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Monthly Matters:
- GreenField
Health Services
- Vitamin D
Deficiency Increasingly Recognized
- Fitness versus
Weight
- False
Advertising: The Airborne Settlement
- Transformation:
Distribution of Calorie Intake
- Family
Matters: Sun Safety
- Office Notes
GreenField Health’s Health Matters
May 2008
GreenField Health Services
As
we grow, our goal is to provide you with a greater range of personal health
services. Over the past year, we have significantly increased those services
with the addition of the highly skilled Drs. Todd Canon and Dave Hays at our
GreenField Health - NE Broadway practice. Drs. Canon and Hays both come with
fantastic experience in a number of procedures and this has greatly expanded
the services that we offer. Our goal is to continually serve you better in a
high-quality, friendly, and efficient manner.
In
addition to our routine primary care personal health services, the physicians
and staff of GreenField Health provide:
Families & Family Planning
- Vasectomies
- IUD
insertion and removal
- Newborn
circumcision
- Prenatal
consultation to discuss newborn care
- “Friends
and Family” CPR classes
Women’s Health including:
- Routine
gynecologic care
- Colposcopy
for the evaluation of abnormal pap smears
- Endometrial
biopsy for abnormal menstrual bleeding
Joints and Injuries
- Joint
aspiration and injection
- Wound
repair
- Minor
injury splinting and casting
Healthy Weight
Other
- Exercise
stress testing and stress thallium testing to screen for heart disease
- Colon
cancer screening
- Evaluation
and treatment of skin conditions – including removal and treatment of some
skin cancers
Please
let us know if you have any questions about these or other services that you
don’t see listed. It is our goal to continue expanding the services we
provide.
Vitamin D
Deficiency Increasingly Recognized
The
term “vitamin” refers to compounds necessary for proper body metabolism and
functioning that the human body does not produce itself. Thus, vitamins need
to be ingested for good health. Vitamins are contained within the foods that
we consume. Those with good dietary habits generally get all the vitamins
they need from their food. Most people are aware of the FDA’s “Recommended
Daily Allowance” of vitamins. Studies of vitamin replacement with either a
daily multivitamin or other more specific vitamin supplements in normal
individuals with good dietary habits have not been shown to be beneficial to
health.
Vitamin
D refers to the compound or vitamin called calciferol. It is important for
bone health as it helps to regulate calcium and bone metabolism – calcium is
obviously a key component of bones. Vitamin D is necessary for the body to
absorb calcium from the diet appropriately. Vitamin D is present in certain
foods such as milk (which is generally fortified with additional Vitamin D),
fish, and eggs and our bodies also make it in our skin after exposure to
sunlight.
Vitamin
D deficiency can occur due to low dietary intake and/or poor exposure to
sunlight. The elderly who may have poor dietary habits and low sun exposure
are particularly susceptible. For those of us who reside in northern climates
such as Portland, the skin production of Vitamin D is very low between
October and April due to low exposure to sunlight.
Vitamin
D deficiency is most frequently associated with poor bone health – a loss of
bone calcium and the resulting bone weakness. The medical terms we use for
this are osteopenia (low bone calcium levels) and osteoporosis (bone weakness
sufficient to increase the risk of fractures). We reviewed this in our
December 2007 GreenField Health’s Health Matters. https://securemail.greenfieldhealth.com/portal/Health+Matters/Health+Matters+December+2007/default.aspx
What
is just being recognized (although much more research is necessary) is that
vitamin D insufficiency seems to be related to poor muscle function. Some
data suggests that low vitamin D levels increase the risk of infections, high
blood pressure, and inflammatory conditions such as rheumatoid arthritis.
Some intervention trials have demonstrated that supplementation with vitamin
D helps to reduce blood pressure in individuals with hypertension (high blood
pressure), improve blood control in diabetics, and improve symptoms of
rheumatoid arthritis and multiple sclerosis. These studies are all relatively
preliminary, but the increasing recognition of vitamin D deficiency will
undoubtedly greatly increase our understanding.
So
what should you do now? Although we could start routinely testing vitamin D
levels, this is not recommended and would be expensive. The current
recommendation is that adults should consume at least 800 International Units
(IU) of vitamin D per day. Doses higher than 2000 IU per day can be toxic and
harmful. Vitamin D is generally included in most multivitamins as well as
some calcium supplements, frequently in the range of about 400 IU/day.
Because
we do live in the north, and because so many people lack sunlight exposure in
the winter months, we recommend that people consider taking a multivitamin
containing vitamin D on a daily basis. We do not believe that normal adults
need to take higher doses of vitamin D.
Those
with osteopenia, osteoporosis, or those at risk of these conditions due to
family history should make sure that they get 800-1000 IU of Vitamin D daily.
Fitness versus Weight
While
few people really desire to be overweight, and while we frequently promote
exercise, dietary control, and weight management in these pages of Health
Matters, we also realize how hard it is for some people to lose weight. It is
not our intent to make anyone feel guilty, and this piece will help allay
some of that guilt.
While
we do believe in weight management, we believe more strongly in overall
physical fitness – good medical studies suggest fitness itself is highly
related to health. This should provide some relief for those who really work
on fitness but still find themselves overweight. While the general goal of
dietary control and weight management are important, fitness is critical
irrespective of one’s weight, and for those who work on being fit but still
find it hard to lose weight, we don’t want you feeling guilty – in fact, you
should feel quite positively about your level of fitness.
A
nice study published recently in the Journal of the American Medical
Association adds to this evidence. They studied individuals 60 and older and
found that fitness was a better predictor of mortality (death rates) than was
weight. In the study, they measured fitness using a standard exercise
treadmill test and measured adiposity (the degree of body fat) by measuring
the Body Mass Index (BMI), waist circumference and body fat percentage.
Fitness trumped body fat as a predictor of mortality.
The
message here is an important one – everyone should focus on fitness as well
as healthy dietary habits, irrespective of their weight or BMI. Regular
physical activity is very important for health and that means exercising at
least 30 minutes (try to do 60) on most days of the week. We know that people
are busy, but there are plenty of extremely busy people who manage to
exercise on a daily basis. For those who are challenged with fitness and
weight management, we do recommend our physician supervised weight management
program: Transformation at GreenField Health.
False Advertising: The Airborne Settlement
The
degree of false advertising for “healthcare supplements” is literally quite
stunning. If you stand in a grocery story check out line, not only are you
assaulted by offensive magazines that push sexuality and various absurd
claims, but you are also assaulted by a variety of healthcare supplements
that claim to provide a vast number of benefits. The maker and marketers of
the supplement “Airborne” for instance have claimed for years that it will
help prevent you from getting a cold, make colds get better faster (to “cure
it”), and that it will boost your immune system overall.
The
only problem with Airborne is that when it has been studied, it hasn’t been
shown to do any of those things. This is called false advertising, and humans
seem particularly susceptible to such tactics as evidenced by the fact that
people spend billions of dollars each year for such dubious and ineffective
products. When standing in the grocery store check out line or when reading
the packaging or advertising for such supplements, we urge you to be very
suspicious and please don’t believe everything you read, whether it is on the
cover of the National Enquirer or the box of Airborne.
For
Airborne, a class action lawsuit over false advertisement will result in the
makers of Airborne refunding $23.3 million to those who bought the product.
The company will also pay for ads in magazines and newspapers instructing
consumers how to get refunds. Created by a second-grade teacher Victoria
McDowell and husband Thomas McDowell, a screenwriter, Airborne claimed to
“boost your immune system to help your body combat germs” and instructed
users to “take it at the first sign of a cold symptom or before entering
crowded, potentially germ-infested environments.” Ms. McDowell also appeared
on the Oprah Winfrey Show, another source of highly reliable scientific
information.
Airborne
provides a variety of products and its basic formula contains vitamins A, C,
and E, various nutrients common in multivitamins, the amino acids glutamine
and lysine, and an “herbal extract proprietary blend.” Airborne may in fact
provide too much vitamin A since two pills contain 10,000 IU which is the
maximum safe level for a day while the package instructs users to take three
per day.
In
a review of Airborne, a scientist from the Center for Science in the Public
Interest (www.cspinet.org) stated that
there’s “…no credible evidence that what’s in Airborne can prevent colds or
protect you from a germy environment. Airborne is basically an overpriced,
run-of-the-mill vitamin pill that’s been cleverly, but deceptively,
marketed.”
For
those who would like a refund for purchases of Airborne, a claim form can be
obtained by calling the Airborne Class Action Settlement Administrator at
1-888-952-9080 or via www.AirborneHealthSettlement.com.
Unfortunately,
the Airborne situation is not unique. Despite this lawsuit, false advertising
will continue in abundance, duping uninformed consumers with false claims.
For example, Airborne along with a vast array of other supplements claim to
“boost the immune system” whereas there is no credible science that they do
so.
Our
advice is to avoid these supplements. The best approach to overall health and
a strong immune system is to eat healthy foods and exercise regularly. It is
fine to take a regular daily multivitamin (particularly in the winter months
in order to get the sufficient amount of vitamin D as noted above) although
there is little scientific evidence that people actually benefit from them
and so called “mega vitamins” should be avoided.
Transformation: Distribution of Calorie
Intake
The Transformation program at
GreenField Health is a lifestyle and weight management program. There have
been scores of participants over the three years of its existence and
their experience has led to the development of “The Seventeen Habits of Successful
Weight- Appropriate People.” Each month in Health Matters, we have been
sharing one of these habits with you and discussing its benefits.
This month, the thing to pay attention to is the
distribution of calorie intake during the day. The goal is to shift the
majority of calorie intake to the early and middle parts of the day, which
results in having your lunch as the largest meal of the day. This way, our
calorie intake more closely matches our calorie expenditure for the day. Most
of us have the habit of having our evening meal as the largest of that day.
It can be challenging with our busy lives to shift that habit, but it can be
a gradual shift. You might want to set the goal that six months from now,
your evening calorie intake will be decreased to two-thirds of its current
level. Once you are there, you can re-assess and see if further calorie
shifting might be of benefit. Remember that we are not cutting total daily
calories with this exercise, just shifting the timing of when we eat them.
Try it and see what you think!
Family Matters: Sun
Safety
(Adapted from AAFP)
It’s
that time of year again in the Northwest when we get to enjoy some sunshine,
and that’s a good thing. Not only is a sunny day a pretty sight, but we
all actually need some sun exposure. It’s the main way we make Vitamin
D as noted above, and Vitamin D is important for healthy bones among other
health benefits.
At
the same time, though, we also need to protect ourselves from the sun.
Too much sun can cause skin damage, eye damage and even cancer. As
about 50-80% of total lifetime sun exposure comes before age 18, it’s
important for adults and children to follow some simple guidelines.
First,
a basic explanation of the three main types of ultraviolet rays in
sunlight:
- UVA rays cause
skin aging and wrinkling and contribute to skin cancer. They make
up the majority of our sun exposure. Tanning beds have UVA rays,
and a UVA tan does not protect you from additional skin damage.
- UVB rays cause
sunburns, cataracts and immune system damage and they contribute to skin
cancer. Most UVB rays are absorbed in the ozone layer but some
still pass through to us.
- UVC rays are the
most damaging but are all absorbed by the ozone layer and don’t reach
the surface of the earth.
Unprotected
sun exposure is unhealthy for all of us but is most dangerous for people with
any of the following characteristics:
- Many moles on the skin (or family members with moles)
- Very fair skin and hair
- Family members with skin cancer (including melanoma)
However,
everybody needs sun protection – even people with darker skin.
There
are many ways to protect you and your family from the sun.
Avoid
the strongest rays. Some situations and locations require extra sun
protection. The sun is stronger at higher altitudes and closer to the
equator so extra sun protection is needed in these areas. Rays are also
stronger near water or snow. Finally, rays are strongest in the summer
and when the sun is highest in the sky (from 10:00 a.m. to 4:00 p.m.)
Cover
up. Wear clothing that blocks out the sun. You shouldn’t be
able to see your hand through clothing. This is especially important
for infants who have thinner skin and because sunscreen is generally not
recommended for infants under six months. You can also cover up using
an umbrella or a tent.
Use
sunscreen. The variety of sunscreens offered is a bit
overwhelming. For you and your family the most important thing to look
for is the SPF (Sun Protection Factor). The higher the SPF, the longer
you can stay in the sun without burning. Choose a sunscreen with SPF 15
or higher. Make sure the sunscreen protects against both UVA and
UVB. Choose a waterproof sunscreen if your plans include swimming
or heavy sweating. Check the ingredients, especially if you are one of
the many people who are allergic to the sunscreen ingredient PABA.
Apply
sunscreen correctly. Use it whenever you or your child will be in
the sun. Apply it in a thick layer about 30 minutes before going into
the sun. Make sure you cover every square inch of skin that may be
exposed. Reapply the sunscreen generously every 2 - 3 hours at a
minimum. Reapply after sweating or swimming.
Use
protective eyewear. Prolonged sun exposure can lead to burns of the
eyes (cornea) and over time can result in cataracts. Purchase sunglasses for
you and your children that have 100% UV protection. Sunglasses without
this label may not protect against UV damage. Try letting your children
choose their own sunglasses: they may be more likely to wear
them.
Next
month we’ll review how to treat a sunburn.
Office Notes
The
offices will be closed on Monday, May 26 in observation of the Memorial Day
holiday. As usual, one of our physicians will be on call and available
to you for urgent and emergent needs.
As
the days get longer and the sun makes more appearances, we hope you’ll
remember the sunscreen, and enjoy the late days of Spring!
Sincerely,
Your
GreenField Team
Amanda
Clark, MA, your Health Coordinator (email)
Angie Ashburn, CMA, your Health Coordinator (email)
Beth Davis, your Benefits Coordinator and Biller (email)
Chuck Kilo, MD (email)
Cindy King, your Benefits Coordinator and Biller (email)
Connie Turner, MA, your Health Coordinator (email)
Cynthia Ferrier, MD (email)
Dana Lee, MA, your Clinical Supervisor (email)
David Hays, MD (email)
David Shute, MD (email)
Desi Lowder, CMA, your Health Coordinator (email)
Elizabeth Hays, MD (email)
Eric Murray, MD (email)
Jill Arena, your COO (email)
Joel Swartzmiller, your IT Manager (email)
Justine Stephens, MA, your Health Coordinator (email)
Kristin Walker, your Program and Executive Assistant (email)
Lea Robinson, your Administrative Assistant (email)
Maria Soutavong, MA, your Health Coordinator (email)
Meena Mital, MD (email)
Pam Mockenhaupt, CMA, your Health Coordinator and Biller (email)
Paula Koeller, MD (email)
Samantha Charles, your Clinic Administrator (email)
Todd Canon, MD, (email)
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GreenField
Health System
9427 SW Barnes Road, Suite 590
Portland, OR 97225
Phone: 503.292.9560
Fax: 503.292.9510
Web: http://www.GreenFieldHealth.com
questions,
concerns, comments always appreciated:
questions@GreenFieldHealth.com
© 2003-2008 GreenField Health
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