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04 } Letter from the Editor NA Dive 05 } DGenetic testing can

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inform a health plan CHIEF EXECUTIVE OFFICER

Douglas Bennett DIRECTOR OF FINANCE

Carrie Cass

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EDITORIAL

Hunter Harrell special sections editor

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DESIGN

Tad Smith manager of creative services

Gary Markstein

Ocular Health

Keeping an eye on inherited disease

ADVERTISING

Jamie Opalenik

Understanding Epigenetics Five ways to optimize your genes

08 } M ental Health Common conditions have genetic factors

director of multimedia sales

Amy Baird Tana Bowen Kelly Bulkley Samantha Crews Cole Davis Abby Feldman Heather Mobley Joe Nelson Chandler Sommerfeldt

12 }  Clean Plates How cultural customs 14 }

affect nutrition

Recipes for Every Meal

Mindful Snacking

16 } Establish Healthy

Habits for the Heart

PRODUCTION

Ryan Brown

17 }  Fit Five Easy chair exercises

production manager

Ballantine Communications uses reasonable effort to include accurate and up-to-date information for its special magazine publications. However, all information comes from a variety of sources and may change at any time for any reason. To verify specific information, refer to the organization or business noted. To view the online version of this guide, visit: www.durangoherald.com.

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18 }  Dealing with Diabetes Genetic Factors and Dental Health

22 } Health Insurance Terms to Know

23 } Health Briefs

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letter FROM THE

EDITOR

Personalize your process to progress in the new decade.

rogress is a process. Small steps can eventually culminate in beneficial changes. When it comes to health, progress relies on education and disease prevention. Most people know it is important to make time for the things that keep us healthy, including nutritious meals, regular exercise, quality sleep and annual exams. Making a commitment to continue to improve our well-being is both a battle and balancing act, but knowing what you are up against can make it easier. To kick off the new decade, Four Corners Healthy Living is diving into DNA to discover how heritage affects health. Whether through genetics or environment and lifestyle, different cultures have different risks for disease. These pages discuss the various ways that our family’s medical history can play a role in our risk for certain diseases, and ways genetic testing can inform our personal healthcare plans.

Four Corners Healthy Living is a quarterly tabloid dedicated to health and lifestyle features. TO RESERVE YOUR SPACE CALL

(970) 247-3504

Reach 88% of adults in Southwest Colorado.

Our contributing authors share tips for making traditional meals more healthy, and recipes ranging from savory to sweet. Health experts offer opinions on topics like eyesight and mental health, and provide advice to help you optimize your well-being. In honor of heart health month, learn how to lower your risk of disease, and raise your heart rate with some muscle-building exercises. Read about the different types of diabetes, and the ways genetics and lifestyle can influence its development. Then take a break from genetics to quiz yourself on insurance terms you should know, and catch up on community briefs. Finally, don’t forget to celebrate your personal progress every step of the way on this journey to a healthier lifestyle. Namaste,

2020

Upcoming Publication Themes:

april Community & Collaboration july Sports & Safety october Communication & Care

To learn more about becoming a contributing writer, please contact specialsections@durangoherald.com

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DNADive

Health Trends

MORE PEOPLE USING AT-HOME TESTS TO DETERMINE DISEASE RISK

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uman DNA is a like a secret recipe. The DNA includes instructions, which are genes coded in a specific order to guide growth, help organs function and so much more. Simply put, an individual’s genes are the ingredients to their unique traits. While multiple genes can be responsible for one trait such as our height, other traits can be determined by the function of a single gene.

RISING TREND

Genetics are a complicated topic, but ongoing research has helped health professionals learn more about how certain sequences affect our development. With more ways to use genetic code as a tool, at-home genetic testing is a rising trend. In fact, about one-third of Americans have tried, or know someone who has tried genetic testing, according to an NPRIBM Watson Health Poll.

COMMON TESTS

Testing DNA for preventative health used to be uncommon. In the past, doctors ordered genetic tests primarily to diagnose rare conditions, or help prospective parents determine their risk for passing genetic conditions to their offspring. Thanks in part to

BY HUNTER HARRELL

the study of genetics, there are now different types of at-home tests that can offer customers clues about their ancestry, provide information about common traits, or assess their risk of developing certain diseases. Though there are benefits to reviewing our genetic information, those who purchase at-home tests should be aware that they have limitations, and some information can be difficult to interpret without an expert’s assistance.

BENEFITS AND LIMITATIONS

When an individual’s primary care physician orders a genetic test, they collect a sample of the DNA, send it to the lab, interpret the results and then schedule an appointment to share those results with a patient. Health professionals can perform tests to predict risk of disease, diagnose disease and reveal how a person reacts to certain medications. Under an expert’s recommendation, sometimes these types of diagnostic testing can be covered by health insurance, but cost can vary by individual plan. At-home tests can be less expensive, and they allow a person to collect their own sample and await

the results, which are usually made available online. While some at-home testing kits offer individuals the ability to consult with professionals, others rely on the customer to interpret the results. This can make understanding the results difficult without further research and education. At-home tests are rarely available for specific conditions and are not to be used for diagnosis or treatment. Tests come with a disclaimer that they are useful for education and research purposes only. Despite the drawbacks, there are some benefits to at-home testing. These tests don’t require approval from health professionals, and collecting a sample is easy. Though at-home DNA tests have their limitations, they are also raising awareness of genetic disease and how genetics play a role in our health. These tests are expanding access to genetic information that could help people play a more active role in disease prevention, as well. Customers should be aware of test limitations, participating in genetic testing can also help further medical research. This rising trend and DNA dive may just help us discover the secret ingredients to a healthier human after all. l

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5 Healthy Habits

UNDERSTANDING EPIGENETICS BY CELESTIA FRENCH

Ways to Optimize Your Genes What if I told you that the choices you make on a daily basis could either take you closer, or further away, from your best health. Contrary to popular belief, our health destiny is not necessarily predetermined by our genes. The term “epigenetics” is the study of our genetic expression and how it is modified by our environment. Genes are segments of DNA, which communicate with our cells about how to function and what traits to express. Our daily behaviors and choices essentially “turn on” or “turn off” gene regulation activity. We inherit codes of DNA from our parents that can affect things like hair and eye color, and even our propensity to inherit certain diseases. And while our hair and eye color are pretty much hardwired, we have a lot more control over our genetic expression than previously thought. Simply by making better choices more often, we can make meaningful modifications to our biology, and thereby improve our health and well-being, and even enhance our ability to prevent disease. Want to learn how? Here are five simple steps.

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There is a whole branch of science called nutrigenomics that is entirely devoted to the study of food and how it affects our genetic expression. Kristy Hall, a Functional Epigenetic Nutritionist at the Living Well Center for Epigenetic Testing, says that everyone can benefit from eating a whole foods diet. While everyone has different nutritional needs, minimizing one’s intake of processed foods (like refined sugar, white flour and corn syrup-based packaged foods), while incorporating a variety of fresh, whole foods (including plenty of vegetables, fruits, spices and herbs) can create favorable conditions for our genes. Research suggests that exercise is extremely supportive to positive gene expression. One study at the Karolinska Institute in Sweden found that exercise changes the fat storage levels of cells, which in turn affects epigenetic gene expression for the better. And while there’s no one “prescribed” amount of exercise that fits everyone’s needs, the study showed that even a small amount of regular daily activity could be an effective way to promote positive gene expression. Did you know that even one missed night’s sleep can effect your genes? A study at Uppsala University found that even one night without sleep could alter the human epigenome, contribute to adverse weight gain, and the loss of lean muscle mass. The research also indicated that chronic sleep loss contributed to an increased risk of type 2 diabetes. You see, during deep sleep, your

body releases accumulated toxins and stress while repairing and self-regulating the cells. So next time you have the inkling to pull an all-nighter, it might be prudent to opt for some extra rest instead.

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but that they have no more power than an actual blueprint. He contends that we give our genes power, for better or for worse, through our thoughts and perceptions about our health. So if you can replace an old negative thought pattern in your unconscious mind, and replace it with the belief that you are young and vibrant (at any age), then this new belief can help flip the switch of your longevity genes. So, the age old question remains: does nature or nurture have a stronger impact on our health? The answer is both. But if you make an effort to nurture your nature, you will likely experience vast benefits over the course of your lifetime. l

STRESS MANAGEMENT:

Chronic stress can speed up cellular aging and wreak havoc on your genes. So finding ways to minimize stress can be a powerful anti-aging agent. Laughter and meditation are both sciencebacked methods of de-stressing that can have powerful physiology-changing benefits. Even just a few minutes of meditation per day has been shown to dissolve fatigue and decelerate the aging process. But whatever you can do to relax, (drinking an extra glass of wine and scrolling through social media does not count) will be reflected favorably by your genetic expression.

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INTERNAL DIALOGUE:

Talk to yourself. No seriously. Changing your internal dialogue about what you believe about your health can impact your genes. In his book, The Biology of Belief, Bruce Lipton states that our genes are the blueprints of our health,

WE’RE MORE THAN MEETS THE EYE Dr. Davis Capaccioli

Dr. Lee Ann Hoven

Celestia French is a holistic wellness and beauty consultant specializing in vitality optimization. She is a certified yoga therapist and wellness coach, lifestyle model and stylist. Listen to her podcast, The Vitality Sessions, or visit her website www.labellauna.com for more.

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Mental Health

Common conditions can have genetic factors BY SARA BARRETT

We share many traits with our family members. Some may be obvious like curly hair, but others may be harder to see, like depression and anxiety. When you see a doctor for a physical health concern, they may ask questions about family history to help determine possible risks of certain diseases. It is the same for mental health. In a first appointment, a mental health professional will gather lots of information, including if there is any family history of mental illness. Genetics may be a factor with many mental health conditions, and you may be more at risk for certain conditions, like depression, if you have a family member with that condition. Genetics aren’t the only reason we may observe mental health conditions like depression running in families. Often times, our life experiences play a role in the development of certain

mental health conditions such as depression and anxiety. Sometimes stressful or traumatic experiences, especially in childhood, can mean a person may be more likely to struggle with depression and anxiety, among other conditions, later in life. It’s possible that experiences, instead of, or in addition to, genetic factors can cause a higher rate of depression and anxiety in some families. Whatever the cause of a mental health condition, everyone has a different experience managing it. For some it can feel upsetting to be diagnosed with a similar condition as their parent or sibling because of how they have seen the condition impact their lives. However, a person’s experience with depression or another condition does not have to be the same as their family members. Medication, counseling and effective coping strategies, along with support

from loved ones can be an effective combination for managing many mental health conditions. Family support can be an important part of managing your mental health. If you are coping with a mental health condition, talk to your family or friends about how they can best support you. Let them know what the signs might be that you are having a hard time and how they can encourage you and help you to seek any additional support. For more information on different mental health conditions, their symptoms and possible causes check out the website for the National Alliance on Mental Illness at www.NAMI.org and click on Learn More. l Sara Barrett is a Licensed Clinical Social Worker, and works as a behavioral health professional for Southwest Medical Group. She provides brief interventions and goal setting to help patients cope and manage stress, depression and anxiety, and other mental health conditions.

Sara Barrett, LCSW

Behavioral Health Services Equipping patients to integrate their physical & emotional health to improve their overall well-being

Behavioral Health Services For more information go to swhealth.org/socialworker or call (970)565-8556

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mental health Across the nation, more individuals are raising awareness of the importance of recognizing mental illness in our busy lives. These facts, statistics and tips sourced from the National Alliance on Mental Health can help you take control of your mental well-being, and recognize when your friends and neighbors need help too. For more information, visit the website for NAMI, at www.nami.org.

Watching for Warning Signs 1 in 5 adults experience mental illness

1 in 25 adults experience serious mental illness

Managing Mental Health 1 2 3

Find a routine that works for you, including regular exercise, diet and sleep. Stay close to your support system. Engage with your loved ones regularly. Continue to find ways to do what you love.

Prevalence of Common Mental Illnesses

1%

Schizophrenia

1%

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1%

Borderline Personality Disorder

1 2 3 4 5 6 7 8 9 10

Feeling sad or withdrawn for more than two weeks. Self-depreciation and self-harm. Out-of-control or severe risk-taking behavior. Sudden, overwhelming fear. Significant weight loss or gain. Seeing, hearing or believing things that are not real. Repeatedly using drugs and alcohol. Drastic changes in mood, behavior, personality or sleeping habits. Extreme difficulty concentrating or staying still. Intense worries or fears that disrupt daily activities.

Approaching Assistance STEP 1

Ask your primary care doctor to rule out physical health conditions.

STEP 2

Be honest about what you’re feeling, and be clear about what you want.

STEP 3

Ask for help finding a therapist or mental health specialist that works for you.

3%

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Dual Diagnosis

Post-traumatic Stress Disorder

Depression

Anxiety Disorders

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Ocular Health KEEP AN EYE ON INHERITED DISEASES BY GRANT GEBHARD

How genes influence eyesight A

dvancements in the study of genetics have expanded our understanding of the impact of genes on our ocular health, and opened doors to exciting new therapies. Although experts have identified many genetic variations that can influence our vision, the exact significance and impact of most of these genes have yet to be fully discovered. Our genetic makeup can impact us by either directly causing a genetic disease or by increasing the risk of disease.

GENETICS & OCULAR DISEASE Many ocular diseases are inherited in a Mendelian fashion – meaning that genes passed from parents to children are responsible for the disease. Autosomal dominant genes will almost always manifest themselves in every generation, while autosomal recessive genes will often skip generations. Due to their rarity, genetic diseases are not always easy to identify. Family history can help an ophthalmologist. The effects of genetic eye diseases can vary from mildly symptomatic to blinding; some of the diseases are even life-threatening. Two examples are epithelial basement membrane dystrophy, where the vast

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majority of those with the disease are unaware they have it; and then there is retinoblastoma, the most commonly inherited intraocular tumor of infancy (usually identified before the age of two years), which, if undetected and untreated, can be fatal. Fortunately, inherited genetic diseases causing visual disability or blindness are rare. For most of these diseases there are no effective treatments to prevent or restore vision loss, but one disease has recently experienced a miraculous breakthrough.

NEW TREATMENTS

Treatments to cure genetic conditions, known as gene therapy, center around replacing defective genes within the body. One of the challenges of gene therapy is delivering the correct gene to the correct tissue. Due to its relative isolation from the rest of the body, the eye is an optimal target for gene therapy. In 2018, Luxturna became the first FDA-approved gene therapy for a genetic disease. The therapy treats patients with a mutation in the RPE65 gene, which causes two diseases, Retinitis Pigmentosa and Leber’s Congenital Amaurosis. Both diseases cause blindness. While this medication is only effective for a small patient population, the results are astonishing and revolutionary. Where there was once incurable blindness, gene therapy has opened the door to the possibility of restoring sight.

FAMILY HISTORY

Genetic inheritance can also cause ocular disease in an indirect manner, where genes confer an increased risk to

the development of a disease, but do not directly cause the disease. This is where knowledge of one’s family history can be an important factor in early detection. The most important family members are relatives such as parents and siblings, as these individuals share the greatest number of genes (50% for parents and roughly 25% for siblings). Knowing history of more distance relatives can be useful for physicians, but does not have as great an impact on the risk of developing disease.

COMMON CAUSES OF BLINDNESS

The most common cause of blindness in the United States is age-related macular degeneration (AMD). Studies have shown that the risk of developing macular degeneration is three to four times higher when a parent or sibling has the disease. Macular degeneration occurs when proteins build up in the retina and cause damage to the retinal photoreceptors. Over 80% of people with AMD have the dry form, which is currently untreatable. Dry macular degeneration is slowly progressive and causes vision loss over the course of many years. Although there are no treatments for AMD, early detection can be beneficial as there are lifestyle modifications such as smoking cessation and special vitamin supplementation that can reduce the risk of vision loss. In addition to family history, age is another important risk factor for developing AMD. Population-based studies have shown a 2% risk for people aged 50-59, increasing to 30% for those over 70. The second most common cause of vision loss and blindness in the United States is glaucoma, a disease characterized by progressive

thinning and atrophy of the optic nerve. When glaucoma progresses, peripheral vision is slowly lost until the eye loses the ability to detect light. There is a strong correlation for risk of glaucoma within families. A family history of glaucoma in a parent or sibling increases the risk of disease four to nine times. The key to effective treatment of glaucoma and prevention of vision loss is early detection. Unfortunately, glaucoma is a disease that remains asymptomatic until reaching an advanced stage, after irreversible vision loss has occurred. Individuals with family members that have glaucoma should be screened for glaucoma periodically throughout their lifetime, as vision loss can often be completely prevented with early treatment. Although there are no specific screening guidelines for glaucoma or AMD, individuals with a family history of glaucoma or macular degeneration should have periodic eye examinations. Talking to family members about their ocular health can be helpful. Genetic research continues to advance our understanding of how genes influence health. Not only do these advances allow us to quantify our risk for developing certain diseases, but they also help us find new ways to treat and cure genetic conditions. Our family’s medical history may one day help us with early diagnosis and treatment of more ocular conditions, which could be instrumental in maintaining clear vision for many years to come. l Grant Gebhard grew up in Denver, Colorado. He earned his medical degree at the University of Colorado and then completed a residency in Ophthalmology in Little Rock, Arkansas. Gebhard works as a comprehensive ophthalmologist at Southwest Eye Consultants.

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Clean Plates CULTURAL CUSTOMS CAN INFLUENCE HEALTH

Modifying diets to reduce the risk of disease W

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Culture is a pattern of ideas, customs and behaviors shared by a particular people or society. hen you grow up in a distinctive culture with eating habits based on traditions, it has a tendency to influence not only your lifestyle but your dietary choices as well. For many people, culture has a greater influence on eating habits than any other factor. Depending on the culture you were raised in, you might have a soft spot for mama’s marinara, dad’s barbecue ribs or grandma’s tamales. Some food traditions and cultures are healthier than others. In fact, modern dietary guidelines recognize the fact that everyone has a different diet

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or eating pattern. Some people grew up on rice and beans, while others are used to eating primarily fish. Different cultures are prone to varying health risks. For example, African-Americans and Southerners may be at greater risk for heart disease. Native Americans run high risks of type 2 diabetes and Caucasians are more prone to type 1 Diabetes. Cultures whose menus focus on lower-fat ingredients with large vegetable portions, such as those of many Asian or Mediterranean cultures, can result in a healthier population. Nutrition experts have long studied typical diets in regions such as Crete, and other parts of Greece, where life expectancy is high and heart disease rates are low. The Mediterranean diet includes seasonal foods with minimal processing. Emphasis is placed on vegetables and whole grains.

Fresh fruits are provided for dessert instead of sugary sweets. Olive oil is the main fat, and the diet includes moderate amounts of dairy products, fish and poultry. No matter what types of foods are a part of your culture, most of them can fit into a healthier lifestyle. With some minor modifications, it’s possible to retain the traditional taste of home while enjoying healthier dishes. Take a look at how varied your diet is. A balanced daily diet should be made up of different food groups, including whole grains, lean proteins, fruits, vegetables, dairy and healthy fats. Consider portion sizes and reduce the serving size of high fat or carb-heavy dishes on your plate. Try halving your serving of pasta and increasing the size of your salad. A meal

should never go overboard on calories, saturated fat, added sugar or sodium. If you’re used to eating an Italian-based diet, you may be eating several servings of pasta per meal. A habit that can add hundreds of unnecessary calories to your diet. Try decreasing the pasta, replacing it with vegetable or bean noodles, or at the very least switch to a whole wheat/whole grain pasta. Do the same with rice, opt for healthier brown rice or even better, wild rice. If your cuisine is filled with fried foods, consider modifying the cooking method. Try baking foods instead of frying them, or try an air fryer, which keeps food crispy without the use of oils. Increase fresh herbs and spices to add flavor and decrease calories. If you tend to use large quantities of sauces and dressings try halving the amount you would normally serve. Lessen the amount of oil. Every tablespoon of oil equals 120 calories. Plant-based oils are healthier, but it’s easy to go overboard. There’s no need to use a half-cup of oil to prepare chicken when you can get the same task done with 1 to 2 tablespoons. Reducing the oil will also reduce your calories by several hundred. Bulk up the portions of fruits and vegetables. The average diet doesn’t include enough fresh produce. Increase the amount you add to each meal and decrease your portions of carbs to help better balance any plate. Enjoy your culture and the foods that make it special, but look for ways to tweak diet traditions to make them healthier. After all, food is the center of many families. The kitchen is the heart of a home and a meal is a perfect way to bond with loved ones. Recipes passed down through the generations help maintain a family history, so don’t ditch them. Eat more fruits and vegetables and limit alcohol consumption. Try substituting less-fattening ingredients and include exercise in your daily routine. l

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This veggie-packed muffin recipe is a great breakfast on-the-go. servings: 12 ingredients: 1 tablespoon olive oil 1 cup chopped red pepper 1 cup chopped green pepper 1 cup chopped yellow onion 2 cups baby spinach 1 cup chopped mushrooms 2 cloves minced garlic 4 whole eggs 4 egg whites Salt and pepper to taste directions: Preheat the oven to 350 degrees. Grease a standard nonstick 12-slot muffin tin with cooking spray and set aside. Heat a large nonstick skillet over medium heat. Once hot, add oil, red pepper, green pepper and onion. Saute 5-7 minutes, or until peppers are tender. Add in spinach and mushrooms and minced garlic, and cook for an additional 2 minutes. Season with salt and pepper, and remove from heat. Crack eggs and egg whites into large measuring cup and whisk together. Stir in cooked veggies, then pour the mixture into the muffin tin. Bake for 15-20 minutes, or until the tops are firm to the touch and eggs are cooked. Cool slightly and serve! To store leftovers, let them cool completely before placing in an airtight container in the fridge. To reheat, pop them into the microwave until warm, about 30 seconds.

The trinity of corn, beans, and squash is a central part of the local Native American culture. Honor that history and your heart health with a dish called Three Sisters stew. servings: 8 ingredients: 1 (15-ounce) can black beans, drained and rinsed 2 cups fresh or frozen corn kernels 1 medium butternut squash, cubed 1 medium yellow squash, diced 1/2 cup roasted green chiles 1 (14.5-ounce) can chopped fire-roasted tomatoes 1 (15-ounce) can pumpkin puree 1 large yellow onion, diced 3 garlic cloves, minced 1/4 teaspoon allspice 1 teaspoon oregano 1 teaspoon ground cumin 2 tablespoons olive oil 4 cups chicken or vegetable stock Salt and pepper to taste directions: In a large pot or dutch oven, sautĂŠ, diced onion in olive oil, stirring occasionally until translucent, 5 to 7 minutes. Add garlic and sautĂŠ, stirring occasionally, until lightly colored 2 to 3 minutes. Add stock and both types of squash to the pot and bring to a boil. Reduce heat to medium-low and simmer, covered, for about 30 minutes. Then add remaining ingredients and cook, uncovered, over medium heat until stew has thickened slightly about 40 minutes. Season to taste with salt and pepper.

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Buffalo Chicken

This slow-cooker recipe for buffalo chicken is a versatile option for an easy lunch. Use the shredded chicken to make wraps, top salads and prepare sandwiches. servings: 6 ingredients: 3 chicken breasts, large 1/2 cup nonfat plain Greek yogurt 1 /3 cup hot sauce of your choice directions: Place chicken breasts in a large slow cooker. Turn to high and cook for about 2 hours, until fully cooked. Remove chicken and use forks to shred. Place in fridge to cool. Once cooled, add greek yogurt and hot sauce. Mix and serve any way you like, hot or cold. Store leftovers in the fridge.

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Banana Chocolate Smoothie

This recipe for a creamy, and guilt-free chocolate banana smoothie from Ellen Brown’s "Super Smoothies: 100 Recipes to Supercharge Your Immune System" helps satisfy chocolate cravings. serving size: 1 cup servings: 4 ingredients: 1 1/2 cups chocolate soy milk 3 ounces chopped dark chocolate 3 tablespoons cocoa powder 2 tablespoons bee pollen 2 tablespoons flaxseed oil 2 cups sliced banana 1 cup chocolate frozen yogurt directions: Combine soy milk, chopped chocolate, cocoa powder, bee pollen, flaxseed oil and banana in a blender or smoothie maker. Blend on high speed for 45 seconds or until mixture is smooth. Add frozen yogurt and blend on high speed again until smooth. Serve immediately.

ccording to the International Food Information Council Foundation (IFICF), mindful eating focuses on slowing down and tuning into the sensations of eating. One of the goals of mindful eating is to prevent unhealthy behaviors associated with food and eating. One such behavior is binge eating, which can have negative consequences long-term. Mindful eating can benefit anyone, including people who are maintaining healthy weights and not considered to be at risk of developing eating disorders. One of the questions people may have

about mindful eating, and mindful snacking in particular, is how they can slow down and tune into the sensations of eating when they snack. Working professionals tend to snack at the office, where it’s not always so easy to slow down and tune in to the foods we eat. In addition, availability may dictate what people eat while away from home, which can lead to people eating unhealthy foods because that’s all that is available. While there’s no denying mindful snacking can be difficult, the IFICF offers these tips to help people slow down and tune in during snack time.

l Assess your hunger. Learning to assess their hunger can help people distinguish hunger from boredom. The IFICF recommends using a hunger scale of one to 10, with one being very hungry and 10 representing feelings of being stuffed. If you determine your hunger is a four or below, then consider a snack. Anything higher than a four and you might just be bored. When snacking, periodically pause to reassess your hunger and determine if you’re satisfied. This reassessment can help you avoid overeating. l Reduce distractions. Distractions can make it hard for people to recognize how much they have eaten. Avoid snacking while watching television or using your smartphone so you don’t accidentally overeat. l Take small bites. Large bites can also make it easier to overeat. Taking small bites, such as one whole grain chip at a time instead of a handful with each bite, can reduce the likelihood of overeating. l Let your senses savor your snacks. Using all of your senses when snacking can force you to slow down and notice flavors and aromas you might otherwise never recognize.

A more mindful approach to snacking can help people better appreciate their food and may help them avoid overeating. Learn more about mindful eating at www.foodinsight.org. J A N U A R Y

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Heart Health SMALL HABITS MAKE BIG IMPACT BY CONNIE SUTTON

Lifestyle choices can increase risk of heart disease F ebruary is Heart Health Month, making it the perfect time to learn about your risk for heart disease. Heart disease – and the conditions that can lead to it – can develop at any age. Gone are the days when this was something that only your grandparents suffered. Heart disease is happening to younger adults more and more often. This is partly because the conditions that lead to heart disease are happening at younger ages. High rates of obesity and high blood pressure among younger adults (ages 3564) are putting them at risk for heart disease earlier in life. There are also genetic and cultural factors that need to be looked at when considering the risks of developing heart disease. Certain health conditions, lifestyle choices and family history can all increase your risk of heart disease. Families share genetics, but they also tend to share behaviors, lifestyles and environments. All of which factor into heart health.

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Heart disease can run in a family, and your risk for heart disease can increase based on your age, your race or your ethnicity. Heart disease is the leading cause of death in the United States for non-Hispanic whites, non-Hispanic blacks, and American Indians. For Hispanics, Asian Americans and Pacific Islanders, heart disease is second only to cancer as the number one cause of death. The risk of heart disease can increase even more when heredity is combined with unhealthy lifestyle choices. Choices such as cigarette smoking and unhealthy eating habits. However, you can take steps to lower your risk by addressing and adjusting the factors in your control. By making changes in your lifestyle, it is possible to reduce your risk of heart disease. Add physical activity to your daily routine, and add more fruits, vegetables and whole grains to your diet. Reduce sugar, fat and alcohol intake. Get cholesterol, diabetes, blood pressure and stress under control. The risk for heart

disease increases as your cholesterol increases. If not properly controlled, diabetes can lead to significant heart damage, including heart attack. There are no guarantees that a heart-healthy lifestyle will keep heart disease away. But, these changes will certainly go a long way towards improving your overall health. Because some risk factors are closely related to others, making changes in one area can have multiple benefits. For instance, adding exercise to your day can help reduce weight and lower stress levels. Both of which can reduce diabetes complications as well as high blood pressure. Small changes can lead to big benefits. Research shows that with simple lifestyle changes, heart disease could be preventable as often as 90% of the time. That’s a huge percentage. Especially when you consider that heart disease causes roughly 735,000 heart attacks, and is responsible for more than 630,000 deaths in the U.S. each year – those are some staggering numbers for a preventable disease. Heart disease is silent until it strikes. It’s important to know and be able to recognize all of the factors that put you at risk. Though there is nothing you can do about your heredity, take time to consider the factors you can control, and make changes to put yourself on a healthier track. l

Fit Five ENJOY EASY CHAIR EXERCISES BY HUNTER HARRELL

Add these activities to a regular routine SINGLE STEP UP

Face the chair with feet shoulder distance apart. Place the left foot on a stable chair, and keep the other on the ground. Lift the right foot from the ground, and shift weight to the left foot on the chair. Place the right foot on the chair and move the left foot to the ground. Keep the back straight and hips level. This exercise engages muscles in the hips, butt and thighs.

BENCH DIP

Sit in the chair and place hands firmly on the edge of the chair, shoulder-width apart. Slide off the chair, keeping the back straight, and extend the legs. Beginners can bend the legs at the knee and use the arms to lower the body. For a bigger challenge, extend the legs to a plank position and repeat the motion with the arms. This challenge strengthens the muscles in the arms, and engages the core.

CHAIR SQUAT

Stand facing away from the chair, preparing to sit. With legs shoulder-width apart, squat, but stop just before touching the seat. Straighten the legs to go back to the starting position. Keep the back straight and knees above the feet at all times. Chair squats are a great strength-training exercise for the legs.

Ditch the gym membership this year, and learn how to use everyday objects as a tool for exercise. In this issue of Four Corners Healthy Living, we share five ways to exercise with a common chair. Use any chair available, as long as it is stable and does not slide. These easy exercises can help build strength in the arms, legs and core, without spending money on expensive equipment. INCLINE PUSH-UP

Face the chair, and place hands on the edge of the chair, shoulder-width apart. Assume the push-up position, and align the feet with the rest of the body. Bend the elbows to lower the chest to the edge of the bench, while keeping the back straight. Then extend the elbows to push the body away from the chair. This movement helps to build upper body strength. It engages muscles in the chest, shoulders, arms, abs, back, hips and legs.

BULGARIAN LUNGE

Face away from the chair with feet hip-width apart. Move the right foot back, and place on the chair. Find the proper footing to balance, and keep the weight on the left foot. Bend the left knee and lean forward in a lunge motion. After several lunges, repeat with the other leg. Like other lunges and squats, this exercise engages muscles in the legs and abdomen, improving core strength, balance and agility.

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Heart Health DEALING WITH DIABETES BY CONNIE SUTTON

Manage lifestyle factors you can control

T

he role that genetics play in risk ultimately depends on the type of diabetes. While the diseases may have many similarities, type 1 and type 2 diabetes have different causes. Here’s a look at how genetics may influence each disease. No matter the type, there are two factors important in both. One, you inherit a predisposition to the disease. Meaning, if there is a history of a specific type of diabetes in your family, you may have a higher risk of developing it too. The second factor is environment. In type 2, for example, lifestyle factors appear to be more influential than genetics. Knowing how genes, lifestyle, and environment affect your risk of diabetes can help minimize your risk.

TYPE 1 DIABETES

Type 1 diabetes is an autoimmune disease. The disease develops when the body’s immune system attacks and destroys the cells in the pancreas that make insulin. This type of diabetes usually appears in childhood or early adulthood, but it can develop it at any age. Research has found that specific genes, that vary by race will also be deciding factors in developing the disease.

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In most cases, people inherit risk factors from both parents, and in the past, doctors believed that type 1 diabetes was wholly genetic. Scientists have found a link to changes in the genes that produce certain proteins. These proteins play a key role in the immune system, and this genetic feature can make a person more susceptible to developing type 1 diabetes. The American Diabetes Association also found links to certain environmental triggers, like cold weather for instance. They found that type 1 diabetes develops more often in winter than in summer. And it’s noted that type 1 is more common in places with cold climates. Early diet may play a role too as type 1 diabetes is less common in people who were breastfed. Another factor? Research supports the theory that some viruses might activate type 1 diabetes in people who are susceptible. Among these viruses are measles, mumps, coxsackie B and rotavirus. People with type 1 diabetes may have autoimmune antibodies for the disease in their blood for years before symptoms present. However, once the disease is triggered symptoms tend to appear quickly, within weeks,

or even days, and once a person develops type 1, they will have it for life. It’s not possible to prevent type 1 diabetes, and while people who have a family history of the condition may be predisposed to developing it, the inheritance pattern is still unclear.

TYPE 2

Type 2 diabetes is the most common form of the disease. The Centers for Disease Control estimate that it accounts for 90-95% of all U.S. cases. Studies show that type 2 diabetes has a much stronger link to family history and lineage than type 1. This tendency may be due to learned habits such as a poor diet and lack of exercise. Families will have similar eating and exercise habits. While genetic factors may play a larger role in this disease, experts believe that lifestyle has the most significant impact. Factors such as weight, age, diet and exercise can all increase the risk of developing type 2 diabetes. There are also indications that certain ethnic groups have a higher risk of developing the disease. These groups include African-Americans, Alaska Natives, American Indians, Asian-Americans, HispanicAmericans, Native Hawaiians, and Pacific Islanders. Studies show that even if these groups are not overweight, they are at a higher risk for type 2 diabetes. A person’s race, ethnicity, or both may also affect the BMI (Body Mass

Index) at which the risk of type 2 diabetes begins. For Caucasian, Hispanic and African Americans, the added risk of development begins with a BMI of 25. For Asian Americans, the BMI that risk increases at is 23, and 26 for those of Pacific Island descent. People with two or more risk factors will have a higher chance of developing type 2 diabetes. It may be difficult to figure out whether your type 2 diabetes is due to lifestyle factors or genetic susceptibility. Most likely both factors play a role. The good news is studies show that it is possible to delay or even prevent type 2 diabetes by making certain lifestyle changes.

MORE ABOUT GENETICS

There are also other, less common forms of diabetes including Gestational, Monogenic Diabetes and Diabetes Insipidus. To learn more about the genetics of all forms of diabetes visit www.ncbi.nlm.nih.gov/ books/NBK1667/ to read the free NIH publication The Genetic Landscape of Diabetes. l

Hyperbarics can be used for multiple treatments:

HBOT: A BRIEF HISTORY

Hyperbaric Oxygen Therapy over the years

In 1662 British physician Nathaniel Henshaw used compressed air in a wooden chamber, called a domicilium, to create a hyperbaric atmosphere for healing. At the same time Irish chemist, physicist, and inventor Robert Boyle stated Boyle’s law: Pressure and volume of gas have an inverse relationship when temperature is held consistent. Two centuries later in 1861, the first hyperbaric chamber was built in the United States by Neurologist James Leonard Coming after witnessing the success in treating decompression illness among Hudson Tunnel workers. In 1921 Physician Orval J. Cunningham built a chamber after observing morbidity and mortality rates from the Spanish

Acclimating to Elevation

influenza pandemic was greater at higher elevations. Cunningham believed that many organisms can be killed with exposure to oxygen. Dutch Cardiac Surgeon, Boerema, reported in 1956 that hyperbaric oxygen therapy (HBOT) was an aid in cardiopulmonary surgery. Now, in 2020, HBOT is used with non-healing infections, blood perfusion insufficiencies, orthopedic injury and surgeries, and neurological conditions, etcetera. We now have sufficient evidence through research and extensive case studies that HBOT may be a useful treatment for a number of conditions, usually in conjunction with other therapeutic interventions. George Glass is the Owner of Mountain Hyperbarics. George has been in healthcare for over twenty-seven years. Mountain Hyperbarics was founded on the inspiration, drive and passion to help those who otherwise would not be able to receive this treatment.

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Oral Health SMILE FOR THE FAMILY PORTRAIT BY HUNTER HARRELL

Understanding how genetics affect oral health G

lancing at the family portrait, it’s easy to see the role genetics play in our physical qualities, like the color of our eyes or the shape of our nose. But genetics can also play a role in our oral health. Genetics determine the composition of the mouth’s microbiome at birth. The microbiome is the different bacteria communities that live on the varied surfaces of the mouth, like the teeth, tongue and gums, as well as in the saliva. Diet and environment change this microbiome as we grow and develop. The purpose of this bacteria is to aid digestion and protect our oral health. An imbalance of these microbe communities can contribute to dental issues like tooth decay and gum disease. Most dental issues can be prevented with proper hygiene. However, some individuals can have an increased risk for certain conditions based on genetic

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factors. By understanding the cause of many oral conditions and its relation to the microbiome, people can prevent dental problems and maintain good oral health.

TOOTH DECAY

Tooth decay is one of the most common chronic diseases worldwide. More than 92% of American adults have dental caries, also known as cavities. By scheduling frequent cleanings at the recommended intervals, maintaining a regular brushing and flossing routine and avoiding sugary drinks, most people can prevent tooth decay before it happens. However, research indicates that there are some genetic factors that could influence and increase the risk of cavities. Some individuals have an increased risk for dental decay due to the structure of their tooth enamel, the shape of their teeth, saliva quality and quantity, and immune systems. Also, many medications can cause dry mouth, which can lead to dental decay. Keeping tabs on your overall oral health can help you avoid tooth decay.

MISALIGNED TEETH

In Western culture, a straight smile is considered desirable. But teeth are designed with function in mind, not fashion. Genetics play a major role in determining our jaw size and structure, which affects how teeth grow. Both baby teeth and permanent teeth can grow into place crooked, or become crooked based on factors like jaw alignment and overcrowding, or habits like thumbsucking, using pacifiers, mouth-breathing, tongue thrusting and reverse swallowing.

Having crooked baby teeth does not equate to having crooked permanent teeth, but having healthy baby teeth will offer a greater opportunity for developing a straighter smile. Misaligned teeth are not a problem unless they cause other issues like jaw pain. Sometimes, the surfaces of the teeth may be more complicated to reach due to crooked teeth. But overlapping teeth are not worrisome, as long as you care for them properly.

GUM DISEASE

ADA RECOMMENDATIONS: • Brush twice a day • Floss once a day • Avoid sugar • Schedule cleanings every six months

Periodontal disease, more commonly known as gum disease, affects the tissue surrounding the teeth. It is caused by bacteria in dental plaque, and symptoms include sensitive and inflamed gums. If left untreated, gum disease can lead to the loss of teeth and bone in the jaw. Factors such as smoking, age and poor oral hygiene increase the risk of periodontal disease. How genetics relate to gum disease is not yet well known. But up to 30% of the population may be more susceptible to gum disease based on their genetics and immune system responses. To avoid the build up of dental plaque, schedule regular cleanings with your dentist. There is so much more to learn about genetics and oral health. However, dentists agree that proper dental hygiene is the best way to sustain oral health. l

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Care Costs HEALTH INSURANCE TERMS TO KNOW

Your guide to understanding industry jargon H

The world of healthcare can be confusing to navigate. People must keep track of their copayments, coinsurance, deductibles and savings plans, which can make it difficult to understand what’s going on with their health insurance.

ealth care is standardized in some areas of the world and publicly financed with little to no out-of-pocket costs for participating citizens. Elsewhere, access to health insurance is provided through employers, government assistance programs or individually purchased. Understanding some health insurance-related jargon is a great way to better educate oneself about the industry. l BENEFIT PERIOD: The benefit period refers to the duration of time services are covered under your plan. It is usually a calendar year from the point of start to end. It may begin each year on the anniversary date when you first received coverage. l COINSURANCE: This is a percentage of the cost of services rendered in specific areas outlined by the health plan that you are responsible for after a deductible is met. For example, a plan may cover 85 percent of costs, with patients responsible for the remaining 15. l COPAYMENT (COPAY): A copayment refers to the flat rate you pay to a provider at the time you receive services. Some plans do not have copays.

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l DEDUCTIBLE: The amount you pay for health services before the insurance company pays. You must meet a set limit, which varies by plan and provider, before insurance will kick in and cover the remaining costs during the benefit period. Many plans have a $2,000 per person deductible. This deductible renews with each calendar year. l HMO: A health maintenance organization offers services only with specific HMO providers. Referrals from a primary care doctor often are needed to see specialists. l HSA: A health savings account enables you to set aside pre-tax income up to a certain limit for certain medical and healthrelated expenses. l LONG-TERM CARE INSURANCE: A specific healthcare plan that can be used for in-home nursing care or to pay for the medical services and room and board for assisted living/nursing home facilities. l NETWORK PROVIDER: This is a healthcare provider who is part of a plan’s network. Many insurance companies negotiate set rates with providers to keep costs low. They will only pay out a greater percentage to network providers. l NON-NETWORK PROVIDER: A healthcare provider who is not part of a plan’s network. Costs may be higher if you visit a non-network provider. l PPO: A preferred provider organization is a type of insurance plan that offers more extensive coverage for in-network services, but offer additional coverage for out-ofnetwork services. l

Health Briefs Southwest Health System appoints Chief Operations Officer for Southwest Medical Group

Southwest Health System (SHS) has solidified their permanent Senior Leadership Team with the addition of Kerri White-Singleton as Chief Operations Officer for Southwest Medical Group. This role will include provider management and oversight, recruitment and retention of physicians and staff as well as other clinic operations. White-Singleton has over 13 years of clinical and administrative leadership experience in many modalities of medicine including surgical clinic practices, nursing administration, surgical services, managed care, quality, education

and process improvement. White-Singleton has worked at SHS since 2017 serving as Surgical Services Director and Interim Chief Nursing Officer. She brings her skills and talents in problemsolving, operational development, communication and collaborative medicine to this role. White-Singleton enjoys spending time with her family of eight doing all things outdoors, including hiking, biking, camping and kayaking.

Southwest Eye Consultants add new doctors to practice Southwest Eye Consultants recently welcomed two new doctors to its practice, Grant Gebhard and Reynell Smith. Gebhard is a comprehensive ophthalmologist and treats patients with a wide variety

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of ophthalmic conditions. He specializes in advanced cataract surgery, minimally invasive glaucoma surgery (MIGS), and eyelid surgery. Gebhard is also a member of the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery. Smith is a fellowship-trained corneal specialist who brings more than a decade of expertise to the practice. She offers the most advanced corneal transplantation techniques, including DSAEK and DMEK, as well as advanced cataract and refractive surgery, and pterygium surgery. To learn more about Smith and Gebhard visit www.sweyeconsultants.com. To schedule an appointment, please call Southwest Eye Consultants at (970) 828-2200.

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