JustCare

Tag: Nutrition

  • Help yourself: Think outside the box with diet and exercise

    Help yourself: Think outside the box with diet and exercise

    People are often pushed away by the thought of “diet and exercise” as a cure-all. The problem is the mental approach many of us take at the onset. We can focus on the challenges of incorporating physical activity and new nutrition habits into our daily lives. Or, we can help ourselves and think outside the box with diet and exercise. Thinking outside the box has its benefits!

    Physical Activity

    At any age, being active on a regular basis is beneficial to physical and mental health — this is not news. However, one of the most common mistakes we make is with our synonymous use of exercise and physical activity. Though both burn calories, exercise is structured aerobic activity that develops muscle, while physical activity is any instance of movement that increases blood flow. In other words, it doesn’t have to be intense. You might be surprised to realize how often you are being physically active — it includes things like walking your dog, taking the stairs or gardening.

    For older adults, being physically active can increase their ability to complete regular tasks on their own and maintain independence in general. It helps promote a strong and healthy heart. And, a strong and healthy heart also increases immunity to infectious diseases and viruses, and it reduces the risk of dangerous complications that can lead to hospitalization.

    The National Institute on Aging proposes some simple ways to incorporate more physical activity into your daily life:

    • Walk every aisle of the grocery store when you go shopping
    • Walk around the block when you go out to get the mail
    • Get off the bus one stop earlier or park your car further away from your destination and walk the extra distance
    • Lift the milk carton or a one pound can a few times before putting it away
    • Walk up and down the steps a few extra times

    The National Institute on Aging also recommends having an “exercise buddy,” a health care buddy, be it a neighbor, friend or family member, who takes walks or yoga classes with you.  If you don’t already have an exercise buddy, there are easy ways to find one. There may be a walking club at your local mall or an exercise class at a nearby senior center.

    Nutrition

    Junk food and added sugar are harmful to health at any age, but can be particularly detrimental to adults with chronic conditions like diabetes or heart disease. While going on a strict diet is likely to be disruptive to your digestive system and mood, try approaching your meals with nutrition in mind. Think — Am I getting enough protein or calcium in this meal? How can I increase the amount of vitamins and minerals by eating different foods?

    By approaching nutrition as an added element to your comprehensive diet, you can improve your mental and physical well-being without the stress of cutting out entire food groups.

    Studies show that even a small amount of physical activity and attention to nutrition can have a variety of health benefits. Approaching these recommendations with a positive attitude not only helps you take the first step toward incorporating them into your life, but also helps you stick with them long term. While it may seem intimidating, you don’t have to navigate your health needs alone — talking to a doctor or family nurse practitioner can help define which specific activities and nutritional elements are right for you.

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  • For-profit PACE programs: Cause for worry?

    For-profit PACE programs: Cause for worry?

    Sarah Varney reports for Kaiser Health News that the for-profit sector will now be providing a program for all-inclusive care for the elderly (PACE). Click here to learn about PACE on Just Care. Until recently run exclusively by non-profit organizations and paid for by Medicare and Medicaid, PACE has provided valuable services. But it has reached only a small fraction of older adults. Are for-profit PACE programs cause for worry or can they reach more adults and deliver as good results as non-profit PACE programs?

    Last year, Congress changed the law governing PACE to permit for-profit companies to run PACE programs. The alleged goal is to reach more people. And, now private equity firms are funding companies to deliver for-profit PACE programs, reaching many more people.

    PACE is intended to help older adults age in place through comprehensive medical and social supports. Medicare and Medicaid pay for the services because they can save money on people in PACE who remain at home, do not need nursing home care and are not as likely to be hospitalized. But, only 40,000 people were enrolled in the program at the beginning of 2016.

    With for-profits in the picture, more people will receive PACE services. And, that could have great value to patients who want to remain at home, as most do, and still be able to socialize and enjoy the services available in their communities. Without PACE, many would remain isolated and homebound, jeopardizing their health and well-being and putting them at increased risk of an early death.

    PACE programs provide key services many older adults would not otherwise be able to afford or access. People may get comprehensive rehabilitation services. They also generally receive critical dental care that Medicare does not pay for outside the PACE setting. Dental care helps prevent infections that can land a person in the hospital. It also helps to ensure good nutrition.

    And, PACE programs also help patients with basic services at home, such as housecleaning and laundering.

    The question remains whether the for-profit sector will deliver the value that non-profit PACE programs have delivered. When for-profit companies began delivering hospice services, the U.S. Office of the Inspector General found that they were treating patients with less costly conditions, avoiding patients who would cost them more money, and they were holding back on services people needed.

    The for-profit programs are paid a flat fee and lose money if PACE enrollees spend too much time in hospital or visit the emergency room frequently. So, for-profit PACE programs may try to avoid patients more likely to use these services, like the for-profit hospice agencies, avoiding patients who would cost them more money. To save money, they may also be more inclined to deliver care through telehealth rather than transporting patients to facilities, failing to recognize the negative health consequences of social isolation and the value of socialization.

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  • To save money, calories and your teeth, stay away from sports drinks

    To save money, calories and your teeth, stay away from sports drinks

    Given all the ads promoting Gatorade and other sports drinks, it’s easy to believe sports drinks deliver special benefits. Based on the research, it appears you can save money, calories and your teeth if you stay away from sports drinks. Sports drinks can lead to obesity and dental erosion.

    In  a 2012 BMJ report, Carl Heneghen and colleagues at the Center for Evidence-Based Research at Oxford, find that 40 years of sports drinks research delivers no compelling evidence of its value. For one thing, the sample size for most of the research is too small.

    Over a long period of time, serious athletes–people who exercise for 90 minutes or more–can improve exercise performance through carbohydrates. However, there is no compelling evidence that drinking carbohydrates is any better than eating carbohydrates.

    “The truth about sports drinks,” another 2012 Feature in the BMJ, reveals the unholy alliance between the sports drink industry and the scientists that companies hire to promote their products. Despite huge amounts of money the industry has invested in research, conflicts among the scientists performing the research minimize its value; bottom line, the evidence is weak that people who exercise benefit from sports drinks.

    Interestingly, marathon runners in the 1970’s were told that drinking water and other beverages would actually slow them down. Hydration was not deemed valuable.  It was only when corporations saw a marketing opportunity with runners that these corporations began hiring academics to focus on the value of hydration. These academics, with a financial interest in the outcome of the research, then taught organizations devoted to sports medicine that hydration was important.

    Gatorade was first out of the gate. Today, its sales are at more than $1.6 billion in the U.S. alone.  And, no surprise, it is a sponsor of many sports organizations, including the U.S. National Athletic Trainers’ Association, the American College of Sports Medicine, and the Australian Institute of Sports. In short, industry has led athletes to believe that hydration is as important to their performance as training.

    Yet, according to the most reliable data, for better performance, you should drink when you’re thirsty. Common sense.

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  • Will skipping breakfast help you lose weight?

    Will skipping breakfast help you lose weight?

    Many of us have a favorite diet. Some of us eat more plants and try to follow the Mediterranean diet, since it has been shown to help keep one’s brain healthy and reduce the risk of Alzheimer’s. To lose weight, some of us believe that fasting is the way to go and that skipping breakfast can help. But, “authorities” from Dr. Oz to the Mayo Clinic to WebMD encourage us to eat breakfast to maintain a healthy weight or even to lose excess weight. The data does not support their claims. In fact, skipping breakfast could help you lose weight.

    A 2014 study published in Frontiers in Public Health suggests that it can be beneficial to extend the time between your last meal of the day and your first meal of the following day. You can do that by skipping late-night eating or delaying or skipping breakfast. Whichever you do, the study suggests you may decrease your risk of obesity and its comorbidities.

    Stat News reviews a range of studies and reports that you can skip breakfast without fear of gaining weight. Or, you can eat breakfast with no guarantees it will help you lose excess weight or maintain a healthy weight. It turns out that the overwhelming majority of studies are based on the weight of people who regularly eat breakfast and the weight of people who regularly skip it. Yet, their weight might have no relation to whether they ate breakfast or not.

    While studies can find an association between people who eat breakfast and people who have healthy weights, these studies do not show causation. In other words, there is no evidence to suggest that eating breakfast leads to weight loss or healthy weight.

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  • How safe is the food you eat?

    How safe is the food you eat?

    How safe is the food you eat? It’s hard to say. The U.S. Food and Drug Administration is leaving it to industry to ensure the safety of the chemical additives in our food. So, processed foods and beverages may contain chemical additives that the FDA has not tested. It’s another reason to follow a Mediterranean diet, if you can and to stay away from processed foods to the extent possible.

    How is it that the FDA is not required to test the chemicals in our food? The Federal Food, Drug and Cosmetic Act requires the FDA to create a system of pre-market review of chemicals added to foods and to reassess their safety periodically as new evidence emerges. But, the FDA can and has allowed the food and beverage industries to conduct their own review of the safety of chemicals in food. And, the FDA lets the industries’ experts determine whether the chemicals are generally recognized as safe, “GRAS.”

    Senator Edward Markey of Massachusetts is on a campaign to get the FDA to assess the safety of all chemicals in foods and beverages rather than delegate this role to the food and beverage industries. Right now, there are an estimated 1000 chemicals in our food supply that the FDA has not tested for safety, according to the Pew Charitable Trusts. The FDA does not even know which chemicals are being used, which foods contain them, and the amount of these chemicals in a particular product, because there are no disclosure requirements on industry.

    The food and beverage industry should not be able to self-determine their safety.  And, they should have to disclose these chemical ingredients in their products. Allowing industry to hire the “experts” who decide whether particular ingredients in their foods are safe poses a real conflict of interest.

    But, there appears to be a question about the scope of the FDA’s authority to assess the safety of these chemical ingredients, which is concerning. It’s not clear that the FDA has the authority to ensure the safety of GRAS ingredients, let alone the budget. It’s also not clear whether the FDA could require special labeling of foods with GRAS ingredients.

    Even when the FDA knows about ingredients with safety concerns, the industry can still include these ingredients in their foods. For example, the FDA found sweet lupin caused allergic reactions in people with peanut allergies. But, the company that notified the FDA about its use of sweet lupin pulled its notice to the FDA. An investigation into the use of sweet lupin found 20 foods containing it; their manufacturers were still allowed to deem the ingredient GRAS.

    At the very least, shouldn’t there be a label on all foods with GRAS ingredients letting the public know that the FDA has not approved these ingredients as safe?

    Here’s more from Just Care on good nutrition and food safety:

  • Change your diet, improve your health

    Change your diet, improve your health

    The USDA Scientific Report of the 2015 Dietary Guidelines Advisory Committee explains that about half of adults in the U.S–117 million people–have diet-related health problems, including at least one preventable chronic disease. Not surprisingly, changing your diet, can improve your health. Physical activity is also key.

    As much as possible, get your nutrition from unprocessed foods rich in vitamins, minerals and fibers, not from supplements. Whole fruits are better than fruit juice.  In particular, blueberries, apples and grapes have been associated with lower risk of type 2 diabetes. And, try to minimize eating foods and drinks with saturated fats, added sugar, high sodium content and high in calories, with the exception of modest amounts of those with mostly healthy, unsaturated fats like those found in olive oil, nuts, and avocados. Healthy eating patterns are key.

    At the end of the day, the best advice is what we continue to hear: Eat a balanced diet rich in whole foods, fruits and veggies, as well as whole grains. A good balanced healthy diet can help prevent obesity, diabetes, heart disease, and cancer. For more advice, please read my post on why eating more plants is associated with significant reductions in your risk of Alzheimer’s disease. 

    Some of this is laid out in the latest U.S. dietary guidelines. But some experts question the guidelines as a product of industry influence and not backed by good science. For example, the World Health Organization advises that processed meat is linked to colorectal cancer and that red meat is a likely carcinogen. But, the U.S. dietary guidelines don’t speak to this.

    Congress has commissioned the National Academy of Medicine to conduct an independent review of the evidence this year. For now, for the scientific evidence, take a look at the Scientific Report from the expert Advisory Committee, on which the U.S. dietary guidelines are in part based.

     

  • Where will you live in later life? Your community matters

    Where will you live in later life? Your community matters

    As we age, it’s typical to think about where we want to live in later life. Few among us want to end up in a nursing home. And, most of us would love to continue to live in our homes. There are different ways to make that work. Many people are lucky enough to be able to depend on family and friends as caregivers. But, lots of older adults do not have that option, and the costs of living independently in the community can be prohibitive, as we become less able to care for ourselves.

    While we’re mobile, there’s value in living in a community where we can walk to the grocery store or the park or the movies. Walkable communities benefit people’s mental and physical health. But, there’s also value in having long-term services and supports available when we are less mobile.

    To keep costs down and continue to live independently, it’s helpful to live in a community with resources to help meet your needs. The Administration for Community Living (ACL) is an agency of the U.S. Department of Health and Human Services that works to ensure access to state and community services for older adults and people with disabilities.

    Every state offers a range of special home and community-based services for people in later life through local area agencies on aging, which are part of the U.S. Administration on Aging. Some offer more and some offer less. So, if you are thinking of moving, learn about available services in different communities. Call the local area agency on aging. Community services may include transportation, adult day care, caregiver support, health promotion programs and much more.

    Some communities offer behavioral health information, chronic disease self-management education programs, diabetes self-management, fall prevention programs and nutrition services, including home-delivered meals.

    No matter where you end up living, it’s important to have friends, family and/or neighbors to talk to and spend time with. There are some innovative housing models to consider, such as elder villages (check out the village to village network) and baugruppen.  More on those in another post.