Making New Year’s Resolutions That Stick Why do most New Year’s resolutions fail? We talked to local experts about it
DEPRESCRIBING UBMD physician Ranjit Singh is on a mission to reduce the number of pills patients take. He is part of Team Alice
JANUARY 2020 • ISSUE 63
Wintertime in WNY Why you are more likely to have a heart attack this time of the year • 10 things you need to do to have a safe season • How to diagnose and treat seasonal affective disorder (SAD). Pages 16, 17
Fitness Trends for 2020
What’s Hot, What’s Not
GBUAHN helping people on Medicaid to get and stay healthier
LONGEVITY Declining life expectancy, a ‘distinctly American phenomenon,’ experts say
Green Leaf Lettuce Looking for a great way to lose weight after the holidays.? Go for salads. Page 13
n 12 surprising benefits of zumba workouts n Can mixing yoga with modern high intensity interval training work?
Pages 8, 9
Excessive Screen Time Study shows average time children spend in front of screens increased from 53 minutes per day at 12 months to more than 150 minutes at 3 years. Page 10
Declining Life Expectancy a ‘Distinctly American Phenomenon’
Findings show life expectancy in the U.S. is rapidly falling behind that of other wealthy countries
fter increasing for decades, U.S. life expectancy is on the decline, and a new study reveals some of the reasons behind the alarming trend. The study, published Nov. 26 in the journal JAMA, found that the decline is mostly among “working-age” Americans, or those aged 25 to 64. In this group, the risk of dying from drug abuse, suicide, hypertension and more than 30 other causes is increasing, the authors said. The findings suggest that life expectancy in the U.S. is rapidly falling behind that of other wealthy countries. Indeed, the particular decline among working-age adults has not been seen in other countries, and is a “distinctly American phenomenon,” said study co-author Steven H. Woolf of Virginia Commonwealth University School of Medicine. “Death rates among working-age adults are on the rise,” Woolf said. “We have known for years that the health of Americans is inferior to that of other wealthy nations, but our research shows that the decline in U.S. health relative to other countries began as early as the 1980s.”
Concerning decline The new study analyzed more than five decades of data on U.S. life expectancy. The results showed that, although U.S. life expectancy increased from 1959 to 2014, those figures plateaued in 2011 and began decreasing in 2014. The main culprits behind the decline appear to be drug overdose, alcohol abuse, suicide and a wide variety of organ system diseases among young and middle-age adults, especially individuals who did not complete high school. In particular, declines were seen among people living in some parts of New England, including Maine, New Hampshire and Vermont, as well as those living in the Ohio Valley, which includes Indiana, Kentucky, Ohio and Pennsylvania. These specific regions have been battered by the opioid epidemic and were among the most hard-hit victims of the collapse of the United States manufacturing sector. Indeed, more than one-third of excess deaths since 2010 have occurred in the Ohio Valley states.
In contrast, life expectancy increased for those living along the Pacific coast from 2010 to 2017.
Woolf suspects that the unique drop is U.S life expectancy may be due to lack of support for struggling families. “In other countries, families that “American phenomenon” fall on hard times have programs and services available to cushion the Data from past decades showed blow. In America, people often have that U.S. life expectancy began to to fend for themselves,” Woolf said. lose pace with that of other countries starting in the 1980s, the authors said. Absence of social services may also explain why the study found larger “Historically this [period] was the beginning of the opioid epidemic, relative increases in mortality among the shrinking of the middle class and women, “who have even fewer support systems, and more childthe widening of income inequality,” care responsibilities,” he added. (See Woolf said. related news under Healthcare in a Although many countries expeMinute column). rienced economic shifts in the 1980s,
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
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TAKE CHARGE Get Informed More than 60 million Americans have some form of heart disease. Heart disease is hereditary in some cases. But in many cases, making healthy lifestyle choices may help reduce the risk of getting heart disease. If you have more questions, you should talk to your provider.
Partner with Your Provider To determine whether you have a heart condition, your health care provider will do diagnostic tests and procedures. If you have heart disease or have had a stroke, members of your family may also be at higher risk of having the disease. It’s very important to make healthy choices now to lower risk.
Be Heart Smart A healthy diet and lifestyle are your best weapons in the fight against heart disease. Here are healthy tips that help protect your cardiovascular system. ♥Get Active ♥Eat Better ♥Lose Weight ♥Control Cholesterol ♥Manage Blood Pressure
New to Medicare? Let WellCare help you live healthier. Jason Hollister, Sales Manager 1-716-846-7900 www.WellCareNow.com
Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Source: www.Heart.org.
WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-699-3552 (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務 。請致電 1-877-374-4056 (TTY: 711) 。 Y0070_NA029115_WCM_FLY_ENG CMS Accepted 05242015
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©WellCare 2015 NA_03_15_WC IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 3
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Free Rabies Vaccination Clinic Scheduled In North Buffalo Dog, cat and ferret owners encouraged to protect their pets against rabies
rie County Executive Mark C. Poloncarz and Commissioner of Health Gale Burstein have announced the date for a free midwinter rabies vaccination clinic. The Erie County Department of Health has scheduled this event from 3 to 7 p.m., Wednesday, Jan. 29, at the North Buffalo Community Center, located at 203 Sanders Road off Colvin Boulevard in North Buffalo. “If you own a dog, indoor or outdoor cat or ferret that is due for a rabies vaccination, please plan to come to this event,” said Erie County Executive Mark C. Poloncarz. “This is an important public health initiative, and we will be announcing future dates for spring and fall clinics in the new year.” “Our division of environmental health and the vector control program vaccinated 3,790 animals in 2019,” said Burstein. “For many people, pets are part of the family, and our clinics help to protect pets from a virus that is deadly to mammals and to humans.” Volunteers from the Niagara Frontier Veterinary Society, the Medaille College veterinary technology, the SPCA serving Erie County and Erie County SMART provide important support to run this clinic and others throughout the year. “We’re appreciative of the partnerships we’ve built with these organizations for our rabies clinics,” said Poloncarz. “We see hundreds of pets come through each clinic, and volunteer support makes these events run smoothly.” Any pet is at risk of being
exposed to a rabid wild animal and rabies is always fatal in animals. “Erie County Department of Health identified a total of 24 animals that tested positive for rabies in 2019 in rural, suburban and urban areas of Erie County,” said Senior Public Health Sanitarian Peter Tripi. “At all times of the year, we see bats get into homes as they seek warmth and winter is no exception. Even ‘indoor’ pets can be exposed to rabies. “Our goal is to have 100 percent of dogs, cats and ferrets in Erie County protected from rabies through vaccination,” Tripi added. Erie County residents should contact the Department of Health at 716-961-6800 if they, a family member or a pet is ever exposed to a wild animal, or if they are bitten by a dog or cat.
HIV Testing, Treatment Not Reaching Many Americans
oo few Americans are getting tested or treated for HIV, a new government report shows. “The time is now to end HIV in America. We have the right tools, the right data and the right leadership to get this done,” said physician Robert Redfield, director of the U.S. Centers for Disease Control and Prevention. “Those living with HIV are our best teachers. They are key to helping us reach people where they are so that we can better diagnose and link patients to care,” he added in an agency news release. The CDC Vital Signs report, early December, found that in 2017 about 154,000 people with HIV did not know they had the AIDS-causing virus and didn’t receive HIV treatment to stay healthy, control the virus and avoid transmitting HIV to others. Young people aged 13 to 24 were less likely to know their HIV status than those 25 and older. Only two-thirds (63%) of people who knew they had HIV had the virus under control through effective treatment. Young people and black Americans were least likely to have the virus under control, according to the U.S. Centers for Disease Control and Prevention researchers.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
In 2018, only 18% of the 1.2 million people who could benefit from pre-exposure prophylaxis (PrEP) — a daily pill that prevents HIV — had received a prescription for the medication. Rates were especially low among young people, black Americans and Hispanics. The CDC noted that the report included data from 92% of all prescriptions from U.S. retail pharmacies, but did not include prescriptions from closed health care systems, such as managed care organizations and military health plans. Therefore, PrEP coverage was likely higher than the estimates in the report. Overall, the report shows that progress in reducing new HIV infections in the United States has stalled in recent years, according to the CDC. New HIV infections remained relatively stable, at about 38,000 per year, from 2013 to 2017, the findings showed. The CDC researchers said that health disparities need to be corrected to achieve the goals of the federal government’s proposed initiative, Ending the HIV Epidemic: A Plan for America, which aims to cut new HIV infections by 90% by 2030.
January 2020 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
By Chris Motola
Ranjit Singh, M.D.
All about deprescribing: UBMD Family Medicine physician is part of Team Alice, a group that’s working to reduce the number of pill patients take Q: What’s Team Alice about? A: Team Alice is a research group at the University at Buffalo with faculty from different departments. We have myself and others from the department of family, people from the school of pharmacy and pharmaceutical sciences, people from the department of industrial engineering, as well as experts from other fields. We’ve been working together for the last few years trying to address this problem of older adults taking medications that might do them more harm than good. We got started because of the case of Alice Brennan, who was brought to our attention by her daughter, Mary Brennan-Taylor, a patient advocate and a member of Team Alice. Alice was a lady in her 80s living independently in the community who went to the emergency department because of pain in her neck and was prescribed something called cyclobenzaprine, which is a muscle relaxer. It can be safe for younger people, but for people her age it’s generally known to be unsafe. It still gets prescribed anyway. She didn’t take it right away, but it ended up coming back onto her list when she was hospitalized and she was given it for several days. She started becoming very confused and having hallucinations, not eating, getting sicker and sicker. She eventually got multiple infections in the hospital and died. We take inspiration from the need to do something about future Alices. We know it’s a complex problem and that people get prescribed medications for different reasons without the provider or prescriber being necessarily being aware of the risks. Q: It sounds there are
two parts to the issue: initially prescribing appropriate medications and deprescribing ones that are no longer appropriate. A: Yeah, sometimes people get prescribed a medication that might be appropriate when they’re younger but as they get older someone needs to say it’s not safe anymore or maybe they don’t need it anymore or maybe they still have the problem it was meant to address but we need to try something safer instead. That’s one scenario. The other is that maybe you should never have been prescribed it in the first place. Q: What opportunities are there to intervene before there’s a crisis? A: I think every elderly patient should get their medications reviewed every year by their primary physician.
We’d also recommend doing it anytime there’s a change in their condition. So if a person is hospitalized, that’s a great opportunity to review their medications. Or if they have a change in their mental status, if they’re experiencing mental fog, fatigue. It’s a difficult thing to fit into a physician’s busy schedule, so one of the things we’re looking to do is incorporate a pharmacist into primary care offices. We have to figure out how best to utilize the pharmacist’s expertise. And the last piece is addressing challenges in sharing information between offices. You might get the medication taken off one office’s list, but it’s still on a hospital’s list, so a medication that’s been stopped might be restarted. It’s especially dangerous in hospitals where a patient may not be in the condition to realize what they’re taking. That can lead to problems. We’re working with HEALTHeLINK to coordinate information between offices, so if a patient shows up in one hospital and then a week later in another, the second hospital doesn’t have to repeat the same tests. It’s a good system, but it hasn’t been used to its fullest potential where medicine is concerned. We’re trying to develop a way to get it to keep track of deprescribed medications. Q: I’d guess that patients would generally be happy to be on fewer medications, but are they concerned when you suddenly tell them to stop taking what they were told was an important medication? A: Sometimes because people are in the habit of taking their medications and have been constantly reminded by their providers to take their medication, and have been told they’re going to have to take it for the rest of their lives. That’s not always the case. As your body ages, it changes and may require less medicine or it may need to be switched to something else. Patients are sometimes resistant because it goes against what they’ve been taught. And doctors aren’t necessarily trained to present it to patients in a way that makes sense. “I know I’ve been telling you one thing all these years, but now we need to adjust it.” If it’s explained clearly, most patients are comfortable with it and happy not to be swallowing 20 pills a day. Q: What impact is this having on physician culture, particularly where the idea of medication compliance is concerned? A: I think you’re onto something. The culture has traditionally been “these are the medications, do what the doctor says,” and if you have side effects, you have to put up with them. I think people need to be more willing to ask questions about side effects and how the medication is supposed to help. I think younger patients are already demanding this; older adults seem more inclined to default
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
“We’ve been working together for the last few years trying to address this problem of older adults taking medications that might do them more harm than good.” to the doctor knows best. We are knowledgeable and trained, but we don’t know everything that’s going on with you. It’s important to express your concerns and communicate with your physician. You want to avoid situations where the patient goes home, reads the list of side effects, decides not to take the medication and never tells their doctor. That’s counterproductive. We want the patient to know what benefit they’re potentially getting from the medication as well as what harms could potentially come from taking the medication and decide whether they want to take it. Some patients would rather just do what the doctor says. We want patients to think about and take charge of their health. A lot of medications we prescribe have only a little bit of a benefit and patients believe they have a lot of benefit. Q: That touches on my next question: for cases where there’s no replacement medication, how serious is it to tell a patient to stop a medication? A: It depends on the situation, but it means asking, what are the risks and benefits of stopping a medication? And if the patient stays on a medication, they still need to know how much the medication lowers the risk, and what the side effects are. Q: Potentially loaded question: do you think, in general, we’re over-prescribing medications? A: Overall, I think, yes, especially for older adults. There’s a culture of more medicine is better. I think we overestimate the benefits and underestimate the risks, especially relative to other ways of staying healthy like being more active, socializing more and eating better.
Name: Ranjit Singh, M.D. Position: Physician with UBMD Family Medicine, Associate Professor of Family Medicine in the Jacobs School of Medicine and Biomedical Sciences at UB Hometown: Rothwell, West Yorkshire, UK Education: University of Cambridge; University of Buffalo Affiliations: Erie County Medical Center Organizations: North American Primary Care Research Group Family: Wife (Julie), two daughters (Sarina and Anisha) Hobbies: Table tennis
Lack of Specialists Doom Rural Sick Patients Research finds higher death tolls, more hospitalizations in small town USA
esidents of rural areas are more likely to be hospitalized and to die than those who live in cities primarily because they lack access to specialists, recent research found. The study, led by Kenton Johnston, Ph.D., assistant professor of health management and policy at Saint Louis University College for Public Health and Social Justice, looked at data from Medicare patients who have chronic health problems. The paper was published in the December 2019 issue of Health Affairs. “People on Medicare with chronic conditions such as heart failure or
diabetes who live in rural areas have higher death and hospitalization rates than their urban peers,” Johnston said. “The biggest reason for this appears to be that people in rural areas have less access to specialist physicians like cardiologists and endocrinologists.” Johnston and his coauthors urge policy makers to target innovations to bring more specialist care to rural areas. Some of the strategies they suggest are: • Expanding telemedicine in key areas, such as cardiology, to provide
routine specialty care visits through technologies such as video conferencing; • Adding incentives for physicians to practice in rural areas such as loan forgiveness; • Considering differential payment rates that offer specialists who practice in rural areas more money; • Incentivizing rural and urban hospitals partnerships; • Bringing urban specialists into rural health systems on certain days of the week. Researchers examined 2006-2013 data from Medicare claims of patients in rural and urban areas who have heart disease, diabetes and other complex chronic conditions. They linked the claims to health care supply data from hospitals that was provided by the Dartmouth Institute for Health Policy and Clinical Practice and determined rural-urban classifications using a Health Resources and Services Administration database. The researchers defined a rural area as any town with fewer than
10,000 people, and found that 10% of Medicare beneficiaries lived in such areas. Patients who saw a specialist at least once in addition to a primary care provider compared to those who saw only a primary care provider were 15.9% less likely to be hospitalized for a preventable cause and 16.6% less likely to die. Preventable hospitalizations were highest in rural areas and lowest in metropolitan areas. Residents of rural areas had 40% higher rates of preventable hospitalizations and 23% higher mortality rates than their metropolitan counterparts. Their findings have implications for all Medicare patients with chronic conditions, Johnston said. “Our research shows that all Medicare beneficiaries with chronic conditions--urban and rural--have lower death and hospitalization rates when they visit a specialist at least once annually,” Johnston said. “Primary care is important, but it is not enough by itself; specialist care is needed as well.”
been cardiovascular, cancer and musculoskeletel. Sixty-seven percent of the respondents also believe costs are driven by inappropriate or unnecessary care.
considers your selected hospital out of network. Also, prices do not reflect outcome. Since most hospital admissions are elective, your physician, for a lot of reasons that have nothing to do with price, will have strong preferences for a particular hospital for your particular procedure. I suspect this well-intentioned rule will push us even faster to a single payer system like the one in Canada.
Healthcare in a Minute
By George W. Chapman
Life Expectancy in the U.S Has Peaked
ur average life expectancy increased almost nine years from 70 years in 1959 to 78.9 years in 2010. Then it leveled off and started to trend downwards from 2014 through 2018. It’s expected to be 78.9 this year, just as it was nine years ago 2010. Those of us between 25 and 64 incurred the largest increase (6%) in mortality, according to a study in the Journal of the American Medical Association. The leveling off of our life expectancy over the past decade has been due primarily to drug over doses, suicide and obesity. Other high -income, developed countries
that spend far less on care than we do on healthcare, have not experienced our leveling off or peaking. Fatal drug overdoses increased 386% between 1999 and 2017. Deaths due to obesity increased 114% and deaths due to hypertension increased 79% over the same years. The majority of us are obese and 80% of adults do not meet basic physical activity guidelines. Researchers conclude life expectancy is not only impacted by medical conditions. Social drivers like income inequality and mental distress are in play as well. (Editor’s note: See related story in this issue).
Fraud recoveries up
will pay out-of-network providers a reasonably fair amount. Not surprisingly, the top specialties for out of network claims or “surprise bills” are typically related to a hospital stay or ER visit: emergency medicine, pathology, anesthesiology, radiology, surgery. Surprise billing typically occurs under two scenarios: local private providers simply do not elect to participate in your insurance plan or the providers are employed by an out of area national or regional company that doesn’t participate. Surprise billing occurs more frequently with rural hospitals that often resort, out of necessity, to contracting with out of town physician placement firms.
Government agencies (Office of Inspector General and Department of Justice) have recovered nearly $6 billion in fraudulent provider claims this year compared to about $3 billion in 2018. Recoveries were across the healthcare gamut including a $43 million settlement regarding genetic testing fraud and a $700 million settlement from a drug company over the fraudulent marketing of the opioid addiction drug Suboxone. Both the OIG and DOJ expect recoveries to decrease as providers realize that the government has gotten serious about investigating healthcare fraud and abuse and has dedicated more resources to such.
Congress has been addressing this issue recently. Consumers are often unaware that particular providers, usually related to a hospital admission or ER visit, do not participate in their insurance plan, although the hospital does. This results in a “surprise bill” from out of network providers for the balance due after payment from the insurance company. Most insurance companies
Cost of care in 2020
A survey of 296 insurers in 79 countries reveals employer-sponsored insurance costs will rise an average of 7% globally. Forty percent of the respondents believe rates will increase by more than 7% for at least three years after 2020. Twenty-seven percent believe mental health conditions will break into the top three conditions driving up costs over the next five years. The top three conditions driving costs historically have
Physician shortage addressed
Congress controls the number of residents in hospital residency programs. In turn, Medicare reimburses hospitals for costs associated with their residency programs. Despite the anticipated physician shortage, there has been virtually no increase in the number of approved residency slots since the 90s. There are two bills addressing the MD shortage. The Resident Physician Shortage Reduction Act would add and pay for 15,000 additional residency slots over five years starting in 2021. The Opioid Workforce Act would add another 1,000 residency slots, over five years, specifically for addiction medicine, psychiatry and pain management.
Hospital price transparency rule
(WARNING: Reading the following could cause severe confusion, helplessness and an urge to move to Canada.) In a well-intentioned effort to help consumers make informed decisions and to create real price competition among hospitals, Medicare has given hospitals until 2021 to post their “standard charges” which include: gross charges, discounted cash prices, payer-specific negotiated rates, de-identified minimum negotiated charges and de-identified maximum negotiated charges. Hospitals are also required to post their charges and payer specific negotiated rates for 300 “shoppable services.” (Did you get all that?) Besides fueling consumer confusion and suspicion about healthcare costs, this rule will be a nightmare for hospitals to comply. Shopping prices in healthcare sounds good, but it will be a wasted effort if your physician does not have admitting privileges at your selected hospital or your health plan
January 2020 •
Speaking of Canada
Despite having to wait months to see certain specialists, and the consequential $2 billion lost in annual wages, Canadians are fiercely defensive when it comes to their healthcare. The outcome statistics that ultimately matter the most are: Canadian life expectancy is 82 vs. 79 in the US; their death rate from treatable causes is 59 per 100,000 versus our 88; their infant mortality rate is 4.5 per 1,000 births versus 5.8 for the US. Rural hospitals and physicians fare better in Canada vs. the US because everyone that presents for treatment is a paying customer.
2020 Medicare Premiums
The standard Part B (physician) monthly premium is $144.60, up about $9 from 2019. The annual deductible is $198. Most seniors will have the Part B premium automatically deducted from their social security checks. The Standard Part A (hospital) monthly premium is $0 because this was paid by you through payroll taxes. If you are hospitalized, your deductible is $1,408. There are daily copays after 60 days. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at firstname.lastname@example.org.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
It’s easy on the joints. With
bone density and joint support decreasing as we age, Zumba’s low-impact workout is easy on the knees. However, you can wear soft knee braces during class for extra protection if you feel you need it. The good news is if you attend classes regularly, you’ll notice increased flexibility over time and a wider range of motion.
Boosts self-confidence. Zum-
ba involves self-expression through dance and a deeper sense of your body’s abilities. After doing it for a while, I began to feel better about my overall health as I built up my cardiovascular fitness and toned my body, which in turn boosted my self-confidence.
12 Surprising Benefits of Zumba Workouts When workouts are fun, we look forward to them, rather than dread them By Marcia Kester Doyle
ive years ago, a few of my friends told me about a new gym nearby and raved about Zumba, a dance-based fitness class that combines aerobic exercise with resistance training. Zumba classes are popular throughout the country. My friends’ enthusiasm for the program piqued my interest, and although I found the competitive nature of most co-ed gyms intimidating, I knew I needed to do something before I ultimately succumbed to living like a sloth. The first Zumba class I attended was filled mostly with women of all shapes, sizes and ages in a body-positive atmosphere that immediately put me at ease. The philosophy behind Zumba is to have fun while you exercise; to embrace your body and to feel good about yourself while you’re dancing. No matter where you live, the classes are designed to make you feel happy and healthier rather than worrying about your appearance. To my surprise, after a few weeks of attending classes, I discovered that Zumba was not only an enjoyable way to exercise, but also had multi-
ple benefits that improved my physical and mental wellbeing. Since I started doing Zumba, I’ve learned how to salsa, mambo, samba and merengue, and I have more energy now than I ever imagined I would at 60. Here are 12 benefits you can look forward to when you join a Zumba class:
Fun while you exercise. Zumba
is an enjoyable way to improve your physical health in an energetic, upbeat atmosphere. The classes promote body positivity, with an emphasis on having fun and feeling good about yourself. The idea is that you don’t have to look or move like others in the class, because there is no right or wrong way to dance. I don’t feel like anyone in the class is watching or criticizing me; they’re focused on their own workout and having fun. And, because it’s fun, the hour goes by quickly, which makes me look forward to exercising, rather than dread it. This helps me stick to a healthy workout routine instead of making excuses to skip the gym.
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workout, gets your heart rate up, which helps you maintain a healthy cardiovascular, respiratory system. It’s also great for building endurance since most of the songs played during class are around 145 beats per minute.
Total body toning. The classes engage every muscle group in specific dance moves, along with squats and twists to tone your entire body.
Weight loss. If your goal is to
lose weight, Zumba workouts help to increase your metabolism, burning 600 to 1,000 calories per class (the rate varies depending on the intensity of your workout). A faster metabolism equals faster results in weight reduction.
Improves balance, coordination and posture. As with most
forms of dancing, your limbs are moving in different directions, and that takes coordination. You might feel awkward doing it at first, but the more you practice, the better you’ll get at following the dance steps and developing a sense of rhythm.
Uplifts mood and relieves stress. Cardiovascular exercise
releases the highest amount of mood-improving endorphins and neurotransmitters that can signal positive thoughts and eliminate stress. Zumba also helps boost energy levels, improving both alertness and concentration — something many of us feel a decrease in as we get older.
410 Mill St. - Williamsville,NY 14221
The cardio is good for your heart. Dancing, like any cardio
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
You can exercise at your own pace. With Zumba, you can
modify the movements to suit your level of comfort. As your ability improves, you can increase your workout level in a more advanced class.
Keeps the brain sharp. The dance patterns of Zumba challenge your hand-eye coordination and right-left brain activity. Similar to dancing the Macarena, your arms are doing something entirely different than your legs and these movements require good memory skills to repeat the sequenced steps correctly.
Variety of class types. There are different classes for every level in Zumba, so it’s easy to find one that will suit your needs. Some of these options include: the standard Zumba class, the most common type with a combination of ages from young adult to 70 and older; Zumba Gold, for older adults; Aqua Zumba, a workout done in a pool and STRONG by Zumba, for spot toning.
Encourages social interaction. This has been my
favorite part of Zumba. I’ve met a lot of fun people who share the same health goals as me, and I’ve made friends. If you’re still feeling a bit intimidated about joining a class, there are plenty of free Zumba videos online to help you practice and get accustomed to the movements. Experts recommend that you do three to four classes per week to receive the full benefits of the workouts. I would also suggest bringing a friend with you to class — the more, the merrier! Zumba has been a game-changer for me, physically and mentally. I’ll always be grateful to my circle of friends who convinced me to dust off my sneakers and salsa my way to a healthier life. Marcia Kester Doyle is the author of the book “Who Stole My Spandex? Life In The Hot Flash Lane.” This article first appeared in www.nextavenue.org. Reproduced with permission.
In Good Health — WNY’s Healthcare Newspaper
Fitness That will be a shift, too. women’s empowerment will continue to be big. • “Beach Body on Demand, like Netflix for fitness, will continue to grow. • “People will want to do things they like. People often start on their kicks in January and give up by February because it’s not sustainable.” Brian DeLuca, physical therapist, director of Physical Therapy and Impact Sports Performance at UBMD Orthopaedics & Sports Medicine:
Fitness Trends for 2020. What’s Hot, What’s Not By Deborah Jeanne Sergeant
erhaps one of your New Year’s resolutions is to get fit. If so, check out the trends area experts predict as becoming more popular in 2020. Phil Haberstro, executive director, The Wellness Institute of Greater Buffalo: • “Consumers today are taking a much more holistic look at fitness and wellness. They’re blending into that the mental, along with the physical and social elements. In that sense, improving the health and wellbeing of communities, we’re also looking at the environment and social side and economic element and the personal choices people make from a behavior standpoint. • “There has always been tension between personal choice and societal responsibility but we’re recognizing
more and more that it takes both. If a person determines they want to improve their health, it’s well recognized they need to be physically active. Moderate doses of regular physical activity have health benefits. What I’ve seen in my professional career is an evolution of physical activity. It started with military readiness with WWII. We went from military to fitness to physical activity and now it’s active living, integrating regular doses of physical activity into your daily living. • “Walking will be the major trend. We see in the literature all the time about ‘walkable communities.’ Walking is the number one physical activity in the world. It’s recognition from a marketplace, where do you get the most bang for your buck? You get it from a society that’s physically active by walking.
• “Lifespan wellness is another trend. In schools, we now have district wellness policies. If you look a Centers for Disease Control and Prevention research, there’s an increase in work promotion of wellness. World Health Organization and AARP have adopted age-friendly community initiatives. • “Another thing we’re seeing in trends with children is the idea of active kids. Children with their parents and families do sampling of different activities. That supports lifelong physical activity. That is the paramount piece. • “We’re also seeing in trends is the growth of trails and parks.” Lucy Connery, health promotion specialist, Wellness Institute of Greater Buffalo: • “Yoga and Pilates are becoming bigger. • “For cardio, instead of running on the treadmill, more people want alternative things like cardio kickboxing and things that are more exciting. • “We’ll see more weight lifting and lifting heavier, especially among girls. They’re lifting heavier weights.
New Fitness Trends to Help You Achieve 2020 Health Goals
f you need some motivation to achieve your 2020 fitness goals, consider incorporating one or several of these new fitness trends from the American College of Sports Medicine (ACSM). From wearable tech to fitness programming to health and wellness coaching, ACSM’s annual fitness trend forecast can help you. Plus, the trends might even spark ideas for last-minute holiday gifts. From activity trackers to heart rate monitors to devices that do both and much more, the newest wearable tech offers sophisticated tools to record steps per day, distance run and calories burned. Wearable tech can also support weight management efforts. Setting a daily step goal and using a basic activity tracker to monitor your progress is an easy way to
HIIT can be good for aging women who struggle with weight gain and are at greater risk of age-associated muscle loss. Beginning exercisers should start slow. Group training offers a great solution if you want to try new types of exercise. These classes provide motivation, encouragement, a sense of community and a chance to learn proper techniques from instructors. These classes are good for beginners and experienced exercisers.
get started moving more and sitting less. High-intensity interval training (HIIT) uses repeated cycles of short exercise alternated with rest. Sessions typically last less than 30 minutes yet lead to fitness improvements.
January 2020 •
• “I see a trend toward younger athletes and older adults involved in formal strength conditioning program to complement the skilled sports training piece. • “Older adults are looking to stay more active into their retirement years versus going to a gym where there’s an open membership. They want structured training classes in small groups or with a personal trainer. People are looking to be healthier later in their years. • “There’s still college aged and middle aged seeking more intense and challenging training environments. The fitness industry is becoming more specialized. Some clients are involved in more intense groups like HIIT or group training. That’s the more popular training. People want to work harder in a group setting where they’re pushing themselves alongside other people. • “Employers are wary as they’re seeking people to hire. They’re looking for more exclusive licensure. We only employ certified strength and conditioning specialists. That’s trickling down into the fitness centers. Personally, I look for individuals with a clinical background. • “Cross Fit is still popular. It has the technique and physical demands of sports, but it has the inherent risks of Olympic lifting. Cross Fit gyms are doing a better job of ramping up their clients slowly so they don’t get an injury.”
Strength training can make everyday activities easier; help maintain bone health and promote weight loss. Personal training. Oneon-one training with a certified personal trainer or exercise physiologist can help you learn proper techniques, try new exercises and keep you accountable. A well-rounded fitness assessment from your exercise physiologist and subsequent tracking over time can help you adjust your training and diet to reach your goals and optimize performance. Body weight training. Popular for building strength and endurance with minimal equipment, body weight training focuses on dynamic movements to build strength and endurance. This type of training can be done almost anywhere, which is great for your budget and home workouts. Remember, whether you decide to incorporate one, several or none of these fitness trends, make sure you find time to be active. Health and fitness will always be trendy!
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Resolve to Take Good Care Of You In 2020
his morning, as I do every morning, I got up early, made a cup of tea and spent some important “me time” in mindful meditation. This daily routine helps clear my mind and launch my day with a more generous heart. Meditation is one of many ways I take care of myself. But that hasn’t always been the case. After my divorce, I adopted a “What’s the point?” approach to caring for myself and my home: What was the point of getting up early, meditating, exercising, eating healthy meals or putting on lipstick when no one was watching? Who cared whether I made my bed or combed my hair? It’s not uncommon for people who live alone to fall into a “What’s the point?” frame of mind. Leaving the dirty dishes in the sink or wearing your pajamas all day may seem harmless, until you consider the impact these acts of indifference can have on your self-confidence and sense of self-worth. Taking good care — very good care — of yourself is about the value of you. It’s about your intrinsic value to yourself, to your family, and to those you encounter throughout your day. It’s an essential part of feeling
good and living alone with success. Here are some of the benefits: It builds self-esteem: When you take good care of yourself you send an important message to yourself that you are worth treating well, cleaning up after, fussing over and protecting. When I come home after a busy day and walk through my front door, I am reinforced when my house is tidy and the kitchen sink is empty. It means I care enough about myself to maintain an inviting home, even if it’s just for me. The appearance of my home is a visible, tangible barometer of how I value myself — and, this is just one of many examples. My self-esteem gets a boost whenever I exercise discipline and do the things I know will deliver positive and self-affirming results. It looks good on you: When you treat yourself with love and respect, it shows and people notice. It opens up your world. During my “What’s the point?” period — my blue period — I would leave the house without paying much attention to my appearance. My sorry, baggy attire was only
s d i K Corner
Study Finds Children Log Excessive Screen-Time Study shows average time children spend in front of screens increased from 53 minutes per day at 12 months to more than 150 minutes at 3 years
study conducted by the University at Albany, the National Institutes of Health and New York University Langone Medical Center uncovered several new findings about the amount of time children spend watching television or using a computer or mobile device. Published in JAMA Pediatrics, the study found that the average time children spend in front of screens increased from 53 minutes per day at 12 months to more than 150 minutes Page 10
at 3 years — time periods that greatly exceed recommendations from the American Academy of Pediatrics (AAP). AAP recommends that digital media exposure should be avoided for children under 18 months of age, introduced slowly to children 18 to 24 months of age and limited to an hour a day for children from 2 to 5 years of age. Additional findings include: • 87 percent of children had
made sorrier by the dour expression on my face. Needless to say, I didn’t turn many heads nor invite connection with others. But, those were the old days. Today, I take more care. When you care about yourself inside and out, you radiate vitality. It’s intriguing. And it may draw people, compliments and unexpected connections and opportunities your way. Life can be richer. It enables you to better care for others: When your own needs are met and you feel happy with yourself, you are better able to respond to the needs of others. I like the familiar “airline” example: When traveling by plane, we are all given instructions on how to use an oxygen mask in an emergency. We are cautioned to put ours on first if we’re traveling with a child or dependent person. The reason is obvious: if we don’t put our mask on first, we risk passing out and putting both lives in jeopardy. One of the best things you can do for others is to take care of yourself. That way, you’ll be better able — both physically and emotionally — to help your friends and family when they need you. It is essential to your health: Eating healthy, enjoying a good night’s sleep, getting regular health check-ups, and exercising can all contribute to feeling good and alive. But living a healthy lifestyle can be a challenge for those who live alone. Without a partner to coax or inspire you, it’s easy to become complacent. I was having an awful time sticking to my exercise routine, so I decided to become a group exercise instructor. I knew I needed the “obligation” of leading a class to force myself to show up. screen time exceeding recommendations from the American Pediatric Academy. • Children were more likely to be in the highest percentile of screen time exposure if their parents had only a high school diploma or equivalent (more than twice as likely) or were children of first-time mothers (almost twice as likely). • Compared to single-born children, twins were more likely to belong to the highest screen time group. • Children in home-based care, whether provided by a parent, babysitter or relative, were more than twice as likely to have high screen time than those in center-based care. • While screen time increased throughout toddlerhood, by age 7 and 8, screen time fell to under 1.5 hours per day. The researchers believe this is due to time consumed by school-related activities. The team, including Erin Bell, professor of environmental health sciences at UAlbany’s School of Public Health, analyzed data from the Upstate KIDS study. Upstate KIDS, an ongoing cohort-based study co-led by Bell, tracks the ongoing growth, motor and social development of more than 6,000 babies born to 5,000 mothers between 2008 and 2010 in 57 counties of Upstate New York. For this particular study, mothers of nearly 4,000 Upstate Kids participants responded to questions
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
Believe me, I wouldn’t be going to the YMCA as often had I not become an instructor. It was one way of taking better care of my physical health and it worked! What might work for you? It is rewarding: Self-care can lead to self-discovery. Like anything else, learning how to care for yourself can reveal opportunities for personal growth and fulfillment. It can be fun and it can take you places far and wide. Again, another personal example: I’ve discovered after years of living alone that just like meditation and exercise, travel is an essential part of my self-care routine. Even in retirement, I can go into overdrive and become overwhelmed with life’s demands. Solo travel gives me time to relax, think and re-balance my priorities. Whether it’s a weekend getaway or long vacation, I return rejuvenated and ready to take on what’s next. However you practice self-care, do so with steadfast resolve. As long as you put yourself first and focus on your overall well-being, you’ll enjoy the blissful benefits. Taking good care of yourself can help you acquire the personal strength, resilience, and energy you need to create or re-invent a life that you truly love and live with gusto.
Gwenn Voelckers is the founder and facilitator of “Alone & Content” empowerment boot camps for women held throughout the year in Mendon. She is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about her boot camp, to purchase her book, or invite her to speak call 585-624-7887, email email@example.com on their children’s media habits when they were 12, 18, 24, 30 and 36 months of age, and then to similar questions when the children were 7 and 8 years old. The study compiled additional demographic information on the mothers and children from birth records and other surveys. “This collaborative study led by our colleagues at Eunice Kennedy Shriver National Institute of Child Health and Human Development has made it clear that screen habits are developing earlier than recommended,” said Bell. “Given the concern that increased screen-time may impact child development, our results suggest an important need to develop strategies for reducing children’s screen time at very young ages to better meet the current AAP screen-time recommendations.
those habits,” says Pelitera. “It’s easy to say you don’t have time to exercise if it’s not been part of your daily routine. So, what you need to do is plan for it. Block off time on your calendar for the time of day when you know you’ll be able to keep the commitment — it’ll get easier once you’re in your new routine.” Pelitera recommends working with a professional when you start new exercise and dieting routines. “A professional will design a plan using exercises that will achieve your desired goals, and will show you proper form so you avoid injury and frustration.” ‘Why do most New Year’s resolutions fail? The reasons vary, but many people fail because they make resolutions that are too broad or too vague.’
Making New Year’s Resolutions That Stick By Nancy Cardillo
ew Year’s Eve is seen by many as a time for self reflection, an opportunity to assess their lives and decide what to change in the new year so as to achieve greater health and happiness. Think of it, if you will, as a personal reboot. If you’ve made resolutions for the new year, you’re not alone. More than half of adult Americans will start 2020 by making at least one resolution. The most popular New Year’s resolutions in 2019, according to inc.com, included: • diet or eat healthier • exercise more • lose weight • save more, spend less • quit smoking Are any of these on your resolution list for 2020? If so, good for you! You’ve taken the first step toward a happier, healthier you. Now, the hard part: making those resolutions stick. Because while millions of Americans will make resolutions with the best
intentions, just a fraction will actually keep them longer than a month or so. Why do most New Year’s resolutions fail? The reasons vary, but many people fail because they make resolutions that are too broad or too vague, such as “I want to lose weight” or “I want to start exercising.” Others set goals that are too difficult to achieve, such as “I’m going to start running five miles a day.” “You’re better off starting small and more realistically, particularly if your resolution is a new habit for you,” says Charles Pelitera, assistant professor and director of health and wellness at Canisius College and owner of Pelitera’s Fitness and Performance Center in North Tonawanda. “Commit to walking one mile a day, then periodically increase the distance you walk, the intensity of your walk [possibly jog] or the number of days [frequency] you walk.” Time is also a factor in not keeping resolutions. “We all develop habits, and it can be difficult to talk ourselves out of
Yoga HIIT Can mixing an ancient practice with modern high intensity interval training work? By Deborah Jeanne Sergeant
igh intensity interval training (HIIT) offers an easier way for busy people to find time for a workout, as it involves short bursts of as-fast-as-you-can-go cardiovascular exercise alternating with slower intervals. Most HIIT sessions are short. Yoga HIIT uses yoga poses during the slower intervals. But can mixing an ancient practice with modern HIIT provide participants a good workout? Phil Haberstro, executive director of The Wellness Institute of Greater
Buffalo, sees the addition of yoga to HIIT workouts as helpful for people seeking a cardiovascular workout. “Lots of people jump right in and it may be too intense if they’re not fit,” he said. “They need to have the proper warm-up and work on flexibility. Having flexibility as part of the intervals can improve it.” Yoga can help people become more limber and in time increase their overall balance and flexibility. Maintaining good balance and flexibility improves healthy aging. Yoga HIIT may offer partici-
Is this the year you finally quit smoking? According to the Center for Disease Control, seven out of 10 adults who smoke say they want to quit completely. It’s not easy: cigarettes contain nicotine, a drug naturally found in tobacco. Nicotine is just as addictive as heroin, cocaine or alcohol, yet more people in the United States are addicted to nicotine than any other drug. “We’ve come a long way in helping people understand that smoking is a physical and psychological addiction,” says Paula Celestino of Roswell Park Comprehensive Cancer Center’s Cessation Services, which administers the New York State Smokers’ Quitline. “The good news is there are available treatments that do work.” Celestino, who has a Master of Public Health degree, says the best way to quit is to combine support from family, healthcare professionals and a quit coach with FDA-approved medications, such as the nicotine patch, nicotine gum or prescription non-nicotine medications. The key, she says, is to make sure you’re taking the proper amount of meds that will work for your level of nicotine addiction. Celestino also stresses it’s never too late to quit smoking. “You will gain health benefits within minutes of quitting, no matter how long you’ve smoked,” she says. “You’ll decrease the risk to your pants some benefits if they have a hit plateau in their fitness, since injecting yoga poses into the cardiovascular regimen adds a whole new dynamic to the workout, especially if they have never tried yoga before, according to Brian DeLuca, physical therapist. DeLuca is a certified strength conditioning specialist and director of physical therapy and impact sports performance at UBMD Orthopaedics & Sports Medicine. He also sees a few disadvantages of cramming together two practices that are so different as yoga and HIIT training. “With both time and money constraints, you see clients wanting combo classes but it may dilute the value of yoga,” DeLuca said. “Yoga to me is about the mental and emotional benefits. It includes meditation, and relaxation is restorative. When you incorporate intense interval training, it doesn’t fit.” But DeLuca understands that time constrains is why some people may want to try yoga HIIT. “It’s what the market wants,” he said. “You have to be careful you don’t combine too many things, but
January 2020 •
How do you make those resolutions stick? Here are some tips: n Approach resolutions honestly. Don’t bow to pressure or guilt. Figure out what is most important for you and set goals accordingly. n Start slowly. Setting too many goals at once can get confusing and frustrating. Start with the goal that will benefit you the most and add in other goals as you progress. n Keep it simple. Set specific and attainable goal: lose 10 pounds by June to fit into a bridesmaid’s dress or cut back to one pack of cigarettes a week. n Set yourself up for success. Rid your kitchen of trigger foods and replace with healthier options. Cook healthier meals and freeze them, so you’re less likely to binge. Sleep in your gym clothes, place your alarm on the other side of the bedroom so you get up and go. n Track your progress. There are apps and online programs that make it easy to track your progress, and noting your achievements can be very gratifying. n Be accountable. Tell your family and friends your goals. Post your progress on your social media accounts. Acknowledge your setbacks, but also celebrate even the smallest of achievements toward your goal. n Be patient. You won’t achieve your goals overnight and you shouldn’t. The smarter, healthier way is to do so slowly. Lose a pound a week. Eliminate one bad food item per week from your diet. Walk, don’t run. Make 2020 a healthier, happier year for you — you deserve it!
heart, improve other chronic conditions, such as high blood pressure and asthma, and if you have cancer, quitting can also improve the effectiveness of your cancer treatments. For more information on quitting smoking, visit nysmokefree.com or call 866-NYQUITS (866-697-8487). you can’t spend all day working out.” Since many yoga poses involve stretching and body weight strengthening, yoga brings to HIIT fitness those aspects that HIIT may not otherwise include, especially for those who feel short on time. For people who practice yoga very traditionally, yoga HIIt may seem a turn-off since the two are so different. Springing up to pop off two minutes of jumping jacks after performing downward dog doesn’t encourage the meditative side of yoga, for example. “I’m not sure how I’d feel about them being together,” said Lucy Connery, health promotion specialist at Wellness Institute of Greater Buffalo who is studying for her Master’s in Public Health at Daemen College. “I’m not sure how much of a recovery the yoga would allow. Traditionally, since HIIT and yoga are two opposite sides of the spectrum, I can see lots of people wanting to integrate both. People opting for yoga HIIT are likely more interested in the physical benefits of yoga than any emotional or spiritual benefits.”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Intuitive Eating Yes, this is a thing when it comes to dieting By Deborah Jeanne Sergeant
n eating plan that says to eat when you want, treats no foods as “good” or “bad” and doesn’t require tracking calories, points or food measurements — it all sounds like a dream come true for people struggling to manage their weight. But that’s intuitive eating, the non-diet eating plan. Popularized in 1995 by the book “Intuitive Eating” by Evelyn Tribole and Elyse Resch, intuitive eating has come back into vogue by influences and themes as diverse as mindfulness, body acceptance (versus body shaming), enjoying whole foods and local foods and finding a pleasurable physical activity instead of a brutal exercise regimen. Danielle Meyer, clinical director of the dietetic internship program in the department of exercise and nutrition sciences at University at Buffalo School of Public Health and Health Professions, finds some merit in listening to the body’s needs. “We’re trying to come away from the ‘diet,’” Meyer said. “It has a lot of negative ideas attached to it.” She promotes mindful eating and eschews the idea of cleaning the plate and eating just because it’s a socially approved mealtime instead of looking for cues of hunger and satiety. By focusing on whole foods and sufficient produce, the body can more readily signal satiety and natu-
ral portion control. “We feel better when we eat well,” Meyer said. “We have to recognize that feel. Any diet like cabbage soup or if you eat only one thing, you’ll detest it. If you like grapefruit but have to eat one a day, you’ll hate it. Those kinds of diet that look into restriction and denial, we don’t use. If you have to reject an entire category of food, that’s a red flag as to what you shouldn’t follow.” Natalie Robertello, registered dietitian, owner of Fit For You in Buffalo, also works through UB Orthpaedics. She said that intuitive eating is about “bringing it back to simple basics and takes complication and anxiety out of food choices.” As most dietitians, Robertello wants to see patients adopt a lifelong healthful eating plan. She views intuitive eating as a good example since it isn’t rigid and also helps patients work on the emotional factors tied to eating and body image. “It’s saying if you want chocolate cake, you have a slice, but that doesn’t mean you have one every single day of your life,” she said. As effective as intuitive eating can be to help people eat better for life, it’s also important to note its caveats. Someone whose poor eating habits have contributed to weight gain may need guidance from a dietitian to learn what foods should
constitute the majority of the diet. As Meyer indicated, that can help the body tune into true hunger cues and not cravings and help prevent overeating. Mary Jo Parker, registered dietitian and owner of Nutrition and Counseling Services Nutritionist in Buffalo, said that people with a history of eating disorders or obesity may feel out of touch with hunger cues and proper food portions. “For a time, measure food and establish a consistent pattern to see if the body will respond by giving the person the signals to recalibrate the hormones that are responsible for giving those hunger signals,” Parker said. “That’s usually what I find as the biggest issue with intuitive eating.” She added that one of the hardest parts of intuitive eating is making peace with food and activity and viewing them as contributors to good health instead of sources of struggle. For people with food addictions not simple cravings, but stemming from a personality that exhibits addictive traits intuitive eating may be trickier.
Slow Cooking a Recipe for Weight Loss? By Deborah Jeanne Sergeant
low cookers such as Sunbeam’s Crock-Pot may be used for far more than beef roasts with carrots and potatoes. Especially for busy people, the slow cooker can make it easier to eat better and maintain healthful weight. It can encourage more careful meal planning instead of swinging through the drive-through on the way home from work. Slow cooking takes some preparation; however, the cooking is all done by early evening without any additional work. Using liners inside the cooking well — the part where the food goes — makes clean-up a breeze. “Traditionally, people think it’s more for comfort meals,” said Natalie Robertello, a registered dietitian and owner of Fit For You in Buffalo who works at UB Orthpaedics. She said that as long as the slow cooker meals can fill half the plate with veggies, one-quarter with protein and one-quarter with carbohydrates, that’s pretty healthful. Using plenty of vegetables and beans boosts nutrition and also lowers calories in soup. Robertello likes making dishes in her slow cooker like minestrone soup, spaghetti squash with a meat ragu and turkey chili. “The Crock-Pot for me is the only Page 12
way I get through the week with a busy schedule,” Robertello said. “It’s all done for you and the leftovers are great. I make a whole lot of soup.” She also makes overnight baked oatmeal with steel cut oats, which take longer to cook, along with a few egg whites for protein. That provides her with a healthful breakfast--a much better way to start the day than grabbing a doughnut or other unhealthful item. Danielle Meyer, clinical director of the dietetic internship program in the department of exercise and nutrition sciences at University at Buffalo School of Public Health and Health Professions, said that slow cookers have many benefits and a few caveats, too. “Just because it’s in a slow cooker doesn’t mean it’s healthful,” she said. “Look at the cuts of meat. A really cheesy recipe won’t be the healthiest one. Watch creamy sauces. Go with broth-based soups. Chili is something you can make it healthful with beans, 93% beef or turkey. You can cut up all kinds of vegetables, like carrot, sweet potatoes, squash.” Though slow-cooking meat does make it very tender — even the cheapest cuts — people who want to lose weight and include more vegetables in their diet should use meat as a seasoning instead of the star of
the show. Scaling back other certain ingredients also helps. “What’s important there is not to fall into the trap of heavy, fatty casserole type of dishes in the CrockPot,” said Mary Jo Parker, registered dietitian and owner of Nutrition and Counseling Services Nutritionist in Buffalo. “If you rely on a lot of pasta, cheeses and butter and heavy ingredients, you’re going to end up with a calorically dense meal which can lend itself to increased weight.” The nature of slow cooking causes any meat or seasoning used in
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
“People who have this propensity feel safer if they have more of a routine and regimen rather than feeling a little freer with it,” Parker said. “Apart from that, ultimately, we do want to be able to trust our bodies to tell us. All foods should be fair game. All foods should be on an even playing field to demystify and take some off a pedestal to get people out of that diet mentality.”
The 10 principles of Intuitive Eating 1. Reject the Diet Mentality 2. Honor Your Hunger 3. Make Peace with Food 4. Challenge the Food Police 5. Respect Your Fullness 6. Discover the Satisfaction Factor 7. Honor Your Feelings Without Using Food 8. Respect Your Body 9 Exercise—Feel the Difference 10. Honor Your Health SOURCE: www.intuitiveeating.org
the recipe to permeate the vegetables in the crock. Parker said that factor can help people who aren’t so fond of vegetables to eat more of them. Pre-made sauces tend to be high in sodium, as are seasoning mixes and canned beans. Rinsing beans can help reduce the sodium. Or use dried beans that have been prepared according to package directions. “I encourage patients to think about making soups in the winter,” Parker said. “You can do a lot with low sodium broth. It’s a good start. Add lots of different vegetables. You can puree everything and make it creamier that way without a lot of fat.” If you need inspiration for using your slow cooker more, visit www. crock-pot.com/recipes.html.
By Anne Palumbo
The skinny on healthy eating
Heads Up: Green Leaf Lettuce Teems with Nutrients
he desire for “clean eating” consumes many of us in January. After weeks of indulging in rich holiday foods, we’re anxious to get back in the saddle of healthier eating. Salads can help pave the way. Flavorful and nutritious, a healthy salad can fill you up without filling you out, with the key here being “healthy.” Many of my salads include green leaf lettuce and here’s why: its curly leaves have a unique buttery flavor; it hasn’t been dogged by E.coli contamination; and it’s remarkably nutritious. Plus, because of its pliable texture, I often use it to wrap other foods, creating a healthy wrapper that’s low in both carbs and calories. Although lighter in color than some of the dark-green heavy-hitters, green leaf lettuce still packs an impressive good-for-you punch. Looking to shore up your bones? An average serving of green leaf lettuce delivers over 100% of our daily needs for both vitamins A and K — two vitamins that contribute to overall bone health. What’s more, vitamin A also promotes a healthy immune system and good vision,
while vitamin K helps blood clot properly. Green leaf lettuce is especially good for hearts, thanks to many factors: its inflammation-lowering antioxidants (vitamins A and C), its cholesterol-lowering fiber and its healthy dose of folate, a B vitamin that helps to reduce arterial hardening. What makes this fat-free lettuce also good for hearts is its low-calorie count: only 10 calories per 2-cup serving. By consuming nutritious foods that are lower in fat and calories, we’re less likely to become overweight or obese. Excessive weight, according to multiple studies, has been linked to several factors — high blood pressure, high cholesterol, diabetes — which may increase one’s risk for heart disease. As diet-friendly as salads can be, they can quickly go from healthy to unhealthy with unchecked ingredients that add fat, calories and sodium. So, be mindful of the add-ons, especially when dining out, such as bacon bits (100 to 300 calories), croutons (100-200 calories), shredded cheese (100 to 200 calories), and
Choose lettuce with healthy outer leaves: fresh, crisp, bright green. Wash greens right before use under cold running water. One method of washing: immerse loose greens in a large pot of cool water and allow a minute or two for debris to sink to bottom, then rinse under running water and dry with a salad spinner or paper towels. Wash organic lettuce, too. creamy dressings (120-150 calories). As an example, The Cheesecake Factory’s Cobb Salad with many of the ingredients listed above has 1540 calories, 2280 mg of sodium, and 124 g of fat.
Green Leaf Salad with Balsamic Vinaigrette, Walnuts and Feta Adapted from Eating Well
¼ cup balsamic vinegar 2 tablespoons plain fat-free Greek yogurt 2 tablespoons olive oil 1 teaspoon Dijon-style mustard 1 clove garlic, minced ½ teaspoon kosher salt ¼ teaspoon black pepper 6 cups (or more) green leaf lettuce 2 apples, such as Honeycrisp or Gala, thinly sliced ½ cup crumbled feta ½ cup dried cranberries or pomegranate seeds ½ cup chopped walnuts, toasted
For vinaigrette, in a small bowl whisk together vinegar, yogurt, oil, mustard, garlic, salt and pepper. In an extra-large serving bowl, combine lettuce, apple, cheese, dried cranberries or pomegranate seeds, and walnuts. Drizzle with half of the vinaigrette; toss to coat.
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at firstname.lastname@example.org.
Better or Worse: 5 Foods Myths You Should Know About Sea salt vs. table salt,, white eggs vs. brown eggs, high-fructose corn syrup vs. sugar. This and other food myths are important for diabetes sufferers
ood nutrition is important for managing diabetes. But there are some food myths that may be wrongly influencing your food choices. Here’s what true about salt and nighttime eating, along with clarity on three other misconceptions:
Myth: Sea salt is healthier than table salt.
Sea salt and table salt have the same nutritional value — about 2,400 mg of sodium per teaspoon. The only difference between the salts is how they are processed. Sea salt is made from evaporated ocean water or salty lake water with minimal processing, and so there’s still some mineral content which gives it its flavor and color. Table salt, mined from underground salt deposits, is more heavily processed and contains additives that prevent clumping. But nutritionally, these salts are the same. True salt substitutes are made from potassium salt. Potassium salt, though, tends to have a bitter, metallic taste. “I would encourage people with diabetes to try and keep their sodium intake to 1,500 mg a day,” said Melissa Kinstlinger, outpatient dietitian and certified diabetes educator at The Diabetes and Nutrition Center at Northwest Hospital. “For instance, you can swap cold cereal for old fashioned oats, which contain zero milligrams of sodium.”
Myth: Eggs from brown shells are better for you than eggs from white ones.
Eggs with brown shells and eggs with white shells have the same nutritional value. The color of the eggshells, quite simply, depends on the breed of the hen that lays them. White Leghorn chickens lay white eggs; Rhode Island Reds and Plymouth Rocks lay brown eggs. But eggs from brown and white shells are both healthy. A typical egg contains lots of vitamins and minerals (such as vitamins D and B12 and riboflavin) and is an excellent source of protein, and it’s only about 80 calories.
Myth: Late-night snacking makes you gain weight.
Always keep in mind that regarding weight loss or weight gain, it does not matter what time of day you eat. It is about what and how much you eat (as well as how often you’re exercising). Eating more calories than you need is what causes you to gain weight. There’s nothing wrong with eating a light snack after dinner as long as you plan for it. For example, if you’re supposed to have 1,500 calories for the day and you plan a snack within that range, that’s fine, even if you eat the snack at night. A snack in the 100 to 200 calorie
Which type of egg is better for you? Brown or white?
range is ideal. Some good options are packaged 100-calorie snacks, low-fat yogurt, fruit or small servings of light butter popcorn. Some ice cream bars are low in calories. Eating every three to four hours can help regulate your hunger as well as your blood sugars.
Myth: You should wash raw meat to eliminate bacteria.
Cooking food at the right temperature is what kills bacteria. Washing raw meat or poultry before cooking is not recommended in large part because bacteria in the juices can cross-contaminate other foods, utensils and surfaces. Some bacteria are so attached to meat they can’t be
January 2020 •
washed away. With regard to consuming meat, Kinstlinger recommends that people with diabetes “choose meats that are labeled 90% or more lean.” “Remove skin from chicken. Bake, grill, lightly sauté — maybe try an air fryer for crispy meat with less fat,” she says.
Myth: High-fructose corn syrup is worse than sugar.
From a chemical standpoint, high-fructose corn syrup and table sugar are similar. High-fructose corn syrup is a mix of glucose and between 42% and 55% fructose. Table sugar is also a combination of glucose and fructose in amounts similar to what is in high-fructose corn syrup. Some studies have shown that people metabolize high-fructose corn syrup and table sugar differently. But the goal for people with diabetes is to cut back on sugar in general, no matter what kind it is. “A quick way to decrease sugar in your diet is to drink zero calorie beverages instead of sugared sodas,” Kinstlinger says.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
The Off-Season: Life of Your Local Farmer By Katie Coleman
inter is here in all of its stillness, beauty and harshness. We’re hunkering down and entering survival mode until spring comes. Although local fresh food options aren’t as plentiful this time of the year, there are still open farmers’ markets and access to locally-sourced foods. Native Offerings Farm in Little Valley, Cattaraugus County, is just settling down for the winter after the holiday. In the past the farm offered a winter share through community-supported agriculture — or CSA — the but because of a fire that destroyed its barn, its owners decide to stop the practice this year. But life continues at the farm. “Whenever we can harvest, we do [sahre our produce],” said Deborah Ann Ritchie, who has owned Native Offerings with her husband Stew since 2002. “There was a cold snap before Thanksgiving and we went out and were harvesting like crazy,” Ritchie said. Since there’s such a short growing season in WNY, winter allows for planning and phasing the next growing season, and some much-needed quiet time. “It’s a different kind of busy,”
Ritchie said. “We’re prepping for next season because when all that lovely produce comes out you can’t focus on other projects. There might be less work in the winter but things take longer.” Native Offerings supplies its produce to the Lexington Co-Op, FreshFix, a local delivery service that sends members a weekly box of locally-grown produce, and West Rose in Ellicottville, a restaurant that offers brunch and dinner, rotating the menu based on what produce is in season. “The beautiful thing about farming is you’re flowing with the season. I appreciate that a lot because it just feels right,” Ritchie said. McCollum Orchards in Lockport also shared a little bit about winter life on the farm. The farm was established in 1827 and it grows year-round with the use of three high tunnels, although its community-supported agriculture wraps up in late December. They’re currently growing lettuce, spinach, kale, chard, celery, bunching onions and micro greens. “Wintertime is when we plan for next season such as crop and fertility management for our fields, we purchase seeds and equipment and do repairs,” said Rich Woodbridge, who
runs the farm with his wife Bree. “We attend workshops and conferences and determine new markets to pursue.” “Wintertime can be frustrating. It’s the only time most farmers have to do necessary repairs or new construction, but there usually isn’t enough daylight or nice weather to get things done the way you want,” said Woodbridge, who sells produce at the Lockport Community Farmers Market during the winter.
Getting LocallyGrown Produce in the Winter n Lockport Community Farmers Market runs from 10 a.m. to 2 p.m. the first and third Saturdays, November through April at 210 Walnut St., Lockport. It sells veggies, fruit, plants, eggs, meat and dairy products, baked goods, breads, body and home goods, wine and spirits, coffee, etc. n Horsefeathers Community Indoor Market at 346 Connecticut St. in Buffalo is open from 10 a.m. to 3 p.m. on Saturdays. It features local
Scott Monaghan, a worker at Native Offerings Farm in Little Valley, Cattaraugus County. farmers and artisans’ produce, baked goods, handcrafted art and more. n The Clinton-Bailey Farmers & Flea Market runs its winter market from 6 a.m. to 1 p.m. on Saturdays until April 30. It sells local veggies, herbs, honey, sausage, jams and jellies, etc. It’s located at 1443-1557 Clinton St. Buffalo, NY 14206.
Plant-Heavy Diet Can Support Athletic Performance By Deborah Jeanne Sergeant
ou may not be an elite athlete or professional sports player; however, scaling back or eliminating the meat and other animal-sourced foods in your diet could give you a competitive advantage if you participate in rigorous activities like marathons and extreme sports or challenges like Tough Mudder races. For decades, anecdotal cases of vegetarian and vegan athletes have claimed that nixing animal-based foods improved their athletic performance through leaner bodies, better glycogen storage in muscles and better blood flow, lower risk of heart damage and lower oxidative damage and inflammation. But why does forgoing meat, dairy and eggs seem to lead to these outcomes? Mary Jo Parker, registered dietitian and owner of Nutrition and Counseling Services in Buffalo, said that eating more plants helps fuel athletes. “Carbohydrates are the main fuel source,” Parker said. “It’s the macronutrient we use first when we start to exercise. Endurance athletes rely on it even more so.” Few long-term studies exist that point to plant-based diets as advantageous for athletic performance; however, the data available seems to strongly indicate that it can help athletes, both long-term for health and short-term for performance. “We know endurance athletes have a higher than average risk for diseases of the heart and arteries and heart damage,” Parker said. “A heart healthy diet is important. When they’re eating more low fat and plant-based foods, it can increase Page 14
their maximum amount of oxygen a body can use during exercise, which can lead to better endurance.” Since reducing animal-sourced foods appears to reduce inflammation, athletes adhering to this eating plan may experience reduced need for recovery time after heavy training days. That can aid them in training harder since they won’t need as much time for recovery. Natalie Robertello, registered dietitian, is the owner of Fit For You in Buffalo and works through UB Orthopaedics. “While we know that vegan and vegetarian diets have a huge benefit for cholesterol management, hypertension and heart disease, the verdict is still out on athletic performance,” she said. “Small studies say it may reduce levels of inflammation, especially with the large quantities of fruits and vegetables and antioxidants. Also, because there is a focus on higher carbohydrates, there’s some ideas it can enhance energy and endurance.” Protein intake supports muscle growth; however, it doesn’t require eating a side of beef or chugging endless milk-based protein shakes. Consuming sufficient nuts, seeds, beans and whole grains can do it. Robertello said that one of the biggest misconceptions about the vegetarian diet is that eating enough protein is difficult. Most people overestimate how much protein they need and many are unaware of alternative sources of protein, like tofu, beans, lentils, nut butters, broccoli and spinach. It’s also not required to go completely vegan to reap many of the benefits of eating more produce. Be-
cause of the many nutrients eggs and dairy contain, Robertello encourages athletes interested in eating plantbased to also include them. “It will encourage the intake of a lot of vitamins and minerals they wouldn’t otherwise get,” Robertello said. “These include B12 and calcium.” Because many of plant foods are low in calories, Robertello said that athletes may need to eat more frequently, as many as nine small meals per day. Danielle Meyer also said that going plant-based doesn’t necessarily mean vegetarian. Meyer is clinical director of the Dietetic Internship Program in the Department of Exercise and Nutrition Sciences at University at Buffalo School of Public Health and Health Professions.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
“Plant-based can mean that the meals are mostly plants,” Meyer said. “It does leave room for meat. We always recommend lean meat fins or feathers.” She also advises pairing up complementary proteins, like beans and rice, to complete a whole protein, which ensures adequate daily intake of the 20 amino acids that form a protein. The human body can’t produce nine of those and must obtain them through food sources. Quinoa, buckwheat and soy are examples of complete proteins. “Eating a variety of foods is important if you want to eliminate meat and dairy,” Meyer said. “It does require a lot of education to ensure they’ll be getting foods even through supplementation.”
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By Michael J. Billoni
ancy Singh has been with Restoration Society, Inc. since 1991 and has served as its chief executive officer since 2016. RSI works with the homeless and the “hard-to serve” population, offering recovery-based person-centered services in Western New York. It employs 125 people has an annual budget of just over $5 million. What type of services are offered? RSI offers holistic, person-centered services premised upon customer self-determination and self-direction. Programs embracing life-coaching strategies facilitate the customer’s personal direction, development and fulfillment. Using life-coaching techniques, RSI assists individuals in achieving and maintaining personal satisfaction in their overall quality of life, integration into self-selected communities and attainment of basic life needs. Life-coaching strategies assist customers to increase independence, achieve desired social roles and community integration and connectedness while reducing reliance on professional supports. RSI has a reputation of working with the hard-to-serve population [those individuals were not successful in other traditional programs]. How many homeless do you serve? RSI has provided homeless services to over 900 homeless individuals in 2019. This includes both the Harbor House program and Code Blue project. Our Harbor House Resource Center at 241 Genesee St. focuses on homeless individuals with a mental health diagnosis. We also work closely with local police and crisis teams to offer a location for individuals to be dropped off without being arrested or hospitalized. It also serves as the hub for coordinated entry, which allows for all homeless
in our community to be assessed and prioritized according to need and vulnerability. What is Code Blue? “Code Blue” is the city of Buffalo and Erie County’s emergency weather safety plan that provides outreach, transportation, shelter and a warm meal to individuals experiencing homelessness on nights when temperatures or wind chill fall to 32 degrees or below from November 15 to April 30. This year’s Code Blue Shelters are located at: Harbor House, 241 Genesee Street, Holy Cross Church, 412 Niagara Street, St. Luke’s Mission of Mercy, 325 Walden Avenue, and the Rural Outreach Center, 765 Olean Road, East Aurora. St. Luke’s Mission only participates as a Code Blue shelter when the temperature or wind chill drops below 15 degrees. The Code Blue project also includes the use of the Code Blue van that follows a route around the city to locate the homeless individuals on the street through outreach and brings them in for shelter. When the temperature falls below 32 degrees a Daytime Warming Center opens at the Harbor House Resource Center. Usually 50 to 70 customers are provided with meals, coffee and can meet with providers for linkages to needed resources such as benefits, employment and housing.
Nancy Singh has been with Restoration Society, Inc. since 1991 and has served as its chief executive officer since 2016.
Has the homeless population in Buffalo changed much over the years? The homeless population has remained fairly stable over recent years. In 2018 there were 5,742 individuals considered to be homeless in Erie County. Each year a point-in-time count provides the general number of people homeless on one given day in January. The point-in-time-count in 2019 found 662 homeless individuals,
which is a slight decrease from 2018. Our community has greatly reduced the number of chronically homeless individuals and the number of homeless veterans. As a community our focus has now turned to homeless youth and families. RSI is active with the Homeless Alliance of WNY and the WNY Coalition for the Homeless, which advocates for the homeless and organizes homeless services.
January 2020 •
There is a strong collaborative effort focused on reducing homelessness overall. A recent grant will provide substantial funding for youth specific programming. This will allow for a youth drop-In center, youth specific housing and an outreach worker who will focus on youth activities. For more information, visit www.rsiwny.org.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
well. Instead, opt for a brisk walk for 30 – 60 minutes each day. If you want to do something more vigorous, do 20-30 minute runs or aerobic workouts three to four times a week with weight lifting in between.
Avoid public places during outbreaks
When you hear of the flu or virus outbreak in your area, stay home if possible. Avoid public places in particular. This will serve double duty by keeping you out of the cold that makes you more susceptible.
medication 8.Take an antiviral
10 Tips to Stay
Healthy This Winter By Kimberly Blaker
he medical field has long known people are more prone to catching colds and the flu during the cold winter months. Previously, scientists primarily attributed this to people living and breathing together in enclosed environments. But cold temperatures also make our immune system sluggish and prevent our bodies from fighting off infection. This is according to a 2015 PBS report, “Scientists Finally Prove Why Cold Weather Makes You Sick.” So follow these tips to stave off colds and the flu this winter.
1.Keep your home warm
Maintaining warmth is essential to ward off winter-related illnesses. So keep your home temperature comfortably warm by setting your thermostat between 68 and 75 °F. Optimum daytime temperatures for living areas are 70 to 72 °F. At night, set the thermostat just a couple of degrees cooler for your bedrooms. What’s comfortable varies from person-to-person. So if you feel cold at 72 °F, turn it up a notch or two. The idea is to remain comfortable.
2.Dress in layers
Layer your clothing, whether you’re at home or heading out. Wear a T-shirt or cami, long-sleeved shirt or blouse, and a sweater over the top. This way, you can set your thermostat at a moderate temperature and peel off layers to maintain the perfect comfort level. Layers will also ensure you maintain comfort if you go out. When you do leave the house, wear warm boots, gloves, and a hat even if you’ll be outside just briefly. We lose most of our body heat through the extremities. So it’s vital to keep those areas warm.
A healthy diet is essential year-round. But during the cold winter months, certain foods are particularly beneficial to the immune system. The much-criticized starchy potato is an excellent source of nutriPage 16
tion. It’s high in vitamins B6 and C, both of which boost immunity. Collards, kale, and chard, among other dark leafy greens, are high in vitamins A, C, and K. Winter squash, including pumpkin, butternut, spaghetti, and acorn, is high in beta-carotene. Our bodies convert beta-carotene to vitamin A, another vital source that boosts the immune system. Several fruits are also particularly beneficial and protect against winter-related ailments. Citrus fruits are a rich source of vitamin C. Kiwi packs even more of a ‘C’ punch than oranges. Other fruits that help keep your immune system strong include pomegranates, blueberries, cherries, and even bananas.
Drink plenty of water
Wash your hands
can survive this way for several hours. If you come along and touch the germ-ridden object, the bacteria transfer to your hands. Then when you scratch your nose or grab a cookie to eat, you become infected. So when you wash your hands, use soap and warm water. Rub between your fingers and underneath your fingernails. Then rinse your hands well and dry them thoroughly. In public restrooms, use a paper towel to turn off the water and open the restroom door after you’ve washed your hands.
An active lifestyle is crucial to a healthy heart, lungs, and bones. But a moderately active lifestyle also improves your immune system, according to a 2010 study cited in “Exercise and Respiratory Tract Viral Infections.” Prolonged intense exercise suppresses the immune system, however. So the key is to exercise regularly but in moderation. Unless you’re trying out for the Olympics, a 20-mile run won’t likely serve you
Dehydration causes a host of health complications. Despite this, most people don’t drink nearly enough water. As a result, health experts say they’re in a state of chronic dehydration. So how much water should you drink each day? A commonly repeated recommendation is eight 8-ounce glasses per day. But why would a 100-pound inactive woman need the same intake as an active 220-pound man? It turns out there’s a formula to determine how much water you should consume. Divide your weight by 2.2. Next, if you’re between age 30 to 55, multiply by 35; and if older than 55, multiply by 30. Now divide your result by 28.3 for the number of ounces you should drink daily. Divide this by 8 to determine the number of cups. One of the best ways to reduce the spread of germs is by washing your hands regularly. This not only reduces the risk of transferring your bacteria to others. It reduces the risk that you’ll transfer bacteria to yourself. When someone with a cold or the flu touches a doorknob, handrail, or other objects, their germs get transferred to the object. Bacteria
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
If you’re exposed to the flu, be proactive and nip it in the bud with a prescription for Relenza or Tamiflu. The only catch is there’s a short window of opportunity for these medications to be effective. These treatments must begin within 48 hours of the onset of symptoms. So as soon as you feel signs of the flu coming on, call your doctor. If your doctor can’t see you right away, go to an urgent care.
9.Get a massage
According to a 2010 study for Cedars-Sinai Medical Center, Swedish massage increases lymphocytes, which improve the effectiveness of the immune system. So now you have the perfect excuse to treat yourself to a massage! If regular massages aren’t in your budget, trade massages with your partner to help stave off illness.
10.Get your z’s
When we sleep, our bodies release cytokines, which promote sleep. Certain cytokines also ward off infection. When we don’t get enough sleep, we’re deprived of the protective cytokines, leaving us more susceptible to infection. Sleep requirements vary from person to person. But adults typically need seven to eight hours.
Why the Risk of Heart Attack Rises in Winter By Jim Miller
veryone knows winter is cold and flu season, but many don’t know that it’s also the prime season for heart attacks too, especially if you already have heart disease or have suffered a previous heart attack. Here’s what you should know, along with some tips to help you protect yourself. In the U.S., the risk of having a heart attack during the winter months is twice as high as it is during
There are a number of factors, and they’re not all linked to cold weather. Even people who live in warm climates have an increased risk. Here are the areas you need to pay extra attention to this winter. • Cold temperatures: When a person gets cold, the body responds by constricting the blood vessels to help the body maintain heat. This
causes blood pressure to go up and makes the heart work harder. Cold temperatures can also increase levels of certain proteins that can thicken the blood and increase the risk for blood clots. So, stay warm this winter, and when you do have to go outside, make sure you bundle up in layers with gloves and a hat, and place a scarf over your mouth and nose to warm up the air before you breathe it in. • Snow shoveling: Studies have shown that heart attack rates jump dramatically in the first few days after a major snowstorm, usually a result of snow shoveling. Shoveling snow is a very strenuous activity that raises blood pressure and stresses the heart. Combine those factors with the cold temperatures and the risks for
heart attack surges. If your sidewalk or driveway needs shoveling this winter, hire a kid from the neighborhood to do it for you, or use a snow blower. Or, if you must shovel, push rather than lift the snow as much as possible, stay warm, and take frequent breaks. • New Year’s resolutions: Every Jan. 1, millions of people join gyms or start exercise programs as part of their New Year’s resolution to get in shape, and many overexert themselves too soon. If you’re starting a new exercise program this winter, take the time to talk to your doctor about what types and how much exercise may be appropriate for you. • Winter weight gain: People tend to eat and drink more and gain more weight during the holiday season and winter months, all of which are hard on the heart and risky for someone with heart disease. So, keep a watchful eye on your diet this winter and avoid binging on fatty foods and alcohol. • Shorter days: Less daylight in the winter months can cause many people to develop “seasonal affective disorder” or SAD, a wintertime depression that can stress the heart. Studies have also looked at heart attack patients and found they usually have lower levels of vitamin D (which comes from sunlight) than people with healthy hearts. To boost your vitamin D this winter, consider taking a supplement that contains between 1,000 and 2,000 international units (IU) per day. • Flu season: Studies show that people who get flu shots have a lower heart attack risk. It’s known that the inflammatory reaction set off by a flu infection can increase blood clotting which can lead to heart attacks in vulnerable people. So, if you haven’t already done so this year, get a flu shot for protection. And, if you’ve never been vaccinated for pneumococcal pneumonia, you should consider getting these two shots (given 12 months apart) too. Jim Miller is the author of Savvy Senior column, which is published every issue in In Good Health.
SAD: Not Just the January Blues By Lucy Connery
anuary marks the end of the holiday season, the beginning of a new year, and is often thought to be a fresh start for a better year and personal growth. However, for many people this time of year is the hardest of all. The holidays can bring stress, emotional distress and unhealthy coping mechanisms like consuming large amounts of unhealthy foods, drinking more alcoholic beverages than usual, staying inside to avoid the cold weather, etc. The National Institute of Mental Health has documented that these behaviors could be indicative of seasonal affective disorder (SAD). This condition is characterized by feelings of depression, anxiety and loneliness or isolation at the same time of year
— spikes in SAD often occur in the winter time. Seasonal affective disorder can also be a response to memories of
losing a loved one, an emotional holiday season, weight fluctuation and even changes in the weather. Not sure if you experience SAD? Symptoms include having low energ, problems sleeping, difficulty concentrating, feeling sluggish or agitated, changes in appetite, and feelings of hopelessness, worthlessness, or guilt. SAD is very common, affecting millions of individuals a year. Prevention includes regular physical activity, spending time outdoors and eating a balanced, nutritional diet. If you already experience SAD, these methods also serve as a form of treatment. Other treatments for SAD may include light therapy, medications and psychotherapy. Accepting and recognizing mental health is not always easy or comfortable, but it is not anything to be ashamed of. If you or a loved
January 2020 •
one is struggling, seek help locally or nationally. Lucy Connery is a health promotion specialist with The Wellness Institute of Greater Buffalo.
How to Get Help • Mental Health Advocates of WNY at (716) 886-1242 or https://mhawny.org • Erie County Warm (non-crisis) Line at 1-844-7493848 • Substance Use & Mental Health (SAMHSA) Helpline at 1-800-662-4357
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
GBUAHN patient health navigator Janice Neal (from left) member Desire Love, and registered dietitian Deanna Gallicchio.
African Heritage Food Co-Op helps provide GBUAHN members with healthy food options this holiday season.
GBUAHN Helping People on Medicaid to Get and Stay Healthier By Jana Eisenberg
ver 40% of Buffalo residents are on Medicaid, the federally funded healthcare program that covers people because of their low-income status or other factors, according to recent data from Deloitte/DataUSA. Frequently, people with low income — those living in poverty — experience one or more multiple chronic diseases (such as hypertension, diabetes, and obesity). And, says physician Raul Vazquez, there are things that can be done to both improve their health. Vazquez is the founder and chief executive officer of the Greater Buffalo United Area Health Network (GBUAHN, pronounced “geebawn”), which is a “health home,” created under the Affordable Care Act, Section 2703. Health homes are organizations which provide care coordination and a variety of other services for exactly this population: people on Medicaid who have multiple or severe chronic conditions. GBUAHN’s mission is to transform health care by removing barriers for people in underserved communities and populations. So, in addition to standard medical care, GBUAHN provides or refers patients for everything from transportation, housing and job training to access to and education about fresh food, how diet affects health, and other opportunities around everything related to those topics, such as eating, cooking, and exercise. Many health homes provide wellness programs, and Vazquez feels that it’s an important part of having a positive effect on people’s lives. One of GBUAHN’s facilities, at 564 Niagara St. in Buffalo, houses Vazquez’s medical offices, as well as an imaging center, a fitness center, a teaching kitchen and specialists’ offices. Vazquez believes that doctors want to help their patients in these deeper ways, but that the system is not set up to make it easy. “Doctors should not be in silos; it’s difficult to help people when you are always sending them elsewhere Page 18
GBUAHN member Terry Daniels-Brown presents her stuffed tomato dish, made during one of GBUAHN’s Member Cooking Classes. for specialist visits to or weight management,” he said. “I call GBUAHN a ‘medical neighborhood’: we can integrate those things into our medical practice. We took nutritionists, chefs, and personal trainers and created a wellness model. We want to remove barriers to accessing health and wellness care—what are called ‘social determinants of health,’ or the things that have an effect on people’s health, like their income, where they live, their education, their job, etc.” With everything integrated, adds Vazquez, his team can measure to gauge if the approach is working. “We’ve seen major positive impacts, for example, on how people with diabetes feel after taking part in the wellness programs. Even better, they feel a sense of community; they enjoy
going to our cooking classes or working out in our gym,” he said. “And, while they’re here, we can assess them, monitor their blood pressure and weight; we’re able get information about whether the foods, exercise and instructions we’re providing are actually changing people’s lives.” GBUAHN even has a collaboration with the African Heritage Food Co-op, through which patients can get vouchers for fresh food. The Coop now has two locations, as well as offering mobile food markets. GBUAHN nutritionists and chefs work with patients, counseling them on food choices. For example, while fresh whole fruit is always better than any other desserts, people with diabetes should still limit their intake of very high-sugar fruits, like pineap-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
ple or strawberries, said Vazquez. If someone with hypertension reports that they never add salt, but then says that they use a lot of ketchup, they need help understanding how much salt is in that and other products. Nutritionists help them to identify palatable substitutes, and the African Heritage Food Co-op actually provides access to some of the food. Jennifer Lepper works at the co-op; she’s also a former chef, and frequently comes into contact with GBUAHN patients. She noted that many neighborhoods with low-income populations are “food deserts,” with limited access to fresh food. She iterates the barriers that people face who want to eat better. “If you can’t get to a place to get good quality fresh, whole foods, maybe because of the lack of stores, or you don’t have a car, you can end up purchasing higher-calorie and more processed foods,” she said. “A lot of people do all their shopping at Walmart; if they have to take one or two busses to get there, how much can they carry? Having something in the neighborhood makes it more accessible.” “Eating better—consuming less fat and salt, and fewer processed foods — can greatly improve people’s health,” continued Lepper. “GBAUHN is helping people learn how to make food that they wouldn’t have access to or know about. People might ask me what something is, like acorn squash. I’m a chef, I tell people how I make it, or give them some suggestions. They appreciate it, and when they come back, I ask them how it came out.” “After accessing our programs and wellness model, I’ve seen some patients lose 60 or 80 pounds. It’s incredible!” said Vazquez. “I will see them when I’m working out in our gym, and they’re unrecognizable! I talk with them, and they say they’re feeling better, and their mental health is better. In those moments, I know we’re accomplishing our mission: we’ve changed that person’s life.”
Look Years Younger
Collagen & Elasticity!
By Jim Miller
How to Manage a Loved One’s Social Media Afterlife Dear Savvy Senior, How do I go about changing or canceling a person’s social media accounts when they die? My sister passed away several months ago and her social media accounts are still active.
Dear Inquiring, I’m sorry for your loss. This a question that’s become more frequent in recent years as most Americans have participated on some type of social media platform. Here’s a run-down of how you can change or cancel some different social media accounts after a loved one dies.
Facebook Let’s start with the biggest and most frequently used social media platform on the web today. When someone with a Facebook profile dies, there are two different things someone with authority over their account can do. You can either “memorialize” it or “delete” it. A memorialized account serves as a place where friends and family can share stories, photos or memories to celebrate the deceased person’s life, with the word “Remembering” shown next to the deceased person’s name. Once an account is memorialized, content the person shared is still visible on Facebook to the audience it was originally shared with, however, the user’s profile will not show up in public spaces such as people you may know, ads or birthday reminders. If you don’t wish to memorialize your sister’s profile, you can also have her account permanently deleted from Facebook. Facebook allows users (when they’re alive) to choose a “legacy contact,” which is a person chosen to look after their account once they’ve passed away, or users can request to have their account permanently deleted after they die. (To do either of these tasks, click on “Settings” on the top right of Facebook, then click on “General” on the left-side menu and then on “Manage Account.”) If your sister didn’t set up a legacy contact before she passed, you can submit a memorialization request at Facebook.com/help — type in “How do I report a deceased person on Facebook that needs to be memorialized?” in the search bar. You’ll be
asked to provide proof of death by providing a copy of either an obituary, death certificate or memorial card. Or, if you would rather have her account deleted, go to Facebook. com/help, and type in “How do I request the removal of a deceased family member’s Facebook account?” This also requires proof of death plus verification that you’re an immediate family member or executor of the account holder.
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Instagram Instagram’s policy on a deceased users’ account is similar to its parent company, Facebook. A deceased users’ account can either be memorialized or removed, which you can request at Help.Instagram. com/264154560391256. Like Facebook, to memorialize an Instagram account requires proof of death, but to remove an account you’ll also need to provide verification that you’re an immediate family member.
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Twitter If your sister was a Twitter user, Twitter will work with anyone who is authorized to act on behalf of her estate, or with a verified immediate family member to have an account deactivated. To request the removal of your sister’s account, go to Help. Twitter.com/forms/privacy. After you submit your request, Twitter will email you with instructions for providing more details, including information about the deceased, a copy of your ID, and a copy of the deceased’s death certificate.
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If your sister also had a LinkedIn profile, the only option is to delete her account. To request this, see LinkedIn.com/help/linkedin/ask/ ts-rdmlp. You’ll need to provide her name and URL to her LinkedIn profile; the relationship you have to her; her email address; date she passed away; link to an obituary; and company she most recently worked for.
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Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Michael J. Billoni, Jana Eisenberg, Kimberly Blaker, Lucy Connery, Katie Coleman, Nancy Cardillo, Marcia Kester Doyle • Advertising: Anne Westcott, Amy Gagliano, Karen Weaver Layout & Design: Dylon Clew-Thomas • Office Manager: Nancy Niet No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Ask The Social
From the Social Security District Office
Need to Change Your Name On Your Social Security Card?
I Cleaner Teeth, Healthier Heart?
rushing your teeth may be good for your heart, a new study suggests.
It included more than 161,000 South Korean adults, aged 40 to 79, with no history of heart failure or the heart rhythm disorder atrial fibrillation. Between 2003 and 2004, participants had a routine medical exam and were asked about a wide range of lifestyle habits, including how often they brushed their teeth. During a median follow-up of 10.5 years, 3% developed a-fib and 4.9 developed heart failure. Those who brushed their teeth three or more times a day had a 10% lower risk of Afib and a 12% lower risk of heart failure during the follow-up. The reduced risk was independent of age, sex, wealth, exercise, alcohol use, body fat and conditions such as high blood pressure, according to the study published Dec. 2 in the European Journal of Preventive Cardiology. Researchers didn’t investigate how regular brushing might reduce heart disease risk. But previous studies have suggested that poor oral hygiene results in bacteria in the blood, causing inflammation that increases odds of heart disease. The study was conducted in one country and was observational, so it does not prove a direct link between regular brushing and reduced heart risk, said senior author, physician Tae-Jin Song, of the department of neurology at Ewha Womans University in Seoul. But he added: “We studied a large group over a long period, which adds strength to our findings.” An editorial accompanying the study said it is “certainly too early” to recommend tooth brushing to prevent a-fib and heart failure. “While the role of inflammation in the occurrence of cardiovascular disease is becoming more and more evident, intervention studies are needed to define strategies of public health importance,” the editorial said.
f you’re changing your name, it’s important to let Social Security know so we can update the information we maintain, send you an updated Social Security card and ultimately ensure we pay you accurate benefits when you retire or if you become disabled. To change your name in our records, you must provide Social Security with documents proving your legal name change and identity. If you are a U.S. citizen, you also must provide our agency with documentation proving your U.S. citizenship.
Q: Can I refuse to give my Social Security number to a private business? A: Yes, you can refuse to disclose your Social Security number, and you should be careful about giving out your number. But, be aware, the person requesting your number can refuse services if you don’t give it. Businesses, banks, schools, private agencies, etc., are free to request someone’s number and use it for any purpose that doesn’t violate a federal or state law. To learn more about your Social Security number, visit www.socialsecurity.gov/ssnumber. Q: I received a notice from Social Security recently. It said my name and Social Security number do not match Social Security’s records. What should I do? A: It’s critical that your name and Social Security number, as shown on your Social Security card, match your employer’s payroll records and your W-2 form. If they don’t, here is what you need to do: • Give your employer the correct information exactly as shown on your Social Security card or your corrected card; or • Contact your local Social Security office (www.socialsecurity.gov/ locator) or call 1-800-772-1213 (TTY 1-800-325-0778) if your Social Security card does not show your correct name or Social Security number. For more information, visit www. socialsecurity.gov. Q: How do I report a lost Social Security card? A: You do not have to report a lost Social Security card. In fact, reporting a lost or stolen card to Social Security will not prevent misuse of your Social Security number. You should let us know if someone is using your number to work, call us at 1-800-772-1213 (TTY 1-800-325-0778). If you think someone is using
You must present original documents or copies certified by the agency that issued them. We can’t accept photocopies or notarized copies. To prove your legal name change, you must show one of the following documents: marriage document, divorce decree, certificate of naturalization showing a new name, court order for a name change. To prove your identity, you must show an unexpired document showing your name, identifying information, and photograph, such as one of the following: U.S. driver’s license, state-issued non-driver’s identification card or U.S. passport.
your Social Security number, there are several other actions you should take: • Contact the Federal Trade Commission (FTC) online at www. ftc.gov/bcdp/edu/microsites/idtheft or call 1-877-ID-THEFT (1-877438-4338); • File an online complaint with the Internet Crime Complaint Center at www.ic3.gov; • Contact the Internal Revenue Service (IRS) Identity Protection Specialized Unit by calling 1-800908-4490, Monday – Friday, 8 a.m. – 8 p.m.; and monitor your credit report. Q: I want to make sure I have enough credits to receive Social Security retirement benefits when I need them. How can I get a record of my Social Security earnings? A: The best way for you to check whether you have earned enough credits (40 total, equaling 10 years of work) is to open a free “my Social Security” account at www.socialsecurity.gov/myaccount to review your Social Security Statement any time you want. Once you create an account, you can: • Keep track of your earnings to make sure your benefit is calculated correctly. The amount of your payment is based on your lifetime earnings; • Get an estimate of your future benefits if you are still working; • Get a replacement SSA-1099 or SSA-1042S; • Get a letter with proof of your benefits if you currently receive them; and • Manage your benefits: – Change your address; and – Start or change your direct deposit. Accessing “my Social Security” is quick, convenient, and secure, and you can do it from the comfort of your home.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
If you don’t have one of those documents available, we may be able to accept your: employer identification card; school identification card; health insurance card or U.S. military identification card. To prove your U.S. citizenship, you must show one of the following documents: U.S. birth certificate, U.S. Consular Report of Birth Abroad, U.S. passport (unexpired), certificate of naturalization, certificate of citizenship To get started, fill out the form at www.socialsecurity.gov/forms/ss-5. pdf and carefully follow the instructions. In most cases, you can mail your signed application with your documents to any Social Security office. We will return any documents you mail to us. You can also locate your local field office at www.socialsecurity.gov/locator to show your required documents in person. In the event you need to replace a lost Social Security card to get a job or obtain government services, but you don’t need to change your name, you can — in most states and the District of Columbia — request your replacement card replacement card online using your my Social Security account at www.socialsecurity.gov/ myaccount. For additional information about Social Security Numbers, visit www. socialsecurity.gov/ssnumber.
Q: How do I apply for disability benefits? How long does it take to get a decision after I apply for disability benefits? A: You can apply for disability benefits online at www.socialsecurity. gov/benefits/. To get a decision on your disability application usually takes three to five months. The time frame can vary depending on: • The nature of your disability; • How quickly we can get your medical evidence from your doctor or other medical source; • Whether it’s necessary to send you for a medical examination; and • Whether we review your application for quality purposes. Create or sign in to your personal my Social Security account at www. socialsecurity.gov/myaccount to check your claim status. Q: I was turned down for disability. Do I need a lawyer to appeal? A: You are fully entitled to hire an attorney if you wish to, but it is not necessary. In fact, you can file a Social Security appeal online without a lawyer. Our online appeal process is convenient and secure. Just go to www.socialsecurity.gov/disability/ appeal or call us at 1-800-772-1213 (TTY 1-800-325-0778) to schedule an appointment to visit your local Social Security office to appeal. Q: I’ve read there is a five-month waiting period before my Social Security disability payments start. Are there any exceptions to this waiting period? Can I receive SSI during this waiting period? A: While there are no exceptions to the five-month waiting period, you may be able to receive SSI payments if you have met Social Security’s strict definition of disability and meet the income and resource requirements of the SSI program. For more information regarding income and resource requirements of the SSI program, visit www.socialsecurity. gov/ssi.
H ealth News Roswell doctor elected to lead AACR Immunology Working Group Chosen for his passion and leadership in immunotherapy research, Roswell Park Comprehensive Cancer Center Deputy Director Kunle Odunsi was elected as the Cancer Immunology Working Group (CIMM) Chairperson-Elect for 2020-2021. CIMM is a scientific working group within the American Association for Cancer Research (AACR). The CIMM works to promote the importance of immunology as it pertains to cancer research, spread inforOdunsi mation about cancer immunology to the scientific community and translate worthwhile concepts to clinic. Odunsi’s goals for his tenure as chairman-elect include making new alliances to pursue strategic objectives in immunology and encouraging the training and mentoring of the next generation of investigators. Hoping to elevate CIMM’s voice in AACR, Odunsi says he looks to “further propel the immunology revolution to its ultimate destination of changing cancer from a terrifying disease to that of a potentially curable disease.” With Roswell Park since 2001, Odunsi also serves as the executive director of the Center for Immunotherapy and chairman of the department of gynecologic oncology and M. Steven Piver Professor of Gynecologic Oncology at the cancer center. Odunsi will formally take office as chairman-elect April 28, during the AACR Annual Meeting in San Diego.
Independent Health to Give $1 Million to ECMC’s New ED Erie County Medical Center (ECMC) Corporation recently announced a $1 million grant from Independent Health for the hospital’s future trauma and emergency department. To date, total private donations to the future facility have reached $14.7 million. “Independent Health is proud to support Erie County Medical Center in its commitment to provide patients with individualized care that is delivered with excellence, compassion, safety and efficiency,” said Independent Health President and Chief Executive Officer Michael W. Cropp. “By improving access to the highest quality trauma and emergency care, ECMC is raising the bar in the critical role it plays in responding to the needs of the community.” The new trauma and emergency department will contain greater efficiencies in patient flow and staff
Daemen students Brook Bittner, from left, Rachel Shopene and Elizabeth Galleher placed first place in a national competition sponsored by the American Physical Therapy Association.
Physical Therapy Students Place First in National Video Challenge
n educational video created by Daemen College physical therapy students on preventing falls among older adults has won first place in a national contest sponsored by the American Physical Therapy Association (APTA). Daemen’s video for the APTA’s Balance and Falls Special Interest Group Falls Prevention Contest educates viewers on the impact of falls on seniors and demonstrates the importance of physical therapy in preventing fall-related injuries.
In recognition of winning the contest, the Daemen physical therapy program has received $500 to be used toward student-based research. The video project was produced by Daemen physical therapy majors Brook Bittner ’20 of Lewisburg, Pennsylvania., and Elizabeth Galleher ‘20 and Rachel Shopene ’20, both of Erie. Daemen’s student team earned first place among submissions from other prominent institutions, including Midwestern University, Creighton University, Oklahoma University Health Center and Washington Uni-
work flow, thereby enabling the department’s medical services team to achieve high quality standards and outcomes. The current facility, built to accommodate 45,000 patients annually, treats over 70,000 patients each year. The customized layout of the new space will better align with physicians’ and staff’s work flow while creating a more patient-oriented space containing larger rooms to accommodate patients’ families and the medical services team. “On behalf of my fellow doard members, I thank Independent Health for their extraordinary support for this critically important project,” said ECMC Board Chairman Jonathan A. Dandes.
James H. Cummings Foundation and Hauptmann-Woodward Medical Research Institute stretches over five decades,” said Edward Snell at CEO, Hauptman- Woodward Medical Research Institute. “During our 63-year history, the Cummings Foundation has generously supported HWI in every effort to bring new, cutting-edge technology and discoveries to Western New York. Our new Cryo-Electron Microscopy Center continues not only the important strides HWI continues to make in medical research and discovery, but does so, once again, with the steadfast support of the Cummings Foundation as our lead donor. We are proud to recognize their invaluable partnership in this way.”
Visitor center to be named ECMCC appoints new for James H. Cummings chief financial officer Jonathan T. Swiatkowski, a Foundation Hauptman-Woodward Medical Research Institute (HWI), an international leader in structural biology and founding member of the Buffalo Niagara Medical Campus, announced that its latest development will honor the generosity of one of the institute’s long-standing partners. Earlier last year, the James H. Cummings Foundation provided the lead gift of $300,000 toward HWI’s new Cryo-Electron Microscopy Center, which is currently under development. The gift was the largest awarded by the foundation in 2019. In recognition of the award, HWI will dedicate the James H. Cummings Visitor Center as part of the new center when it opens in 2020. “The partnership between the
certified public accountant, has been named chief financial officer for Erie County Medical Center Corporation. After a three-month national search, Swiatkowski was appointed following a thorough and extensive interSwiatkowski view process of many potential candidates. He succeeds Stephen M. Gary Sr., who left the position Dec. 31. “Jon Swiatkowski comes to ECMCC at an exciting time of growth and collaboration for our patients
January 2020 •
versity in St. Louis. “This video project was a great opportunity for our physical therapy students to become better informed about falls risks and prevention and to engage in advocacy for the profession,” said Christina Kelly, assistant professor of physical therapy, who oversaw the project. “Our students were also able to apply their knowledge and understanding of aging factors that impact balance, which they learn about in our program’s curriculum, to educate the public about this important topic.” Held in conjunction with National Fall Prevention and Awareness Month, the contest was designed to give physical therapy students a meaningful experience that strengthens their passion toward the profession and to increase awareness on the role of physical therapists in decreasing injurious falls. Daemen’s win in the video contest will be featured in an upcoming newsletter issue for the APTA Balance and Falls Special Interest Group. and community,” said ECMCC President and CEO Thomas J. Quatroche Jr., Ph.D. “He also comes as our local and national healthcare environment sees tremendous change and reimbursement pressures.” Swiatkowski had been with Kaleida Health from 2001 to February 2019, serving initially as vice president for finance and business operations and then was appointed chief financial officer for the organization in 2014. In February 2019, Swiatkowski was named vice president of finance and strategic integration for the Great Lakes Health System of Western New York. In that role, Swiatkowski was responsible for coordination and oversight of Great Lakes Health financial planning and reporting, supporting Kaleida Health, ECMC, affiliations and business development efforts. He also provided financial oversight and support to the organizations various non-hospital entities like Optimum Physician Alliance, Great Lakes Cancer Care and the EMR optimization project. Swiatkowski helped guide Kaleida Health through major financial milestones, including an improvement in system operating results; the expansion of Millard Fillmore Suburban Hospital; the closure and sale of the former Millard Fillmore Gates Circle Hospital; the financing, construction and opening of the Gates Vascular Institute and HighPointe on Michigan; the financial integration of several affiliates; and the planning, financing and fundraising for the new John R. Oishei Children’s Hospital.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
H ealth News
Dedication of the Rocco C. Venuto MD Transplant and Vascular Access Center on Dec. 3.
ECMC Honors Dr. Rocco Venutto Center dedicates the ‘Rocco C. Venuto MD Transplant and Vascular Access Center’
rie County Medical Center (ECMC) Corporation Dec. 2 dedicated one of its renal facilities in memory of physician Rocco C. Venuto. The Rocco C. Venuto, MD, Transplant and Vascular Access Center was named in memory of the physician, instructor and scientist. Venuto most recently served at
ECMC as medical director of renal transplant and director of the chronic kidney disease program, having brought the benefits of more than 40 years of nephrology practice to his patients. ECMC performed 2,265 kidney transplants since Venuto was first named director of Nephrology in 1978.
As a professor and mentor, he welcomed residents, fellows, nurses, pharmacists and medical students in the clinic and on rounds. Venuto held a number of medical and teaching roles in Western New York and beyond, including as a tenured professor of medicine at the University at Buffalo. “Dr. Venuto was the physician that every patient would want: a superb diagnostician, but he was extremely caring and patient,” said physician Brian M. Murray, chief medical officer, ECMC and associate professor of medicine in the division of nephrology, University at Buffalo said.
Building Bone Crucial for Women Men also need to keep bones strong, however women’s already smaller bones can get even weaker, especially as estrogen levels dip because of menopause By Deborah Jeanne Sergeant
aintaining bone health into later life is important for women who want to stay healthy and independent. Fractures after falls represent a leading cause of hospitalization among frail elderly people. According to the National Institutes of Health, people 65 and older represent 86% of those who suffer hip fractures. With normal care, the one-year mortality after having a hip fracture is between 14% and 58%. Of course, men also need to keep bones strong; however, it is especially crucial for women. As estrogen levels dip because of menopause, women’s already smaller bones can get even weaker. Diet, supplementation and exercise all play roles in bone health. “You have some bone and muscle loss as you age, but if you keep up with things, it’s not a foregone conclusion that your bones are going to deteriorate to the point where you’ll have osteoporosis,” said Mary Jo Parker, registered dietitian and owner of Nutrition and Counseling Services Nutritionist in Buffalo. The traditional approach is Page 22
consuming more dairy sources of calcium to help minimize bone loss; however, many non-dairy foods also contain calcium. Plant sources of calcium include poppy, sesame, celery and chia seeds; sardines and canned salmon; dark greens like collard greens and spinach; almonds; soy sources, like edamame and tofu; and maple syrup, nearly close to the same amount of calcium per volume as milk, although as a high calorie food, maple syrup should be eaten in moderation. In addition to calcium, strong bones require other minerals. These include magnesium, boron, strontium, copper, zinc, manganese and chromium, many of which are available in the foods listed above. “People aren’t as familiar with good sources of those nutrients,” Parker said. In addition to calcium, nuts, seeds, and dark leafy green vegetables are also sources of many minerals. Since vitamin D is generated by sun exposure, it’s difficult for people living in the North to maintain adequate levels of D in the wintertime.
That’s why Parker recommends supplementing. Many D supplements come paired with other bone-building minerals. Heather M. Ochs-Balcom, an associate professor of epidemiology at the University at Buffalo, said that in addition to a better diet and possibly supplements, “our recent study suggests that sleep is associated with lower bone mineral density; this gives us another reason to strive to get the recommended seven hours of sleep per night.” Since sufficient sleep is only good for the body, it’s worth it to get
Venuto’s experience encompassed a number of areas related to renal care, including treating patients with virtually every type of kidney disease. He conducted extensive research in his field, including on the kidney-related complications of pregnancy and complications of medications used in transplant immunosuppression regimens. Other research in collaboration with the University at Buffalo School of Pharmacy aimed at refining medication regimens led to identification of the best treatment protocols for each individual patient. Venuto and his team also worked on research initiatives related to medication for polycystic kidney diseases and the use of big data in the care of chronic kidney disease sufferers, resulting in cutting-edge care for patients. Venuto’s work garnered numerous honors, including the Lifetime Achievement Award from Upstate New York Transplant Services of which he was a co-founder, the Gift of Life Award from the Western New York Kidney Foundation, and the Diversity of Spirituality Award from ECMC. Venuto was a fellow of the American Society of Nephrology and the American College of Physicians. Born in Niagara Falls, he earned a bachelor’s degree at Niagara University and his medical degree from the University at Buffalo, where he also performed his internship and residency. He performed his fellowship at Ohio State University. enough rest. Och-Balcom added, “regularly exercising and lifting weights can all help to prevent osteoporosis.” As with dietary improvement, it’s never too late to start. Weight-bearing exercise includes activities such as walking and weightlifting. Many people are surprised at the latter; however, Brian DeLuca, physical therapist, said that even minimal resistance with bands can help — it doesn’t require hefting heavy weights or living at the gym. DeLuca is also a certified strength conditioning specialist and director of physical therapy at UBMD Orthopaedics & Sports Medicine in Cheektowaga. “Most women can achieve benefit through body weight training,” he said. “The beauty is you can do it at home, or through virtual training through apps if you’re disciplined enough. There are lots of resources available away from the gym where you don’t need equipment.”
A 3-D rendering showing the progression of osteoporosis.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2020
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