20 Little Ways to Drop Pounds, Keep Them Off

We're in the midst of the holiday season, and it's tempting to indulge. But with cases of obesity in America climbing at an alarming rate, tis the season to watch your weight -- and that means your health.

According to an article in Health Magazine, the average person gains one to two pounds a year. But by consuming just 100 fewer calories each day you can avert that weight gain, experts say.

If you’ve already packed on some extra pounds — and you want to lose some of that weight—you have to downsize by 500 calories a day. But you don’t have to slash them all from your plate.

According to Holly Wyatt, MD, a clinical researcher at the Center for Human Nutrition in Denver, you can eat 250 calories less and then burn 250 by walking for 30 to 40 minutes. Over a week, that will produce about a pound of weight loss..

Here are 20 suggestions of how you can make small tweaks that can pay off over time:
1. Order two appetizers
According to a study at the University of North Carolina, the average hamburger is 23 percent larger today than it was in 1977. Choose a pasta dish and salad or soup from the appetizer column, instead.
2. Visit the vending machine
Nibbling on single servings is better than digging your way to the bottom of a megabag of chips.
3. Start with salad…
and eat less during the rest of the meal, says a study from Pennsylvania State University. When salads were topped with low-fat mozzarella and low-calorie Italian dressing instead of high-fat alternatives, women ate 10 percent fewer calories over the course of the day.
4. Stick a fork in it
If you prefer your salad dressing on the side, dip your fork into it before stabbing your greens. That little maneuver could cut hundreds of calories.
5. Watch coffee calories
The fancy concoctions that are now the javas of choice for many people can contain as many calories as an entire lunch.
6. Walk and talk
When your cell phone rings, slip on your walking shoes and stroll the halls at work or hoof it outside. If you did this for 10 minutes every workday at a moderate 3 mph pace, you’d burn about 1,000 calories a month and lose 3 pounds a year.
7. Crack a nut
Dieters in a Harvard University study who ate a handful of peanuts or mixed nuts daily were more likely to keep weight off than a group whose regimen didn’t include the high-fat snacks.
8. Don’t just sit there
The average person burns 100 calories per hour sitting and 140 per hour standing. Get on your feet 2 hours a day while you work, and you could drop an extra 6 pounds over the year.
9. Sleep well, lose more
Insufficient shut-eye appears to increase production of the stress hormone cortisol, which regulates appetite. High levels seem to worsen bingeing and hunger. Too little sleep could keep your body from burning carbohydrates, which translates to more stored body fat.
10. Double your protein
The high-protein, low-carb approach may help keep you from losing muscle along with fat, according to a study published in The Journal of Nutrition. According to study author Donald K. Layman, PhD, of the University of Illinois, the amino acid leucine — found in beef, dairy, poultry, fish and eggs — may help preserve muscle tissue.
11. Keep an exercise journal
Writing down your fitness achievements is a great way to track your progress, give yourself positive feedback, and maintain focus on your goals.
12. Eat dairy daily
A piece of cheese or a cup of milk or yogurt can rev up your metabolism. People who cut 500 calories a day from their diets while eating yogurt three times a day lost 13pounds over 12 weeks, more weight and more body fat than a control group who only cut calories.
13. Have an apple before dinner
How did 346 people in small-town Washington State lose an average of 17 pounds each in 3 months? With regular exercise, balanced eating and an apple with every meal. The typical apple has 5 grams of fiber, which makes you feel fuller.
14. Be wary of white foods
That’s the color of most high-calorie carbs — bagels, potatoes, breads, rice, creamed corn and the like.
15. Drink water
Your body often mistakes thirst for hunger, so staying hydrated means you’ll probably also stay satiated.
16. Act like a kid
Expand your definition of physical activity to include busting a move with your kids. It’s a welcome break from the StairMaster and can burn just as many calories (about 120 every 20 minutes).
17. Munch a handful of M&Ms
Just under half a pack of plain candies adds only 100 calories to your daily tally and can satisfy a sweet tooth.
18. Be picky about bread
Select loaves with whole grain listed as the first ingredient and make sure each slice contains at least 2 grams of fiber.
19. Eat breakfast
A Harvard study found that people who did so every day cut their chances of becoming obese and developing diabetes by 35 to 50 percent, compared with those who ate breakfast only twice a week.
20. Brush your teeth after every meal
It doesn’t just fight cavities: Brushing serves as a physical and psychological cue to stop eating. When you’re on the go, a few Altoids or a breath strip can have the same effect.

Is It a Stroke? What Symptoms to Look For.

I often answer questions on our 24-hour nurse line from callers anxious to find out if a spouse, parent or friend might be having a stroke. Every 45 seconds, someone in America has a stroke. What is a stroke? A common definition is the sudden death of some brain cells when blood flow to the brain is blocked or an artery to the brain is ruptured. According to the National Stroke Association, a stroke might be compared to a heart attack. But instead of involving the heart, a stroke is a “brain attack.”

Sometimes the symptoms of a stroke are difficult to identify. Unfortunately, lack of awareness could spell disaster. The stroke victim may suffer brain damage when people nearby fail to recognize the symptoms.

Doctors now say that someone can recognize when another person is having a stroke by asking three simple questions:

• Ask the person to smile.
• Ask the person to raise both arms.
• Ask the person to speak a simple sentence.

Think of “SAS,” which means Smile, Arms and Sentence. If the victim has trouble with any of these tasks, call 9-1-1 immediately, describe the symptoms to the dispatcher or quickly drive the person to the hospital yourself. Every second counts because brain cells could be dying.

According to the American Stroke Association, widespread use of the SAS test can result in prompt diagnosis and treatment of stroke and prevention of brain damage.

Many health plans, organizations and employers offer access to a nurse line to help members determine if certain symptoms might mean calling an ambulance or taking a loved one to the hospital.

See you later,
Sue Brown, R.N. and Vice President of Clinical Operations

Is a reverse mortgage different than a conventional one? Who’s eligible?

For some older Americans, the chance to turn the worth of their home into cash sounds appealing. While many seniors own their own homes, or nearly do, they may be faced with little income as well as hefty medical expenses or home repair costs.

A reverse mortgage or Home Equity Conversion Mortgage (HECM) allows a homeowner to receive part of the worth of their home as a loan, which they don’t need to repay as long as they live in the home. With a conventional mortgage, you pay a monthly payment. With a reverse mortgage, you receive monthly payments against the equity of your home.

The number of reverse mortgages has take a huge climb from 18,000 in 2003 to more than 107,000 in 2007, according to the U.S. Department of Housing.

To be eligible for a reverse mortgage, you need to be at least 62 years old, live in the home as a primary residence, and either own the home “free and clear” or hold a small mortgage balance.

A reverse mortgage is generally tax free and has no income restrictions. In addition, most payments from a reverse mortgage won’t affect Social Security or Medicare benefits.

Homeowners who obtain a reverse mortgage can take their money as a line of credit that bears interest, a monthly payment or a lump sum. The older you are, the more money you can receive with a reverse mortgage. For example, a 62 year old can expect to receive about 30 percent of the value of the home, while a 95 year old may receive 80 percent.

Important: Remember that a reverse mortgage keeps reducing the equity or worth of your home as the years go on. It also means you can’t leave your home to a family member upon your death; a reverse mortgage is like a conventional mortgage in that the home essentially belongs to the lender.

An organization that maintains some consumer education as well as a code of conduct for reverse mortgage lenders is the National Reverse Mortgage Lenders Association.

Some workers who want to go about obtaining a reverse mortgage for their elderly parents can get expert guidance if their employer offers an advocacy services program. Such professional services can help callers better understand the details about reverse mortgages and be directed to a list of local approved outlets that can provide the actual reverse mortgage.

Until next time,
Patricia Stern, Director of Advocacy Services

Who’s at Risk for Pre-Diabetes?

Before people develop type 2 diabetes, they almost always have “pre-diabetes.” This means blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes, according to the American Diabetes Association.

Normal fasting blood glucose is below 100 mg/dl. A person with pre-diabetes has a fasting blood glucose level between 100 and 125 mg/dl. If the blood glucose level rises to 126 mg/dl or above, a person has diabetes.

Research has also shown that if you take action to manage your blood glucose when you have pre-diabetes, you can delay or prevent type 2 diabetes from ever developing. Action includes lifestyles changes, namely modest weight loss and regular exercise

Pre-diabetes risks factors are the same as those for type 2 diabetes. They include:
~ Being overweight or obese (i.e., BMI of 25 or higher)
~ First-degree family history of diabetes
~ Being age 45 or older
~ Sedentary lifestyle
~ Low HDL cholesterol (35 mg/dl; 0.90 mmol/l) and high triglycerides (250 mg/dl; 2.82 mmol/l)
~ High blood pressure (consistent reading of 140/90 mmHg or higher)
~ History of gestational diabetes or gave birth to a baby weighing more than 9 pounds
~ Belonging to one of the following ethnic populations: African Americans African Americans, Native American Indians, Latinos, Asian Americans, Pacific Islanders
~ Having polycystic ovary syndrome (PCOS)
~ Having a history of vascular disease

The American Diabetes Association uses screening recommendations for pre-diabetes that are based on the current guidelines for type 2 diabetes screening. Testing is recommended for men and women 45 years of age and older, especially those with a body mass index at or above 25. Individuals younger than 45 should also be screened if they have a BMI of 25 or more and additional risk factors.

Some employers and health plans offer a 24-hour nurse line for their members to help them determine if they or their family members may be at risk for pre-diabetes, and if they should schedule an appointment with a doctor.

See you later,
Sue Brown R.N. and Vice President of Clinical Operations

What Is Home Medical Equipment? Is it Covered by Insurance?

If someone were asked whether they would rather spend time at home or in a hospital, the answer is clear. And home medical equipment often makes staying home and living a more normal life possible when a person is limited by medical issues.

A patient whose care is being managed from home or other private facility by a nonprofessional caregiver or family member is often eligible for home medical equipment (HME). The equipment often goes by the name durable medical equipment (DME), because it is intended to withstand repeated use.

Examples of durable medical equipment are wheelchairs, air purifiers, artificial limbs, commodes, seat lifts, nebulizers and respiratory assist devices. There are a host of other items, as well.

Medical supplies that can be used up such as bandages, rubber gloves and irrigating kits are not considered to be durable medical equipment.

Most home medical equipment require a doctor’s prescription, though is not always necessary for minor items such as walkers or canes. And home medical equipment is typically covered by the patient’s health insurance, including Medicare (Part B). Sometimes the items are purchased and other times rented, depending on the need of the patient.

Be a Wise Medical Equipment Consumer
It helps to make sure you obtain your home medical equipment from a supplier that has local service and maintenance offices. This helps ensure the supplier’s ability to deliver and maintain equipment on a timely basis.

Beware of suppliers who use high-pressure tactics, offer equipment at no charge, present themselves as representatives of Medicare, or use Medicare emblems and symbols on their literature. Contact your health insurer and/or Medicare carrier and report such suppliers.

The best suppliers provide proper delivery and setup of equipment, and make sure your home is suitable and safe for the proper use of the equipment. They will train the patient, family and caregivers in the use and maintenance of the equipment, and will provide 24-hour contact in the event of equipment malfunction or other emergency.

Some employers and organizations provide a health advocacy service for its employees or members in order to guide them to the most reputable home medical equipment suppliers anywhere in the country.

Until next time,
Patricia Stern, Director of Advocacy Services

What Is a Magnet Hospital for Nursing? Is It an Important Choice?

There are many different types of hospital accreditations. But there’s a particular one that directly affects the frontline quality of patient care, the Magnet Recognition Program for Excellence in Nursing. It measures the quality and effectiveness of a hospital’s nursing staff and culture.

As of this writing, only 4 percent of hospitals in the U.S. have qualified for Magnet status, which is awarded by the American Nurses Credentialing Center (ANCC).

Magnet hospitals are ones through which nursing delivers excellent patient outcomes, where nurses have a high level of job satisfaction, involvement in data collection and decision-making, and low staff nurse turnover rates.

The Magnet Recognition Program for Excellence in Nursing requires hospitals to meet more than 65 standards developed by the ANCC. The standards must be demonstrated in an extensive written document and clarified by a multiple-day site visit.

“Considered the gold standard of nursing care, Magnet status is the most prestigious honor a hospital’s nursing staff can achieve,” said Susan Heath, assistant dean of clinical-nursing practice at the University of Washington, School of Nursing. “Magnet designation affirms that [a hospital’s] nurses are among the best in the country; exceeding professional standards in nursing education, research, leadership and patient care.”

Multiple sources of evidence show that hospitals with Magnet status have improved nurse-to-patient ratios and patient satisfaction is higher than in non-magnet hospitals. Independent research also shows that Magnet hospitals consistently outperform their peers in recruiting and retaining nurses, resulting in increased stability in patient care throughout those hospitals.

Many employer groups enlist the assistance of a health advocacy service to help their employees choose the best medical facilities for their conditions, including finding hospitals with Magnet status.

See you later,
Sue Brown, R.N. and Vice President of Clinical Operations

Is Life Insurance for the Young or Old?

Ah, life insurance. For many, it’s not the most exciting, front-of-mind topic, no matter what age. But it’s an important part of a financial puzzle that most people underbuy and don’t understand.

Who needs insurance? Simply put, if someone depends on you financially, chances are you need life insurance.

Many people believe older people are the only ones who need life insurance. Some may ask, “Who will pay for their funeral expenses and debts? What about the spouse left behind?” However, many retired people have their house paid off, children grown and married with their own families, and enough savings and retirement funds to tide themselves over. But as we know, everyone’s circumstances vary.

Actually, married or single parents with young children are the most in need of life insurance. If a parent died suddenly, could the mortgage be paid or would the house need to be sold? Would college education for the kids quickly be out of the question? What about the ordinary day-to-day expenses of raising a family until the children are grown?

According to National Underwriter magazine, 70 percent of surviving spouses report their spouse’s premature death had a “devastating” or “major” impact on their family’s financial security.

Most single people don’t need life insurance because no one depends on them financially. However, if a single person supports an aging parent, cares for siblings or carries a hefty debt, such as a large college loan, life insurance might be in order.

There are three basic forms of life insurance: whole life, universal life and term life. Certain universal life plans also include long term care insurance. According to research, most people who buy life insurance purchase too little. Ask your life insurance agent which type and amount are best for your needs.

Some employers provide their employees with a health and benefits advocacy service to help them understand life insurance benefits, as well as find resources to address financial and emotional issues when a loved one dies.

Until next time,
Patricia Stern, Director of Advocacy Services