(ARA) – Paul T. Meagher sometimes gets disapproving stares when people see him sprinkle his food with salt as he has done since he was a young lad growing up in Ireland. He has a response for such people.
“I tell them you can take my blood pressure right now, or we can have a run around the block, and I guarantee you I’m in better shape than you,” said Meagher, 68, who now lives in Westport, Mass. “I’m fit, at least for my age, and I use salt every day in volume. Hasn’t done me a blind bit of harm, which is the way we put it from where I come from.”
Recent research quantifies Meagher’s experience. In 2011, half a dozen medical studies showed the health benefits of salt or revealed the significant risks of low-sodium diets — providing vindication for this essential nutrient and the people, like Meagher, who love it.
“The vindication of salt is probably the biggest health and nutrition story of the last year,” says Lori Roman, president of the Salt Institute. “Everyone knows salt tastes good, but the latest research published in leading medical journals confirms that salt is good for you, too. The medical studies underline what we have been saying for years: science is on salt’s side.”
The new data raises questions about the federal government’s effort to put Americans on a low-salt diet. The Food and Drug Administration is inviting online public comments about ways to reduce sodium consumption. In the past, such invitations have foreshadowed the rollout of new regulations.
The six peer-reviewed medical studies documented:
Type 1 Diabetes risk: In a study of patients with type 1 diabetes, low sodium intake was associated with renal disease and premature death.
Type 2 Diabetes risk: In an Australian study of type 2 diabetes patients, lower sodium was associated with increased risk of death from cardiovascular disease.
No benefit to salt reduction: A study published in the American Journal of Hypertension showed eating less salt will not prevent heart attacks, strokes or early death. On the contrary, low-sodium diets increase the likelihood of premature death.
Risk of death: A study published in the Journal of the American Medical Association concluded that lower salt intakes resulted in higher death rates.
Other negative effects of low-salt intakes: An analysis published in the American Journal of Hypertension showed individuals placed on the U.S. Dietary Guidelines-recommended salt levels experienced significant increases in cholesterol and other risk factors for diabetes and cardiovascular disease.
Risk with current U.S. Dietary Guidelines: An analysis published in the Journal of the American Medical Association showed that people who ate salt at the levels recommended by the U.S. government were at greater risk of cardiovascular events.
The research has prompted new scrutiny of the government’s attempts to put all Americans on a low-salt diet. Scientific American reviewed medical studies over several decades and concluded in a headline: “It’s time to end the war on salt.” The respected magazine also said, “The zealous drive by politicians to limit our salt intake has little basis in science.”
Meagher remembers when the federal government told him eggs could be bad for his health. He ignored that advice, too.
“I would rather the federal government stay well away from my kitchen altogether,” Meagher says. “I will continue to eat my boiled eggs from an egg cup, with an egg spoon, and with plenty of salt.”

Please note date change

Trying to lose those holiday pounds? Join Renee DeFrang, Registered Dietitian, for a weekly weigh-in followed by a 10-minute motivational talk on weight loss and a 10-minute group walk. The cost for the program is $30.  The program will be held on Wednesdays starting January 18 through February 29, 2012 from 4 to 4:30 p.m. at Greenville High School, Room 534, 111 Hillcrest, Greenville. (Park in the lot off of Yellow Jacket Drive and use the back entrance.) Registration is required. For more information, call 616.754.6185, ext. 100 or 800.406.4551.

The Circle of Care Network will be promoting Elder Law awareness with free educational Elder Law Solutions Panel Discussions throughout the New Year. Our January presentation will be held at the Cascade Winery on Jan. 31st from 5:30-7:00pm. This event will be held at the Cascade Winery’s private tasting room and includes hors d’oeuvres, desserts, and wine tasting. It’s all at no cost, but you must RSVP due to space limitations. There will be prizes and a free estate plan giveaway.
The Circle of Care Network is a consortium of local West Michigan professional organizations dedicated to educating, preparing, and assisting families with life’s transitions. Through free seminars and presentations we provide information and resources to make life’s transitions go as smoothly as possible. Our expert partners include Elder Law attorneys, Certified Public Accountants, Certified Financial Planners, healthcare council, and representatives from the banking field. Topics include:
•    Estate Planning Documents
•    Tapping into Government Benefits
•    Social Security Disability
•    VA Aid & Attendance
•    Protecting your Family Assets
•    Medicare/Medicaid Planning
•    Caregiver Contracts
•    Estate Law Changes
•    Tax Strategies for Today’s Seniors
•    Trust Management
For more information or to RSVP contact Jeremy M. Johnson at 616-458-3994 or email: jjohnson@pmalawpc.com.

A Healthy, Happy 2012!

By James N. Martin, Jr, MD
President, The American Congress of Obstetricians and Gynecologists

The beginning of a new year is a great time to get your priorities in order and to set goals for the next 365 days.  ACOG urges women to put health at the top of their 2010 to-do lists. Remember these healthy living tips:
Eat Healthier. Aim to eat a balanced diet rich in a wide variety of colorful fruits and vegetables, whole grains, lowfat dairy, and lean protein. According to the US Department of Agriculture, a 35-year-old woman who gets 30–60 minutes of exercise per day should eat a 2,000 calorie daily diet consisting of 6 ounces of grains (at least half from whole grains), 2 ½ cups of vegetables, 2 cups of fruit, 3 cups of low/nonfat milk or milk products, and 5 ½ ounces of lean meat, fish, and beans. Additionally, cut back on sodium, fats, processed sugar, and refined grains.
Get Active. Regular physical activity helps increase overall well-being while lowering the risk of diabetes, osteo-porosis, some cancers, and other illnesses caused by inactivity. Aim for at least 30 minutes of exercise on most days of the week to lower the risk of chronic disease; 60 minutes on most days to maintain weight; and at least 60 to 90 minutes on most days to lose weight. A well-rounded exercise regimen should be fun, sustainable, and include cardiovascular, strength training, and flexibility components.
Quit Smoking. Despite the numerous dangers of smoking—increased risk of heart disease, infertility, early meno-pause, and more than 10 different cancers, to name a few—one in five American women still smoke. Quitters gain an improved sense of taste and smell, better circulation, easier breathing, and less hoarseness. They also reduce their risk of heart attack by 50% within a year of quitting.
Drink in Moderation. Alcohol has been linked to both positive effects such as improvements in heart health and bone density, and negative ones including an increased risk of breast and other cancers. If you drink, try to keep it to less than one alcoholic beverage a day.
Get Some Rest. Your body repairs and regenerates tissue, builds bone and muscle, and strengthens its immunity while you sleep. Not getting enough sleep may cause short-term problems such as irritability and memory loss and long-term conditions including diabetes and heart disease. The average adult should aim to get seven to nine hours of sleep each night.
Visit Your Ob-Gyn. Women should see their doctor regularly for preventive care. Routine visits to the ob-gyn help ensure women receive age appropriate screenings, exams, and immunizations, and they allow physicians to identify and treat common problems before serious health risks develop.
For more information, ACOG Patient Education Fact Sheets are available at http://acog.org/For_Patients.aspx.

Life Line Screening will hold a stroke screening on Tuesday, January 3, 2012, at Solon Center Wesleyan Church, 15671 Algoma, Cedar Springs (just north of 19 Mile). Preregistration required. Call 1-800-364-0457. For more info, see the insert in this week’s paper.

American Heart Association offers lifesaving tips to get through the season

As many of us hope for a white Christmas, keep in mind the snow and cold winter months can be very hard on people with potential heart problems and people with existing heart problems. Some studies even suggest that harsh winter weather may increase a person’s risk of heart attack due to overexertion. Therefore, the American Heart Association is sharing some safe winter weather tips for your heart.
This winter, while you’re outdoors in the cold weather, be aware that your heart is working harder. If you’re not accustomed to physical activity, you should avoid sudden exertion, like lifting a heavy shovel full of snow. Even walking through heavy, wet snow or snowdrifts can strain a person’s heart.
To help make snow removal safer, the American Heart Association suggests:
*Give yourself a break. Take frequent rest breaks during shoveling so you don’t overstress your heart. Pay attention to how your body feels during those breaks.
*Don’t eat a heavy meal prior or soon after shoveling. Eating a large meal can put an extra load on your heart.
*Use a small shovel or consider a snow thrower. The act of lifting heavy snow can raise blood pressure acutely during the lift. It is safer to lift smaller amounts more times, than to lug a few huge shovelfuls of snow. When possible, simply push the snow.
*Learn the heart attack warning signs and listen to your body, but remember this: Even if you’re not sure it’s a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Don’t wait more than five minutes to call 9-1-1
*Don’t drink alcoholic beverages before or immediately after shoveling. Alcohol may increase a person’s sensation of warmth and may cause them to underestimate the extra strain their body is under in the cold.
*Consult a doctor. If you have a medical condition, don’t exercise on a regular basis or are middle aged or older, meet with your doctor prior to the first anticipated snowfall.
*Be aware of the dangers of hypothermia. Heart failure causes most deaths in hypothermia. To prevent hypothermia, dress in layers of warm clothing, which traps air between layers forming a protective insulation. Wear a hat because much of your body’s heat can be lost through your head.
Wind Chill
Besides cold temperatures and snow, we know we’ll have high winds to cope with also.  Wind is especially dangerous, because it removes the layer of heated air from around your body.  At 30 degrees Fahrenheit in a 30-mile wind, the cooling effect is equal to 15 degrees Fahrenheit.
To keep warm, wear layers of clothing. This traps air between layers, forming a protective insulation. Also, wear a hat or head scarf. Heat can be lost through your head. And ears are especially prone to frostbite. Keep your hands and feet warm, too, as they tend to lose heat rapidly.
Alcohol
Don’t drink alcoholic beverages before going outdoors or when outside. Alcohol gives an initial feeling of warmth, because blood vessels in the skin expand.  Heat is then drawn away from the body’s vital organs.
Heart Attack Warning Signs
Some heart attacks are sudden and intense — the “movie heart attack,” where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:
*Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
*Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
*Shortness of breath with or without chest discomfort.
*Other signs may include breaking out in a cold sweat, nausea or lightheadedness
As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea or vomiting, and back or jaw pain.
Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. EMS staff is also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. It is best to call EMS for rapid transport to the emergency room. If you can’t access EMS, have someone drive you to the hospital right away.
For more information, visit your physician or call the American Heart Association at 800-AHA-USA1 or visit online at www.heart.org.

From the Kent County Health Department

Women who are pregnant or just joined motherhood have a new, powerful tool, right at their fingertips: text4baby. This texting service is free, and will help expectant and new moms through their baby’s first year.
The National Healthy Mothers, Healthy Babies Coalition (HMHB) launched text4baby. Text4baby is available to pregnant women and new moms from pregnancy through a baby’s first year.
Michigan’s infant mortality rates have increased in recent years, and the state currently ranks 37th in the U.S. “Kent County Health Department is glad that the Michigan Department of Community Health is working hard to fight infant mortality,” says Cathy Raevsky, Administrative Health Officer of KCHD.  “Together, we can inform mothers and give babies a healthy start. The information provided to mothers in these texts could make a difference in the lives of children in Kent County.”
Women can sign up by visiting www.text4baby.org or text BABY to 511411 (or BEBE for Spanish). The service sends three free SMS text messages each week, timed to the baby’s due date or date of birth. Messages include information about birth defects prevention, immunization, nutrition, oral health, safe sleep, and more.
This service has been successful in California, where more than 75 percent of moms surveyed said they learned of a medical warning that they did not previously know, and more than 70 percent talked to their doctor about information they learned over text4baby.  The service gives accurate health information and resources in a format that is personal and timely, and can reach a large population: more than 85% of Americans own a cell phone and 72% of cell users send or receive text messages.
Text4baby is made possible through a broad, public-private partnership that includes government, corporations, academic institutions, professional associations, non-profit organizations, and more.

A new plan to assess and treat patients who go to the hospital emergency more than 10 times a year could save millions of dollars in costs, as well as free up the emergency room.
Spectrum Health announced the formation of a multi-specialty clinic to assess and treat high-frequency patients at area emergency departments (EDs). The Spectrum Health Medical Group Center for Integrative Medicine began seeing patients December 5, and will employ a novel approach to assess the issues facing chronic ED users.
The Center will employ enhanced medical management, aggressive social services and intensive psychiatric evaluation and treatment. The Center’s mission is to help these patients integrate into primary care and other traditional outpatient medical settings as opposed to seeking care in EDs.
The Center is a response to an issue identified by emergency and addiction medicine specialist R. Corey Waller, MD, MS, in 2008. During that year, approximately 950 patients were identified as visiting Butterworth and Blodgett hospital EDs greater than 10 times. These patients were responsible for more than 20,000 total visits and 40-50 million dollars in costs.
These patients were mainly young, healthy people with hard to diagnose conditions, psychiatric illness, chronic pain and/or addiction as their major medical issues. A pilot study of 30 of these patients completed in 2008 showed an 85 percent decrease in ED visits and close to one million dollars in savings.
The central goal of the Center is to identify, accurately diagnose, and develop a care plan for each patient. When treatment is stable and the patient has successfully followed up with a primary care physician, the patient will be transferred into a primary care office.
This approach will result in better patient care, improved ED operations, and will help hospitals by reducing unreimbursed care in a higher-cost setting. It is estimated that the program could save commercial insurers plus Medicare and Medicaid more than $15 million in Spectrum Health ED reimbursements during the first year of operation.
“This model of care is a win for patients, providers and insurers,” said Waller, who will serve as medical director of the Center. “We’re dealing with patients who need an in-depth care plan and a continuum of care that can’t be delivered efficiently in an ED setting. It can also free up space in the ED and allow them to deliver care more efficiently. In addition, insurers are paying for primary care for these patients instead of more expensive emergency care.”
People visiting EDs more than 10 times a year will be identified as potential patients for the Center. New Center patients undergo a series of in-depth evaluations through multiple visits. The visits include a:
*Full history and physical by a physician trained to care for these patients
*Mental health evaluation by a mental health professional
*Comprehensive addiction screening and planning
*Comprehensive medical social work–case management evaluation and intervention
The team will develop a care manual for each patient. Patients will be seen for a three to six month period to monitor how well they follow the plan. After success completion of this period, patients will be discharged to a permanent medical home under the care of a primary care physician.
For the first few months, the Center will be evaluating identified high-frequency visitors from Butterworth and Blodgett hospital EDs, then will accept referrals from other hospitals. Meanwhile, Waller will meet with ED directors from local hospitals to discuss high-frequency patients visiting multiple EDs who would benefit from being seen sooner.
The Center will employ approximately seven people and be located at a Spectrum Health owned building at 75 Sheldon, SE.  Staff from Network180 will provide behavioral health assessments and treatment plans.
“Many of the persons who are frequent users of emergency services are already involved with Network180. This project will improve the health of these patients, in a comprehensive way, by partnering with Dr. Waller and Spectrum Health to integrate our behavioral health services with this clinic,” said Mark Witte, planning director of Network 180.
“We’re always looking for ways to deliver health care more effectively and efficiently and the Center is an excellent example of that approach,” said Matt Van Vranken, executive vice president, Spectrum Health Delivery System. “Getting these patients into a clinic designed for their needs with follow up care by a primary care provider is the best way to serve these patients. Hospitals also benefit since care provided in an ED setting can be more expensive and those costs are not fully reimbursed through Medicaid and Medicare.”
Another benefit of this program is getting hard-to-place people into primary care settings, Waller said. “About 54 percent of this population are Medicaid patients and about 16 percent are Medicare patients. It’s historically been hard to get primary care physicians to accept these patients—partly because they have complex medical issues. Because of the Center, every one of these patients going to a primary care practice has a full diagnosis and care plan prepared. This approach doesn’t overly stress primary care groups’ resources. It lets physicians focus on working the plan with patients.”
Waller says the benefits of this approach are not limited to Grand Rapids patients, hospitals and insurers. “The Center’s approach could easily be replicated in other communities throughout Michigan. The pilot program showed we can reduce ED visits among this population by up to 85 percent. I estimate that Medicare and Medicaid could expect a savings of $12-15 million in charges from Spectrum Health patients alone, which mean $8 million would be saved in one year through Michigan’s Medicaid program. This could mean an estimated one-year savings of $150-250 million in actual state Medicaid expenditures for these patients if this clinical model was copied throughout the state. This estimation is based on the assumption that ED visits would decrease by 50 percent, like they did in our pilot program.”

Children rank tops in state – Vaccinations are currently available

Have you received your vaccination against the flu yet? Mid-season estimates released today by the Michigan Department of Community Health suggest that Kent County residents are doing very well in getting children vaccinated this year.  Children in Kent County have the best flu vaccination rate in the state: 30% under 18 have received their vaccinations.  Here’s a look at where Kent County children stand:
6 months through 4 years      44.4%    Second highest in state   (Ottawa Co. – 46.3%)
5-12 years of age     30.9%    Third highest in state (Marquette County – 33.7%)
13-18 years of age    16.7%    Highest in state

While influenza activity for the 2011-12 flu season is just starting to be diagnosed, now is an ideal time to vaccinate. “You should note that the vaccination can take about two weeks to become effective,” says Cathy Raevsky, Administrative Health Officer for the Kent County Health Department. “Flu vaccines for children and adults are safe, and we have plenty of injection and nasal mist available right now.” Kent County adults rank 8th in the state for flu vaccinations at 13 percent.
The Centers for Disease Control and Prevention say last year’s flu season led to 115 laboratory-confirmed influenza-associated pediatric deaths. Six were Michigan children. More than half (51.2 percent) of Michigan children 6 months through 4 years were vaccinated against influenza last flu season; that ranks our state 45th in the nation. The national flu vaccine average level for children in that age group was 63.6 percent.
Signs and symptoms of flu include fever (or feeling feverish/chills), cough and/or sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue (very tired), vomiting and diarrhea (more common in children than adults).  Not everyone with flu will have a fever, or experience all of the symptoms.
Be sure to check out the Kent County Health Department website, “Stick it to the Flu” at http://www.stickittotheflu.com/ to learn more about flu vaccinations, prevention tips and treatment, or call (616) 632-7200 to make an appointment.

By Mary Anne Meyers

Much of our holiday cheer comes during celebrations with friends and family around the table. If a loved one or friend has been diagnosed with an illness such as cancer, however, that meal may pose problems because of treatment side effects. Registered dietician Sharlene Bidini says planning ahead of time can help. For example, she suggests that the host ask the guest in treatment about the best day for the celebration.
“Often, if they’re receiving chemotherapy, say on a Tuesday, they have a pattern of feeling bad Wednesday, Thursday, Friday. But maybe they might rebound and feel good on the weekend.” Bidini, who counsels cancer patients at the Oakwood Cancer Center, Dearborn, says it’s best to ask the person questions like this first, because many times only small adjustments need to be made so that everyone can enjoy the meal and a memorable holiday.
Some treatments cause a sore mouth or throat, so something cool and creamy can provide comfort, she says.“Instead of hot, crispy cherry pie right out of the oven, they might prefer pumpkin pie with whipped cream right out of the refrigerator.”
Some people might need something as simple as the croutons or tomatoes left out of their salad, or a side dish may have to be changed, Bidini says.
In general, the main dish is usually not a problem, she adds. “Whatever you choose—turkey, ham, chicken, fish—whatever your primary protein is, that’s excellent for healing.”
Bidini understands that a diagnosis of cancer can be stressful for a family, but she says by asking such questions and doing a little research, attention can return to what’s really important: “Creating memories, having fun holiday times together, not focusing in so much on how much they are eating or not eating, but just relaxing and enjoying each other’s company.” For tips on coping with cancer during the holidays and holiday recipes go to www.cancer.org.