Catching the Right Kind of Island Fever

As the thermometer lingers in the single digits, snow piles up and the cold winter wind chills us to the bone, a tropical vacation becomes more appealing every day. If you’re planning an island escape this winter–or any time of year, for that matter–there are several warnings to heed before you venture to areas of the world where diseases that are rare here can be rampant.

Because the risk for certain diseases varies greatly depending on where you’re going, it’s important to know as much about your itinerary as possible. This is true whether you are traveling with a guided tour or planning your own visit. When you review your itinerary, be sure to consider:

  • Where you will be traveling, including whether you will be in urban or rural areas
  • How long you will visit
  • What season you will visit
  • Lodging conditions (air conditioning, open-air tents, or screened-in house or room)
  • Mode of travel
  • Food
  • Planned activities

Travelers should get vaccinated before visiting certain areas of the world to help protect them from serious illnesses. Travel vaccines are safe, effective ways to help protect travelers from bringing home more than they bargained for. There are a variety of other simple precautions to consider, as well. You can check which vaccinnes are recommended or required by visiting the Centers for Disease Control and Prevention’s Travel Center.

Hand washing is critical, as is carrying around an alcohol-based sanitization gel. It’s also important to know which foods are safe to eat, drinking water that is bottled or boiled to get rid of organisms, and to be careful about other bottled, carbonated drinks.

Some of the nastiest ailments in the world fall under the category of “tropical diseases.” In 2015, the Caribbean became a recognized hub for the Zika Virus, a health threat predominantly for pregnant women. Additionally, Chikungunya is an illness caused by a virus that spreads through mosquito bites. The most common symptoms of chikungunya are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash.

Travelers who go to Africa, Asia, parts of Central and South America, islands in the Indian Ocean, Western and South Pacific, and to the Caribbean are at risk. The mosquito that carries chikungunya virus bites primarily during the daytime, both indoors and outdoors, and often lives around buildings in urban areas. There is no vaccine or medicine to prevent chikungunya. The only way to prevent chikungunya is to prevent mosquito bites. That can be difficult, but it is important, as you can get sick after just one bite.

Using insect repellant religiously and liberally, wearing long sleeves and hats, and sleeping under mosquito netting when outdoors or in open conditions are important safety considerations. Specific drugs are used to prevent malaria and should be used by travelers to certain regions.

Other travel-related health risks

While oceanfront dining often means the freshest seafood, in some underdeveloped countries, a lack of sufficient plumbing can lead to waterborne illnesses.

Bivalves such as oysters and clams filter large amounts of water when feeding. If shellfish are living in water that has been contaminated with stool containing the hepatitis A virus, the shellfish may carry the virus. People then may get it when they eat the raw or undercooked shellfish. To reduce the chance of getting sick, make sure that shellfish have been cooked thoroughly.

You also can catch the disease if you drink water or food that’s been contaminated with the stool of someone with the virus. Other ways to get infected with hepatitis A include:

  • Eating fruits, vegetables, or other foods that were contaminated during handling
  • Eating raw shellfish harvested from water that’s got the virus in it
  • Swallowing contaminated ice

Protective measures include getting vaccinated for hepatitis A and B, and making sure your children get vaccinated as well. The CDC recommends the vaccine for all children starting at one year old.

If you’re cooking on your own in foreign countries, practice good hygiene habits such as regular hand washing, especially after using the toilet, after changing a diaper, and before you prepare or consume food. Wash dishes in hot, soapy water or in a dishwasher, and don’t eat or drink anything if you’re worried about how it was prepared. Also, drink bottled water or boil water before drinking it, and avoid drinks made with ice cubes.  Finally avoid raw foods, including unpeeled fruits or vegetables.

Here is a list of vaccine-preventable, travel-related diseases that are not covered by routine adult vaccinations:

  • Hepatitis A
  • Hepatitis B
  • Typhoid and Paratyphoid Fever
  • Meningococcal disease
  • Yellow Fever
  • Dengue fever
  • Malaria
  • Rabies
  • Japanese Encephalitis

You may need one or more of these vaccines depending on any number of variables. In some cases, proof of vaccination is required before you can obtain a visa. Still, it’s important to discuss preventative steps with your physician relative to your destination.

Many travel immunizations need to be taken in a series of shots given over a period of days or weeks. Plus, vaccines take time to work. Travel health experts recommend giving yourself four to six weeks to meet with a travel health provider about how to plan for your travel and to get any needed travel vaccinations.

If you are taking medications for a condition like diabetes, there may be certain drug interactions you need to be aware of. For example, some drugs may reduce the effectiveness of travel vaccinations. Also be aware that in some countries, you may have trouble filling your maintenance prescriptions, so plan accordingly so you don’t run out.

Finally, the wisdom of any sexual encounter in the Caribbean also needs to be weighed against the very real risks of disease, sexual violence, or worse. The Caribbean has the second-highest rate of HIV/AIDS in the world: at least 230,000 people in the region have the disease.

Vacation should be fun, not spent in a hospital bed or filled with worry and anxiety. If you take the proper precautions before you travel and while abroad, chances are you’ll have a fantastic time and the only thing you’ll catch is the travel bug.

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!

Vitamins As a Substitute for Sunlight and Important Nutrients? What Works and What Doesn’t

January through March are particularly tough months–even though the days are growing longer, it’s dark and dreary. With the frigid temperatures, sun exposure is a tease. Typically, the few minutes we get between our houses, work, school, or the grocery store isn’t enough to revitalize us or replenish natural nutrients and vitamins.

What’s more, the average American diet typically lacks in a number of essential nutrients, including calcium, potassium, magnesium, and vitamins A, C, and D. Many people turn to dietary supplements in hope of getting an extra boost and a preventive buffer to help ward off disease.

But supplements don’t always deliver better health. In fact, some can even be dangerous when taken in larger-than-recommended amounts.

Are supplements dangerous?

Many supplements help replace vitamins that may be lacking in our diets. For example, studies claim vitamin D is a possible defense against a long list of diseases, including cancer, diabetes, depression, and even the common cold. Omega-3 fatty acids are touted for warding off strokes and other cardiovascular events. And antioxidants such as vitamins C and E and beta carotene have been studied as effective agents against heart disease, cancer, and even Alzheimer’s disease.

But much of the testing has been observational; the results of more stringent randomized controlled trials, which also examine dietary factors, exercise habits and other variables, haven’t yielded overall positive results. Additionally, people who take supplements already tend exercise more, eat better, and have an overall healthier lifestyle.

Outside of observational studies, some supplements turned out to be not only ineffective but also risky. Vitamin E, initially thought to protect the heart, was later discovered to increase the risk for bleeding strokes. Folic acid and other B vitamins were once believed to prevent heart disease and strokes, but later studies raised concerns that high doses of these nutrients might increase cancer risk.

Stay focused on proper nutritional balance

We need a variety of nutrients each day to stay healthy, including calcium and vitamin D to protect our bones, folic acid to produce and maintain new cells, and vitamin A to preserve a healthy immune system and vision.

It is best to try to get these vitamins, minerals, and nutrients from food as opposed to supplements. Fruits, vegetables, fish, and other healthy foods contain nutrients and other substances not found in a pill, which work together to keep us healthy. Taking certain vitamin or mineral supplements in excess may even interfere with nutrient absorption or cause side effects.

For many people, simply taking a multi-purpose daily vitamin is enough. For others, certain vitamins missing from our diets can be replenished specifically. Often a simple blood test can help identify potential vitamin deficiencies. Vegan or vegetarian diets, can be especially susceptible to a lack of calcium and vitamin D.

Sun exposure in the winter months also is helpful, even in small doses. Many people get depressed in the winter–some may be suffering from Seasonal Affective Disorder (SAD), which affects approximately 10 percent of the population. Symptoms of SAD include sleeping too much, lack of energy and low moods or depression. Usually symptoms clear up when the weather changes.

Light therapy is a common and effective treatment for SAD. The use of bright light for up to one hour per day has been shown to be effective and can work after just one week. Being active at dawn and dusk may help reset the sleep/wake cycle of those with SAD. And though it may seem like an obvious solution, tanning booths are not healthy alternatives to proper sun exposure.

Vitamin deficiencies and solutions

Before taking supplements it’s important to know whether the potential benefits outweigh the risks. Look at the results of well-designed studies and discuss your overall health with a licensed nutritional expert and your physician, especially if you have a chronic diseases or are taking other medications.

Psychology Today lists some common vitamin concerns and potential solutions:

B-Complex vitamins affect your mood and energy by  converting proteins from your diet into neurotransmitters. B-complex vitamins also support heart health, improve our response to stress, and help boost energy levels. While most B vitamins have some benefits for mental health, in terms of depression, the most important B vitamins include vitamin B6, B9 (folic acid) and B12.

Good sources of B-vitamins include beef, poultry and organ meats, tuna, nutritional yeast, brewer’s yeast, whole grains, potatoes, bananas, lentils tempeh, beans, dark leafy vegetables, fortified cereals and molasses. Vitamin B12 is not available from plants, which makes B12 deficiency a concern for strict vegans.

Vitamin D deficiency is particularly likely in the winter when low levels of sunlight and lack of stored vitamin D exacerbate borderline or low vitamin D levels. Vitamin D deficiency is especially common in vulnerable populations such as African-Americans, the elderly, children, the obese, pregnant women and breastfed babies.

The suggested upper limit for adults is 2,000 IU per day of vitamin D3. However, if this does not produce a healthy blood level of vitamin D, higher doses can be used under the supervision of a health care practitioner.

St. John’s Wort is thought to have an antidepressant effect. Research has shown that it is effective for mood, anxiety, and depression-related insomnia.

Most studies used dosages of 300 mg of an extract three times daily. But there are potential side effects, including its potential to lower the efficacy of certain medications including birth control pills, medications for migraines (Imitrex, Zomig, other triptans), alprazolam (Xanax), the cough medicine Dextromethorphan (Robitussin DM and others), Digoxin, Fenfluramine, Demerol and other medications. Talk to your doctor before taking St. John’s Wort if you have been diagnosed with bipolar affective disorder or you are on prescription antidepressant medications.

Fish oil is a well-recognized mood-support supplement. Consumption of fish in the diet or supplementation of omega-3 fatty acids is safe and cost-effective and has been shown to benefit heart disease, reduce suicide risk, and reduce symptoms of depression and bipolar disorder. Higher consumption of fish is also associated with lower rates of seasonal affective disorder (SAD) and postpartum depression.

Foods high in omega-3 fatty acids include fish, leafy greens, soy, nuts and seeds. For mild mood changes, take 2,000 – 3,000 mg daily. However, if you take a blood thinner, check with your physician before taking fish oil as it may increase bleeding time.

If you believe you may be lacking in a particular nutrient, ask your doctor whether you need to look beyond your diet to make up for what you’re missing, but never take more than the recommended daily intake for that nutrient unless your health care provider advises it.

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!

So What If It’s Winter – Get Out and Play!

As winter descends with its shorter days, frigid temperatures, ice and snow, the harsher weather conditions shouldn’t be seen as a deterrent to going outdoors. If anything, the winter landscape is beautiful and inviting . . .  as long as you dress properly and take cold-weather precautions to keep you healthy and safe.

Preventing hypothermia is a major concern for those who work or recreate outdoors in the winter months. Hypothermia is caused by prolonged exposures to very cold temperatures. When exposed, your body begins to lose heat faster than it’s produced. Lengthy exposures will eventually use up your body’s stored energy, which leads to lower body temperature.

Body temperature that is too low affects the brain, making us unable to think clearly or move well. This makes hypothermia especially dangerous, because a person may not know that it’s happening and won’t be able to do anything about it.

While hypothermia is most likely at very cold temperatures, it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water. Victims of hypothermia are often older adults with inadequate food, clothing, or heating; babies sleeping in cold bedrooms; people who remain outdoors for prolonged periods, such as the homeless, hikers, hunters, skiers and snowmobilers; and people who drink alcohol or use illicit drugs.

Warning signs of hypothermia include shivering and exhaustion; confusion and fumbling hands; memory loss; slurred speech; and drowsiness. If you notice any of these signs, take the person’s temperature. If it is below 95° F, the situation is an emergency—get medical attention immediately.

If medical care is not available, begin warming the person, as follows:

  • Get the victim into a warm room or shelter.
  • If the victim has on any wet clothing, remove it.
  • Warm the center of the body first, including his or her chest, neck, head and groin, using an electric blanket, if available. You can also use skin-to-skin contact under loose, dry layers of blankets, clothing, towels, or sheets.
  • Warm beverages can help increase body temperature, but do not give alcoholic beverages.
  • After body temperature has increased, keep the person dry and wrapped in a warm blanket, including the head and neck.
  • Get medical attention as soon as possible.

A person with severe hypothermia may be unconscious and may not seem to have a pulse or to be breathing. In this case, handle the victim gently, and get emergency assistance immediately. Even if the victim appears dead, CPR should be provided. CPR should continue while the victim is being warmed, until the victim responds, or medical aid becomes available. In some cases, hypothermia victims who appear to be dead can be successfully resuscitated.

Dress for the weather

No matter your choice of outdoor activity, take appropriate measures to protect yourself. That includes dressing for the weather, making sure you’re properly hydrated, wearing sunscreen, knowing your limitations, and always respecting Mother Nature.

Dressing in layers and wearing the right types of materials are critical for keeping yourself warm in the cold weather. But when planning your outdoor wardrobe, moisture management is also an important consideration. To keep the body warm during high-energy activities, clothing should transport moisture away from the skin to the outer surface of the fabric where it can evaporate.

Cotton is a poor choice for insulation, because it absorbs moisture and loses any insulating value when it gets wet. Instead, moisture-wicking synthetics, which move moisture away from the skin and stay light, are the best choice for active winter sports like skiing, snowboarding, hiking or climbing. Not only do synthetic fabrics wick moisture away from the skin, they dry quickly and help keep you warm in the process.

Your next layer should be a lightweight stretchy insulator, such as a breathable fleece sweater or vest. The final part of your cold-weather wear should be a lightweight and versatile shell jacket. Fabrics like three-layer Gore-Tex and Windstopper allow companies to create shells that are ultra lightweight while remaining waterproof, windproof, and breathable. For aerobic activities, a shell’s ventilating features are particularly important. Look for underarm zippers, venting pockets, and back flaps.

Always bring a hat and gloves, regardless of the weather or your activity level. Proper foot protection is critical, as well — you should be wearing insulated and water-proof shoes or boots, and synthetic socks that won’t absorb sweat. As with the rest of your clothing, synthetic materials work best for protecting you against the extremes. Look for fleece hats made with Windstopper fabric, gloves and mittens layered with Gore-Tex and fleece, and socks made of synthetic, moisture-wicking materials.

Finally, bring an abundance of water or sports drinks when you recreate outdoors, and try to avoid caffeine or alcohol — both actually dry you out, instead of hydrating, and alcohol lowers your body temperature. Also, make sure you have a cell phone, that somebody knows where you are, and when you’ll be returning. And remember to wear sunscreen — the sun’s ultraviolet rays remain potent, even in the winter, and hydrating your skin with a UV-protective moisturizer will help protect you from wind and other elements.

Getting outdoors in the winter months should be part of your healthy-living planning. Exercising or working outdoors, or simply enjoying the winter beauty will help keep you well, emotionally and physically.

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!

Reducing Year-end Burnout

The end of each year, as well as the accompanying holidays, bring a multitude of gifts. While the holidays represent joy, gratitude and happiness for many people, they also are punctuated by a wide spectrum of emotional reactions including nostalgia, guilt, loneliness and, for many, sadness. These can become overwhelming and lead to depression, anxiety or illness.

The culmination of our business and calendar years increases pressure on us as we rush around trying to multitask, wrap up projects and budgets, deal with personal and family needs and prepare ourselves for the coming year. If money challenges are wearing on us, this time of year exacerbates financial woes, adding to stress and guilt. And if we’re alone, or missing people in our lives who have passed, moved away or otherwise departed, those feelings can come home to roost as the holidays rapidly approach.

It’s also a time of overindulgence, especially when it comes to eating and drinking. These activities, as wonderful as they are in moderation, may contribute to an unhealthy sense of self, which typically results in more unhealthy practices. Statistics for how much weight Americans tend to gain during this end-of-the-year smorgasbord vary from one pound to 10, but it’s undoubtedly a tough time for anyone trying to eat healthfully.

But it’s more than just overeating; exercise substantially reduces, as well. According to the National Center for Health Statistics, most Americans (approximately 60 percent) do not engage in vigorous, leisure-time physical activity. Add in the time demands of the holidays and the urge to stay inside because of the weather, and you have a recipe for even more inactivity.

What we need is our own way to help reduce stress and disorganization, improve our focus, and slow down enough – in a short, manageable period – to regain our emotional and physical footing without losing traction or productivity. Some people hit the gym, run or take a walk; others go out to eat, read, nap, pray or call a friend. Many also find that the pursuit of mindfulness – the ability to slow ourselves down, focus and truly be present in the moment – can be enhanced through meditation or other relaxation activities.

Taking charge

Many factors combine to increase the urge to overeat or feel stressed during this season. Holiday feasting, as well as stress, exhaustion and wintry weather can dampen the best of workout intentions. To make this holiday season a healthier one, it’s important to be conscious of what we’re eating, and to manage our stress and emotions.

  • Practice awareness.  It’s important to be conscious of what we eat and how much. Allow yourself some special treats at the holidays but consider moderate servings. When there’s a lot of food available, try an appetizer-sized helping of each dish instead of a full serving. Don’t deprive yourself, but be aware of content and calories. When possible, avoid foods rich in fats, salt, sugar, and preservatives. Remember, we don’t have to indulge every minute. We can allow some treats for those special days, and then get back into our healthy routines the next day.
  • Manage stress and emotions.  For some people it’s an abundance of friends and family coming out of the woodwork that has them down. In contrast, you may be alone, not have your family or friends nearby, and feel isolated. The holidays are very nostalgic, but for every good memory there also may be memories of family members and friends now deceased or living far away, and traditions no longer possible. Spending time with difficult family members, grieving the loss of a loved one, feeling pressure to give gifts when finances are tight, and loneliness can leave people feeling sad, angry, or even depressed. And these feelings are aggravated by the shorter, colder days and reduced sunlight.
  • Outreach and consistency are good. It’s always beneficial to try and continue our normal routines to help feel like we’re still in control. We can consciously try to not over-eat and make time for exercise and rest. Additionally, personal outreach, especially socializing and connecting with old friends and associates, is important for our emotional health. We humans are social creatures, and while digital outreach is valuable and sometimes our easiest option, the Internet tends to act as a buffer between us and real intimacy.
  • Dealing with the holiday blues. Though depression as the holidays near is common, there is a difference between the holiday blues, which are often temporary and go away once the season ends, and more serious conditions. Seasonal Affective Disorder (SAD) is a psychological state that literally changes your biology and can cause or add to depression. Depressed individuals tend to feel helpless and hopeless about changing their situation. If the holiday blues seem to linger or become more intense, seek help from a mental health professional.
  • Do your personal planning. This is the perfect time to assess what you did or didn’t accomplish in your personal health and wellness efforts, and to plan action for the coming year. Set simple goals, and commit to action. That choice is yours, and can involve joining a gym or fitness center, changing your eating habits, participating in organized athletic events, swimming, learning to meditate, reading more, or getting involved through volunteering or charity work. Telling a friend about your goals or enlisting someone to be a partner increases your chance of success, and is more fun.

This season certainly isn’t a time to be punishing yourself. No matter if you forget to follow the above advice, your healthy habits slip a little, or you do end up eating that extra pumpkin pie, cookies or cheesecake – this is a time to recognize how far you’ve come this year, to celebrate what you’ve achieved and to show your body and yourself the love and respect you deserve.

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!

Wrap Up the Year With the Gift of Wellness

As the year winds down, it’s the perfect time to reflect on your 2017 health and wellness efforts, and to contemplate how you can do more in 2018. One of the best gifts employers can give themselves and their employees are gifts that “keep on giving,” such as improved long-term employee health, tools for reducing stress, and activities that will enhance teamwork, productivity and morale.

Helping employees meet individual or team goals through successful planning and execution, a sense of accomplishment, providing service, and feeling valued are indisputable contributors to success, retention, and service excellence. Additionally, generosity, giving, and awareness create a sense of increased goodwill and can increase the bond between employer and employee, and among staff.

By supporting employees’ interests in local or national organizations through donations, fund- raising activities and in-kind services, you help your staff achieve that valuable sense of accomplishment and caring that comes from generosity and giving to others.

Additionally, every month brings a variety of wellness, disease awareness and health-related special events, activities and recognition. These represent some of the proverbial “low-hanging fruit” for promoting, encouraging and rewarding employee workforce participation. And if you time your internal outreach to the wide variety of wellness material available online, through your healthcare insurance provider and from CBIA, you’ll find the resources and educational information robust and easily available.

Here are some simple ideas you can consider for a healthier new year:

  • Health and wellness planning:Host a planning session — led by employees or by an outside expert – where participants can talk about their personal health and wellness goals, and discuss possible group support, in-house challenges and activities.
  • Nutritional guidance: Ask a professional nutritionist or dietitian to meet with staff at a group lunch, or in one-on-one or small group meetings to talk about healthy eating, smart dieting and nutritional awareness.
  • Gym memberships:If you don’t already, consider offering an allowance to employees to use for purchasing a gym, yoga or fitness center membership, or consider bringing a fitness trainer or yoga instructor onsite.
  • Offer incentives:Some organizations incentivize employees by rewarding them for healthy activities such as setting and achieving personal wellness goals, or by completing wellness workshops and classes. Many companies also allow employees to take work time to visit their primary care physician for their annual physicals.
  • Community outreach: Building up morale in the company is a commonly overlooked wellness initiative, but the results are always positive. Lead this initiative by getting a team together for a charity event or race, volunteer, “adopt” a family or charity for the holidays, raise money as a team for gifts, match team and individual efforts, and encourage employees to donate food, time and services.
  • Stress relief: Studies show that a power nap or meditation increases alertness, memory and stamina. Some companies have designated an office or area where employees can reserve times during the day for relaxing, and forward-thinking organizations find ways to reward employees and help them “recharge” by allowing them much-needed “down time” that is customized to individual needs. Also consider inviting a yoga instructor or massage therapist to the workplace, and if possible, create a space for team instruction.
  • Teambuilding activities: Some companies sponsor art nights, onsite or at local art centers, where employees can paint, complete ceramics or pursue other artistic endeavors as a team. Charitable walks and runs, fitness competitions or bicycle rides, bowling or volleyball are other good team activities, as are skating, skiing and other outdoor recreational challenges that can be turned into team fun. Many companies also sponsor facilitated off-site retreats focused on team building, communication, planning and interpersonal development.
  • Smoking-cessation:A variety of free or inexpensive smoking cessation programs are available locally through the American Lung Association, hospitals and other sources.

Whatever you choose, remember that sometimes the best gifts can’t be wrapped!  Have a happy and healthy holiday season and year to come.

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!

Keeping It Clean

We are already neck deep in holiday eating, and the extended forecast calls for seasonal gluttony, gluttony and more gluttony. While eating in moderation is advised, we might as well enjoy ourselves, and start thinking about how we’re going to shed a few pounds, exercise more or generally focus on maintaining or improving our personal health in 2018.

One process that gets a lot of attention is detoxification, or using a “cleansing diet” to rid ourselves of unwelcome compounds. Detoxification is performed naturally, 24/7, utilizing important nutrients from our diet. Our bodies transform molecules, or toxins, that need to be removed from the body. They fall into two main categories: toxins made in the body as byproducts of regular metabolism (endotoxins), and those that come from outside the body and are introduced to the system by eating, drinking, breathing or those absorbed through the skin (exotoxins).

Endotoxins include compounds such as lactic acid, urea and waste products from microbes in the gut. Exotoxins include environmental toxins and pollutants, pesticides, mercury in seafood, lead from car exhaust and air pollution, chemicals in tobacco smoke, dioxin in feminine care products, phthalates from plastic and parabens from lotions and cosmetics.

Detoxification also is the process by which medications are metabolized, then excreted. Because toxins are potentially dangerous to human health, they need to be transformed and excreted from the body through urine, feces, respiration or sweat. Our ability to detoxify varies and is influenced by environment, diet, lifestyle, health status and genetic factors.

But, like many other bodily systems, too much “in” and not enough “out” can throw off our gastrointestinal balance, exceeding the body’s ability to excrete toxins. When this occurs, the toxins may be stored in fat cells, soft tissue and bone, negatively affecting health.

How to detoxify

Detoxification protocol recommends removing processed foods and foods to which some people are sensitive, such as dairy, gluten, eggs, peanuts and red meat. Instead, we should try and eat organically grown vegetables, fruit, whole nonglutenous grains, nuts, seeds and lean protein.

Fasting, which seems a normal reactive response, may actually suppress detoxification pathways in the body. Many health practitioners advise against this practice. Detoxification programs can vary widely and may pose a risk for some people (such as people with multiple maladies, those who take multiple medications and pregnant or breast-feeding women). Whatever you choose to do, it is important to work with a credentialed health professional for guidance and support.

Simple, ongoing detoxification doesn’t require a rigorous plan; doing some or all of the following can support healthy detoxification:

  • Maintain adequate hydration by consuming plenty of clean water.
  • Eat five to nine servings of fruit and vegetables per day.
  • Consume a significant amount of fiber each day from vegetables, nuts, seeds and whole grains.
  • Eat cruciferous vegetables, berries, artichokes, garlic, onions, leeks, turmeric and milk thistle, and drink green tea. These foods support detoxification.
  • Consume adequate protein, which is critical to maintaining optimum levels of glutathione, the body’s master detoxification enzyme.
  • Consider taking a multivitamin/multimineral to fill any gaps in a healthy diet, since certain vitamins and minerals enable the body’s detoxification processes to function.
  • Eat naturally fermented foods such as kefir, yogurt, kimchi and sauerkraut, eat yogurt with active enzymes, or take a high-quality probiotic to help the body manage toxins from microbes that live in the gut.
  • N-acetylcysteine (NAC), a precursor to glutathione, often is recommended to support the body’s natural detoxification activity.
  • Maintain bowel regularity.

Beware of juicing and cleansing products

Many popular “juice cleansing” or all-liquid diets are available in stores, or touted online, but they aren’t necessarily healthy or safe, or the best path to true wellness.

Juice cleanses often require expensive, prepackaged bottles of pulverized produce blends, or they can be homemade in a juicer or blender. Trendy beverages might contain kale, spinach, green apple, cucumber, celery and lettuce, or a red concoction made with apple, carrot, beets, lemon and ginger. While popular (and containing healthy foods), there’s no scientific research that proves these cleansing diets provide short- or long-term benefits, nor are they a healthy or safe approach to weight loss.

One of the most well-known detox diets instructs people to drink lemon juice and water spiked with maple syrup and cayenne pepper — supposedly this helps the body remove toxins and aid in speedy weight loss. Physicians worry that any 10-day liquid diet, regardless of the combination of liquids you imbibe, could pose serious health risks, especially for people who use it for longer periods of time.

During the first few days of a juice cleanse, a person initially burns their glycogen stores for energy. Using glycogen (the stored form of glucose) pulls a lot of water out of the body, which causes weight loss. But the loss of water weight comes at the expense of a loss of muscle, which is a steep price to pay. Weight loss is not always about the numbers on a scale, it’s also about the ratio of body fat compared to lean muscle mass.

A cleansing diet is low in dietary protein and calories. Having more lean muscle and less body fat means burning more calories and boosting metabolism, in the long run. Additionally, a cleanse could also lead to side effects such as a lack of energy, headaches and shakiness due to low blood sugar. Over time, it may lead to constipation from a lack of fiber, as well as irritability. Physicians also caution against any diet that uses natural or synthetic laxatives.

Once we come off a cleansing diet and return to solid foods, it’s easy – and very common — to regain the weight we’ve just lost.  Some people may experience a psychological lift from a cleanse, such as feeling ready or motivated to adopt healthier eating habits, but it doesn’t replace smart, common-sense nutritional practices and healthy lifestyle changes. That includes setting simple goals, taking the time to determine how we’ll achieve them, and figuring out how to measure our success.


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!

Can You Pay Attention to This Article?

If you’re like most people, you have a lot on your plate. There’s always much to do for work, life and family, let alone finding time for personal issues, errands and recreation. Staying focused can be challenging, especially with so many distractions from goings-on around us, social media, work, school and deadline demands. Some people are adept at eliminating or controlling distractions and able to get things done on time and without too many deviations. But for others, remaining present, in the moment and able to focus effectively on one task while others are pounding on the door or waving for your attention can be difficult and often insurmountable.

The difficulty of remaining focused, an inability to complete tasks without interruption, and the failure to successfully negotiate the distracting pull of multiple requirements can be signs of chemical, emotional and genetic challenges such as Attention Deficit Disorder (ADD), or Attention Deficit Hyperactivity Disorder (ADHD).

Over the past decades, these symptoms have been more readily diagnosed in children, especially those having trouble in school or unable to relax, play quietly or get along effectively with others. With today’s technological advances, it’s easy to blame over-stimulation for playing a strong supporting role in keeping kids off balance, more easily bored without technology, and wanting more all the time. But for adults, these same symptoms can be more insidious, limiting our efficiency at work and at home, straining relationships, and interfering with sleep and health.

ADHD affects at least five percent of children, and about half of them will carry those symptoms into adulthood, says the American Psychiatric Association. The Centers for Disease Control and Prevention estimates numbers are even higher. On top of that, many adults have ADHD or ADD but have never been diagnosed.

Signs you might have ADD or ADHD

If you exhibit or suffer from these traits, you might want to speak with your physician or seek a psychiatric evaluation for ADD or ADHD:

  • Lack of focus.Possibly the most telltale sign of ADHD, “lack of focus,” goes beyond difficulty paying attention. It means being easily distracted, finding it hard to listen to others in a conversation, overlooking details, and not completing tasks or projects.
  • Hyperfocus. While people with ADHD are often easily distracted, the flip side of the coin is called hyperfocus. A person with ADHD can be so engrossed in something that they can ignore anything else around them. This kind of focus makes it easier to lose track of time, ignore those around you, and cause relationship misunderstandings.
  • We all forget things occasionally. But for someone with ADHD or ADD, forgetfulness is an everyday part of life. This includes routinely forgetting where you’ve put something or important dates. Some can be menial. Others can be serious. The bottom line is that forgetfulness can be damaging to careers and relationships because it can be confused with carelessness, lack of intelligence, or ambivalence.
  • Impulsivity. Impulsiveness in someone with ADHD or ADD can manifest in several ways:
    • Interrupting others during conversation
    • Being socially inappropriate
    • Rushing through tasks
    • Acting without much consideration to the consequences
  • Even a person’s shopping habits are often a good indication of ADHD. Impulse buying, especially on items they can’t afford, is a common symptom of adult ADHD.
  • Restlessness and anxiety. As an adult with ADHD, you may feel like your motor can’t shut off. Our yearning to keep moving and doing things constantly can lead to frustration when we can’t do something immediately. This leads to restlessness, which can lead to frustrations and anxiety. Anxiety is a very common symptom of adult ADHD, as the mind tends to replay worrisome events repeatedly.
  • Poor health. Impulsivity, lack of motivation, emotional problems, and disorganization can lead a person with ADHD or ADD to neglect their health. This can be seen through compulsive poor eating, neglecting exercise, or forgoing important medication. Anxiety and stress negatively affect health, so without good habits, the negative effects of these illnesses can make other symptoms worse.
  • Relationship issues. An adult with ADHD or ADD often has trouble in relationships, whether they are professional, romantic, or platonic. The traits of talking over people in conversation, inattentiveness, and easily being bored can be draining on relationships as a person can come across as insensitive, irresponsible, or uncaring.

Treatment and coping mechanisms

People who experience some or many of these symptoms also change employers more often, miss deadlines, experience higher use of alcohol, tobacco and drugs, and suffer from repeated relationship failures, including divorce. If all of this sounds too familiar, it doesn’t mean you suffer from adult ADD or ADHD. But if you do, here are a few steps you can take to improve your life.

Treatment for adult ADHD or ADD is similar to treatment for childhood ADHD/ADD, and includes stimulant drugs or other medications, psychological counseling (psychotherapy), and treatment for any mental health conditions that occur along with adult ADHD.

Stimulants (psychostimulants) are the most commonly prescribed medications for ADHD, but other drugs may be prescribed. Stimulant drugs are available in short-acting and long-acting forms. Other medications used to treat ADHD include antidepressants. The right medication and the right dose vary between individuals, so it may take some time in the beginning to find what’s right for you. Talk with your doctor about the benefits and risks of medications. And keep your doctor informed of any side affects you may have when taking your medication.

Counseling for adult ADHD can be beneficial and generally includes psychological counseling (psychotherapy) and education about the disorder. Psychotherapy may help you:

  • Improve time management and organizational skills
  • Learn how to reduce impulsive behavior
  • Develop better problem-solving skills
  • Cope with past academic and social failures
  • Improve self-esteem
  • Learn ways to improve relationships with family, co-workers and friends
  • Develop strategies for controlling temper

It’s important to remember that ADD and ADHD are neuropsychiatric conditions that are typically genetically transmitted. They are caused by biology, by how our brain is wired. It is not a disease of the will, nor a moral failing or weakness in character. Many people with these behaviors have trouble accepting these syndromes as being rooted in biology, but through professional help, support groups, education and communication these challenges can be managed, or even overcome.


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!

Pre-diabetes is Predictable, Prevalent, and Preventable

One of the nice things about being an adult is we can eat our dessert before our meal. But even if we give ourselves permission to indulge, we should tune in to the potential damage those desserts or anything we eat loaded with sugar is causing to our long-term health. With the holidays rapidly approaching, we also face the opportunity to heap an abundance of alcohol-based drinks, sweet punches, soda and a multitude of cookies, cakes and treats to our already struggling metabolic systems. But the long-term cost is not worth the short-term pleasure.

We all know someone with diabetes or “sugar issues,” but the real numbers that accompany this malady are staggering:  In addition to the 30 million Americans suffering from either type-1 (insulin dependent) or type-2 diabetes (which can often be controlled by drugs, exercise and careful diet), 86 million American adults – more than one out of three people – have prediabetes. What’s more, 90 percent of them don’t know they’re at risk.

November is National Diabetes Awareness Month. Diabetes mellitus refers to a group of diseases that affect how our body uses blood sugar (glucose). Glucose is vital to our health because it’s an important source of energy for the cells that make up our muscles and tissues. It’s also our brain’s main source of fuel.

Insulin is a hormone that comes from a gland situated behind and below the stomach. Called the pancreas, it secretes insulin into the bloodstream, which circulates, enabling sugar to enter our cells. Insulin lowers the amount of sugar in our bloodstream — as our blood-sugar level drops, so does the secretion of insulin from our pancreas.

If we have diabetes, no matter what type, it means we have too much glucose in our blood, although the causes may differ. Too much glucose can lead to serious health problems. In type 2 diabetes, our cells become resistant to the action of insulin, and our pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into our cells where it’s needed for energy, sugar builds up in our bloodstream.

Exactly why this happens is uncertain, although it’s believed that genetic and environmental factors play a role in the development of type 2 diabetes. Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight.

Don’t let the “pre” in prediabetes fool you

Prediabetes is a serious health condition where blood-sugar levels are higher than normal, but not high enough yet to be diagnosed as diabetes. Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease and stroke. Diabetes affects every major organ in the body. People with diabetes often develop major complications such as kidney failure, blindness, and nerve damage (nerve damage can lead to amputation of a toe, foot, or leg). Some studies suggest that diabetes doubles the risk of depression, and that risk increases as more diabetes-related health problems develop. All can sharply reduce quality of life.

Though people with prediabetes are already at a higher risk of heart disease and stroke, they don’t yet have to manage the serious health problems that come with diabetes, which includes daily insulin injections and carefully regulated nutrition. Between 90 percent and 95 percent of people with diabetes have type 2; only about 5 percent have type 1, which is caused by an immune reaction that is not preventable. Type 2, however, can be prevented or delayed through lifestyle changes.

You can have prediabetes for years but have no clear symptoms, so it often goes undetected until serious health problems show up. That’s why it’s important to talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, which include:

  • Being overweight
  • Being 45 years or older
  • Having a parent, brother, or sister with type 2 diabetes
  • Being physically active less than three times a week
  • Ever having gestational diabetes (diabetes during pregnancy) or giving birth to a baby that weighed more than nine pounds

Race and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk.

Nutritional tips for a healthier holiday season

Here are some useful tips to help manage our sweet tooth when dessert and other foods high in calories, sugar, fat and salt are served:

  • Decide ahead of time what and how much you will eat and how you will handle social pressure.
  • Eat a healthy snack early to avoid overeating at the party.
  • Bring a nutritious snack or your own healthy dessert such asplain cookies, baked apples, or sugar-free puddings.
  • Look for side dishes and vegetables that are light on butter and dressing, and other extra fats and sugars such as marshmallows or fried vegetable toppings.
  • If there is someone else at the party who is trying to watch what they eat, buddy up! Avoid tempting sweets and ask your fellow conscious eater to join you for a walk while dessert is out on the table.
  • Choose low-calorie drinks such as sparkling water, unsweetened tea or diet beverages. If you choose to drink alcohol, limit the amount, and have it with food.

Additionally, there are ways to revise dessert recipes so they are healthier and still tasty. Often, we can replace up to half of the sugar in a recipe with a sugar substitute. We can also try cutting down on sugar and increasing the use of cinnamon, nutmeg, vanilla, and other sweet-tasting spices and flavorings.

We can often blame type 1 diabetes on genetics, but type 2 isn’t as easy to pass off – we don’t have to give up all of our holiday favorites if we make healthy choices and limit portion sizes. How we eat, what we eat and our willingness to exercise and control our weight are the key factors to remaining healthy and avoiding the trauma of type 2 diabetes and its nefarious side effects.


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!

Take Care of Your Skin

As soon as the thermostat falls and the heat goes on, many of us suffer from dry itchy skin, especially on our faces, hands and feet. The dry, cold air exacerbates skin conditions like eczema, saps moisture and critical natural oils, and can leave our skin feeling parched, raw, flaky and irritated. Cold-weather elements affect us regardless of the type of heating we use at home or at work, but there are several steps we can take to mitigate the damage and to help keep our skin healthier.

Using moisturizers is a sure bet, but with so many choices and marketing pitches, it’s hard to know what’s best for your own skin. The moisturizer you use in the warmer months may not be as effective in the winter, so as the weather changes, you should adapt your skin regimen, as well. Find an ointment that’s oil-based, rather than water-based, since the oil creates a protective barrier on the skin that retains more moisture than a cream or lotion.

Seeing a specialist is recommended, as well. A dermatologist can analyze your skin type, diagnose maladies, screen for skin cancer and other illnesses and provide professional advice on steps you can be taking and the types of products best suited for your body chemistry and situation. Remaining properly hydrated throughout the winter months is critical for your skin and overall health, and wearing sunscreen when outdoors is essential.

Here are several additional tips for helping maintain healthy skin in the colder, drier months:

  • Apply moisturizers. Content, not cost, should drive this decision. Higher-priced products are charging you for packaging and marketing as well as content. How your skin responds should be the deciding factor. Switch to oil-based products in the colder months, but be aware that not oil-based moisturizers are appropriate for your face. Choose “non-clogging” oils like avocado, mineral, primrose or almond oil. Shea oil or butter can clog facial pores. Also look for lotions containing “humectants,” a class of substances (including glycerin, sorbitol, and alpha-hydroxyl acids) that attract moisture to your skin.

Also, if your facial skin is uncomfortably dry, avoid using harsh peels, masks, and alcohol-based toners or astringents, all of which can strip vital oil from our skin. Instead, find a cleansing milk or mild foaming cleanser, a toner with no alcohol, and masks that are “deeply hydrating,” rather than clay-based, which tends to draw moisture out of the face, and apply them less often.

  • Use sunscreen. Even in the winter months, the sun’s ultra violet rays can penetrate and damage our skin. Use a broad-spectrum sunscreen on exposed face and hands about half an hour before going outdoors and remember to reapply it if you’re outside for a long period playing, walking or working.
  • Wear gloves. It’s hard to keep our hands warm in the cold, dry weather because the skin on our hands is thinner and has fewer oil glands.  To avoid itching and cracking, wear gloves when outdoors. Cotton and wool are preferable to synthetics; if you have sensitive skin, wear a thin cotton glove under your regular gloves for added protection.
  • Avoid wet gloves and socks. There’s nothing as uncomfortable as having wet hands and feet. That moisture trapped against your skin also causes dryness and irritation. Wear cotton near your skin whenever possible, or invest in “wicking” materials which help keep your skin dry. Also use latex or rubber gloves if your hands are in the water often, such as when washing dishes, doing laundry or at work.
  • Invest in a dehumidifier. Whether you’re heating your home with oil, electricity, gas or wood, dry air is bad for our skin. Humidifiers add moisture to the air, which helps our skin and our lungs. Place units in different locations in the house, and in your bedroom.
  • Remember your feet. Don’t forget that our feet dry out in the cooler months, along with our faces and hands. Use lotions that contain petroleum jelly or glycerin instead of water-based lotions. And use exfoliates to get the dead skin off periodically; that helps any moisturizers you use to sink in faster and deeper.
  • Avoid really hot baths or showers. As great as hot water feels on our tired bones, the intense heat of a hot shower or bath actually breaks down the lipid barriers in the skin, which can lead to a loss of moisture. A lukewarm bath with oatmeal orbaking soda can help relieve skin that is so dry it has become itchy.

If you practice these common-sense skin-care steps, your body will thank you. Remember to check in with a dermatologist or skin-care specialist to ensure you’re doing the right things for your specific needs, and enjoy all the winter has to offer!


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!

ERs vs. Urgent Care Centers: Knowing the Difference Can Save a Bundle

When you are injured or sick enough to require emergency care, you don’t want the cost of that care to prevent you from seeking professional medical help. But there’s no ignoring the hefty price tag that accompanies a visit to a hospital emergency room. If it’s a true emergency requiring a call to 911, the ambulance crew aren’t going to ask about cost or insurance – they’re going to take you to the nearest or the most appropriate ER depending on your condition, especially if you may be having a heart attack, stroke or other medical event that renders you unresponsive, in shock or suffering from severe blood loss. But if the injury or illness you have experienced is not life threatening, your choice of service provider has a significant impact on the cost.

“Emergency care” is a broad term, ranging from serious injuries or life-threatening events toeye injuries, sprains, broken bones, earaches, sore throats, burns, fevers, infections, animal bites and much more. Deciding where to go can be confusing, and price shouldn’t deter you from seeking help. However, there are a wide variety of more affordable choices now available that offer different levels of emergency or “urgent” care that is sufficient for incidences that do not require emergency rooms, and won’t break the bank.

Knowing the difference is especially important. If you’re an employer, helping your employees choose the proper level of care will save you and them money. Copays and out-of-pocket costs for emergency room visits continue to rise in an effort to control costs. Dissuading patients from going to ERs when a walk-in clinic will do just fine is prudent and sensible. In fact, the next step in this cost-awareness evolution now being implemented by some health insurance carriers will be to penalize members who seek care at an ER when it is not medically necessary.

Protecting against unnecessary emergency medical costs

Ask your insurer for documentation on what your plan will and won’t cover if you or your employees need emergency care. For example, get clarity on your ER copay and coinsurance and on what the plan will cover if you’re not admitted. Your insurer can also tell you which area hospitals take your insurance. You also can then ask the billing department at your hospital of choice whether the ER doctors participate in your insurance plan. And because most insurers cover medically necessary ambulance rides, know how your plan defines that—typically, it means the patient is unconscious, bleeding heavily, or in severe pain.

But the biggest single step employees – patients – can take to reduce medical costs is to choose the right kind of medical care center for themselves and their children. While the emergency room can help care for any medical situation, it costs an average of three times more than a visit to an urgent-care center. In a non-life threatening situation, you can usually be treated at an urgent-care center effectively and far more quickly.

Walk-in urgent-care centers are typically staffed by at least one emergency medical physician, as well as physician assistants and advanced practice resident nurses. They handle non-life threatening situations, and many facilities have x-rays and labs onsite.

While hospital ERs are open 24/7, many urgent-care centers are open late and on weekends and holidays. Emergency rooms are meant for true medical emergencies and can handle trauma, diagnostic x-rays, surgical procedures and other life-threatening situations. In addition to the added cost, which averages approximately $2,300 according to industry data, the average wait at an ER is 4.5 hours. In comparison, the average cost of visiting an urgent-care center is $176, and waiting times are typically significantly shorter.

Visit an emergency room if you experience:

  • Allergic reactions to food, animal or bug bites
  • Broken bones
  • Chest pain
  • Constant vomiting
  • Continuous bleeding
  • Severe shortness of breath
  • Deep wounds
  • Weakness or pain in a leg or arm
  • Head injuries
  • Unconsciousness

Visit an urgent-care center for these common conditions:

  • Flu and cold
  • Coughs and sore throat
  • High fevers
  • Ear aches and potential eye infections
  • Vomiting, diarrhea, stomach pain
  • Cuts and severe scrapes
  • Minor broken bones such as fingers or toes
  • Minor injuries and burns

Getting the right care when needed always should be your priority. But with the plethora of urgent- and walk-in-care medical centers now available, making a wise and informed choice can save employees thousands of dollars and help stem the continuing rise in healthcare costs that affect all of us.


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!