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Sit Less, Move More – Exercise Guidelines for Diabetes and Prediabetes

November 14, 2016 Leave a comment

By Elana Paddock, RDN, LD, CDE, Cooper Clinic Nutrition Services

Many people with diabetes do not exercise despite all of its proven benefits. If you have diabetes or prediabetes, physical activity is more than just a way to lose weight – it can also make it easier to keep your blood glucose (sugar) levels closer to normal.

When you have diabetes, your body’s insulin action is less effective in storing glucose and regulating your blood sugars, but exercise sensitizes insulin. During exercise, stored glucose becomes a source of energy for your muscles and as the stores gets depleted, your blood sugar goes down and can stay down for 24-48 hours.

What types and amounts of physical activity are recommended for diabetes?

  • Aerobic exercise includes brisk walking, bicycling, swimming, aerobics, elliptical, dancing, rowing, tennis and stair climbing. Engage in at least 150 minutes of moderate-to-vigorous intensity activity weekly, spread over at least three days per week, with no more than two consecutive days without activity.
  • Resistance training includes exercises with weight machines, free weights, elastic resistance bands, body weight and group strength training classes. Perform these at least two times a week on non-consecutive days.
  • Balance and flexibility training includes yoga and tai chi. Aim for two or three times a week.
  • Light-intensity activities daily (read below under “updates”).

To better fit your schedule, you can break up 30 minutes into 10- or 15-minute segments several times a day. Research has shown the health benefits are similar. Recent studies have also shown that a 15-minute walk after meals can help lower your blood sugar.

What are the updates in the latest exercise guidelines?

People with diabetes are advised to incorporate “light” activities throughout the day, particularly when sedentary for prolonged periods of time (working on the computer, sitting in a meeting or watching TV). Take a light activity break for three minutes for every 30 minutes of sitting. Examples include:

  • Overhead arm stretches
  • Leg extensions
  • Torso twists
  • Walking in place

Exercise Tips:

  • Have a very specific plan. Define what, when, where and for how long you’re going to commit to working out. This will improve your chances of adherence and success.
  • What kind of exercises will you do? Make a list of activities and be creative. If you enjoy what you’re doing, you’re more likely to stick with it!
  • When are you going to fit in a workout? Make a schedule of the specific days and times you will exercise. Prioritize them on your calendar as “appointments.”
  • Are you going to exercise at a gym, in a group class, at a park or track or at home using a workout DVD or technology app? Decide what might work best for you.
  • Do you prefer to exercise solo, with a buddy, in a class or with a personal trainer? Participating in supervised training may provide more health benefits for people with diabetes than non-supervised programs. Plus, the accountability to others can be very motivating.
  • How long will you exercise? Be realistic and set achievable goals. If you are brand new to working out, start with 10 minutes and build up to 30 minutes or more.
  • Keep a log of your exercise to stay on track. You can use fitness technology resources like a pedometer, fitness band or exercise watch to track steps, calories and heart rate. Don’t forget to give yourself credit for what you do-every step counts!

When you have diabetes, prioritize exercise as part of your lifestyle to better control your blood sugars. Beyond managing your diabetes, exercise can help you feel better about yourself and improve your overall health.

For more information about preventing and managing diabetes and prediabetes, visit the Cooper Aerobics website.

Prevention and Safety While Traveling Abroad

Traveling to a foreign country for a large, global event such as the Olympics, holiday events and more requires much preparation in order to stay safe and healthy through the duration of the trip. Michele Kettles, MD, MSPH, Chief Medical Officer of Cooper Clinic, offers tips for travelers embarking on journeys abroad.

Pre-Trip Preparation

Once you finalize plans to travel abroad, visit the Centers for Disease Control and Prevention (CDC) website and select the country to which you will be traveling. The website provides information about required vaccinations needed before traveling to the country along with other travel warnings and tips. Dr. Kettles recommends visiting a Passport Health travel clinic to receive vaccinations and medications specific for the country you are visiting and the activities planned during your trip.

When it comes time to pack for your trip, consider the following:

  • Bring along any over-the-counter medications you may need, such as Afrin® or Sudafed®. These can be difficult to obtain in a foreign country.
  • If you’re worried about diarrheal or respiratory issues while traveling, ask your doctor about prescribing an antibiotic. Dr. Kettles recommends a Z-Pak; another antibiotic that is common for travelers, Cipro, is being phased out by many doctors because it can cause harmful side effects.
  • If you’ll be using your cell phone while traveling abroad, talk to your wireless service provider about access you may have in the country you’re traveling to, or if you need to set up an international service plan for your time abroad.
  • Download Google Translate on your phone or portable device if you don’t speak the language of the country you’re traveling to. You’ll want to know how to communicate upon arrival and should an emergency occur during your trip.
  • Make a copy of your passport, and pack it separately from the original. If you become stranded without identification in a foreign country, odds are your stress level will increase dramatically and your vacation may be cut short.
  • Provide a family member or friend with your travel itinerary and contact information for the duration of your trip.

A Safe Trip is a Fun Trip

A safe trip abroad begins while you’re en route to your destination–oftentimes, this can be a long flight. Blood clots, also known as deep vein thrombosis (DVT) are a primary concern for travelers who must sit on planes for hours at a time. Make sure to stand up and walk around when it is safe to do so, drink plenty of water to stay hydrated and don’t take medication that will leave you asleep for hours on end. Immobilization from sleeping for the duration of a long flight leaves you at a higher risk for blood clots.

Upon arrival, be smart about what you eat and drink. In many countries, tap water and ice may not be safe to drink for visitors. Eating certain foods can be risky as well. If possible, try to eat foods you can wash, peel and cook. Steer clear of foods at buffets and salad bars, as you won’t know how well uncooked food was washed and if it has contaminated other foods around it.

Additionally, go the extra mile to prevent illness and injury. For example, if you’re visiting an area where malaria or the Zika virus is present, taking medication before the trip may not be enough. Wear mosquito-repellent clothing and use sprays and nets to protect yourself, and prevent the risk altogether by avoiding going outside at dusk and dawn, when mosquitos are most active.

Be Aware of Your Surroundings

According to Dr. Kettles, motor vehicle accidents are the number one cause of injury and death to Americans while traveling abroad. Be cautious of how you plan to get around while traveling, because options can vary greatly depending on where you are traveling. Don’t hop on the first form of public transportation you come across–be choosy about motor vehicles you ride in, and make sure to wear a seat belt.

In situations such as the Olympics, Super Bowl or World Cup, it’s important to be diligent about your personal safety. People travel from around the world to attend these events, and criminals do the same. Be aware of your surroundings at all times:

  • Don’t go out at night in strange or unsafe areas
  • Avoid flaunting glamorous clothes or accessories in public
  • Be prepared and knowledgeable about where you are going–try not to look like an obvious target if you are lost or unsure about something

Be Prepared for the Worst

It never hurts to be overly prepared and cautious when it comes to your health and safety, especially when traveling away from home. Bringing your medical records with you to a foreign country is a good idea, especially if you have a significant medical condition. At the very least, make sure to carry a complete list of medications and brief medical history summary. If possible, make use of the technology you have on-hand. If you’re a patient at Cooper Clinic with access to the Internet, you can access your medical records at any time and on any device via the new patient portal.

If you suffer an injury or illness and end up in a hospital in a foreign country, it’s important to be aware of your treatments. Depending on where you are, the blood supply at the hospital may not be as well policed as it is in the United States. Screening blood for HIV, hepatitis and other infections varies country to country. If you can avoid blood transfusions and any use of needles, it is best to do so.

Being up-to-date on all common vaccinations in the United States can help reduce your risk of infection in another country, but being prepared for specific risks is key to having an enjoyable and safe trip abroad. For more information about Cooper Clinic, visit cooper-clinic.com or call 972.560.2667.

Millie Cooper Honored by American Heart Association

February 9, 2016 2 comments

Every 34 seconds, someone in the United States has a heart attack. Every 60 seconds, someone in the United States dies from a heart disease-related event. Cardiovascular diseases claim more lives than all forms of cancer combined.  According to the American Heart Association, heart disease is the number one killer of women, causing one in three deaths each year. That’s approximately one woman every minute! Additionally, 90 percent of women have one or more risk factors for developing heart disease.

Millie Cooper, known as the “First Lady of Aerobics,” was recently honored with the Sandi Haddock Impact Award at the American Heart Association’s Go Red for Women Luncheon in Dallas thanks to her global efforts to promote physical activity and healthy habits.  Dr. and Mrs. Kenneth H. Cooper, are longtime supporters of the American Heart Association and major advocates of living healthy lifestyles to prevent heart disease.

Go Red Luncheon Family Crop

From left to right: Dr. Kenneth H. Cooper, Millie Cooper, T.J. Estes, Berkley Estes, Angie Cooper and Dr. Tyler Cooper

At the February 4 luncheon, close to 1,300 attendees heard from heart attack survivor Elissa Taylor, a Dallas-area mother who in 2015 had a heart attack at age 39. Her message to women is to take care of yourself, slow down, see your doctor and know the warning signs of a heart attack (which are different in women than in men).

Additionally, Lori Greiner of Shark Tank and QVC-TV paralleled business success with living healthy lifestyles. She explained the importance of women taking control of their health, not being afraid to ask questions and working hard to be healthy, safe and there for their loved ones.

Go Red Luncheon Lori

The phrase “Go Red” is a call to action for women to understand the risk of heart disease and stroke and actively work to keep their bodies healthy in order to prevent a cardiac event.  Remember…

G – Get Your Numbers

O – Own Your Lifestyle

R – Raise Your Voice

E – Educate Your Family

D – Donate

To learn more about the Go Red for Women campaign, click here. To see more photos from the event, visit the Cooper Aerobics Facebook page.

How Many Calories Do You Need?

Recently, I visited FOX 4 Good Day with Cooper Clinic Registered Dietitian Nutritionist Meridan Zerner, MS, RDN, CSSD, LD, to ‘weigh in’ (pun-intended) on recent allegations of fitness bands and fitness technology making us fat.

If you don’t have a fitness band, the likelihood that you know someone who does is pretty high. Now there are even Tory Burch bracelets designed to make the Fitbit® Flex more fashionable to wear. The technology’s purpose is to help you achieve your health and fitness goals, but if you’re only receiving the data provided (i.e. calories burned and steps walked) you may misinterpret your results. Click here to watch Meridan’s explanation on Good Day. Her recommendation is to use the fitness technology as a tool and to educate yourself by meeting with a registered dietitian to learn your Resting Metabolic Rate for a baseline measurement.

After the news segment, I met with Colleen Loveland, MS, RD, LD, CDE, to try out the Resting Metabolic Rate test myself. Check out the video below!

For optimal relaxation, Colleen said she typically turns down the lights and plays soothing music. Since we wanted to capture it on video for our followers, we made a few adjustments. To learn more about the Resting Metabolic Rate at Cooper Clinic, visit our website or call 972.560.2655.

Nutrition Consultation at Cooper Clinic

August 11, 2014 Leave a comment

In this year’s Medscape survey, 50 percent of primary care respondents said they spent 16 minutes or less with patients. Cooper Clinic physicians spend up to two hours with every patient. We’re rounding out the blog series that broke down each of the six components of the comprehensive preventive exam at Cooper Clinic. If you haven’t followed along, read about the first five (of six) components to get caught up.

  1. Medical Exam & Counseling
  2. Laboratory Analysis
  3. Cardiovascular Screening
  4. Multidetector Computed Tomography (MDCT) Scan
  5. Skin Cancer Screening
  6. Nutrition Consultation

One-on-one consultations with a registered dietitian nutritionist (RDN) are designed to help patients gain the knowledge and skills needed to achieve a healthy lifestyle. This consultation includes nutrition coaching, a personalized action plan with diet recommendations and a computer analysis of a Three-Day Food Record to calculate the nutrients in your diet.

If eating well were easy, we would all be healthier and weigh less. But the bottom line is that staying faithful to mindful nutrition is hard. We may know what foods to choose, but just cannot find the strategy to make good choices. Or we may think we know the right food choices to make, only to find that a “healthy” bran muffin has as much fat and calories as a gooey cinnamon roll. Some of us would not know how to recognize a good fat from a bad fat if our life depended on it (which in some ways is kind of does).

Our RDNs can take the complex concepts of nutrition and translate them in simple terms as they apply to your individual dietary habits. Are there specific foods you love that need to be modified to be more nutrient dense? If your cholesterol is a tad high and you want to increase fiber in your diet for cholesterol lowering? An RDN can show you how to make simple changes in your food choices to make that happen. Are you on the go and prone to missing lunch? Our RDNs can tell you which of the meal bar substitutes (and there are a zillion out there) make the most sense for your nutritional needs, taste preferences and weight goals.

There is so much information online and in the news that it can be difficult to separate fact from fiction. Is it good to take calcium supplements to protect the bones or bad to take calcium supplements because of risk to the heart? Do I get enough calcium in my diet so I don’t even have to worry about supplements?

With a one-on-one consultation, your specific needs can be addressed. Are you a vegetarian worried about protein intake? Are you pre-diabetic and wonder which food choices will help you lower your blood sugar? Do you entertain clients at restaurants and need to find a way to eat a healthy meal from the menu without being a wet blanket? Surely nothing kills a party faster than having the host order a chicken breast with kale and a side of water.

Just as important as helping you make a road map for your nutrition journey, our dietitians are with you every step of the way. They are there for you if you need to come in to the clinic for a visit to brainstorm about roadblocks or you can schedule a phone consultation as frequently as would like to keep you headed in the right direction. The nutrition train is definitely one you want to get on board.

To learn more about Cooper Clinic’s preventive exam, click here or call us at 866.906.2667 (COOP).

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Does Sitting Too Much Affect Your Heart Health?

There is a new area of science looking specifically at the harms of physical inactivity or sedentary behavior, which is not necessarily the inverse of benefits of physical activity, according to Nina Radford, MD, Cardiologist and Director of Clinical Research at Cooper Clinic.

Most of the data suggests that if you spend too much time sitting, you’re more likely to develop risk factors for heart disease and diabetes. The more time you spend sitting, the more weight you gain, the more your waist circumference increases, your blood sugar rises and cholesterol profile worsens.

Improve Your Heart Health
There are several conventional recommendations to people who sit long periods of time each day. Some of these suggestions include:

  • Get up once an hour and take a walk.
  • Stand while on the phone or opening mail.
  • Rather than emailing a colleague who works down the hall, walk down the hall to speak to them instead.
  • At lunch, take some time to walk around your building or around the block.

While these suggestions can’t hurt, there’s a bigger picture we have to look at, says Dr. Radford. Being sedentary isn’t only about sitting at your desk at work. It’s a sedentary lifestyle that is truly dangerous. People who are sedentary get less moderate physical activity and may have worse diet patterns.

New research shows that someone who is physically fit and makes regular exercise a priority, but who has a desk job, has fewer risk factors for heart disease than someone who has a desk job and is not physically fit.

“There is a new idea that if you sit at your desk all day, going to the gym at night won’t help, but that is not necessarily the case,” says Dr. Radford.

Researchers at The Cooper Institute have found that the adverse effects of time spent sitting are less pronounced the more fit you are.

“The notion that you can’t undo the ravages of a sedentary lifestyle by exercising every day is a bad public health message and the data doesn’t convincingly demonstrate that,” says Dr. Radford

So what does Dr. Radford recommend? Be generally active and get an annual physcial exam. Make it a priority to get 150 minutes of moderate physical activity every week. If you do have to sit long periods of time, get up and move around as much as possible, but the real emphasis is on living an otherwise active lifestyle.

Look Great and Feel Great This Summer

An easy way to remember the servings of fruits and vegetables you should be eating daily is to think, “five is fine, nine is divine”.

Everyone wants to look great and feel great, especially in the summer months. Cooper Clinic dietitian Elana Zimelman, RDN, LD, CDE, provides simple strategies to wear summer tank tops, shorts and swim suits with confidence.

Hydrate every day. It is recommended that women get 11 cups of fluid per day and men get 15 cups of fluid per day. These do not have to be solely water. Keep a water bottle handy so you have it on your mind and have it with you all of the time. Water prevents over-snacking; we think we are hungry but we are probably thirsty. Not only will hydration help you feel great at the pool, but studies show dehydration can affect energy levels, fitness and even job performance.

Don’t overdo the alcohol. Moderation is essential when it comes to alcohol, because there’s a fine line between a potential benefit of a glass of red wine and doing harm to your body. Alcohol provides extra calories—that add up quickly! It reduces your inhibitions, which leads you to eat unhealthy foods and more of it. To moderate your alcohol intake, alternate each alcoholic drink with a glass of water, decaffeinated tea or another sugar-free beverage.

Don’t eat a lot of salty foods. To look and feel your best, plan a clean diet with fresh produce, fruits and veggies. This is easy to do in the summer with watermelon, peaches, plums and more, all in season. Elana says fruit is nature’s candy—enjoy it!

With a turkey sandwich for lunch, replace the starchy pretzels, crackers or chips with crunchy carrot sticks or cucumber slices. This will help get rid of processed foods that are high in salt, which makes us retain water.

Receive proper nutrition every day and keep your calories in check.

  1. Eat breakfast every day. Eating breakfast has proven to decrease the chances of overeating during the day and it helps to pack in the nutrients early! Aim to pair fiber and protein to start your day. Prepare a bowl of oatmeal, sweetened with raspberries with a side of egg whites. If you’re not an oatmeal lover, try natural peanut butter on 1-2 slices of whole wheat toast with a sliced banana.
  1. Eat every 3-4 hours. Plan three meals, with 1-2 snacks prepared throughout the day. Measure and pre-package snacks to manage portion control. Ideally each snack should be approximately 150-200 calories. My two favorite snacks that Elana suggested to pack for the office are 1) a small handful of nuts (10-14 almonds) with an apple and 2) a high fiber granola bar like the Kashi® Dark Chocolate Mocha (it goes great with a cup of decaffeinated coffee!) When selecting protein or snack bars, look for lower amounts of sugar and plenty of protein and fiber. View Cooper Clinic healthy snack recipes here.

With these helpful strategies, soak up the sun (don’t forget SPF) and enjoy the beautiful summer weather. For information about Cooper Clinic Nutrition services, click here or call 972.560.2655.