Tuesday, November 29, 2016

Can I Burn Off Those Extra Holiday Calories With Exercise?

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Can I Burn Off Those Extra Holiday Calories With Exercise?
Karen Collins, MS, RDN, CDN, FAND of the American Institute for Cancer Research answers this common question.
It depends on the treats you choose and how fast you walk. Holiday cookies often have 60 to 140 calories each, and sweet desserts may contain from 200 to 600 calories or more per serving.
If you walk at a moderate three-miles-per-hour pace and weigh 150 pounds, you would need about 24 minutes to burn the calories in one 140-calorie cookie, and well over an hour for other sweet desserts. If you can comfortably walk at a brisk pace of about 4 miles per hour, you could cut your walking time to 15 minutes to burn the same number of calories; or if you walk briskly for 24 minutes, you’ll burn almost 200 calories.
Looking at this math, it’s easy to see that although boosting physical activity at a time when there’s more high-calorie food around can help avoid weight gain, adding extra exercise can’t easily keep up with how quickly excess calories accumulate with overeating. However, don’t look at walking and other exercise simply as a way to balance calories you consume. Physical activity, independent of weight, is linked with numerous health benefits, including lower risk of several cancers. It also helps your body regulate blood sugar and keeps several hormones at healthy levels.
For many people, daily physical activity also helps handle stress, raise energy levels and improve sleep quality, which are all often challenges at busy times of year. So enjoy sweet treats of the season, choosing those that you enjoy most at times when you can truly taste and savor them.

Tuesday, November 22, 2016

December 5–9, 2016 Is Older Driver Safety Awareness Week

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The holidays are a time when many families visit elderly parents, grandparents and other loved ones. That’s why December is the month when families are most likely to realize that Mom and Dad might not be safe behind the wheel. There might be some new dents on the car or the garage door. Maybe when Grandpa picked them up at the airport, they got a firsthand look at the trouble he was having reading signs and navigating lane changes.
We are a car-centric culture, so anyone asking a senior driver to give up driving can expect to be met with resistance. It can be a very emotional topic! For most Americans, driving equals independence, and giving it up may seem like a serious blow to self-esteem, even triggers for depression and grief. You can help. Here are seven things to think about before you start the conversation:
  1. Not all seniors are bad drivers. Consider whether you are really reacting to things you’ve noticed about your loved one’s driving, versus stereotypes that older adults drive poorly. Studies show that many drivers retain their skills well into their later years. However, visual impairment, hearing loss, decreased manual dexterity, slower reaction time and memory loss all can make it harder to be safe on the road. Studies show many seniors self-limit their driving in response to these changing abilities, avoiding driving at night and sticking to familiar routes. But for many, it’s best to give up the car keys. The Centers for Disease Control and Prevention (CDC) reports that the rate of crashes increases noticeably after a driver turns 70; more than 500 seniors are injured while driving each day.
  2. Senior drivers can improve their skills and extend their safe driving years. Driver’s ed—it’s not just for teenagers! Driver safety classes for older adults are available through AARP, AAA and other organizations. Your loved one also might benefit from an exercise program to increase flexibility and range of motion. The eye doctor can recommend the best type of glasses for driving, including protection against glare. Seniors with hearing loss should wear their hearing aids while driving. And if the driving skills of a senior loved one seem to have taken a sudden dip, medication side effects might be to blame. Your loved one should ask for a medication review, and report side effects, such as drowsiness and confusion.
  3. The car might be part of the problem. Be sure the car is in good repair. Adding safety features like improved mirrors and new windshield wipers can make the car safer to operate. And bottom line, the car just may not be a good fit any more. If it’s large and difficult to maneuver, check out smaller cars that are easier to drive and park. Newer cars have certain safety features that seem like they could have been designed for older adults, such as backup cameras and warning sensors.
  4. You can call in experts to help. Many families find that their senior loved ones do not want to have the conversation about driving. Here’s where the opinion of an outsider may carry more weight than yours. Encourage your loved one to seek an evaluation by their doctor or by the DMV.  The American Occupational Therapy Association, sponsors of Older Driver Safety Awareness Week, reminds us that occupational therapists have the skills to evaluate a person’s overall ability to operate a vehicle safely. They can provide a good picture of your loved one’s abilities, and suggest some of the appropriate strategies as mentioned above. Aging life care professionals (geriatric care managers) can also offer resources and assessment.
  5. Start the conversation before there’s a problem. In many families, the discussion of senior driving safety only begins when an elder loved one has had an accident. This isn’t exactly the ideal time to first be talking about the issue. Start talking about driving safety early on, while your loved one is still a capable driver. If it’s a possibility, assure your loved one that you will be one transportation resource—but that’s only the beginning. With your loved one, research the public transportation options, such as the bus or subway, taxi cabs or ride sharing services (such as Uber or Lyft) and special transportation for seniors with disabilities. Once your loved one gets the hang of public transportation, they may enjoy being “subway-savvy” or summoning their Uber.
  6. Create an “advance directive” for driving. In the same way that you plan with your loved one for future care and living options, make driving safety part of the plan. The earlier you talk about it, the more likely your loved one will be to heed your concerns. A study from the University of Colorado showed that most older adults realize that they may not be the first to recognize a problem, and they would be willing to designate a family member, doctor or other trusted person to say when their driving was no longer safe.
  7. Talk about the cost of owning a car. Many seniors balk at paying for public transportation, without really thinking about how much it costs to have a car. Add it all up: car payment, gas, insurance, maintenance and repair costs and parking. That is most likely a pretty good chunk of change that would be available for alternative transportation costs. Remind your loved one that driving isn’t the ultimate goal—mobility and independence are! Staying active and engaged in their favorite activities, volunteer jobs, faith community and whatever places they love to go is more important than what they rode to get there.

Monday, November 14, 2016

That Thanksgiving Heartburn—Could It Be GERD?

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November 20–26, 2016 is Gastroesophageal Reflux Awareness Week
There’s a month or a week for just about every health condition. Most of the dates seem to be arbitrarily chosen, but when it comes to Gastroesophageal Reflux Awareness Week, it makes sense to “celebrate” around Thanksgiving! That’s the week when many of us experience heartburn—a burning sensation in the chest, behind the breastbone and in the middle of the abdomen.
The International Foundation for Functional Gastrointestinal Disorders (IFFGD) sponsors this week to help call attention to symptoms that might mean we’re suffering from more than the usual, temporary heartburn. If symptoms persist and heartburn becomes chronic, or we experience regurgitation, swallowing problems, a sore throat or hoarseness in the morning, we might have gastroesophageal reflux disease (GERD), which is caused when the contents of the stomach often flow backwards into the esophagus.
According to the National Institutes of Health (NIH), if GERD is left untreated, it can cause chronic inflammation of the esophagus, swallowing problems, lung problems and erosion of the teeth. The NIH reports that GERD may be caused by:
  • A hiatal hernia—a condition in which the opening in the diaphragm lets the upper part of the stomach move into the chest
  • Pressure on the abdomen from obesity (or, temporarily, pregnancy)
  • Certain medications, including those used to treat asthma, high blood pressure, allergies or depression
  • Smoking
Statistics also suggest that age-related changes in the digestive tract raise the risk as we grow older.
Says IFFGD president Nancy Norton, “The symptoms of GERD can seem so common that many people do not consult with their healthcare providers or mention them during routine exams.” She warns, “When symptoms often occur two or more times a week or become more severe, it is important to talk to a physician. Left untreated, GERD can lead to complications, or other health problems.”
The IFFGD says that anyone experiencing these symptoms should schedule an appointment with their healthcare provider, and share this information during the appointment:
  • A list of when your heartburn occurs (time of day, after meals, etc.) and how often
  • The severity of your heartburn
  • Other symptoms you are experiencing
  • How your symptoms affect your daily activities
  • How your symptoms affect your sleep
  • What changes in diet and lifestyle choices you have made to relieve your symptoms and how effective this has been in providing relief
  • What antacids and other over-the-counter medications you have used and what relief, if any, they have provided
So this Thanksgiving and throughout the holiday season, how can we avoid a case of heartburn that’s sure to put a damper on the festivities? Dr. Juan Carlos Bucobo of Stony Brook University Hospital in New York offers six tips:
  1. Nibble, don’t hoard. Overeating and eating too fast will increase the chances of heartburn if you are predisposed. Smaller portions separated over time will decrease the chances you will burn in agony. At the main meal, try using a smaller plate and eating slowly.
  2. Identify the culprits. Certain foods are more likely to worsen GERD and heartburn. These include fatty foods, spicy foods, onions, garlic, caffeine, chocolate, citrus fruits and juices, and mints. So make sure to pass on the deep fried turkey.
  3. Kick the habit. There’s no reason to wait for New Year’s to start your resolutions and stop smoking. Nicotine reduces the pressure of the muscle between the esophagus and stomach, increasing the likelihood of acid reflux, among other deleterious effects.
  4. Avoid lying down after a meal. Overeating and alcohol are sure to make you want to snooze after a holiday meal. Resist the urge to lie down within three hours of eating, as it is likely to worsen your heartburn.
  5. Skip the eggnog. Alcohol, especially in large quantities and particularly red wine, has been implicated in worsening heartburn. If you are going to drink alcohol, do so in moderation.
  6. Seek help. There are several categories of over-the-counter medications available to ease the burn. When symptoms become frequent, more than 2–3 times per week, visiting a doctor is important in establishing the diagnosis and prescribing the most effective treatment.
Remember: GERD can be treated—and that’s something to be thankful for!

Tuesday, November 8, 2016

November Is Diabetic Eye Disease Awareness Month

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November is American Diabetes Month, and it’s also the month when we are urged to learn more about a common cause of vision loss. Diabetic Eye Disease Awareness Month, sponsored by Prevent Blindness (www.preventblindness.org), is an opportunity to educate the public about diabetic retinopathy, which robs the sight of so many. Prevent Blindness is the nation’s oldest volunteer eye health and safety nonprofit organization.
Today more than 8 million Americans have diabetic retinopathy, with that number expected to jump in the coming years, according to a study, The Future of Vision: Forecasting the Prevalence and Costs of Vision Problems.
Diabetic eye disease is a group of eye conditions that affect people with diabetes, including:
Diabetic retinopathy—A leading cause of blindness in American adults, it is caused by damage to the small blood vessels of the retina, the seeing layer of the eye. Retinal blood vessels can break down, leak, or become blocked, affecting oxygen and nutrient delivery to the retina, impairing vision over time. More damage to the retina can occur when abnormal new blood vessels grow on the surface of the retina and leak fluid or bleed. This can initially result in blurring of vision, and in late stages, retinal detachment and/or glaucoma.
Diabetic macular edema (DME)—DME is a complication of diabetes caused by fluid accumulation in the macula, the central portion in the retina, which is in the back of the eye and where vision is the sharpest. Vision loss from DME can progress over a period of months and make it impossible to focus clearly.
Diabetic eye disease also includes cataracts and glaucoma. Vision changes due to diabetic eye disease may include blurred vision, double vision, sudden increase in eye floaters, seeing halos around lights or flashing lights, and sudden loss of vision in one eye.
Everyone with diabetes is at risk of developing diabetic eye disease. To help prevent diabetic eye disease, Prevent Blindness suggests:
  • Maintaining good blood sugar, blood pressure, and cholesterol control.
  • Getting a comprehensive dilated eye exam and/or obtaining retinal photographs that are examined by an eye doctor, at least once a year, or more often as recommended by the eye doctor.
  • Pregnant women who had diabetes prior to pregnancy should have a comprehensive dilated eye exam early in their pregnancy. The eye doctor may recommend additional exams during pregnancy.
  • Keeping a healthy lifestyle that includes exercising regularly, not smoking and following a healthy diet. Talk to a dietician about eating habits and a doctor before starting an exercise program.
“It is imperative for anyone with diabetes to get an annual eye exam,” said Hugh R. Parry, president and CEO of Prevent Blindness. “Although there is no cure for diabetic eye disease today, vision loss can be lessened with early diagnosis and proper treatment from an eye care professional.”
Medicare Part B (Medical Insurance) covers a yearly eye exam for diabetic retinopathy by an eye doctor who is legally allowed to do the test in the state. All people with Part B who have diabetes are covered.
For more information on diabetic eye disease or other eye health information, please call Prevent Blindness at (800) 331-2020 or visit preventblindness.org/diabetes.

Tuesday, November 1, 2016

Alzheimer Spouses Benefit from Counseling and Support

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November is Family Caregivers Month. Sponsored by the Caregiver Action Network (formerly the National Family Caregivers Association), this event is a time to recognize and honor family caregivers who do so much for their loved ones. This year’s theme, “Take Care to Give Care,” reminds us that caregiving can be stressful and can tax the health of caregivers—making it harder for them to provide good care for their loved ones.
November is also National Alzheimer’s Disease Awareness Month, which is also fitting, because the millions of Americans who provide care for a loved one with dementia are so deserving of our support! While we are advocating for increased resources for people with Alzheimer’s disease and other forms of dementia, we shouldn’t overlook the needs of the millions of dementia caregivers, who work tirelessly to ensure the best quality of life for their loved ones.
While many adult children serve as dementia caregivers, an increasing number of spouses are filling the role. A study performed by a leading researcher on Alzheimer’s caregivers issues sheds light on the need to support these spouse caregivers.
Spouses of people with Alzheimer’s disease usually are older adults. While people who take on the caregiving role tend to initially be healthier than those who do not, caring for someone with Alzheimer’s disease is difficult in the best of circumstances, and can take a toll on a person’s health. Counseling and support for people caring for a spouse with Alzheimer’s disease helps to preserve their health, according to a study led by Mary S. Mittelman, Dr.P.H., research professor in the Department of Psychiatry at New York University School of Medicine.
The study resulted from research conducted over 20 years by Dr. Mittelman, which was the longest research study ever devoted to testing an intervention to improve the well-being of Alzheimer’s caregivers. The study involved 406 spouse caregivers of people with Alzheimer’s disease who were divided equally into two groups. The first group received enhanced counseling and support, including six sessions of individual and family counseling, support groups, and telephone counseling for the caregiver and family members as needed. The second group received information and help upon request, but didn’t participate in formal counseling sessions.
Results from the ongoing study showed that caregiver spouses who received enhanced counseling and support were able to delay placing their ailing spouse in a nursing home on average 1½ years longer. Dr. Mittelman and her colleagues also found that counseling and support substantially eased the depression of spouse caregivers.
Caregivers in the study who received the intervention, which was developed at NYU Medical Center by Dr. Mittelman and her colleagues, also reported less of a decline in their own physical health. Dr. Mittelman pointed out, “Preserving the health of spouse caregivers through counseling and support also benefits the person with Alzheimer’s disease, as caregivers who are in poor health are more likely to have difficulty providing good care.” Dr. Mittelman concluded, “Individualized counseling programs that improve social support for caregivers can have many indirect benefits, including sustaining their physical health.”
In 2015, Dr. Mittelman and her team received a grant to develop the NYU Caregiver Integrated Support and Services Access Program (CISSAP), aimed at providing counseling and support to New York City caregivers, which is expected to provide increased insight into effective interventions.