Healthy You from UMR - Fall 2018

Healthy You Fall ~ 2018

Start something new

The power of routines

9 tips for a healthier

Thanksgiving How to get a grip on

screen time

It's go time!

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© 2018 United HealthCare Services, Inc.

About this magazine “Healthy You” magazine is published as an educational resource for UMR members and provides information about tools and resources available from UMR as a part of our member online services.

Available features and benefits are dependent on the products and features included in the plan design. Not all members will have access to all features shown.

Copyright ©2018 United HealthCare Services, Inc. Reproduction in whole or part is not permitted without permission in writing from UMR. All information and links were accurate and functional at the time of publication.

However, because this electronic publication contains links to third-party sites, information can change and become unavailable.

While using this electronic publication, you may click on a link to other websites. We provide links to other websites that may contain information that may be useful or interesting to you. We do not endorse, and are not responsible for, the content and accuracy of linked websites operated by third parties or for any of your dealings with such third parties. You are solely responsible for your dealings with such third parties and we encourage you to read the terms of use and privacy policies on such third-party websites.

© 2018 United HealthCare Services, Inc.

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Buried in paperwork?

A single click lets you track all your claims Hassle-free access when you need it Check in at your convenience to see if a claim has been processed and what you might owe.

To get more details on a specific claim, click view claim details or view EOB. And, take advantage of the "action needed" prompt to know when you need to follow-up on a specific claim.

Make sure you check out this FREE resource.

Log into your member account on umr.com

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Š 2018 United HealthCare Services, Inc.

CONTENTS REFLECT AND RENEW

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As the seasons change, take time to ponder the past year and look ahead to the new one.

GETTING A HANDLE ON SCREEN TIME

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Learn about the dangerous side of screen time, plus six ways to cut back.

ROUTINES RULE

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A good routine can give you a powerful mental and physical boost. Find out how to create yours.

HEALTH LITERACY 101

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Confused by health care lingo? We’ve explained the terms you need to know.

15 ASK A NURSE 20 FIND A DOCTOR 21 UMR ON THE GO 24 TURN THE TABLES ON DIABETES 25 WHERE TO GET CARE 31 HOW TO REGISTER ONLINE 34 MEAL MAKEOVER 35 EN ESPAÑOL

GIVE THE GIFT OF CONNECTION

These seven gift-giving strategies will help you make more meaningful connections 22 (and buy less stuff ) this holiday season.

9 GREAT TIPS TO A HEALTHIER THANKSGIVING DAY

32

You can skip the side of guilt this Thanksgiving by using these healthy Turkey Day tactics.

© 2018 United HealthCare Services, Inc.

THE DANGERS OF VAPING

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E-cigarettes may seem harmless, but these popular little devices can cause some big health problems.

GO ONLINE

Register on umr.com to take advantage of all our online resources for members.

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Letter from the Editor

Reflect After summer’s constant call to “go,” “do” and “connect,” fall beckons us to slow down, turn inward and reflect. Now is the time to take stock of our achievements, our blessings and even our shortcomings.

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© 2018 United HealthCare Services, Inc.

and Renew Whether it’s a garden you’ve been tending since winter’s last frost or a healthy habit you’ve proudly stuck with, make space to enjoy the fruits of the seeds you’ve sown throughout the year, in the earth and within yourself. Evaluate what went right and what could have gone better.

Autum is also the perfect time to reset and reprioritize as you look ahead to the New Year.

Our article about the benefits of establishing – and sticking to – a routine (page 8) will help you optimize your schedule and recalibrate your habits. In fact, you may be surprised by the powerful physical and mental health benefits you can gain simply by adopting a routine.

Having a routine can also help you resist the temptation to slip into unhealthy behaviors. It’s no secret that this season’s comforts lean heavily on food and drinks, and you’ll likely feel the pressure to partake. But instead of resigning yourself to giving in, set limits and take pride in your convictions and your accomplishments. You’ll most likely inspire someone else to do the same. Turn to page 32 and check out “9 great tips to a healthier Thanksgiving” for some helpful ideas.

No matter what your priorities are for these last few months of the year, allow yourself to enjoy the season of life that you’re in right now.

Harvest. Gather. Reap. Renew. © 2018 United HealthCare Services, Inc.

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Routines

RULE Kelly Parke’s dream was to write a book, but after five years, she was nowhere close to finishing the project. Her busy life as a designer, college student, wife and mom always seemed to get in the way of her personal goals – and her health. A few months ago, she realized the endless cycle of working extremely hard then crashing during school breaks was unproductive and unfulfilling, and it was wreaking havoc on her diabetic body.

To make sustainable changes, Parke needed a better framework for her life ...

a routine she could stick to.

The power of

routine

Something as simple as implementing a new routine can have dramatic mental and physical health benefits. People with consistent routines report: • Better (and longer) sleep • M ore time for hobbies and relaxation • Increased productivity • H ealthier exercise and nutrition habits • More discipline with money

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© 2018 United HealthCare Services, Inc.

“I clock in at 9 a.m., take a two-hour lunch to prepare my food, eat it and let it digest, then I hop on the treadmill. The rest of the afternoon I feel energized while finishing up illustrations for my book," Parke says.

"What's even more inspiring is that I have the evening hours to make a nice dinner, blast my iPad and dance around while cleaning house, then settle down to do freelance work for a couple hours before calling it a night."

Medical practitioners even suggest routine-building as a helpful tool for patients combating anxiety and ADHD, because an organized and structured environment provides security and puts predictable everyday tasks on auto-pilot so your mind can focus on more taxing stuff.

On the flip side, having to think through every mundane activity in your day uses up valuable brainpower and energy that could be harnessed in more productive ways. The more you have to think about how you’ll complete a task, the less energy you’ll have for future activities.

© 2018 United HealthCare Services, Inc.

In fact, your health can actually suffer when you lack structure within your day, as Parke’s did. “Two months ago, after all my teeth

were falling out and crumbling from diabetes, I made a huge lifestyle change, focusing on taking care of myself,” she says. She adopted a plant-based diet and cut out refined sugar, caffeine, and pre-packaged and fast food. She also started exercising. Then she left her toxic work environment and started freelancing so she could really focus on self-care. She admits the changes were overwhelming at first, but once she committed to them and set a work schedule for her home office, it had a huge impact on her well-being.

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Creating your

personal routine Keep in mind that a successful routine can look very different from person to person, and even from year to year in your own life. Not everyone can implement the same type of routine that self-employed Parke did. All that matters is that the structure, schedule and habits you establish work for you.

THINK SMART Specific and Small Measurable Attainable Relevant Timely Once you’ve outlined your new routine, think about the new habits you’ve built into it and apply the SMART goal principle to each of them. You’re more likely to reach a goal like “exercise more,” “eat healthier”or “stick to a budget” if you break it down into smaller action steps and then make a plan. Decide which small step to take first and what you need to do to get started.

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Ask yourself a few questions to get started: What’s motivating me?

For Parke, this was finishing her book and improving her health. What’s your end goal?

What habits will move me toward that goal?

This is where lifestyle changes related to exercise, diet, sleep, budget, work/life balance and family priorities come into play.

Thursday

is the best day of the week to start a new habit.*

© 2018 United HealthCare Services, Inc.

Finding

the payoff What habits are holding me back?

You’ll need to take an honest look at the way you’re currently doing things and what needs to change.

What mundane, everyday tasks can I schedule or automate?

When your life has order and predictability, you’re more likely to find time to relax, check off your to-do list and feel less stressed and overwhelmed. You’ll also waste less time bouncing aimlessly from task to task, whether at home or at work.

Before making and sticking to a routine, Parke was staying up until 4, 5 or 6 a.m. and rarely felt good or had enough energy for everything she wanted and needed to accomplish.

Building in set time and processes for things like packing your work or gym bag, paying bills, grocery shopping, walking the dog or scheduling appointments will allow you to conserve your energy for those tasks that require more mental effort, or free up more time for relaxation or recreation.

How will I hold myself accountable?

Put your schedule in writing, whether it’s in a planner or an app. The act of writing down your plan reinforces your commitment to it and also serves as a reminder to keep you on task. Telling other people about your routine – especially those you live and work with – can also help you stay on track.

© 2018 United HealthCare Services, Inc.

“ Now I get tired at 11 p.m. and wake up early without an alarm,” Parke says. “This schedule will adjust when the college quarter starts up again, but now I have a more balanced schedule where I maximize productivity as well as allow time for self-care. It has saved me from creative collapse.” * According to Fast Company,

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GETTING A HANDLE ON

screen time The new TV season. Televised football games.

Online homework. These are just a few of the activities that draw our attention to screens this time of year. And with fewer hours of daylight and colder weather comes more time spent indoors on devices for kids and adults alike.

So what's the big deal?

The digital downside Too much screen time has been associated with: • Sleep deprivation • Obesity • Vision problems • Aches and pains • Speech delays • Poor social skills • Aggressive behavior • E xposure to unhealthy or inappropriate content

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The studies are not conclusive, but experts caution that the overuse of screens may have significant effects on brain chemistry, especially in developing kids and teens. And screen time can be habit-forming: Children and adults can exhibit addictive behaviors around screen usage, such as irritability and symptoms of withdrawal, when screens are taken away. © 2018 United HealthCare Services, Inc.

How much screen time is OK? Of course, not all screen time is bad. Technology connects us with others, gives us access to education, provides us with helpful tools and entertains us. But we need to be conscious of the time we’re spending with screens.

NUMBER OF HOURS WE SPEND WITH SCREENS PER DAY 1 The Centers for Disease Control and Prevention (CDC) estimates 2 Common Sense Media

Tweens ages 11-14

Parents

9.5

2

9

1

Teens ages 15-18

Children ages 8-10

7.5

6

1

1

RECOMMENDED USAGE IS ONLY 2 HOURS A DAY

ADULTS Focus on the hours within your control outside of work or school.

CHILDREN The American Academy of Pediatrics recommends the following:

18 months and younger

6 and older

Avoid use of screen media other than video-chatting.

Place consistent limits on the time spent using media, and the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.

18 to 24 months Choose high-quality programming, and watch it with your children to help them understand what they're seeing.

2 to 5 years One hour per day of high-quality programs.

© 2018 United HealthCare Services, Inc.

The key is to balance media use with other healthy behaviors, like getting the 60 minutes of physical activity the CDC recommends for kids each day. And it’s important for kids and teens to understand why limits are in place so they can learn to prioritize their time in a healthy way.

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6 WAYS TO CUT BACK ON

screen time Pick a screen-free day Choose a day of the week when everyone is required to ditch the devices. Encourage family members to participate in a fun physical activity, read a book or work on a non-digital project.

(Tip: Make it fun by pairing “Taco Tuesday” with “TechnologyFree Tuesday.”)

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Practice what you preach Be a good example for your kids – and your friends – by putting down your phone or turning off the TV when they’re around and giving them your full attention.

Try an “hour on, hour off”approach

Designate media-free times

If keeping track of your family’s overall screen time is challenging, establish an “hour on, hour off" rule. This gives your eyes and your brain a break and encourages you to stretch and move.

Make dinner, drive-time, outdoor play and family activities such as game night device-free. This goes for adults and kids.

Ban electronics from bedrooms

Monitor usage and set limits

Mental activity and light prevent your body from heeding important sleep cues. So keep computers, phones and TVs out of bedrooms. If you use your phone as an alarm clock, put it out of reach when you turn in for the night.

And stick to printed books for bedtime reading instead of a tablet.

There are products you can use to set time limits, apply filters and monitor electronic usage for every member of the household. This not only provides limits for children, but can also help adults get an accurate snapshot of just how much time they’re spending connected to devices.

© 2018 United HealthCare Services, Inc.

Ask a nurse My annual health screening report showed an elevated blood sugar level. Does having "prediabetes" mean I am considered diabetic?

And what can I do to bring my numbers down?

Rob in Florida

I am expecting my second child, and at my last checkup I found out I have gestational diabetes. How worried should I be? And will I have diabetes after my baby is born?

April in Arkansas

Prediabetes is a condition in which a person’s blood sugar (glucose) levels are higher than normal but not high enough for a diagnosis of diabetes.

More than one-third of U.S. adults have prediabetes, putting them at higher risk for developing Type 2 diabetes, heart disease and stroke.

Although gestational diabetes can cause a pregnant mom to worry, it can be controlled and well managed by eating a healthy diet, getting regular exercise and taking medication, when needed. Working together with your physician can help ensure you and your baby will stay healthy and avoid complications.

Individuals can live with prediabetes for years without any clear symptoms, so regular blood glucose screenings are important. A blood sugar level of 100-125 mg/dL is considered prediabetes.

Having prediabetes doesn’t automatically mean you will develop Type 2 diabetes, and the following lifestyle changes may help return your blood glucose level to a normal range:

About half of all women who have had gestational diabetes will develop Type 2 diabetes later in life.

Continuing with a healthy diet, regular exercise and regularly monitoring your blood sugar (glucose) levels after delivery, as directed by your physician, can help you maintain healthy blood sugar levels and avoid further complications associated with diabetes. LEARN MORE

• Losing 5-7% of your body weight • E xercising moderately for 30 minutes a day, five days a week • E ating a healthy diet (watching fat and caloric intake)

Email askanurse@umr.com and your question may be featured in a future issue of Healthy You.

• Managing stress © 2018 United HealthCare Services, Inc.

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Health Literacy Let’s face it: Understanding health and benefits terms is like learning a foreign language. Knowing the difference between co-insurance and co-payment can be confusing. And deciphering an EOB from COB shouldn’t require a PhD. Fortunately, you don’t need a foreign language professor or CIA codebreaker to understand all of these terms.

That’s what we're here for.

Many of you will be making your benefits elections this quarter, so we want to equip you to make the best choices for you and your family.

Today's lesson How do different types of health plans work?

How can I estimate my health care costs based on my plan?

What do all those health care benefits acronyms mean?

We know that health care and health benefits terms can be difficult for anyone. Log in to umr.com and select the Glossary tile to find thousands of terms defined in plain, clear language to help you make informed decisions.

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© 2018 United HealthCare Services, Inc.

Learn the language of health care PPO plan A health plan that covers care provided both inside and outside the plan’s provider network. Preferred provider organization (PPO) members typically pay a higher percentage of the cost for out-of-network care. Seeing in-network providers can help members see significant savings.

HMO plan A health plan that covers care provided by doctors and hospitals inside the HMO’s network. Health maintenance organizations (HMOs) often require members to get a referral from their primary care physician in order to see a specialist.

High deductible plan A health plan with lower premiums and higher deductibles than a traditional health plan. Being covered by an HDHP is also a requirement for having a health savings account. Some HDHP plans also offer additional “wellness” benefits provided at no cost to you.

Indemnity plan A health plan that allows you to direct your own health care and visit almost any doctor or hospital you like. Your insurance company then pays a set portion of your total charges.

© 2018 United HealthCare Services, Inc.

Indemnity plans are also referred to as fee-for-service plans. An indemnity plan may also require you to pay for services up front and then submit a claim to your insurance company for reimbursement.

Health savings account (HSA) Member-owned, tax-free savings you never lose. This type of savings account lets you set aside money on a pretax basis to pay for qualified medical expenses. An HSA can be used only if you have a high deductible health plan.

Flexible spending account (FSA) Planned pretax dollars for qualified health expenses that must be used within a calendar year. This type of savings account lets you set aside money on a pretax basis. You decide how much to put in an FSA, up to a limit set by your employer. If money is left at the end of the year, your employer can offer one of two options: • Y ou get 2.5 more months to spend the leftover money • Y ou can carry over up to $500 to spend the next plan year

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Health reimbursement account (HRA) 100 percent employer-funded group health plans from which employees are reimbursed tax-free for qualified medical expenses up to a fixed dollar amount per year. Unused amounts may be rolled over and used in subsequent years. The employer funds and owns the account.

Health incentive account (HIA) Account to receive incentive deposits to pay for qualified medical expenses.

Your remaining balance rolls over each year as long as you remain enrolled in an eligible medical plan and you do not participate in an HSA. Unused funds are forfeited if you leave your job or if you lose eligibility.

Deductible The amount you have to pay before your plan pays for specified services.

Deductibles are usually an annual set amount. A deductible may apply to all services or just a portion of your benefits.

It depends on your benefits plan.

Co-insurance A set percentage of costs that are covered by your plan after your deductible has been paid. Your plan pays a higher percentage. You pay a lower percentage.

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Co-payment A small set fee. It is paid each time you have an office visit, outpatient service or prescription refill. The fee is determined by your health plan. Co-payments don’t vary with the cost of service.

Out-of-pocket expense The amount you pay during a coverage period (usually one year) for your share of the costs of covered services. After you meet your maximum, the plan will usually pay 100 percent of the amount. This limit helps you plan for health care costs.

In-network A doctor, health care professional or facility that is part of your health plan’s network of providers with which it has negotiated a discount. You usually pay less when using an in-network provider, because those networks provide services at a lower cost to your health plan.

Out-of-network A doctor, health care professional or facility that isn’t part of your health plan’s network. If you use an out-of-network provider, your out-of-pocket costs (like co-payments, co-insurance and deductibles) are usually higher because out-of-network providers do not have a contract with your health plan to provide services at lower rates.

© 2018 United HealthCare Services, Inc.

Health cost estimator

Coordination of benefits (COB) Many families are covered by more than one health plan. The coordination of benefits (COB) process determines which plan pays first. It also determines if the second plan will pay any remaining charges not covered by the first plan.

The process makes sure your doctor doesn’t get paid twice for the same service, and that you maximize your benefits.

Explanation of benefits (EOB) An EOB is simply the statement explaining your benefits activity.

It is not a bill. It includes the services provided, the amount billed and the amount paid, if any. You should review your EOBs carefully. Visit umr.com or call the number on your ID card if you have questions about an EOB.

Know before you go UMR’s health cost estimator lets you see what you can expect to pay before you go to the doctor.

You can use the estimates to discuss the options with your doctor and plan for out-of-pocket expenses. Here's how it works: 1. Search for your treatment.

You'll see treatment or procedure options in your area.

2. See estimated price ranges.

View a range of costs based on your medical plan.

3. Make informed decisions.

Talk to your doctor about the best course of treatment for you.

Log in to umr.com and look for the shopping cart icon to use this handy tool.

October is Health Literacy Month. Check out past issues of Healthy You for helpful information on health literacy topics, such as creating a personal health record, finding a primary care provider and advance directives.

© 2018 United HealthCare Services, Inc.

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Finding a doctor or hospital on

umr.com

Make the most of your health care dollars when you use in-network doctors, hospitals, pharmacies, labs and other providers.

1

Log in to umr.com

2

Once logged in, click on Find a provider

3

Search for a medical provider from your network listing.

Call us with any questions Find the toll-free phone number for UMR member services on the back of your health plan ID card.

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Š 2018 United HealthCare Services, Inc.

On the go?

Visit umr.com on your mobile device

It's quick and easy There’s no app to download.

Simply visit umr.com and add us to your favorites.

Š 2018 United HealthCare Services, Inc.

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Gift-giving season is right around the corner, and with it comes both excitement and stress. Some people are fun to buy for while others are notoriously difficult. Meanwhile, most of us are already overwhelmed with “stuff,” and accumulating more can feel like more of a burden than a blessing.

Why not rethink your gift-giving strategy this year?

1 SET UP A SPA DAY Schedule mani-pedis, facials or massages for the two of you.

Give the gift of

connection 2 GIVE AN EXPERIENCE

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ways to help connect with family and friends

Buy a pair of concert tickets, museum passes or a voucher for a class that you can participate in together.

Challenge yourself to find creative gift ideas that help you spend more time with the people you usually only see during the holidays. Instead of focusing on “things,” consider giving gifts that encourage activity and strengthen relationships.

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© 2018 United HealthCare Services, Inc.

4 ARRANGE A TRIP

DOWN MEMORY LANE

Fill a journal with page prompts like “What’s your earliest memory?” or “What was your favorite vacation?”

Fill in your own answers and ask the recipient to share theirs with you. Make a date to talk about your memories or visit some of your favorite places together.

3 GET ON THE SAME PAGE Share a book you love and invite your giftee to discuss it over coffee when they’re finished reading it.

s your What wa acation? favorite v

5 SWING INTO ACTION Give your favorite fitness buff tickets to a sporting event, a membership to your gym, or a gift card for a yoga class or round of golf you can enjoy together. Or schedule a recurring walking or bike riding date.

6 BE THE HOST Plan a dinner, movie night or game night (don’t forget the healthy snacks) and include your families or mutual friends.

7 SHARE YOUR SKILLS Are you a wonder with watercolors?

An unbelieveable baker? A sensational salsa dancer? Teach someone how to do something you love.

Research suggests that giving an experience rather than a material item can strengthen a relationship. © 2018 United HealthCare Services, Inc.

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Turn the tables on diabetes 'Tis the season of sugary treats, from Halloween candy to Thanksgiving pies to December sweets and drinks. And it can be particularly hard to navigate the holidays if you're living with diabetes – especially if your doctor has recommended a plan to help you lose weight.

But losing as little as 10 to 15 pounds may help you better manage your blood sugar (glucose) and improve your blood pressure and cholesterol counts if you have Type 2 diabetes.

Visit diabetes.org for tips on how to stay more active, choose the right foods and set realistic goals for managing your weight.

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SEPTEMBER: National Childhood Obesity Awareness Month Fruits & Veggies - More Matters Month Ovarian Cancer Awareness Month Pain Awareness Month Prostate Cancer Awareness Month

OCTOBER: National Breast Cancer Awareness Month Health Literacy Month Mental Health Awareness Week

NOVEMBER: American Diabetes Month COPD Awareness Month Lung Cancer Awareness Month Š 2018 United HealthCare Services, Inc.

Know where to go when

someone is sick or in a crisis situation.

Where you go for medical services can make a big difference in how much you pay and how long you wait to see a health care provider.

Explore the following information to help you decide the appropriate setting for your care.

What you need to do:

1

Find your member ID card

2

Find a provider On the back of your member ID card, you’ll find: • Your PPO network • Contact number • Pharmacy contact if applicable You can also visit our website at umr.com.

!

If you are severely ill and/or it's an emergency, call 911.

FIND OUT WHERE TO GO ON THE NEXT PAGE © 2018 United HealthCare Services, Inc.

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COLD, FLU OR ALLERGIES RETAIL CLINIC Retail clinics, sometimes called convenient care clinics, are located in retail stores, supermarkets and pharmacies.

You can find over-the-counter medications and you can talk to your pharmacist for help.

TIMES TO GO:

• • • •

Vaccinations or screenings Sinus infections Minor sprains, burns or rashes Headaches or sore throats

Expect to wait 15 minutes or less

Average cost $50-$100

(per service for non-employer sponsored facilities)

NOT FEELING WELL (NOT URGENT) DOCTOR’S OFFICE Seeing your doctor is important. Your doctor knows your medical history and any ongoing health conditions.

TIMES TO GO:

• Preventive services and vaccinations • Medical problems or symptoms that are not an immediate, serious threat to your health or life

Expect to wait 1 day to 1 week or more for an appointment

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Average cost $100-$150

Note: Costs may vary based on your plan. Costs shown represent national averages.

© 2018 United HealthCare Services, Inc.

MILD ASTHMA ATTACK URGENT CARE Urgent care centers, sometimes called walk-in clinics, are often open in the evenings and on weekends.

TIMES TO GO:

• • • • • •

Sprains and strains Sore throats Minor broken bones or cuts Minor sprains or burns Minor infections or rashes Earaches

Expect to wait 20-30 minutes

Average cost $150-$200 (for non-employer sponsored facilities)

SUDDEN HEALTH CHANGES EMERGENCY ROOM Visit the ER only if you are badly hurt. If you are not seriously ill or hurt, you could wait hours and your health plan may not cover non-emergency ER visits.

TIMES TO GO:

3 Determine the severity of the symptoms and choose the provider that works for you.

• Sudden weakness, trouble talking or blurred vision • Large open wounds • Difficulty breathing • Severe head injury

Expect to wait 3-12 hours (for non-critical cases)

© 2018 United HealthCare Services, Inc.

• • • • •

Heavy bleeding Spinal injuries Chest pain Major burns Major broken bones

Average cost $1,200-$1,500

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THE DANGERS OF

VAPING

This popular trend comes with some uncool consequences.

Think using e-cigarettes or vapes is harmless because they don’t produce smoke? You’re not alone. Unfortunately, that’s simply not the case. These products contain dangerous chemicals and might even be a “gateway” to cigarette smoking and other tobacco products. And because of the misconceptions about their safety, along with their appealing colors and flavors, e-cigarettes are now the most commonly used nicotine product among youth, surpassing conventional cigarettes in 2014, according to the Surgeon General.

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According to Truth Initiative, a nonprofit public health organization dedicated to making tobacco use a thing of the past, 63 percent of people who used one of the most popular e-cigarette brands did not know that the product contains nicotine.

© 2018 United HealthCare Services, Inc.

WHAT ARE E-CIGARETTES? E-cigarettes are part of a class of products called End Nicotine Delivery Systems (ENDS). These battery-operated devices turn liquid, which often contains nicotine, flavorings and other chemicals, into a vapor. Users then breathe in the vapor instead of the smoke produced by conventional cigarettes. Using any of these devices is commonly referred to as “vaping.”

ENDS come in many forms, each containing four components: a cartridge that holds the liquid, a heating element, a power source and a mouthpiece. These are some of the most common types: • Rechargeable or disposable e-cigarettes

• Hookah pens

• E-cigars

• Vape pens

• E-pipes

• Mods

>N ICOTINE ADDICTION >L UNG DISEASE AND CANCER

• Vapes

These products also contain harmful substances like lead, flavorings, small particles and

• E-hookahs These products appeal to both youth and young adults due to curiosity, flavoring/taste and low perceived harm compared to other tobacco products. The devices themselves can be colorful or discreet – some are as small as a flash drive or look like a regular pen. And sweet flavors like bubblegum, brownie batter and cotton candy are tempting for teens and tweens.

HOW POPULAR ARE E-CIGARETTES? E-cigarette use has more than tripled among middle- and high-school students since 2011.

And it more than doubled among young adults 18–24 between 2013 and 2014. And those numbers continue to rise.

© 2018 United HealthCare Services, Inc.

2011

vs

2013

vs

While not all ENDS contain nicotine, using those that do can lead to:

2018

2014

chemicals.

> EXPOSURE TO HARMFUL AEROSOLS AND CHEMICALS Although these devices do not produce smoke, those who are near someone using them can be exposed to the harmful aerosols and chemicals they contain.

>H IDDEN DRUG USE E-cigarettes can also be used as a discreet way to consume drugs, and there are easy-to-find online tutorials that describe how to do it. Teens are using e-cigarettes to vaporize opiates, marijuana (in THC or hash oil form, or by steeping the leaves in a liquid nicotine solution) and synthetic drugs, often unbeknownst to parents who think the devices are harmless toys.

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HOW CAN I GIVE OR GET HELP? If you know or suspect your child is using one of these products, talk to them. But make sure you know the facts and are ready to be patient and listen before you start the conversation.

Be prepared to address misconceptions, such as: • A ren’t e-cigarettes safer than conventional cigarettes?

• I thought e-cigarettes didn’t contain nicotine – just water and flavoring.

• M y friends have tried it and nothing bad happened – why shouldn’t I do it?

= One pod of e-liquid can contain 20 cigarettes worth of nicotine.

DID YOU KNOW? You must be 18 to legally purchase e-cigarettes, but it's not difficult for tweens and teens to get them.

Even tobacco products labeled “natural,” “organic” or “additive-free” are harmful to your health.

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The Surgeon General offers a helpful tip sheet for parents who want guidance when talking to their teens about e-cigarettes. You can also ask your family’s health care provider for information and help.

One of the best ways to influence your kids positively when it comes to these products is to be nicotinefree yourself. If you or another adult needs help quitting e-cigarettes or other tobacco

*Not available with all benefit plans

products, there are several programs and services that can assist people in their efforts, including: • Enrolling in the UMR Tobacco Cessation program* at 1-800-207-7680 • C alling the National Cancer Institute (NCI) Quitline at 1-877-44U-QUIT • U sing NCI’s LiveHelp online chat at livehelp.cancer.gov

© 2018 United HealthCare Services, Inc.

Registering for online services is as easy as 1-2-3

Click or touch the New User link to register.

1

2

3

Be sure to have your member ID card handy.

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9 great tips to a healthier

Thanksgiving day Thanksgiving day may bring out the glutton in all of us, but with a little self-control and simple planning, you can enjoy the annual family food fest without the extra serving of guilt afterwards.

Shift your focus Begin with breakfast Don’t skip the most important meal of the day with the feast ahead.

You’ll make better decisions later if you start strong with oatmeal or an egg white omelet. Your blood sugar will thank you.

Start the day on the right foot A morning workout – or even a walk – will get the blood pumping, the calories burning and the metabolism going before the big meal.

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Stay small

To help reign in the potato pileup, seek out smaller plates to help keep your portions under control. And remember, protein the size of your fist is a good rule-of-thumb.

While food will always be star of the day, pay attention to family and friends and try helping the host prepare.

Don’t double up

Find yourself filling both hands?

Choose one. By limiting one hand to either a snack or drink, you’ll consume fewer calories before sitting down for the main course. © 2018 United HealthCare Services, Inc.

Practice mindful eating

The idea of being in the moment may be a little overdone these days, but what better time to savor the moment than Thanksgiving? Try turning your awareness to the flavors of every bite.

Bring a dish

Contributing a healthy dish may help out the host, and you’ll guarantee there’s one nutritious side to choose from.

© 2018 United HealthCare Services, Inc.

Know thyself

If stuffing and mashed potatoes are your downfall, don’t deprive yourself, but don’t go overboard. A smallbut-satisfying helping of each will go a long way to help manage your cravings.

Be body conscious Find yourself hanging around the food too long? Take breaks from the snacks and move your body away from the appetizers and drinks to help curb mindless munching.

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Meal Makeover This year, do something different with your Thanksgiving leftovers.

Remake your mashed potatoes and veggies into a shepherd’s pie full of fall flavors and savory goodness.

It’s a vegetarian take on a tried and true classic.

We like to think you’re extending the Thanksgiving celebration.

Serves 6

SHEPHERD'S PIE INGREDIENTS: 1 medium onion, diced 1 1/2 tablespoons olive oil 1 large carrot, diced 1 celery rib, diced 1/2 cup stemmed and diced mushrooms (button, shiitake or other varieties) 1/2 cup zucchini 1/2 teaspoon sea salt 1/2 teaspoon black pepper 4 cloves finely chopped garlic Fresh thyme leaves (from 2-3 sprigs) 2 teaspoons fresh rosemary, minced 1 teaspoon dried oregano 3/4 cup red wine 1 cup dried green lentils

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View the twist on shepherd’s pie recipe

2 1/2 cups low-sodium vegetable broth

Visit foodhero.org for other creative recipe ideas

1 1/2 cups frozen or canned (and drained) corn kernels

1 1/2 tablespoons red wine vinegar

3 cups mashed potatoes

DIRECTIONS: 1. Preheat the oven to 375 degrees.

2. In a large skillet, heat oil over medium heat and stir in the carrot, onion and celery. Cook until they soften, 3 to 5 minutes.

3. Add the zucchini and mushrooms, and cook the mushrooms until they soften, 3 to 4 minutes.

4. Sprinkle in the salt and pepper.

5. Add the rosemary, garlic, thyme, oregano and red wine, and cook for 1 minute. Add the lentils and broth, and cook uncovered until the lentils are firm and just tender, 25 to 35 minutes. Add more broth as needed.

6. Finish with the red wine vinegar, pepper and another pinch of rosemary.

7. Spread the lentil mixture across the bottom of an oven-safe casserole dish. Add a little broth if dry.

8. Sprinkle a layer of corn over the lentil mix.

9. Smooth the mashed potatoes across the top.

10. Loosely cover with aluminum foil and bake for 30 minutes.

11. Make sure it’s cooked through.

Serve warm. © 2018 United HealthCare Services, Inc.

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