO Creators.com Many of us were raised singing along with a popular children’s show, “One of these things is not like the other ...” This statement is so true when it comes to our bodies and nutritional needs. A diet that works for one may be an epic fail for someone else. Worse, the diet that works so well for someone else may actually endanger your health. Nutritionists are trained and educated in nutrition and are usually well versed in the values of various foods and what nutrients and vitamins are needed for a client’s particular needs. But nutritionists are not licensed or certified and do not require specialized degrees to hold the title. A registered dietitian, or dietitian/nutritionist, has taken extensive courses at an accredited school and must pass rigorous testing and registration requirements for certification. In addition, registered dietitians are required to take continuing education in their field to maintain the title. Some registered dietitians also have taken specialized training to understand the nutritional needs of people with certain chronic diseases and conditions, and some specialize in areas such as oncology, bariatrics or nephrology.
Several popular diet plans are accessible online or in book form, but these diets are literally built as one size fits all. They don’t take into account underlying medical conditions, preferred foods, individual metabolic rates or the true level of activity for each potential dieter. Consultation with a registered dietitian (or a qualified nutritionist) will help you start a personalized diet that not only will help you lose weight, but also avoid irreparable harm. It is also recommended that you make an appointment with your doctor to make sure you are in good health and physically fit before beginning any weight loss or exercise regime. However, most general practitioners will only be able to offer you generalized diet plans for your overall health. The more the plan is catered to your individual nutrition needs the healthier you will feel and the more successful the weight loss and subsequent maintenance will be. Many popular one-size-fits-noone diets emphasize low carbohydrates, low fat and high protein — as high as 65 grams of protein daily. However, people who suffer from chronic kidney disorders are warned not to eat diets high in protein or phosphorous. A dietitian can customize a weight-loss diet that will benefit the kidneys. The same customization can be
U.S. DEPARTMENT OF AGRICULTURE/CREATORS.COM
A dietitian can help guide you toward making eating choices that will meet your nutritional needs. made for diabetes, high cholesterol, food allergies, lactose intolerance, celiac disease and more. While it seems easy to pull up lists of foods that are preferred for any one of these conditions, a good dietitian can customize a healthy diet that will meet the needs of patients who have multiple con-
ditions and avoid the confusion of conflicting lists. A healthy diet will suit your lifestyle, include a wide variety of foods from all food groups, promote physical activity and help you to focus on realistic lifelong changes to eating and exercise habits. Several North American di-
etitians examined recent studies with participants who were overweight or obese and between 18 and 65 years of age and determined that for significant safe weight loss, an energy deficit was required, which was commonly achieved by reduced fat intake. Increased dietary fiber, physical activity and behavior training such as self-monitoring contributed to successful outcomes and weight maintenance. Academy of Nutrition and Dietetics President Sonja L. Connor delivered the opening remarks at the 2014 Food and Nutrition Conference and Expo held in Georgia this past October. She said dietitians have been “empowered to be the food and nutrition leaders so we can optimize health through food and nutrition.” She explained that the field of dietetics was created out of a need to feed the U.S. armed forces during World War II, and the skills and specialties learned since then will be invaluable in the field of health care for years to come. The Academy of Nutrition and Dietetics, based in Washington, D.C., recommends that anyone who is interested in beginning a weight-loss diet see a registered dietitian first. Ask your doctor for recommendations, or visit the academy’s website, at http:// www.eatright.org, to locate a registered dietitian near you.
Save your hearing; be smart about buds you use By CATHERINE MCNULTY Creators.com Exercising is hard, but there is scientific proof that music makes it better. In a recent article in Scientific American, writer Ferris Jabr notes that “music distracts people from pain and fatigue, elevates mood, increases endurance. ... When listening to music, people run farther, bike longer and swim faster.” In today’s world full of smartphones, MP3 players and apps to help you find the perfect play list, working out with music is a no-brainer. But not so fast. The earbuds you use to deliver those tunes might be doing more harm than good. Your aural health may not be something you spend much time thinking about, but you should. As the world we live in gets ever louder, noise-induced hearing loss is becoming more of a problem. To understand how this can harm your hearing, you first need to understand how your ear works. The ear is a complex organ. It has three main parts: the outer ear (what you see), the middle ear and the inner ear. Within the inner ear is the cochlea, which contains fluids and tiny hair cells that help interpret sound and pass it along to the brain for further processing. Loud sounds can damage these delicate parts. Any damage to the cochlea and its hair cells is permanent. How loud is too loud? Sound is measured in decibels, and according to the National Institute on Deafness and Other Communication Disorders, prolonged or repeated exposure to sounds at 85 decibels can cause hearing damage. For perspective, a normal speaking voice measures between 50 decibels and 60 decibels. A vacuum cleaner is 70 decibels. A hair dryer is 85 decibels. And a jet taking off measures 100 decibels. It should be noted that decibels are a unit of measurement based on human hearing and increase by a factor of 10. So zero decibels is
near total silence and something 10 times louder than that would be 10 decibels. So how do earbuds damage something buried so far in your head? Earbuds are essentially speakers you insert into your outer ear. Because they are inserted, they are that much closer to all the sensitive stuff: the eardrum, the cochlea. Not only that but how often do you thoughtlessly turn up the volume when the world around you gets louder? Earbuds can easily exceed 85 dB, and you can go hours and hours before you need to recharge your player. This doesn’t mean you need to give up your earbuds or your favorite workout mix. It just means you need to be aware of how and when you use them. The best way to do this is to set a maximum volume (about 60 percent of the possible volume is recommended by hearing experts) and never exceed it. Yes, this will be hard, especially if you’re used to blasting your
favorite songs during the tough parts of your workout. Definitely don’t try to drown out the outside world; you’ll only be hurting yourself. One of the reasons earbuds soared in popularity is because they are relatively cheap. Any iPod or smartphone comes with a complimentary pair, and beyond that, replacement pairs can be had for as little as $10. But you get what you pay for. The cheaper the earbud the more ill-fitting and the more likely you are to turn up the volume to compensate for that. If you’re willing to spend some money, you can get noise-reducing earbuds that will fit your ears better and deliver a better quality of sound. Bose is by far the industry standard, but also the most expensive. The Bose QuietComfort 20i acoustic noise-canceling headphones come with an aware mode to help you know what’s going on around you. If they cost more than you are willing to spend, Sony’s
MDR-NC13 noise-canceling headphones offer many of the same benefits at a fraction of the cost. The best option is to get a pair of noise-canceling, over-the-ear headphones. The outside world will be almost entirely shut out,
and you can listen to your music at a reasonable volume. But it can be awkward to work out with overthe-ear headphones when you’re used to earbuds. Whatever you choose, don’t sacrifice your aural health.
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PAGE 10 ■ HEALTH & WELLNESS
THE HERALD ■ FRIDAY, APRIL 24, 2015
Panel gives controversial advice on mammograms By KAREN KAPLAN Los Angeles Times An expert panel convened by the federal government is standing by its controversial recommendation that most women should get mammograms to check for signs of breast cancer only once every two years, and that the tests need not begin until the age of 50. The draft report from the U.S. Preventive Services Task Force reiterates that mammograms do indeed save lives. But it also emphasizes the test’s downsides, many of which are unappreciated by doctors and the general public. Chief among the problems associated with screening mammography is the risk that it will result in unnecessary procedures and treatment by finding abnormal cells that would have been harmless if left alone, according to the panel, which first raised questions about the test in 2009. “About one out of every five women diagnosed by screening mammography and treated for breast cancer is being treated for cancer that would never have been discovered or caused her health problems in the absence of screening,” according to the re-
port released Monday. Breast cancer is the secondleading cause of cancer death among women in the U.S., after lung cancer. Among every 10,000 women in the U.S., about 125 are diagnosed with breast cancer each year and 22 die of the disease. That translated to about 233,000 new diagnoses and 40,000 deaths in 2013. No wonder, then, that women eager to stay healthy have embraced mammograms. Two-thirds of American women ages 40 and above said they’ve had the test within the last two years, including 51 percent who had it within the last 12 months, according to the American Cancer Society. Several groups — including the American Cancer Society, the National Comprehensive Cancer Network and the American College of Radiology — continue to recommend annual mammograms for women at average risk of breast cancer beginning at age 40. But the task force reiterated its advice that most women get tested only once every two years, and that the test is most effective for women between the ages of 50 and 74. “Age is the most important risk factor for breast cancer,” the
Heart disease, hot flashes can be linked By JOE SMYDO Pittsburgh Post-Gazette PITTSBURGH — New research from the University of Pittsburgh suggests that women who experience hot flashes at a younger age — and who have them more often than their peers — may be at increased risk of heart disease. The research by Rebecca Thurston, an associate professor of psychiatry at the University of Pittsburgh School of Medicine, offers potential insights for diagnosing and managing a leading killer. Thurston, who has a doctorate in clinical health psychology, presented her findings this week during an American College of Cardiology meeting. Most menopausal women experience hot flashes, thought to be a malfunction of the body’s temperature-control system. The
body thinks it’s overheated, and triggers a hot flash to cool down, said Thurston, who chairs the research arm of the North American Menopause Society. She found evidence of a link between hot flashes in younger women and the health of the brachial artery — specifically, its capacity to dilate under certain circumstances — in the upper arm. The dilation is controlled partly by the endothelium, a blood vessel’s inner lining. Researchers previously established a link between dysfunction of this inner lining and heart disease, and Thurston said a properly functioning endothelium “is one of the first things to go” in the development of cardiovascular disease. See FLASHES on Page 12
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panel wrote. For instance, if 10,000 women in their 60s were screened for a decade, the result would be 21 fewer deaths due to breast cancer, according to data from clinical trials. Among women in their 50s, the same amount of screening would avert eight breast cancer deaths. Against those benefits, the experts considered the costs of treating breast tumors that are revealed by mammograms but aren’t dangerous. They also factored in the unnecessary procedures brought on by false-positive test results as well as the small but real number of breast cancers that are caused by the radiation in mammograms. Overall, the panel determined
“the net benefit of screening mammography in women ages 50 to 74 is moderate.” But for most women in their 40s, the net benefit of screening is too small to warrant a blanket recommendation in its favor, the panel determined. “Women ages 40 to 49 must weigh a very important but infrequent benefit (small reduction in breast cancer deaths) against a group of meaningful and much more common harms,” according to the report. These harms include “overdiagnosis and overtreatment; unnecessary and sometimes invasive follow-up testing and psychological harms associated with false-positive tests; and false reassurance from falsenegative tests.”
However, if women in this age group have a first-degree relative — a mother or sister — who has been diagnosed with breast cancer, their own risk of the disease is comparable to that of a typical woman in her 50s. As a result, biannual screening for these women makes sense, the panel wrote. Researchers have not conducted clinical trials to test the value of screening mammograms among women over the age of 70. Mathematical models indicate the tests can be useful for women between the ages of 70 and 74. Beyond that, the data needed to endorse the test for older women is “insufficient,” the panel wrote. All of these recommendations are in line with those made in 2009.
THE HERALD ■ FRIDAY, APRIL 24, 2015
HEALTH & WELLNESS ■ PAGE 11
Sara Whatmore, right, an elementaryschool teacher, trains for triathlons to test her endurance. PHOTO COURTESY OF SARA WHATMORE CREATORS.COM
Training part of the fun for triathletes By ANICA WONG Creators.com After years of marathoning at a high level and a string of injuries, Sara Whatmore decided she needed to be kinder to her body. She was already cycling, thanks to her husband, so she decided to throw swimming into the mix and turned into a triathlete. “I’ve always enjoyed testing my endurance and setting big goals,” the elementary-school teacher says. “Triathlons give me the opportunity to continue to push myself while being mindful of the amount of impact I put on my body.” Whatmore isn’t alone. According to USA Triathlon, the sport’s governing body, membership was at an all-time high in 2013. In order to compete in USA Triathlonsanctioned events, athletes must be members of the organization. Training to tackle all three events (swimming, biking and running) can be daunting. Even for Whatmore, who had many running and swimming races under her belt, being able to string these events together required doing research, putting a training plan in place and updating her eating habits. “I did look at a lot of training plans in books and online to get some ideas, but I mostly created a plan for myself that fit my schedule,” Whatmore says. But she remained flexible about getting her workout in. If a group of friends were going on a bike ride that didn’t sync with her training calendar, she’d make adjustments so she could be social while sticking to her plan. AJ Johnson, a coach for D3 Multisport who is also a USATcertified coach, says that training plans are key and often underutilized by beginner triathletes. Training for all legs of the race and all of the possible demands on your body will set you up for a successful event, even if you are stronger in one area than another. “I think many athletes train what they are best at more than they should. Balance is a key in triathlon, so take time to bring up your weakest leg of the race,” Johnson says. He also suggests that athletes do a “brick” workout (a bike/ run combo) to see what it feels like to jump off the bike and onto the road. He didn’t add these into his training for his first triath-
lon, and when it came time to transition into the run portion, he was surprised at how wobbly his legs felt. Again, he stresses, think about the demand you are placing on your body and train accordingly. Nutrition is also an important component to training and competing. While Johnson is not a nutritionist, he has done enough races and coached enough athletes to know how integral nutrition is. For shorter triathlon distances (sprint or Olympic), he suggests some water and a gel during both the bike and run legs. For longer distances (half-Ironman or Ironman), it can get a bit tricky because your stomach is probably going to reject most solid foods as the day progresses. What should be highlighted, though, is that you should never try new things on
race day. “Work on your nutrition plan in practice, and know what you need and what works best for you (before the race),” says Johnson For any beginner triathlete, once the training comes together and you’re confident in your eating habits, relish in what you are working toward. “I enjoy having such a variety of activities, places to go, gear to use and people to see. One day I’m at the lake, and then I’m riding up a mounting, and then I’m running at the park. It keeps things fresh,” Whatmore says. And keeping things fun is one of the biggest tips that Whatmore has for athletes just getting into the sport. If you’re not having fun, it’s not worth it. For Johnson, the fun comes from being able to help athletes reach their goals. “I’ve coached some athletes to their very first
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PAGE 12 ■ HEALTH & WELLNESS
Flashes (Concluded from Page 10) Richard Chazal, American College of Cardiology vice president and medical director of the Heart and Vascular Institute at Lee Memorial Health System in Fort Myers, Fla., said it would be premature to describe early onset of hot flashes as a warning sign of heart disease. Thurston reviewed data, which had been collected as part of a broader study in four cities, on 104 post-menopausal women with symptoms of heart disease. She found that those who first experienced hot flashes when they were 42 or younger had significantly poorer endothelial function — the brachial artery dilation was measured by ultrasound — than those who first experienced hot flashes at a later age. She also conducted a separate study involving 189 relatively healthy women between the ages of 40 and 60. She divided the women into three age groups — those 52 and under made up the youngest group — and monitored the number of hot flashes each woman had in a 24-hour period. The more hot flashes experienced by women in the youngest group, she found, the poorer their brachial artery and endothelial function. She said she found no such correlation for women in the other two groups. Chazal said exercise forces blood vessels to dilate and can help keep them healthy. Thurston said women who experience hot flashes at a relatively young age also may want to pay particular attention to diet, glucose control, weight and blood pressure and see the doctor for a cardiovascular workup. “Typically, they’re not going to get that until they’re a bit older,” she said. Susan Hellier, an associate professor of nursing at Robert Morris University, said only a small percentage of women seek treatment for hot flashes. Early menopause has been associated also with osteoporosis and family and personal histories are key tools for assessing heart disease risk, she said.
THE HERALD ■ FRIDAY, APRIL 24, 2015
To supplement or not to supplement? By JEANELLE HORCASITAS Creators.com I have only taken a few supplements in my lifetime, the Flintstones multivitamin as a kid and, now, the Vitafusion MultiVites for adults. Clearly, I gravitate toward supplements that claim to cover a range of health benefits. The Vitafusion MultiVites bottle states that taking two vitamins per day will provide my daily dose of vitamin A (one cup of broccoli), vitamin C (one tangerine), and vitamin D (5 ounces of salmon). However, rather than gathering needed vitamins from supplements, it is important to gain them from an organic source: your food. According to Kathleen M. Zelman of WebMD, “vitamins and other dietary supplements are not intended to be a food substitute. They cannot replace all of the nutrients and benefits of whole foods.” Therefore, following a nutritious diet will be the most effective way to obtain the vitamins your body needs. I find it easiest to plan out your meals for the week to keep yourself accountable through a vitamin checklist. Health magazine’s website has a helpful gallery, “The Best Foods for Every Vitamin and Mineral,” which offers a simple A-Z for vitamins that your body needs, and the types of foods that are most helpful in fulfilling those categories. Including more of these foods in your daily diet will keep your body healthy and happy. However, sometimes eating healthy foods is not enough when dealing with specific deficiencies. For example, my mother has an iron deficiency that makes her to need daily iron supplements. If you believe that you or someone you know might be suffering from a deficiency, visit a medical professional. Explore the Nutrition. gov website for a wide range of fact sheets and resources to help determine what your body may be lacking and what you can do about it. But what about fitness enthusiasts who heavily rely on taking supplements to enhance their
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Is it difficult to determine the health benefits of supplements. workout regiments? In addition to multivitamins and a healthy diet, an individual who is constantly subjecting the body to strenuous activities is at risk for burning muscle, but not retaining it — which is why there is a need for extra supplements. A helpful solution is a branchedchain amino acid supplement to help retain lean muscle mass. This supplement promotes growth to help compensate for the muscles that are burned during a workout.
According to Layne Norton from Bodybuilding.com, “BCAAs not only increase the rate of protein synthesis, but they also increase the cell’s capacity for protein synthesis.” This proves valuable for those trying to “bulk up” while also staying lean. Or, as Norton succinctly states, “more muscle mass retained, and a greater percentage of lost body fat.” In addition, consuming a pre-workout amino drink keeps the amino acids in
your body and prevents you from burning muscle while you work out. According to Mike Roussell, Ph.D., from Bodybuilding. com, “The nutrients you ingest around your workouts are extremely critical to developing and refining your physique. If you skip pre-workout protein, you skip a chance to support intra-workout anabolism (muscle growth) and reduce post-workout catabolism (muscle breakdown).” Despite this expert advice from Bodybuilding. com, as always, it is important to consult with your doctor and be mindful of your body. As a result, it is difficult to determine whether or not supplements are beneficial. If you are simply trying to maintain a healthy lifestyle, consuming dietary supplements such as multivitamins can provide a boost. However, it is ultimately food that should be the main source of vitamin intake. Additionally, multivitamins and a healthy diet prove to be valuable for those who partake in hardcore workouts. However, because of the intensity of the exercise, these individuals require the extra supplements to retain muscle mass and produce the desired results. Before you decide on supplements, remember to do your research and pursue the plan that works best for you and your body.
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THE HERALD ■ FRIDAY, APRIL 24, 2015
HEALTH & WELLNESS ■ PAGE 13
Keep weight off with regular maintenance By CHELLE CORDERO Creators.com Congratulations on achieving your goal. Enjoy the feeling of being healthier. Weight loss has a positive effect on looks, but more importantly, it helps how you feel about yourself. You worked hard, and now you feel that you are ready to stop dieting and live a normal and healthier life. It’s time to move from a weight-loss diet to a maintenance diet. Too many people are ready to scare you with negative stories of how most people fail to maintain their weight loss for any length of time. It is shockingly disheartening to realize that you will most likely be “dieting” to some degree for the rest of your life. Realize that temporary weight-loss diets aren’t eternal fixes; maintaining that glorious weight loss means permanent lifestyle changes. Gone are the days when you could eat whatever you wanted in seemingly unlimited quantities. But cheer up! The good news is that maintaining that positive change doesn’t have to be drudgery — and certainly not deprivation. Although you have ample reason to be happy for reaching your
desired weight after all of the sweating, counting calories and bypassing the dessert table, don’t celebrate with a binge. With all things, use moderation. Chances are that if you counted calories, ate well-rounded meals and exercised regularly, you will find it easier to continue those healthy habits and maintain your impressive results. Dieters who used prepackaged diet plans will have to allow for a period of close scrutiny of what they are eating for a while to establish a lifelong healthy eating and exercise routine. If you lost weight slowly and steadily, then you are already on your way to a successful maintenance plan. You just need to permanently adopt the lifestyle changes you’ve already made. Some of the things you can do to make your after-diet weight maintenance a little easier include: ■■ Avoiding sugar and sugary/ sweet foods. Sugar can make you feel hungry and increase your appetite and may cause you to overeat. ■■ Keeping a food journal. You may have done this while you were losing weight. By remaining aware of what and when you are
eating, it will be easier to ensure you are not overindulging. ■■ Not being afraid to have the occasional dessert or treat, especially on special occasions. It’s important that you don’t feel deprived, because then it becomes more tempting to fall off the wagon. Remember this catchphrase: All things in moderation. ■■ Noting what you have eaten when you have felt hungrier than usual. These are triggers that should be avoided if possible.
■■ Not stopping exercising or engaging in physical activity just because you achieved your goal weight. Walking is an excellent activity; buy a pedometer and keep track of how many steps you take every day. Exercise also has the benefit of strengthening your muscles and bones, improving circulation and aiding in your overall cardiac health. ■■ Planning and preparing as many meals at home as possible so that you have better control
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of what you are actually eating. Learn to substitute lower-calorie and lower-fat ingredients to reduce negative food counts. ■■ Weighing and measuring yourself regularly and acting immediately (by dieting) if you notice a weight gain. Realize that minor fluctuations in both weight and size are normal, but do react if there is a consistent gain. See WEIGHT on Page 14
PAGE 14 ■ HEALTH & WELLNESS
THE HERALD ■ FRIDAY, APRIL 24, 2015
Modern aids for determining ovulation Weight By LESLIE MANN Chicago Tribune Like many of today’s moms, Faith Kirkpatrick waited until she was in her 30s before she tried to get pregnant. Then she knew her biological clock was ticking. “I’m a planner,” said Kirkpatrick, 34, of New Rochelle, N.Y. “So once my husband and I made the decision, I wanted to get pregnant quickly.” With the help of an ovulation test called Knowhen Saliva Fertility Monitor, Kirkpatrick was pregnant in two months. “Month 1, we tried, but it didn’t work,” she said. “Month 2, we tried harder!” Kirkpatrick’s daughter, Logan, was born in November. The word “ovulation” dates to the 1700s, but it was misunderstood for most of human history. Doctors knew the definition: An egg (ovum) travels from an ovary, down a fallopian tube, in search of sperm. If a sperm scores a touchdown, it may grow into a fetus. If not, the uterine lining sheds and the woman menstruates. The timing of the egg’s journey, though, was a mystery. So incorrect fertility advice came from everyone from Plato (have sex once a week, he advised) to Aristotle (have sex anytime during the month but separate slowly afterward, and refrain from sneezing). Finally, in 1946, American physician George Papanicolaou (the Pap smear inventor) wrote that ovulation occurs two weeks after a woman’s period and can be identified by a fern-like pattern in the vaginal mucus. His research subjects were his laboratory guinea pigs and his wife, Mary.
Weight loss option tested By MACKENZIE CARPENTER Pittsburgh Post-Gazette PITTSBURGH — She’s 35 pounds overweight and has tried everything, but when that patient goes to see George Eid, a bariatric surgeon in the Allegheny Health Network, he usually has to tell her she’s not heavy enough for weight-loss surgery. Soon, though, there may be a new option for that overweight patient who doesn’t need to lose 100 pounds, but maybe a third of that — to jump start a weight-loss program, perhaps, or prepare for a surgical procedure. Eid, along with doctors at 15 medical centers across the country, is testing a new pill that, once swallowed, is pumped full of nitrogen gas to inflate a balloon in the stomach. “The idea is that with the balloon taking up space, patients will feel fuller faster and eat less,” said Eid, director of AHN’s Bariatric and Metabolic Institute. “This is really a way to help people who are on their way to becoming obese but maybe aren’t there yet. If we halt weight gain early enough in the process, they may never have to get there.” The balloon was developed by Obalon Therapeutics, a California-based company, which has a video on its website (www.BalloonTrial.com) that shows how it’s done. The procedure, which is already approved for use in Europe, involves three balloons See TESTED on Page 15
(Concluded from Page 13)
True or false The science of ovulation is young, so it’s no wonder myths persist. Are the following true or false? ■■ You don’t ovulate after being on the pill. False. In fact, Frederick said, the pill can help regulate your irregular cycle before you try to get pregnant. ■■ Drinking cough syrup triggers ovulation. False, but if it contains
The “Day 14” advice still rules, even though timing varies from one woman to the next. “You may have regular periods but not ovulate,” said Dr. Jane Frederick, medical director of Newport Beach, Calif.-based HRC Fertility (orangecountyfertilitydr.com). “Or you may have no periods, then ovulate.” Sperm don’t follow rules either. “They’re sneaky,” Frederick said. “They can lie in wait for an egg for 48 to 72 hours.” A woman who is trying to get pregnant is against the clock because her egg supply decreases monthly. “You have the highest num-
alcohol, it may loosen inhibitions. ■■ Tender breasts or abdominal cramping signal ovulation. It depends. Many women feel no signals. ■■ Breast-feeding prevents ovulation. False. Witness all the siblings born nine months apart. ■■ Being overweight or underweight affects ovulation. True. ■■ Swallowing semen increases fertility. False. “Your reproductive
ber of eggs — about 6 million — in your fifth month in utero,” Frederick said. “By puberty, it’s 200,000. Your best eggs are those released in your 20s. After that, they’re fewer and feebler.” Initial tests for Frederick’s infertility patients include checking their egg reserves, looking for fallopian-tube blockages and analyzing their partners’ sperm quality. A woman can have some control in determining the best time to try. At home, she can monitor ovulation by catching a temperature spike with a basal-temperature thermometer or with urineor saliva-based ovulation kits. The saliva type is reusable and
plumbing is at the other end!” Frederick said. ■■ Adopting causes pregnancy. False. “You can adopt a child and get pregnant the same year, but one doesn’t cause the other,” Frederick said. ■■ Too much sex can reduce fertility. True. For best results, give the sperm a chance to regenerate. ■■ Getting a new partner can alter your cycle. True.
indicates a longer window of opportunity. But, Frederick warned, it measures salt, which is higher among overweight women, ovulating or not. Also, women use ovulation kits not only to determine when to get pregnant but also when they won’t get pregnant, said Helen Denise, a Newark, N.J., civil engineer who developed Knowhen after suffering an ectopic pregnancy. “The pill makes me nauseous,” Kirkpatrick said. “So the kit helps me use a more natural form of birth control while I’m trying to avoid pregnancy. Then, when I’m ready to have another baby, it will help me know which days to try.”
■■ Making vegetable salads with low-cal dressings the beginning of every meal. Drink water before you eat and with the meal (instead of sugary beverages). ■■ Making sure that you are eating high-protein, high-fiber foods and drinking several glasses of water daily. ■■ Keeping your pantry stocked with superfoods — such as pears, oats, black beans, blueberries, broccoli, green tea, lentils, almonds, kidney beans, brown rice, avocados, salmon and bananas — for addition to meals or snacks. Superfoods will help fill you up, are great sources of protein and fiber, and offer healthy carbs to boost your energy level. Support from friends and family remains important during weight and diet maintenance. Change your mindset, and don’t slip back into decreased activity and poor eating habits. Focus on the positive changes and improved health that your weight loss gave you. Congratulate yourself on your achievement and the strength that got you where you are today.
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THE HERALD ■ FRIDAY, APRIL 24, 2015
HEALTH & WELLNESS ■ PAGE 15
Kids develop kidney stones; diet may be culprit By JOE SMYDO Pittsburgh Post-Gazette PITTSBURGH — The first time the reddish color appeared in Bella’s urine, Loren Carroto blamed the ice pops her daughter had eaten at a birthday party. But the discoloration returned intermittently. It turned out to be blood, not food coloring, and the diagnosis was one affecting a growing number of children: kidney stones. Five years later, Bella, now 9, remains on a low-salt diet, which helps prevent new kidney stones from forming but keeps her from eating many of the fast foods that kids love. “It’s a constant battle,” said her mother, who enforces the dietary restrictions. Comprehensive studies have not been done, so estimates of the number of U.S. pediatric kidney stone cases are unavailable. However, doctors say they are seeing more children with the ailment, and some hospitals, including Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, have established special programs to diagnose and treat it. In the past year, Children’s saw about 100 patients who have had kidney stones, said Michael Moritz, clinical director of pediatric nephrology.
Kidney stones are tiny mineral deposits that form in some people’s kidneys. If they remain there, they cause no pain, and a person would be unaware of them. Trouble comes when a stone leaves the kidneys and travels through or gets stuck in the narrow urinary tract. Blood is one symptom; intense pain is another. “It’s extremely, extremely painful,” Dr. Moritz said, noting that some women have described kidney stones as being as painful as childbirth. Looking back, Carroto said, it’s possible that Bella experienced stone-related pain that, at the time, she attributed to stomach viruses. Kidney stones are roughly the same size in children and adults, but children’s organs are smaller, so they may have a more difficult time passing them, Dr. Moritz said. If stones do not pass out of the body on their own, they may have to be surgically removed. Because pediatric kidney stones remain an emerging trend, medical professionals may not be quick to suspect them, said Gregory Tasian, a pediatric urologist at The Children’s Hospital of Philadelphia. If physicians do suspect them, Dr. Tasian said, they first should use ultrasound to look for them instead of other imag-
ing tests that would expose young bodies to radiation. In Bella’s case, neither a pediatrician nor emergency room doctor could pinpoint her problem. “Nothing showed up” on X-rays and other tests, Carroto said. Then she and her husband, Chad Carroto, took her to Dr. Moritz, who diagnosed the kidney stones with the help of an ultrasound. Marian Riggins said her daughter, Taylor, 7, began experiencing bloody urine in December 2013. Although doctors insisted Taylor had a urinary tract infection, the problem persisted, and Riggins challenged that diagnosis. “I wanted somebody to listen to me because I knew something was wrong,” she said. Riggins took her to The Children’s Hospital of Philadelphia, where Dr. Tasian diagnosed kidney stones. In a year, Dr. Tasian said, his program treats about 500 patients, about 100 of them newly diagnosed. Because they’ve been studied less than the adult condition, pediatric kidney stones are something of a mystery. According to an August 2011 article in the Clinical Journal of the American Society of Nephrology, children’s stones occur more frequently in girls than boys even though most adult cases affect men.
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placed in the stomach over a period of several weeks. The first balloon is swallowed in the form of an inflatable capsule, with a tube attached. The gas is then pumped into the tube and then an X-ray determines that it has been properly placed. The tube is then removed. After six months, the balloons are removed using a flexible tube camera that is inserted into the mouth. Then, the patient, who theoretically has lost weight, will continue for the next six months with diet and exercise counseling and, possibly, weight-loss medication. Patients enrolled in the clinical study, Eid said, will be randomly placed into two groups: one gets the pill containing the Obalon Balloon, while the other gets a sugar pill, or “sham” device. Those in the second group will, after the initial six-month period, be offered the balloon at no cost. Participants must be between
the ages of 22 and 64; have a body mass index, or BMI, of between 30 and 40; and not have had any previous surgeries. Eligibility for weight-loss surgery is based on one’s BMI, Eid said. “If a patient comes to me with a BMI of over 40, there’s no problem. They should get surgery since it’s the only proven and effective way to treat that level of obesity. If the BMI is between 35 and 40, it’s a gray zone — patients are eligible if they have co-morbidities — conditions such as diabetes or sleep apnea. If you come in with a 30 to 35 BMI, you are technically in what is known as Class 1 obesity, but I can’t offer you any (surgical) interventions.” The Food and Drug Administration is expected to approve other weight-loss balloon technologies in the coming months, Eid said, adding that hundreds of federal studies show that obese patients with a BMI of 30 and above are resistant to diet and exercise. Those other techniques use saline to in-
TO HEALTH & WELLNESS Ja s per, IN
10, do not have kidney stones, has been a good sport about her own dietary restrictions. “She will be the first one to check something and say, ‘I can’t have it,’” said Riggins, who has introduced baby snacks and gluten-free foods to the household. Dr. Moritz said treatment at Children’s in Pittsburgh includes a metabolic analysis of the patient’s urine and a “targeted dietary approach,” while Dr. Tasian said his program’s comprehensive approach includes a metabolic assessment and a team of nephrologists, urologists, dietitians and radiologists. Carroto said she doesn’t know whether Bella passed her kidney stones, but her daughter, a soccer player who has taken medication in addition to watching her diet, has been symptom-free for a year and a half. “Prevention is the best treatment,” her mother said. After having one stone removed, Taylor also is doing well. Dr. Tasian, who saw no evidence of additional stones during a recent examination, said she’s “doing a tremendous job.”
Tuesday, May 5, 2015 6:30 PM
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Dr. Tasian said prevalence has increased so quickly over the past 25 years that environmental factors are more likely to blame than genetic causes. “Diet is a strong risk factor,” he said. He and Dr. Moritz said children by and large don’t drink enough water, which flushes stone-forming minerals from the body. Nor, Dr. Moritz said, do children eat enough fruits and vegetables, which have alkaline properties that counter stone production. On the other hand, kids eat too many fatty, salty foods and drink dark colas, which contain an acid that some doctors believe to be a factor in stone formation. With Bella’s diagnosis, Carroto said, she had to increase her daughter’s water intake and limit her access to fast food and sodas. The challenge opened her eyes to the pervasiveness of salty, processed foods. When she realized how much salt was in chicken nuggets and other school-prepared meals, she said, she began packing Bella’s lunches. Riggins said Taylor, whose sisters, Hannah, 13, and MacKenzie,
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flate the balloon. “This is all aimed at addressing unmet needs in a population that still needs help,” Eid said. “I’m sure people get flak for doing this, but if it means we can eliminate diabetes through this kind of weight-loss intervention instead of giving medication, isn’t that OK?”
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PAGE 16 ■ HEALTH & WELLNESS
THE HERALD ■ FRIDAY, APRIL 24, 2015
Yoga and the headstand fail By JESSICA VELDMAN Creators.com
A few months ago, I decided that I really wanted to up my yoga game and learn to do a headstand. All the models were doing it on Instagram, so it seemed like the cool thing to do. Plus, I thought maybe it’d make my inner yogi proud. Naturally, I did the first thing all yogis do to learn a new move: I consulted YouTube. It was at this point that I realized I may have been a bit out of my element, not having a clue what the difference was between a tripod headstand, a forearm headstand, a handstand and about a handful of other words that meant balancing upside down that I could not fathom. Upon choosing the “easiest” looking pose, the forearm headstand, I was ready to begin. The very soothing voice told me to measure the distance of my forearms, and I thought, “I got this.” Then she told me to place my head between my hands and lift my bum into the air. No biggie. I walked my feet forward as far as they could go. And then the woman crouched up into the next step, and my body couldn’t follow. Somehow, she was balancing on her head and forearms and had her knees in very close to her body, which she then shot up into the air. I thought maybe that middle part was just for beginners, clearly weaker people. So I shot my legs straight into the air. And I held my very first forearm headstand for about less than
one glorious second before I rolled over into my bedside table, probably terrifying my neighbors who lived on the floor below and causing my roommate to run into my room to check on me. It was then, rising up bruised, red faced and with a bit of a headache, that I realized I needed to get into headstands slowly if I was serious about doing one on my own. Google will tell you there are dozens of reasons to do a headstand a day, including reducing your risk of depression, strengthening core muscles and the simple fact that it’s a pretty cool party move, albeit I have yet to bust out a headstand at a friend’s party and can only see that going badly. However, those weren’t the reasons why I wanted to learn to do a headstand. I wanted the challenge. I had become a bit bored with my routine and honestly wanted to try something new. More importantly, I wanted to learn how to do a headstand so I could change my profile picture on Facebook to a photo of me balancing on my forearms on a paddleboard. Let’s be honest. That was the main reason. Despite practicing this move for several months in order to achieve my new goal, I still get very excited when I can hold my forearm or tripod headstand (I finally learned the difference!) for about 30 seconds before toppling over. Some days, my dogs want to do yoga with me, which leads to some very interesting variations. I still continue practicing near a
Going upside down makes you feel proud of your body and helps you appreciate the strength you have within. PIXABAY CREATORS.COM
wall, mainly so I do not land on said dogs. They avoid me for the rest of the day when that happens. Yet I have really come to appreciate my yoga inversions (and not just because some online articles say they help prevent grey hair
and keep the girls perky). Going upside down makes me feel proud of my body and helps me appreciate the strength within. Yoga seems much more exciting with my small challenge, and the inversions help brighten my
mood for the rest of the day. Maybe those online articles were right and there are very positive reasons to do a headstand every day. Word to the wise, though: Start small, against a wall, and warn your roommate beforehand.
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