| Issue Number 13 |
Thursday, May 31, 2002 |
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Don Hall DrPH, CHES
Founder of Wellsource, Inc.
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How
much sleep do you need for good health?
This new study indicates at least 7 hours daily.
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Sleep
and Longevity
Does
it matter how much sleep you get? Does insomnia result in increased
mortality? These are some of the questions researchers asked as
they looked at the hours of sleep people reported getting and their
mortality rates in the large prospective Cancer Prevention 2 Study
(1.1 million people).
Researchers
found that the best survival rates (lowest mortality) were in those
people getting about 7 hours of sleep per night. In their statistical
model, they controlled for age, habits, health factors, and use
of medications. Surprisingly, people who got more sleep, 8-8.5 hours
per night, had a slightly higher mortality level than those getting
7 hours. People getting less sleep, 6 hours or less, also had higher
mortality levels as might be expected.
These results
are similar to previous studies but suggest a little less sleep
is needed. In the Alameda County study people getting 7-8 hours
of sleep daily lived the longest. Those persons getting 9 hours
or more per day had higher mortality levels.
When the researchers
in the Cancer Prevention 2 study looked at insomnia, they saw no
increase in mortality for those bothered frequently with insomnia.
That makes one less thing for people with insomnia to worry about.
However, those who regularly took prescription sleeping pills did
have a significantly higher mortality rate than those who didn't.
The authors suggest this needs further study as to why.
Summary.
We all know that if we miss too much sleep, we don't feel or perform
as well, mentally or physically, as when we have a good night's
rest. Be sure to get at least 7 hours of sleep each night. Some
people seem to need more sleep to function at their best. If you
need a full 8 hours to feel good, continue to get your full 8 hours.
If you just
enjoy laying in bed, maybe getting up a half hour earlier and getting
30 minutes of aerobic exercise might do you more good than the extra
half hour of sleep.
If you don't
feel rested and are continually tired, you should check with your
doctor. You may have a physical problem such as anemia or depression
that can also affect fatigue and sleep patterns.
Factors that
can help improve the quality of sleep include: a dark, quiet, cool
sleeping room, and not going to bed on a full stomach. If your stomach
can also rest, you will sleep better, have less problem with gastric
reflux (heart burn), and wake up more refreshed.
Resources Test
Your Sleep I.Q.
Reference
Kripke,
DF et al, Mortality Associated with Sleep Duration and Insomnia,
Archives of General Psychiatry 59(2):131-6, Feb. 2002
Building
a Case for Smallpox Vaccination
The
Centers for Disease Control and Prevention are gearing up to handle
a terrorist biological attack with smallpox virus. The former Soviet
Union developed biological weapons including viruses that cause
smallpox and supplies may have fallen into other hands. All you
need to create an epidemic is for an infected person to get to a
populated place and just walk about contacting people. The newly
infected people could spread the disease to others and it could
spread rapidly throughout the nation.
If a smallpox
epidemic would break out in several large cities throughout the
nation, resulting deaths are estimated to range from 100,000 to
as many as a million people. Because of the serious possibility
of this occurring, the U.S. government is quickly preparing enough
vaccine to inoculate the entire U.S. population.
A recent survey
shows that 61% of the population currently would voluntarily choose
to be vaccinated today if the vaccine were available. The benefits
of preemptive, voluntary vaccination are great. One immediate outcome
is deterrence. To try to vaccinate the whole population after a
smallpox epidemic occurs would be a tremendously difficult task
to accomplish and is unlikely to be successful.
The CDC has
already vaccinated its own smallpox response team. They suggest
that other key public safety and public health personnel should
be offered voluntary immunization next. When vaccine is available,
the rest of the population, on a voluntary basis, could receive
the vaccine through doctor's offices and public health departments.
What are the
potential hazards? Every choice we make has some consequences. Best
estimates, based on the complication rates from the last year smallpox
vaccinations were given, is that there could be one death for every
one million people vaccinated or a total of 180 deaths. Weigh this
against the possibility of 100,000 to 1 million deaths if the population
is not vaccinated. While it seems very tragic to initiate a health
program that might result in 180 deaths, the CDC reminds us that
people choose to drive their cars each day and that 180 people die
from auto accidents every 1.5 days. All choices have consequences.
Living in times
of terrorist threats is not pleasant and difficult decisions and
precautions must be taken. Medical organizations are calling for
a public forum on this issue. We must all be informed and make decisions
on how we will respond to this potential threat to our nation.
Resources
Centers for Disease Control and Prevention smallpox
home page.
Reference
New
England Journal of Medicine, "Sounding Board", April 25,
2002
CDC web site on smallpox, accessed May 1, 2002 (see link above)
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5,000
people die from foodborne illnesses each
year in the United States.
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Foodborne
Illness -- More Common than You Think
America's food
supply is one of the safest in the world. Yet we still have frequent
cases of foodborne illness which most of us have experienced occasionally
in our lives.
A recent news
release from the Centers for Disease Control (CDC) and the Food
and Drug Administration (FDA) states, "There are an estimated
76 million cases of foodborne illness each year, resulting in more
than 5,000 deaths and 325,000 hospitalizations annually in the United
States." This is a serious public health problem and it is
everyone's responsibility! Most of these cases could have been prevented
by proper food handling and sanitation.
Symptoms.
Foodborne illness is often thought to be the flu or other problems.
You can see why when you look at the list of varied symptoms: fatigue,
chills, fever, dizziness, headaches, muscle aches, upset stomach,
diarrhea, vomiting, severe cramps, and even death. Symptoms can
occur from 30 minutes to two weeks after eating contaminated food.
Most often, though, symptoms occur within 4-48 hours and disappear
in another 1-2 days.
Rest and plenty
of fluids are all that is needed for mild cases. If symptoms persist
or become severe, it is important to see your doctor. This is especially
important when you have:
bloody diarrhea when diarrhea
and vomiting is excessive or severe when the
following three symptoms all appear: stiff neck, severe headache,
and fever when symptoms
persist longer than 3 days if the person
affected is a high risk (such as a child or older person)
What causes
foodborne illness? Eating food contaminated with bacteria (most
common), viruses, parasites, or chemicals are the main cause. If
the food is not cooked or stored properly, bacteria can multiply
and in some cases also produce toxins (such as botulism). Bacteria
need three things to grow: food (especially protein), moisture,
and warm temperature. Most organisms that cause foodborne illness
come from animal foods and often enter other foods by cross contamination
in the food preparation phase or contamination in storage.
Bacteria thrive
on protein. Foods such as meat, poultry, fish, eggs, and milk offer
ideal mediums for growth of bacteria. It is especially important
to properly cook these foods to kill any bacteria present and to
store them at the proper temperature (less than 40 degrees or warmer
than 140 degrees) to prevent their growth. Under the right conditions,
bacteria can double in number every 20-30 minutes. They can become
trillions in just 24 hours.
Here are steps
everyone needs to take to prevent foodborne illness.
Keep food
clean. Keep everything clean that comes into contact with food:
hands, towels, sponges, utensils, cutting boards, deck space, etc.
Wash all raw fruit and vegetables under running water before eating.
Keep hot
foods hot. Cook and hold hot foods at temperatures higher than
140 degree F. Temperatures between 160 to 212 degrees F. kill most
bacteria. Temperatures higher than 140 degrees F. prevent bacterial
growth. Cooked foods containing meat, poultry, fish, eggs, or milk
products should never stand out at room temperature longer than
2 hours.
Keep cold
food cold. Rapidly cool any cooked foods that are to be served
cold or keep them refrigerated at 40 degrees F. or below. At this
temperature, bacteria grow very slowly. Below freezing, bacteria
survive but don't grow.
Wash your
hands with warm, soapy water for at least 20 seconds before you
handle food.
Separate
raw and ready to eat foods while shopping, preparing, and storing.
Nearly all raw meats, poultry, fish, eggs, and some vegetables have
bacteria on them. Don't cross contaminate these foods with already
prepared foods. Thoroughly clean any surfaces raw foods come into
contact with, as well as utensils, dishes, and hands before handling
ready to eat food.
Cook foods
properly and thoroughly. Undercooked animal foods (meats, eggs,
etc.) are potentially unsafe, especially hamburger. Thoroughly reheat
leftovers to at least 165 degrees F. Reheat soups and gravies to
a boil. Cook eggs until whites and yolks are firm.
If you are not
sure whether a food has been prepared, served, or stored properly,
throw it out.
Other Resources
www.foodsafety.gov
FDA,
USDA, Foodborne Illness Education Information Center
References
1. CDC News release, AMA and U.S. Government Release New Foodborne
Illness Information, Jan. 25, 2001
2. DHHS, Dietary Guidelines for Americans, Keep Food Safe to Eat,
2001
3. Fight BAC, Avoid Foodborne Illness, www.fightbac.org accessed
May 2, 2002
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Overweight
persons who had a high intake of milk and milk products had a 72%
decrease in risk of
Insulin Resistance
Syndrome (IRS)
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Dairy
Consumption and Insulin Resistance Syndrome
A
new risk condition getting much attention lately is insulin resistance
syndrome (IRS). It is characterized by high blood insulin levels
and is linked to obesity, high blood pressure, low HDL levels, high
blood triglycerides or blood fats, high blood sugar levels, and
high risk for diabetes and heart disease.
Recent studies
indicate that 24% of the adult population exhibits IRS resulting
in major health problems. Factors that increase the risk for this
problem are excess body weight, inactivity, smoking, and poor dietary
habits; especially a low fiber intake and a high intake of refined
carbohydrates (a high glycemic load).
New research
indicates that milk may be protective against IRS. A large prospective
study looking at heart disease in young adults (18-30 years old),
called the CARDIA Study, was used to study milk consumption and
risk of IRS. They looked at lifestyle factors, body weight, and
eating habits for 10 years in 3157 young adults, both blacks and
whites, and men and women.
Here is what
they found. There was a consistent decrease in risk of IRS for
each increase in the level of milk products eaten in those persons
who were overweight (BMI of 25+) but not in lean people. When you
compare the highest intake of milk products eaten (top 20%) to the
lowest intake of milk products eaten (bottom 20%) the risk of IRS
dropped by a significant 72% in the overweight group. This protective
relationship remains even when adjusting for race, gender, other
dietary factors, activity level, and other possible confounders.
It's been known
for some time that fiber is also protective against IRS. People
who ate the least milk products and the lowest fiber intake had
seven time the rate of IRS compared to those who had a high intake
of both dietary fiber and milk.
The authors
point out that trends in eating in the past few decades include
a decrease in milk consumption, an increase in drinking soda pop,
and an increase in snacking and refined foods. This is certainly
not a healthy trend, especially in our children. At the same time,
obesity and insulin resistance have been increasing. The food guide
pyramid recommends two servings of milk products daily, preferably
low fat choices.
In summary,
researchers observed that overweight people with a higher intake
of milk and milk products (such as yogurt and cottage cheese) had
a significantly lower rate of:
The authors
conclude by saying, "Our study suggests that increased dairy
consumption may protect overweight individuals from the development
of obesity and insulin resistance syndrome, two key risk factors
for the development of type 2 diabetes and cardiovascular disease."
These are two of our nations leading causes of death.
Comments: Keep
in mind that if you are lean (BMI < 25) milk had no added protective
benefit against IRS. Other things you can do to prevent IRS are:
exercise regularly, stay lean, avoid smoking, eat a diet high in
dietary fiber (in this study fiber was even more protective than
milk), and limit highly refined carbohydrates (foods with a high
glycemic index such as white bread, soda pop, white rice, sweets,
etc.).
Reference
Mark A. Pereira, et al, Dairy consumption, obesity, and the insulin
resistance syndrome in young adults, JAMA 287:2081-2089, April 24,
2002
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Of
the current 48 million smokers, more than 33 million report they
want
to quit smoking.
44.3
million adults
have already stopped smoking in the U.S.
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Stopping
Smoking: What Works?
Most
smokers know that smoking causes lung cancer, heart disease, and
emphysema. So why do they continue to smoke? They become addicted
to nicotine and quitting is not easy. 70% of current smokers report
that they want to quit. About one-third of all smokers attempt to
quit each year. But few seek help and most don't stop.
People who stop
smoking experience withdrawal symptoms such as irritability, anger,
difficulty concentrating, insomnia, anxiety, and sometimes depression.
Another stumbling block for many is the possibility of weight gain.
Smokers have
a much higher rate of success when they seek help. According to
a recent article in the New England Journal of Medicine, people
who seek help are more than twice as likely to succeed. So, if you
know someone who has tried and failed, encourage them to try again.
Here are the suggestions made in this article to help improve a
person's chances of stopping.
Physician support.
Talking over your problem with your physician helps. He or she can
help direct you to sources of support and counseling if needed.
Your doctor can also help prescribe cessation aids such as nicotine
replacement therapy (NRT) or other medications that improve success
in quitting.
Counseling.
Individual or group counseling is effective when provided by a trained
stop smoking counselor and when provided over a period of at least
4 weeks. Typically, you will learn to identify smoking cues and
how to break the link between these cues and smoking. For example,
if you normally smoke after eating it's imperative that you substitute
a different activity immediately after eating such as going for
a walk or engaging in some activity you enjoy.
You also learn
strategies for coping with stress, managing nicotine withdrawal
symptoms, and preventing relapse by anticipating tempting situations
and rehearsing coping strategies. It also helps to have someone
helping you in the stopping process, someone to report to, and someone
to call on for help if needed.
Nicotine Replacement.
Person who use nicotine replacement therapy (NRT) are much more
likely to succeed in quitting, usually doubling the quit rate at
one year. Ask your doctor for guidance. You may use NRT from eight
weeks to six months.
Medications.
Medicines such as Bupropion (Zyban), Aventyl, and Pamelor are antidepressants
that also help smokers stop smoking. Ask your doctor whether one
of these medications might help you. Again, people who use these
aids are generally twice as likely to succeed at quitting.
Preventing Weight
gain. The average smoker gains 5-10 pounds after stopping. This
can be overcome by initiating a daily activity program. Regular
exercise also helps control anxiety, depression, and restlessness
experienced during quitting. Choose moderate activities to begin
with such as walking, biking, swimming, or golf. Build up to exercising
a half hour or more daily.
Social Support.
Don't try to go it alone. Get help from your doctor. Ask your dentist
for help and a teeth cleaning as soon as you stop. Enlist the support
of your spouse, family, and friends. It helps to have many people
pulling for you and helping you succeed.
When you are
ready to quit, line up counseling and set a quit date. On your quit
date, eliminate as many smoking cues (triggers) as possible. Put
away ash trays and have your clothes washed or dry-cleaned to remove
the odor of smoke. Get your doctor's guidance regarding stopping
aids. Have a supply of gum, carrot sticks, etc. ready to keep your
mouth busy. Let your friends and family know when you plan to stop.
When the quit
date arrives, stay busy, follow your plan, avoid any extra stress
or pressures, keep physically active, drink lots of water, and think
positive. Remember that half of all smokers have quit. You can too.
Additional Resources
The American Lung Association
www.lungusa.org/tobacco
American Cancer Society, Quitting
Smoking
American Heart Association,
"How can I Quit Smoking?"
National Cancer Institute, www.nci.nih.gov
CDC, "You
Can Quit Smoking"
National Women's Health Information Center, A
Breath of Fresh Air
Office on Smoking and Health www.cdc.gov/tobacco
USDHHS, You
Can Quit Smoking -- Help for Pregnant women
Reference
Nancy A. Rigotti, M.D., Treatment of Tobacco Use and Dependence,
New England Journal of Medicine 346(7):506-512, Feb. 14, 2002
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Getting
adequate water daily may reduce your risk of heart disease
by 40-50%
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Water
and Coronary Heart Disease
Getting adequate water intake daily may be protective to your heart
a new study in the American Journal of Epidemiology reports. People
who have low intakes of water tend to be dehydrated or marginally
so. This can affect the blood's viscosity (thickness), hematocrit,
and fibrinogen levels, all of which can increase the risk of a heart
attack.
This study looked at water and other fluid intake in 8280 men and
12017 women in the Adventist Health Study, a large prospective study
in California. Over the 6 years of study, 246 fatal heart attacks
occurred. These deaths from heart attacks were then correlated with
water intake.
Here is what
they found. Men who had a high intake of water (five or more
glasses per day) had less than half as many heart attacks (relative
risk of 0.46) as men who had low intakes (two glasses per day or
less). Women had similar findings, a 41% lower risk of heart deaths
in those women drinking more water. This relationship held even
after adjusting for common risk factors such as age, smoking, high
blood pressure, obesity, diet, education, etc.
When they looked
at other fluids, coffee, soda pop etc. they found no protective
effects of higher fluid intake. In fact, those who had the highest
fluid intake from other beverages (in place of water) had higher
mortality rates, especially in women.
This is a most
interesting finding. Here is another simple way to improve your
health and reduce your risk of heart disease -- simple drink more
water, at least 5 or more glasses daily, preferably 6-10 glasses,
especially if you live in warm climates.
Getting adequate
water can also reduce the risk for bladder cancer, help prevent
headaches, and reduce constipation. It's a simple remedy with great
benefits and no side effects! Drink up! Water that is.
Reference
Jacqueline Chan, et al, Water, Other Fluids, and Fatal Coronary
Heart Disease, American Journal of Epidemiology 155 (9):827-33,
Jan. 2002
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Physical
Activity -- How Is the Nation Doing?
Increasing overall participation in leisure time physical activity
has been one of the Nations top health objectives since the first
Healthy People Goals came out in 1980. In the current Healthy People
2010 Goals, physical activity is the first health priority listed
for the nation. Physical activity is powerful preventive medicine.
In the U.S. Surgeon General's Report on Physical Activity and Health,
the surgeon General listed the major health consequences of inactivity:
high blood
pressure coronary
heart disease diabetes osteoporosis obesity colon cancer breast cancer depression
In light of
this knowledge and after 20 years of promoting fitness, how fit
is the nation doing today? To find out how active people are today,
the National Center for Health Statistics conducted the National
Health Interview Survey. It includes over 68,000 adults (age 18
and older) from a random sampling of the entire U.S. population.
Here is what
they found. Overall, 30.6% of the population engage in regular
physical activity (light to moderate physical activity or vigorous).
That means that nearly 70% do not get any regular physical activity!
Only about 1
in 10 people (11.6%) engage regularly in any vigorous physical activity.
Thus about 90% of the population get no regular, vigorous activity.
As people age,
activity levels decrease. Young adults are twice as active as older
adults even though activity is one of the best ways to reverse the
negative effects of aging.
People living
in the West were the most active. Those living in the South were
the least active.
Married women
were the most active of all women groups. Those with higher education
levels were twice as likely to be active as those with lower education
levels.
When asked about
strength building exercises, 22.9% of adults reported doing any
strength exercises. That means nearly 80% of adults do no activities
to improve or maintain strength.
These data show
the great need still remaining for improvement in fitness in the
US Regular physical activity is one of the best strategies for combating
the health risks associated with obesity, high blood pressure, diabetes,
high cholesterol, heart disease, depression, and even certain cancers.
Consider what you can do to improve the fitness level of your family,
business, church, or community.
Reference: CDC,
Advance Data from Vital and Health Statistics, No. 325, April 7,
2002
Resources
Surgeon General's Report, Physical
Activity and Health
CDC, Physical
Activity. Ready. Set. It's everywhere you go!
CDC, List
of Nutrition and Fitness Promotion Organizations
Reference
New England Journal of Medicine, "Sounding Board", April
25, 2002
CDC web site on smallpox, accessed May 1, 2002 (see link above)
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Products
Seminars
Wellsource News
Effective...
Accurate...
Easy... Confidential...
Wellness
Seminar
July 22-23, 2002
Porrtland, Oregon
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HealthStyle
Index (HSI)
HSI
is our newest health and lifestyle assessment. It is based on the
national goals of Healthy People 2010 -- to "Increase quality and
years of healthy life." HSI is a online health assessment including
28 lifestyle questions that can be completed and scored in only
a few minutes. The Personal Report features: Stop smoking assistance,
diabetes prevention, good nutrition, improving physical activity,
controlling cholesterol levels, weight reduction, preventing heart
attacks, improving mental and social health.
Questions
deal with health practices that are all related to health and longevity
in evidence based research including:
Cancer Prevention
II study Alameda County
Good Health Practices Study Other research
linked to health and longevity -
Healthy
People 2010 -- Understanding and Improving Health.
The
HSI assessment can be added to your website for health promotion
purposes. It delivers real-time online reports to the user through
virtually any Web browser and is also linked to health improvement
information articles.
For further
information on the HealthStyle Index, visit our website www.wellsource.com,
call your Director of Business Development at 1-800-533-9355, or
e-mail marketing@wellsource.com.
July
22-23, 2002.......Marketing Wellness Seminar
The Successful Health Management Systems™ Seminar, presented
by Wellsource, the leader in population health management applications
will be teaching health professionals and others how to develop and
market wellness programs, July 22-23, 2002 at the 5th Avenue Hotel
in Portland, Oregon.
The seminar
provides professionals in the health care industry with the opportunity
to network with peers and share successes and challenges. The learning
experience is facilitated with interactive workshops that encourage
participation. For program
schedule and registration form.
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Wellsource Inc.
15431 SE 82nd Dr.
Portland, OR 97015
(503) 656-7446
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About
Making Healthy Choices
Making
Healthy Choices is written by Don Hall, DrPH, CHES president of
Wellsource Inc. with contribution from associated health professionals.
It is available as a resource to Wellsource
clients and other select organizations involved in promoting health.
Content
is general health information from evidence based research. Its
purpose is not to treat disease but to promote healthy lifestyles.
Persons with health problems should consult their physician for
specific guidance.
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