Nod yes, not off, if you’re feeling sleepy

Some days, there’s more of the Sleepy Dwarf in us than we’d care to admit. Beyond the excuse of extremely active weekends and occasional late nights, we’ve gotten too used to feeling fatigued. We drag ourselves to work, school and activities with the promise that, next weekend – or when we take that last exam, get through this big project, or finish the season – we’ll get some much-needed sleep. But how much IS enough? Is five or six hours a night really cutting it for us?

The answer, for most human beings, is definitely “no.”  Everyone’s individual sleep needs vary. In general, most healthy adults require 16 hours of wakefulness and need an average of eight hours of sleep a night. However, some individuals are able to function without sleepiness or drowsiness after as little as six or seven hours of sleep. Others can’t perform at their peak unless they’ve slept 10 hours. And, contrary to common myth, the need for sleep doesn’t decline with age, although the ability to sleep for six to eight hours at one time may be reduced.

Sleep is essential for a person’s health and well-being, according to the National Sleep Foundation (NSF). Yet millions of people do not get enough sleep and suffer related consequences relating to performance, irritability, accidents and reduced productivity. Surveys conducted by the NSF revealed that at least 40 million Americans suffer from over 70 different sleep disorders, and 60 percent of adults report having sleep problems a few nights a week or more. Most of these problems go undiagnosed and untreated. In addition, more than 40 percent of adults experience daytime sleepiness severe enough to interfere with their daily activities at least a few days each month, with 20 percent reporting problem sleepiness a few days a week or more.

Psychologists and other scientists who study the causes of sleep disorders have determined problems directly or indirectly tied to abnormalities in the brain and nervous, cardiovascular and immune systems, and with metabolic functions. Furthermore, unhealthy conditions, disorders and diseases can also cause sleep problems, including:

  • Pathological sleepiness, insomnia and accidents
  • Hypertension and elevated cardiovascular risks (including stroke)
  • Emotional disorders (depression, bipolar disorder)
  • Obesity
  • Metabolic syndrome and diabetes
  • Alcohol and drug abuse

Though common, not everyone who is tired has a sleep disorder. There is a lot we can do to get a better night’s sleep, feel refreshed when we awake, and remain alert throughout the day. It’s called “sleep hygiene” and refers to those practices, habits, and environmental factors that are critically important for sound sleep.

We all have a day/night cycle of about 24 hours called the circadian rhythm. It greatly influences when we sleep and the quantity and the quality of our sleep. The more stable and consistent our circadian rhythm, the better our sleep. This cycle may be altered by the timing of various factors, including naps, bedtime, exercise, and especially exposure to light (from traveling across time zones to staring at television or a laptop in bed at night).

Aging also plays a role in sleep and sleep hygiene. After the age of 40 our sleep patterns change, and we have many more nocturnal awakenings than in our younger years. This not only directly affects the quality of our sleep, but also interacts with any other condition that may cause arousals or awakenings, like the withdrawal syndrome that occurs after drinking alcohol close to bedtime. Additionally, psychological stressors like deadlines, exams, marital conflict, and job crises may prevent us from falling asleep or wake us from sleep throughout the night.

Here are 10 sleep hygiene tips to help us relax, fall asleep, stay asleep, and get better sleep so we wake up refreshed and alert:

  1. Avoid watching TV, eating, and discussing emotional issues in bed. The bed should be used for sleep and sex only. When we associate the bed with other activities it often becomes difficult to fall asleep.
  2. Minimize noise, light, and temperature extremes during sleep with ear plugs, window blinds, or an electric blanket or air conditioner. Even the slightest nighttime noises or luminescent lights can disrupt the quality of our sleep. Try to keep the bedroom at a comfortable temperature — not too hot (above 75 degrees) or too cold (below 54 degrees).
  3. Try not to drink fluids after 8 p.m. This may reduce awakenings due to urination.
  4. Avoid naps if possible, but if you do nap, make it no more than about 25 minutes about eight hours after you awake.
  5. Do not expose yourself to bright light if you need to get up at night. Use a small night-light instead.
  6. Nicotine is a stimulant and should be avoided, particularly near bedtime and upon night awakenings. Smoking tobacco products before bed, although it may feel relaxing, is actually putting a stimulant into our bloodstream.
  7. Caffeine is also a stimulant and is present in coffee (100-200 mg), soda (50-75 mg), tea (50-75 mg), and various over-the-counter medications. Caffeine should be discontinued at least four to six hours before bedtime. But note that if we consume large amounts of caffeine and cut ourselves off too quickly, we may get headaches that could keep us awake.
  8. Although alcohol is a depressant and may help us fall asleep, the metabolic machinery that clears it from our body when we are sleeping causes a withdrawal syndrome. This withdrawal causes awakenings and is often associated with nightmares and sweats.
  9. A light snack may seem sleep-inducing, but a heavy meal too close to bedtime interferes with sleep. Stay away from protein and stick to carbohydrates or dairy products. Milk contains the amino acid L-tryptophan, which has been shown in research to help people go to sleep. So milk and cookies or crackers (without chocolate) may be useful and taste good as well.
  10. Do not exercise vigorously just before bed, especially if you are the type of person who is aroused by exercise. If possible, it’s best to exercise in the morning or afternoon (preferably an aerobic workout, like running or walking).

We know when we’re tired, but doing something about the negative effects of fatigue and sleeplessness requires focus, discipline and often, professional assistance. Seek help if you can’t seem to get the sleep you need.  And if you’re just afraid of missing something, wake up. If you don’t want to morph from chronically Sleepy to permanently Grumpy, get some rest!

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

Getting healthier is all in the wrist

When we were kids, pedometers were pretty cool . . . right up there with Dick Tracy two-way communication wristwatches, which weren’t real, but we knew they would be, some day. That day came and went with a yawn – people (the Boomers) really didn’t care that much. But then millennials took over the world, geeky became trendy, mobile phones changed our universe irrevocably, and personal fitness took center stage. So the marketing wizards figured out how to put chic back on our wrist and in our pockets by combining technology, health and wellness, and 20-somethings’ love of gadgets.

One of the oldest fitness gadgets is the pedometer. This simple device counts a person’s steps by detecting the motion of his or her hands or hips. Used originally by sports and physical fitness enthusiasts, pedometers are popular as an everyday exercise counter and motivator.

Today there are apps included on your mobile devices such as Apple Health for iOS and Google Fit for Android. And you can download even more apps to measure heart rate, track calories, set calendars, and engage step counters. There are related yoga and meditation apps, and apps for tracking where and how long you run, how many times you hydrated, calorie counters, when you should expect your period, when you took your medicine, how long you slept, and much more.

Function has replaced style for devices worn on the wrist. Devices like the Fitbit – which basically are just fancy pedometers – track steps, though the more sophisticated ones can detect things like heart rate, and sleep (how often you wake, tossing and turning, etc.). These can be synced to your phone and/or computer for tracking and analyzing data. Other popular wrist-worn devices include those from Jawbone, Garmin, Mio, and even Microsoft. The list continues to grow.

Finally, there also are “smart scales,” weight counters you step on, just like in the old days. These use WiFi and Bluetooth technology to sync weight results with your tablet, computer, phone or device. This allows you to integrate results in tracking and reporting programs. These modern scales are especially useful for helping physicians monitor weight loss or gain for chronically ill patients, shut-ins or people who can’t easily get to medical facilities. The results are sent via phone lines to a monitoring location, where technicians and nurses can identify red flags and call the patient or his or her doctor for an intervention.

The bottom line is that anything that helps you exercise more, set goals and measure your progress is good. But trends change, and people lose interest in their devices as new ones come along, and when they see it still requires work. And, sure, you could simply write down your numbers on a pad . . .  but what fun is that?

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

Fending off the Zika virus

Thanks to the incessant coverage of the U.S. presidential nominating process, the Zika virus alarm bells being sounded by the Centers for Disease Control and Prevention (CDC) have been temporarily overshadowed. But we are getting closer to the Summer Olympics in Rio de Janeiro this August. In addition to the superb athletics, people will be buzzing about Zika, which has been far more widespread in South America than in North America. Cases have been reported here in Connecticut now, and people have to be cautious and concerned.

The Zika virus is spread to people primarily through the bite of an infected Aedes aegypti mosquito. While this mosquito species is not currently present in Connecticut, a closely related species, Ae. albopictus, the Asian tiger mosquito, and related species are and may become carriers of the disease in Connecticut.

The Ae. aegypti, also common known as the Yellow fever mosquito, is found throughout tropical regions of the world and are the same mosquitoes that spread dengue and chikungunya viruses. Mosquitoes become infected with the Zika virus when they bite a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites.

Symptoms include fever, rash, joint pain, and conjunctivitis (red eyes). According to the CDC, illness is usually mild with symptoms lasting several days to a week — deaths are rare. There is no vaccine to prevent or medicine to treat Zika virus infection; however there is medication to treat some of the symptoms.

People are cautioned to contact their health care provider if they develop symptoms after returning from areas where Zika virus has been identified.  Of enormous concern, Zika virus can spread from a pregnant woman to her fetus, which can cause serious birth defects. Because of this, pregnant women should not travel to areas where Zika is present. Zika virus can also be spread from men to women by sexual contact.

Zika virus was first discovered in 1947 and is named after the Zika forest in Uganda. In 1952, the first human cases of Zika were detected and since then, outbreaks of Zika have been reported in tropical Africa, Southeast Asia, and the Pacific Islands. Zika outbreaks have probably occurred in many locations. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infection in Brazil, and on Feb 1, 2016, the World Health Organization (WHO) declared Zika virus a public health emergency of international concern. Transmission has been reported in many other countries and territories, especially in Latin America. Brazil has confirmed 2,844 cases of Zika in pregnant women.

Avoid infection by preventing mosquito bites. Use insect repellent according to label instructions, wear long-sleeved shirts, long pants and hats, empty any items around your property that can hold water, and use air conditioning or window/door screens. It is important to practice these protective measures when traveling to areas where Zika virus is found, and these are useful steps to help reduce mosquito and insect bites in general.

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

The Main Event: Vegan vs. Vegetarian

In this corner, at five feet, four inches, weighing 130 pounds and eating only fruit, vegetables, eggs, dairy products, and grains we have our challenger, Veggie Betty. In the opposite corner, at five feet five inches, eating only grains, fruit and vegetables and tipping the scales at 125 is our current champion, the queen of clean, Vegan Vicky. We’re looking for an apples-to-apples fight over the advantages and benefits of not ingesting meat and fish, and the differences between these two philosophies. Now, at the bell, come out arguing, and may the healthiest eater win!

Eating healthfully is a battle, no doubt. But both of these contestants are winners – people following vegetarian and vegan diets tend to live longer, have fewer health issues and generate less negative impact on the environment. The real battle is about staying healthy, but the debate over established and faddy diets and the advantages of veganism over vegetarianism rages on.

The term vegetarian generally means a person who does not consume animal products; this includes land and sea animals. Most vegetarians generally do consume eggs and dairy products (milk products). Vegetarian diets are considered excellent dietary methods for controlling weight, are heart-healthy, and excellent for controlling and preventing diabetes.

On the other hand, vegans eliminate all animal and dairy products (including eggs and honey) from their diet, as well as anything made with gelatin, which comes from animal bones and hooves. Vegans load up on fruits, vegetables, leafy greens, whole grains, nuts, seeds, and legumes. Research has found a low-carb vegan diet reduces cholesterol levels, plus risk for developing heart disease.

But since animal products are the most convenient sources of protein and iron, vegans have a harder time getting an equal fix and have to work harder at balancing their diet through protein-packed alternatives such as lentils, black beans and soy products, and by increasing iron absorption by pairing foods rich in iron with foods rich in vitamin C, such as leafy vegetables and citrus. As a warning, vegans often suffer from Vitamin B12 deficiencies, so should consult their physician or nutritionist to ensure a healthy balance and determine if supplements are needed.

Vegetarians eliminate most animal products from their diet, too, but typically eat dairy and eggs. Like vegans, vegetarians consume a lot of fruits and vegetables, leafy greens, whole grains, nuts, seeds and legumes. But unlike vegans, According to the American Heart Association, there is no single vegetarian eating pattern.

For example, a lactovegetarian eats plant-based foods, cheese, and dairy, while a lacto-ovovegetarian (lacto-ovo) eats all of the above and eggs. There are also semi-vegetarians, or people who don’t eat red meat but eat chicken and fish with their plant-based foods, dairy, and eggs. Most vegetarians are lacto-ovo.

Vegetarians have long been hailed as the healthiest eaters. A study published by the American Heart Association found people who mostly adhere to a pro-vegetarian diet (70 percent of food intake is derived from plants) were less likely to die from cardiovascular disease. And research  associates this particular diet with reduced risk for certain types of cancer, high blood pressure, and early death.

And again, like vegans, maintaining a mostly plant-based diet is beneficial to the environment. One cow’s annual output of the greenhouse gas methane is equivalent to the emissions generated by a car burning 235 gallons of gasoline. And the amount of feed necessary to raise beef, chicken and pork requires an enormous amount of energy and resources, including fossil fuels, medicine and water.

Until recently, the benefits of vegetarianism and veganism were more anecdotal than clinically proven. However, over the past couple of decades numerous studies have indicated that a person who adopts a vegan or vegetarian diet will:

  • Have a lower body weightOne study found that those who continue eating meat will put on more weight over a five year period, compared to those who switched over to vegetarianism. The same study found that vegans put on even less weight as they get older, compared to vegetarians and meat eaters. The study looked at 22,000 meat eaters, fish eaters, vegetarians, and vegans.
  • Have better cholesterol levels– Scientists have demonstrated that a vegetarian diet made up of specific plant foods can lower cholesterol as effectively as a drug treatment. The study, published in the Journal of the American Medical Association, compared a diet of known cholesterol-lowering, vegetarian foods to a standard cholesterol-reducing drug called lovastatin.
    The diet reduced levels of LDL the ‘bad’ cholesterol known to cause clogging in coronary arteries — in participants by almost 29 percent, compared to a 30.9 percent decrease in the lovastatin participants. The diet consisted of a combination of nuts (almonds), soy proteins, viscous fiber (high-fiber) foods such as oats and barley and a special margarine with plant sterols (found in leafy green vegetables and vegetable oils).
  • Live longer– Several studies have shown that vegans and vegetarians have a much lower risk of becoming obese, developing diabetes, cancer and cardiovascular diseases. All these conditions and diseases reduce one´s life expectancy.
  • Have a lower risk of developing cancer– Several studies have shown a reduced risk of developing many different types of cancer among vegans and vegetarians, compared to meat eaters. The study also found, however, that vegetarians have a higher risk of developing cancer of the colon.
  • Have a lower risk of developing several diseases– A 2012 article published in Food Technology documented that plant-based diets either reduce or completely eliminate people’s genetic propensity to developing long-term diseases including diabetes type 2, cardiovascular disease, and cancer. Additionally, plant-based diets have shown to be effective in treating diseases like Multiple Sclerosis.

Vegetarian food is generally lower in fat, especially saturated fats, and much higher in fiber, than animal based foods. However, a vegetarian, like a meat eater, has to watch his or her intake of calories, snack foods, refined carbohydrates, whole milk dairy products, and non-meat junk foods.

So whichever path you are contemplating, a gradual change into vegetarianism or veganism works better as a general lifestyle change and longer-term strategy. Some people find that sudden changes to their eating patterns may have unpleasant consequences for their digestive systems, such as irritable bowel and other GI-related maladies. A healthful, gradual change includes increasing your intake of vegetables, fruits, legumes (beans, lentils), and whole grains, while cutting down on your intake of meats and fish.

Additionally, the American Dietetic Association offers these tips for people who want to convert to vegetarianism or veganism:

  • Select whole-grain products, including whole wheat bread, wild/brown rice, and whole-grain cereals
  • Make sure your diet is varied
  • Choose low- or non-fat dairy products (if you wish to continue consuming dairy)
  • Do not eat more than three or four egg yolks per week
  • Plan ahead when you go shopping
  • Read the food labels carefully when you are out shopping
  • Find out where specialty stores that cater to healthy eating are located, and try shopping there.

Fortunately, there is much information available on these diets. And anyone contemplating a significant dietary change should touch base with their physician and get their baseline numbers to help chart progress. Ultimately, though, everyone who participates is a winner!

For more information on plant-based diets, visit Ornish Lifestyle Medicine and Dr. McDougall’s Health & Medical Center.

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

 

Become an Informed Healthcare Consumer

Purchasing a new or used car normally involves advance research on make, model, performance history, mileage, and resale value. We examine color options and accessories, visit showrooms or car lots, review consumer reports on the vehicle type, and peruse online feedback about the dealer or vehicle we’re considering. By the time we sit down with a salesperson, we’re reasonably well informed, know what we want, have figured out how we’re going to pay for it, and are ready to make a deal and write a check.

Now compare that process to preparing for surgery. Typically, patients listen to their physician’s advice, see the specialists he or she refers them to, complete any required pre-surgical preparation such as drawing blood, fasting or stopping certain medications, and then have their surgery. The more curious among us might do some research online at a variety of websites to learn more about our procedure, options or recovery tips. But most patients still rely primarily on information their doctor gives them, verbally or in print, and get advice from neighbors, family and work associates.

Apparently, we’re a relatively trusting lot when it comes to surgery. But when you consider the potential outcomes, costs, risks and long-term consequences, don’t you wonder why we are so much better informed and prepared to buy a car then to go under the knife?

Approximately 51 million Americans have elective or emergency surgical procedures performed in hospitals, outpatient surgical centers or their physician’s offices annually. That’s everything from cataracts and colonoscopies to angioplasty, caesarean sections, hysterectomies, knee and hip replacement, tissue removal and you name it . . . if you have a part that isn’t working properly, it can likely be removed, subdued, or improved!

But the psychology of obtaining surgery differs greatly from auto purchases, and three primary factors – trust, perceived boundaries and a lack of reliable, useful information – hinder our ability to be informed and properly engaged.

First, trust. We have confidence in our physician and the specialists, hospitals or clinical settings he or she sends us to. Typically that’s been established over years of visits and care, or is limited by cost or type of insurance. If our regular doc sends us to a specialist he or she knows and trusts, that’s good enough for us. And with the labyrinth of insurance issues our provider helps manage prior to a surgical procedure, we’re happy to leave it all in their hands and be compliant.

Second, boundaries. They’re the experts with years of medical school and training, we’re the patients. Many healthcare consumers lack the medical knowledge and chutzpah to ask tough, insightful or truly probing questions. We don’t want to be perceived as troublesome, annoying patients, or risk insulting our physicians with stupid, anxious or paranoid questions. It’s bad enough when an electrician or plumber treats us as though we’re an inconvenience – why risk feeling that way with a physician when your life is going to be in his or her hands?

And finally, there’s the lack of reliable, useful information. When it comes to specifics on doctors and hospitals, there simply isn’t much available data when it comes to quality, outcomes and performance histories. Hospital and medical rating systems managed by private, State and federal agencies exist for measuring provider and hospital performance, but they keep this information close to the vest. The data is used for addressing safety and medical errors, and for determining how the government reimburses hospitals and physicians, but it isn’t public knowledge.

This conspiracy of silence is endemic to the industry, and is driven, in part, by litigation and malpractice fears. There have been efforts to try and capture and publish some related metrics – items such as infection rates, “avoidable” readmissions to hospitals within 30 days, surgical errors – but this information is tightly guarded, and difficult if not impossible to access. Some government healthcare programs, like Medicare, make certain information available on specific procedures, but it’s not easy for the layperson to find or understand. And there aren’t any simple-to-understand, straightforward websites or annual reporting mechanisms available to consumers.

So what can you do to be a better medical consumer? Ask smart, direct questions, and do some research prior to meeting with the physician. Here are some examples of questions to ask before surgery:

  • How many times and how often have you done this procedure? This is important because high-volume practitioners have more experience and may be better able to deal with unexpected problems or emergencies.
  • How experienced is the team you will work with at the hospital or clinic? Chemistry and longevity in the operating room is an important variable, and good communication among surgical team members enhances outcomes.
  • Can the facility you’re considering for surgery handle unexpected complications? For example, if you experience a heart problem during surgery, does the facility have the staff onsite necessary to address this complication? Does the facility have a trauma center for adults or infants, or more comprehensive diagnostic imaging tools?
  • What are the potential side effects or outcomes?
  • What can I do to limit or control potential side effects, or to hasten recovery?
  • What are the exact costs or co-payments for this surgery? It’s important to understand exactly what the insurance provider, if you’re covered, will pay for and what you will be expected to contribute for your care.
  • Where can I get more information on this procedure? Ask the physician for specific web addresses or other sources of information that may be helpful.
  • Can this be done through less-invasive surgery, such as laparoscopy or robotics? Physicians practicing at some smaller hospitals may lack the experience for minimally invasive procedures, or the hospital may not be able to afford certain types of surgical tools and expensive equipment. The difference in recovery time, pain and potential complications can be significant, so it’s worth inquiring about before you proceed.
  • What will I require for post-surgical care? This may include physical rehabilitation, a short-term stay in a step-down unit, a variety of follow-up visits, home care assistance, medications and a comprehensive list of foods or activities to limit or avoid.
  • What forms and releases will I be expected to complete at the hospital or surgical center? Even though your physician will have you complete pre-surgical paperwork, most facilities ask you or your guardian to sign a variety of releases immediately prior to the procedure, often when you’re at your height of pre-surgical anxiety, and distracted. Asking in advance may help you pose intelligent questions and not feel pressured.

If your provider balks at these questions or offers ambiguous or evasive answers, you might consider another physician. Remember, you don’t want to be thinking about these issues as you’re lying on the gurney being rolled into surgery, and hindsight is always 20/20! The better you’re prepared and engaged in your care in advance, the better the experience for you and your medical team. It’s not just about competence – it’s about being an informed consumer, and making sure you know what you’re buying.

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

Diet and Colorectal Cancer

Diet plays an integral role in keeping us healthy. But beyond strong bones, eyes and teeth, a proper diet also helps prevent or reduce the likelihood of contracting a number of serious illnesses, including many kinds of cancers. One specific example is colon (colorectal) cancer, which kills more than 50,000 men and women a year in the United States alone.

Excluding skin cancers, colorectal cancer is the third most commonly diagnosed cancer.  American Cancer Society estimates for the number of newly diagnosed U.S. colon cancer cases exceeds 103,000 men and women, and another 37,000 will be diagnosed with rectal cancer.

Studies suggest that diet is a key contributor to colon cancer risk. Colon cancer is most prevalent in Westernized societies, where diets are higher in animal products and processed foods and lower in unrefined plant foods.  The cells lining the intestinal tract come into direct contact with what we choose to eat, and the substances contained in our food can have profound effects on these cells and tissues. The protective value of fruits and vegetables has been established by several studies following subjects for years, keeping track of dietary patterns and colon cancer diagnoses.

Our nutritional choices can help prevent colon cancer, especially if our diet includes more vegetables and fruits and less refined and processed foods. Nutritious foods are very rich in fiber, and disease-causing foods are generally fiber-deficient. Several food components that may modulate colon cancer risk have been identified: Fiber, omega-3 and -6 fatty acids, and certain antioxidants, vitamins, and minerals all play a partial role. Red meat and processed meats are the most cancer causing, but all meats and dairy products do not contain any fiber, and are also lacking in anti-oxidants and phytochemicals. Foods made from refined grains (such as white bread, white rice, and pasta) are also not only fiber deficient but void of micronutrients and phytochemicals as well – these foods are also associated with colon and rectal cancers.

Prevention starts with awareness

March is Colorectal Cancer Awareness Month, and the perfect time to become familiar with risk factors and prevention. Risk factors include:

  • Age 50 or older
  • A family history of cancer of the colon or rectum
  • A personal history of cancer of the colon, rectum, ovary, endometrium, or breast
  • History of polyps in the colon
  • A history of ulcerative colitis (ulcers in the lining of the large intestine) or Crohn’s disease
  • Eating a diet high in fat (especially from red meat)
  • Obesity
  • Smoking
  • Alcohol use

The prognosis and chance of recovery following a colon cancer diagnosis depends on several items, including the stage of the cancer when discovered, damage it may have already caused, blood chemistry and a patient’s general health. If you experience any stomach discomfort, bleeding in your stool, or sudden weight loss, contact your physician immediately.

Beginning at age 50 (age 45 for African Americans), both men and women at average risk for developing colorectal cancer should receive a screening test. These tests are designed to find both early cancer and polyps. There are simple blood and stool tests, and surgical testing such as colonoscopies can be done virtually (using diagnostic imagery) or surgically. Talk to your doctor about which test is best for you.

People once thought that there was little that they could do to protect themselves against cancer. But we’ve learned more about how the disease develops and what biological and environmental factors increase cancer risk. We now have better weapons for fighting the disease, including more options for diagnosis and treatment, improved therapies and new technologies for early detection.

In a world where so much is beyond our control, it’s nice to know that we can still make smart choices that are likely to improve or maintain our health. Research suggests that up to 35 percent of cancers are related to poor diet. Choosing a diet rich in nutrient-dense plant foods like vegetables, fruits, beans, nuts, and seeds is a simple step we can take to protect ourselves and our loved ones against colon cancer. And by remaining active and exercising regularly, we can reduce our risk of cancer and other health problems.

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

Understanding thyroid health

The thyroid — a small, butterfly-shaped gland located in our lower neck below our voice box — has enormous responsibility for our body’s metabolic processes. Specifically, our thyroid releases two primary hormones — triiodothyronine (T3) and thyroxine (T4) — that control metabolism.

When working properly, the T3 and T4 hormones travel through our bloodstream and help cells get energy from the food we eat. Thyroid hormones are also responsible for helping to regulate our body temperature and blood calcium levels, helping with growth and development and, during infancy, brain development.

For an estimated 27 million Americans, however, the thyroid produces either too much or too little hormone, which causes an array of health symptoms, some severe. January is Thyroid Awareness Month. Because thyroid disease is often misdiagnosed or simply overlooked, it’s estimated that more than half of affected Americans don’t know they have a problem.

The thyroid constantly releases hormones into the blood, helping to regulate many bodily functions.  Additional hormones are produced when the body needs more energy in certain situations.

Women are much more likely to have thyroid problems than men, and may have up to a one in five chance of developing thyroid problems during their lifetime. The risk increases with age and family history, as well as having an autoimmune disease or a close relative with one; through radiation exposure; by going through menopause or perimenopause; or following childbirth.

Hypothyroidism (underactive thyroid) accounts for the majority of thyroid disease cases — up to 80 percent according to some estimates. This condition occurs when our body produces too little thyroid hormone, leading to symptoms such as fatigue and general sluggishness; unexplained weight gain or increased sensitivity to cold; pain, stiffness or swelling in joints; muscle aches and weakness; heavy menstrual periods; depression; brittle hair and nails; and elevated blood cholesterol.

If left untreated, hypothyroidism can lead to obesity, joint pain, infertility, goiter (thyroid enlargement) and heart disease, but because the symptoms can mimic other diseases, or even be attributed to aging, many people do not realize the thyroid connection. Further, the symptoms may be mild at first, becoming increasingly severe only after a number of years, making them easy to overlook.

A blood test that measures our levels of thyroid-stimulating hormone (TSH) is typically used to diagnose hypothyroidism, and treatment usually involves taking a synthetic or natural thyroid hormone daily.

In contrast, hyperthyroidism results from an overactive thyroid. Symptoms include weight loss; nervousness, anxiety and irritability; increased perspiration; racing heart, hand tremors; difficulty sleeping; increased bowel movements; and muscle weakness, especially in the upper arms or thighs.

A TSH blood test can typically diagnose hyperthyroidism, and the condition is usually treated with anti-thyroid drugs that block the gland’s ability to produce thyroid hormone. Other treatments include surgery, or radioactive iodine, which destroys overactive thyroid cells.

Diet and thyroid health

As with virtually every bodily function, our diet plays a role in the health of our thyroid. There are some specific nutrients that the thyroid depends on and it’s important to include them in our diet:

  • Iodine: Our thyroid contains the only cells in our body that absorb iodine, which it uses to make critical hormones. Without sufficient iodine, the thyroid cannot produce adequate hormones to help our body function on an optimal level. Iodine deficiency is not that common in the United States because of the prevalent use of iodized salt. However, according to the CDC, up to 36 percent of women of childbearing age may not get enough iodine from their diets,and it’s thought that iodine deficiency is on a slow but steady rise.
  • Selenium: This mineral is critical for the proper functioning of our thyroid gland, and is used to produce and regulate an important hormone. Selenium can be found in foods such as shrimp, snapper, tuna, cod, halibut, calf’s liver, button and shitake mushrooms and Brazil nuts.
  • Zinc, Iron and Copper: These metals are needed in trace amounts for healthy thyroid function. Low levels of zinc have been linked to low levels of TSH, and iron deficiency has been linked to decreased thyroid efficiency. Copper is also necessary for the production of thyroid hormones.Foods such as calf’s liver, spinach, mushrooms, turnip greens and Swiss chard can help provide these trace metals in our diet.
  • Omega-3 Fats: These essential fats, which are found in fish or fish oil, play an important role in thyroid function, and many help our cells become sensitive to thyroid hormone.
  • Coconut Oil: Coconut oil is made up of mostly medium-chain fatty acids, which may help to increase metabolism and promote weight loss, along with providing other thyroid benefits.This is especially beneficial for those with hypothyroidism.
  • Antioxidants and B Vitamins: The antioxidant vitamins A, C and E can help our body neutralize oxidative stress that may damage the thyroid. In addition, B vitamins help to manufacture thyroid hormone and play an important role in healthy thyroid function.

Finally, there are certain foods that should be avoided to protect our thyroid function. These include:

  • Aspartame: There is concern that the artificial sweetener aspartame, sold under the brand name NutraSweet, may trigger Graves’ disease and other autoimmune disorders in some people. The chemical also may trigger an immune reaction that causes thyroid inflammation and thyroid autoantibody production.
  • Non-fermented Soy: Soy is high in isoflavones, which are goitrogens, or foods that interfere with the function of our thyroid gland. Soy, including soybean oil, soy milk, soy burgers, tofu and other processed soy foods, may lead to decreased thyroid function. Fermented soy products, including miso, natto, tempeh and traditionally brewed soy sauce are safe to eat, as the fermentation process reduces the goitrogenic activity of the isoflavones.
  • Gluten: Gluten is a potential goitrogen and can also trigger autoimmune reactions in people who are sensitive. Gluten is found in wheat, rye and barley, along with most processed foods.
  • Isothiocyanates found in cruciferous vegetables like broccoli, cauliflower, cabbage and Brussels sprouts are goitrogens as well. While large amounts of these vegetables, eaten raw, could interfere with thyroid function, they offer many other health benefits that make the benefits outweigh the risks for most people. If you know you have thyroid disease and want to be especially careful, steaming these vegetables will negate the goitrogenic effect, making them a healthy addition to your diet.

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

Still smoking?

Autumn and winter bring special breathing challenges for many Americans. Dry heat from central heating systems aggravates respiratory issues, and the air becomes even drier when homeowners use wood-burning stoves, space heaters, and fireplaces. When you add to this potent mix the negative effects of smoking tobacco products, breathing becomes more intense for smokers and nonsmokers alike, especially when driven indoors where windows in houses, offices and vehicles are closed up.

November is COPD Awareness Month and Lung Cancer Awareness Month. It’s not a coincidence that the two are recognized together. The primary cause of chronic obstructive pulmonary disease (COPD) is the inhalation of cigarette smoke. Up to 24 million Americans show impaired lung function, which is common among those with COPD, the third-leading cause of death in the United States. It’s a staggering number — more than 12 million Americans have been diagnosed with COPD, while an estimated 12 million more have it, but have not been diagnosed.

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. 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. However, more than half of these smokers have attempted to quit for at least one day in the past year.

Still smoking?

Nearly everyone knows 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 in the late 1990s, the U.S. Centers for Disease Control and Prevention (CDC) 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.

Why 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.

If you have any habits at all, you know how hard it is to break cycles, cravings and addictions. Humiliating, shaming or punishing smokers isn’t the answer – we’re all adults here, and like it or not, it’s not illegal to smoke, just to smoke in certain places.

But there are several steps we can take to improve our 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!” If you’ve tried to eliminate smoking, you know it isn’t easy. But you’re not alone. The American Cancer Society is marking the 38th Great American Smokeout on November 19th by encouraging smokers to use the date to make a plan to 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.

Quitting is hard, but you can increase your chances of success with help. The American Cancer Society can tell you about the steps you can take to quit smoking and provide the resources and support that can increase your 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.

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

Breast cancer awareness

Even with amazing medical progress, promising research and new treatment advances, thousands of American women and men are diagnosed with breast cancer annually. Early detection and treatment are keys to treating and containing this disease. When detected early before it can spread to other parts of the body, breast cancer can be treated successfully through radiation, drug therapy and surgery, and many cancer survivors live long, healthy lives.

October is National Breast Cancer Awareness Month. Knowing your family history, getting regular exams and avoiding known cancer-causing foods and activities are critical, proactive steps. By eating well, exercising regularly, not smoking tobacco products, and drinking in moderation women reduce their chances of contracting breast cancer.

But the numbers remain staggering: About one in eight American women, close to 12 percent, will develop invasive breast cancer over the course of her lifetime. Approximately 230,000 new cases of invasive breast cancer are diagnosed in U.S. women annually, along with approximately 58,000 new cases of non-invasive breast cancer. Additionally, more than 2,000 new cases of invasive breast cancer are diagnosed in men. Breast cancer results in close to 40,000 deaths in the United States alone, annually.

If you discover a persistent lump in your breast or any changes in breast tissue, it is very important that you see a physician immediately. Fortunately, eight out of 10 breast lumps are benign, or not cancerous. But women sometimes stay away from medical care because they fear what they might find. Take charge of your health by performing routine breast self-exams, establishing ongoing communication with your doctor, and scheduling regular mammograms.

Males need to remain diligent, as well. Men should speak with their doctor if they find suspicious lumps, abnormal skin growths, experience tenderness or experience other changes in their breasts.

For women, a mammogram remains one of the best tools available for the early detection of breast cancer. While women who have a family history of breast cancer are in a higher risk group, most women who have breast cancer have no family history. If you have a mother, daughter, sister or grandmother who had breast cancer, you should have a mammogram five years before the age of their diagnosis, or starting at age 35.

Here are 10 healthy lifestyle choices we can make that may reduce our risk of developing breast cancer:

  1. Maintain a healthy weight.Gaining weight after menopause increases the risk of breast cancer. In general, weight gain of 20 pounds or more after the age of 18 may increase the risk of breast cancer. Likewise, if you have gained weight, losing weight may lower your risk of breast cancer.
  2. Add exercise to your routine.Exercise pumps up the immune system and lowers estrogen levels. With as little as four hours of exercise per week, a woman can begin to lower her risk of breast cancer. Physical activity involves the energy that you release from your body. It not only burns energy (calories), but may also help lower the risk of breast cancer. This is because exercise lowers estrogen levels, fights obesity, lowers insulin levels and boosts the function of immune system cells that attack tumors. Do whatever physical activity you enjoy most and that gets you moving daily. All you need is moderate (where you break a sweat) activity like brisk walking for 30 minutes a day.
  3. Maintain a healthy diet.A nutritious, low-fat diet with plenty of fruits and vegetables can help reduce the risk of developing breast cancer. A high-fat diet increases the risk because fat triggers estrogen production that can fuel tumor growth.
  4. Limit alcohol intake.Research has shown that having one serving of alcohol (for example, a glass of wine) each day improves your health by reducing your risk of heart attack. But many studies have also shown that alcohol intake can increase the risk of breast cancer. In general, the more alcohol you drink, the higher your risk of developing breast cancer. If you drink alcohol, try to limit your intake to one drink a day.
  5. Women, limit postmenopausal hormones.For each year that combined estrogen plus progestin hormones are taken, the risk of breast cancer goes up. Once the drug is no longer taken, this risk returns to that of a woman who has never used hormones in about five to 10 years. Post-menopausal hormones also increase the risk of ovarian cancer and heart disease. Talk to your doctor about the risks and benefits.
  6. Breastfeed, if you can.Breastfeeding protects against breast cancer, especially in pre-menopausal women. There are many breastfeeding benefits for the baby, as well.
  7. If you don’t smoke, don’t start.You do your body a world of good by avoiding tobacco. If you do smoke, ask your doctor for help in quitting. Although there is no conclusive evidence that smoking causes breast cancer, smoking has been linked to many other types of cancer and diseases. There are health benefits from quitting at any age.
  8. Focus on your emotional health.Researchers continue studying the relationship between our physical and emotional health, but there is conclusive evidence that people who are stronger, emotionally, are more resistant to illness and certain diseases. It is also important to keep a healthy attitude. Do things that make you happy and that bring balance to your life. Pay attention to yourself and your needs. Read books, walk in the park, have coffee with a friend. Find what works for you – many things can help you be healthier and feel better about yourself in spite of what is going on in your life.
  9. Schedule regular mammograms. Even though many women without a family history of breast cancer are at risk, if you have a grandmother, mother, sister, or daughter who has been diagnosed with breast cancer, this does put you in a higher risk group. Have a baseline mammogram at least five years before the age of breast cancer onset in any close relatives, or starting at age 35. See your physician at any sign of unusual symptoms.
  10. Give yourself abreast self-examat least once a month. Look for any changes in breast tissue, such as changes in size, a lump, dimpling or puckering of the breast, or a discharge from the nipple. If you discover a persistent lump in your breast or any changes in breast tissue, it is very important that you see a physician immediately. However, eight out of 10 lumps are benign, or not cancerous.

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

Fighting ovarian cancer

Science has made tremendous progress battling certain cancers and other potentially deadly diseases. But one of the best advances, arguably, is how much more informed we are today about chronic and life-threatening illnesses, and our willingness to learn the factors — such as family history, nutrition and life-style choices — that can help reduce or prolong our lives.

One insidious disease that continues to plague women is ovarian cancer, and September is Ovarian Cancer Awareness Month. While medical researchers still don’t know how to prevent ovarian cancer, they do know a great deal more about this disease, and now have a variety of screening methods for detecting it earlier, when there’s a better chance to stem its advance.

Most importantly, this disease must be taken seriously. Each year in the United States, about 20,000 women get ovarian cancer and about 14,500 die from it. Ovarian cancer causes more deaths than any other cancer of the female reproductive system, but it accounts for only about three percent of all cancers in women.

What women — and men — need to know

Women have two ovaries that are located in the pelvis, one on each side of the uterus. The ovaries make female hormones (estrogen, progesterone and testosterone) and produce eggs. When cancer starts in either ovary, it is called ovarian cancer.

Fallopian tube cancer (which starts in the fallopian tube) and primary peritoneal cancer (which starts in the lining that supports the abdomen) are very similar to ovarian cancer. Many of the signs and symptoms are the same, and doctors treat these cancers in the same way.

All women are at risk for ovarian cancer, but older women are more likely to get the disease than younger women. About 90 percent of women who get ovarian cancer are older than 40 years of age, with the greatest number of cases occurring in women aged 60 years or older. A woman’s risk of getting ovarian cancer during her lifetime is about one in 73. Her lifetime chance of dying from ovarian cancer is about one in 100.

Ovarian cancer is more common in white women than African-American women. Fortunately, through earlier detection and more advanced treatments, the rate at which women are diagnosed with ovarian cancer has been slowly falling over the past 20 years. However, that’s no reason to relax.

Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is difficult to treat and is often fatal. Like most illnesses, the earlier it’s detected, the better your chances for leading a normal and longer life.

Physicians diagnose ovarian cancer through pelvic examinations, the use of ultrasound scanning or by taking small tissue samples. The type of ovarian cancer someone has helps determine prognosis and treatment options.

Ovarian cancer signs and symptoms

Researchers are studying ways to improve ovarian cancer treatment and looking into ways to detect ovarian cancer at an earlier stage — when a cure is more likely. Symptoms of ovarian cancer, however, are not specific to the disease, and they often mimic those of many other more-common conditions, including digestive problems.

Signs and symptoms of ovarian cancer may include:

  • Abdominal pressure, fullness, swelling or bloating
  • Pelvic discomfort or pain
  • Persistent indigestion, gas or nausea
  • Changes in bowel habits, such as constipation
  • Changes in bladder habits, including a frequent need to urinate
  • Loss of appetite or quickly feeling full
  • Increased abdominal girth or clothes fitting tighter around your waist
  • A persistent lack of energy
  • Low back pain

Make an appointment with your doctor if you or someone you know has any signs or symptoms that worry you. If you have a family history of ovarian cancer or breast cancer, talk to your doctor about your risk of ovarian cancer. In some cases, your doctor may refer you to a genetic counselor to discuss testing for certain gene mutations that increase your risk of breast and ovarian cancers.

Certain factors may increase your risk of ovarian cancer. Having one or more of these risk factors doesn’t mean that you’re sure to develop ovarian cancer, but your risk may be higher than that of the average woman. These risk factors include:

  • Inherited gene mutations, which can often be determined through genetic testing.
  • Family history of ovarian cancer.If women in your family have been diagnosed with ovarian cancer, you have an increased risk of the disease.
  • A previous cancer diagnosis.If you’ve been diagnosed with cancer of the breast, colon, rectum or uterus, your risk of ovarian cancer is increased.
  • Increasing age.Your risk of ovarian cancer increases as you age. Ovarian cancer most often develops after menopause, though it can occur at any age.
  • Never having been pregnant.Women who have never been pregnant have an increased risk of ovarian cancer.

Overall, the best advice is to talk with your physician about risks and to determine appropriate testing. Again, early detection is critical to increased survival, so remain diligent and encourage other women at risk to do the same!

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