Hold the gluten, please

Chances are, growing up you never heard of glutens or of Celiac Disease. Theories abound for why cases of this digestive disorder have become so prevalent, but there’s no denying that gluten sensitivities, allergies and related maladies such as lactose intolerance, Crohn’s Disease, Irritable Bowel Syndrome (IBS) and heartburn are tying our stomachs up in knots.

We’re all bombarded by tempting pastries, cakes and cookies, pasta and breads of every sort. For people who have or suspect they may have issues related to grains, eating healthfully poses a problem. But what exactly is “grain sensitivity” such as gluten intolerance or Celiac Disease, and how can you determine if you have it?

May is National Celiac Disease Awareness Month. Celiac Disease is an autoimmune disease in which a person can’t tolerate gluten, a protein in wheat, rye, and barley. Gluten shows up in bread and pasta, but may also hide in many other foods such as cold cuts, salad dressings, beer and even candy and sweetened drinks.

If a person with Celiac Disease eats gluten, the lining of their small intestine becomes inflamed and damaged. That hampers the absorption of nutrients and can lead to malnutrition and weight loss. Celiac patients also struggle with symptoms such as diarrhea, stomach upset, abdominal pain, and bloating. While only one percent of Americans have Celiac Disease, as many as 10 percent may be gluten sensitive, which often causes similar symptoms, but doesn’t appear to damage the patients’ intestines.

Celiac Disease may take years to diagnose because people don’t seek medical help, and because doctors often mistake it for IBS or other stomach disorders. It’s often a waiting game, and a process of testing and running through a list of possible culprits. For long-term sufferers, years of poor calcium absorption, a related side effect, can lead to joint and tooth problems and, for women, delayed menstruation. Besides gastrointestinal symptoms, gluten-sensitive people often complain of fatigue and headaches, as well.

Celiac Disease is on the rise, with rates doubling about every 20 years in Western countries.  Ironically, researchers suspect that hygiene may play a role in that expansion. Due to far cleaner environments and hygiene, children today aren’t exposed to as many antigens in the environment while their immune systems are developing. This, it’s theorized, may result in our immune systems responding intolerantly toward glutens.

Though Celiac Disease can be diagnosed through a blood test and an intestinal biopsy, there’s no reliable test for gluten sensitivity. Diagnosis requires a historical perspective (it often runs in families) and discussion and tracking of symptoms. In fact, patients are typically asked to eat glutens so the body produces antibodies for the blood test to detect Celiac disease. If a person simply stops ingesting gluten, a Celiac Disease diagnosis can be missed or delayed.

The “good news,” at least for people with gluten allergies or sensitivities, is that a strict, gluten-free diet can typically allow the intestines to restore themselves to health and alleviate suffering.  Supermarkets and health food stores now carry a variety of gluten-free products, and new labeling requirements on processed foods do a better job of listing ingredients. Many restaurants and take-out food services have gluten-free products, as well.

It’s important to note, though, that while gluten-free eating is life-changing for many, if you don’t have gluten sensitivities or Celiac Disease, going “gluten free” is not good for your health. Contrary to common belief, a gluten-free diet won’t aid weight loss, and can cause deficiencies in iron, vitamin B12, vitamin D, magnesium, fiber, and other nutrients that we typically gain through bread, cereals and other grains that are fortified. Additionally, gluten-free products on store shelves are typically higher in carbohydrates, fat and sodium, and lower in fiber.

With proper direction, people can bake healthier breads at home, varieties that are higher in fiber and protein and made with gluten-free grains that have been certified to be uncontaminated and gluten-free, such as quinoa, amaranth, or millet. Either way, if you suspect you may be gluten sensitive, talk with your physician – there is hope, and there are many tasty alternatives!

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Being sandwiched eats away at our health

Generational forces are driving socio-economic changes in lifestyles and families that are contributing to stress and negatively affecting our health and wellbeing. One prime example is the pressures faced by Baby Boomers as they come of age and, in many cases, find themselves faced with caretaker burdens that “sandwich” them between supporting their children, themselves, and aging parents.

It is estimated that American families provide 80 to 90 percent of all in-home long-term care services for their aging family members, disabled adult children, and other loved ones.  These services may include assistance with activities of daily living, medical services coordination, medical supervision, administration of medications and assistance with financial, legal, spiritual and emotional concerns. These family caregivers often go unrecognized and are typically over-utilized. Focusing on their children, parents, and jobs, their own needs often go unfulfilled, which leads to additional stress.

Typically the American “Sandwich Generation” caregiver has been a woman in her mid-forties, married, employed and caring for her family and an elderly parent, usually her mother. Today, however, there are more and more men finding themselves in a caregiving role as well, and often they are squeezed in between the generations. 

The demanding role of being multi-generational caregivers spreads across all racial, gender, age and ethnic boundaries.  Some of the common stressors that affect both urban and rural sandwich generation caregivers are:

  • Splitting time between children/family and elder loved ones
  • Finding time for each caregiving role
  • Finding time for marriage or a significant other
  • Finding time for yourself
  • Not falling behind in your work or bringing your home stress to the work place
  • Keeping generational peace between children and elder loved ones
  • Finding the resources needed to care for family members
  • Combating feelings of isolation
  • Dealing with all the guilt associated with not having enough time to accomplish all that “should” be done.

Related challenges include geographic barriers to resources, and isolation from other caregivers, family members or informal supports.  The lack of service or care network availability, especially burdensome outside of cities, can add to caregiver stress, burnout, and depression. Solving these issues and controlling related stress and health factors is critical, though not easy – it requires adjustments on both sides, establishing boundaries, and setting priorities that include time for yourself, empathy and outreach to others. If you’re “sandwiched,” here are a few tips to help achieve better balance:

Regular “team” communication. Consider having a weekly family meeting where you discuss upcoming events, responsibilities, issues and opportunities. This gives everyone in the family the opportunity to discuss what’s on his or her mind in an open, safe environment. Use this forum to discuss the many different caregiving tasks that need to be accomplished each day or week. 

Set a family weekly or monthly task list.  Set mutual expectations for how the many tasks of caregiving will be accomplished.  Caregiving often becomes a one-person show but it does not need to be if you have family support. 

Ask for assistance. Make a point of picking up the telephone and spending time calling resources such as your local area Agency on Aging, hospital, a social worker, a physician or a local church or temple. There are a variety of services available in most communities and cities. Many can be found on the internet or simply by talking with other caregivers, social service agencies, behavioral health centers and related professionals.

Take time to care for yourself.  Sandwich generation caregivers become run down and sick because they have not taken time to care for themselves.  You can’t care effectively for your loved ones if you don’t care for yourself, as well.  Here are some useful hints to help make sure you focus on your own needs as well as those you are caring for:

  • Take time every day to “check-in” with yourself, even if it is only for half an hour.  This should be your protected time.  Enjoy this time by reading, listening to music, exercising or whatever you like to do.
  • Remember to take time to laugh, talk with friends, and eat properly, especially nutritious food rather than prepared foods high in fat, sugar and salt.
  • Take time to be “in” your marriage or relationship.
  • Try to “be present” at work as much as possible… our jobs exercise our creativity and usefulness in different ways, and association with others outside the home is valuable, emotionally.
  • Listen to your body – if it’s telling you to slow down, or that something is not right, seek medical advice.  Also seek assistance from a therapist or professional counselor versed in caretaker stress.

Every caregiver and caregiving situation is unique, but there are always common factors bridging situations and caregivers.  Support can come from many different sources and in many different ways as long as you seek it out and remember, always, that taking care of yourself is your most important job.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Mirror mirror on the wall, who’s the sneeziest of them all?

Sneezy, Sleepy, and Grumpy may have been three of the seven dwarves of Disney fame, but Itchy, Runny, and Miserable could be their springtime cousins. The flowering trees in New England are a colorful and welcome break from the bleak winter landscape. However breathtaking, though, they can take our breath away… literally. For all its beauty, this is a difficult time of year for millions of Americans, and the severity of allergy season can vary according to where you live, the weather, indoor contaminants and many other elements.

Seasonal allergic rhinitis is usually caused by mold spores in the air or by trees, grasses, and weeds releasing their pollens. Outdoor molds are very common, especially after a spring thaw. They are found in soil, some mulches, fallen leaves, and rotting wood. Everybody is exposed to mold and pollen, but only some people develop allergies. In these people, the immune system, which protects us from invaders like viruses and bacteria, reacts to a normally harmless substance called an allergen (allergy-causing compound). Specialized immune cells called mast cells and basophils then release chemicals like histamine that lead to the symptoms of allergy: sneezing, coughing, a runny or clogged nose, postnasal drip, and itchy eyes and throat.

Asthma and allergic diseases, such as allergic rhinitis (hay fever), food allergy, and atopic dermatitis (eczema), are common for all age groups in the United States. For example, asthma affects more than 17 million adults and more than 7 million children. It’s estimated that one-fifth of all Americans are allergic to something, whether seasonal, airborne or food related. Nasal allergy triggers can be found both indoors and outdoors, and can be year-round or seasonal. It’s important to be aware of the times of day, seasons, places, and situations where your nasal allergy symptoms begin or worsen. If you can identify your triggers, and create a plan for avoiding them when possible, you may be able to minimize symptoms. Here are a few points to remember:

  • You may be reacting to more than one type of allergen. For example, having nasal allergies to both trees and grass can make your symptoms worse during the spring and summer, when both of these pollens are high.
  • Molds grow in dark, wet places and can disperse spores into the air if you rake or disturb the area where they’ve settled.
  • People with indoor nasal allergies can be bothered by outdoor nasal allergies as well. You may need ongoing treatment to help relieve indoor nasal allergy symptoms.

If avoidance doesn’t work, allergies can often be controlled with medications. The first choice is an antihistamine, which counters the effects of histamine. Steroid nasal sprays can reduce mucus secretion and nasal swelling. The National Institutes of Health (NIH) says that the combination of antihistamines and nasal steroids is very effective in those with moderate or severe symptoms of allergic rhinitis. However, always consult with your physician before taking even over-the-counter medicines for allergies, as they may conflict with other medications or aggravate symptoms of other illnesses or chronic conditions.

Another potential solution is cromolyn sodium, a nasal spray that inhibits the release of chemicals like histamine from mast cells. But you must start taking it several days before an allergic reaction begins, which is not always practical, and its use can be habit forming. Immunotherapy, or allergy shots, is an option if the exact cause of your allergies can be pinpointed. Immunotherapy involves a long series of injections, but it can significantly reduce symptoms and medication needs.

Your physician can help pinpoint what you are allergic to, and tell you the best way to treat your nasal allergy symptoms. Provide detailed information about your lifestyle and habits to your healthcare providers. It will help them to help you with an appropriate treatment plan for relieving your symptoms.

The American Academy of Allergy, Asthma, and Immunology has some useful tips for those who suffer from seasonal allergies:

  • Wash bed sheets weekly in hot water.
  • Always bathe and wash hair before bedtime (pollen can collect on skin and hair throughout the day).
  • Do not hang clothes outside to dry where they can trap pollens.
  • Wear a filter mask when mowing or working outdoors. Also, if you can, avoid peak times for pollen exposure (hot, dry, windy days, usually between 10 am and 4 pm). Although pollens are usually emitted in early morning, peak times for dissemination are between around 10 am and 4 pm.
  • Be aware of local pollen counts in your area (visit the National Allergy Bureau Website).
  • Keep house, office and car windows closed; use air conditioning if possible rather than opening windows.
  • Perform a thorough spring cleaning of your home, including replacing heating and A/C filters and cleaning ducts and vents.
  • Check bathrooms and other damp areas in your home frequently for mold and mildew, and remove visible mold with nontoxic cleaners.
  • Keep pets out of the bedroom and off of furniture, since they may carry pollen if they have been outdoors (or exacerbate your allergies if, for example, you’re allergic to cat dander).

For allergy information from NIH’s National Institute of Allergy and Infectious Diseases, visit www.niaid.nih.gov/publications/allergies.htm. For prevention strategies from NIH’s National Institute of Environmental Health Sciences, visit www.niehs.nih.gov/airborne/prevent/intro.html.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Use your head to save backs — and bucks

If you or your workers spend a portion of each day working at a computer, a desk, or other type of workstation, repetitive motions, posture, and back, arm and wrist support all play significant roles in physical health and wellness. Proper chair type, size and design, workstation height, location of keyboards, phones, shelves, and tools can contribute to body fatigue, muscle strain, repetitive-motion injuries, and other debilitating factors affecting work and quality of life.

Ergonomics is the scientific discipline concerned with the understanding of interactions among humans with other elements of a system. It’s particularly relevant in the design of things such as safe furniture and easy-to-use interfaces with machines and equipment. Proper ergonomic design is necessary to prevent repetitive strain injuries and other musculoskeletal disorders, which can develop over time and lead to long-term disability.

Ergonomics examines the “fit” between the user, equipment and their environments. It takes account of the user’s capabilities and limitations to ensure that tasks, functions, information and the environment suit each user. To assess the fit between a person and the technology, ergonomists consider the job (activity) being done and the demands on the user; the equipment used (its size, shape, and how appropriate it is for the task), and the information used (how it is presented, accessed, and changed).

Proper ergonomics may prevent musculoskeletal injuries (such as back strain or carpal tunnel syndrome) by reducing physical and mental stress caused by the workstation setup. By focusing on the physical setup of workstations and the tools employees use, employers can reduce chances of injuries. It also is important to evaluate the work process, including job organization, worker rotation, task variety, and demands for speed and quality.

Working intensely over long periods of time without taking breaks can greatly increase the risk for musculoskeletal injuries. Taking regular breaks from work and doing stretching exercises may reduce the risk of repetitive motion injuries. For example, it’s advised that workers try taking three- to five-minute breaks or change tasks every 20 to 40 minutes. Here are some tips to improve workstation safety and efficiency:

  • Arrange work so you (or a worker) can sit or stand comfortably in a position that does not put stress on any specific area of the body. You should be able to keep your neck in a neutral position and minimize the need to look up or to the sides continuously while you are working.
  • Eliminate most movement from the waist. Keep the workstation and workstation tools within reach without having to lean, bend, or twist at the waist frequently.
  • Vary postures if possible.
  • Take 10- to 15-second breaks frequently throughout tasks. For example, look away from the computer monitor or machine, stand up, or stretch arms and legs. Short breaks also reduce eyestrain and buildup of muscle tension.
  • Stretch your body by getting up out of your chair and stretching your arms, shoulders, back, and legs. When you are sitting, shrug and relax your shoulders, and if you have a chance to take short walks, do so whenever possible.
  • If you do similar work or activities at home, be sure to apply these principles there as well to avoid the cumulative effect of repetitive motions.

For office workers, particularly, there are a variety of preventive solutions that can help limit or avoid muscular discomfort or injuries. Computer monitors, for example, should be easy to see without having to lean forward or look up to one side. They should be placed at a height where the top of the screen is at eye level or within 15 degrees below eye level, and less than an arm’s length from the user.

Protection against eyestrain can prevent headaches and vision problems. Glare guards can be placed over the monitor screen, and plasma screens reduce glare. Additionally, many keyboards and keyboard trays have wrist supports to help keep wrists in a neutral, almost straight position. But wrist pads are just there for brief rests. They are not meant to be used while typing, even though some people find they help even during keying.

It’s important to have a computer keyboard and keyboard tray that allows comfortable typing or keying, and it should be at a height that allows elbows to be bent about 90 degrees and close to your sides. Also, when you type, try raising your wrists from the support so your wrists are in a neutral position. You may want to alternate between resting your wrists on the supports and raising them up. Also, a computer mouse or pointing device that does not require a lot of forearm movement or force, such as a trackball mouse or touch pad, is more comfortable than a standard mouse for some people.

Of vital importance is the comfort and design of the office or workplace chair, which should maintain normal spinal curvature. A supportive chair:

  • Is adjustable, so that you can set the height to rest feet flat on the floor. Keep feet supported on the floor or on a footrest to reduce pressure on the lower back. Some people like to sit in a slightly reclined position because it puts less stress on the back, although this may increase stress on the shoulders and neck when they reach for items.
  • Supports the lower back.
  • Has adjustable armrests that allow elbows to stay close your sides. If you are not comfortable with armrests, move them out of your way. It is still important to keep your arms close to your sides even if you choose not to use armrests.
  • Has a breathable, padded seat.
  • Rolls on five wheels for easy movement without tipping.

These and many other ergonomic principles available online and through facilities consultants and workplace-design specialists will help ensure a healthier workplace and workers that are more comfortable and less prone to workplace-related injuries. Investing properly in worker comfort is more than a simple amenity – it will improve morale, safety and productivity, and reduce worker’s compensation costs and absenteeism.

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If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!