Reducing Employee Tobacco Use and Vaping for Improved Health

Tobacco use remains the single largest preventable cause of disease and premature death in the United States, yet more than 45 million Americans still smoke cigarettes, according to the U.S. Centers for Disease Control and Prevention (CDC). Half of all smokers who keep smoking will end up dying from a smoking-related illness. In the United States alone, smoking is responsible for nearly one in five deaths, and about 8.6 million people suffer from smoking-related lung and heart diseases.

There also are approximately 13.2 million cigar smokers in the U.S., and 2.2 million who smoke tobacco in pipes. Additionally, the CDC reports that more than 3.2 percent of American adults use e-cigarettes. Additionally, more than 2 million teens (11.3 percent of high school students and 4.3 percent of middle school students) were using e-cigarettes in a national study conducted in 2016, and it’s expected that those numbers have soared over the past two years.

The CDC says that more than half of these smokers have attempted to quit for at least one day in the past year, often without lasting success. That is an opportunity for employers to assume a supporting role through education and personal outreach to help address a calamity that is costing American businesses billions of dollars annually in related healthcare costs and robbing millions of Americans of their health.

Need More Fuel?

Most consumers – including smokers – know that smoking can cause lung cancer, but few people realize it is also linked to a higher risk for many other kinds of cancer too, including cancer of the mouth, nose, sinuses, lip, voice box (larynx), throat (pharynx), esophagus, bladder, kidney, pancreas, ovary, cervix, stomach, colon, rectum, and acute myeloid leukemia.

Smokers are twice as likely to die from heart attacks as non-smokers. Smoking is a major risk factor for peripheral vascular disease, a narrowing of the blood vessels that carry blood to the leg and arm muscles. Smoking also affects the walls of the vessels that carry blood to the brain (carotid arteries), which can cause strokes. Smoking can cause abdominal aortic aneurysm, in which the layered walls of the body’s main artery (the aorta) weaken and separate, often causing sudden death. And men who smoke are more likely to develop erectile dysfunction (impotence) because of blood vessel disease.

Based on data collected by the CDC, it is estimated that adult male smokers lost an average of 13.2 years of life and female smokers lost 14.5 years of life because of smoking.

Each year, smoking causes early deaths of about 443,000 people in the United States. And given the diseases that smoking can cause, it can steal our quality of life long before we die. Smoking-related illness can limit our activities by making it harder to breathe, get around, work, or play.

The Dangers of Vaping

Vaping involves using electronic cigarettes (also referred to as e-cigarettes). These devices contain heating elements, batteries and a reservoir that holds vaping liquid. According to the CDC, the liquid usually consists of varying amounts of nicotine, flavorings and chemicals. When users puff e-cigarettes, the heating element is activated and produces an aerosol, or vapor, which is inhaled.

Many chemicals that cause cancer are in this vapor. That includes formaldehyde, heavy metals, and ultrafine particles that can get stuck in the deepest parts of our lungs. Other potentially harmful substances found in e-cigarettes include flavorings like diacetyl (a chemical linked to lung disease), volatile organic compounds, cancer-causing chemicals and heavy metals such as lead, tin and nickel.

It’s hard to know how much of these chemicals are breathed in when people vape. The levels are usually lower in e-cigarettes than regular cigarettes. But some studies show that high-voltage e-cigarettes have more formaldehyde and other toxins than standard e-cigarettes, and most contain nicotine, which is addictive and dangerous.

Getting the word out to employees about the health risks of vaping – through workplace wellness programs, company-wide newsletters, signs, posters or email blasts – helps lower disease risks and improve health, wellness and productivity in the workplace.

Help Employees Quit Now

No matter how old you are or how long you’ve smoked, quitting can help you live longer and be healthier. People who stop smoking before age 50 cut their risk of dying in the next 15 years in half compared with those who keep smoking. Ex-smokers enjoy a higher quality of life. They have fewer illnesses like colds and the flu, lower rates of bronchitis and pneumonia, and feel healthier than people who still smoke.

Habits and addictions are hard to break. Humiliating, shaming or punishing smokers isn’t the answer – it’s not illegal to smoke in Connecticut, just to smoke in certain places like restaurants and where otherwise dictated. But there are several steps people can take to improve health and longer-term quality of life. The most important is to quit smoking immediately and keep as physically fit as possible. Keeping active is essential for improved breathing function, and pulmonary rehabilitation can help rebuild strength and reduce shortness of breath.

November 15th is the Great American Smokeout

Mark Twain famously reported: “Quitting smoking is easy. I’ve done it a thousand times!” The American Cancer Society is marking the 41st Great American Smokeout on November 15th by encouraging smokers to use the date to help smokers quit, or to plan in advance and quit smoking that day. By doing so, smokers will be taking an important step towards a healthier life — one that can lead to reducing cancer risk.

There are an abundance of programs, many free, to help smokers quit. Physicians can prescribe supportive medical aids as part of a more formal program, there are over-the-counter remedies, and support groups are available in most communities and through local hospitals. Most health insurance providers also offer smoking-cessation assistance.

Quitting is hard, but employees can increase their chances of success with help. The American Cancer Society provides an abundance of information about the steps to quit smoking and provides resources and support that can increase the chances of quitting successfully. To learn about available tools, call the American Cancer Society at 1-800-227-2345 or visit www.cancer.org. The American Lung Association also has a wealth of information and resources. Reach them at 1-800-LUNG-USA, and find online support at www.lung.org.


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!

Why Health Illiteracy Could Be Making Employees Sick

How well do you listen to your doctor’s directions or orders regarding medications, exercise, diet and other health-compliance issues? When you go for a test, do you understand what’s being done and why? Are you aware of recommended preventive-care measures you should be practicing? Do you recognize signs and symptoms of potentially serious illnesses early enough to intervene, or wait until your health deteriorates enough to justify calling a medical professional?

If you recognize yourself in any of these queries, you are among the 88 percent of American adults with health literacy challenges. And when you stop to consider that nine out of 10 adults may lack the skills to manage their health and prevent disease – and apply that consideration to your workforce – the impact of that lack of knowledge should make you feel sick!

The Department of Health and Human Services defines health literacy as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” Nearly 90 million Americans have difficulty understanding and using the information shared by their doctor, clinic or hospital. A high degree of reading literacy does not necessarily translate into a high degree of health literacy, nor does a college education.

Poor health literacy affects individuals of many different ages, languages, cultures and education levels. For example, someone may question if he can drink coffee before a fasting lab test, forget how and when to take newly prescribed medication, or decide to stop taking medication when she is feeling better. And it can be difficult for anyone, regardless of their reading literacy skills, to remember instructions or read a medication label when feeling sick.

Only 12 percent of adults have proficient health literacy, according to the National Assessment of Adult Literacy. Furthermore, 14 percent of adults (30 million people) have below-basic health literacy. In studies, these adults were more likely to report their health as poor (42 percent). Additionally, there is a mismatch between the reading level of health information and the reading skills of the public. There also is a mismatch between the communication skills of lay people and health professionals.

Without clear information and an understanding of the information’s importance, people are more likely to skip necessary medical tests, end up in the emergency room more often, and have a harder time managing chronic diseases like diabetes or high blood pressure. As reported by the U.S. Department of Health and Human Services, individuals with limited or low health literacy

  • Skip preventive care
  • Are more likely to have chronic conditions and less able to manage the conditions
  • Have more preventable hospital visits and admissions, with longer stays
  • Are more likely to use medications inappropriately or ineffectively
  • Are often ashamed to ask for help making health care decisions.

Improving Health Literacy in the Workplace

For employers, the relationship of low health literacy to poor health behaviors results in overall higher costs of drug, medical and disability claims, lower productivity and higher absenteeism. Employers can have a significant positive impact on the health literacy of their employees and, ultimately, influence better health and financial outcomes. Here are recommended steps to improve health literacy in the workplace:

  • Use clear and simple messaging. Keep it simple. Clearly state the actions you want your employee to take, and discuss options and potential consequences.
  • Get rid of complex jargon.Insurance and medical industry professionals throw around a lot of jargon. Ask your insurance provider and benefits consultant to include descriptions of benefits and how to use the benefits in consistent, easy-to-understand language. This includes their member website or portal, Explanation of Benefits (EOB), emails, and mailers.
  • Treat everyone the same.No matter their job title, assume all employees may have difficulty understanding health, wellness and benefits communications. Use simple, easy-to-understand language.
  • Empower employees to take charge of their health.When people take an active role in their healthcare, research shows they fare better in both health and financial outcomes. Increase employee confidence in their ability to advocate for themselves by providing educational materials and holding workshops. Topics could include how to talk to a doctor, how to get more support when you need it, and how to ask questions about insurance coverage.
  • Identify a navigator.Consider a current staff member or external support person who can help employees navigate the complex world of benefits available.
  • Technology isn’t for everyone. Don’t leave behind those who aren’t as comfortable or familiar with technology. Depending on the range of ages and skills in your workforce, use a variety of communication methods to share health and wellness information. This includes emails, texts, and verbal updates at team meetings.
  • Repeat information regularly.Don’t expect your once-a-year open enrollment presentation to be memorable enough that your employees remember their benefits. Plan year-round campaigns and communications using frequent but brief messages, and talk with employees about their role in managing their health.
  • Remember the household decision makers. While you may give employees a lot of information while they are at work, the person making decisions about when and where to go for healthcare may not be getting that same information translated to them. Consider home mailings, invitations to open-enrollment meetings, and other ways to ensure all family members on the medical plan receive credible sources of health and wellness information.

The benefits of health literacy improvement include enhanced communication, greater adherence to treatment, increased ability to engage in self-care, and overall improved health status. Healthier employees result in a healthier workplace, and we can all feel good about that.


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!

This One’s for Men, Unfortunately

We don’t need to live our lives afraid of disease and illness, but the better we arm ourselves with accurate and reliable information and take preventative steps, the more we’re likely to live to a ripe old age. That’s why if you’re a man reading this – or a woman who has a man or men in her life it’s important that you pay attention to this cautionary primer on prostate cancer, one of the most common cancers afflicting American men.

Other than skin cancer, which is the most common, more men – as many as one in nine – will develop prostate cancer in their lifetime. The American Cancer Society estimate that approximately 165,000 new cases of prostate cancer will be diagnosed in 2018, resulting in close to 30,000 deaths. About six cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66.

Though prostate cancer can be a serious disease, most men diagnosed with prostate cancer do not die from it. About one man in 41 will die of prostate cancer, but more than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.

Prostate cancer occurs more often in African-American men and Caribbean men of African ancestry than in men of other races. African-American men are also more than twice as likely to die of prostate cancer than white men. Prostate cancer occurs less often in Asian-American and Hispanic/Latino men than in non-Hispanic whites. The reasons for these racial and ethnic differences are not clear.

Prostate cancer is malignancy that occurs in the prostate — a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm. Usually prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

When detected early — when it’s still confined to the prostate gland men diagnosed with prostate cancer have a better chance of successful treatment.

Symptoms of Prostate Cancer

Prostate cancer may cause no signs or symptoms in its early stages. When it’s more advanced, common signs and symptoms include:

  • Trouble urinating
  • Decreased force in the stream of urine
  • Blood in semen
  • Discomfort in the pelvic area
  • Bone pain
  • Erectile dysfunction

There are a variety of factors that can increase the risk of prostate cancer. These include age, race, family history and obesity. If men in your family have had prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher. In fact, having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. The risk is much higher for men with several affected relatives, particularly if their relatives were young when the cancer was found.

Men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. Often, these men also tend to eat fewer fruits and vegetables.

While there is no sure way to prevent prostate cancer, there are some things we can do that might lower our risk for this disease. Typically, they involve controlling body weight, remaining physically active, and maintaining a healthy diet. Studies have found that men who are active and exercise regularly have a slightly lower risk of prostate cancer. Vigorous activity may have a greater effect, especially on the risk of advanced prostate cancer.

Several studies also have suggested that diets high in certain vegetables (including tomatoes, cruciferous vegetables, soy, beans, and other legumes) or fish may be linked with a lower risk of prostate cancer, especially more advanced cancers. Examples of cruciferous vegetables include cabbage, broccoli, and cauliflower. Avoid high-fat foods and instead focus on choosing a variety of fruits, vegetables and whole grains. Fruits and vegetables contain many vitamins and nutrients that can contribute to your overall health.

When to See Your Doctor

Men with a higher risk of prostate cancer may consider medications or other treatments to reduce their risk. If you’re concerned about your risk of developing prostate cancer, talk with your doctor. Prostate screening tests include two traditional procedures:

Digital rectal exam (DRE). During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. If your doctor finds any abnormalities in the texture, shape or size of the gland, you may need further tests.

Prostate-specific antigen (PSA) test. A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that’s naturally produced by your prostate gland. It’s normal for a small amount of PSA to be in your bloodstream. However, if a higher than normal level is found, it may indicate prostate infection, inflammation, enlargement or cancer.

For men diagnosed with low-risk prostate cancer, treatment may not be necessary right away. Some men may never need treatment. Instead, doctors sometimes recommend active surveillance such as regular follow-up exams, blood tests and, if necessary, biopsies. If tests show the cancer is progressing, patients may opt for a prostate cancer treatment such as surgery or radiation.

September is National Prostate Cancer Awareness Month. Do yourself or the men in your life a favor by reminding them of the importance of obtaining regular prostate cancer screenings for early detection and treatment as required, and for eating healthy and exercising. With those simple steps, men are likely to beat the odds on this common but dangerous disease.


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!

Breaking Your Stones

Kidney stones are aren’t exactly small rocks, but despite the coarse comparison to a certain part of a male’s anatomy, they’re no laughing matter: If you have or have had kidney stones, you already know it can range from bearable discomfort to intense pain.

Kidney stones are hard deposits made of minerals and salts that form inside your kidneys. They form when your urine contains more crystal-forming substances—such as calcium, oxalate and uric acid—than the fluid in your urine can dilute. At the same time, your urine may lack substances that prevent crystals from sticking together, creating an ideal environment for kidney stones to form.

Kidney stones have many causes and can affect any part of your urinary tract—from your kidneys to your bladder. Often, stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together. While painful, passing kidney stones usually cause no permanent damage as long as they are dealt with appropriately. You may need to only take pain medication and drink lots of water to pass a kidney stone. In other instances—for example, if stones become lodged in the urinary tract, are associated with a urinary infection or cause complications—surgery may be needed.

What Causes Kidney Stones?

Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a naturally occurring substance found in food and is also made daily by our liver. Some fruits and vegetables, as well as nuts and chocolate, have high oxalate content. Dietary factors, high doses of vitamin D, intestinal bypass surgery and several metabolic disorders can increase the concentration of calcium or oxalate in urine.

Calcium stones may also occur in the form of calcium phosphate. This type of stone may also be associated with certain migraine headaches or with taking certain seizure medications, such as topiramate (Topamax).

Struvite stones form in response to an infection, such as a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning. Uric acid stones can form in people who don’t drink enough fluids or who lose too much fluid, those who eat a high-protein diet, and those who have gout. Certain genetic factors also may increase your risk of uric acid stones. And cystine stones form in people with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria).

People prone to kidney stones should make some changes to their diet to help prevent recurrences. This may include drinking more water, reducing salt intake and eating less meat. There are certain foods you can have, and other foods you should avoid, to reduce the chance that kidney stones will return. If you had kidney stones before, you are more likely to get them again. But by following the eating plan your doctor or dietitian suggests, you may prevent new kidney stones.

How to Prevent Kidney Stones

Here are some tips to help lower your chance of getting kidney stones:

• Drink more fluids, especially water. Try to drink eight to 10 glasses of water a day. If you don’t already drink that much, slowly increase how much you drink over a week or two. This slow increase will give your body time to adjust to the extra fluids. You are drinking enough water when your urine is clear or light yellow. If it is dark yellow, you are not drinking enough fluids.
• Eat less salt and salty foods. One way to do this is to avoid processed foods and limit how often you eat at restaurants, as well as to avoid adding salt to your meals and when you cook.
• Talk to your doctor or dietitian about how much calcium you need every day. Try to get your calcium from food, rather than from supplements. Milk, cheese, and yogurt are all good sources of calcium.
• If you had an oxalate kidney stone, your doctor may ask you to limit certain foods that have a lot of oxalate, such as dark green vegetables, nuts, and chocolate. You don’t have to give up these foods, just eat or drink less of them.
• Eat a balanced diet that is not too high in animal protein. This includes beef, chicken, pork, fish, and eggs. These foods contain a lot of protein, and too much protein may lead to kidney stones. You don’t have to give up these foods. Talk to your doctor or dietitian about how much protein you need and the best way to get it.
• Increase how much fiber you eat. Fiber includes oat bran, beans, whole wheat breads, wheat cereals, cabbage, and carrots.
• Avoid grapefruit juice.
• Drink lemonade made from real lemons (not lemon flavoring). It is high in citrate, which may help prevent kidney stones.

Talk to your doctor if you take vitamins or supplements. He or she may want you to limit how much fish liver oil or calcium supplements you take. Also, do not take more than the recommended daily dose of vitamins C and D.

Treating Kidney Stones

Kidney stones that can’t be treated with conservative measures — either because they’re too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections — may require more-extensive treatment. Procedures may include:

Using sound waves to break up stones. For certain kidney stones — depending on size and location — your doctor may recommend a procedure called extracorporeal shock wave lithotripsy (ESWL).

ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable.

Surgery to remove very large stones in the kidney. A traditional procedure involves surgically removing a kidney stone using small scopes and instruments inserted through a small incision in your back. You will receive general anesthesia during the surgery and be in the hospital for one to two days while you recover. Your doctor may recommend this surgery if ESWL was unsuccessful.

Using a scope to remove stones. To remove a smaller stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter. Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing. You may need general or local anesthesia during this procedure.

Remember, the best way to reduce your risk of kidney stones is to drink a lot of water. It’s also a good idea to ask your doctor for a referral to a dietitian who can help you develop an eating plan that reduces your risk of kidney stones.


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!

Who Would Take Home Gold at an Olympic Tea Party?

In the spirit of the Winter Olympics and healthy competition, here’s a fun category that you won’t find in South Korea: Competitive tea drinking. And an unexpected country takes the gold: Turkey; silver goes to Ireland; and bronze is bestowed, not surprisingly, upon the United Kingdom. Russia comes in a distant fourth, and as for the United States, we totter in at 35th.

Famous for their tea imbibing, the English consume 165 million cups of tea every day. The Irish average 4.8 pounds of tea per person per year, far less than the Turks, at 6.9 pounds annually. The U.S., in comparison, averages half a pound per person annually. But beyond the cultural comparison, we Americans are missing out on the benefits the rest of the world seems to be enjoying.

Drinking tea is good for us, in many ways. In addition to a multitude of flavors and varieties, there’s compelling evidence that tea reduces the risk of heart disease, and possibly even helps prevent cancer and Alzheimer’s disease. Considered by many a super food—whether it’s black, green, white, oolong or herbal—tea gets the job done, health wise.

All those tea types, with the exception of herbal teas, come from the same tea plant, Camellia sinensis. They are rich in polyphenols, antioxidants that detoxify cell-damaging free radicals in the body. Tea also has about eight to 10 times the polyphenols found in fruits and vegetables. For black tea, a process called oxidation turns the leaves from green to a dark brownish-black color. Green tea comes from the same plant, but is not oxidized.

Oolong tea is made from leaves of the same plant that green and black teas come from. The difference lies in how long the leaves ferment. Green tea leaves are unfermented, while leaves for black tea are fully fermented. Oolong comes from leaves that are partially fermented.

Research suggests that regular tea drinkers — people who consume two cups or more a day — have less heart disease and stroke, lower total and LDL cholesterol, and recover from heart attacks faster. There’s also evidence that tea may help fight ovarian and breast cancers.

Tea also helps soothe stress and keep us relaxed. One British study found that people who drank black tea were able to relax faster than those who drank a fake tea substitute. The tea drinkers had lower levels of cortisol, a stress hormone.

Why Is Tea Good for Us?

Catechins, a type of disease-fighting flavonoid and antioxidant, are the key to tea’s health benefits. The longer you steep the tea, the more flavonoids you get. For the best tea benefit, some studies suggest drinking three cups each day to cut heart disease risk. If caffeine consumption is a problem, you can drink decaffeinated tea or herbal teas.

The fermentation process used to make green tea boosts the levels of antioxidants. Black and red teas have them, too, but in lesser. Antioxidants latch on to and neutralize chemicals called oxidants, which cells make as they go about their normal business. Elevated levels of oxidants can cause harm—for example, by attacking artery walls and contributing to cardiovascular disease.

Green, black, white and oolong teas contain caffeine and a stimulating substance called theophylline. These can speed up the heart rate and make us feel more alert. In fact, black tea extract is sold as a supplement, largely for this purpose.

Some scientists think that specific antioxidants in tea, including polyphenols and catechins, may help prevent some types of cancer. For example, some research shows that women who regularly drink black tea have a much lower risk of ovarian cancer than women who do not. More research is needed to confirm this. There also is some evidence that the antioxidants in black tea may reduce atherosclerosis or clogged arteries and help lower the risk of heart attack.

Regularly drinking black tea may reduce stroke risk and also lower our risk of developing diabetes, high cholesterol, kidney stones and Parkinson’s disease, though more scientific research has to be conducted to formally prove these claimed benefits. Green tea has been used in traditional Chinese medicine for many centuries, and has been used as a remedy for headaches and depression.

How Much Caffeine Is in Tea?

Most tea has between 15 and 70 milligrams of caffeine per cup, compared to between 80 and 123 mg per cup of regular coffee.

All true teas from the Camellia sinensis plant contain caffeine, which is a naturally-occurring stimulant found in several plants. Caffeine is water soluble, and is extracted into the brewed cup when preparing tea, coffee, or other caffeinated beverages.

Tea can be made from different parts of the tea plant, and these parts contain different quantities of caffeine. Leaf buds (tips) and younger leaves are higher in caffeine than older, mature leaves. In the tea plant, caffeine acts as a natural insecticide, serving to protect the plant against being eaten by insects. Since the tips and tender young leaves are most vulnerable to insects, these parts of the plant are highest in caffeine; the older leaves are tougher and lower in caffeine.

Despite tea’s many health benefits, heavy caffeine use can have a negative impact on our health, including anxiety, insomnia and stomach irritation from acid. While the amount of caffeine in tea tends to be low, and brewing time effects caffeine levels, drinking large quantities of tea isn’t a great idea for people sensitive to caffeine for medical reasons.

In addition to caffeine, tea also contains L-theanine; theanine can interact with caffeine, allowing a smaller dose of caffeine to have a stronger effect in terms of boosting concentration and alertness.

The blending of tea with caffeine-free ingredients to produce flavored teas can result in a lower total caffeine content so long as less total tea leaf is used in the blend. It’s important to avoid sweetened teas, as the sugar isn’t good for our health.

Herbal teas are beverages made from the infusion or decoction of herbs, spices, fruits or other plant materials in hot water. They do not usually contain caffeine, unlike the true teas or decaffeinated tea, which are prepared from cured leaves. In addition to exploring herbal teas, people desiring caffeine-free tea-like drinks might want to try South African rooibos and honeybush, two plants which are often described as being similar to tea in flavor, health benefits, and manner of production.

Who knows, maybe by the 2020 Olympics in Tokyo, American tea drinkers will be contending for consumption medals while improving overall wellness.


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!

Protecting Our Hearts

Right about now, the pact you made with yourself back in December to go to the gym and eat more healthfully may be wearing thin, though your waistline isn’t. The cold winter months make exercising more challenging and early sunsets and inactivity can prompt us to stress eat or seek solace in comfort calories.

Even if you aren’t working out as often as you’d like, there are some nutritional adjustments you can make to help further your personal wellness efforts. And since it’s February—which is American Heart Month—it’s a perfect time to eliminate or reduce foods that are high in cholesterol, a major contributor to heart disease.

Heart disease is the leading cause of death and a major cause of disability in the United States.

Cholesterol plays an important and useful role in our bodies, but not all cholesterol is good for us. So-called “bad cholesterol” increases our risk of heart disease, stroke and developing type-2 diabetes. It can be controlled, to an extent, through diet and exercise, but susceptibility to the development of plaque on our arteries also can be naturally occurring, based on genetics.

The most common heart disease in the United States is coronary heart disease, which often appears as a heart attack. Each year, an estimated 785,000 Americans have a new coronary attack, and about 470,000 have a recurrent attack. About every 25 seconds, an American will have a coronary event, and although heart disease is sometimes thought of as a “man’s disease,” it is the leading cause of death for both women and men in the United States, with women accounting for nearly half of heart disease deaths.

Good health begins with good knowledge . . . and action. Understanding how cholesterol affects us and how to limit intake or mitigate existing damage are important considerations and well within our control.

How Cholesterol Works in Our Bodies

Cholesterol is a waxy substance found throughout the body. It is critical to the normal function of all cells. The body needs cholesterol for making hormones, digesting dietary fats, building cell walls, and other important processes. Our body makes all the cholesterol it needs, but cholesterol is also in some of the foods we eat.

When there is too much cholesterol in our blood, it can build up on the walls of the arteries. This buildup is called plaque. Over time, it can cause narrowing or hardening of the arteries—a condition called atherosclerosis—which can cause blockage and keep our heart from getting the blood it needs.

Keeping our cholesterol levels in check is one of the best ways to keep our hearts healthy, and to lower our chances of getting heart disease or having a stroke. The American Heart Association recommends all adults age 20 or older have their cholesterol, and other traditional risk factors, checked every four to six years. It typically only requires a simple blood test.

Our total cholesterol and HDL or good cholesterol are among numerous factors physicians use to predict our risk for a heart attack or stroke. Other risks include family history, if you are a smoker, diet, the amount we exercise, and if we have high blood pressure.

With HDL or good cholesterol, higher levels are better. Low HDL cholesterol puts us at higher risk for heart disease. People with high blood triglycerides usually also have lower HDL cholesterol. Genetic factors, type 2 diabetes, smoking, being overweight and being sedentary can all result in lower HDL cholesterol. A low LDL or bad cholesterol level is considered good for our heart health.

Certain foods, such as red meats and full-fat dairy products, fried foods, potato chips and cookies tend to be high in cholesterol. Foods to limit or avoid include:

  • Butter and hard margarines
  • Lard and animal fats
  • Fatty red meat and sausages
  • Full-fat cheeses, milk, cream and yogurts
  • Coconut and palm oils, and coconut cream

Should You Be Taking Statins?

 If your cholesterol levels are off your physician may recommend dietary changes. He or she also may recommend that you take one of the primary medicines millions of Americans use to help their bodies regulate or offset the negative effects of cholesterol—a widely prescribed class of drugs called statins.

Statin drugs work by blocking the action of the liver enzyme that is responsible for producing cholesterol. Statins lower LDL cholesterol and total cholesterol levels. At the same time, they lower triglycerides and raise HDL cholesterol levels. Triglycerides are another type of fat, and they’re used to store excess energy from our diet. High levels of triglycerides in the blood, which are associated with atherosclerosis, can be caused by being overweight or obese, physical inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates (more than 60 percent of total calories).

People with high triglycerides often have a high total cholesterol level, including a high LDL cholesterol (bad) level and a low HDL cholesterol (good) level. Many people with heart disease or diabetes also have high triglyceride levels.

Statins help stabilize plaques in the arteries. Since their arrival on the market, statins have been among the most prescribed drugs in the United States, with about 17 million users. The statin medications that are approved for use in the U.S. include Lipitor, Livalo, Mevacor (or Altocor), Zocor, Pravachol, Lescol and Crestor. There also are generic versions available.

Statins also carry warnings that memory loss, mental confusion, high blood sugar, and type 2 diabetes are possible side effects. Due to the possibility of side effects that can damage the liver, patients taking statins are required to have periodic blood tests. It’s important to remember that statins may also interact with other medications.

If you experience any unexplained joint or muscle pain, tenderness, or weakness while taking statins, you should call your doctor immediately. Other potential side effects include headaches, difficulty sleeping, muscle aches, tenderness or weakness, or abdominal cramping, bloating or constipation. Pregnant women or those with active or chronic liver disease should not use statins. Also, if you take a statin drug, tell your doctor about any over-the-counter or prescription drugs, herbal supplements, and vitamins you are currently taking or plan on taking. Also be aware that certain foods—such as grapefruits—limit the effectiveness of statins and should not be consumed while taking this medication.

Changes in your diet, exercise and even statins won’t fix a broken or lonely heart, so it may be a little ironic that American Heart Month and Valentine’s Day fall in the same month. However, you can give yourself and your loved ones the best Valentine’s Day gift possible by keeping your heart and body healthy. Even if your physician recommends you take a statin, maintaining a healthy lifestyle while taking one of these drugs can improve its effectiveness. Be sure to eat a balanced, heart-healthy diet; get regular physical activity; limit alcohol intake; and avoid smoking. Over time – and with sustained healthy weight loss and regular exercise – some patients are able to go off statins, but always speak with your physician before stopping any prescribed medication.


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!

New Lung Cancer Screening Reduces Deaths Through Early Detection

New screening technologies are being used to help identify potential health issues earlier in patients who may be at risk of contracting certain cancers.

Symptoms of lung cancer usually don’t appear until the disease is already at an advanced, non-curable stage. Even if there are symptoms, many people may mistake them for other problems, such as an infection or long-term effects from smoking.

Screening is the use of tests or exams to find a disease in people who don’t have symptoms. Doctors have looked for many years for a good screening test for lung cancer, but only in recent years has research shown that a test known as a low-dose CT (LDCT) scan can help lower the risk of dying from this disease.

The National Lung Screening Trial (NLST) was a large clinical trial that looked at using LDCT scans of the chest to screen for lung cancer. CT scans of the chest provide more detailed pictures than chest x-rays and are better at finding small abnormal areas in the lungs. Low-dose CT of the chest uses lower amounts of radiation than a standard chest CT and does not require the use of intravenous (IV) contrast dye. LDCTs expose people to a small amount of radiation with each test.

The trial compared LDCT of the chest to x-rays in people at high risk of lung cancer to see if these scans could help lower the risk of dying from lung cancer. The study included more than 50,000 people aged 55 to 74 who were current or former smokers and were in fairly good health. The study did not include people if they had a prior history of lung cancer or lung cancer symptoms, if they had part of a lung removed, if they needed to be on oxygen at home to help them breathe, or if they had other serious medical problems.

People in the study got either three LDCT scans or three chest x-rays, each a year apart, to look for abnormal areas in the lungs that might be cancer. After several years, the study found that people who got LDCT had a 20 percent lower chance of dying from lung cancer than those who got chest x-rays. They were also 7 percent less likely to die overall (from any cause) than those who got chest x-rays.

Screening with LDCT also had some downsides. For example, because it is more sensitive to abnormalities (as many as one in four tests) this may lead to additional tests such as other CT scans or more invasive tests such as needle biopsies or even surgery to remove a portion of lung in some people. These tests can sometimes lead to complications, even in people who do not have cancer (or who have very early stage cancer).

Guidelines for lung cancer screening

The cost for a low-dose CT scan as a screening test for lung cancer is generally about $300 for each test, but prices vary widely at different centers. Under the Affordable Care Act, most private insurers must cover the cost of yearly lung cancer screening in people considered at high risk: aged 55 to 80, with a 30 pack-year history of smoking, and either a current smoker or quit within the last 15 years. Medicare also covers the cost of lung cancer screening in people considered at high risk, although the age range is slightly different (55 to 77 years).

According to the American Cancer Society, people who meet all of the following criteria may be good candidates for lung cancer screening:

  • 55 to 74 years old
  • In fairly good health
  • Have at least a 30 pack-year smoking history
  • Are either still smoking or have quit smoking within the last 15 years

Screening should only be done at facilities that have the right type of CT scanner and experience using LDCT scans for lung cancer screening.

If you fit all of the criteria, you should talk to your doctor or health care provider about screening and if it’s right for you. If you smoke, you should consider counseling about stopping. Screening is not a good alternative to stopping smoking, but it’s one more way you can take a more active role in helping to prevent or potentially reduce the risk of contracting a serious disease like lung cancer.


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!

The Importance of Dental Hygiene

It’s said the eyes are windows to our souls. That would make our mouths gateways to something, though what that might be is up for debate depending on how well you practice good dental hygiene. While oral health is important to our appearance and well-being, it plays an equally important role in limiting damage from or aggravating serious conditions such as diabetes and respiratory health. Untreated cavities can be painful and lead to serious infections, and poor oral health has been linked to sleeping problems, as well as behavioral and developmental problems in children. It can also affect our ability to chew and digest food properly.

Gum disease is an inflammation of the gums, which may also affect the bone supporting the teeth. Plaque is a sticky, colorless film of bacteria that constantly builds up, thickens and hardens on the teeth. If it is not removed by daily brushing and flossing, this plaque can harden into tartar and may contribute to infections in the gums. Left untreated, gum disease can lead to the loss of teeth and an increased risk of more serious illnesses.

Additionally, the bacteria in plaque can travel from the mouth to the lungs, causing infection or exacerbating existing lung conditions. It creates risks for heart patients, too, as it can travel through the bloodstream and get lodged in narrow arteries, contributing to heart attacks. Also, people with diabetes are more susceptible to gum disease and it can put them at greater risk of diabetic complications.

Regular brushing and checkups are critically important, as is flossing, which does about 40 percent of the work required to remove plaque from the hard-to-reach spaces between our teeth.

Most floss is made of either nylon or Teflon, and both are equally effective. People with larger spaces between their teeth or with gum recession (loss of gum tissue, which exposes the roots of the teeth) tend to get better results with a flat, wide dental tape. If teeth are close together, try thin floss that bills itself as “shred resistant.” Bridges and braces require more effort to get underneath the restorations or wires and between the teeth. Use a floss threader, which looks like a plastic sewing needle. Or look for a product called Super Floss that has one stiff end to fish the floss through the teeth, followed by a spongy segment and regular floss for cleaning.

What’s in your toothpaste?

The first known toothpaste recipe dates to the fourth century AD. This recipe was written in Greek on a scrap of papyrus. The Egyptian scribe explained that the recipe created a “powder for white and perfect teeth.”

Egyptians would have mixed the paste with a bit of their own saliva and then used their fingers to scour their teeth. The recipe aligned with traditional home medicinal practices that are still in use around the world. Classical herbals list Iris as good for toothache and for sweetening the breath.  Pepper would have stimulated the gums, mint would have added the fresh taste we still love in modern toothpaste, and rock salt would have been a purifying abrasive.

Egyptians had many recipes for tooth powders. Favored ingredients included the powdered ashes of oxen hooves, crushed myrrh, burned egg shells, and powered pumice stone. The Persians liked using burnt shells of snails and oysters. In China a mix of ginseng, various mints, and salt was the preferred recipe. Many Europeans modeled themselves after the ancient Greeks, cleaning their teeth with a rough cloth (usually linen) or a sponge that they’d dipped into a paste made of ashes, sulfur oil and salt, until well into the sixteenth century.

In 1873, Colgate released the first mass-produced toothpaste. It was called Crème Dentifrice, and was sold in a jar. By 1896, the name had changed to Colgate Dental Cream and it was packaged in collapsible tubes. Fluoride was introduced in 1914 and was quickly added to most of toothpastes on the market.

Toothpaste, also called dentifrice, can be marketed as a paste, gel or powder. Today, toothpaste ingredients typically consist of mild abrasives to remove debris and residual surface stains; fluoride to strengthen tooth enamel and re-mineralize enamel in the early stages of tooth decay; humectants to prevent water loss in the toothpaste; flavoring agents, such as saccharin and other sweeteners to improve taste; thickening agents or binders to stabilize the toothpaste formula; and detergents to create foaming action.

Toothpastes may contain several active ingredients to help improve oral health.  Fluoride actively helps prevent tooth decay by strengthening tooth enamel. All toothpastes with the ADA Seal of Acceptance contain fluoride. In addition to fluoride, toothpastes may contain active ingredients to help improve tooth sensitivity, whiten teeth, or reduce gingivitis or tartar build-up. No ADA-accepted toothpaste contains sugar or any other ingredient that would promote tooth decay.

Ultimately, one of the best ways to control plaque is brushing your teeth thoroughly at least twice a day. But you don’t need toothpaste to do this, just a soft toothbrush and good brushing techniques will remove plaque. Flossing, limiting sugary food and drinks, regular checkups and professional cleanings should keep your teeth in top shape. And by the way:  Whatever type of toothpaste you choose to use, don’t mimic commercials and smear your brush with a huge stripe of paste – a pea-sized drop is sufficient.


 

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!