Too much fun in the sun isn’t fun at all

Think about the years before wearing seat belts in automobiles was mandatory. Thousands of U.S. adults and children got seriously hurt or killed every year in car accidents, but that wasn’t enough to change behaviors. Safety officials and physicians advised people to install and use these restraints, and national legislation requiring mandatory seat belt installation in cars was passed in 1968. Still, it took until 1984 before the first state laws were passed requiring people to actually wear the belts. But thousands more died, unnecessarily, before seat belt use became commonplace.

Now, think about skin cancer, the most common form of cancer in the United States.  Each year, over 5.4 million cases of non-melanoma skin cancer are treated in more than 3.3 million people, and 90 percent of them are the result of exposure to UV radiation. In fact, more new cases of skin cancer are diagnosed than new cases of breast, prostate, lung, and colon cancer combined. One in five Americans will develop skin cancer in their lifetime, and one American dies from skin cancer every hour (most often from melanoma, the most fatal type of skin cancer).  And if that isn’t sobering enough, contemplate the economic reality: The annual cost of treating U.S. skin cancer cases is estimated at $8.1 billion.

There certainly aren’t any laws requiring that we protect ourselves, but are we paying attention yet? Unprotected exposure to UV radiation is the most preventable risk factor for skin cancer. In fact, UV radiation from the sun is classified as a human carcinogen by the U.S. Department of Health and Human Services and the World Health Organization.

Chronic exposure to the sun suppresses our natural immune system and also causes premature aging, which over time can make the skin become thick, wrinkled, and leathery. Since it occurs gradually, often manifesting itself many years after the majority of a person’s sun exposure, premature aging is often regarded as an unavoidable, normal part of growing older. However, up to 90 percent of the visible skin changes commonly attributed to aging are caused by the sun. With proper protection from UV radiation, many forms of skin cancer and most premature aging of the skin can be avoided.

How to protect ourselves from excess UV exposure

The best way to lower our risk of developing skin cancer is to protect our skin from the sun and ultraviolet light. Using sunscreen and avoiding the sun help reduce the chance of many aging skin changes, including some skin cancers. However, we can’t rely too much on sunscreen alone. Sunscreen and hats are helpful for reducing exposure, but not an excuse to increase the amount of time we spend in the sun. Even with the use of sunscreens, people should not stay out too long during peak sunlight hours; UV rays can still penetrate our clothes and skin and do harm.

If possible, avoid sun exposure during the peak hours of 10 a.m. to 4 p.m., when UV rays are the strongest. Clouds and haze do not protect us from the sun, so use sun protection even on cloudy days. Use sunscreens that block out both UVA and UVB radiation. Products that contain either zinc oxide or titanium oxide offer the best protection. Less expensive products that have the same ingredients work as well as expensive ones. Older children and adults (even those with darker skin) benefit from using SPFs (sun protection factor) of 15 and over. Many experts recommend that most people use SPF 30 or higher on the face and 15 or higher on the body, and people who burn easily or have risk factors for skin cancer should use SPF 50+.

When and how to use sunscreen:

  • Adults and children should wear sunscreen every day, even if they go outdoors for only a short time.
  • Apply 30 minutes before going outdoors for best results. This allows time for the sunscreen to be absorbed.
  • Remember to use sunscreen during the winter when snow and sun are both present.
  • Reapply at least every two hours while you are out in the sunlight.
  • Reapply after swimming or sweating. Waterproof formulas last for about 40 minutes in the water, and water-resistant formulas last half as long.

 

Here are additional safety tips for protection from harmful UV radiation:

  • Adults and children should wear hats with wide brims to shield from the sun’s rays.
  • Wear protective clothing. Look for loose-fitting, unbleached, tightly woven fabrics. The tighter the weave, the more protective the garment.
  • Buy clothing and swimwear that block out UV rays. This clothing is rated using SPF (as used with sunscreen) or a system called the ultraviolet protection factor (UPF) index.
  • Avoid surfaces that reflect light, such as water, sand, concrete, snow, and white-painted areas.
  • Beware that at higher altitudes we burn more quickly.

We all need the vitamins from the sun and can still enjoy the outdoors, but taking proper precautions allows us to be outdoors more safely, year round, and to reduce the risks of developing skin cancers and other skin-related diseases. As the old seat belt commercials used to tell us, “Don’t become a statistic.” Whether applying to car seats, consumption of tobacco products, or sun exposure, that’s sound advice for us and our children.

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About Chronic Fatigue Syndrome

Let’s face it, most of us push ourselves too hard and burn the candle at both ends — as well as in the middle. We work a ton, chase the kids and animals, and prowl the grocery store at night. We run around days and weekends, go out for adult play, stay up late, and simply don’t get enough sleep.

Of course we’re tired. Even if we try to eat healthfully, exercise regularly and get better-than-average sleep, fatigue may set in. It could be stress related, a nutritional deficiency, or poor sleep hygiene ranging from sleep apnea to bad late-night eating habits. Sleep supplements and more rest may help; but what happens when nothing appears to be working and the fatigue gets so bad that it interferes with your job, your family or school time, and causes you to make mistakes, or worse, endanger yourself or others?

Chronic Fatigue Syndrome (CFS), sometimes called myalgic encephalomyelitis (ME), is a condition that makes you feel so tired that you can’t do all of your normal, daily activities. There are other symptoms too, but being very tired is the main one. Some people have severe fatigue and other symptoms for many years.

Your being tired isn’t just in your head . . . it may be your body’s reaction to a variety of factors. CFS is not well understood — most experts now believe that it is a separate illness with its own set of symptoms.

Most CFS patients have some form of sleep dysfunction. Common sleep complaints include difficulty falling asleep, hypersomnia (extreme sleepiness), frequent awakening, intense and vivid dreaming, restless legs, and nocturnal myoclonus (night-time muscular spasm). Most CFS patients report that they feel less refreshed and restored after sleep than they felt before they became ill.

Doctors don’t know what causes CFS. Sometimes it begins after a viral infection, but there is no proof of any connection. It’s likely that a number of factors or triggers come together to cause CFS, but since there are no tests for CFS, it is difficult to determine. Because of this, many people have trouble accepting their disease or getting their friends and family to do so.

Extreme tiredness, or fatigue, is the main symptom. If you have CFS:

  • You may feel exhausted all or much of the time.
  • You may have problems sleeping. Or you may wake up feeling tired or not rested.
  • It may be harder for you to think clearly, to concentrate, and to remember things.
  • You may also have headaches, muscle and joint pain, a sore throat, and tender glands in your neck or armpits.
  • Your symptoms may flare up after a mental or physical activity that used to be no problem for you. You may feel drained or exhausted.

Depression is common with CFS, and it can make your other symptoms worse. Since there are not tests for CFS, doctors can diagnose it only by ruling out other possible causes of your fatigue. And since so many other health problems can cause fatigue, most people with fatigue have something other than chronic fatigue syndrome.

Doctors can help people with CFS adopt good sleep habits. Patients are advised to practice standard sleep hygiene techniques, such as:

  • Establish a regular bedtime routine
  • Avoid napping during the day
  • Incorporate an extended wind-down period
  • Use the bed only for sleep and sex
  • Schedule regular sleep and wake times
  • Control noise, light, and temperature
  • Avoid caffeine, alcohol, and tobacco
  • Try light exercise and stretching earlier in the day, at least four hours before bedtime, because this may also improve sleep.

While there is no treatment for CFS itself, many of its symptoms can be treated. A good relationship with your doctor is important. That’s because the two of you have to work together to find a combination of medicines and behavior changes that will help you get better. Some trial and error may be needed, because no single combination of treatments works for everyone. If you believe you may have CFS, speak with your physician as soon as possible, and consider meeting with a behavioral health counselor as well.

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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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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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Saying “Thanks” is Healthy for Giver and Receiver

Think about your own life, work, and accomplishments. It feels good when we do a good job. But while that satisfaction itself can be very rewarding, acknowledgement from our bosses, peers, family members, and friends is equally important. Telling someone he or she has done a good job isn’t just the right thing to do, but also is a mechanism for improving emotional and physical health, productivity, teamwork, and service.

When someone feels taken for granted, unrecognized or under-appreciated, it has a direct impact on their emotional health and stress levels. Lack of recognition, especially in the workplace, often is mentioned as a contributing factor to overall employee dissatisfaction. And the more unhappy employees are at work, the more productivity, teamwork and customer relations may suffer.  Quality suffers, as well, and increased stress is a known factor in promoting irritability, increasing conflict, interfering with sleep and diet, boosting absenteeism and increasing “presenteeism,” a loss of workplace productivity resulting from employee health problems and/or personal issues. It also contributes to increases in blood pressure, heart disease, poor nutrition and weight gain.

Americans like being told “thanks” but aren’t that great at thanking others, according to a national survey on gratitude commissioned in 2012 by the John Templeton Foundation. The polling firm Penn Shoen Berland surveyed over 2,000 people in the United States, capturing perspectives from different ages, ethnic groups, income levels, religions and more.

Gratitude was enormously important to respondents, who also admitted they think about, feel, and espouse gratitude more readily than expressing it to others. This might be why respondents also felt that gratitude in America is declining.

  • More than 90 percent of those polled agreed that grateful people are more fulfilled, lead richer lives, and are more likely to have friends.
  • More than 95 percent said that it is anywhere from “somewhat” to “very” important for mothers and fathers to teach gratitude.
  • People are less likely to express gratitude at work than anyplace else. Seventy-four percent never or rarely express gratitude to their boss. But people are eager to have a boss who expresses gratitude to them. Seventy percent would feel better about themselves if their boss was more grateful, and 81 percent would work harder.
  • 93 percent of those polled agreed that grateful bosses were more likely to be successful, and only 18 percent thought that grateful bosses would be seen as “weak.”

The bottom line is that we’re better at noticing and tallying what we personally do than what other people do.  According to the data, most of the people surveyed appreciate being appreciated, but lack in their tendency to say “thanks”– despite knowing that expressing gratitude can bring more happiness, meaning, professional success, and interpersonal connection into their lives.

Ultimately, there are so many ways to say “thanks” to our employees. Whether verbally, through written or public commendation, one-on-one, or in front of peers at staff meetings, gratitude is an important employee relations, productivity and stress-reduction tool. And while bonuses, pay raises, gift cards, and compensatory time off are terrific recognition tools, employees want to feel like it is more than simply “doing their jobs and meeting expectations” that matters.

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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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The Truth about Generic Drugs

When you go to the grocery store, you can often buy “brand X” or the store’s own version of a variety of products ranging from potato chips, salsa and packaged or fresh cheese to bread, paper goods, laundry detergent, cosmetics and much more. These “generic” products are of varying quality, sometimes as good as the name-brand items you may have been purchasing for years, sometimes not as good. The price difference, however, is usually significant, and it’s often well worth the savings.

Can the same comparison be made for generic drugs?  Yes – but with a huge caveat:  What makes generic food and paper supplies different from generic drugs and medicines is strict federal oversight. The generic drugs often are being made by the same pharmaceutical companies as their more expensive brand-name cousins, or by other companies once patents on the brand-name drugs have expired. Proven quality, consistency, strength and testing by the Federal Food and Drug Administration (FDA) assures the consumer that the generic being substituted for the brand-name drug is safe, effective and just what the doctor ordered.

In fact, eight out of 10 brand-name drugs are now available in generic equivalents. Generics are, on average, 80 percent to 85 percent cheaper than brand-name drugs, saving U.S. consumers close to $200 billion annually.

Pharmaceutical companies mark up their proprietary brands to reflect the upfront costs involved in research, testing, clinical trials, manufacturing, distribution and marketing and advertising. Marketing and promotion is a huge expense, which is reflected in the purchase cost of brand-name drugs. Drug manufacturers are allowed to protect that brand for a certain number of years to recoup their investments. Once that patent protection expires, other companies are allowed to produce the product without the costly start-up charges or advertising, and the price drops due to competition.

When a generic drug product is approved, it has met rigorous standards established by the FDA with respect to identity, strength, quality, purity, and potency. However, some variability can and does occur during manufacturing, for both brand-name and generic drugs. When a drug, generic or brand name, is mass-produced, very small variations in purity, size, strength, and other parameters are permitted. FDA limits how much variability is acceptable, and monitors those differences.

Generic drugs are required to have the same active ingredient, strength, dosage form, and route of administration as the brand-name product. Generic drugs do not need to contain the same inactive ingredients as the brand-name product, though.

To ensure quality and performance, the generic drug manufacturer must prove its drug is the same as (or bioequivalent to) the brand-name drug. For example, after the patient takes the generic drug, the amount of drug in the bloodstream is measured.  If the levels of the drug in the bloodstream are the same as the levels found when the brand-name product is used, the generic drug will work the same. Through review of bioequivalence data, FDA ensures that the generic product performs the same as its respective brand-name product. This standard applies to all generic drugs, whether immediate or controlled release.

Additionally, all generic manufacturing, packaging, and testing sites must pass the same quality standards as those of brand-name drugs, and the generic products must meet the same exacting specifications as any brand-name product. In fact, many generic drugs are made in the same manufacturing plants as brand-name drug products.

When to be cautious

With the proliferation and availability of drugs sold online, consumers must be careful that the products they’re buying – especially those created and shipped from other countries – meet the same standards as American generic drugs. It’s one thing to apply an adhesive bandage made abroad, another to ingest a medicine critical to your recovery from an illness, maintenance meds for a chronic condition, or vitamins and supplements that could be harmful or result in death.

The reason for caution is that the FDA often does not regulate, review or test these drugs that come from potentially nefarious sources in India, China, South America and the Far East.  Oftentimes, drugs that are advertised “made in Canada,” for example, actually come from other countries. And manufacturers are expert at using similar-sounding names for better-known drugs to confuse consumers. They also prey on the elderly, less-educated and needy.

The cash price for online drugs might be right, but the physical price could be extremely costly. When in doubt, consumers can visit the U.S. Food and Drug Administration website for safety information, alerts and pharmaceutical product details.

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Heart Health: About Cholesterol and Statins

Every February there’s plenty of talk about hearts – loving hearts, broken hearts, chocolate hearts and tiny candy hearts with heart emoticons and goofy sayings like “text me”– but there’s rarely talk about healthy hearts, and the things we can be doing to help keep them that way.

Coincidentally, February is American Heart Month and a perfect time to remind people of one of the major contributors to cardiovascular disease: Too much bad cholesterol, or not enough good cholesterol. It’s also important to talk about one of the primary medicines millions of Americans consume to help their bodies regulate or offset the negative effects of cholesterol – a widely prescribed class of drugs called statins.

A brief primer on cholesterol

Cholesterol is a waxy substance found in all parts of 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 (blood vessels that carry blood from the heart to other parts of the body). This buildup is called plaque. Over time, plaques can cause narrowing or hardening of the arteries – a condition called atherosclerosis – which can clog our arteries 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 (good) cholesterol are among numerous factors our doctors can use to predict our lifetime or 10-year risk for a heart attack or stroke. Other risks include family history, if you are a smoker, your diet, the amount you exercise, and if you 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 (“bad”) cholesterol level is considered good for our heart health.

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.

The down side to statins

Most people who take statin drugs tolerate them very well. But some people experience side effects. The most common statin side effects include:

  • Headache
  • Difficulty sleeping
  • Flushing of the skin
  • Muscle aches, tenderness, or weakness
  • Drowsiness or dizziness
  • Nausea or vomiting
  • Abdominal cramping, pain, bloating or gas
  • Diarrhea or constipation

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. 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.

Give yourself 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.

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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!

Got coffee?

When we were little tykes watching our parents drink coffee, they told us we couldn’t have any because the caffeine would stunt our growth. When we got a little older, they poured an ounce of coffee in a cup, filled the rest with milk, loaded in the sugar, and we thought we were big shots.  Later in the day, we may have drunk soda or eaten chocolate — which also have caffeine — but most of us grew up little the worse for the wear.

Adding to the mystery, the health benefits of caffeine often are touted, and myths abound about coffee’s healing properties for headaches, hangovers and as a tonic for keeping us awake. It’s easy to see why we grew up confused about this incredibly popular beverage.  So, is caffeine bad for us, and if so, why?

The answer, like the question, is complicated. But the bottom line is that – as in many things – moderation and information are the keys to healthy caffeine consumption.

Caffeine stimulates the central nervous system, alleviating fatigue, increasing wakefulness, and improving concentration and focus.  As a stimulant, regular use of caffeine does cause mild physical dependence. But caffeine doesn’t threaten our physical, social, or economic health the way addictive drugs do. For most healthy adults, moderate doses of caffeine – 200 to 300 milligrams (mg), or about two to four cups of brewed coffee a day – aren’t harmful. But some circumstances may warrant limiting or even ending our caffeine routine.

If you drink four or more cups a day, take note. Although moderate caffeine intake isn’t likely to cause harm, too much can lead to some unpleasant effects. Heavy daily caffeine use – more than 500 to 600 mg a day – may cause

  • Insomnia
  • Nervousness
  • Restlessness
  • Irritability
  • Stomach upset
  • Fast heartbeat
  • Muscle tremors

Coffee and caffeine in other forms — such as in tea, soda and chocolate — may make us jittery. Some people are more sensitive to caffeine than are others. If you’re susceptible to the effects of caffeine, just small amounts may prompt unwanted effects, such as restlessness and sleep problems.

How we react to caffeine may be determined in part by how much caffeine we’re used to drinking. Caffeine content can range from as much as 160 milligrams in some energy drinks to as little as 4 milligrams in a one-ounce serving of chocolate-flavored syrup. Even decaffeinated coffee isn’t completely free of caffeine. People who don’t regularly drink caffeine tend to be more sensitive to its negative effects. Other factors may include body mass, age, medication use and health conditions such as anxiety disorders or heart disease. Research also suggests that men are more susceptible to the effects of caffeine than are women.

Women who are pregnant often are advised to avoid or limit caffeine because some studies have indicated a higher potential incidence of miscarriage. People with high blood pressure should watch their caffeine intake, as it increases the risk of stroke; and because caffeine does act as a mild diuretic, it will cause us to urinate more often. But studies show drinking caffeinated drinks in moderation doesn’t actually cause dehydration, especially if we drink water and other liquids during the day.

And finally, as for stunting childrens’ growth, there’s an irony to that misconception:  The added sugar that children and many adults consume in flavored coffees and caffeinated energy drinks promotes obesity, and caffeine can aggravate anxiety or irritability, in children and in adults.

Caffeine and sleep

Most adults need seven to eight hours of sleep each night. But caffeine can interfere with this much-needed sleep. Chronically losing sleep – whether it’s from work, travel, stress or too much caffeine – results in sleep deprivation. Sleep loss is cumulative, and even small nightly decreases can add up and disturb your daytime alertness, overall health and performance.

Our body quickly absorbs caffeine. But it also gets rid of it quickly. Processed mainly through the liver, caffeine has a relatively short half-life. This means it takes about five to seven hours, on average, to eliminate half of it from our body. After eight to 10 hours, 75 percent of the caffeine is gone. For most people, a cup of coffee or two in the morning won’t interfere with sleep at night.

But using caffeine to mask sleep deprivation can create an unwelcome cycle. For example, we drink caffeinated beverages because we have trouble staying awake during the day. But the caffeine keeps us from falling asleep at night, shortening the length of time we sleep. Additionally, certain medications and herbal supplements may interact with caffeine, including some antibiotics and other specialty drugs, and certain herbal supplements like Echinacea, which people take to ward off colds.

Talk to your doctor or pharmacist about whether caffeine might affect your medications. He or she can say whether you need to reduce or eliminate caffeine from your diet.

Curbing our caffeine habit

Whether it’s for one of the reasons above – or because we want to trim spending on pricey coffee drinks – cutting back on caffeine can be challenging. An abrupt decrease in caffeine may cause caffeine withdrawal symptoms such as headaches, fatigue, irritability and nervousness. Fortunately, these symptoms are usually mild and resolve after a few days.

To change caffeine habits more gradually, try these tips:

  • Note intake. Start paying attention to how much caffeine you’re getting from foods and beverages. It may be more than you think. Read labels carefully. Even then, your estimate may be a little low because not all foods or drinks list caffeine. Chocolate, which has a small amount, doesn’t.
  • Cut back. But do it gradually. For example, drink one fewer can of soda or drink a smaller cup of coffee each day. Or avoid drinking caffeinated beverages late in the day. This will help your body get used to the lower levels of caffeine and lessen potential withdrawal effects.
  • Go decaf. Most decaffeinated beverages look and taste the same as their caffeinated counterparts.
  • Shorten the brew time or go herbal. When making tea, brew it for less time. This cuts down on its caffeine content. Or choose herbal teas that don’t have caffeine.
  • Check the bottle. Some over-the-counter pain relievers contain caffeine – as much as 130 mg of caffeine in one dose. Look for caffeine-free pain relievers instead.

For most adults, caffeine is a part of our daily routine. And most often it doesn’t pose a health problem. But curtailing our caffeine habits can be better for our health – and our wallets!

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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!