May 2015 Health Bulletins

	Ask the doc Dr. Davis Smith is director of health services at Westminster School, Simsbury, Connecticut

“Diabetes runs in my family. What else can I do besides exercising to keep my risk low?”
—Bryan M., George Fox University, Oregon

There are two types of diabetes, so it depends on which type runs in your family.

Type 1 diabetes (DM-1) is a condition in which the pancreas can’t produce enough insulin (a hormone that regulates the level of sugar in the blood) to effectively manage the breakdown of sugars (glucose metabolism). It develops because of genetic factors and other triggers that aren’t fully understood. The patient takes insulin in order to keep their blood sugar levels stable.

Type 2 diabetes (DM-2) is a condition in which the patient may produce enough insulin but its action is blocked. This is called insulin resistance. Type 2 is caused by genetic factors as well as lifestyle. In the US, DM-2 is often associated with obesity, and being overweight does increase the likelihood of developing this illness. As a result, DM-2 may be prevented or even reversed by consuming a diet that is healthy and balanced and overall low in simple sugars and fats. Regular physical activity is also important.

The end result is the same in both Type 1 and Type 2 diabetes: The body isn’t able to manage dietary sugars appropriately, and this can result in a high concentration of glucose in the blood. It also means that the sugar isn’t getting to liver,
fat, and muscle cells in order to be used for fuel. Diabetes can cause fatigue, vision and nerve damage, gum disease, and poor circulation.

If it is DM-2 that runs in your family, you can take several steps to lower your risk:

1. Make sure you have a thorough physical exam annually. You will want to have your fasting glucose level tested periodically, perhaps every year.
2. Be thoughtful about what you eat. Follow standard healthy dietary guidelines: a balance of lean protein, whole grains, and plenty of vegetables and fresh fruit. Limiting fried foods, fatty meats, salt intake, and processed sugar is also a good idea.
3. Get regular physical activity: Aim for 30 minutes a day (or more). Of course, physical activity is a healthy habit for anyone, regardless of their risk for diabetes.

Remember that the influence of genes is different among different people. I have some patients who are very attentive to diet and exercise but still need to take medication to control DM-2.

But by eating a healthy, balanced diet and engaging in regular physical activity, they are able to limit the amount of medication they need and improve their overall well-being.

For more info on diabetes, check out this resource from the National Institutes of Health

	Ask the trainer Frankie Romeo is a certified personal trainer, small group training coach, and graduate student at Lipscomb University in Nashville, Tennessee

“What’s the best way to burn fat from your thighs?”
—Kirkland A., Wheaton College, Massachusetts

Many people have the same question. In most women, adipose tissue (connective tissue composed of fat cells) is stored in the hips and thighs. In males, adipose tissue is usually stored around the belly.

The false belief in spot reduction
Some people try to do exercises that pinpoint certain body parts, with hopes of “burning” fat in that particular area (ever heard of the ThighMaster?). This does not work.

Why doesn’t spot reduction work?
Think about how you would cook a chicken. Would you use a candle or an oven? Even if we only want to cook the chicken thigh, an oven is much more effective. The same principle applies to exercise and weight loss.

How are you feeling about your body?
If you’re finding you want to “spot reduce” parts of your body, first ask yourself why. Is it because it feels like society and the media are telling you that thin thighs or six-pack abs are the thing to have? Or is it because you want to lose weight to improve your overall health? If you said yes to the first question, try to focus on appreciating your body and what it can do,
and maintaining or improving your health. If your goal is weight loss for health reasons, discuss this with a health care provider.

What does work?
Targeting the outer thigh with leg lifts may result in a burning sensation, but this is insignificant in terms of energy expenditure
and overall fitness. Rather than targeting specific muscles, perform compound exercises that incorporate large muscle groups.

Compound exercises for overall fitness
These compound moves will improve fitness and help with weight management:

• Squats
• Lunges
• Step-ups
• Deadlifts
• Kettlebell swings
• Bench press
• Back row
• Pull-ups
• Dips
• Bicycle crunch

For best results, pair aerobic activity, such as jump rope, running, and biking, with compound exercises.

	Ask the nutritionist Karen Moses, director of wellness and health promotion at Arizona State University in Phoenix.

“Are sports drinks (e.g., Gatorade and Powerade) really as good for your body as the commercials make them sound?”
—Mikayla W., University of Regina , Saskatchewan

Everyone’s needs for hydration and energy vary. Sports drinks provide fluid, electrolytes, and calories to support various levels of activity. Whether or not sports drinks are a good idea for you depends on a few factors, such as:

• The intensity and duration of the activity
• Body size
• Temperature and humidity
• Fitness level

When water works best
Water works well for light or moderate physical activity lasting fewer than 60 minutes, such as going for a walk or a leisurely bike ride. The American College of Sports Medicine recommends drinking 2–4 ounces of water for every 15–20 minutes of exercise. If you’re in a hot climate, or if you sweat a lot, you may want to drink more.  

When sports drinks are a good option
The combination of fluid, electrolytes, and carbohydrates in sports drinks can boost energy and endurance for bouts of intense exercise that last an hour or longer, such as a run, a strenuous bike ride, or a kickboxing class.

Electrolytes
The electrolytes found in sports drinks can help replace some of the nutrients you lose when you sweat. Electrolytes help maintain fluid balance, muscle contraction, and neural activity.

Carbohydrates
Carbohydrates give you fuel for your workout. The American College of Sports Medicine recommends consuming 30–60 grams of carbohydrates per hour of exercise. The carbohydrates found in sports drinks tend to come from more than one source, such as from the sugars in glucose and fructose. Consuming carbohydrates from a variety of sources may improve your body’s ability to absorb them. Aim for a sports drink that has about 14 grams of carbohydrates per 8 ounces of fluid.

Nutrients in food
Eating foods that contain sodium, chloride, potassium, magnesium, and calcium is another effective way to replenish your body after sweating a lot.

Try these snacks (plus water) instead of a sports drink:

• Bananas
• Salted peanut or nut butter
  on wholegrain bread
• Low-fat milk, yogurt, or cheese
• Green leafy vegetables
• Beans and lentils

So: Are sports drinks helpful? 
Answer: It depends on your needs.

	Ask the professor Amy Baldwin, MA, is the director of university studies at the University of Central Arkansas.

“What are the best approaches to meeting with professors?”
—Jordan M.,* Berea College, Kentucky

The humorous answer: “The best approaches are very careful ones.” Although I like to say that we don’t bite—at least I have not bitten a student yet—I do think that knowing how to approach a professor and what to say (and not say) are great ways to make the most of your encounter with them.

Here are a few tips that can start you off with a professor the right way:

Take it outside
We professors love taking the stage in our classrooms; we can require you to listen to us for 50 minutes. Likewise, we love when our students stop by and see us (with an appointment, preferably) when we are in our dressing rooms, um, I mean our offices. If you want to get the attention you need and deserve, ask to speak with your professors outside of class, in their offices, where they can give you undivided attention.

Don’t confess
If the purpose of the meeting is to get back on track or recover from a failing grade, I recommend that you not confess your sins. A professor doesn’t want to think that her class is not your most important—even if that is true—and she doesn’t want to think that you don’t like the subject (that she spent 10 years studying) or you don’t think her class (that she spends hours and hours preparing for) is useful.

Be yourself
Professors, for the most part, really like their students and like them even more when they know something about them. Don’t feel you have to impress them with your grasp of US–China relations in the 1960s (although they may be impressed) or that you have to speak and act formally as if you are meeting the King of Denmark. Manners are always appreciated, but you both get so much more out of your meeting if you feel comfortable and can be yourself.

Be grateful
This can go a long way—show some sort of appreciation for the time. A “thank you” as you rise to leave, a handshake of appreciation, or a brief email expressing your gratitude are, unfortunately, rare. But if a professor feels you valued the time he or she is going to be more than happy to be available next time.

Edible Stress Busters

By Julio Mario Flores

You’re approaching the end of the academic year. That means projects, papers, and finals—and sometimes comfort foods. Although sweets stimulate the short-term release of serotonin, a calming brain chemical, over the next day or two, junk foods leave us cranky. For edible stress busters, try these alternatives:

Fresh fruits and veggies
Eating 7–8 servings a day of fresh fruits and vegetables boosts mood in young adults, according to a 2013 British study involving undergraduates.

Fish
Fatty fish is one of the best protein sources for keeping your stress hormones under control. Top crackers with water-canned tuna, sardines, or salmon.

Wholegrain breads, pastas, & cereals
Eating carbs can raise your level of serotonin though the effects are variable from person to person. Stick with complex carbs, which take longer to digest than processed (white) carbs. Check food labels and make sure “whole grain” is the first or second ingredient.

Milk, yogurt, and leafy greens
Calcium deficiency has been linked to anxiety. Adults aged 19–50 should get about 1,000 mg of calcium a day: An 8 oz. serving of low-fat yogurt provides about one-third of that requirement. Any time spinach and kale are being served, grab some. More info on sources of calcium.

Young adults feel better on Obamacare

By Brandy Reeves, MPH, MS

More young adults are covered by health insurance as a result of the Affordable Care Act, and they appear to be feeling the benefits in terms of both health and finances, according to recent studies. Since “Obamacare” passed in 2010, young adults…

• Are paying less out of pocket for their medical care
• Are receiving more treatment for mental health conditions
• Consider themselves healthier

The gains appear to be the result of millions of young adults remaining on their parents’ health plans until age 26, one of the earliest provisions of the law to take effect. In addition to incurring lower out-of-pocket medical costs, young adults have become more likely to report that they are in excellent physical and mental health, according to a study published in the Journal of the American Medical Association, 2014.

People ages 18–25 with possible mental health or substance use disorders received 5 percent more mental health treatment relative to a comparison group, according to a study published in Health Affairs in 2014. Substance abuse treatment appeared unchanged.

The Patient Protection and Affordable Care Act created several mechanisms for expanding health insurance coverage among young adults:

• Young adults can be covered on their parents’ plans up to age 26
  
• Some young adults are eligible for expanded Medicaid programs
  
• Some young adults are eligible for subsidies to help pay for health insurance premiums
• A Massachusetts study found a decline in mortality rates since expanded health insurance coverage became available starting in 2006.

Need health insurance? Here are some options:

• If you’re under 26, talk with your parent or guardian about staying on their health insurance plan. 
• Your college or university might offer health insurance for college students. Check with your student health center or similar department.
• Open enrollment is closed for 2015, but in some situations you might be eligible to sign up anyway. Find out

World Day for Cultural Diversity for Dialogue and Development

May 21 is World Day for Cultural Diversity for Dialogue and Development, a global event established by the United Nations in 2002. It’s an opportunity to deepen our understanding of diverse cultural values and to learn to live together more comfortably.

Since coming to college, you’ve likely met people whose racial, ethnic, religious, or social background varies from yours. Or maybe your experience of the world is different because you or a friend. What have you learned about your friends’ experiences and cultural practices? That’s a great way to expand your knowledge and understanding
of people whose lives don’t match yours.

On this day, the UN encourages us all to “do one thing” for diversity and inclusion. Need ideas?

• Read about another religion, attend an unfamiliar service in a place of worship, or try an interfaith event.
• Visit an art exhibit or a museum dedicated to other cultures.
• Plan an international movie night.
• Volunteer with an organization that works for diversity and inclusion.

More ideas