Posts made in June 2017

Impact of Alcohol on Health

Impact of Alcohol on Health

We know nutrition and exercise are ways to improve our health, but it’s also important to discuss alcohol consumption and the impact of excessive alcohol use on our health. Drinking excessively is harmful, but it can be controlled and prevented. According to the Centers for Disease Control and Prevention (CDC), excessive alcohol use leads to about 88,000 deaths in the U.S. each year and shortens the life of those who die by almost 30 years.1

What’s considered a ‘drink’?

  • 12 ounces of beer (5% alcohol by volume)
  • 8 ounces of malt liquor (7% alcohol by volume)
  • 5 ounces of wine (12% alcohol by volume)
  • 1.5 ounces of distilled spirits such as vodka, whiskey, gin, etc. (40% alcohol by volume)

Do you know the signs of excessive alcohol use?

Signs of excessive alcohol useSource: CDC1

Binge drinking is the most common, costly, and deadly pattern of excessive alcohol use in the U.S. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 grams percent or above. This typically happens when men consume 5 or more drinks or women consume 4 or more drinks in about 2 hours. Most people who binge drink are not alcohol dependent.2

Who binge drinks?

  • One in six U.S. adults binge drinks about four times a month, consuming about eight drinks per binge.
  • Binge drinking is most common among younger adults aged 18–34 years old.
  • The prevalence of binge drinking among men is twice the prevalence among women.2

The Cost of Excessive Alcohol Use

Excessive drinking cost the American economy $249 billion in 2010:

  • Workplace productivity: $179 billion (72%)
  • Healthcare: $28 billion (11%)
  • Criminal Justice: $25 billion (10%)
  • Collisions: $13 billion (5%)3

Binge drinkers account for most of the cost at $191 billion (77% of the total cost). For more details, visit the CDC.

Short-Term Health Risks

Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These are most often the result of binge drinking and include the following:

  • Injuries, such as motor vehicle crashes, falls, drownings, and burns.
  • Violence, including homicide, suicide, sexual assault, and intimate partner violence.
  • Alcohol poisoning, a medical emergency that results from high blood alcohol levels.
  • Risky sexual behaviors, including unprotected sex or sex with multiple partners. These behaviors can result in unintended pregnancy or sexually transmitted diseases, including HIV.
  • Miscarriage and stillbirth or fetal alcohol spectrum disorders (FASDs) among pregnant women.4

Long-Term Health Risks

Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including:

  • High blood pressure, heart disease, stroke, liver disease, and digestive problems.
  • Cancer of the breast, mouth, throat, esophagus, liver, and colon.
  • Learning and memory problems, including dementia and poor school performance.
  • Mental health problems, including depression and anxiety.
  • Social problems, including lost productivity, family problems, and unemployment.
  • Alcohol dependence, or alcoholism.4

By not drinking too much, you can reduce the risk of these short- and long-term health risks.

Life-Threatening Signs of Alcohol Poisoning Include:

  • Inability to wake up
  • Vomiting
  • Slow breathing (fewer than 8 breaths per minute)
  • Irregular breathing (10 seconds or more between breaths)
  • Seizures
  • Hypothermia (low body temperature), bluish skin color, paleness5

Alcohol Poisoning Deaths

According to the CDC, most people who die of alcohol poisoning are non-Hispanic whites (68%). Additionally, 76% of deaths are men and 24% are women. Alcohol poisoning deaths vary by state and are most common among middle aged adults.5

Alcohol poisonings by state

Image Source: CDC5

What is Moderate Drinking?

The Dietary Guidelines for Americans defines moderate drinking as up to 1 drink per day for women and up to 2 drinks per day for men. In addition, the Dietary Guidelines do not recommend that individuals who do not drink alcohol start drinking for any reason.

However, there are some people who should not drink any alcohol, including those who are:

  • Younger than age 21.
  • Pregnant or may be pregnant.
  • Driving, planning to drive, or participating in other activities requiring skill, coordination, and alertness.
  • Taking certain prescription or over-the-counter medications that can interact with alcohol.
  • Suffering from certain medical conditions.
  • Recovering from alcoholism or are unable to control the amount they drink.

By adhering to the Dietary Guidelines, you can reduce the risk of harm to yourself or others.

Alcohol Use Disorders

Alcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to feel drunk. Stopping suddenly may cause withdrawal symptoms.

You may have an alcohol use disorder if you:

  • Have little or no control over the amount you drink, when you drink, or how often you drink.
  • Tried to limit or stop your drinking but found you could not.
  • Had withdrawal symptoms when you tried to stop drinking. (These symptoms include tremors, anxiety, irritability, racing heart, nausea, sweating, trouble sleeping, and seizures.)
  • Have put yourself in a dangerous situation (such as driving, swimming, and unsafe sex) on one or more occasions while drinking.
  • Have become tolerant to the effects of drinking and require more alcohol to become intoxicated.
  • Have continued to drink despite having memory blackouts after drinking or having frequent hangovers that cause you to miss work and other normal activities.
  • Have continued to drink despite having a medical condition that you know is worsened by alcohol consumption.
  • Have continued to drink despite knowing it is causing problems at home, school, or work.
  • Start your drinking early in the day.6

Screening Tests

There are many screening tests that doctors use to check for alcohol use disorders. Some of these tests you can take on your own. The CAGE test is an acronym for the following questions. It asks:

  • Have you ever felt you should CUT (C) down on your drinking?
  • Have people ANNOYED (A) you by criticizing your drinking?
  • Have you ever felt bad or GUILTY (G) about your drinking?
  • Have you ever had a drink first thing in the morning, to steady your nerves, or to get rid of a hangover (use of alcohol as an EYE-OPENER [E] in the morning)?
  • If you responded “yes” to at least two of these questions, you may be at risk for alcoholism.6

Screening in the Doctor’s Office

Primary care doctors should screen adults for alcohol misuse, according to guidelines from the U.S Preventive Services Task Force (USPSTF). Health care providers can give people identified at risk brief behavioral counseling interventions to help them address their drinking.

Medications for Alcohol Use Disorders

Oral naltrexone (ReVia, generic) and acamprosate (Campral, generic) are effective medications for treating alcohol use disorders, according to a 2014 study in the Journal of the American Medical Association.

Alcoholism Resources

The following organizations are good resources for information on alcoholism:


References

  1. https://www.cdc.gov/alcohol/pdfs/alcoholyourhealth.pdf
  2. https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm
  3. https://www.cdc.gov/alcohol/onlinemedia/infographics/cost-excessive-alcohol-use.html
  4. https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
  5. https://www.cdc.gov/vitalsigns/alcohol-poisoning-deaths/infographic.html#infographic
  6. A.D.A.M., Inc.
Grocery shopping tips

Master the Grocery Store and Shop Healthier

If you are like most people, navigating the grocery store can be a daunting and frustrating task especially when you are trying to make healthier meal choices. This can be especially difficult when you are in a time crunch or forget the grocery list at home. However, changing the way you think about the grocery store and the way you see food can be a helpful way to manage this task. Creating a plan and having a strategy in place when you enter the grocery store will help you avoid filling your cart with junk and instead with the foods that will help nourish your body.

Prior to entering the grocery store door, you should have a plan in place to keep you focused and on track. Time and time again we enter the grocery store with one specific item in mind and walk out buying five other things and forgetting the one thing we actually needed. Having a plan for the store can not only keep you focused on purchasing only the food you need, but can save you time and money! If you are unsure on where to start with building your grocery store plan, consider these tips.

1. Create a Master Grocery List

  • Have your family write down things you need throughout the week on one master list so that at the end of the week you can take the list to the store and purchase the things you need without playing the guessing game down the aisle.
  • Keep the list in an easily accessible place such as the refrigerator and remember to bring it with you to the store with a pen to easily cross off items you have already put in your cart.
  • Separate your list into categories such as produce, meat and protein, and dairy to increase your efficiency in the grocery store and take less time overall to get back home.

2. Look for Sales

  • Before you head to the grocery store review the store’s sales ads. Look for produce that is on sale; typically, this means that it is in peak season and will be the freshest. Buying food that is currently on sale will not only save you money, but also help you plan meals based on the ingredients you purchased.
  • Also, don’t forget to look for coupons as they can save you additional money at the grocery store! Stores often have additional incentives on their website or easily available on their app available on your mobile phone.

3. Prepare Yourself

  • Whatever you do, avoid the grocery store when you are hungry. Chances are, we are all familiar with what occurs when we step into the grocery store when we are hungry and leave the store with double the amount of junk food which are often high in calories, sugar, saturated fat, and sodium.
  • Make sure when you plan your trip to the grocery store you wear comfy shoes and allow yourself adequate time to get everything on your list.

Tips for Mastering the Aisles

We all know by the end of the week there are a lot of things that have piled up on the grocery list, so once you step into the grocery store try these tips to successfully shop.

1. Stick to the List

Your shopping list is your best friend at the grocery store and will keep you from getting into trouble at the checkout and once your shopping is complete, in your pantry.

2. Shop the Perimeter of the Store

The perimeter of the store is often where you can locate the foods you need to stay on track with properly nourishing your body and managing your weight. Foods such as fresh fruits and vegetables, lean meat, seafood, and low-fat dairy products can typically all be found without stepping down a center aisle where temptations may sprout.

3. Buy in Bulk

If you have a family more than likely you understand the concept of buying in bulk when you have several mouths to feed. Buying in bulk often saves you money as the per unit price is lower with the larger quantity. Buying in bulk is especially helpful when food you regularly eat is on sale. For example, if chicken breast is on sale this week purchase extra to freeze for next week when it is no longer on sale.

4. Read the Labels

FDA Nutrition Facts Label

Learning to read the Nutrition Facts Label can help you gain freedom from strict diet planning as you are aware of how to make healthy choices and tell the difference between a food that is healthy and the one that only appears to be.

  • Check the label for serving size, calories, total saturated fat, total sugar, and sodium content (see example to the left;  Visit FDA.gov for details).
  • Reading the ingredient list is also another great method to avoid buying products that appear to be healthy when they truly are not. If there is a list of ingredients you are unable to pronounce, it is not a good choice.
  • In general, purchase whole foods as much as possible that have not been processed or preserved.

5. Plan to be Busy

We all know life happens and things don’t always go as planned. In addition to your grocery list make sure you:

  • Add 1 or 2 healthy options that you and your family can take on the go, for example, ingredients to make a healthy snack wrap or fresh prepared salads offered in the deli section of the grocery store.
  • Avoid frozen convenience foods as a go-to meal.

Tips on How to Fill Your Cart

1. Fruits and Veggies

  • Fresh produce is always a winner in the grocery cart and can be incorporated into every meal or snack to provide you with essential nutrients your body needs to thrive. Aim for half your plate to be fruits and vegetables for every meal.
  • If you find yourself limited on time for meal preparation, grocery stores offer pre-cut fruits and vegetables at a slightly higher price.
  • Frozen steam bags are also another quick method to incorporate veggies into your diet regularly.

2. Protein

  • Meat is a great source of protein; however, it is important to consider the saturated fat content and choose low-fat options by reading labels and looking for those that specifically say lean.
  • Purchasing skinless meats, turkey, very lean beef, lean hamburger, sirloin steaks, and pork loin are great additions to your grocery cart!

3. Dairy

  • Dairy foods such as milk, cheese, and yogurt can provide protein and calcium which is essential to you body.
  • Look for low-fat and skim milk options to get the most benefit from this food group!

4. Grains

  • When buying grain items like bread, cereal, or pasta choose those that are whole grain to provide you with the most nutrients and fiber.
  • Make sure you read the labels to ensure that the first ingredient is whole wheat or another whole grain such as whole barley or whole buckwheat for example. Oatmeal is also another great example of a whole grain. Make sure you choose plain oats that do not have added sugar.

As times change, so does the way we shop. If you find yourself strapped for time, several grocery stores now offer a delivery service that allows you to shop from the comfort of your own home. Simply look up the food items you want to purchase and add them to the cart on your computer or smart phone and wait for them to arrive promptly at your front door. This method ensures that you cannot be tempted with store displays or hunger cravings as you get only what you placed in your cart.


References:

  1. https://www.choosemyplate.gov/MyPlate
  2. http://www.eatright.org/resource/food/planning-and-prep/smart-shopping/save-time-and-money-at-the-grocery-store
  3. http://www.eatright.org/resource/food/planning-and-prep/smart-shopping/supermarket-psychology

 

Root Cause of Disease

Treating the Root Cause of Disease, Not Just the Symptoms

Our country is amid a population health transformation. Healthcare is moving from treating symptoms to finding and treating the root cause of disease. With healthcare costs on the rise and 51% of all mortality1 being directly attributable to lifestyle choices, people have more control over their health than they think. For example, 85% of all type 2 diabetes diagnoses (and the side effects associated with the disease) are preventable!1

The ultimate goal is to reduce healthcare utilization and costs by improving the health and wellbeing of individuals and communities. U.S. Preventive Medicine (USPM) has a vision to Empower Communities to Add Life to Their Years and Years to Their Life…One Person at a Time!  We approach population health management as a population of one. It starts with one, it starts with you. It starts with each one of us.

There are three tiers of preventive medicine that when combined, can create sustainable healthy individuals and workplaces:

  • Primary: Wellness/Health Promotion
  • Secondary: Early Detection
  • Tertiary: Early Intervention Care Management

While many wellness companies address primary and secondary prevention, they fail to address disease acuity and risk management. This is where the highest costs can come from. Care management includes treating the chronic conditions with a personalized care plan, care coordination, and treatment plan adherence.

Even with an interactive web portal or a convenient wearable device, technology alone is not enough to drive sustainable behavioral change. The personal touch of coaching and care management combined with innovative technology drives a much higher level of engagement. USPM’s coaching philosophy recognizes the unique circumstances, environments, experiences, and social impacts that affect individuals. This recognition helps us view each individual as a complex, multidimensional person who can make decisions for him or herself.

The Preventive Plan® wellbeing program provides a customized roadmap for everyone to follow to better manage their health. The Plan outlines the risks, action items and educational information that are meaningful to an individual, and avoids short duration, high-intensity programs and cookie-cutter approaches that don’t last or deliver high levels of sustainable behavioral change.

A personalized plan can only be created once all the factors are taken into consideration for each individual. Someone who has a medical condition such as asthma, back and neck pain, coronary artery disease (CAD), or depression will have a tailored and unique set of action plans to address health risks.

This is why U.S. Preventive Medicine believes and supports the high-touch model of wellness. Our team of health coaches and care managers provide a supportive, non-judgmental learning experience and help identify barriers, assist with strategies and goal setting, monitor progress, and provide positive feedback to guide individuals toward a better quality of life by reducing risks and achieving and maintaining a healthy lifestyle.

In addition, USPM offers programs to increase member resiliency to everyday stress. We have partnered with the Cleveland Clinic Wellness Institute to evolve traditional wellness into whole-person wellbeing. By integrating precision analytics to include stress and mental health conditions, we address the root-cause of illness.

In one health system over 6 months, our work on reducing and managing participant stress resulted in:

  • 35% decrease in perceived stress
  • 29% decrease in depersonalization
  • 27% decrease in emotional exhaustion

“Higher levels of resilience were found to have beneficial effects on worker’s perceptions of stress, psychological responses to stress, and job-related behaviors related to stress regardless of difficult environments. Faced with especially difficult work environments, workers with higher levels of resilience seem able to avoid absences and be more productive than workers with low resilience.”2

Evolve beyond wellness to comprehensive population health management. Address the root cause of risk and rising health care costs with evidence-based interventions, precision analytics, and a guaranteed quantifiable return on investment.


References

  1. Mokdad AH, et.al. Actual Causes of Death in the United States, 2000. JAMA. 2004; 291:1238-1245.
  2. “The Positive Effect of Resilience on Stress and Business Outcomes in Difficult Work Environments”, Andrew Shatte´, PhD, Adam Perlman, MD, MPH, et al. JOEM: Volume 59, Number 2, February 2017.
June is Men's Health Month - Take Charge of Your Health

Men: Take Charge of Your Health

June is Men’s Health Month and we would like to focus on increasing awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. Take charge of your health now by seeking regular medical advice and early treatment for disease and injury. Men can proactively take care of their health as they age with annual physicals and screenings, a well-balanced diet, exercise, and keeping up-to-date with flu shots and vaccinations.

Did you know?

Compared to women, men are more likely to:

  • Smoke
  • Drink alcohol
  • Make unhealthy or risky choices
  • Put off regular checkups and medical care1 

The good news is it’s never to late to start taking better care of your health.

What can you do to take charge of your health?

See a doctor for regular checkups even if you feel fine. This is important because some diseases don’t have symptoms at first. Plus, seeing a doctor will give you a chance to learn more about your health.

You can also take care of your health by:

  • Getting screening tests that are right for you
  • Making sure you are up to date on important shots
  • Watching out for signs of health problems like diabetes or depression
  • Eating healthy
  • Getting and staying active

It’s not too late to start healthier habits. Make eating healthy and being active part of your daily routine. A healthy diet and regular physical activity can help lower your:

  • Blood pressure
  • Blood sugar
  • Cholesterol
  • Weight

By keeping these numbers down, you can lower your risk of serious health problems like type 2 diabetes and heart disease.

Help prevent health problems by:

  • Drinking alcohol only in moderation
  • Quitting smoking

If you have a concern about your smoking or alcohol consumption, talk with a doctor or health care professional for advice.

Make small changes every day.

Small changes can add up to big results – like lowering your risk of type 2 diabetes or heart disease.

  • Take a walk instead of having a cigarette.
  • Try a green salad instead of fries.
  • Drink water instead of soda or juice.

Talk about it.

Don’t be embarrassed to talk about your health. Start by talking to family members to find out which diseases run in your family. Share this information with your doctor.

Get preventive care to stay healthy.

Many people think of the doctor as someone to see when they are sick. But doctors also provide services – like shots and screening tests – that help keep you from getting sick in the first place.

Get screening tests to find problems early.

Screenings are medical tests that doctors use to check for diseases and health conditions before there are any signs or symptoms. Screenings help find problems early, when they may be easier to treat.1

  • Get your blood pressure checked at least once every 2 years.
  • Talk to your doctor about getting your cholesterol checked. You could have high cholesterol and not know it.
  • If you are age 50 to 74, get tested regularly for colorectal cancer. Ask your doctor what type of colorectal cancer screening test is right for you.
  • If you are a man age 65 to 75 and have ever smoked, talk with your doctor about your risk for abdominal aortic aneurysm (AAA).
  • If you feel stressed, anxious, or sad, ask your doctor to screen you for depression. Most people with depression feel better when they get treatment.

Ask your doctor about taking aspirin every day.

If you are age 50 to 59, taking aspirin every day can lower your risk of heart attack and colorectal cancer. Talk with your doctor about whether daily aspirin is right for you.

Men’s Cancer Screenings 

Every year, more than 300,000 men in the United States lose their lives to cancer.2 The most common kinds of cancer among men in the U.S. are:

    • Skin cancer
    • Prostate cancer
    • Lung cancer, and
    • Colorectal (colon) cancer

Colorectal (colon) cancer: If you are 50 to 75 years old, get tested. Talk to your doctor. The schedule depends on the type of test used.

Lung cancer: If you are 55 to 80 years old and are a heavy smoker or a past smoker who quit within the last 15 years, ask your doctor about a low-dose CT scan every year.

Prostate cancer: Talk to your doctor. The U.S. Preventive Services Task Force (USPSTF) recommends against PSA screening for men who do not have symptoms.

Skin cancer: Talk to your doctor. The USPSTF has concluded that there is not enough evidence to recommend for or against routine skin cancer screening.

Eating Healthy: The Basics

Eating healthy means getting enough vitamins, minerals, and other nutrients – and limiting unhealthy foods and drinks. Eating healthy also means getting the number of calories that’s right for you (not eating too much or too little).

Be sure to get plenty of:

  • Vegetables, fruits, whole grains, and fat-free or low-fat dairy products
  • Seafood, lean meats and poultry, eggs, beans, peas, seeds, and nuts

It’s also important to limit:

  • Sodium (salt)
  • Added sugars – like refined (regular) sugar, brown sugar, corn syrup, high-fructose corn syrup, and honey
  • Saturated fats, which come from animal products like cheese, fatty meats, whole milk, and butter, and plant products like palm and coconut oils
  • Trans fats, which may be in foods like stick margarines, coffee creamers, and some desserts
  • Refined grains which are in foods like cookies, white bread, and some snack foods3

To get a personalized Daily Food Plan to help you choose healthy foods, visit www.choosemyplate.gov.


References

  1. https://healthfinder.gov/healthtopics/population/men/doctor-visits/men-take-charge-of-your-health#the-basics_1
  2. https://blogs.cdc.gov/cancer/2016/06/13/mens-cancer-screening-cheat-sheet/
  3. https://healthfinder.gov/HealthTopics/Category/health-conditions-and-diseases/diabetes/eat-healthy

Copyright © 2019 U.S. Preventive Medicine. All Rights Reserved.