Winter 2016
Tackling Pain Head On
Healing Sounds
Innovative Treatment Helps Former NFL All-Pro Seth Joyner Get His Life Back
Wearables for Wellness The Skinny on the Latest Fitness Devices
Read Between the (Label) Lines What You Need to Know About Nutrition Labels
Arrowhead Health Centers Finds Ways to ‘Let the Music Heal You’
Keeping New Year Resolutions Experts Offer Advice for Setting and Achieving Health Goals
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Contents
Winter 2016 4 VITALITY n 5 Exercise Tips for Back Pain n Building Your Cold-Battling Toolkit
12 INNOVATION n Working Smarter: Get a Hiring Edge n Wearables for Wellness
22 HEALTH & WELLNESS n Nutrition: Read Between the (Label) Lines n Understanding the Politics of Health n The Cost of Sleepless Nights
30 LIFESTYLE & NUTRITION n Keeping Your New Year’s Resolutions On Track n Sole Searching: Finding the Perfect Fitting Shoe n Grill and Chill: Winter Barbecuing Recipes!
18 COVER
Tackling Pain Head On Innovative Treatment Helps Former NFL All-Pro Seth Joyner Get His Life Back
36 PUZZLE
8 FEATURE
Healing Sounds Arrowhead Health Centers Finds Ways to ‘Let the Music Heal You’
Visit us online at healthstylemagazine.com
Winter 2016 • Healthstyle Magazine
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Editor’s Letter
Preparing for a Season of Change
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Jason Stevens is in marketing and passionate about helping to create customer experiences and tell the stories of those individuals. His role at Arrowhead Health Centers has enabled him to see the important role that an integrated healthcare experience can play in a patient’s health and recovery. During the holiday season you can find Jason enjoying the cooler weather hiking or making gingerbread houses and enjoying claymation holiday favorites with his kids!
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ith the holiday season upon us Bing Crosby is silently serenading the family in the background as the feeling of winter is finally in the air. Our homes are decorated with our favorite traditional items and are filled with the aroma of treats and holiday favorites. Many of us are frantically searching for those last minute stocking stuffers or waiting for our online orders to come in. This time of year is when we reflect on upcoming change and our paths. A cup of hot chocolate and the infamous “to do” list is easily distracted by plans for the next year and thoughts of how quickly this year flew by again. In just a few short weeks we will be ringing in the New Year and with it comes plans for improved health, paying off debt, fitness goals, and crossing off items from your bucket list. Our goals, ambitions and career paths are constantly on our minds as we think of what the next year holds. Planning for the New Year is exciting, we think about our goals and reflect on what we want. Based on those goals we make resolutions that will help us move in the direction that we hope the New Year will take us. But the reality is that many of those resolutions become thoughts of the past and we tell ourselves; okay on Monday I’ll start or at the beginning of the month I’ll start. Well this year we all start and finish our resolutions together by following some great advice from our staff. If part of those New Year’s goals include health, fitness, and wellness then we are excited to share with you the latest on fitness trackers as we keep up with the newest technology available this season. Consider purchasing a wellness tracker that helps you keep track of everything from steps to distance running or some that will track what you eat. I personally have one that I use religiously. With an activity tracker you will get motivation and the help you need as you take the next step in keeping track of those goals. Speaking of the next step, it is time to do some sole searching. Yes, we are talking shoes! A properly fitting shoe is imperative for your body
Healthstyle Magazine • Winter 2016
as a whole, not just for fitness but for everyday wear. Learn a few tips from physical therapist, Shaun Koth, as he talks about the importance of a perfect-fitting shoe. In the last edition of Healthstyle Magazine, we were lucky to speak with Samantha Culiver and Shane Doan who talked to us about the importance of preparation and care for your body when training. Their preparations as elite athletes is quite different from yours and mine. But the approach is still the same and still important. It is important to take care of your body over the long run because eventually all those years will catch up to you. Seth Joyner, retired NFL player, spent time with Healthstyle Magazine’s staff talking about care received at Arrowhead Health Centers. Seth had a very successful career in the NFL but the game takes a toll on your body. Seth went through six surgeries while playing and with chronic back pain decided to go to Arrowhead Health Centers and try their placental tissue matrix therapy. By tackling his pain this innovative treatment helped Seth with an improved quality of life and can help you too. With the arrival of the holidays it is also the arrival cold and flu season. With the holidays being so busy those symptoms can sneak up on you with late nights and stress. Learn how to recognize the symptoms, what to do if you have them and more importantly, how to protect yourself from them. Arrowhead Health Centers and Kendra Scott share tools on how to build a cold-battling toolkit to help fight those seasonal symptoms, aches and pains to stay healthy. As we move towards the beginning of another year may this issue help you find a way to reach those New Year’s goals and stay focused. We are excited for the tips and advice in this issue and hope that you too are encouraged to face 2017 with a renewed sense of accomplishment and aren’t afraid to tackle those goals, whatever they are and as difficult as they may seem. Jason Stevens EDITOR
Special Thanks
On the Cover Model: Seth Joyner, a former NFL linebacker and Super Bowl champion with the Denver Broncos. Joyner sought treatment at Arrowhead Health Centers to help alleviate discomfort in his back and knees after retiring.
Special Thanks David Berg Guy Berry Frank Bevacqua Ryan Caracciolo Robert Cucitrone Donte Green Doug Houvener
Janice Johnston Seth Joyner Shaun Koth Bethany Lindsey Catherine Lindstrom Kendra Scott Deepesh Shah
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Winter 2016 • Healthstyle Magazine
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Vitality
Back Pain — How To Treat & Avoid It Tips To Strengthen Your Back BY PAT WHITNEY
I
t can be as simple as getting out of your car. Paralyzing pain strikes your lower back. The worst you’ve ever had. You can’t straighten up. The spasm may linger for days, weeks, even months. You try home remedies. Or try a muscle relaxant. Still suffering? You seek alternative therapies. “When I see patients with back pain, they usually come in with a 10 out of 10 on the pain scale,” says Robert Cucitrone, DC (Doctor of Chiropractic), director of Chiropractic and Rehabilitation at Arrowhead Health Centers. “After the exam and diagnostic testing, we discuss treatment options and our team approach. Physiotherapy and muscle work address muscle spasms and inflammation. Manipulation of the vertebral component lubricates the joints, taking pressure off nerves and reducing painful spasms. Stretching and adjustment follow.” If indicated, Cucitrone directs patients to an Arrowhead Health Centers physical therapist or pain management specialist.
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Tips to Strengthen Your Upper and Lower Back
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Do core-strengthening exercises—swimming, water aerobics, yoga and Pilates. Do postural exercises, roll shoulders back, holding head up straight. Do two sets of five. Lie on stomach, lift legs and arms off the ground in Superman pose. Hold for 15 seconds. Relax. Do two sets of five.
4 5
Lie flat on back. Squeeze shoulder blades together. Hold. Repeat.
Push back of head into a pillow. Hold for five seconds. Do five repetitions.
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Healthstyle Magazine • Winter 2016
Who’s Most At Risk? Few escape the misery of chronic back pain. It is estimated that 80-85 percent of people worldwide experience back pain at some point in their lives. No demographic—age nor race nor gender—escapes its wrath. Only the type of pain felt varies. Causes range from accidental falls and improper lifting to bad posture and poor ergonomics at work. Contributing factors are being overweight and out of shape, arthritis and heredity. Auto accidents and sports-related and workrelated injuries often make up the bulk of patients seeking chiropractic treatment.
Strengthen Your Back, Avoid Back Pain Cucitrone, a chronic back pain sufferer himself, found relief through swimming. “Swimming literally saved my back,” he said. “Exercises that tone your stomach strengthen your back muscles. A strong core equals a strong back.” Sitting all day at a computer can stiffen and tighten your back. Cucitrone recommends an ergonomically-correct work station and chair with lumbar support or sitting on an exercise ball which forces good posture. “Stand up every 15 minutes or so. Roll neck and shoulders around. Move hips from side to side to loosen your hips.” His number one prescription: Stay active.
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Vitality
Building Your Cold-Battling Toolkit How to Reduce Your Chance of Getting a Cold and What to Do if it Catches You BY JOAN WESTLAKE
W
inter weather brings the festive holidays and the dreaded colds and flu season. The Centers for Disease Control report that there are millions of cases of the common cold annually with adults having two or three colds each year. You know the symptoms: sore throat, runny nose, coughing, sneezing, facial congestion, watery eyes and headaches lasting up to three weeks. Don’t despair. Kendra Scott, PA-C at Arrowhead Health Centers, has tips on putting together a toolkit to help reduce your chances of getting a cold and treating one when you do.
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Healthstyle Magazine • Winter 2016
Prevention “A healthy lifestyle is your best weapon,” said Scott. “Making well-rounded food choices, exercising regularly and getting enough sleep keep your body in cold-fighting mode. Wash hands regularly; sanitize countertops and hardware in the house along with germ-laden remotes and cell phones.” When the cold virus does hit, Scott advises getting plenty of rest, staying well-hydrated by drinking half of your body weight in ounces of water each day and turning off ceiling fans so dust doesn’t add to already irritated breathing passages. Breathe in steam from a hot shower twice daily. If
“Making well-rounded food choices, exercising regularly and getting enough sleep keep your body in cold-fighting mode.”
you must go into work, frequently clean what you touch.
Toolkit Scott urges you not to wait to put together your cold fighting toolkit until all you want to do is crawl in bed with the covers over your head. Here are items to include: • Facial tissues • Liquids such as warm tea or warm honey water • Cough drops and salt-water gargles for sore throats and coughing • Comfort foods like chicken soup or hot vegetable broth • Over-The-Counter nasal saline rinses or sprays such as Flonase or Nasacort • Mucinex, Allegra or Dayquil/Nyquil preparations • Avoid decongestants or nose sprays such as Afrin, which can make symptoms worse • No to antibiotics, because they are for bacterial infections and the common cold is caused by viruses such as the rhinoviruses.
– KENDRA SCOTT, PA-C
Warning signs • • • •
Fevers higher than 100.4F Sharp ear pain, ringing in the ears or hearing loss Significant pain when you touch your face or upper teeth Wheezing
“If you have these more serious symptoms call Arrowhead Health Centers at (888) 995-4899,” said Scott. We can schedule a same-day appointment and quickly find out how to get you back on the road to wellness.”
Get the Shot, Not the Flu. Protect yourself this flu season, get a flu shot! Call to schedule your shot, or simply walk in to one of our conveniently-located clinics to get yours today.
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Winter 2016 • Healthstyle Magazine
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Vitality
Healing Sounds Arrowhead Health Centers Finds Ways to ‘Let the Music Heal You’ BY KRISTINE BURNETT
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usic is proven to stimulate physiological and emotional changes in the brain. For those working to overcome an illness or injury, music can be instrumental in reducing pain, alleviating anxiety or serving as a much-needed distraction from the health care process. Arrowhead Health Centers leverages the healing and entertainment aspects of music to benefit patients through a program called Let the Music Heal You.
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Healthstyle Magazine • Winter 2016
Research Today for a Cure Tomorrow Become a Clinical Research Participant The Research Department at Arrowhead Health Centers is currently seeking volunteers. Qualified research participants may receive study medication and health assessments free of charge in addition to compensation for time and travel. For more information, please send us an e-mail at research@arrowheadhealth.com.
Learn more about studies regarding: • Asthma • Cardiovascular Disease
• Influenza • Psoriasis • Strep Throat
Contact us today to see if you qualify! 623-334-4000 x7307 research@arrowheadhealth.com
• Type II Diabetes
Vitality
Blending music and medicine, Arrowhead Health Centers invites local and visiting musicians to play for patients in the lobbies of four of its six locations across the Valley. When trained musicians aren’t playing, the patients become performers, strumming guitars made available for their use and enjoyment.
Help to Heal Janice Johnston, MD, co-founder and medical director of Arrowhead Health Centers, has been a lifelong lover of music. She introduced Let the Music Heal You about eight years ago, fulfilling a dream of incorporating music as part of the health care experience. “I’ve been a huge music fan all my life,” she said. “I think it does good for me, and I think it does good for a lot of people. Hearing a song [that makes you feel good] releases all the good hormones in your brain. Those hormones can help aid in the healing process.” At first glance, a doctor’s waiting room might not seem like the most likely setting for a musical experience. However, Dr. Johnston, whose office is situated directly behind one of those waiting rooms, sees and hears the impact firsthand. “Every day, someone picks up one of the guitars and begins playing,” she noted. “It’s awesome to hear that and to know that our patients are enjoying it.”
Easing Stress Dr. Johnston and her colleagues have seen children sit at the feet of musicians, mesmerized by the sight and sound of a live performance. They’ve watched elderly couples cast aside their inhibitions and dance in the waiting room. They’ve been witness to music’s ability to wipe away stress for those who are worried about an upcoming medical treatment or procedure. Even better, Dr. Johnston says Let the Music Heal You has strengthened relationships between patients, providers and staff at Arrowhead Health Centers. “Going to the doctor shouldn’t be scary,” she explained. “Music can help take away fear and help patients find comfort in their surroundings. Its just one more way we put patients first.”
Watch this video to learn more about the Let the Music Heal You program and Arrowhead Health Centers’ philosophy on music in the healthcare setting. Youtube.com/arrowheadhealth
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Healthstyle Magazine • Winter 2016
Winter 2016 • Healthstyle Magazine
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HOW IT WORKS
Working Smarter Redirect Health Brings Hiring Edge to Entrepreneurs Looking for Top Talent BY BRIAN SODOMA
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oday, many U.S. businesses struggle to offer employees affordable health insurance coverage. Smaller businesses — some of which are now staring down 50 percent, or even higher, health plan rate hikes — are forced to make the tough decision of whether to offer any coverage at all. But some positive market disruption is benefitting today’s entrepreneurs, as more are learning of a unique option called Redirect Health. Without breaking the bank, it gives small businesses the chance to better compete for top talent by offering employees extremely
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Healthstyle Magazine • Winter 2016
affordable (sometimes even free), high-quality healthcare benefits.
Making Healthcare Work For You For healthcare consumers, the current system plays out something like this: choose an insurance plan, allow that plan to dictate your providers and hospitals. Show your insurance card every time you visit a physician, pay a copay, pay for prescriptions and, with fingers crossed, hope for very few pricing surprises. It’s a system anchored in age-old wasteful
Through Redirect Health’s EverydayCare plan, routine doctor visits for colds, the flu and checkups are streamlined through its Care Logistics phone concierge — available 24/7, 365 days a year. When you need care, a Care Logistics team member helps you decide if a doctor’s office visit is needed. Many situations can be handled by telemedicine, avoiding expensive hospital or urgent care scenarios. Redirect also taps prescription discount resources to find the best medication prices. Under the model, prescriptions often cost less than those with an insurance prescription benefit. Redirect’s care team also seeks out assistance programs to cover more specialized treatments and tests for more acute situations. “You get all the healthcare first and we put insurance at the end of the cycle. A lot of times you don’t even have to use it. Insurance is less relevant because this works so well,” Berg noted. “We think insurance is very important, but we don’t want to use it all the time … You don’t want to put it first.”
Innovation unlimited primary, injury and rehabilitative care (including chiropractic). Some entrepreneurs happily pay the full price of the plan, requiring no employee contribution, and leverage those minimal dollars into a very effective free healthcare benefit to prospective employees, says Dr. David Berg, co-founder of Redirect Health.
Grow Your Business
administrative practices clouding price transparency and eroding the value proposition. On the other hand, Redirect Health is not insurance, but instead a healthcare plan that is fully compliant with Affordable Care Act (ACA) minimal essential requirements. Reasonably-priced plans start as low a $105 a month. There are no copays, no deductibles,
“Entrepreneurs are underappreciated,” Berg said. “They’re out creating jobs, taking risks. … There are so many burdens and obstacles from the outside world that they must look crazy for taking these risks, but at Redirect Health, we get them. We understand them. We love to help them grow their business.” It’s a plan that’s working for Geoff Stanisic, a Redirect Health customer and owner of YC’s Mongolian Grill in Phoenix. “Redirect Health gives me a lot more control than I’ve ever had. It actually gives me a competitive advantage. Now healthcare works for me, not the other way around,” he added.
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“Redirect Health gives me a lot more control than I’ve ever had. It actually gives me a competitive advantage.” – GEOFF STANISIC
To learn more, visit redirecthealth.com.
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Wearables for Wellness From Activity Trackers to Heart Monitors, Here’s the Skinny on the Latest Fitness Devices BY MICHELLE JACOBY
I
n an age where having a burger, fries and milkshake delivered directly to your door (by way of Uber driver, of course) is now the norm, the meaning of “instant gratification” has reached an all-new level. But this immediate need for satisfaction isn’t just for cravings and indulgences. The fitness focused and health conscious can get instant, realtime results on their workouts and physical activities thanks to the latest fitness trackers and devices. Here are a few to keep “track” of.
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Healthstyle Magazine • Winter 2016
Innovation
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Fitbit Charge 2
With a full line of fitness products under its umbrella, Fitbit is a definitive leader in the wearable tech industry. The newest addition to the Fitbit line is the Charge 2, an all-day activity tracker that monitors steps, distance, calories burned, floors climbed, active minutes and hourly activity. It also tracks your heart rate to maximize workouts and guide you through personalized breathing sessions. The Charge 2 tracks specific exercises through its multi-sport mode option, and provides real-time run stats like pace, distance and route through your smartphone’s GPS. It also calculates a personalized “cardio fitness score” to help you get a better understanding of your fitness level, helping you improve over time.
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1
2
Apple Watch Nike+
Two of the biggest brands in the world have come together to develop a fitness device any serious runner would want to have. The Apple Watch Nike+ features a built-in GPS to track runs, with stats displayed on a bright, bold and easy-to-read face. The custom-designed Nike Sport Band features compressionmolded perforations made with a light, flexible material that’s comfortable and breathable. The watch can be set with personal reminders based on run history and weather. You can also share your runs with friends and set up a virtual leaderboard to help motivate and keep each other on track.
4
Garmin Vivoactive HR
Apple Watch Series 2
It’s been more than a year since the first Apple Watch hit the market, and while the original version’s fitness tracking capabilities are impressive, the new Series 2 takes it even further. Whether you’re going for a run, ride or swim, the device measures step count, distance traveled, calories burned and time spent exercising. It can also log specific activities, such as outdoor runs or indoor cycling sessions. With a water-resistant design, the Series 2 is perfect for swimmers, who can track swim styles and strokes. There’s also a GPS sensor for distance workouts like running or cycling. Proving there’s more to health than fitness, the Apple Watch features sensor that measures heart rate throughout the day and a beautifully animated app that guides you through a series of deep breaths, and reminds you to practice mindfulness every day.
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3
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While Garmin has a complete line of activity trackers and watches, the Vivoactive HR is a versatile sports watch ideal for athletes interested in tracking specific activities. For instance, swimmers can track different kinds of strokes, while skiers can measure speed and distance. Even golfers can track their fitness and performance while hitting the links, and can also download course maps from a database containing more than 38,000 courses worldwide. Taking full advantage of its GPS expertise, the Garmin Vivoactive HR uses GPS to collect data on distance, speed, time and calories on any distance activity. The watch is ultra-thin and a has a sunlightreadable, high-resolution color touchscreen.
Tackling
Pain
Head On
Retired NFL player Seth Joyner receives placental tissue matrix therapy to alleviate discomfort in his back and knees BY MEGHANN FINN SEPULVEDA
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Healthstyle Magazine • Winter 2016
University of Texax-El Paso
H Innovation
Seth Joyner had a successful football career as an NFL linebacker, including a Super Bowl win while playing for the Denver Broncos, before retiring in 1999. But his passion for football, which sparked as a young boy, was what kept him going even after the numerous injuries he sustained during the 13 years he played in the NFL. Joyner recently received placental tissue matrix therapy at Arrowhead Health Centers which significantly reduced pain in his knees and lower back, allowing him to get back to a healthy, active lifestyle.
Lifetime of Pain As a linebacker, Joyner played one of the most grueling defensive positions in football, and would repeatedly get hit and tackled in just a single game. “I love the game but it really takes a toll on your body,” he said. “It’s taxing.” Joyner underwent six surgeries during his playing career and experienced sciatic issues that led to chronic pain in his lower back. In 1997, he had surgery to repair a meniscus tear in his right knee. It took more than a year for him to fully recover.
Seeking Alternative Treatment This summer, Joyner met with his doctor to discuss options for alleviating pain in his lower back and knees. While trying to avoid
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Healthstyle Magazine • Winter 2016
another surgery, he learned about placental tissue matrix therapy at Arrowhead Health Centers, and was intrigued. “I really did not want to go under the knife again if I didn’t have to,” he said. “I was optimistic that the treatment would work.” Placental tissue matrix therapy, is an innovative treatment being offered at Arrowhead Health Centers. The treatment is helping patients who suffer from chronic pain in their shoulder, hand, foot, knee, ankle, wrist and hip because of fractures or injuries, along with medical conditions such as osteoarthritis, rheumatoid arthritis, tendinitis and carpal tunnel syndrome.
Identifying Candidates In September, Joyner received injections in his lower back and knees. “The best thing about this therapy is that a large majority of patients are good candidates,” said Deepesh Shah, MD, a double board certified interventional pain specialist and anesthesiologist at Arrowhead Health Centers. “Many target sites are options and patients can immediately begin to feel relief.” During the quick and painless procedure, physicians inject donor placental tissue from healthy mothers that would normally be discarded after birth, containing proteins, growth factors and natural cells, into degenerative areas of the body which will
“The best thing about this therapy is that a large majority of patients are good candidates.” – DEEPESH SHAH, MD
Do You Have
Knee Pain? Introducing a Breakthrough Treatment Program for OsteoArthritis of the Knee
Have you been told surgery is your only option for the OsteoArthritis pain in your knees? We have your solution. Using this patented, proven treatment program, Arrowhead Health Centers’ team of multi-specialty providers combines highly specialized diagnostics, medical treatment, and functional strength training to get to the root of your symptoms and help get you back to doing the things you love. Call today for a free one-on-one consultation with one of our knowledgeable providers. Know the Signs & Symptoms. When the cartilage in your knees is damaged, you may start to notice the following symptoms getting worse over time: • Joint stiffness in the morning • Uneasiness caused by instability or upon standing up • Difficulty walking up and down • Aches, pains and swelling • Limited range of motion stairs • Locking or popping sensations
What Causes OsteoArthritis? OsteoArthritis is commonly referred to as ‘wear and tear’ arthritis. As you age, the cartilage in your knees can wear down, reducing the natural cushioning in your joints. When this happens, it can cause the bones in your knee to rub together, which is the source of the pain experienced with OsteoArthtitis of the Knee.
Join the 91% of Patients Experiencing Relief. Arrowhead Health Centers is offering a no obligation one-on-one consultation with one of our doctors. • Covered by Medicare & most • FDA-approved non-surgical major insurers process • Latest Regenerative Placental • Custom knee bracing for Tissue Technology containing support where you need it placental stem cells and other most special growth factors* • Performed by specially trained & accredited medical providers *Regenerative Medicine portion is not covered by insurance.
Why Arrowhead Health Centers?
Arrowhead Health Centers is a comprehensive health center that covers primary and family care along with a variety of needs-based programs, diagnostic services, and treatments. Founded in 1997, Arrowhead Health Centers has focused on quality of care and quality of service. They simply asked patients what they wanted and delivered it. This is the Arrowhead Health Centers difference. They put patients first, and it shows.
“Before the OsteoArthritis Knee Program, every step hurt. I just remember that I couldn’t ride my bike or even walk, really, when I first started the program. But as I went through the program, I was able to continue my active lifestyle more and more – even before I was done with my program. It really worked!” - Jane R.
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H Innovation
Seth Joyner
BY THE NUMBERS AGE
51 HEIGHT
6’2” WEIGHT
245 BORN
NOV. 18, 1964 IN SPRING VALLEY, NEW YORK PLAYED COLLEGE
TEXAS-EL PASO then regenerate new, healthy tissue. Physicians at Arrowhead Health Centers evaluate and determine the right candidates for the non-invasive treatment by discussing symptoms with patients and reviewing imaging records in advance. “This cutting-edge therapy is used for a wide range of indications for chronic joint, tissue and muscle pain,” Shah said. “Our hope is that over time, inflammation will decrease, pain will go away and function will be restored so patients can get back to doing the things they love.” Relief from pain lasts approximately three to six months or longer. “This therapy has the potential to delay or eliminate the need for surgery,” Shah added.
Improved Quality of Life Just a few days after receiving the injections, Joyner followed the recommendations of his doctors at Arrowhead Health Centers and resumed his workout regimen at the gym. “The pain in my lower back and knees is monumentally better,” Joyner said. “I am now working on the stabilizer muscles and building strength up again in these areas.” Strength training can be beneficial for all types of injuries and helps with overall recovery.
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Healthstyle Magazine • Winter 2016
NFL CAREER
13 SEASONS GAMES PLAYED
195 GAMES SOLO TACKLES
766 SACKS
52 INTERCEPTIONS
“It aids in balance, proper joint mechanics and bone health,” said Janice Johnston, M.D., medical director and co-founder of Arrowhead Health Centers. Today, Joyner is working as a sports commentator for the Philadelphia Eagles and is looking forward to running and playing golf. “I’ve been able to heal my injuries without surgery,” he said. “That’s huge.” Learn more about the placental tissue matrix therapy at Arrowhead Health Centers at arrowheadhealth.com.
24 Watch Seth’s story at ahcback.com
Want to learn more about this program and how it can help you? Call (480) 397-7360
Spend More Time Doing What You Love.
Convenient, Comprehensive Care for Your Whole Family. Comprehensive means we combine a variety of specialties including primary care, pain and injury management, diagnostics, chiropractic, and rehabilitation. Our multi-specialty team of providers work together with you and your family as a team to get you healthy and help you stay that way. Our unique approach allows us to offer convenient, accessible programs to all members of your family: • • • • • • • • • •
Acute Conditions -(cough, cold, flu, etc.) Allergy Testing Annual Physicals and Wellness Visits Back, Neck, and Joint Pain Carpal Tunnel Program Chronic Headaches Chronic Pain Management DOT Physicals Diabetes Management Immunizations
• •
• • •
Injured Workers Interventional Pain Procedures (Epidurals, Facet Injections, Nerve Blocks, Spinal Cord Stimulation, and Manipulation Under Anesthesia) Labs & Blood Work Motor Vehicle Accidents OsteoArthritis of the Knee Program
• • • • • • • • •
Peripheral Neuropathy Program Physical Rehabilitation Skin Cancer Screening & Treatment Sports & School Physicals Sports Injuries & Medicine Therapeutic Massage Total Joint Rejuvenation Program Workers Compensation X-Ray & Diagnostics
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Health & Wellness
Read Between the Lines What You Need to Know About Nutrition Labels to Make Healthier Food Choices BY NICOLE COTTRELL
M
ost people know what a healthy diet consists of: more fruits and vegetables, less pizza and soda. However, what many consumers don’t know is how to select the healthiest packaged foods based on nutrition labels. What does “light” really mean? How many calories per serving should a person consume? The FDA introduced the nutrition label more than 20 years ago to answer some of these very questions. Recently, the label was given a much needed overhaul to help people make healthier and, thus, better food choices.
Sugar By Any Other Name
Misleading Reading
Dangers of Salt
According to Bethany Lindsey, an Arrowhead Health Centers Pain and Rehabilitation Manager who provides nutritional information to her clients, nutrition labels, despite their intent, can sometimes be misleading, steering consumers to focus on the wrong things. “Everyone is quick to look at fat and sugar. I say, make sure you look at your ingredients and the serving size,” explains Lindsey. Ingredients matter, she reinforces. The fewer you can pronounce or recognize, chances are, the less healthy a food item you’ve got on your hands. Instead, of multi-syllable words, look for whole foods.
Let’s not forget about sodium, for example. According to Lindsey, any product and its appropriate serving size should contain 140 mg of sodium or less. High sodium content can affect those with diabetes or high-blood pressure, she says. When it comes to serving size, Lindsey observes consumers often “grab healthy items, but consume too much.” Pay closer attention to serving size to avoid overeating. It’s also important to remember that nutrition labels are based on a 2,000-calorie diet, so depending on your individual nutritional needs, those calories may need to be adjusted up or down. As a general rule, Lindsey suggests shopping the perimeter of a grocery store first, where the freshest and healthiest food items can be found, such as produce and fruits and vegetables.
Beyond that, Lindsey also recommends taking time to learn at least three of the different names for sugar, which are often hidden in products with terms like “fructose, corn syrup, and dextrose.” Companies will also try and persuade consumers with labels such as “made with whole grains” or “all-natural.” “Cheerios say ‘heart healthy,’ but they have more sugar than Pop Tarts. Those carbs turn into sugar,” Lindsey explains. Fortunately, a few labels are regulated by the FDA, such as “low fat,” “sugar free,” and “organic.”
“Cheerios say ‘heart healthy,’ but they have more sugar than Pop Tarts. Those carbs turn into sugar.” — BETHANY LINDSEY, ARROWHEAD HEALTH CENTERS
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Health & Wellness
Politics of Health The Affordable Health Care Act Can’t Fix Complex Healthcare System, But Employers Can BY BRIAN SODOMA
T
he Affordable Care Act (ACA) extended insurance coverage to millions of Americans who previously did not have it. However, healthcare costs are reportedly spinning out of control and many Americans are struggling to pay high premiums for plans offering thin coverage. Blaming healthcare system ills on the ACA, however, may be like pinning a leg fracture to a missed daily calcium supplement, according to David Berg, founder of Redirect Health and Arrowhead Health System. “Healthcare didn’t really work at any price, but as it got more expensive, then people started to say it’s REALLY not working,” Berg said. “Obamacare is not the problem. It’s a symptom of the bigger problem, which is not recognizing that complexity is the real problem.”
Solving the Problem If you listen to the liberal-leaning left, you’re likely to hear that the core of healthcare system problems lies in having too many uninsured Americans. Ask a conservative and you’re more likely to hear about the need for personal accountability. Both do not come close to solving the problem when the proposed solution is just more complexity; in the form of complicated laws like Obamacare, Health Savings Accounts, Flexible Savings accounts, Accountable Care Organizations, and many other regulations. Berg adds, a lack of pricing transparency and administration-heavy expense loads are the very core of American health system woes. Today, insurers are pulling what they call money-losing plans from the ACA, even though our publicly traded insurance companies show stock histories tracing back to January 2010, when Obamacare fully rolled out, that are now up more than 500 percent, Berg argues. “Even though investor perception of value for health insurance companies is up 5x more than the DOW since the ACA rolled out in 2010, it’s easy to argue that consumer perception of value is significantly down. The ACA is just more layers of complexity that hides what’s really happening. … It does very little that should be expected to decrease costs or improve results,” Berg explained.
Putting Care First Simplicity and streamlined, effective, efficient healthcare with full pricing transparency wins, Berg says. Under the Redirect Health model he helped found, a telephone concierge service helps a person navigate the healthcare system, finding the best care, the best medications at the best price, 24-7 and 365 days a year. For a reasonable monthly fee ($105 for an individual plan), there are no copays, no deductibles, unlimited primary, injury and rehabilitative care (including chiropractic) and insurance is only needed if a situation becomes expensive or requires hospital treatment. “If you put healthcare first, the system becomes very simple and efficient. If there are no copays there’s no need for the credit card machine. There’s no merchant account, no coding, no explanation of benefits, no monthly statements that confuse everyone including your doctors. So much nonvalue add expense simply evaporates, with all the savings passed back to the customer” he said.
Other Options In the ACA environment, Berg says it’s important for employers to learn that non-insurance-based options like Redirect Health are available to them and their employees. Then, they can stop putting expensive, inefficient and complex insurance plans ahead of the quality care and convenience. This is what people appreciate most as they move through their day. “Today, the only way individuals can deal with Obamacare in an efficient way is if their employer deals with it in an efficient way,” he added. To learn more about how to put healthcare - not insurance - first, visit redirecthealth.com.
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OVER 18 MILLION AMERICANS SUFFER FROM SLEEP APNEA OR 1-15 PEOPLE The world of sleep medicine is taking off at light speed, especially when referring to the treatment of Obstructive Sleep Apnea (OSA). Millions of people suffer from OSA due to partially or fully blocked airways, causing a plethora of symptoms. Some of these include daytime sleepiness, irritability, depression, weight gain, forgetfulness, accident proneness, hypertension, or even heart attack or stroke. The effects of OSA are often prevalent even when the person gets a “normal” amount of sleep. What’s alarming is that many people are not aware they experience OSA, or remain frustrated because they don’t want to see a doctor for it. With the help of Arrowhead Pro Sleep Lab, handling your sleep apnea doesn’t have to be a Sisyphean task. Arrowhead Pro Sleep Lab along with Koala Centers for Sleep Disorders are the pinnacles of sleep medicine, located right here in the Arrowhead community of Glendale, Arizona. Arrowhead Pro Sleep allows you to take a sleep test in the comfort of your own home. With the utilization of Oral Appliance Therapy (OAT), patients can experience a comfortable and dependable alternative to the CPAP therapy or
corrective surgery. Oral appliances also boast a much higher compliance rating than the CPAP, which means that a majority of patients prefer using oral appliances rather than the CPAP. There is no doubt that OAT has a definite and powerful role in treating sleep apnea. Arrowhead Pro Sleep also enjoys a relationship with Pro Player Health Alliance (PPHA), which is an organization dedicated to helping former NFL players through providing testing and treatment options for those who suffer from sleep apnea. The PPHA also plays a huge part in preparing our “medical partners” to administer exceptional care through consistent educational events and effort to bring awareness to sleep apnea. This means that you can visit Arrowhead Pro Sleep worry free and be confident that our professionals are always up to date on the latest news and treatment aspects of sleep apnea, and that they are armed with the correct knowledge to handle your sleep disorder. Let us take care of you, and help to solve all of your sleep apnea issues. Tackle your sleep apnea today!
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What Is Sleep Apnea?
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Sleep apnea, sometimes spelled “apnoea” - one of the most potentially dangerous sleep disorders - is when the patient stops breathing during regular sleep. The term apnea literally means “without breath”. The period of stoppage is usually short (a few seconds) before breathing resumes. The seriousness of apnea varies considerably and depends on how long the sleep stoppages are how many happen. Also referred to as sleep-disordered breathing, or SDB, apnea occurs widely in adults and children. Experts estimate apnea affects 1 in 15 people or 18 million Americans. Men are more susceptible to sleep apnea than women. “All-cause” mortality risk increases significantly with apnea. The worse the apnea, the higher the risk of death from a number of factors.
Health & Wellness
The Cost of Sleepless Nights Sleep Deprivation Poses Serious Health Risks for an Estimated 30 Percent of Americans BY ELISE RILEY
W
e’re supposed to spend 8 hours a night in a blissful slumber, recharging and renewing for a new day. But the reality for most everyone is that 8 hours of sleep is a dream,
not a reality. According to the National Institutes of Health, up to 30 percent of adults in the United States aren’t getting the sleep they need. The consequences of sleep deprivation are profound — an estimated $16 billion in annual healthcare expenses.
A Serious Situation While a night of restless sleep might seem like a simple aggravation, the fact is that sleep loss is quite serious because of its long-term, cumulative effects on our overall health. Researchers have found links between lack of sleep and diabetes as well as weight gain. According to a Harvard University report, researchers have found a direct link between lack of sleep and the production of cortisol, which is also known as the “stress hormone.” Additionally, sleep loss has connections with the production of leptin, a hormone that tells the brain when you’re full. Simply put, not sleeping makes people more stressed — and more hungry. Additionally, those researchers found connections between the way the body processes glucose and sleep. Poor sleepers produce glucose more slowly, which over time can lead to Type 2 diabetes.
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Are You Sleeping Well? The National Institutes of Health recommends talking to a healthcare provider if you experience any of these situations three or more nights a week: n It takes you more than a half-hour to fall asleep n You wake up frequently at night and have trouble falling back to sleep n You wake up too early n You sleep more than 7 or 8 hours, but don’t feel rested when you wake up n You feel sleepy during the day and can fall asleep within 5 minutes if you nap n Your partner reports that you snore loudly, choke, snort, or jerk your arms or legs during sleep n You experience creeping or tingling feelings in your legs n You need caffeine to wake up and stay awake
And if those two situations weren’t serious enough, there’s also a direct link between quality sleep and cardiovascular disease.
A Painless Problem Perhaps what’s most insidious about sleep deprivation is that it’s largely painless. Aside from a morning “sleep fog” headache, nearly all sufferers of sleep deprivation report no discomfort. Instead, troubles with sleep gradually affect someone’s health. Less energy means someone is less likely to exercise. It’s harder to fight off a cold. The body doesn’t recharge and restore. And unlike other disorders, there’s no blood test for sleep deprivation. But there are ways to evaluate the quality and quantity of sleep you’re getting. Sleep studies, performed at centers such as Arrowhead Pro Sleep, provide an analysis of someone’s sleep patterns to detect issues such as sleep apnea, restless leg syndrome or other issues related to insomnia. Through an analysis like this, you can find out what’s keeping you up at night — and how to resolve it through sleep maintenance, medication or assistive devices.
To learn more about your sleep loss or find out if you’re suffering from sleep apnea, contact Arrowhead Pro Sleep at 602-680-4540 or visit arrowheadprosleep.com.
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Lifestyle & Nutrition
Keeping on Track for Keeping Resolutions Experts Offer Advice for Setting and Achieving Health Goals BY PAULA HUBBS COHEN
T
he start of the New Year is traditionally a time for taking stock of lifestyle goals. On January 1st, we often have a gung-ho attitude, but by February 1st, our good intentions tend to have fallen by the proverbial wayside. To find out why — and more importantly to offer advice on how to avoid the dreaded “resolution drop-off ” — we spoke with Catherine Lindstrom, PhD, a psychologist in private practice at The Beatitudes in North Central Phoenix, and Frank Bevacqua, PhD, a psychologist based in Scottsdale.
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We asked three questions: 1. Why do most resolutions fail? 2. Does it really take 21 days to make a behavior a habit? 3. What health-related lifestyle changes can folks easily make and stick to?
Set Short-Term Goals, Enlist Support Bevacqua said many resolutions fail because the new goal may be too ambitious. “It is easy to become discouraged when you realize how much sacrifice might be necessary,” he said. Lindstrom agreed, noting that some people make a resolution because they think it’s what they ought to do — or they feel pressured to make a change. “None of us like being shamed or pushed into doing things,” she said, “even if those things are helpful.” ADVICE: “Set short-term, small goals,” Bevacqua said, “and enlist the help and support of others.” Lindstrom suggested using reminders on your bathroom mirror or desk. “But you have to keep changing the wording in order for your brain to continue to notice it,” she said. “Otherwise, it fades into the background.”
Repetition, Repetition, Repetition While saying it takes a certain number of days to create a habit is arbitrary, the concept is this, Lindstrom said: “There is one way to rewire your brain — and that is repetition, repetition, repetition. You didn’t learn to ride a bike or play a piano in one try,” she said. “The brain required exposure to it over and over.” Lindstrom said the brain prunes away unused neural wiring, but the pruning of old habits takes longer. “That’s because the neural network associated with the habit has to be unused for longer periods before pruning happens,” she said. ADVICE: “Repeat a new habit over and over to form new neural linkages,” Lindstrom said. “Avoid doing the older habit so the brain will prune it.” Bevacqua said while you can establish a “routine” in 21 days, a true “habit” takes longer. “Start with small changes that are easier to sustain until they start to feel automatic,” he said.
Stop Smoking, Take A Walk, Exercise Finally, Bevacqua said something as simple as taking a short walk every day can make a positive impact on health. ADVICE: Exercise regularly, and if you smoke, get help to stop. “The benefits of stopping smoking are well-known, while exercise is showing up as an effective technique to forestall negative body changes associated with aging as well as to keep the body tuned-up and ready to function,” Lindstrom said.
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Lifestyle & Nutrition
Sole Searching How to Find the Perfect-Fitting Shoe BY PAT WHITNEY
T
hink shoes should fit your feet like a glove fits your hand? Not necessarily, says Shaun Koth, a 22-year-veteran physical therapist at Arrowhead Health Center. He maintains a little extra room is good, especially for people with foot issues or diabetes who need circulation to avoid ulcers. But if you’re playing tennis, Koth says you don’t want a lot of play in your shoes. “It’s important to match the shoe with the activity. Don’t wear running shoes to play tennis or basketball shoes for running.” Finding the perfect fit is no easy feat because most manufacturers design shoes ‘down the middle’. “If shoes don’t support the feet properly, the whole body suffers — feet, knees, hips and back,” Koth said.
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European manufacturers provide more width choices. What if you have a wide toe box but want to wear tapered shoes? Have a high instep, plantar fasciitis or Achilles problems?
Koth’s Tips For a Good Fit n Shop at a reputable store. Search out a knowledgeable salesperson. For medical issues, seek advice from a podiatrist or physical therapist. n Match shape of shoe to shape of foot. n Know your current size. Feet spread with age. Know your foot style. Have high arches? Wide feet? Flat feet? Low arches and flexible feet need additional support for stability.
“Ideally, it’s a good idea to rotate two or three pairs of shoes so they can recover in between wearing.” – SHAUN KOTH, PT Shopping Outside the (Shoe) Box Koth advises people to be flexible when shopping for shoes. “I hear ‘but I can’t wear a size 10. I’m only an 8 ½.’ Sizes and widths vary among brands,” she said. He recommends retiring running shoes after six or eight months if used daily — everyday shoes after a year of normal wear. “Your athletic shoes may look like they aren’t worn, but what you can’t see is the breakdown of cushion which can affect performance and comfort. Ideally, it’s a good idea to rotate two or three pairs of shoes so they can recover in between wearing.” Once you find the right shoe, he suggests buying more than one pair. There’s nothing more frustrating than finding the shoe is discontinued. “Invest in a good pair of shoes. Don’t skimp. But don’t overpay. You can find a good shoe for under $100 off the shelf. There’s no need for $200 orthotics either. “If you’re not sure, get help from a professional.”
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Our program offers non-surgical pain relief with one simple, painless injection. The goal of this treatment is to help restore or improve the function of muscles, joints, and other damaged tissues while reducing the pain associated with damage to those areas.
The regenerative medicine therapy offered at Arrowhead Health Centers is safe, effective, and easy to inject. It is obtained from placental/ amniotic tissues from healthy mothers with healthy newborns (which is normally discarded after birth).
Call to Schedule Your Consultation! (480) 397-7360 Winter 2016 • Healthstyle Magazine
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Lifestyle & Nutrition
Grilled Pork with Blackberry-Sage Sauce
Grill & Chill Fire Up the Barbeque This Winter with Fast, Fresh, Heart-Healthy Dishes BY MICHELLE JACOBY
W
hile most home cooks around the country are turning to their ovens and Crockpots this winter season, we desert dwellers look to our grills. If you’re looking at putting a fresh spin on your holiday fare this season, these recipes—from a festive pork tenderloin with a blackberry-sage sauce, to a fast, casual turkey burger with a Mediterranean twist—are guaranteed to make your holidays healthy and delicious.
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Ingredients Cooking spray 2 tbsp. minced shallots 3 cups fresh blackberries (about 1 lb.) 1/2 tsp. chopped fresh sage 1 (14 oz.) can fat-free, less-sodium chicken broth 2 tbsp. balsamic vinegar 1-1/2 teaspoons sugar 1 tbsp. butter 3/4 tsp. kosher salt, divided 1 tsp. black pepper 1 (1-1/2 lb.) pork tenderloin, trimmed Sage sprigs (optional) Preparation Prepare grill to medium heat. Heat a medium saucepan over medium heat. Coat pan with cooking spray. Add shallots to pan; cook 3 minutes or until tender, stirring occasionally. Add blackberries, sage and broth; bring to a boil. Reduce heat and simmer 20 minutes or until blackberries break down. Press blackberry mixture through a fine sieve over a bowl; discard solids. Return liquid to pan. Stir in vinegar and sugar; bring to a boil. Cook until reduced to 3/4 cup (about 9 minutes); remove from heat. Stir in butter and 1/4 teaspoon salt, stirring until butter melts. Keep warm. Sprinkle remaining 1/2 teaspoon salt and pepper over pork. Place pork on grill rack coated with cooking spray; cover and grill 20 minutes or until a thermometer registers 155 degrees (slightly pink), turning pork occasionally. Let stand 10 minutes. Cut crosswise into 1/4-inch-thick slices. Serve with blackberry sauce; garnish with sage sprigs, if desired.
Grilled Chicken and Pineapple Sandwiches Ingredients 4 (6 oz.) skinless, boneless chicken breast halves 1/2 tsp. salt 1/4 tsp. freshly ground black pepper Cooking spray 1/4 cup fresh lime juice (about 2 limes) 4 (1/2-inch-thick) slices fresh pineapple 4 (1.5 oz.) whole wheat hamburger buns, toasted Light mayonnaise (optional) 4 large basil leaves
Cilantro-Lime Chicken with Avocado Salsa  Ingredients 2 tbsp. minced fresh cilantro 2-1/2 tbsp. fresh lime juice 1-1/2 tbsp. olive oil 4 (6 oz.) skinless, boneless chicken breast halves 1/4 tsp. salt Cooking spray Salsa 1 cup chopped plum tomato (about 2) 2 tbsp. finely chopped onion 2 tsp. fresh lime juice 1/4 tsp. salt 1/8 tsp. freshly ground black pepper 1 avocado, peeled and finely chopped Preparation To prepare chicken, combine first 4 ingredients in a large bowl; toss and let stand 3 minutes. Remove chicken from marinade; discard marinade. Sprinkle chicken evenly with 1/4 teaspoon salt. Heat a grill pan over medium-high heat. Coat pan with cooking spray. Add chicken to pan; cook 6 minutes on each side or until done. To prepare salsa, combine tomato and next 4 ingredients (through pepper) in a medium bowl. Add avocado; stir gently to combine. Serve salsa over chicken.
Preparation Prepare grill. Sprinkle chicken evenly with salt and pepper. Place chicken on grill rack coated with cooking spray; grill 5 to 6 minutes on each side or until done, brushing occasionally with lime juice. Grill pineapple 2 to 3 minutes on each side or until browned. Spread mayonnaise on bottom halves of buns, if desired. Top each with 1 chicken breast half, 1 pineapple slice, 1 basil leaf, and 1 bun top. Serve immediately.
Mediterranean Turkey Burgers Ingredients 1/2 cup panko (Japanese breadcrumbs) 1/4 cup (1 oz.) crumbled feta cheese 1 tbsp. minced red onion 2 tbsp. commercial pesto 1/4 tsp. salt 1/4 tsp. freshly ground black pepper 1 lb. ground turkey breast 1 garlic clove, minced Cooking spray 2 cups arugula 2 (6 inch) whole-wheat pitas, toasted and halved Preparation Combine first 8 ingredients in a bowl; mix until combined. Divide panko mixture into 4 portions, shaping each into a 1/2-inch-thick oval patty. Heat a nonstick grill pan over medium-high heat. Coat pan with cooking spray. Add patties to pan; cook 6 minutes on each side or until done. Place 1 patty and 1/2 cup arugula in each pita half. Tzatziki sauce: Combine 1/2 cup plain low-fat, Greekstyle yogurt; 1/4 cup finely chopped seeded cucumber; 1/4 teaspoon salt; and 1/8 teaspoon ground red pepper. Serve with sliced bell pepper and celery sticks.
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Puzzle
WHEN RIGHT IS WRONG
ACROSS 1) Pay your dues at church 6) Threshing byproduct 11) U.K. network 14) For a special purpose, as a committee 15) Concerning the kidneys 16) “_ you for real?” 17) What leaving a salon creates? 19) Put on 20) Lasting beginning? 21) Some custard tarts 23) Wrongly victimized in print 27) High school subject 29) Inspire with love 30) New, on a shelf 31) Bring to the mix 32) Grind, as teeth 33) Uncooked 36) Early invader of Britain 37) Shows Bossy who’s boss?
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Healthstyle Magazine • Winter 2016
38) 39) 40) 41) 42) 44) 45) 47) 48) 49) 50) 51) 58) 59) 60) 61) 62) 63)
Start for “bucks” “Do the Right Thing” pizzeria owner Gillis of old TV Hop on a plane Aglet target Buyer or purchaser Retrieved, as baggage in an airport Lured with a wooden duck? Natural hair dye Tiny smidgen World-finance org Spoke well of? Man who asked “Who’s on first?” Botanical seed Spa feature Place to spend the night Airport choices Enclose firmly, as in concrete
DOWN 1) “You’re it!” 2) Statement that makes two one 3) Despite, in poetry 4) Mortar bearer for a mason 5) Battlefield formation 6) Bawled 7) Frau’s mate 8) Go on ... “ 9) “Airplane Flying Handbook” org. 10) Angle, in a way 11) Like an anxious imp? 12) Something to bust out West 13) Add aroma to 18) Positively state 22) Author Harper 23) Bounds’ partner 24) Home of Hyderabad 25) What squirting someone with a hose is? 26) Give off or send forth 27) Chinese calendar creature 28) Use swear words 30) Yet to be ignited 32) Laughed at with contempt 34) Correspond grammatically 35) Got in the water 37) Marilyn Monroe feature 38) Less than stereo 40) Rabble-rouser 41) Word repeated in “We’re Off to See the Wizard” 43) Yang counterpart 44) Block, as a bill 45) Five-alarm food 46) Certain citrus fruit 47) Rotunda covers 49) Eric of “Monty Python” 52) Eggs, to Nero 53) Umpire’s call, sometimes 54) Scottish head cover 55) Atlanta, to Delta Airlines 56) 180 deg. from WSW 57) “Dear old” guy Source: uclick.com
Puzzle answers online at healthstylemagazine.com/ winter-2016/
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