Wellness

WELLNESS Your resource for Women’s Health

PREGNANCY Health care—before, during and after

EVERYDAY HEALTH

Answers to common concerns

RECIPES

Eat better, feel better

Women’s Screening Test Checklist The table below lists the most common women’s screening tests recommended by the Centers for Disease Control and Prevention (CDC) and U.S. Preventive Services Task Force (USPSTF). These tests and other preventive services are included in Western Health Advantage’s Preventive Health Guidelines at mywha.org/guidelines. You can also track your test results by using our wellness tools at mywha.org/healthyroads.

TEST

FREQUENCY

Body mass index (BMI)

Annually

Cholesterol (total):

Beginning at age 44 or at age 20 if at risk for heart disease and

• HDL (good)

as recommended by your doctor

• LDL (bad) Triglycerides Blood pressure

Ages 18 to 49 every 1 to 2 years; ages 50+ annually or as recommended by your doctor

Breast cancer (mammogram)

Annually beginning at age 40 or as recommended by your doctor; clinical breast exam every 2 years beginning at age 18

Cervical cancer

Every 3 years, beginning at age 21 or as recommended by your doctor

Colorectal cancer screening

Between the ages of 50 and 75

Chlamydia test

Age 24 or younger and sexually active women should be tested

Sexually transmitted diseases

All women should discuss risks with their physician.

Osteoporosis

Beginning at age 65+ and women under age 65 who are at risk for fractures

(Bone mineral density test) Flu vaccine

Annually or as recommended by your doctor

WOMEN’S WELLNESS Chief Medical Officer •Don Hufford, M.D. Manager, Health Promotion & Disease Management •Laura Monteil, R.N. Chief Marketing and Brand Officer •Rick Heron Marketing Manager •Nora Bruce Contributors•Karen Bennett, Elena Medrano

Produced by

2349 Gateway Oaks Drive, Suite 100 Sacramento, CA 95833 916.563.2250 westernhealth.com

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Wo m e n ’ s W e l l n e s s 2 013

twitter.com/westernhealth, facebook.com/westernhealth, blog: mywha.org/blog © 2013 by Western Health Advantage. Women’s Wellness magazine is published as a health resource exclusively for WHA members and employer groups. Questions and comments may be directed to Western Health Advantage at the address and phone number provided or by email to Advantage@westernhealth.com. The information in this publication is not intended for the purpose of diagnosing or prescribing. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

WELLNESS

YOUR RESOURCE FOR WOMEN’S HEALTH

Contents 6

12

PREGNANCY AND CHILDBIRTH 5 10 Steps: Preparing for Pregnancy 6 From Prenatal to Postpartum

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EVERYDAY HEALTH 8 10 12 13 14 16

Breast Cancer Myth Busters FAQs: Cervical Cancer FAQs: HPV Vaccines for Women FAQs: Chlamydia 9 Steps to a Healthier Heart FAQs: Osteoporosis

19

HEALTHY EATS 17 Broiled Halibut 18 Oven-Crusted Chicken Breast 19 Sunshine Salad

VISIT WHA ONLINE: HEALTH INFO AND TOOLS • Personal Access: Manage your health coverage online; register at mywha.org/personalaccess • Healthyroads: Classes, videos, research and more, mywha.org/healthyroads* • Nurse24: WHA’s nurse advice line, available 24/7 online and by phone, mywha.org/Nurse24 • WHA Mobile App: Available from iTunes App Store or Android Marketplace • Gym discounts: Discounts on local memberships, mywha.org/gyms • Health and wellness classes: Several convenient locations, mywha.org/classes • Toward peace of mind: Behavioral health services, mywha.org/bh * UC employees, please check with your employer for available wellness and fitness programs.

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A User’s Guide: Pregnancy and Childbirth

Sources: womenshealth.gov, nichd.nih.gov, cdc.gov, arhp.org, Amazing Talents of Newborns

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Pregnancy and Childbirth

10 Steps: Preparing for Pregnancy When you’re thinking about having a baby, it’s never too early to start planning for a healthy pregnancy. Experts recommend starting preconception care at least three months before you get pregnant.

You are less likely to experience complications such as a premature delivery or low-birth-weight baby when you take time to prepare your body for pregnancy. Following these 10 steps at any time can also boost your health and make a difference in the event of an unexpected pregnancy.

1. INCLUDE 400 MICROGRAMS OF FOLIC ACID IN

5. IF YOU SMOKE OR USE ALCOHOL OR DRUGS, TELL

YOUR DAILY DIET (from supplements or foods you eat)

YOUR DOCTOR. Quitting isn’t easy, but you can do it.

at least three months before you get pregnant and

Ask your doctor for help.

during pregnancy. This can reduce the risk of certain birth defects of the brain and spine.

2. AIM TO MAINTAIN A HEALTHY WEIGHT—SO GET MOVING AND FOLLOW A HEALTHY DIET. Did you know that being obese can affect your ability to get pregnant? In addition, being obese or overweight can cause complications during pregnancy—so can being underweight.

3. STAY UP TO DATE WITH IMMUNIZATIONS AND SCREENINGS. This includes rubella and chickenpox vaccines, Pap tests and testing for sexually transmitted infections (STIs) and HIV. 4. GET ANY EXISTING HEALTH PROBLEMS UNDER CONTROL. Asthma, diabetes, oral health, high blood

6. ALERT YOUR DOCTOR TO YOUR CURRENT MEDICATIONS. Mention prescription and over-thecounter drugs as well as herbal and dietary supplements.

7. KEEP AWAY FROM TOXIC SUBSTANCES, including chemicals and cat or rodent droppings.

8. GET PLENTY OF ZZZS. Make it your goal to get seven to nine hours of sleep each night.

9. TAKE GOOD CARE OF YOUR MENTAL HEALTH. Try to reduce stress and seek help if feelings of anxiety, sadness or stress interfere with your daily life.

10. REPORT YOUR FAMILY HEALTH HISTORY TO YOUR DOCTOR. Some genetic tests can assess the chances of either parent getting or passing on a genetic disorder.

pressure and epilepsy can all affect your pregnancy.

50%–70% That’s the percentage of cases of spina bifida or anencephaly—birth defects of the brain and spinal cord—that could be prevented if women took 400 micrograms of folic acid daily, before and during pregnancy.

Source: Centers for Disease Control and Prevention

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Pregnancy and Childbirth

From Prenatal to Postpartum Keeping up with your medical appointments is key Prenatal Appointments Studies show that pregnant women who receive prenatal care are less likely to deliver prematurely or have other serious problems related to their pregnancy.

As soon as you think you are pregnant, schedule your first prenatal checkup. Your first exam should be within the first six to eight weeks of your pregnancy or when you first suspect you are pregnant.

At these checkups, your doctor might discuss nutrition and physical activity, what to expect during the birth process and basic newborn care. The first appointment, which usually takes the most time, often involves: • A full physical (includes pelvic exam and Pap test) • Urine and blood samples for lab tests • Due date calculation Most subsequent visits include checking your blood pressure, your weight and the baby’s heart rate, and measuring your abdomen to check the baby’s growth.

Countdown for Prenatal Checkups If you’re healthy and free of risk factors for complications, here’s a typical schedule for prenatal visits to your doctor.

Did You KNOW?

• Once each month for weeks four through 28

Research shows that even before birth, a baby

• Weekly for weeks 36 to birth

is able to recognize his or her mother’s voice,

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• Twice a month for weeks 28 through 36 If you’re over 35 years old or your pregnancy is

notice different tastes and odors, and sense

considered high risk for another reason, your doctor will

touch and motion.

wish to see you more often.

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Pregnancy and Childbirth

Your Postpartum Checkup After your delivery, the best thing to do to ensure your newborn’s health is to take care of yourself. The postpartum checkup—three to six weeks after delivery—is an opportunity for: • Counseling on nutrition and supplements • Advice on birth control and when to resume sexual activity • Guidance on baby care, breastfeeding and immunization schedules • Discussion of sadness, irritability and other depression symptoms • Early diagnosis and treatment of any potential complications • Referral to a specialist, if needed Note: If you had a C-section or other complications, your doctor may want to see you sooner. For your general well-being: Get plenty of rest, eat well and exercise often, rally your support system of family and friends, and consider joining a mothers’ or postpartum support group.

Help for the Baby Blues During your postpartum visits, your doctor will talk to you about “baby blues”—also known as postpartum depression.

Postpartum depression is not uncommon after childbirth.

The symptoms are different for every woman and can include deep sadness, tearfulness, anxiety or guilt that does not go away within a few weeks. Your WHA behavioral health provider can work with you to help you feel like yourself again.

Magellan/HAI-CA, WHA’s health care provider for behavioral health services, provides a Postpartum Depression Prevention

Study Up In addition to excellent classes on childbirth preparation, most hospitals

Program that includes telephone contact services to newly delivered moms. The program is designed to educate moms about postpartum depression and to offer resources for assistance. For more information, visit mywha.org/BH. If you need more information about your behavioral health

affiliated with WHA also offer clinics on

benefits, please call the phone number on the back of your

specialty topics such as baby care, car

WHA member card.

seat safety and more. To learn more, check mywha.org/classes.

*UC employees, please contact your Human Resources Department for more information about behavioral health services.

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Your Health

Breast Cancer Myth Busters Find out what’s true— and what’s not There’s plenty of information about breast cancer floating around, but some myths have been repeated so many times they’ve gained credibility. To take good care of your breast health, you need to know the facts. The following are some common breast cancer myths that have gained steam but simply aren’t backed by evidence-based science.

Myth: If you find a lump in your breast, you most likely have cancer.

Fact: If you find a lump in your breast, you most likely don’t have cancer. Breast lumps are common, and eight out of 10 are not cancerous. Most are just fluid-

Myth: When checking yourself for signs of breast cancer, simply examine your breasts for lumps.

Fact: While you should certainly be on the lookout for breast lumps, they aren’t all you need to check for. You should also schedule an appointment with your doctor if you notice thickening breast tissue,

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filled cysts or noncancerous growths (some are called fibroadenoma). Still, if you notice a lump in your breast, it’s important to have it checked out by a doctor so you can get a proper diagnosis.

Myth: If a lump is cancerous, it will feel hard and won’t move around.

Fact: Some cancerous lumps are smooth and will

continuous breast pain, puckering of the breast

move if you slide your hand over them. Only your

skin or nipple changes.

doctor can determine whether a breast lump is cancer.

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Your Health

Myth: A mammogram can determine whether you have breast cancer.

Fact: Mammography is an important tool for detecting breast cancer early. But while a mammogram can reveal a suspicious mass, it can’t tell your doctor whether that mass is cancerous. To do that, your doctor must do a

Screenings and Exams

biopsy, in which tissue is removed and examined under a microscope.

• A screening mammogram is an X-ray of

Myth: If you have had a mastectomy, you can’t get breast cancer.

Fact: A mastectomy, which removes nearly all of your breast tissue, dramatically reduces your chances of getting breast cancer in the future. But there is a small chance that some cancer cells might have remained on your chest wall. So, even women who have had a mastectomy should continue with regular breast exams.

Myth: Breast cancer mainly affects women who have a family history of the disease.

Fact: About 90 percent of women who are diagnosed with breast cancer have no family history of the disease.

the breast used to detect breast changes in women who have no signs or symptoms of breast cancer.

• Women age 40 or older should have screening mammograms every year.

• Women who are at higher-than-average risk of breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.

• Good breast cancer prevention also includes an annual clinical breast exam by your doctor beginning at age 40. Visit mywha.org/women to learn how to take charge of your health!

Sources: cancer.org, nationalbreastcancer.org, mayoclinic.com, webmd.com, breastcancercampaign.org, hopkinsmedicine.org

Win a $100 Gift Card

To show our appreciation for completing your mammogram, your name will be entered for a drawing to win a $100 gift card when proof of your exam is provided.* Simply complete the form online at mywha.org/women. *To qualify, the exam must have been performed by a WHA provider within the past year and you must have been an active member at the time of the service.

Limited to one submission per year.

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Your Health

FAQs: Cervical Cancer The good news: This slow-growing cancer is highly curable when detected and treated early WHAT CAUSES CERVICAL CANCER?

WHAT CAN I DO TO PREVENT CERVICAL CANCER?

Cervical cancer, which forms in the tissues of the cervix

To lower your risk:

(the organ connecting the uterus and vagina), is almost

• Get the HPV vaccine, which protects against the two

always caused by human papillomavirus (HPV) infection,

types of HPV that cause 70 percent of cervical cancer

which is spread through sexual contact.

cases (for details, see page 12).

WHO IS AT RISK FOR CERVICAL CANCER? All women are at risk for cervical cancer, but it occurs most often in women over age 30. Your risk for HPV infection increases if you began having sex at an early age or if you or your partner has had several partners.

The following are additional risk factors for cervical cancer:

precancerous or cancerous changes on the cervix— even if you have been vaccinated against HPV. • Use condoms and limit your number of sexual partners.

• Don’t smoke.

• Smoking

WHO SHOULD GET A PAP TEST?

• Having HIV or another condition that weakens the

The U.S. Preventive Services Task Force (USPSTF)

immune system

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• Get a regular Pap test—which screens for

recently updated its guidelines for average-risk women,

• Taking birth control pills for five or more years

recommending that most women ages 21 to 65 get a Pap

• Giving birth to three or more children

test once every three years. Women ages 30 to 65 may

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Your Health

wait five years between Pap tests if they test for HPV at the same time.

FYI: The HPV test isn’t advised for women under age 30.

News to Use

The USPSTF recommends against Pap tests for women: • under age 21.

• over age 65 who have had adequate prior screening and are not otherwise at high risk for cervical cancer.

• who have had a hysterectomy, including removal of the cervix, and who do not have a history of cervical cancer or high-grade precancerous lesions.

Women with certain risk factors may need more frequent

BEHIND THE NEW THINKING ON PAP TESTS

screenings.

When it comes to the frequency

HOW SHOULD I PREPARE FOR MY PAP TEST?

necessarily better.

Schedule it at a time when you are not menstruating. For

of Pap tests, more often is not The USPSTF updated its guidelines

two days before your Pap test, you should not have sex,

in March 2012, recommending less

douche, use a tampon or use birth-control foam.

frequent Pap tests—every three to

WHAT’S THE BOTTOM LINE? Protect yourself. Get regular screenings and always discuss symptoms with your doctor. If you have abnormal Pap test results, consult with your doctor, who will determine a treatment plan if necessary. (Note: Pap tests also screen for precancerous changes on the cervix, so abnormal results do not necessarily mean you have cervical cancer.)

five years—for average-risk women.

The American Cancer Society and the American College of Obstetricians and Gynecologists (ACOG) agree with many of the USPSTF’s recommendations and even advise against annual Pap tests for average-risk women of any age.

Another plus: This leaves more time to discuss other health matters—from family planning to menopause—at the

Did You KNOW? According to the American Cancer Society, the death rate for cervical cancer declined nearly 70 percent between 1955 and 1992, mainly because of early detection.

annual well-woman visit, which ACOG advises is still an essential aspect of women’s health care.

Talk to your doctor about how often you need preventive screenings, such as mammograms and PAP tests, based on your age, personal health

Sources: cdc.gov, cancer.gov, uspreventiveservicestaskforce.org, acog.org, cancer.org

and family history.

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Your Health

FAQs: HPV Vaccines for Women Protection against the main cause of cervical cancer WHAT IS THE HUMAN PAPILLOMAVIRUS (HPV)?

HOW EFFECTIVE IS THE HPV VACCINE?

HPV, a common virus spread through genital contact,

The vaccine targets two types of HPV that cause 70

is the main cause of cervical cancer. The virus can also

percent of cervical cancer cases; Gardasil also protects

cause genital warts and cancers of the anus, vagina,

against two HPV types that cause 90 percent of

vulva, mouth and throat. Most sexually active people have

genital warts cases. The vaccine is partially effective in

an HPV infection at some point, but many don’t know it

preventing HPV-related diseases in young women who

because the body often fights it off before it can cause

have already been exposed to one or more HPV types.

health problems.

HOW CAN I PREVENT HPV?

IF I’VE BEEN VACCINATED AGAINST HPV, DO I STILL NEED PAP TESTS?

In the past seven years, the FDA has approved two

Yes. You should still get regular Pap tests because the

vaccines—Cervarix and Gardasil—that protect against

vaccines don’t protect against all HPV types that can

the types of HPV that cause most cervical and anal

cause cervical cancer.

cancers. Gardasil also safeguards against genital warts and vulvar and vaginal cancers. Both vaccines are

Sources: cdc.gov, cancer.org

administered in a series of three doses over six months.

WHO SHOULD GET THE VACCINE? The vaccine is recommended for 11- and 12-year-old girls, but it can be given to girls as young as 9. Those girls who benefit most receive all three doses and develop an immune response before becoming sexually active. The vaccine is also recommended for teens and young women up to age 26 who have not been vaccinated or completed the vaccine series. The vaccine is not recommended for pregnant women.

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15,000 That’s the CDC’s estimate of the number of U.S. women who

ARE YOU UP-TO-DATE ON YOUR VACCINES?

are affected by HPV-related cancers each year. With vaccination, those

Visit mywha.org/shots for a schedule of

cancers could be prevented.

recommended vaccines from the CDC.

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Your Health

FAQs: Chlamydia Don’t discount annual testing for this STI. Left untreated, chlamydia can cause infertility and other complications.

WHAT ARE THE SYMPTOMS OF CHLAMYDIA?

HOW CAN I LOWER MY RISK?

Chlamydia, a sexually transmitted infection (STI) that

Always use a condom, since chlamydia can be transmitted

initially affects the cervix and/or urethra, is sometimes

via vaginal, oral or anal sex. The most certain way to

called a silent infection because most women have

prevent infection is by abstaining or having a mutually

no symptoms. However, some infected women do

monogamous relationship with a partner who’s been

experience symptoms, including abnormal vaginal

tested and is known to be uninfected.

discharge and a burning sensation when urinating.

HOW IS CHLAMYDIA TREATED?

WHO SHOULD GET TESTED FOR CHLAMYDIA?

Chlamydia can be treated and cured with antibiotics.

The Centers for Disease Control and Prevention

Be sure to tell any recent partners so they can be tested

recommends annual testing for sexually active women

and treated. On the flip side: If your partner is being

ages 25 or younger, as well as all pregnant women and

treated, you should see a doctor. Get tested again three

older women with risk factors including having a new

to four months after treatment, since it’s possible to get

partner or multiple partners. Chlamydia is most common

reinfected. Be open with your partner about chlamydia

among young people, but anyone who is sexually

and other STIs.

active can get it. Discuss risk factors with your doctor to determine how often you should be tested.

Sources: cdc.gov, womenshealth.gov

WHAT COMPLICATIONS CAN ARISE? If left untreated, the infection can spread to the uterus and fallopian tubes, causing pelvic inflammatory disease, a serious condition that can permanently damage the

Did You KNOW?

reproductive tract and lead to chronic pelvic pain,

The CDC estimates that there are about 20 million

infertility or pregnancy outside the uterus (ectopic

new STI cases in the United States each year.

pregnancy). Infants born to infected mothers might

Chlamydia cases among U.S. women are on the

be delivered prematurely or have pneumonia or eye

rise—in 2011, up 7.2 percent from the previous year.

infections.

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Your Health

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Steps to a Healthier Heart Beat the odds: Heart disease causes 1 in 3 of U.S. women's deaths each year—but you can lower your risk

SURE, YOU’VE PROBABLY HEARD THAT HEART DISEASE IS THE NO. 1 KILLER OF U.S. WOMEN, YET YOU MAY BE LESS AWARE OF YOUR OWN PERSONAL RISK AND HOW TO LOWER IT. TAKE CONTROL OF YOUR CARDIOVASCULAR HEALTH WITH THE FOLLOWING STEPS:

Understand your personal risk. Schedule

Get physical.

Munch heart-healthy

a doctor’s appointment to discuss heart

Exercise two and

foods. A low-fat, low-

disease risk factors, which include:

a half hours each

sodium diet rich in fruits

• High blood pressure and cholesterol

week by doing

and vegetables should help

• Diabetes

activities like fast

keep your blood pressure and

• Smoking

walking, water

cholesterol down. Be sure to

aerobics, biking

include whole grains, fat-free

• Being overweight • Low level of physical activity

on mostly flat terrain or pushing a

or low-fat dairy products, and

• Family history of early heart disease

lawn mower. Whatever you do, go

protein; choose lean meats,

• Age 55 or older

at a moderate intensity—enough

poultry without the skin,

Having even one risk factor doubles your

to amp up your heart rate and

seafood, soy products, nuts,

chance of developing heart disease.

break a sweat.

seeds, beans and peas.

Aim for a healthy weight. BMI (body mass index) is a

Quit smoking. Ask

numerical value that relates your weight to your height.

your doctor for tips

According to the American Heart Association, BMIs are

on kicking the habit.

good indicators of healthy or unhealthy weights for adult men and women, regardless of body frame size. A BMI between 25 and 29.9 is considered overweight; a BMI of 30 or higher indicates obesity.

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Your Health

Control your blood pressure. Try the previous steps— including consuming less sodium—plus limit your alcohol intake and manage stress, both of which can lead to increases

Rosie O’Donnell: My Heart Attack

in blood pressure.

Keep your

Monitor your

cholesterol

blood sugar.

down.

If you have

If nutrition and

diabetes, reduce your

exercise

blood sugar levels

don’t do the

through diet, exercise

trick, ask your

and medication,

doctor about

which slows heart

medications

and organ damage

to control your

and other long-term

cholesterol level.

complications.

Know ALL the signs of a heart attack. Chest pain— uncomfortable pressure, squeezing, fullness or pain in the center of the chest that lasts more than a few minutes or goes away and comes back—is the most common heart attack symptom in women and men, but some women have heart attacks without chest pain. The following symptoms occur more often in women than in men: • Pain or discomfort in one or both arms, the neck, back, jaw or stomach • Shortness of breath • Cold sweat, nausea, vomiting, light-headedness • Unusual fatigue If you experience any of these symptoms, call 9-1-1 immediately.

Free Smoking Cessation Resources Healthyroads offers free online smoking cessation resources that are available to all WHA members. Visit mywha.org/healthyroads to register for Healthyroads.* Classes are also available through our medical groups. For more information, visit mywha.org/classes. * UC employees should check with their employer for available wellness and fitness programs.

IN AUGUST 2012, ROSIE O’DONNELL RECALLED HER EXPERIENCE IN A BLOG POST: i am happy to be alive last week i had a heart attack … i had an ache in my chest both my arms were sore everything felt bruised muscular – i thought strained or pulled tissue i went about my day the pain persisted i became nauseous my skin was clammy i was very very hot i threw up maybe this is a heart attack i googled womens heart attack symptoms i had many of them but really? – i thought – naaaa i took some bayer aspirin thank god saved by a tv commercial literally i did not call 911 50% of women having heart attacks never call 911 200,000 women die of heart attacks every year in the US by some miracle i was not one of them the next day i went to a cardiologist the dr did an EKG and sent me to the hospital where a stent was put in my LAD [coronary artery] was 99% blocked they call this type of heart attack the Widow maker i am lucky to be here know the symptoms ladies listen to the voice inside the one we all so easily ignore CALL 911 save urself Source: Rosie.com (excerpts)

Sources: cdc,gov, heart.org, goredforwomen.org, www.nhlbi.nih.gov, mylifecheck.heart.org

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Your Health

FAQs: Osteoporosis Building strong bones is a priority WHAT IS OSTEOPOROSIS AND WHO’S AT RISK? Osteoporosis is a disease characterized by weakened bones and is most common among older women. Throughout our lives, our bodies break down old bone and replace it with new. By age 30, many of us have reached our peak bone mass. As we get older, we break down more bone than gets replaced, causing our bones to weaken.

Contributing risk factors include: • Menopause • Certain conditions including type 1 diabetes, premature menopause and rheumatoid arthritis • Long-term use of certain medications, including steroids for treating asthma and arthritis • Small, thin body • Family history of osteoporosis • Ethnicity—white or Asian women are most at risk

HOW DO I KNOW IF I HAVE OSTEOPOROSIS? If you are a woman age 65 and older or are a younger woman with certain risk factors, your doctor will recommend you have a bone density test to screen for osteoporosis and discuss what treatments are available if necessary.

HOW CAN I PREVENT OSTEOPOROSIS AND THE INJURIES IT CAN CAUSE? Exercise regularly and eat a balanced diet. Avoid nicotine substances, such as cigarettes, and limit alcoholic drinks to one a day since these can deplete bone mass. Safety-proof your home to avoid falls and prevent fractures.

HOW MUCH EXERCISE SHOULD I GET? The American College of Sports Medicine recommends 30 to 60 minutes of moderate- to high-intensity weight-bearing endurance activities three to five times a week and activities that target the major muscle groups, such as jumping and resistance exercise, two to three times a week.

Include activities that help with balance, such as yoga or tai chi.

Sources: nihseniorhealth.gov, womenshealth.gov, acsm.org

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Want to Bone Up?

Climb stairs.

Jog.

Lift weights.

Eat a balanced diet.

Play tennis.

Get some sun.

Dance.

Healthy Eats

Staving Off Osteoporosis Getting enough calcium from the foods you eat is crucial to helping your bones stay strong and healthy. This recipe packs a whopping 535 milligrams of the bone-building mineral per serving, about half of what a woman needs each day. Accompany this dish with mixed vegetables, including lightly cooked white button mushrooms, which will provide the vitamin D needed to help your body absorb calcium.

Broiled Halibut

With Tangy Yogurt Sauce TOTAL SERVINGS: 2

INGREDIENTS

DIRECTIONS

2 cups plain low-fat or nonfat yogurt

1. Preheat broiler.

¼ cup lemon juice

2. Combine yogurt, lemon juice, garlic, salt and

1 clove large garlic, crushed ½ teaspoon salt

pepper in a small bowl; mix well.

3. Line a broiler pan with foil and place fish on top,

¼ teaspoon ground black pepper

skin side down. Spread half the yogurt sauce

2 (6-ounce) halibut fillets

over fish fillets. Put fish 4 inches under broiler and cook for 10 minutes, or until fish flakes easily with a fork and topping is golden.

4. Serve warm with yogurt sauce on the side.

Nutritional Facts (per serving)

Calories: 350 Total fat: 8 g Saturated fat: 3 g Polyunsaturated fat: 1.4 g Monounsaturated fat: 3g Sodium: 845 mg Carbohydrates: 21 g Protein: 49 g Fiber: 0 g Vitamin A: 399 IU Vitamin C: 17 mg Calcium: 535 mg Iron: 5.7 mg

Courtesy of the Dairy Council of California, http://www.healthyeating.org/Healthy-Eating/Meals-Recipes/Browse-Search-Recipes/rid/16471/broiled-halibut-with-tangy-yogurt-sauce.aspx

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Healthy Eats

Nutritional Facts (per serving)

A Delicious Way To Be Heart-Healthy Healthy fried chicken might seem like a contradiction, but this recipe tastes like the

Calories: 264 Total fat: 11 g Saturated fat: 2 g Cholesterol: 49 mg Sodium: 263 mg Total fiber: 3 g Protein: 24 g Carbohydrates: 18 g Potassium: 553 mg

real thing, with about half the total fat and saturated fat of the traditional recipe. The recipe includes a delicious salad and recommends a side of oven-roasted potatoes.

Oven-Crusted Chicken Breast TOTAL SERVINGS: 4

INGREDIENTS

DIRECTIONS

For Chicken:

1. Preheat oven to 350ºF.

4 boneless, skinless chicken breasts

2. Place chicken in a freezer bag with the air squeezed out, and pound each

(3 ounces each) 1 egg white (or substitute liquid egg white) 1 cup fat-free evaporated milk

breast down to ½-inch thickness.

3. Combine the egg white and evaporated milk in a bowl; mix well. In a separate bowl, combine the breadcrumbs and crushed oats; mix well.

4. Coat the chicken breasts in flour; shake off the excess. Dip the chicken breasts

1 cup breadcrumbs

in the egg and milk mixture; drain off the excess. Then dip the chicken breasts

¼ cup rolled oats, crushed; pulse a few

in the breadcrumb mixture to coat, and shake off the excess. After all chicken

times in the food processor or crush between fingers to make smaller pieces

breasts are coated, discard any leftover breading mixture.

5. Heat oil in a large saute pan. Stir-fry the chicken over medium-high heat on

1 cup whole-wheat flour

one side until golden brown, about 2–3 minutes. Turn carefully, and pan-fry

2 tablespoons olive oil or vegetable oil

the second side for an additional 2–3 minutes or until golden brown. Remove

For Salad:

from the pan, and place on paper towels to soak up excess oil. Place on

2 tablespoons lemon juice

baking sheet, and finish cooking in a 350°F oven for about 5–8 minutes (to a

½ tablespoon olive oil

minimum internal temperature of 165ºF).

4 cups red leaf lettuce, rinsed and dried 1 cup cherry tomatoes, rinsed and halved

6. Salad: Combine lemon juice and olive oil; mix well to make a dressing. Toss lettuce leaves and tomatoes with the dressing, salt and pepper.

¼ teaspoon salt

7. Serve 1 cup salad with one piece of chicken.

¼ teaspoon ground black pepper

Tip: Try serving with a side of oven-roasted potatoes.

Courtesy of the National Heart, Blood and Lung Institute, http://hp2010.nhlbihin.net/healthyeating/recipedetail.aspx?linkId=11&cId=2&rId=15&AspxAutoDetectCookieSupport=1

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Wo m e n ’ s W e l l n e s s 2 013

Healthy Eats

Eating for a Healthy Pregnancy Two things to keep in mind when you’re choosing what to eat during pregnancy: getting enough folate (which is also prescribed in prenatal vitamins) and making every calorie count. This recipe contains two top folate foods—spinach and oranges. It also provides a blast of flavor and nutrition, with no fat and only 70 calories per serving.

Sunshine Salad

Nutritional Facts (per serving)

TOTAL SERVINGS: 5

INGREDIENTS

DIRECTIONS

5 cups spinach leaves (packed, washed

1. Toss all ingredients together in

and dried well)

a large bowl.

½ red onion (sliced thin)

2. Add dressing and toss again.

½ red pepper (sliced)

3. Serve immediately.

1 cucumber (whole, sliced) 2 oranges (peeled and chopped into bite-size pieces) cup vinaigrette dressing (“lite,” around 15 calories per tablespoon or less)

Calories: 70 Total fat: 0 g Trans fat: 0 g Cholesterol: 0 mg Sodium: 180 mg Carbohydrates: 16 g Dietary fiber: 3 g Sugars: 9 g Protein: 2 g Vitamin A: 560 mcg Vitamin C: 90 mg Calcium: 60 mg Iron: 0.5 mg

Courtesy of United States Department of Agriculture, http://recipefinder.nal.usda.gov/recipes/sunshine-salad

westernhealth.com

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Talk to your doctor about how often you need preventive screenings, such as mammograms and PAP tests, based on your age, personal health and family history. As a Western Health Advantage member, you will not pay a copayment or deductible* to receive these preventive services: Well woman visits Immunizations STD screenings Cancer screenings Depression screenings High blood pressure screenings

get your mammogram > enter to win $100 visit mywha.org/women for details; some restrictions apply. *Coverage may vary depending on your plan.

Refer to your EOC/DF for determining the preventive services limitations, including WHA’s right to coordinate care in a cost-