The crisis is clear. Chronic diseases are crushing health care.
As people live longer, chronic diseases have skyrocketed, accounting for nearly 75 percent of the nation’s annual $2 trillion health expenditures, according to the Kaiser Family Foundation. Seven out of 10 deaths among Americans each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50 percent of all deaths each year.
Our health-care system is good at treating short-term problems, such as broken bones and infections. Medical advances are helping people live much longer than in the past. But obesity is reaching epidemic proportions. The population is aging. We need to do a much better job managing chronic diseases.
Chronic conditions such as diabetes, heart disease, lung disease and Alzheimer’s disease take a heavy toll on health. Chronic conditions also cost vast amounts of money. The current trends are going in the wrong direction:
Over 162 million cases of seven common chronic diseases — cancers, diabetes, heart disease, hypertension, stroke, mental disorders, and pulmonary conditions — were reported in The United States in recent reports. These conditions shorten lives, reduce quality of life and create considerable burden for caregivers.
The global economic impact of the five leading chronic diseases — cancer, diabetes, mental illness, heart disease and respiratory disease, could reach $47 trillion over the next 20 years, according to a study by the World Economic Forum (WEF) released in the summer of 2011.
Chronic disease is estimated to account for 35 million deaths worldwide. Cardiovascular disease and cancer comprise a major proportion of chronic diseases in both developed and developing countries. Other than cardiovascular disease and cancer, obesity-related diseases such as type 2 diabetes, end-stage renal disease, osteoarthritis and non-alcoholic hepatitis are also becoming significant public health problems.
The prevalence and incidence of these diseases may rapidly increase in the near future in the United States because the prevalence of obesity has increased. At the same time, the population is gradually aging, and age-related degenerative diseases/conditions claim enormous health and economic tolls. Age-related cataracts are the leading cause of blindness, accounting for about 42 percent of all blindness. Approximately one in five people over age 65 live with age-related macular degeneration, and adults with advanced macular degeneration have a markedly reduced quality of life and need for assistance with activities of daily living. The incidence of dementia also increases with age. Alzheimer’s disease accounts for more than half of dementia cases.
Chronic illnesses impact every aspect of the lives of people who suffer with them. They have three major tasks. They have to deal with the medical management of their disease — whether it’s taking pills, or doing exercise, or diet or whatever. They have to deal with the fact that the things they want to do and need to do in life may also change. That can go all the way from no longer being able to work to no longer being able to do a loved hobby or having to change things in a major way. And they have to cope with the emotional impact, whether this is fear or anxiety or depression.
Adopting a pessimistic attitude, some people believe that there is nothing that can be done, anyway. In reality, the major causes of chronic diseases are known, and if these risk factors were eliminated, at least 80 percent of all heart disease, stroke and type 2 diabetes would be prevented; over 40 percent of cancer would be prevented.
There are two different types of disease that people can suffer from: acute and chronic. Acute diseases come on fast, with mild to severe symptoms that last a certain amount of time. In some cases they can be life threatening. Chronic diseases, on the other hand, take place over time. They too can be either mild or severe, but it takes a lot longer for them to develop and it takes longer for them to disappear. The symptoms also have a tendency to come and go repeatedly.
When it comes to avoiding chronic diseases, there are several preventive measures that can be taken:
1. Do not smoke. According to the American Heart Association, approximately 26.2 million men and 20.9 million women smoke in the United States. Smoking increases your risk of heart disease, emphysema and lung cancer. To prevent the onset of these diseases, do not smoke or quit if you currently do.
2. Get some exercise. Exercise brings with it a number of benefits: It helps reduce weight, improves mobility, elevates mood, strengthens bones and helps improve circulation. All of these factors will help reduce the chances of developing diabetes, heart disease, osteoporosis and atherosclerosis. Aim for 30 minutes of moderate exercise on five or more days a week.
3. Reduce your alcohol intake. Drinking excessive amounts of alcohol can cause a number of health problems. A chronic condition that can occur is cirrhosis of the liver. This is a chronic condition where scar tissue replaces healthy tissue causing the liver to not function optimally. To prevent this disease, keep your alcohol intake moderate.
4. Cut out unhealthy foods. What you eat plays a big role in developing chronic diseases. Foods that are processed, have large amounts of refined sugar or are high in saturated fats should be avoided. They can cause obesity, high blood pressure, high cholesterol and diabetes.
5. Eat plenty of fiber. Fiber is a non-digestible substance that gets passed through the digestive system. Eating fiber helps relieve constipation and it reduces your chances for colon cancer, diverticulitis, diabetes and kidney stones. The Institute of Medicine recommends eating 14 grams of fiber for every 1000 calories you eat. Some examples of fiber-rich foods are fruits, vegetables, whole grains, beans and oat bran.
On our current path, The United States will experience a dramatic increase in chronic disease in the next 20 years. But there is an alternative path. By making reasonable improvements in preventing and managing chronic disease, we can avoid a projected 40.2 million cases of chronic conditions in 2023.
Remember, I’m not a doctor. I just sound like one. Take good care of yourself, and live the best life possible!
The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice.
Glenn Ellis is a health advocacy communications specialist. He is the author of “Which Doctor?” and is a lecturing health columnist, radio commentator, and is an active media contributor nationally and internationally on health related topics.
His second book, “Information is the Best Medicine,” is due out this fall. For more good health information, visit: www.glennellis.com.
When Carlette Knox was diagnosed with breast cancer in 2009, she turned to the Fox Chase Cancer Center for treatment.
This led her to tap into the Fox Chase’s Risk Assessment program, which offers genetic testing to help better inform prevention and testing options.
“I was introduced to the Risk Assessment program so that we could determine whether or not I was a carrier of the BRCA gene,” said Knox, who was diagnosed at the age of 34.
Knox, who is one of five sisters, has a family history of cancer. Her grandmother died from breast cancer when her mother was just 12 years old. Her father died of colon cancer at the age of 72. Her mother battled both breast and pancreatic cancers and died in April.
She would learn that she carried the BRCA gene, which meant she had different treatment options available. She underwent chemotherapy, radiation and a bilateral mastectomy in 2010.
Knox elected to undergo a bilateral mastectomy, a surgical procedure where all the breast tissue is removed, as a way to prevent breast cancer from reoccurring.
“Just seeing how cancer had impacted her and the women in my family, it was the right thing to do,” she says of her decision.
“The key for me now is early detection and understanding what the options are and really knowing what the risks are.”
When Knox’s mother was impacted by breast cancer in her early 30s, she didn’t have the option of genetic testing. According to the National Cancer Institute, a woman with a BRCA1 or BRCA2 gene is at increased risk for developing breast, ovarian or other cancers.
For Knox, working with a genetic counselor was difficult because she lacked detailed information about her family’s history with cancer.
“It’s really ironic, because in the African-American community, we don’t talk about it (cancer) so it was really difficult for me to work with a genetic counselor and trace back the cancer,” says Knox.
Three of Knox’s sisters chose to undergo genetic testing, while one opted not to. Out of the four siblings who were tested, two tested positive for the BRCA gene. Knox says the sibling who initially elected not be tested, is now considering the possibility.
While Knox and her sisters were growing up and accompanying their mother to the doctor’s offices for her breast cancer care, she said they were never informed about genetic testing.
“It’s amazing to us that no one ever said you should consider testing,” she pointed out.
Knox is sharing her story at a time when Fox Chase’s Risk Assessment Program marks its 20th anniversary.
“When we founded it in 1991 we knew there were genes but we didn’t know what they were. The last 15 years have been remarkable in terms of finding genes and making genes available for testing,” said Dr. Mary Daly, founder of Fox Chase’s Risk Assessment Program.
“Part of the value of risk assessment is it helps an individual put their risk in the context that is appropriate for them and sometimes that means indicating that they have an increased risk and sometimes that means telling them that they are not at increased risk,” said Daly.
Program participants undergo a blood test, give a detailed family history and submit information about health behaviors that might impact their risk for developing cancer.
According to Daly, more than 10,000 people have participated in the program since its inception. Approximately 30 to 50 people sign up to participate on a monthly basis.
The program assesses risk for breast, colon, ovarian, colon, prostate and skin cancers.
“It’s been an opportunity for a lot of research. We’ve used the information from our families to decide whether prophylactic surgery is working, whether it’s saving lives or if certain medications might help them,” Daly added.
“People who participate in this program, not only get the information for themselves but they are contributing to research for everybody.”
As a resident of Einstein Healthcare Network’s chaplain residency training program, George Akins is striving to become a beacon of spiritual support for patients.
Akins, 54, is one of five residents enrolled in Einstein’s chaplain residency training program, where he is receiving clinical pastoral education (CPE).
Akins had been a lay minister in his church while he was in the Army, and decided to attend the Princeton seminary after he retired in 2008. While there, he conducted his field training at a psychiatric hospital in Belle Mead, N.J., where he became fascinated by the idea of chaplaincy in a clinical setting.
“I learned this whole idea of serving where you are,” said Akins.
Akins is learning the skills needed to provide patients with spiritual support as they cope with their health challenges, pain and grief.
“One has to have a tool bag full of tools that are all designed to deliver a ministering moment – one that helps the patient heal, one that helps the patient navigate through their challenges,” said Akins, who is a retired Army lieutenant colonel.
He works five days a week and two weekends a month at Einstein where he is assigned to patients in the cardiac intensive care unit and the Belmont Center for Behavioral Health.
“Here I think the chaplain is viewed as a part of the health care team, just like the nutritionist, cardiologist, respiratory or physical therapist. We recognize that spiritual health and emotional health is as much of a component in the healing as the other pieces,” Akins said in regard to Einstein.
For Akins, participating in the training program has been quite a learning experience. He recalled a recent situation when he was called to talk with a family after a patient experienced a miscarriage.
“I went to be with this family, thinking that the mother would be in a state of shock, grief and pain over this miscarriage of this child. It turned out that she was emotionally stable. It was her husband who was grieving the loss to that child,” said Akins, who is the senior pastor at Refuge Church of God in Christ in Englewood, N.J.
“In this ministering moment, my job is to go where the person is and help them articulate how they feel. In most cases, regardless of what the particulars that brought them to the hospital, it’s about their pain. It’s about coming to a place, acknowledging and recognizing their pain and how they feel about it.”
Einstein’s residency program enables students to earn three units of CPE while receiving a stipend and employee benefits. The program prepares residents for professional chaplaincy certification and or chaplaincy positions.
According to the Association for Clinical Pastoral Education, CPE began in 1925 as a form of theological education that takes place not exclusively in academic classrooms but in clinical settings where ministry is being practiced such as hospitals, hospices, geriatric and rehabilitation settings and congregational settings.
Akins plans to use his CPE to become a chaplain with the Veterans Administration hospital. After more than 20 years in the Army, he says he is well-positioned to work with veterans.
“Soldiers are a particular breed. When a solider recognizes that you are someone who is like them they will talk to you. They’re not quick to open up to someone who hasn’t been where they’ve been and hasn’t done what they’ve done,” Akins said.
Akins, the son of Arkansas sharecroppers, grew up in a home where money was scarce. Akins credits his third-grade teacher, Betty Clark, with inspiring him to become successful. He was crying in her class one day because other kids wouldn’t share their candy. She gave him a nickel and urged him to ask for money whenever he wanted candy.
He was inspired to please his teacher by becoming a stellar student who strived for academic excellence. He received an academic scholarship to college, graduated at the top of his class and went on to receive two graduate degrees while serving in the military.
“I attribute all of that to Miss Clark and the inspiration that she provided for academic excellence,” Akins said.
Einstein’s chaplain residency program has been in existence for more than 10 years and is very competitive. According to Rabbi Leah Wald, Einstein’s clinical manager chaplaincy services, about 100 applicants apply on the yearly basis for the five residency slots. Einstein also offers five slots for part-time interns in the programs.
“We really recognize the value of caring for the whole person, which is their spirit as well as the body,” Wald said.
“An artist has a paintbrush, a musician has their instrument, we have ourselves as a tool and each of our residents brings their unique background as a tool.”
Researchers from the University of Pennsylvania have received a $2 million grant from the National Institutes of Health (NIH) to study novel approaches to preventing chronic diseases in HIV-positive African-American men.
“African-American men who are infected with HIV are living longer than ever before and are now being impacted by the same chronic diseases that affect the general population of African-American men over 40,” said principal investigator John B. Jemmott, Ph.D., professor of communication in psychiatry at the Perelman School of Medicine and Kenneth B. Clark, professor of communication at the Annenberg School for Communication.
“We know that in addition to standard age-related factors, many of these chronic illnesses have behavioral components — risk is influenced by what people do and don’t do, their diet, and the amount of physical activity they get. Based on this complex intersection, we need to identify novel strategies to help these men navigate their lives in the healthiest way possible.”
Jemmott says that although the high risk for multiple behavior-linked chronic diseases among HIV-positive individuals has long been recognized, there is a lack of evidence-based interventions specifically tailored to their needs. The risk is heightened by HIV infection, but also its treatment with certain agents used in highly active antiretroviral therapy (HAART) combinations.
“We hope this research will help in the urgent need for interventions to reduce the risk of non-HIV related chronic diseases, including cardiovascular diseases, cancer and diabetes in HIV positive African-American men age 40 and older,” said Jemmott.
Additional Penn faculty involved in the trial are: Loretta Sweet Jemmott, Ph.D., University of Pennsylvania School of Nursing; Dr. Ian Frank, Division of Infectious Diseases, Perelman School of Medicine; and Scarlett Bellamy, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine.
During a family reunion I found out that several of my family members have high blood pressure. I don’t have high blood pressure now and I don’t want to develop the condition. What can I do to avoid developing high blood pressure?
High blood pressure can cause serious problems, such as stroke, heart attack, kidney failure and congestive heart failure. High blood pressure, also called hypertension, can be controlled with medication along with a change in diet, weight control, exercise, cessation of smoking and relaxation.
Limiting sodium intake is important because your blood pressure increases with use of sodium. Your diet should be high in fiber, which includes foods, such as fresh or frozen green leafy vegetables, fresh fruits and whole grain breads and cereals. These foods should make up about 65 percent of your diet. Proteins such as milk, egg whites, beans, fish, chicken, and an occasional slice of very lean beef should make up about 25 percent of your diet. Mono or polyunsaturated fats should make up around 10 percent. You should also be sure to drink water on a daily basis. Sometimes a change in diet and exercise can make you feel better and lower your resting blood pressure, but, no one should discontinue taking prescribed medication, unless your doctor tells you to stop.
Exercise can be beneficial to a person who has hypertension, but precautions should be taken. Before you get involved in an exercise program you need to have an exercise stress test administered by a professional. Initially, you may have to be supervised at a facility, which specializes in cardiac care or therapy. Sometimes people are tempted to quit taking medication, thinking that exercise will lower resting pressure. Your blood pressure is more likely to lower because of a combination of proper diet, exercise and medication. If it is high, you should avoid exercises that include sprint training, stop and go sports, such as karate, racquetball, heavy weight training and power lifting. Instead, lift moderate weights for 10–15 repetitions for toning. Because a sudden increase in blood pressure can be induced by exercise, it’s important to warm up slowly and increase the amount of time you exercise gradually. Walking, jogging, cycling and swimming should be done at low intensity. You should breathe normally while exercising and cool down slowly at the end of your exercise routine. It is important to follow these tips to keep blood vessels from dilating and constricting rapidly causing drastic changes in your blood pressure.
Are fried vegetables just as bad as other fried foods? I have fried eggplant a lot.
All fried foods if eaten in excess can affect your cholesterol, body fat level and increase your risk of heart disease and cancer. A study done in Australia found that vegetables absorb more fats when fried than fried meats. The amount of fat absorption depends on the type of vegetable and the length of time it is cooked. For example, eggplant is the worst offender, with a single serving absorbing 83 grams of fat in 70 seconds. That’s a lot of fat.
If you must fry at all, try stir-frying in canola oil or olive oil until they’re tender. Shorter cooking time means less fat absorbed in the food.
My feet hurt
“I jog everyday and my feet hurt almost everyday. My doctor hasn’t found anything wrong. What can I do with my tired, hurting feet?”
If you're a jogger, walker, play tennis or stand all day, make sure you give your feet some tender loving care. It only takes a few minutes a day and can help reduce pain, cramps and tiredness. Each day you should massage the whole foot gently. Then flex your toes upward toward the body and extend them by pointing the toes. From your ankle, roll the whole foot around. Stand on the ball of one foot and really press it into the floor, then do the supporting foot. Alternate holding your position for about 5 seconds. To give your feet the support they need always wear the proper shoes for the activity you're involved in. Sometimes you may have to use a professionally fitted shoe support. Ultimately, it will be well worth it. If you take care of your feet, they will take wherever you want to go.
Can you give me some tips to help me quit smoking?
Below are some tips that may help you quit smoking.
1. Exercise to relieve tension; it’ll help take the edge off while you quit.
2. Hold your breath for 10 seconds and release slowly when the urge hits.
3. Quit smoking with a buddy.
4. Drink a lot of fluids, but avoid coffee and alcohol. Drinking plenty of water will help to clean your system.
5. Keep gum handy; it’ll give you something to put in your month.
6. Get rid of all the things that remind you of smoking.
Smoking is hard to quit but you can join millions of other Americans each year as they quit smoking forever.
There are several techniques to help you quit smoking. For more information on how to quit call the American Cancer Society.
Colds in the gym
How easy is it to catch a cold in the gym?
Working out lately and can’t seem to get rid of a cold? It could be your gym. Working out in the gym can be hazardous to your health. Cold viruses can survive for several hours on your hands, hard surfaces and in cloth. Healthy people pick up a virus with their hands and infect themselves by touching their noses and eyes. The gym is loaded with surfaces that have been touched by other people who have viruses. According to some researchers, the way to train in a gym and reduce your chance of getting a cold is to wash your hands after your workout and keep your hands out of your face.
Before starting your fitness program, consult your physician. For help with drug, alcohol and mental health problems call Sobriety Through Outpatient drug, alcohol and mental health treatment center at (215) 227-7867. Watch or listen to our recovery media stations every day at www.stop-recoveryradio.com.
Listen to “Tips to be Fit” with Vince daily at www.stop-recoveryradio.com.
Fish are an excellent source of protein, monounsaturated fatty acids and a lot of minerals. They contain the highest sources of iodine and potassium. Most fish is also low in saturated fat.
Fish can be categorized as freshwater, saltwater and shellfish. Each category differs slightly in nutritional value. Freshwater fish provide magnesium, phosphorus, iron, zinc and copper. Saltwater fish and shellfish are rich in iodine, fluorine, phosphorous, copper, iron, calcium and cobalt. The fat content of fish varies not only with the size and type of fish, but with the time of year. Fatty fish, which include halibut, mackerel and salmon, are higher in fat but contain more vitamins A and D. Shellfish are low in fat but are higher in cholesterol than most other fish.
According to the American Heart Association, you can have at least two servings of low mercury content seafood each week. Fish that is high in methylmercury can be very unhealthy. Women who are planning to become pregnant or are pregnant, nursing or feeding a young child should modify the type and the amount of fish they eat.
Guidelines recommended by Tthe American Heart Association include:
1. Don’t eat shark, swordfish, king mackerel or tilefish. They all contain high levels of mercury.
2. Choose light tuna over albacore (white) tuna because it has more mercury. Don’t eat more than 6 ounces per week of albacore tuna.
3. If you eat fish from local lakes, streams or rivers, make sure you know what is in the water. If you don’t, eat only six ounces of any fish for the week.
When buying fish, you should know your store. It should have good refrigeration. When it’s on display, the ice should cover enough of the fish to keep it cold. Fresh fish should smell fresh. It should have a mild sea breeze odor. It should never have a strong fishy odor. A whole fresh fish should have bright, clear and shiny eyes. The scales should be shiny and cling tightly to the skin. The gills should be bright red or pink. Steaks and fillets should be moist and free from drying or browning around the edges.
Never buy fish at a store when cooked seafood is stored next to raw seafood. When buying canned fish, never buy swollen or dented cans.
Fish is also bought frozen. When buying frozen fish, make sure the packages are not damaged and the fish are frozen solid. Never buy frozen fish that is covered with ice crystals or appears to have freezer burn. Always buy frozen fish that is below the frost line in the display case. Frozen shellfish should be packaged in closefitting, moisture-proof containers. Frozen shellfish that is prepared, such as crab cakes or breaded shrimp, should be frozen solid and should not show any discoloration or drying or have an unpleasant odor.
When you want to buy the freshest shellfish, they should be alive. Live mussels, clams or oysters will close tightly when you tap them. Live crabs and lobsters will show leg movement. Fresh oysters and scallops should have a fresh odor. Fresh oysters should be surrounded by a clear, slightly milky or light gray liquid. When in doubt about freshness, you can ask the store owner to show you the certified shipper’s tag that should accompany all types of fish.
Storing your fish is just as important as buying good fish. You should refrigerate your seafood purchase as soon as possible. You should keep your refrigerator’s temperature between 340 and 400F and your freezer should be at 00F or colder. You should keep fish in the original wrapper and in the coldest part of the refrigerator, which is under the freezer, or in special meat keepers. When storing fish in the refrigerator, always cover it tightly. Freezer bags make good containers. You should never leave fish in a hot car for extended periods of time. If your frozen fish should thaw, you cannot refreeze it. Fish can be stored frozen for three to six months. The longer these foods are stored frozen, the more likely they will lose flavor, texture and moisture. Products such as crab meat can be stored up to six months in the refrigerator before being opened. Once opened, you should use the fish within three to five days. Canned fish can be stored in a cool, dry place for a year. You should refrigerate or freeze leftovers immediately in a moisture-proof package or container.
You should defrost seafood in the refrigerator. If you don’t have the time, you can put it in a resealable plastic storage bag and immerse the bag in cold water. If you defrost your fish in the microwave, you should cook it immediately after defrosting.
To avoid problems when handling or preparing your fish for cooking, you should take some precautions. You should always wash your hands with hot soapy water before and after handling raw seafood. Don’t leave cooked or raw seafood unrefrigerated for more than two hours. This includes preparation time. When marinating fish, do it in the refrigerator and always throw away the marinade you used. Bacteria will linger on all the surfaces that the raw fish touches. Don’t reuse a dishcloth or a sponge used to clean up counters or other surfaces that you’ve used during your food preparation. You should replace sponges on a regular basis. You should always wash your counters, utensils, plates, cutting boards and other surfaces that have been touched by raw seafood. Always use hot soapy water to clean up after handling seafood. This should include the inside of your refrigerator.
When cooking fish, the 10-minute rule is a good guide. This rule also applies to baking, broiling, grilling, steaming and poaching. Measure the fish at the thickest part. Figure 10 minutes of cooking time for each inch of thickness. If the fish measures less than one inch, try 3 to 5 minutes. Add five minutes if the fish is cooked in a sauce. Double the cooking time if the fish is frozen.
Fish is done when the flesh is opaque and begins to flake easily when tested with a fork at the thickest part. Fish is usually ready when the internal temperature reaches 1450F. You should cook shrimp until it turns pink and is firm. Depending on the size, it takes three to five minutes to boil or steam one pound of medium sized shrimp in their shell. Shellfish, such as clams, mussels and oysters will become plump and opaque when cooked completely. The edges of oysters will turn up when completely cooked. Scallops turn milky white or opaque and firm when completely cooked. They take three to four minutes to cook thoroughly depending on the size. Lobster turns bright red when completely cooked. You should allow five to six minutes per pound. Don’t put the lobster in the pot until the water begins to boil. The cooking time doesn’t start until the water starts to boil again after putting the lobster in the pot.
If you enjoy raw or lightly marinated seafood, you should make sure it comes from certified waters. You can ask to see the certificate. You should keep this type of seafood dish refrigerated until you get ready to eat it.
Seafood can be a safe nutritious protein source if we handle it carefully.
Before starting your fitness program, consult your physician.
For help with drug, alcohol and mental health problems call Sobriety Through Outpatient drug, alcohol and mental health treatment center at (215) 227-7867. Watch or listen to our recovery media stations every day at www.stop-recoveryradio.com.
An initiative is underway to increase well-baby pediatric visits during an infant’s first year of life.
The Maternity Care Coalition has partnered with the National Healthy Mothers, Healthy Babies Coalition, Merck and the National Medical Association to launch Healthy Beginnings for Babies.
Healthy Beginnings for Babies launched in three urban areas, Philadelphia, Baltimore and Chicago.
“The program really hopes to increase the number of moms who are taking their babies for well-baby care and ensuring that all babies get the vaccinations they need during the first year,” said Karen Pollack, MCC’s director of programs.
“What we find in working with families is that there are a lot of things that make it difficult for moms to get kids to the doctor.”
MCC staff is working to educate parents about the importance of well-baby visits by distributing educational materials and conducting outreach through health fairs and other activities.
MCC is distributing a booklet for parents titled “Guide For Baby’s 1st Year” that offers information on child development issues, what parents can expect for pediatric visits during their babies first year, questions to ask their health professionals and a scheduling chart for well-baby visits and immunizations.
Well-baby appointments enable medical providers to ensure that a baby is healthy and developmentally on track. During the appointments, a baby’s growth is charted and the baby is given a physical examination. The healthcare provider will also check the baby’s general development, provide nutritional information and administer vaccinations.
“When babies aren’t getting all their immunizations, and when they’re not regularly going to a healthcare provider, there is a concern about potential developmental delays or it makes them at greater risk for exposure to different illnesses,” says Pollack.
Founded in 1980, MCC focuses on improving maternal and child health and well-being.
December 7 marks the deadline for Medicare beneficiaries to make changes to their Medicare Advantage (Part C) or prescription drug plans (Part D).
“There will not be an extension. People really do need to make that change by December 7,” said Roseanne Egan, Centers for Medicare and Medicaid (CMS) acting regional administrator.
The open enrollment period, running from Oct. 15 to Dec. 7, is the period when existing Medicare recipients can make changes to their plans. Medicare beneficiaries who do not make any changes by the deadline will remain in their existing plans.
Centers for Medicare and Medicaid recently mailed Medicare & You handbooks and postcards to more than 42 million households, reminding them of this year’s earlier deadline. In previous years, the enrollment period was Nov. 15–Dec. 31.
“The reason we did that is to allow the Medicare Advantage plans and prescription drug plans the opportunity to process all the changes in the new enrollment so that the beneficiaries can get their new cards for the January 1 date, so there won’t be any delays in access to care,” Egan said.
“This year CMS is highlighting plans that have achieved an overall quality rating of 5 stars with a high performer or “gold star” icon — so people with Medicare can easily find high-quality plans.
CMS officials said all Pennsylvanians have the opportunity to access Medicare Advantage plans that have zero premiums. There are 36 available prescription drug plans available in Pennsylvania.
This year, Independence Blue Cross introduced a low-cost Medicare Advantage plan with premiums as low as $15 a month.
“Medicare is just one of the many areas in our business where we saw an opportunity to be more responsive to our customers’ needs and were able to develop an innovative solution to meet those needs,” said Daniel J. Hilferty, president and CEO of IBC.
“We share our members’ concern about access to affordable Medicare health plans, and we’re pleased to launch this new HMO that offers low monthly premiums with the same high-quality benefits and services our members expect from us.”
As beneficiaries look over their new plan options, they will see better value in the Medicare Advantage and prescription drug plan benefits.
Beneficiaries with Part D coverage who are in the coverage gap, or “donut hole,” will continue to receive 50 percent discounts on covered brand-name drugs thanks to the Affordable Care Act. Average premiums for Part D prescription drug plans will also decrease to $30 in 2012, about 76 cents less compared to the average 2011 premium.
CMS officials said that as of October, 149,988 people in Pennsylvania with Medicare have saved an average of $592 per person on their prescriptions, accounting for savings of $89 million statewide.
As a result of the Affordable Care Act, more than 898,000 people have received at least one of the new free Medicare preventative benefits.
For enrollment information visit www.medicare.gov/find-a-plan, call 1-800-MEDICARE or call the APPRISE network at 1 (800)-783-7067.
Does drinking water help increase your energy production during a workout?
Mark C., Glassboro, N.J.
Water is the most abundant nutrient in the body. We lose about 3 quarts daily through normal activity and more during a workout. Drinking water during your workout helps increase your blood volume, which will increase cardiac output. Cardiac output is the amount of blood being pumped during each heartbeat. The more blood your heart pumps with each beat the more nutrients and oxygen are transported throughout the body. Oxygen and nutrients in the blood provide energy for work. Many people run out of steam during an exercise session because they don’t replace water lost through exercise. Studies show that drinking water before, during and after a workout will increase energy production. This is true during hot and cold weather.
Sweating after workouts
Why do I sweat more after I finish my workout than I do when I’m working out?
Tina B., Tampa, Fla.
Tina, the body has a certain amount of blood to send to various systems. Exercising causes blood to be shunted from the skin to the working muscle, which causes a build up of heat. Exercises such as running walking or biking will allow sweat to evaporate during your workout. When you stop exercising the body sends more blood to the skin causing you to sweat and release excess heat. Cessation of sweating after a workout is a good way to gage whether you have spent enough time cooling down.
Deodorants that control wetness
Are deodorants that control wetness safe?
Deodorant companies are always telling us we shouldn’t sweat. But you should never stop your body from sweating. Sweating is your body’s way of cooling itself. If you stop this process, you could do a lot of harm to your body. As your body’s temperature rises, small blood vessels in your skin expand and draw heated blood to the surface. You also begin to sweat from the pores in your skin. As the sweat evaporates it draws heat from the skin and blood vessels. The cooler blood then recirculates throughout your body. If you stop your body from sweating, you could overheat your system. You can also aggravate the skin if you have a problem with blemishes and you don’t allow your body to sweat naturally. The difference between regular deodorants and antiperspirants is that deodorants will allow your body to sweat. Use a deodorant or finely ground baking soda instead of antiperspirants. Before applying, make sure your underarm area is completely dry.
Are starchy foods like corn bad for you if you’re losing weight? I like corn.
Starchy foods are important for balanced nutrition. They supply you with needed fiber, minerals and vitamins. Starchy foods are also low in fat. The fat content increases when you add butter or other high-calorie sauces that contain saturated fat.
Corn is a starchy vegetable, but don’t stop eating corn it’s an excellent source of vitamin A and C. It’s also low in sodium and fat. Sweet corn can be either yellow or white. Ears should be full with firm, bright, milky kernels, but give a little when pressed. Look for fresh green husks. The husk should be dry and the silk yellow.
There are several ways to cook corn. When boiling, use enough water to cover the corn. You should cover the pot and cook rapidly for 7 to 10 minutes. You can season your corn by adding oregano, parsley and Italian seasoning to the water.
You can also add cooked corn kernels to your pancakes, waffles and muffins. Corn will digest best with other vegetables.
Diet and metabolism
What is the difference between losing weight by dieting alone and losing weight by exercising?
Dieting alone to lose weight will lead to a muscle mass loss of around 50 percent and a fat and water loss of around 50 percent. Weight lost through proper diet and exercise will result in a fat loss of around 98 percent and lean muscle mass may increase. The loss of lean muscle will weaken the muscles and organs and slow down metabolism. The rate at which the body burns calories is directly related to lean body weight. In other words, muscle helps burn calories. When you lose weight by dieting alone your metabolism burns calories at a slower rate. When you quit dieting your body continues to burn calories slowly. Consequently, you gain the weight you lost and sometimes more. Each time you diet this way, your metabolism is strained, as well as heart function, kidney function, and bone and muscle production.
Instead of cutting calories, workout for 30–60 minutes 3–5 times a week. Walking is great for the beginner and jogging can become addictive. You’ll also want to do toning exercises for each part of the body, such as weight training or calisthenics. Experiment with different workouts and find something you enjoy. Make sure you consume between 12 to 15 calories per pound of body weight daily.
Family high blood pressure
During a family reunion I found out that a number of my family members have high blood pressure. I don’t have high blood pressure now, and I don’t want to develop the condition. What can I do to avoid developing high blood pressure?
High blood pressure can cause serious problems such as stroke, heart attack, kidney failure and congestive heart failure. High blood pressure, also called hypertension, can be controlled with medication along with a change in diet, weight control, exercise, cessation of smoking and relaxation.
Limiting sodium intake is important because your blood pressure increases with the use of sodium. Your diet should be high in fiber, which includes foods such as fresh or frozen green leafy vegetables, fresh fruits, and whole grain breads and cereals. These foods should make up about 70 percent of your diet. Proteins such as milk, egg whites, beans, fish, chicken and an occasional slice of very lean beef should make up about 20 percent of your diet. Mono- or polyunsaturated fats should make up 10 to 15 percent. You should also drink 6–8 glasses of water daily. Sometimes a change in diet and exercise can make you feel better and lower your resting blood pressure, however, no one should discontinue taking prescribed medication unless your doctor tells you to stop.
Exercise can be beneficial to a person who has hypertension, but precautions should be taken. Before you get involved in an exercise program you need to have an exercise stress test administered by a professional. Initially, you may have to be supervised at a facility, which specializes in cardiac care or therapy. Sometimes people are tempted to quit taking medication thinking that exercise will lower resting pressure. Your blood pressure is more likely to lower because of a combination of proper diet, exercise, and medication. If your blood pressure is high, you should avoid exercises that include sprint training, and stop-and-go sports such as karate, racquetball, heavy weight training and power lifting. Instead, lift moderate weights for 10–15 repetitions for toning. Because a sudden increase in blood pressure can be induced by exercise, it’s important to warm up slowly and increase the amount of time you exercise gradually. Walking, jogging, cycling and swimming should be done at low intensity. Breathe normally while exercising and cool down slowly at the end of your exercise routine. It is important to follow these tips to keep blood vessels from dilating and constricting rapidly causing drastic changes in your blood pressure.
Before starting your fitness program, consult your physician.
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Milk is sometimes called the perfect food. According to one magazine article, milk has been used for more than 10,000 years. This universal food has also been associated with a lot of health problems that include heart disease, allergies and diabetes. For every study that condemns milk, you’ll find one that gives it great praise. What can you believe?
Most milk is pasteurized and homogenized. It is pasteurized to kill bacteria to prevent milk-borne diseases. Pasteurization involves heating the milk to a high temperature and then cooling it rapidly. Raw milk comes in two parts. Homogenization is the process that disperses the fat content — evenly throughout the milk.
How much fat?
The numbers can be confusing. Milk is grouped in several categories, whole, 2 percent, 1 percent and skim. Whole milk is 51 percent fat, 2 percent milk is 35 percent fat, 1 percent milk is 22 percent fat and skim milk is 4 percent fat. Whole milk has the most saturated fat; skim milk has the least. Saturated fat is the fat that you should avoid. When most people switch to low-fat milk, they don’t like the taste it initially, but eventually acquire a taste for it. For those who don’t digest milk easily, Lactaid brand milk provides the same benefits of regular milk with only 2 grams of fat per serving. If you make your change from whole to low-fat milk gradually, the taste won’t be an issue.
Evaporated milk is whole milk with about one -half of the water content removed. Condensed milk has one-half of the water removed and sugar added. Dried milk has 95 to 98 percent of the water from whole milk.
You get the same amount of calcium in all forms of milk. The only difference among the types of milk is the fat content. The calcium is found in the nonfat part of the milk. So removing the fat doesn’t affect the calcium. A cup of milk will give you about 300 milligrams of calcium.
A few studies have linked a series of amino acids found in cow’s milk and juvenile onset diabetes. The ingestion of these amino acids by those genetically predisposed to diabetes triggers an immune response that can attack the milk protein and insulin producing cells in the pancreas which can lead to diabetes. It was pointed out that the risk is greater in infants younger than 12 months.
The American Academy of Pediatrics has discouraged the feeding of animal milk to infants since 1976. They’ve pointed out that milk is a poor source of iron and can cause bleeding in the digestive tract, which can lead to anemia.
Milk is one of the best sources of calcium. It’s recommended that an adult take in 800 milligrams of calcium daily. That’s about 2 1/2 cups of milk. Teenagers, young adults, and lactating women need 1200 milligrams daily. That’s only 4 cups of milk. Some experts also recommend postmenopausal women take in 1200 milligrams of calcium daily.
Calcium is the most abundant mineral in the body. Ninety-nine percent of the calcium in your body is found in your bones. Though it’s true that calcium plays a crucial role in building strong bones and teeth, it has many important functions.
Calcium helps to regulate your heartbeat, nervous system and blood-clotting action, and prevents too much acid or alkali from accumulating in the blood. Calcium also helps the body utilize iron and aids in muscle contraction and relaxation. Recent studies show evidence that adequate calcium intake can help with problems such as water retention, cramps, mood swings and bloating associated with PMS, hypertension, arthritis and rheumatism. A calcium deficiency can lead to cramps, joint pain, irregular heartbeat, insomnia, tooth loss and bone ailments.
Oxalic acid, found in chocolate, spinach and rhubarb, when combined with calcium makes an insoluble compound, which may cause the formation of stones in the kidney or gallbladder. These foods should not be ingested with milk.
Eating a diet rich in calcium is one way to maintain strong bones. Most low-fat dairy products will provide at least 300 mgs of calcium per serving. Other sources of calcium are listed below.
Sardines, Atlantic (drained) 3 oz.
Salmon, sockeye, (drained) 3 oz.
Ice cream (1 cup)
Ice milk (1 cup)
Tofu (3 oz.)
Pizza, cheese (1 med slice)
Blackstrap molasses (1 tbsp)
Broccoli, raw cut (1 cup)
Soy flour, defatted (1/2 cup)
Almonds (1/4 cup)
Broccoli, cooked (1/2 cup)
Soybeans, cooked (1/2 cup)
Parmesan cheese, grated (1 tbsp.)
Collard greens, cooked (1/2 cup)
Dandelion greens, cooked (1/2 cup)
Mustard greens, cooked (1/2 cup)
Kale, cooked (1/2 cup)
Chick-peas, cooked (1/2 cup)
In addition to eating foods high in calcium, you can protect your bones by performing weight-bearing exercises such as walking or jogging. Walking outdoors is excellent because you also get a dose of sunshine, which helps the body synthesize vitamin D.
Fewer than half of American children and adolescent boys consume the government-recommended amount of dairy products. Less than 20 percent of the adolescent girls meet those same recommendations. Adolescents need to drink three 8-ounce glasses of milk or equivalent of dairy products, such as yogurt) daily.
The American Academy of Pediatrics recommends children up to 2 drink whole milk, because of the saturated fat content. The fat is needed for brain development. “Eighty percent of brain development occurs in the first two years of life.
Children over the age of 2 should drink reduced-fat milk (1 percent or 2 percent). “At this age they begin to take in more fat then needed in their diets.
In February 1994, the Food and Drug Administration approved the hormone bovine somatotropin (BST). This drug is can increase milk production in cows up to 25 percent. Opponents of BST say the hormone may increase the public risk for cancer and other health problems. The extra milk production requires the cow to be milked more often. This could increase the incidence of udder infection, which is treated by antibiotics. This could increase the growth of antibiotic-resistant strains of bacteria. It can also affect milk drinkers who are allergic to antibiotics.
Milk, even with all its problems, is a great source of calcium, complete protein and riboflavin. Milk also contains phosphorus, thiamine, and vitamins B6 and B12.
Before starting your fitness program, consult your physician.
For help with drug, alcohol and mental health problems call “Sobriety Through Outpatient” drug, alcohol and mental health treatment center at (215) 227-7867. Watch or listen to our recovery media stations every day at www.stop-recoveryradio.com.