Wednesday, January 19, 2011

Be a Smart Health Care Consumer

For the first time since people traded chickens for house calls, Americans are focusing on how they use and pay for their health care.



No matter what you think about health care reform – love it, hate it, couldn't care less – one thing is certain. It has brought to light the fact that health care has never worked like other businesses.
Think about buying a car. We spend weeks thinking about which car to buy. Then we do research, and go on test drives. We go online to check quality and safety measures. We ask friends and family for advice about what to buy and what to avoid. We compare prices at local dealerships and online to look for the best deals. After all of that, we buy a car.
But when our family doctor says, "You need surgery," we wait to be pointed in the right direction. We should ask:
  • which hospital has the best results?
  • what surgeon is the best at this procedure?
  • how much of the cost will my health plan cover and how much will I pay?
Armed with information, you can review your choices and make wise decisions.
Being a smart health care consumer means looking at health care as a business. It's in your best interest to be informed about the quality and costs of what you're buying, just like any other purchase you make. Why?
Greater awareness can help you:
  • find high quality care
  • stay safe
  • reduce your costs
If any of those sounds good to you, read on.

Monday, January 17, 2011

Brussels Sprouts Salad


You can make this salad any way you wish. We have made this with aged cheddar cheese, Manchego, and hard goat cheese. Try pecans or pine nuts or almonds. You’ll be wanting to eat your sprouts. No kidding.
24 Brussels sprouts, washed and dried, woody ends cut off
8 ounces Gruyere cheese, grated fine
6 ounces walnuts, broken into small pieces
3 tablespoons apple cider vinegar
9 tablespoons extra-virgin olive oil
2 teaspoons Dijon mustard 
kosher salt and cracked black pepper
Slice the Brussels sprouts thin on the slicing disc of the food processor. (If you don’t have a food processor, you can use a mandoline, carefully, or a sharp knife.)
Put the sprouts in a large bowl. Add the cheese and walnuts.
Put the apple cider vinegar, olive oil, and mustard into a small jar, along with the salt and pepper. Put on the lid and shake that jar until the vinaigrette has come together.
Dress the salad with the vinaigrette. Toss and serve.
Feeds 8.

Wednesday, January 12, 2011

New Year's resolutions? Brain can sabotage success

WASHINGTON –

Uh-oh, the new year's just begun and already you're finding it hard to keep those resolutions to junk the junk food, get off the couch or kick smoking. There's a biological reason a lot of our bad habits are so hard to break — they get wired into our brains.
That's not an excuse to give up. Understanding how unhealthy behaviors become ingrained has scientists learning some tricks that may help good habits replace the bad.
"Why are bad habits stronger? You're fighting against the power of an immediate reward," says Dr. Nora Volkow, director of the National Institute on Drug Abuse and an authority on the brain's pleasure pathway.
It's the fudge vs. broccoli choice: Chocolate's yum factor tends to beat out the knowledge that sticking with veggies brings an eventual reward of lost pounds.
"We all as creatures are hard-wired that way, to give greater value to an immediate reward as opposed to something that's delayed," Volkow says.
Just how that bit of happiness turns into a habit involves a pleasure-sensing chemical named dopamine. It conditions the brain to want that reward again and again — reinforcing the connection each time — especially when it gets the right cue from your environment.
People tend to overestimate their ability to resist temptations around them, thus undermining attempts to shed bad habits, says experimental psychologist Loran Nordgren, an assistant professor at Northwestern University's Kellogg School of Management.
"People have this self-control hubris, this belief they can handle more than they can," says Nordgren, who studies the tug-of-war between willpower and temptation.
In one experiment, he measured whether heavy smokers could watch a film that romanticizes the habit — called "Coffee and Cigarettes" — without taking a puff. Upping the ante, they'd be paid according to their level of temptation: Could they hold an unlit cigarette while watching? Keep the pack on the table? Or did they need to leave the pack in another room?
Smokers who'd predicted they could resist a lot of temptation tended to hold the unlit cigarette — and were more likely to light up than those who knew better than to hang onto the pack, says Nordgren. He now is beginning to study how recovering drug addicts deal with real-world temptations.
But temptation can be more insidious than how close at hand the cigarettes are.
Always snack in front of your favorite TV show? A dopamine-rich part of the brain named the striatum memorizes rituals and routines that are linked to getting a particular reward, explains NIDA's Volkow. Eventually, those environmental cues trigger the striatum to make some behaviors almost automatic.
Even scientists who recognize it can fall prey.
"I don't like popcorn. But every time I go to the cinema, I have to eat it," Volkow says. "It's fascinating."
Much of what scientists know about dopamine's role in habit formation comes from the study of alcohol and drug addiction, but it's a key player in more common habits, too, especially overeating.
In fact, for anything that links an action and a reward, "dopamine is indispensable for the formation of these habits," Volkow says.
A movement to pay people for behavior changes may exploit that connection, as some companies offer employees outright payments or insurance rebates for adopting better habits.
It's not clear yet just how well a financial incentive substitutes as a reward. In one experiment, paying smokers at General Electric up to $750 to kick the habit nearly tripled the number who did, says Dr. Kevin Volpp, who directs the Center for Health Incentives at the University of Pennsylvania.
A similar study that dangled dollars for weight loss found no difference — and environmental temptation might help explain the differing results.
It's getting hard to smoke in public but "every time you walk down the street, there's lots of sources of high-calorie, tasty, low-cost food," Volpp says.
However paying for behavior plays out, researchers say there are some steps that may help counter your brain's hold on bad habits:
_Repeat, repeat, repeat the new behavior — the same routine at the same time of day. Resolved to exercise? Doing it at the same time of the morning, rather than fitting it in haphazardly, makes the striatum recognize the habit so eventually, "if you don't do it, you feel awful," says Volkow the neuroscientist, who's also a passionate runner.
_Exercise itself raises dopamine levels, so eventually your brain will get a feel-good hit even if your muscles protest.
_Reward yourself with something you really desire, Volkow stresses. You exercised all week? Stuck to your diet? Buy a book, a great pair of jeans, or try a fancy restaurant — safer perhaps than a box of cookies because the price inhibits the quantity.
_Stress can reactivate the bad-habit circuitry. "You see people immediately eating in the airport when their flight is canceled," Volkow points out.
_And cut out the rituals linked to your bad habits. No eating in front of the TV, ever.
"What you want to be thinking about is, `What is it in my environment that is triggering this behavior?'" says Nordgren. "You have to guard yourself against it."
___
EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

Monday, January 10, 2011

Caribbean Seafood Stew

2 lbs of  raw seafood (I used 1 lb of wild caught shrimp and 1 lb of mahi mahi pieces, both from Trader Joe’s)
1 yellow onion, diced
5 cloves garlic, minced
2 tablespoons cumin
1 bunch cilantro
3 tomatoes, chopped
1 can coconut milk
1 tbsp coconut oil
Sea salt and black pepper to taste.
Dice up the stems of the cilantro bunch and set aside. In a large soup pot saute the onions in the coconut oil.  When the onions start to turn brown, add the garlic and the cilantro stems and saute for another 2-3 onions.  Add the tomatoes, cumin, salt and pepper, mix well and cook for another 2-3 minutes.  Add the coconut milk and bring to a simmer. Add the seafood and cook for another 3-5 minutes or until the seafood is done.  Serve with the cilantro leaves on top as a garnish.
Enjoy!

Friday, January 7, 2011

The Incredible Flying Nonagenarian




On the third floor of the Montreal Chest Institute, at McGill University, Olga Kotelko stood before a treadmill in the center of a stuffy room that was filling up with people who had come just for her. They were there to run physical tests, or to extract blood from her earlobe, or just to observe and take notes. Kotelko removed her glasses. She wore white New Balance sneakers and black running tights, and over her silver hair, a plastic crown that held in place a breathing tube.
Patrik Giardino for The New York Times
STRENGTH Kotelko holds the world indoor shot-put record for women 90 and over.

Olga Kotelko’s Record:16.1 ft.
High-School Record, Women’s: 54 ft.
World Record, Women’s: 74.3 ft.
Patrik Giardino for The New York Times
AGILITY She holds two world records in javelin for women over 85.

Olga Kotelko’s Record: 41 ft
High-School Record, Women’s:176.5 ft.
World Record, Women’s: 237 ft.
Tanja Taivassalo, a 40-year-old muscle physiologist, adjusted the fit of Kotelko’s stretch-vest. It was wired with electrodes to measure changes in cardiac output — a gauge of the power of her heart. Taivassalo first met Kotelko at last year’s world outdoor masters track championships in Lahti, Finland, the pinnacle of the competitive season for older tracksters. Taivassalo went to watch her dad compete in the marathon. But she could hardly fail to notice the 91-year-old Canadian, bespandexed and elfin, who was knocking off world record after world record.
Masters competitions usually begin at 35 years, and include many in their 60s, 70s and 80s (and a few, like Kotelko, in their 90s, and one or two over 100). Of the thousands who descended on Lahti, hundreds were older than 75. And the one getting all the attention was Kotelko. She is considered one of the world’s greatest athletes, holding 23 world records, 17 in her current age category, 90 to 95.
“We have in masters track ‘hard’ records and ‘soft’ records,” says Ken Stone, editor of masterstrack.com — the main news source of the growing masters athletic circuit. “Soft records are like low-hanging fruit,” where there are so few competitors, you’re immortalized just for showing up. But Stone doesn’t consider Kotelko’s records soft, because her performances are remarkable in their own right. At last fall’s Lahti championship, Kotelko threw a javelin more than 20 feet farther than her nearest age-group rival. At the World Masters Games in Sydney, Kotelko’s time in the 100 meters — 23.95 seconds — was faster than that of some finalists in the 80-to-84-year category, two brackets down. World Masters Athletics, the governing body of masters track, uses “age-graded” tables developed by statisticians to create a kind of standard score, expressed as a percentage, for any athletic feat. The world record for any given event would theoretically be assigned 100 percent. But a number of Kotelko’s marks — in shot put, high jump, 100-meter dash — top 100 percent. (Because there are so few competitors over 90, age-graded scores are still guesswork.)
In Lahti, watching Kotelko run fast enough that the wind blew her hair back a bit, Taivassalo was awed on a personal level (she’s a runner) and tantalized on a professional one. She hoped to start a database of athletes over 85, testing various physiological parameters.
Scientifically, this is mostly virgin ground. The cohort of people 85 and older — the fastest-growing segment of the population, as it happens — is increasingly being studied for longevity clues. But so far the focus has mostly been on their lives: the foods they eat, the air they breathe, the social networks they maintain and, in a few recently published studies, their genomes. Data on the long-term effects of exercise is only just starting to trickle in, as the children of the fitness revolution of the ’70s grow old.
Though the world of masters track offers a compelling research pool, Taivassalo may seem like an unlikely scientist to be involved. Her area of expertise is mitochondrial research; she examines what happens to the body when mitochondria, the cell’s power plants, are faulty. Her subjects are typically young people who come into the lab with neuromuscular disorders that are only going to get worse. (Because muscle cells require so much energy, they’re hit hard when mitochondria go down.) Some researchers now see aging itself as a kind of mitochondrial disease. Defective mitochondria appear as we get older, and these researchers say that they rob us of endurance, strength and function. There’s evidence that for young patients with mitochondrial disease, exercise is a potent tool, slowing the symptoms. If that’s true, then exercise could also potentially be a kind of elixir of youth, combating the ravages of aging far more than we thought.

Tuesday, January 4, 2011

Wondering what to wear?


Here's a great tool to use when you're not quite sure what you should be wearing for a workout.  It asks you about the temp, weather conditions and your preference-cool, in-between, or warm.

Runner's World-What to Wear

Monday, January 3, 2011

Falafel with Avocado Spread


Yield: 4 servings (serving size: 1 stuffed pita half)

Ingredients

  • Patties:
  • 1  (15-ounce) can pinto beans, rinsed and drained
  • 1/2  cup  (2 ounces) shredded Monterey Jack cheese
  • 1/4  cup  finely crushed baked tortilla chips (about 3/4 ounce)
  • 2  tablespoons  finely chopped green onions
  • 1  tablespoon  finely chopped cilantro
  • 1/8  teaspoon  ground cumin
  • 1  large egg white
  • 1 1/2  teaspoons  canola oil
  • Spread:
  • 1/4  cup  mashed peeled avocado
  • 2  tablespoons  finely chopped tomato
  • 1  tablespoon  finely chopped red onion
  • 2  tablespoons  fat-free sour cream
  • 1  teaspoon  fresh lime juice
  • 1/8  teaspoon  salt
  • Remaining ingredients:
  • 2  (6-inch) pitas, each cut in half crosswise
  • 4  thin red onion slices, separated into rings
  • Microgreens

Falafel with Avocado Spread
Preparation

To prepare patties, place pinto beans in a medium bowl; partially mash with a fork. Add cheese and next 5 ingredients (through egg white); stir until well combined. Shape bean mixture into 4 (1/2-inch-thick) oval patties.
Heat oil in a large nonstick skillet over medium-high heat. Add patties to pan; cook 3 minutes on each side or until patties are browned and thoroughly heated.
To prepare spread, combine avocado and next 5 ingredients (through salt), stirring well. Place 1 patty in each pita half. Spread about 2 tablespoons avocado spread over patty in each pita half; top with onions and greens.

Nutritional Information

Calories:
281 (30% from fat)
Fat:
9.5g (sat 3.4g,mono 3.9g,poly 1.5g)
Protein:
12.2g
Carbohydrate:
37.4g
Fiber:
5.9g
Cholesterol:
13mg
Iron:
2.4mg
Sodium:
625mg
Calcium:
188mg

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