Healthy Tips – November 2018

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HEALTHY TIPS – NOVEMBER 2018


Topics This Issue:


Best Tactic for Diabetes? Find and Treat It Early


Over 30 million Americans have diabetes, but 7 million of those people are not yet diagnosed!* Are you one of them? Getting tested is a smart step for your long-term health.

Diabetes is a life-altering disease, and it’s important to catch it early. The earlier you detect diabetes, the better your chances of avoiding future health problems, including heart attack, kidney disease, limb amputation and blindness.

With diabetes, there is too much glucose (sugar) in the blood. This occurs when a person’s body is unable to produce or use insulin, a hormone that regulates blood sugar levels in our bodies. There are two types of diabetes:

  • Type 1 diabetes is typically diagnosed in children and young adults. It occurs when the pancreas produces little to no insulin. Type 1 can be managed with daily insulin injections.
  • Type 2 diabetes accounts for 90 percent of cases. It occurs when your body resists the effects of insulin or doesn’t produce enough.

If left untreated, either form of diabetes can increase the risk of serious health complications.

Learn Your Risk Factors and Get Screened

Risk factors for type 2 diabetes include a family history of diabetes, age 45+, being overweight, infrequent/irregular physical activity and certain races/ethnicities (including Pacific Islander, Asian-American, Mexican-American and African-American). Also, women who had diabetes during pregnancy are at higher risk.

If you have one or more risk factors for diabetes or notice any of the above symptoms, talk with your doctor about being screened as soon as possible. If you receive a diabetes diagnosis, you are not alone. Ask your doctor about diabetes education and nutrition support.

Think of Exercise as Diabetes “Medicine”

It’s important to make physical activity a part of your life. If you don’t have diabetes, regular exercise can help prevent the disease. If you do have diabetes and you exercise regularly, it can lower your blood pressure and blood sugars—and can even prevent the need for diabetes medication for a long period of time.

You don’t need to run a marathon to reap the benefits of exercise! Walking between 6,000 and 10,000 steps daily is an attainable goal for most people. Use a step counter—or simply count your steps for 5 minutes and do some math. If you have mobility problems, water aerobics is a great alternative. Whatever you do, aim for 150 minutes of exercise per week, or 20-30 minutes every day.

If you are looking for a primary care provider, we invite you to meet the PacMed Primary Care team. If you are already living with diabetes or have recently been diagnosed, the PacMed Diabetes Management Program offers comprehensive medical care, health education and support.

*Statistics as reported in the 2017 National Diabetes Statistics Report by the Centers for Disease Control (CDC).

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Help Your Immune System Fight Winter Illness


Does it seem like you always get sick at this time of year? There are powerful things you can do to help you and your family avoid colds and flus. Your best bet is to avoid getting sick in the first place! Try this two-pronged approach.

Eat Smart to Boost Immunity!

The immune system is your body’s defense against infectious organisms and other invaders. Many nutrients from food specifically “feed” the immune system, thus strengthening your body’s protective response.

  • Remember your cruciferous. Cruciferous vegetables—such as cabbage, Brussels sprouts, broccoli, cauliflower, bok choy—strengthen the liver so it’s better able to flush the body of harmful substances.
  • Skip the sugar. Want a sweet? Reach for whole, fresh fruit! The simple sugars in cookies, soda and pastries can weaken your white blood cells’ ability to fend off foreign invaders … like viruses.
  • Add some zing. Garlic and ginger have antiviral and active molecules that help the body fight off viruses and bacteria. (Worried about garlic breath? Ask your provider about high-quality garlic supplements.)
  • Feed your gut. Fermented foods contain good bacteria, or probiotics, that help the digestive tract fight off foreign invaders. Try sauerkraut or kimchi (cabbage), or yogurt, kefir and sour cream (dairy).
  • Talk with your doc about vitamin D. Vitamin D plays a big role in regulating your immune system. With our dark Northwest winter, your doctor may recommend a daily dose of D for you.
  • Devour fish. Cold-water, fatty fish like salmon and sardines are the highest in omega-3 fatty acids, which enhance the function of certain immune cells. Fish is also a rare source of vitamin D.

Take Preventive Steps!

You can do a lot of things to help prevent you and your family from catching a cold or flu this season.

  • Wash your hands: Good handwashing is the number one way to protect yourself from getting sick. Scrub for at least 20 seconds with soap.
  • Get the flu vaccine: Everyone over the age of 6 months should get a flu shot. While it won’t keep you from getting a common cold, it will help protect you and others around you from the flu.
  • Avoid people who are sick: Keep your distance! Sick children/adults should stay home from school/work.
  • Sleep well: Your body needs good sleep for a healthy immune system. Go to bed earlier so your body can get the nightly sleep it needs: adults, 7-8 hours; teens 8-9 hours; “tweens” 9-10 hours; young school-age kids 10-12 hours; toddlers/preschoolers, 11-13 hours.
  • Eat well: Maintain a well-balanced diet of healthy protein, whole grains, healthy fat like olive oil and avocado, limit added sugar, and eat plenty of fruits and vegetables. Read more below!

Eat well, sleep well and be well this winter!

Are you looking for a primary care provider? PacMed offers preventive, primary care through our Family Medicine and Internal Medicine teams. Therapists in our Behavioral Medicine department are also available for counseling.

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Nutrition Corner: Six Ways to Stick to Healthy Eating This Holiday Season


With forethought and a few tricks, you can stick to your health goals this holiday season! Try these six tools this year.

  1. Be mindful. Aim for a healthy relationship with food this year by practicing mindful eating—an exercise that builds awareness of our actions, thoughts, feelings and motivations behind eating. This practice focuses on listening to your body, acknowledging your hunger and satiety cues, and keeping tabs on how certain foods make you feel. Mindful eating can also help you create a better eating environment by slowing down at mealtimes and focusing on cherishing food. Mindfulness can remove the guilt around food intake and help you experience the joy of eating again.
  2. Continue your exercise routines. Maintaining your exercise routine in the midst of parties, travel and winter darkness will keep your stress down and your immune system at its best. Set realistic expectations for the holiday season. Create a new routine if it means you are more likely to stick with it. Often, success is best achieved when you include your favorite spin or yoga class in your weekly schedule—or find an activity that offers more flexibility.
  3. Prepare yourself with a plan. Come up with a realistic plan for parties, office treats or temptations when out shopping. Some people benefit from eating a light, healthy meal before attending a party to reduce their potential to binge on higher-calorie foods. This trick also will ensure you get your servings of fruits or vegetables beforehand, while boosting your willpower by not being hungry. When you head out shopping or to work, pack healthy snacks to avoid impulse purchases or grabbing an extra dessert from the workplace cafeteria. Some easy ideas are roasted chickpeas, apple or orange slices, or whole-grain crackers.
  4. Know your stressors. Take a few minutes before the holidays to write a list of your main stressors. Is it your family, the business of events, your kids during their sugar highs? Make a plan for handling these stressors to lessen the burden on your body. For example, if planning for guests is your stressor, try to delegate tasks instead of doing it all yourself or schedule some self-care activities before or after the event.
  5. Plan for indulgences. Let’s get real—holidays are delicious especially when all your favorite traditional foods come back, like grandma’s apple pie, uncle’s pepperoni rolls or, mm-mm, auntie’s artichoke dip. How about being a little pickier with your food choices this year? Try focusing on just your favorites while forgetting the empty-calorie or high-calorie fillers. Feel good about the foods you choose to indulge in and really savor every bite.
  6. Rethink your drink. Cutting out sweetened beverages is one way to stick to your health goals while still enjoying favorite traditions. Many drinks are full of calories yet have no or little nutritional benefit. In particular, alcoholic drinks not only are caloric, but also tend to loosen our decision-making skills around food intake (hello, late-night munchies). Turn to infused, sparkling or regular water as an alternative and practice moderation when drinking alcohol, which is defined as up to one drink per day for women and up to two drinks per day for men.
  7. Sticking with these suggestions can help you to alleviate stress and enjoy a healthy holiday season with family and friends. Don’t beat yourself up over the occasional splurge. Just keep your focus and continue to set goals that keep you on track.

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    Keeping Holiday Stress at Bay (or under Control)


    For most of us, our lives are already busy, and with the holidays come additional burdens and stressors, from social obligations and cooking, to juggling out-of-town guests and kids on vacation. Stress drains us physically and mentally, making it that much harder to get enough sleep and maintain our exercise routines. Overeating is also common, especially when stress is combined with the many temptations of special foods and beverages. By thinking through your personal approach to stress, you can call on internal and external resources to help you enjoy the winter holiday season.

    Your Personal Stress Response

    When you feel stressed, your body undergoes a physiological change—your “fight or flight” response has been activated. Your heart rate increases, your muscles feel tense, you feel on alert. In essence, your body is giving you extra energy so you can deal with a perceived challenge.

    Take a minute to consider how you personally tend to respond to stress. If you have a sweet tooth, think ahead about how you can limit your access to sweets. If you tend to stop moving and become sedentary, can you find an exercise buddy and schedule weekly walks? Even short bursts of activity, like walking around the block or taking the stairs, can make a difference. If your weak spot is not getting enough sleep, try setting a go-to-sleep alarm on your smart phone. When it goes off, begin to ready your brain for sleep by turning from brain-busy activities to calmer ones.

    Setting Expectations and Limits

    Our outlook and expectations also can play a central role in how we manage the holidays. Picture this: Your neighbors are throwing a party, and they’ve asked you to bring all the appetizers. But you have gifts to wrap and want to spend time with your family baking. While you feel extremely overwhelmed and prefer to relax at home with your family, you feel a sense of obligation to please others.

    In this and other stressful holiday situations, try these stress-busters:

    • Think about your expectations. Be honest about what you want, and be realistic about what is possible. Then, try these two rules: Keep it simple. Don’t overcommit. Remember that you are not superman or superwoman; scale back your commitments. Don’t let “supposed to do” take the place of what you would like to do or what brings you enjoyment.
    • Accept people as they are. Don’t expect others to behave as you would like them to. This is a recipe for disappointment, if not misery. Recognize that the people in your life will celebrate the holidays as they want to and not the way you want them to. So don’t try to change or control them.
    • Remember, even the best-laid plans can go awry. This goes back to expectations. Expect that some problems are possible or even likely—inclement weather, delayed guests, an overcooked dinner. Try to approach unexpected challenges with an open mind, patience, creativity or a sense of humor.
    • Take a few slow breaths. Deliberately slowing your breathing for a minute or two calms your body a bit so that you can pause, think more clearly and choose an effective response to the situation.
    • Talk to someone. Discussing how you feel with a trusted supporter can increase your resilience. You will often find you are not the only one experiencing a particular problem.

    For some people and situations, stress levels can be too high to manage alone. If you are experiencing insomnia, chronic anxiety, panic attacks, or two weeks or more of low mood or lack of interest in activities you previously enjoyed, talk with your primary care. They can refer you to a specialist to help manage your stress.

    Remember, the holidays are short, as is life. Make the most of them!

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    Sage and Pecan Stuffing


    This recipe from Serious Eats is my new holiday tradition. The stuffing stays moist, provides grand flavor and best of all, keeps your vegetarian guests happy! To get the most out of this recipe, I highly recommend using the homemade stock available in the link below. It takes a bit of time but can be made in advance and adds so much to this recipe.

    Serves 10-14 Total Time: 2 hours (active time: 45 minutes)

    Ingredients

    • 2 1/2 pounds’ hearty rye bread (about 2 loaves), crusts removed, cut into 3/4-inch pieces
    • 1-pound button, cremini or shiitake mushrooms (or a mix), roughly chopped
    • 6 ounces’ pecan halves, toasted
    • 1/2 cup olive oil
    • 1/2 cup minced fresh sage leaves, or 1 tablespoon dried sage leaves
    • 1 large yellow onion, finely chopped
    • 1 large leek, white part only, finely chopped
    • 4 large ribs celery, finely chopped
    • 2 cloves garlic, minced
    • 4 cups Hearty Vegetable Stock (see note below)
    • 1/4 cup minced fresh parsley leaves, divided
    • Kosher salt and freshly ground black pepper

    Directions

    Adjust two oven racks to lower-middle and upper-middle positions. Preheat oven to 275 F, spread bread evenly in two rimmed baking sheets. Stagger trays on oven racks and bake until bread is completely dried, about 50 minutes total, rotating trays and stirring bread cubes several times during baking. Remove from oven and allow to cool.

    Increase oven to 350 F.

    In two batches, pulse mushrooms in food processor until roughly chopped, about 8 short pulses. Transfer to a large bowl. Place pecan halves in food processor (do not wipe out bowl) and process until roughly chopped, about 12 short pulses. Set aside.

    Heat oil in a large pot over medium-high heat until shimmering but not smoking. Add chopped mushrooms and cook, stirring frequently, until all moisture has evaporated, about 8 minutes. Add half of sage and continue to cook, stirring, until mushrooms are well browned, about 5 minutes longer. Add onion, leek, celery, garlic, and remaining sage and cook, stirring frequently, until vegetables are softened, about 10 minutes. Add stock, half of parsley and chopped pecans and bring to a boil. Add bread cubes and gently fold in until evenly mixed. Season to taste with salt and pepper.

    Transfer mixture to a greased 9x13-inch rectangular baking dish (or 10x14-inch oval dish), cover tightly with aluminum foil, and bake until hot throughout, about 30 minutes. Remove foil and continue baking until golden brown and crisp on top, about 10 minutes longer. Remove from oven, let cool for 5 minutes, sprinkle with remaining parsley and serve.

    Note

    This recipe includes a Hearty Vegetable Stock, which you must prepare beforehand. I strongly recommend using the stock recipe instead of store-bought vegetable stock, which I feel is universally inferior stuff. When making your own stock, add any extra vegetable or mushroom trimmings for extra flavor. If keeping the dish vegan is not of concern to you, feel free to substitute homemade or store-bought low-sodium chicken stock for the vegetable stock.

    Nutrition Information

    Serving Size: 1/10 of recipe

    Calories 550, Total Fat 25g, Saturated Fat 3g, Cholesterol 0mg, Sodium 500mg, Total Carbohydrate 60g, Dietary Fiber 11g, Sugars 3g, Protein 13g

    Recipe lightly adapted from J. Kenji Lopez-Alt from SeriousEats.com.

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