January 2013 issue TM
Inside this issue
THINK DIFFERENT How a Family History of Type II Diabetes Inspired Me to Think Differently About Diet & Exercise By Tatiana Dueñas, CareATC
This quarter’s topics !
A brief overview of cancer, heart disease, and diabetes prevention
Read tips from the American Cancer Society to help lower your risk for cancer
Read Janessa’s inspiring story about heart disease prevention, and Jenny’s heart healthy chicken soup recipe
New Year’s Resolutions!
A Pep Talk from Coach Moon, the “Wellness Dude”
Continue Tatiana’s story about her family history of type 2 diabetes
Food For Thought! & Additional Resources
High school graduation was in sight. In only a few short weeks, I would be walking across a crowded stage and hear the cheers of my family. The loudest praise would undoubtedly come from my six foot tall Cuban grandfather. When it comes to volume, Cubans usually take the cake. Growing up, my grandpa was at the center of my wide-eyed world. Saturdays always meant a day long visit to his lush backyard with my cousins - a true secret garden filled with imaginary pirate ships, science experiments, and expeditions. We could tell that the Southern Californian sun marveled at this place as much as we did by the look of our sun-kissed faces at day’s end.
My grandfather made sure we were in want of nothing. Treats were in abundance when he was around. He cured my donut fixes and after a day at the park, he made certain we had ice cream to replenish all the energy spent chasing ducks. My fondest memories include my grandfather and, although my elder, he became my very best friend. As graduation approached, school work became scarce and I found myself feeling carefree and relishing time spent with friends. The Santa Monica Pier was our getaway. No parents. No school. No sorrow from the changes that were to come postgraduation. And this day was no different. We spent the day laughing, talking, and just being kids. The sun had set and it was time to go home. Continued on Page 7
January Cancer Prevention
1,638,910 The estimated number of new cancer cases for 2012 is 1,638,910.
-3.4% From 1992 - 2009, the rates of cancer incidence in the United States decreased by a total of 3.4%.
$228 billion The total estimated direct and indirect cost of all cancer and benign neoplasms in 2008.
Information from www.cancer.gov
Heart Disease Prevention
13.8% The percentage of US adults with high cholesterol (31.9 million).
Information from www.diabetes.org and CDC National Diabetes Fact Sheet, 2011
The total direct and indirect cost of stroke and heart disease in 2009 (more than any other diagnostic group).
The percentage of US adults with high blood pressure (78 million). Only 53% with documented high blood pressure have the condition controlled to target levels.
The total direct and indirect cost of diagnosed diabetes. Factoring in adjustments for undiagnosed diabetes, the total estimated cost is $218 billion.
The percentage of US adults with diabetes (19.7 million). It is also estimated that an additional 8.2 million have undiagnosed diabetes.
The Diabetes Prevention Program (DPP) showed that lifestyle intervention (weight loss and increased exercise) reduced type 2 diabetes development by 58%.
Information from www.heart.org
March Diabetes Prevention
In January, we will focus on cancer prevention. More than half of all cancer deaths could be prevented by making healthy choices. In January, learn how to help lower your chances of getting cancer, plus what screening tests are recommended for you. For most Americans who do not use tobacco, the most important cancer risk factors that can be changed are body weight, diet, and physical activity. One-third of all cancer deaths in the United States each year are linked to diet and physical activity, including being overweight or obese, while another third is caused by tobacco products. Although our genes influence our risk of cancer, most risks are due to factors that are not inherited. Avoiding tobacco products, staying at a healthy weight, staying active throughout life, and eating a healthy diet may greatly reduce a person's lifetime risk of developing or dying from cancer.
In February, we will focus on heart disease prevention. Here are some heart disease prevention tips: • Find a doctor and have regular wellness exams. Establishing a relationship with a physician means you can start heart-health screenings now. Talk to your doctor about your diet, lifestyle and checking your blood pressure, cholesterol, heart rate, body mass index and waist circumference. You may also need your blood sugar checked if you are pregnant, overweight or have diabetes. Knowing where your numbers stand early makes it easier to spot a possible change in the future. • Be physically active. You can slowly work up to at least 2½ hours (150 minutes) of moderate-intensity aerobic physical activity (like brisk walking) every week or an hour and 15 minutes (75 minutes) of vigorous intensity aerobic physical activity (such as jogging or running) or a combination of both every week. Additionally, on two or more days a week you need muscle-strengthening activities that work all major muscle groups. • Don’t smoke and avoid secondhand smoke. If you’re a smoker, it’s time to quit. Even exposure to secondhand smoke poses a serious health hazard. Nonsmokers are up to 30 percent more likely to develop heart disease or lung cancer from secondhand smoke exposure at home or work.
In March, we will focus on diabetes prevention. Who is at greater risk for type 2 diabetes? • People with elevated blood sugars • People over age 45 • People with a family history of diabetes • People who are overweight • People who do not exercise regularly • People with low HDL cholesterol, high triglycerides, or high blood pressure • Certain racial and ethnic groups (e.g., Non-Hispanic Blacks, Hispanic/Latino Americans, Asian Americans and Pacific Islanders, and American Indians and Alaska Natives) • Women who had gestational diabetes, or who have had a baby weighing 9 pounds or more at birth Discuss with your doctor what you can do to prevent developing diabetes.
Shopping List Basic Ingredients for a Healthy Kitchen (adapted from www.cancer.org)
The first step to cooking healthy is to stock your kitchen with a variety of foods that you can throw together for healthy meals in a hurry. Keep these foods on hand for fast meals on busy nights.
In the cupboard • Canned fruits and vegetables • Grains: Couscous, orzo, cornmeal, whole-wheat crackers, whole-wheat pasta, brown rice • Meats: Canned tuna, salmon, minced clams, and chicken • Sauces: Pasta, pizza, tomato • Soups: Canned soups, broth, and bouillon and dried soup mixes • Vinegars: Cider, red and white wine, balsamic • Peanut butter
In the refrigerator • Vegetables and fruits • 100% vegetable and fruit juices • Reduced-fat dairy: milk, yogurt, cheese, sour-cream, cream cheese • Whole-wheat and corn tortillas • Sauces: Worcestershire, soy, teriyaki, and chili • Ketchup and mustard • Salad dressings with olive oil or reduced-fat
In the freezer • Frozen vegetables, fruits, and 100% juices • Meats: Chicken breast, ground turkey breast, extra-lean hamburger • Fish: Red snapper, salmon, orange roughy, cod, flounder, sole
Cancer Prevention By Tatiana Dueñas (adapted from www.cancer.org) More than half of all cancer deaths could be prevented with healthy lifestyle choices.* Learn four ways your can reduce your risk of getting cancer.
1. Say “No” to Tobacco Cigarette smoking accounts for at least 30% of all cancer deaths in the United States. To put that number in perspective, cigarettes kills more Americans than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined. No matter what form it comes in, all tobacco products are harmful and addictive. Visit www.smokefree.gov and talk to your doctor about steps towards a tobacco-free life.
2. Practice Safe Sun Reducing unprotected exposure to the sun and avoiding artificial ultraviolet (UV) light from indoor tanning beds, tanning booths, and sun lamps can lower the risk of skin cancer. If you plan on spending more than one hour outside, use one of these three sun protective behaviors: use sunscreen, wear a long sleeve shirt and/or wear a wide brimmed hat to shade the face, ears, and neck. Sure it may be inconvenient or not fashion forward, but it will save your skin - literally.
3. Get Excited About Exercise You don’t have to run a marathon to benefit from physical activity. You just need to get your body moving for at least 30 minutes each day. Think of each exercise as gift you give yourself. It’s a gift that reduces stress, improves sleep, and just makes you feel better. Begin by walking at your local park. Too hot or cold? Walk around in an indoor mall. Member of a gym? Take advantage of classes offered. You’ll find that working alongside people as motivated as you are to be encouraging. On the days you feel least motivated, tell yourself that you just need to move for ten minutes you’ll find yourself wanting to complete a normal workout’s time.
4. Enjoy Healthy Foods The American Cancer Society recommends eating 5 or more servings of fruits and vegetables each day to help prevent cancer. Consuming wholegrain foods is also recommended since they contain more fiber and nutrients than processed grains. When it comes to meats, eat more fish and chicken. Populations who eat the most red meat and fat in their diet have the highest incidence of cancer. Stock your kitchen with healthy, cancer fighting foods (see left for some ideas). You can find a complete list at www.cancer.org. * American Cancer Society, 2012
Vegetable Lover’s Chicken Soup from the kitchen of Jenny Avera
Preventing heart disease through diet is made easier with heart-healthy chicken recipes. With this recipe, classic comfort food is yours, in just slightly more than half an hour. Serve with some crusty whole-grain bread and top with grated Romano or Parmesan cheese. This recipe can be stored in a refrigerator for up to 3 days, or frozen for up to 3 months. INGREDIENTS 1 tablespoon extra-virgin olive oil 8 ounces chicken tenders, cut into bite-size chunks 1 small zucchini, finely diced 1 large shallot, finely chopped 1/2 teaspoon Italian seasoning blend 1/8 teaspoon salt
2 plum tomatoes, chopped 1 14-ounce can reduced-sodium chicken broth 1/4 cup dry white wine 2 tablespoons orzo, or other tiny pasta, such as farfelline 1 1/2 cups packed baby spinach
PREPARATION 1. Heat oil in a large saucepan over medium-high heat. Add chicken and cook, stirring occasionally, until browned, 3 to 4 minutes. Transfer to a plate. 2. Add zucchini, shallot, Italian seasoning and salt and cook, stirring often, until the vegetables are slightly softened, 2 to 3 minutes. 3. Add tomatoes, broth, wine and orzo (or other tiny pasta); increase heat to high and bring to a boil, stirring occasionally. Reduce heat to a simmer and cook until the pasta is tender, about 8 minutes, or according to package directions. 4. Stir in spinach, the cooked chicken and any accumulated juices from the chicken; cook, stirring, until the chicken is heated through, about 2 minutes.
NUTRITION Per serving: 261 calories; 8 g fat (1 g sat, 5 g mono); 72 mg cholesterol; 12 g carbohydrates; 0 g added sugars; 31 g protein; 2 g fiber; 335 mg sodium; 483 mg potassium.
My Journey to a Healthy Heart by Janessa Eades
At 24, I was facing the harsh reality of being overweight and on blood pressure medicine. This was not a future I wanted to live and I wanted more for my life and my children’s lives. After having my daughter in 2011, I decided it was the perfect time to change my bad habits, and pop was the first thing I let go. My secret is that I have never let myself think I am dieting, but simply eating better. By doing so, I have dropped 53 pounds, lost the blood pressure medicine and given myself a new outlook on health.
New Year’s Resolutions A Pep Talk with Coach Moon, the “Wellness Dude” By Eric Moon, MA, NASM, The Holmes Organisation
Why is New Year’s so important to us? It is really just one more day chronologically in your life but for some reason it resonates with many as a time to try to renew, refresh, or reboot.
Make the right career choices. Your job often defines you, as well as determines your lifestyle, so find the motivation to work toward mastering new skills or challenges at work.
We ring in the New Year with a party, and promises to change something or everything about ourselves in the coming year. We pledge to engineer a radical life makeover the likes of which Ty Pennington has never seen, but we end up with a gym membership, an unfulfilled commitment to quit smoking or lose weight, and a pulled hamstring from an overly aggressive jogging routine. To expect to be a better spouse, parent, co-worker, PTA volunteer, and basketball coach, as well as become a tri-athlete is only setting most of us up for failure.
Don’t go on a diet. Change your diet. Eat food as fresh as possible, of every color and variety. Avoid consuming meats excessively, never miss breakfast, & stop eating when you’re 80% full.
Radical change may get us hiking on the trail to the top of the mountain, but it takes us putting one foot after another to get to the top. Author Malcolm Gladwell succinctly states in his book Outliers that from the Beatles to Bill Gates, it is not just natural ability; it is 10,000 hours of practice to make us good at something. Don’t expect change without serious effort. These are modern arguments for that which old adages have continually reminded us “Rome was not built in a day.”
At each day’s end, ask yourself “How full is your bucket?” Each of us has an invisible bucket for our emotions, and we feel best when our bucket is full. Did you fill any buckets today? Did you kick someone’s over?
Sleep well. Sleep is cumulative; if you lose sleep one day, you feel it the next. If you miss adequate sleep several days in a row, you build up a “sleep deficit,” which impairs your reaction time, “Radical change judgment, vision, information processing, shortmay get us hiking term memory, performance, motivation, vigilance and patience.
on the trail to the top of the mountain, but it takes us putting one foot after another to get to the top.”
Start small. Look through the following list (or your own New Year’s Resolutions) and pick three. Once you become successful at one, add another. This will often start a ripple effect. For example, if you start an exercise program, chances are that exercise will lead to better sleep, clearer thinking, and a more positive attitude. Walk 10,000 steps a day. Choose a high quality pedometer or application to measure your steps. Don’t guesstimate.
Exercise the fit principal F+I+T+T+E. Frequency- How often do you engage? IntensityHow hard do you work? Time- How much time do you commit? Type- What is the activity? Enjoyment- If you do not enjoy it, then it really is not going to work!
Maintain or enhance your relationships with family and friends. Dan Buetter’s books Thrive and Blue Zones are detailed accounts of the places on Earth where people are happiest and live longest. Positive social relationships are as important as access to health care. Find your compass. Define what is true and important to you and move forward each day knowing that you are going the right direction. Don’t break the chain. For each day that you accomplish a goal or complete a workout, put a big red X over that day on your calendar. After a few days, you will have a chain. Keep at it and the chain will grow longer every day.
Stay hydrated. Divide your body weight by 2, and that is roughly your goal (in ounces) for daily water intake.
How a Family History of Type II Diabetes Inspired Me to Think Differently About Diet & Exercise By Tatiana Dueñas, CareATC (Continued from page 1) I hopped into my grandfather’s borrowed small blue pickup and I decided to pay him a visit. I approached the street where my grandparents lived. Familiar cars were lining the streets. Being a weekday, I found it odd so many family members were visiting. Was there a birthday I had forgotten about? I finally found parking and stepped out. My cousin came running out. I could see her eyes were puffy and weary from weeping. She embraced me and whispered, “Grandpa passed away. He is in heaven now.” My mind and body went numb. I couldn’t feel anything. It wasn’t until a few months later that I accepted his passing and finally cried. My grandfather lived with Type II diabetes for the greater part of his life. Two years before he passed away, my grandfather began dialysis, a blood-cleansing procedure for people with renal damage. People with a long-term health problem such as kidney or liver disease, high blood pressure, obesity, or diabetes have a greater chance of experiencing renal damage. Dialysis is an exhausting procedure and with each passing month, I saw my grandfather slipping away. Despite his condition, I thought I had more time with him. My grandfather’s story puts a face to a disease all too prevalent in my family and in the Untied States. Statistics often objectify conditions like diabetes, they seem to be cold numbers derived from a study. But once I see these numbers as people, things change. I see a
father missing his son’s wedding; a mother missing Christmas; or a beloved grandfather missing a high school graduation. Diabetes is personal. A healthy diet and daily exercise isn’t an inconvenience anymore, it is a gift that yields a better quality of life. Don’t get me wrong. Infusing healthy habits into my life wasn’t easy. There are still times when I don’t want to go to the gym or order a salad. The important thing is to get back up when you fall. Take ownership of your decisions and educate yourself on what’s best for your body. Remember that your doctor is your biggest advocate for a healthier you. Be sure to talk to your doctor and let her know what your goals are. She can provide helpful tips and recommendations to equip you for your wellness journey. You’ll find that accountability, especially coming from your doctor, is a powerful thing. Your family and friends will thank you.
When to See Your Doctor
The American Diabetes Association recommends blood glucose screening if: • You are age 45 or older and overweight • You’re younger than age 45 and overweight with one or more additional risk factors - such as a sedentary lifestyle or a family history of diabetes. If you meet either of these risk factors, ask your doctor if diabetes testing is right for you.
food for thought
Dress Down Your Salad Adapted from people.bu.edu/salge
A tablespoon of regular dressing can have as much as seven times the calories of the leafy greens it coats. Try using a variety of light dressings or dilute regular oilbased, bottled salad dressings by draining some of the oil that is floating on the top and replacing it with water or a flavored vinegar. See below for a couple of quick, easy, and light salad dressing recipes from www.eatingwell.com
Sesame Tamiri Vinaigrette
1/4 cup orange juice 1/4 cup rice vinegar 2 tablespoons reduced-sodium tamari, or reduced-sodium soy sauce 1 tablespoon toasted sesame oil 1 tablespoon honey 1 teaspoon fresh ginger, finely grated
1/2 cup buttermilk 1/4 cup reduced-fat mayonnaise 2 tablespoons champagne, or white-wine vinegar 1/2 teaspoon granulated garlic 1/2 teaspoon salt 1/2 teaspoon pepper 1/3 cup chopped fresh herbs, such as chives, tarragon, basil or dill
Preparation 1. Whisk orange juice, vinegar, tamari, oil, honey and ginger in a small bowl until the honey is incorporated. Transfer to a jar and refrigerate.
Nutrition (per 2 tablespoon serving) 37 calories; 2 g fat ( 0 g sat , 1 g mono ); 0 mg cholesterol; 4 g carbohydrates; 0 g protein; 0 g fiber; 303 mg sodium; 21 mg potassium
Preparation 1. Whisk buttermilk, mayonnaise, champagne (or white-wine) vinegar, garlic, salt and pepper in a small bowl until smooth. Stir in herbs.
Nutrition (per tablespoon) 16 calories; 1 g fat ( 0 g sat , 0 g mono ); 1 mg cholesterol; 1 g carbohydrates; 0 g protein; 0 g fiber; 103 mg sodium; 17 mg potassium
Upcoming Newsletter Topics April
www.cancer.gov The National Cancer Institute (NCI), established under the National Cancer Institute Act of 1937, is the Federal Government's principal agency for cancer research and training. The NCI is part of the National Institutes of Health (NIH), one of 11 agencies that compose the US Department of Health and Human Services.
www.heart.org TheÂ American Heart AssociationÂ is a national voluntary health agency to help reduce disability and death from cardiovascular diseases and stroke.
www.diabetes.org The mission of the American Diabetes Association is to prevent and cure diabetes and to improve the lives of all people affected by diabetes.
www.mayoclinic.com Mayo Clinic's medical experts and editorial professionals bring you access to the knowledge and experience of Mayo Clinic for all your consumer health information needs.