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Wise Woman

HAP takes care of you while you take care of everyone else. Volume 12, Issue 2

Summer 2012

Shopping Cart Smarts Annual HAP Wise Woman Reader Survey now online!


Wise Woman

HAP takes care of you while you take care of everyone else.

In This Issue … Members

Health

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Women Helping Women HAP Wise Woman readers share their lifestyle tips.

Advice 3 Wise Woman Book Review The End of Overeating – Taking Control of the Insatiable American Appetite by David A. Kessler, M.D. 7

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Nutrition on a Budget Do healthy foods really cost more? Ask the Doctor Do Breezes Cause Sneezes?

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Nutrition 3

Introducing Cook eKitchen™ Fun online video segments and recipes will have your family fixing healthy meals in minutes.

Family on Board When you’re ready to adopt a healthier lifestyle, here’s how to bring your family along for the ride. Achy Feet? Start with Your Calves Marc Chicorel, D.P.M., offers tips for aching feet. Hormone Replacement Therapy: Ask Your Doctor, Not Your Friends What you really need to know if you’re considering HRT. Ages & Stages – Shopping Cart Smarts Should your age determine what’s in your cart?

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Grapefruit and Avocado Salad Recipe

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Ask Zonya Your nutrition questions answered.

Events 11

We’re going green this year – our annual survey is now online. Go to hap.org/hww2012survey and tell us what you think. (See page 11 for additional details.)

Cover photo: HAP Member Tiffany Weekly with Zonya Foco, R.D. Location: Hiller’s Market, Commerce Township Photo by: John Sobczak

Editorial Staff:

Fitness 9

Take our reader survey!

On Your Mark … Get Set … Sign Up! How to get ready for your first … or next … race. Exercise = Energy Need an energy boost? Get moving. Upcoming Events

Editor Amy Strauss Editorial Advisors Tiffany Baker Gina Jones Terri Kachadurian Irita Matthews, M.P.H., J.D. Donna M. Nuznoff Susan Schwandt, A.P.R.

Marketing Staff: The information in this publication does not change or replace the information in your HAP Subscriber Contract, Group Health Insurance Policy, Riders or Handbooks and does not necessarily reflect the policies or opinions of HAP, its officers or board of directors. The information is for general educational purposes and is not a substitute for the advice of your doctor. You should consult your HAP personal care physician for your health care needs. HAP does not discriminate on the basis of race, color, national origin, age, religion, sex or mental or physical disability in its employment practices or in the provision of health care services. © 2012 Health Alliance Plan of Michigan

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Director Anita Landino Senior Marketing Specialist Meribeth Tyszkiewicz


Wise Members

Women Helping Women Wise women share tips for successfully managing their many roles.

I’ve learned to overcome my fears and try new experiences. I thought karate would be a good family activity for my son, husband and me, but being a “fluffy” lady it was nerve-wracking for me. In our first class, we had to stand in lines, adults in the back. Behind us were parents watching their kids. I was so embarrassed doing the forms in front of those parents, but then I thought, at least I’m trying. Two years later, I’ve lost 36 pounds, and I took second place in the category of form and weapons in a recent tournament. My new motto truly has become “Fight Like a Girl!” Stephanie Lamas, Lake Orion

Wise Woman Book Review

Introducing Cook eKitchen™

The End of Overeating – Taking Control of the Insatiable American Appetite by David A. Kessler, M.D.

“What’s for dinner?” Whether the whine is from your kids or your stomach, it often starts before you’re even all the way through the door.

How many times have you thought, “I’ll just have one slice of pizza,” only to realize, half an hour later, you’ve eaten the whole thing? Why is it so hard to stop eating?

Either way, we have the solution.

The answer may not be a simple matter of willpower. David A. Kessler, M.D., a pediatrician who also served as commissioner of the U.S. Food and Drug Administration, examines research about how our brain’s reward system may be overstimulating our appetites. Dr. Kessler provides tools and insights to help us break the unhealthy overeating cycle. In a world of large portion sizes, chain restaurants competing for our business and readily available unhealthy snack foods, this book may offer you the knowledge to take control back.

Cook eKitchen™ is a new, free recipe site on hap.org. In short, fun video clips, chefs Mehdi Chellaoui, Ji Young Min and Rich Estrin demonstrate quick, healthy recipes, such as chicken stirfry, whole-wheat pita pizza or cinnamonraisin muffins. There are plenty of gluten-free, vegetarian and diabetes-friendly recipes too. They’re so simple that if it’s your kids doing the whining, you can have them check the site and get to work. Find Cook eKitchen™ on the home page of hap.org. Your friends can access it even if they’re not HAP members. Let them know!

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Wise Health

Family on Board You’ve attended HAP Weight WiseSM seminars. You’ve resolved to adopt healthier eating habits and exercise regularly. There’s just one problem: It’s not just you. You’ve also got a family. Maybe a spouse, adolescent or pre-adolescent kids. And when you set down the scrumptious stir-fry you’ve slaved over, they clamor for pizza. Kevin Sloan, M.S., L.L.P., psychologist at Beaumont Hospital, begins with an analogy. “You know how when you get on a plane and the flight attendants give that part of the preflight speech about the oxygen masks? They say ‘put your own mask on before helping others.’ Life works the same way. When Wise Women take care of themselves, they’re better able to take care of their families. That’s Kevin Sloan, nothing to feel guilty about. Once you care for M.S., L.L.P. yourself, you’ll often find your family’s opposition is minimized, because you have more energy and more assertiveness to stick with your goals. Know that taking care of yourself will enhance your ability to take care of your family.” Kevin suggests: l

Communicate your plan in a family meeting.

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Establish and maintain structure and consistency.

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Eliminate unhealthy options. You’ll get less opposition if unhealthy choices aren’t easily accessible. Kids have an infinite capacity to adjust.

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If you’re providing choices, make them healthy. Offer choices between celery or carrots, or a walk and a bike ride.

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Have a plan for integrating the healthy habits. If you’re taking a kid to soccer practice, take a walk during the practice. Picking kids up from school? Have healthy snacks ready so you don’t end up hitting the drive-thru.

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Think about your own motivation and reasons to stay on track. Maybe you want to be a better role model, or have more energy to keep up with your kids or more self-confidence.

Take our reader survey! We’re going green this year – our annual survey is now online. Go to hap.org/hww2012survey and tell us what you think. (See page 11 for additional details.)

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Wise Health

Achy Feet? Start with Your Calves Marc E. Chicorel, D.P.M., podiatrist with Henry Ford Health System, is nothing if not realistic. “In an ideal world, we’d wear lace-up shoes with a wide toe box and no heels,” he says. But heels have been around for centuries; they’re probably here to stay.” The problem? “Squeezing our forefoot into that narrow toe box puts pressure on the first and fifth toe, then the toes in between. Over time, tendons adapt and shorten, and the squeezing causes bunions and hammertoes.” And heels? Don’t get him started. “When the heel is higher than the front of the foot for an extended period, the Achilles tendon and calf muscles will shorten. If you’re in dress shoes all day, stretch the two calf muscles – the gastroc (short for gastrocnemius) and the soleus,” explains Dr. Chicorel.

Marc E. Chicorel, D.P.M.

Gastroc Stretch 1. Stand with your hands against a wall, one leg forward. 2. Keep back knee straight, with the heel pressed to the floor. 3. Push hips forward, while pressing your back heel to ground. 4. Hold 30 to 40 seconds. 5. Repeat three times for each leg.

Soleus Stretch Do the same as above, but keep back knee bent, with the heel pressed to the floor. “If you’re experiencing foot pain that won’t go away after seven days, or if your foot is red, hot or swollen, it’s time to see a doctor,” Dr. Chicorel says. Gastroc Stretch

Hormone Replacement Therapy: Ask Your Doctor, Not Your Friends Hot flash during your big presentation? Sleepless nights? Can hormone replacement therapy (HRT) fix this? “HRT replaces the hormones – estrogen, progesterone or both – that a woman is missing due to the natural transition into menopause,” says Ken Ginsburg, M.D., a reproductive endocrinologist and director of the Henry Ford Center for Reproductive Medicine. “There are three reasons to consider HRT. The first is menopause symptoms, like hot flashes, sleep disturbances, mood changes and vaginal dryness. Second, there is evidence that HRT provides some protection against osteoporosis (thinning bones), although there are other ways to prevent that. Third, there may be cardiovascular benefits.” HRT isn’t without risks, including an increased risk of breast cancer in some women, and possible increased risk of uterine cancer, blood clots or gallbladder disease. “If your family has a strong history of breast cancer, think twice about using estrogen,” Dr. Ginsburg cautions. The bottom line on HRT? Don’t decide based on what somebody else’s doctor says. The risks and benefits of HRT will be different for every woman, so at your next appointment, discuss your symptoms and family history with your doctor, who can help you make an informed decision if HRT is right for you.

Ken Ginsburg, M.D.

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Wise Health

Ages & Stages Shopping Cart Smarts “As we approach another decade (it happens quite quickly, it seems), it’s important for us to realize that for every decade we age, our metabolism decreases, and we burn about 50 calories less every day,” says Zonya Foco, R.D., facilitator of the HAP Weight WiseSM program. “That means, if we do not ‘cut back’ by 50 calories (like nixing four ounces of juice or a pat of butter) every day, we’ll pack on five pounds every year. That sure explains a lot now, doesn’t it?”

Incorporate these foods into your diet regularly 30s l

1 cup of kidney beans with brown rice cup cooked spinach over pasta l 4 ounces of orange juice and fortified cereal l 1⁄2

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A potassium-rich salad of spinach, raisins and orange slices with a serving of whole wheat bread l A cup of oatmeal with strawberries l Quinoa tossed with spinach, cucumbers and tomatoes

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A cup of cooked barley topped with stir-fried tofu, broccoli, carrots and cauliflower l Sauté some bok choy with black soybeans l Flax-rich cereal with soy milk topped with diced apples

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The bottom line: “If at any time the scale is starting to creep up on you, just curb something that is part of your daily routine,” Zonya suggests. “Change to a smaller-sized juice glass, eliminate the butter from your toast, take your coffee black or enjoy cereal without sugar. Adopting these habits will go a long way to keep off unwanted weight gain over the decades!” Besides a balanced and healthy array of groceries, what should be in a Wise Woman’s grocery cart? The answer depends on your age. Choosing the best foods for your age can help you power through the changes that are going on in your body.

In Your 30s … “Scoop up folate-rich fruits and vegetables like bananas, oranges, leafy greens, dried lentils, beans and split peas. You should aim for 400 mcg of folate a day. Also include vitamin C-rich citrus to help you absorb iron, to fend off anemia from heavy periods,” advises Zonya.

In Your 40s … “It’s time to adjust to the changin’ times,” Zonya says. “That means it’s time to increase consumption of probiotic and calcium-rich nonfat yogurt and skim milk. Plus, be sure you get added fiber in your diet from fruits, vegetables and whole grains. This will help you to feel satisfied as you begin dialing down portion sizes (and calories) to adjust to the next decade.”

In Your 50s … “To help combat the effects of menopause, go for the rich phytoestrogens in ground flax seed, soy milk, soy nuts, black soybeans and tofu. And don’t forget to take a vitamin D supplement,” suggests Zonya.


Wise Advice

Nutrition on a Budget How can you put a price on a healthy diet for your family? The cheap choices tempt us from grocery shelves. Do you snap up the box of prepackaged mix that can feed a family of four for $5? Or do you scour the produce section in search of affordable organics? “A spending plan, including your grocery budget, should be valuesbased,” advises Robin Thompson, M.A., president of Budget Wise Consulting and the WXYZ Channel 7 Money Coach. “Some advisors say grocery budgets should be 15 percent of your income – but if you value eating healthy more Robin highly than that, you might cut back on Thompson entertainment and dining out to offset the cost of healthier food. Whatever your grocery budget, you can make affordable healthy choices.”

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Buy frozen vegetables. They’re often cheaper than fresh or canned, and they don’t spoil, so you don’t waste money. They are nutritious. Seek reduced-price produce. Stores will often have a “reduced” rack of riper produce. If you know you can use it today or tomorrow, buy it. Buy the store brand. Generics can knock 20 to 25 percent off your food bill. Hit the farmer’s market. Local in-season foods are cheaper; you avoid shipping costs. Stock up, and can or freeze for later. Eat less meat and more beans, such as lentils, black-eyed peas, pinto or black beans. This can offset the cost of healthier meats, such as grass-fed, organic, hormone-free chicken and beef. Drink more water! Reduce or eliminate soda pop.

What About Bulk? “Warehouse clubs now offer bargain-priced organic foods,” says Robin. That can save time and money, but proceed with caution, especially with snack foods. “Studies show that the bigger the box, the more people eat,” adds Zonya Foco, R.D. “That could actually cost you more in new clothing and medical bills associated with excess weight. If you buy in bulk, consider ‘pre-portioning’ into small snack bags so you’re not ‘tricked’ by the larger container. Also, don’t assume bulk is cheaper. Keep a small notebook to jot down ‘per ounce’ prices, so you can really compare and know.”

Zonya shares more tips for eating healthy on a budget in her webinar Eat Right and $ave Money Doing It. Log in at hap.org, select the My Health & Wellness tab, then Member Programs > Weight Wise > Weight Wise Webinars.

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Wise Advice

Ask the Doctor

Do Breezes Cause Sneezes?

Nancy S. White, M.D., Henry Ford Medical Group

As Michigan summer breezes spread pollen in the air, they can leave Wise Women sneezing and fighting itchy, watery eyes and noses. “In June, the main outdoor allergens are pollen and mold,” says Nancy White, M.D., Henry Ford Medical Group. “Plus, there are many indoor allergens to consider, including dust mites, cats, dogs and mold. Even women who don’t normally have allergy problems may notice, when these things combine in the warmer weather, that they have significant symptoms, such as sneezing, a clear runny nose, watery eyes and a cough.”

What Can You Do? “The key is avoidance,” says Dr. White. “If you’re having trouble with outdoor allergens, stay inside, in the air conditioning, as much as possible. If you’ve been outside, shower to decrease allergens in your hair or on your body. “If you’re indoors, avoidance is still the key. Using special allergy cases for mattresses, pillows and cushions will help. If you’re allergic to your pet, bathe it frequently and vacuum and clean thoroughly. If you have mold issues in your home, eliminate those, and keep humidity at less than 50 percent,” advises Dr. White. For Wise Women who love exercising outdoors, especially in the Michigan summer, there is still hope if you suffer from allergies. “Exercise early in the morning or later in the evening when the allergen counts are lower,” Dr. White suggests. “Drink extra water when allergies are in full swing, because you’ll have increased fluid loss with the sneezing and runny nose symptoms. If you have highly sensitive allergic reactions, you may want to switch to indoor exercise or use a mask while exercising outside.”

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Allergies: If You Can’t Beat Them, Here’s How to Treat Them l

Over-the-counter non-sedating antihistamines (Claritin® or Allegra®) are long-acting and usually easy to tolerate.

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Benadryl® is an antihistamine, but it may make you sleepy.

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Nasal corticosteroid sprays are common treatments, but you’ll need a prescription.

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Over-the-counter nasal sprays (like Afrin®) are helpful in the short term (i.e., a few days) but they can cause problems if used regularly.

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Rinsing with a Neti pot (www.neti-pot.com for information) is helpful to minimize allergens in the nasal cavity.

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If these measures don’t work, see your doctor for testing to identify triggers. Allergy shots may be used if you don’t respond to the treatments mentioned here.


Wise Fitness

On Your Mark … Get Set … Sign Up! Do you want to get in shape? One of the best ways to do it is to sign up for an official walk, run or triathlon, says Sherry McLaughlin, physical therapist, facilitator of HAP’s MoveWell Every Day program and president and founder of the Michigan Institute for Human Performance, Inc. It may be your first time. Or maybe you’ve done your first 5K or 10K, and you’re ready to improve your time or take on a half-marathon, marathon, biathlon or triathlon. As the saying goes, you’re stronger than you think you are. Sherry notes that having a great experience at your event is a matter of taking four simple steps:

1. Find a Race Sherry McLaughlin, M.S.P.T. and HAP-affiliated physical therapist

“When people ask me how to lose weight, I say sign up for a half-marathon,” says Sherry. “When you start training, you’ll see the weight melt off. Plus, once you pay that money to register, you’ll be committed. Don’t wait and see if you get in shape first. If you do that, it will never happen. I have a friend who lost 65 pounds training for the ‘Tri Goddess Tri’ triathlon (www.trifind.com). It’s a touch shorter than regular triathlons, and women of all sizes and ages participate. It’s a great, friendly event. The Detroit Free Press/Talmer Bank Marathon, October 21, 2012, offers a marathon, half-marathon, relay and 5K. You still have time to train for that one (www.freepmarathon.com). Another idea is to choose a race that supports a cause, like Team in Training® for the Leukemia and Lymphoma Society® (www.teamintraining.org) or the Susan G. Komen Race for the Cure® (ww5.komen.org).”

2. Find a Friend “Get a friend to sign up with you,” advises Sherry. “Even if you can’t train together, you can hold each other accountable to the training plan.”

3. Find a Plan “Most training plans are 12 to 16 weeks from couch potato to 5K,” Sherry notes. “They’re easy to follow and integrate into your day. For a 10K, you start at three miles, then three and a half, going up gradually. You can find free training plans online, including marathon and half-marathon plans at www.halhigdon.com.”

4. Just Do It “Strap on your shoes and get it done. It’s the most empowering thing women can do.”

Have you committed to doing a walk or run with your family or friends? Tell us about it at hapwisewoman@hap.org. Or like us on Facebook, www.facebook.com/hap, and share it there.

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Wise Nutrition

Grapefruit and Avocado Salad

Ask Zonya Zonya Foco, R.D., author, HAP Weight WiseSM facilitator, TV host and national speaker

Tangy grapefruit and mild avocado add variety to salad greens and make this a delicious salad any time of the year. Ingredients

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1 medium avocado 2 tablespoons lime juice 1 grapefruit, peeled ⁄2 cup thinly sliced green onions 1

10-12 ounces mixed salad greens, torn (about 2 quarts) Dressing ⁄4 teaspoon ground cumin

2 tablespoons apple cider vinegar

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1 tablespoon olive oil

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1 tablespoon water 2 teaspoons sugar or the equivalent in artificial sweetener

⁄8 teaspoon ground black pepper ⁄8 teaspoon salt (optional)

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Directions Peel and slice the avocado, then place in a bowl. Pour lime juice over avocado to prevent browning. Section grapefruit and cut into bite-size pieces. In a large salad bowl, mix grapefruit, green onion and salad greens. Drain avocado, reserving lime juice. Mix reserved lime juice with dressing ingredients. Add avocado to the salad. Pour dressing over salad and toss. Makes 10 cups. Serving size: 2 cups. Nutrition information for 1 serving: Calories: 134 (128 with Total carbohydrates: 16 g artificial sweetener) (14 g with artificial sweetener) Fat: 8 g Fiber: 5 g Sugar: 10 g (8 g with artificial sweetener) Protein: 3 g Source: Quick & Healthy Recipes and Ideas, 3rd Edition, ©2008 Brenda J. Ponichtera, R.D.,  Small Steps Press. Find Brenda’s FREE Recipe Newsletter, emailed each month, at www.QuickandHealthy.net.

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I’ve heard about the new “MyPlate” that’s replaced the old food pyramid. What does that mean for me? Every Wise Woman should use the new “MyPlate” (visit www.myplate.gov) to remind herself, as well as her family members, to include fruits and vegetables at every meal and snack. The plate graphic is a simpler replacement of the food pyramid – in essence, as long as we eat proper portions, and half of our meal contains fruits and vegetables alongside our lean proteins, whole grains and low-fat dairy, we’re eating a healthy meal. For example, if you want pizza, two slices count for half the plate, and the rest should be salad and a fruit.


Wise Events

We’re going green this year and offering our annual HAP Wise Woman Reader survey online! We want to know what you think! Please go to hap.org/hww2012survey and take a few moments to share your opinion. Your comments and suggestions help shape the direction of HAP Wise Woman magazine and the health education programs we offer. All responses received by August 20, 2012, will be eligible to win one of five $25 Hallmark Insights gift certificates (good at over 300 retailers)!

Mark your calendar for these upcoming events Weight Wise for Women – Learn It September 29, 2012 SM

Revive® – Simple Tools to Overcome Stress October 27, 2012 Weight Wise for Women – Live It November 15, 2012 SM

To learn more about these events, please log in at hap.org, select the My Health and Wellness tab and then click on Member Programs. For the Weight Wise programs click on Weight Wise. For the Revive® program click on Wise Woman. Remember, you will be able to register for each of these programs on hap.org one month prior to the event date. SM

Facebook Fans If you missed our first live Facebook chat with Zonya Foco, R.D., don’t worry, we’re having another one in August! Anyone can follow us, but you must have a Facebook account. Like us at www.facebook.com/hap.

American Cancer Society launches Choose You campaign Did you know one in three women will get cancer in her lifetime? Choose You is the American Cancer Society’s new national movement that encourages women to put their health first and make healthy lifestyle choices to stay well and prevent cancer. Go to www.ChooseYou.com to commit to reaching your personal health goals.

Henry Ford Health System offers sports physicals for kids With summer here, that means fall isn’t far behind with school sports. Henry Ford Health System is offering sports physicals for student athletes on Saturday, August 2, 2012, at Lawrence Technological University in Southfield. For more information, go to www.henryford.com/sportsphysicals.

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2850 W. Grand Blvd. Detroit, MI 48202

PRSRT STD U.S. POSTAGE

PAID GRAPHICS EAST, INC.

Exercise = Energy It’s a simple, though unexpected, equation. After all, once you’ve completed a long day of work, errands, housework, cooking and taking care of your family, exercise is probably about the last thing you’d choose for an energy boost. The truth is, exercise dials up your body’s demand for energy. In turn, your body rises to the challenge and produces more. Exercise also speeds oxygen and nutrients to your cells, making your cardiovascular system work more efficiently. The result? An energy surplus. Researchers say that even for people coping with conditions such as cancer, diabetes and heart disease, regular exercise can increase energy levels.

Need an energy boost? l

Take a brisk 15-minute walk.

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Do a few minutes of gentle stretching.

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Play a physical game you enjoy, such as tennis or Wii™ bowling.

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Go for a jog or bike ride.

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Watch your favorite TV show while you work out on the elliptical machine or treadmill.

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Take an aerobics or karate class.

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Even if you feel too tired to do anything, simply get up and walk around the room.

FEEDBACK We love hearing from you. You may contact us:

By mail: HAP Wise Woman Editor 2850 W. Grand Boulevard Detroit, MI 48202

By email: hapwisewoman@hap.org

Your HAP Board of Directors Jack Martin, Chairperson

Marvin B. Beatty

Joyce V. Hayes Giles

Robin Scales-Wooten*

William A. Conway, M.D.

Harvey Hollins, III

Nancy M. Schlichting

William R. Alvin

Linda Ewing

Jamie C. Hsu, Ph.D.

Rebecca R. Smith

Cindy Bala-Brusilow, Ph.D.*

Lauren B. Foster, C.P.A.

Kirk J. Lewis

Susie M. Wells*

Shari Burgess

*Member-Elected

67.5M 5/12 322


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