Health for life

The Disease Management Care Blog feels your pain. 

You help lead a unique and innovative care coordination initiative.  Your program has some preliminary data that strongly suggests quality has increased while costs have remained neutral or gone down.  Patients are satisfied.  Docs are happy.  You even have a patient anecdote or two.

But somethings missing.

While your institutions marketing department has been supportive, you believe that the customers you want to serve are tired of glossy brochures, breathless press releases and chatty sales reps.  Your customer meetings are fun, but you cant tell if the positive feedback is the result of real insight or that second glass of wine. 

On the other hand, the prospect of publishing your findings in some scientific journal is too dreary to contemplate. 

You know some more meaningful is at stake.  You want to share your good news and get some feedback.

Heres your solution: the Care Continuum Alliance Annual Conference.  Hundreds of individuals just like you - individuals who give a damn about patients, are excited about making a difference and want to make a living doing it - will be available to give feedback.  Who knows, some of them may talk partnerships.  Others will resent your competition, confirming that you are on the right track.

The CCA Call for Proposals can be found here.  You have until March 6 to submit.

If childhood obesity expert Melinda Sothern could wave her magic wand and help kids live healthier lives, shed want parents and children to dine together every night. "Research is clear that family meals equal healthier weights, emotional stability and better school performance," she says.
She would have parents insist that their kids ditch cellphones and other media devices when they come home from school and go outside to play for an hour, or if its too dark when they get home, then they can put on some music and dance inside.
"This active time will burn four to five times more calories than sitting and help prevent obesity and type 2 diabetes," says Sothern, an exercise physiologist and a professor at Louisiana State University Health Sciences Center in New Orleans, who has treated more than 3,000 overweight children over the past 23 years. Shes the co-author of Trim Kids.
She also wishes parents would make sure that kids eat a healthy breakfast daily, get plenty of shut-eye and stop snacking mindlessly. "Parents have far more power than they realize to guarantee a healthy future for their children."
Sothern and other top national researchers in childhood obesity and nutrition are presenting their latest research at the annual Obesity Society meeting in Atlanta this week. In one session on Tuesday, several experts will offer parents practical tips on how to create healthy habits at home.
Currently, about a third of kids in this country are overweight or obese, according to the Centers for Disease Control and Prevention. Extra pounds put kids at a higher risk of type 2 diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea and other health problems.
Some ideas from nutrition and exercise researchers on setting up a healthier home environment:
• Plan healthy, tasty breakfasts. Offer children a lean protein at breakfast such as eggs, string cheese, Canadian bacon, turkey bacon or hummus, Sothern says. Serve them fresh fruit such as berries. Or whole-grain cereal with nuts is another option. Top off the meal with a glass of fat-free or 1% low-fat milk or a carton of low-fat yogurt, she says.
• Discourage mindless munching. Dont let kids eat in front of the TV or computer and gradually restrict all eating and drinking, except for water, to the kitchen counter, table or dining room, Sothern says.
• Get them involved. Take kids to the grocery store. Skip the soda, cookie and candy aisles and have children select one fruit and vegetable to try each week. At home, include children in lunch and dinner preparation, Sothern says.
• Reinstate family traditions. Insist on family dinners, set the table with real cloth napkins, light candles and play soft music in the background to encourage discussion. Compliment the children on their healthy food selections, cooking and manners, she says.
• Get some shut-eye. Allow kids no more than one hour of media time before bedtime. Try to make sure they get the required 9 to 10 hours of sleep a night. Research shows that lack of sleep equals unwanted weight gain, behavioral problems and difficulty concentrating the next day, Sothern says.
• Offer a nutritious starter course. Pennsylvania State University research shows that adults who eat a broth-based bowl of vegetable soup; a large, low-calorie, lettuce-based salad; or an apple before a meal consume about 110 to 190 fewer calories at the meal, including the calories in that first course. The same idea could work with kids, says Barbara Rolls, a professor of nutritional sciences at Penn State. Theyll not only fill up on fewer calories, but theyll be eating a healthy first course.
• Trick their tummies. Add their favorite fiber-rich vegetables — such as spinach, zucchini, yellow squash, broccoli, carrots, peppers and onions — to lasagna, casseroles, pasta dishes and pizza. The veggies lower the calories and increase the nutrients in each bite, Rolls says. Also increase the proportion of vegetables in stir-fry dishes, broth-based soups and stews and extra vegetables to sandwiches. Substitute vegetable or fruit purees for half or even two-thirds of the added fat in quick breads and muffins, she says.
• Use smaller plates. A study of first-graders showed that most kids served themselves more at lunch (about 90 calories more) when they used adult-sized dinner plates compared with using child-sized plates, which is about the size of an adult salad plate. "We know that adults over-serve themselves with larger plates, and this study says the same holds true for children. Using smaller plates at home may promote healthy child portion sizes," says Jennifer Orlet Fisher, an associate professor of public health at Temple University in Philadelphia.
• Teach kids to dance. Tell them youre playing Dancing with the Stars and let them waltz, do the cha-cha-cha or swing dance, Sothern says. This active time will burn four to five times more calories than sitting and improve their overall health.
• Swap sedentary time for active time. Kids only burn 30 to 50 calories when they are sitting for an hour, but they burn 400 to 500 calories in an hour if they are playing tag, dancing or doing field sports, she says. The governments physical activity guidelines say children and teens should do an hour or more of moderate-intensity to vigorous aerobic physical activity each day. Sothern recommends they do at least two hours of physical activity a day.
• Play outside with your children. Moms and dads should teach their kids to throw, pitch, catch, pass, jump and ride a bike because their kids may not be learning these important skills at school.
• Encourage physical-activity breaks. "There is a lot of evidence that kids should not sit still for more than 60 minutes at a time," says Penny Gordon-Larsen, a professor of nutrition at the University of North Carolina, Chapel Hill. When kids are doing their homework or on the computer, they need to get up regularly and move around or consider standing while they are working, she says. Every little bit of activity counts. Have them do at least 20 to 30 minutes of physical activity after school, such as shooting hoops, biking, playing soccer, jumping rope, dancing, walking or playing a fitness-related video game, Gordon-Larsen says.
• Steer clear of sugary drinks. This includes regular sodas, sweet teas, high-calorie specialty coffees, energy drinks and juices, Gordon-Larsen says. "Its such an easy way to cut out excess sugar and calories," she says. Instead offer water and low-fat milk, even low-fat chocolate milk.
_http://www.usatoday.com/story/news/nation/2013/11/10/kids-eating-exercising-healthfully/3358229/

Baby boomers have long been spending millions to save their sagging skin, fix their crows feet, and plump their lips. Now, however, boomers are turning to brain boosters to fight an invisible effect of aging: memory loss.

While body parts sag and wrinkle, the brain actually shrinks with age, neural connections slow down, and fewer nerve cells are created, experts explain.
The process begins as early as your 30s and affects tens of millions of Americans, leaving them not only frustrated but also causing a loss of self-confidence, social impairment, and loss of enjoyment of life that can sometimes lead to self-neglect and serious health issues.

To thwart age-related memory loss, many people have turned to brain exercises and brain games such as chess, crossword puzzles, reading aloud, brushing teeth, and computer games like MindFit and Posit Science that promise mental sharpness if you practice enough.

But do those activities really work?


Brain Booster No.1: Exercise

Exercising is one of the most frequently cited activities to improve age-related memory.

"The one that has the most robust findings is physical exercise," says Molly Wagster, PhD, chief of the behavioral and systems neuroscience branch division of the National Institute on Aging.

And it helps if the exercise is aerobic, Wagster says. Studies have shown that older people who exercise -- and were talking fairly easy exercise of moderate walking a few times a week -- outperformed couch potatoes after six months.

Experts do not fully understand why exercise helps boost brainpower, but it could be for several reasons. First, exercise diminishes stress, a key drain of brain energy, and it also helps overall health. It also helps people sleep better, which improves memory and keeps the blood flowing to all parts of your body.

"In general, whats good for the heart is good for the brain," says Gary Small, MD, director of the UCLA Center for Aging and author of iBrain, which examines, among other things the effect of the Internet on our brains.
Brain Booster No. 2: Eating a Rainbow of Fruits and Vegetables

Experts stress that people must pay attention to their diets and eat a variety of fruits and vegetables, five to seven servings daily ranging from leafy greens to blueberries to tomatoes to sweet potatoes. While there is no one "brain food," antioxidants -- which are often found in fruits and vegetables -- help to curb free-radical damage to cells.

"Our brain kind of gets rusty with age," explains Small.

Also, experts say theres no magic brain vitamin or supplement that will protect against memory loss. P. Murali Doraiswamy, MD, chief of biological psychiatry at Duke University Medical Center and author of The Alzheimers Action Plan, says that B vitamins may help, as could the spice turmeric, but that studies are inconclusive.

Brain Booster No. 3: Mental Workouts

To keep your brain sharp, many experts say, you need to challenge it regularly.

"Its just like it is with muscles," says Randolph Schiffer, MD, director of the Cleveland Clinic Lou Ruvo Center for Brain Health.

There is some evidence that mental gymnastics can help preserve memory, but some of the promises of computer games outstrip the reality of the benefits, researchers say.

"Nothing has met the gold standard," explains Doraiswamy. "If they had, theyd all be sold as prescription drugs."

Still, the games cant hurt, says Brenda Plassman, PhD, a professor in the department of psychiatry at Duke University Medical Center and the principal investigator of the Aging, Demographics and Memory Study. Plassman says she would simply caution older people not to spend money on something that hasnt been proved to work to help age-related memory loss.

"I would encourage people to look at various options for free," says Plassman.
Brain Booster No. 4: Sleep

Healthy sleep patterns are crucial for cognitive performance, especially memory, the experts say. That means at least seven hours of sleep each night.

Sleep is essential to lower levels of stress hormones, to relax and resh your entire body, and to literally turn off your brain. "There are parts of sleep where memory gets archived," says Doraiswamy.

While it may be tempting to take over-the-counter -- or even prescription -- sleeping medications, be aware that many may impair memory. Check with your doctor about side effects of sleep medications, as well as all drugs.

Also, limit your intake of alcohol if you experience sleeping problems, as it can disrupt sleeping patterns.
Brain Booster No. 5: Red Wine

Some studies indicate that red wine is good for the heart and thus the brain, the experts say. Not all the reasons are understood, but many researchers believe red wine may be good for you because it contains the antioxidant resveratrol.

There is a possibility, however, that the benefits associated with red wine could come from other factors, such as the social aspect of wine drinking or income level associated with those who drink wine.

A 2007 study of elderly Italians showed that drinking alcohol in moderation may slow the progression to dementia in elderly people who already have mild mental declines. Defined in the study as less than one drink a day, low to moderate drinking was associated with a significantly slower progression to dementia among people with mild age-related cognitive declines, compared with nondrinkers.
Brain Booster No. 6: No More Multitasking

One of the biggest causes of failing to remember something, explains Small, is that "people arent paying attention."

"As our brain ages, its more difficult to do several things at once," says Plassman.

Multitasking thus becomes an impediment to remembering names, a recipe, or something you just read. Thats because the brain first has to encode information before it can retrieve the information as memory. Unless the brain is paying attention and taking in the information it will later need, the brain cannot encode the information.

Brain Booster No 7: Learning New Memory Tricks

Small, who also authored the best-selling book The Memory Bible, says he teaches a technique called "look, snap, connect" in which participants are taught how to focus on someone or something and make a connection that will help them remember.

"These kinds of techniques can be learned very quickly," Small adds.

Long-practiced strategies such as linking a persons name to something else or another person are also helpful, or using sound associations, says Plassman. Check your local library, senior center, or hospital to see whether free classes might be offered.

While age-related memory loss is typically minor, be on the lookout for more serious memory loss in yourself or a loved one. "Forgetting where you parked your car is one thing," says Doraiswamy. "Forgetting that you have a car is another."

If memory loss is making an impact in your everyday life or getting worse, consult with a doctor.

Also, try to laugh a little about the age-related memory loss while doing what you can to curb it. While the loss is real, its not as if you are losing control of your brain. The loss is relatively subtle, and in most cases, your brain still works like the incredible organ that it is.