Remembering Memorial Day

We would like to thank all those who have and are protecting us here at home. Your sacrifices should always be remembered not just today, but every day! Happy Memorial Day from the staff of Total Family Healthcare.

What To Look For In A Weight Loss Program

 

Some people lose weight on their own; others like the support of a structured program. Overweight people who are successful at losing weight, and keeping it off, can reduce their risk factors for heart disease. If you decide to join any kind of weight-control program, here are some questions to ask before you join.

• Does the program provide counseling to help you change your eating activity and personal habits?
  The program should teach you how to change permanently those eating habits and lifestyle factors, such as lack of physical activity, that have contributed to weight gain.
• Is the staff made up of a variety of qualified counselors and health professionals such as nutritionists, registered dietitians, doctors, nurses, psychologists, and exercise physiologists?
  You need to be evaluated by a physician if you have any health problems, are currently taking any medicine or plan on taking any medicine, or plan to lose more than 15 to 20 pounds. If your weight-control plan uses a very low-calorie diet (a special liquid formula that replaces all food for 1 to 4 months), an exam and follow-up visits by a doctor also are needed.
• Is training available on how to deal with times when you may feel stressed and slip back to old habits?
  The program should provide long-term strategies to deal with weight problems you may have in the future. These strategies might include things like setting up a support system and establishing a physical activity routine.
• Is attention paid to keeping the weight off? How long is this phase?
  Choose a program that teaches skills and techniques to make permanent changes in eating habits and levels of physical activity to prevent weight gain.
• Are food choices flexible and suitable? Are weight goals set by the client and the health professional?
  The program should consider your food likes and dislikes and your lifestyle when your weight-loss goals are planned.

There are other questions you can ask about how well a weight-loss program works. Because many programs don't gather this information, you may not get answers. But it's still important to ask them:

• What percentage of people complete the program?
• What is the average weight loss among people who finish the program?
• What percentage of people have problems or side effects? What are they?
• Are there fees or costs for additional items, such as dietary supplements?

Remember, quick weight loss methods don't provide lasting results. Weight-loss methods that rely on diet aids like drinks, prepackaged foods, or diet pills don't work in the long run. Whether you lose weight on your own or with a group, remember that the most important changes are long term. No matter how much weight you have to lose, modest goals and a slow course will increase your chances of both losing the weight and keeping it off.

How to Change Your Behavior About Food

Your Weight Is Important

Over the past few years it has become clear that weight is an important health issue. Some people who need to lose weight for their health don't recognize it, while others who don't need to lose weight want to get thinner for cosmetic reasons. We understand that in some ways your weight is different from, for example, your cholesterol level or your blood pressure, because you can't see what these are by looking at someone. Many patients have had health care providers who approached their weight in a less-than-sensitive or helpful manner. Some patients may have had health care encounters in which they felt blamed, but not helped. Successful weight management is a long-term challenge.

Weight can affect a person's self-esteem. Excess weight is highly visible and evokes some powerful reactions, however unfairly, from other people and from the people who carry the excess weight. The amount of weight loss needed to improve your health may be much less than you wish to lose, when you consider how you evaluate your weight. Research has shown that your health can be greatly improved by a loss of 5–10 percent of your starting weight. That doesn't mean you have to stop there, but it does mean that an initial goal of losing 5–10 percent of your starting weight is both realistic and valuable.

Behaviors That Will Help You Lose Weight and Maintain It

Set the Right Goals
Setting the right goals is an important first step. Most people trying to lose weight focus on just that one goal: weight loss. However, the most productive areas to focus on are the dietary and physical activity changes that will lead to long-term weight change. Successful weight managers are those who select two or three goals at a time that are manageable.

Useful goals should be (1) specific; (2) attainable (doable); and (3) forgiving (less than perfect). "Exercise more" is a great goal, but it's not specific. "Walk 5 miles every day" is specific and measurable, but is it doable if you're just starting out? "Walk 30 minutes every day" is more attainable, but what happens if you're held up at work one day and there's a thunderstorm during your walking time another day? "Walk 30 minutes, 5 days each week" is specific, doable, and forgiving. In short, a great goal!

Nothing Succeeds Like Success

Shaping is a behavioral technique in which you select a series of short-term goals that get closer and closer to the ultimate goal (e.g., an initial reduction of fat intake from 40 percent of calories to 35 percent of calories, and later to 30 percent). It is based on the concept that "nothing succeeds like success." Shaping uses two important behavioral principles: (1) consecutive goals that move you ahead in small steps are the best way to reach a distant point; and (2) consecutive rewards keep the overall effort invigorated.

Reward Success (But Not With Food)

An effective reward is something that is desirable, timely, and dependent on meeting your goal. The rewards you choose may be material (e.g., a movie or music CD, or a payment toward buying a more costly item) or an act of self-kindness (e.g., an afternoon off from work or just an hour of quiet time away from family). Frequent small rewards, earned for meeting smaller goals, are more effective than bigger rewards that require a long, difficult effort.

Balance Your Food Checkbook

"Self-monitoring" refers to observing and recording some aspect of your behavior, such as calorie intake, servings of fruits and vegetables, amount of physical activity, etc., or an outcome of these behaviors, such as weight. Self-monitoring of a behavior can be used at times when you're not sure how you're doing, and at times when you want the behavior to improve. Self-monitoring of a behavior usually moves you closer to the desired direction and can produce "real-time" records for review by you and your health care provider. For example, keeping a record of your physical activity can let you and your provider know quickly how you're doing. When the record shows that your activity is increasing, you'll be encouraged to keep it up. Some patients find that specific self-monitoring forms make it easier, while others prefer to use their own recording system.

While you may or may not wish to weigh yourself frequently while losing weight, regular monitoring of your weight will be essential to help you maintain your lower weight. When keeping a record of your weight, a graph may be more informative than a list of your weights. When weighing yourself and keeping a weight graph or table, however, remember that one day's diet and exercise patterns won't have a measurable effect on your weight the next day. Today's weight is not a true measure of how well you followed your program yesterday, because your body's water weight will change from day to day, and water changes are often the result of things that have nothing to do with your weight-management efforts.

Avoid a Chain Reaction

Stimulus (cue) control involves learning what social or environmental cues seem to encourage undesired eating, and then changing those cues. For example, you may learn from reflection or from self-monitoring records that you're more likely to overeat while watching television, or whenever treats are on display by the office coffee pot, or when around a certain friend. You might then try to change the situation, such as by separating the association of eating from the cue (don't eat while watching television), avoiding or eliminating the cue (leave the coffee room immediately after pouring coffee), or changing the circumstances surrounding the cue (plan to meet your friend in a nonfood setting). In general, visible and reachable food items are often cues for unplanned eating.

Get the Fullness Message

Changing the way you go about eating can make it easier to eat less without feeling deprived. It takes 15 or more minutes for your brain to get the message that you've been fed. Eating slowly will help you feel satisfied. Eating lots of vegetables and fruits can make you feel fuller. Another trick is to use smaller plates so that moderate portions do not appear too small. Changing your eating schedule, or setting one, can be helpful, especially if you tend to skip, or delay, meals and overeat later.

 

From The National Institute of Health

Great News! We now accept Cigna & Aetna!

Happy St. Patrick's Day

 

May there always be work for your hands to do
May your purse always hold a coin or two;
May the sun always shine on your windowpane;
May a rainbow be certain to follow each rain;
May the hand of a friend always be near you;
May God fill your heart with gladness to cheer you.

Increased Red Meat Consumption Linked to Higher Diabetes Risk

According to a new long-term observational study from researchers at the Harvard School of Public Health and the National       University of Singapore, increasing the number of servings of red meat over time increases the risk of getting type 2 diabetes, while cutting back reduces the danger. The study is published in JAMA Internal Medicine.

Using food questionnaires, researchers tracked the eating habits of almost 150,000 people every four years for an average of 20 years of follow-up. Their analysis took into account age, family history, race, smoking status, initial red meat consumption and  lifestyle factors such as physical activity, alcohol intake and diet quality.

The study found that among those who ate more red meat as the study progressed showed higher rates of diabetes than those whose red meat consumption didn’t change.

Consuming 3.5 more servings of red meat per week during a four-year period increased a person’s chance of developing diabetes by almost 50 percent in the subsequent four years.

Those who consumed 3.5 less servings of red meat per week during a four-year period didn’t have a short-term reduced risk of developing the disease, but over the subsequent 10 years, reduced their risk of developing type 2 diabetes by 14 percent.

The findings apply to both processed red meats, such as lunch meat and hot dogs, and unprocessed red meat, such as hamburger, steak and pork. The association was stronger for processed meat.

Some experts suggest that the high calories and fat in red meat are to blame for the association between increased consumption and higher risk of diabetes. Indeed, people who are overweight are more likely to develop the condition. However, even after the  researchers controlled for body mass index and weight gain, the linkage between increased red meat consumption and  type 2 diabetes remained.

In an invited commentary in the journal , William J. Evans, Ph.D., head of the Muscle Metabolism Discovery Performance Unit at GlaxoSmithKline, and an adjunct professor of geriatric medicine at Duke University, suggests that the problem isn’t red meat, but the amount of saturated fat in the meat.

According to lead author An Pan, Ph.D.:

“The public-health message is to try to limit red meat consumption (particularly processed red meat) and switch to plant-based food choices and more fish or poultry. While there is no cutoff point or recommendation regarding how many servings per week, the current evidence suggests the less, the better.”

The study is the first to look at red meat consumption changes over time and how it affects diabetes risk.

 

AAP SPEAKS OUT AGAINST RETAIL-BASED CLINICS

For Release: Immediate
CHICAGO - The American Academy of Pediatrics (AAP) has issued a new policy statement opposing the use of Retail-Based Clinics (RBCs) - limited, lower-cost services at walk-in facilities located in supermarkets, pharmacies and large retail stores - as a source for medical care of infants, children and adolescents. These clinics do not support the AAP's commitment to the medical home model that provides accessible, family-centered, comprehensive, continuous, coordinated, compassionate and culturally effective care for which the pediatrician shares responsibility with the family.
The AAP is particularly concerned with the following aspects of RBC care:

• Fragmentation and possible lower quality of care
• Care for children with special health care needs
• Lack of access to a central health record
• Use of tests and diagnosis without proper follow-up
• Public health issues surrounding exposure to contagious diseases in a retail environment

While the AAP is opposed to the use of RBCs, it does acknowledge that these clinics will likely continue to exist. To help ensure the best care possible through these outlets, the AAP has issued the following guidelines:

• RBCs should support the medical home model by referring patients back to primary care physicians for future care. A medical home ensures a main source for a child's health care and medical records
• RBCs should communicate with the patient's pediatrician or other primary care physician within 24 hours of the visit.
• All those providing care to children should follow AAP clinical guidelines as well as those developed by other medical organizations.
• RBCs should be subject to health facility standards and precautions should be taken to avoid the spread of contagious diseases.

In addition, the AAP is opposed to waiving or lowering co-pays or offering financial incentives for visits to RBCs in lieu of pediatricians or primary care providers. These types of incentives would further promote the fragmentation of care.

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.