5 Factors that Raise Your Blood GlucoseDiabetes occurs when your body does not make enough insulin or none at all, or when the body cannot use the avail-able insulin well. This results in blood glucose levels are too high. Keeping your blood glucose at a normal level will help keep you healthy. Here are five factors that can raise your blood glucose and what you can do to combat them.

�Stress. Stress hormones can raise your blood glucose. Ex-

ercising regularly can help re-duce stress. Breathing deeply for five to 20 minutes, at least once a day, can help you relax.�Sickness. Even a cold can affect your blood sugar levels. Follow the sick day care plan you and your doctor made. Call your doctor if your blood glucose is not controlled following the plan.�Carbohydrates.�Eating too many carbohydrates raises

blood glucose. Know how many carbs you can eat. Track how many you eat each day to stay within your limit.�Inactivity. Any type of exercise whether it’s walking or dancing can help lower blood glucose. Aim for 30 minutes of exercise five days per week.�Excess�weight.�Being over-weight increases your risk for diabetes, but following

OutlookChoosing a healthier life | Winter 2012

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Metabolic syndrome is a cluster of any three of five risk fac-tors (elevated triglycerides, high blood pressure, high blood sugar, low levels of HDL cholesterol, and increased abdominal fat) that increases the risk for heart disease, stroke, and diabetes. People with this syndrome need to get certain tests and screenings. Please discuss the following topics with your health care provider:❯❯ Measuring your cholesterol and triglyceride levels once a year❯❯ Having your blood pressure checked at every office visit❯❯ Screening for diabetes—you may be tested every three years

if your blood glucose reading is in the normal range, or every year if it is above the normal range❯❯ Reviewing your medicines, exercise, eating, and weight goals

Be�sure�to�also�talk�with�your�health�care�provider�about�these�topics:❯❯ Managing your weight❯❯ Getting help to quit smoking, if you smoke

Good Health Guidelines

Understand�the�Lipid�Profile�TestA lipid profile is a lab test that measures the amount of cer-tain fats and cholesterol in your blood. High lipid levels can lead to a heart attack or cause heart disease to worsen. You should have a lipid profile at least once a year. Your LDL, or “bad,” cholesterol should be lower than 100 mg/dl, and your triglycerides (also “bad”) should be lower than 150 mg/dl. For men, your HDL, or “good,” cholesterol should be 40 mg/dl or higher. For women, it should be 50 mg/dl or higher. Talk with your health care provider about helping you meet these goals. Write down the date of your next lipid profile test in your calendar.

Although these are suggested guidelines for care, please check with your benefits plan for coverage.

A closer look

The information presented in this publication is not intended to be a substitute for medical care or advice provided by a physician. Always consult your physician for appropriate examinations, treatment and care recommendations. If you have any questions about this information, you should call your physician. Specific treatments and therapies may not be covered by your health plan. For questions about your benefits, please consult your health plan. Any reference in this material to other organizations or companies, including their Internet sites, is not an endorsement or warranty of the services, information or products provided by those organizations or companies. All models are used for illustrative purposes only. © 2011 Healthways, Inc.

Your�Health�To-Do�List

When it comes to your health to-do list, be sure two vaccines are on it:

❯ Flu vaccine: Different viruses cause the flu each year. Everyone age 6 months or older should get the vaccine every year starting in September—especially if you have a chronic illness.

❯ Pneumonia vaccine: All adults age 65 and older and anyone age 2 or older with a chronic illness that increases the risk for pneumonia should get the vaccine. Children younger than age 2 should have an age- appropriate pneumonia vaccine.

Not sure what vaccines you need? Call your doctor if you have any questions. Take steps to ensure your vaccines are up to date.

Good QuestioNHeAltH tiP√

Winter 2012

WInTEr 2012 | Healthy Outlook 3

Throw a Snowball! Winterize Your Exercise

It reduces your risk of getting heart disease and diabetes. And it may even help protect you from the sniffles, based on a study in the British Journal of Sports Medicine. The study found that frequent exercisers spent about 40 percent fewer days suffering from upper respi-ratory tract infections, compared to people who rarely exercised.

Work with the cold—not against it—to spice up your ex-ercise routine. Snowshoeing and cross-country skiing offer great aerobic benefits and are easy on your joints. Tossing snowballs, building a snowman, or sliding

downhill on a sled (and then hauling it back uphill again) will get your heart pumping as well.

Snow�Day�TipsWhen the thermometer plunges, a few extra steps can help you stay safe and warm while exer-cising outdoors:❯❯ Do�a�warm-up�first. Your

muscles, ligaments, and tendons are more likely to get injured when cold.❯❯ Dress�in�light�layers.�

That way, you can remove or replace clothing as needed. The innermost layer should be made of breathable fabric

that lets sweat pass through. Avoid tightly woven fabrics or heavy cotton sweats that trap moisture next to your skin. The outer layer should pro-tect you from blustery winds.❯❯ Don’t�forget�your�hat�and�

scarf. Heat is lost from your body from any exposed area. The head and neck are no exception.❯❯ Drink�plenty�of�fluids.

It’s easy to get dehydrated without realizing it in cold weather, so be sure to bring your water bottle.

Move�It�InsideWhen the weather outside is frightful, another option is to move your favorite summer activity inside. Walk at the mall, jog or bike at the gym, swim in an indoor pool, or shoot hoops on an indoor court.

Some activities, such as ten-nis and softball, don’t have exact equivalents. But you can still stay in shape for next summer. Now is the perfect time for that kickbox-ing, yoga, or salsa aerobics class you’ve always wanted to take.

At home, a new fitness toy—such as a Hula-Hoop, stability

Don’t use cold weather as an excuse to stay on the couch until spring. Keeping physically active through the winter helps control your weight, which is crucial for managing metabolic syndrome.

looking for tips on how to stay safe and healthy in cold weather? Sign up to receive the CDC’s Cool Tips of the Week by email or text at emergency.cdc.gov/disasters/winter.

Trying to Lose Weight?Why You May Be Hanging on to Extra Pounds

Have you been struggling to whittle your waistline? Are you eating right and exercising, but not seeing results? If you’ve gained weight despite your best efforts, it may be due to a physical condition, changes in metabolism—even your sleeping habits. The key is to find out where those extra pounds are coming from, and then learn how to shed them for good.

Your basal metabolic rate is the rate at which your body burns calories at rest. Sometimes your metabolism may be slow. And the slower the metabolism, the fewer calories are needed each day to fuel the body, making it easier to gain weight. What are some reasons that your metabo-lism slows down?

Loss�of�Muscle�Mass�People with greater muscle mass have higher metabolic

rates. But as we age, our bodies naturally lose muscle mass. As a result, it’s common to pack on extra pounds over time. So try and increase your strength training. Adults should engage in muscle-building exercises at least twice a week.

Too�Few�CaloriesDiets that drastically cut calo-ries are hard to stick with. Most people give them up quickly and regain the weight they lost. The

body goes into a semi-starvation mode when you eat fewer than 1,200 calories a day. This slows your metabolism and makes you less efficient at burning fat.

Medication�UseSome medicines can slow your metabolism. Others can in-crease your appetite or cause you to hold on to extra water. And all of these side effects can cause weight gain. Some com-mon types of drugs that can

DID�YoU�Know!adults should engage in muscle-building exercises at least twice a week.

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WInTEr 2012 | Healthy Outlook 5

lead to extra pounds include steroids, antidepressants, and seizure medications. Talk with your doctor about all the medi-cations you take and ask about side effects that may be affect-ing your weight.

Hormone�ChangesHormones help regulate how our body functions. They can also affect our ability to control weight. A few issues that may change hormone levels include:❯❯ Too�little�sleep. The less

people sleep, the more likely they are to be overweight. That’s partly because the body releases hormones during sleep that control appetite. To avoid weight gain and reap countless other health ben-efits, aim for seven to eight hours of sleep every night.

❯❯ Too�much�stress.�Long-term stress can lead to obesity. Your body releases hormones when you’re under stress, and too much of certain hormones may cause weight gain.

❯❯ Menopause-related��weight�gain. Studies show that estrogen may help regu-late body weight in women. And as estrogen levels drop during menopause, weight can creep up. Although you can’t avoid this hormone change, you can work to counteract its associated weight gain by eating a low-fat, low-sugar diet and incorporating physical activity into your day.

The�Bottom�LineThere are many reasons you may be putting on weight, and discovering the underlying cause should be your first step.

Men,�Are�You�At�Risk�for�CV?Men with metabolic syndrome are at high risk for erectile dysfunction. recently, researchers in Italy set out to learn why. In a study published in Diabetes Care, these researchers reported that men with both erection problems and metabolic syndrome often had cavernosal vasculopathy (CV). This means the men had diseased blood vessels in a specific area of the penis. Blood flowing into that area is what creates an erection. So poor blood flow there is one cause of erectile dysfunction.

How much do you know about CV? Test your knowledge with the true-or-false quiz below:1. The corpora cavernosa—structures in the penis for which

CV is named—are two round clumps of nerve tissue. ❍❯t ❍❯F

2. When men develop atherosclerosis—a buildup of fatty deposits inside their arteries—the penis is usually affected before the heart is affected. ❍❯t ❍❯F

3. For men with metabolic syndrome, lifestyle changes can improve overall health, but they don’t help with CV. ❍❯t ❍❯F

Answers1. False. The corpora cavernosa are two chambers that run the length of the penis. They are filled with spongy tissue. During an erection, blood flows into spaces within the tissue. This makes the penis expand.2. true. The penis is typically affected by blood vessel disease before the heart, brain, and legs are affected. So erection prob-lems may be an early warning sign. By taking action, men may be able to avoid a heart attack or stroke.3. False. Quitting smoking, losing weight, and exercising more

sPeciAl rePort

6 Healthy Outlook

You hear a lot about how metabolic syndrome increases your chance of having heart disease, stroke, or diabetes. What you might not have heard is that it also raises your risk of developing peripheral artery disease (PAD). This disease involves arteries outside the heart and brain—most often, in the legs. In a study of more than 27,000 women, published in the journal Circulation, those with metabolic syndrome had about a 60 percent higher risk of developing PAD.

Poor�Circulation�in�Your�LegsPAD occurs when fatty deposits build up inside the walls of the arteries. This narrows the blood vessels and restricts blood flow there. Many people with PAD don’t have any symptoms. How-ever, others have symptoms such as:❯❯ Pain, aches, or cramping in the legs or buttocks when walking❯❯ Rest pain, or pain in the legs or feet at night that can be re-

lieved by hanging them over the side of the bed❯❯ Numbness in the legs when active❯❯ Less leg hair or toenail growth❯❯ Slow healing of cuts or sores on the legs or feet❯❯ Skin that is pale, bluish, or cool to the touch❯❯ A weak or absent pulse in the legs or feet

An�ounce�of�PAD�PreventionFortunately, many steps that improve your overall health also help prevent or delay PAD. When you have metabolic syndrome, these steps are especially important:❯❯ Quit�smoking,�if�you’re�a�smoker.�This is the single largest

risk factor for PAD that you can control.❯❯ Get�regular�exercise. Physical activity helps

fight off PAD and cuts down on the problems caused by it.❯❯ work�with�your�doctor. Having high blood pressure, high

cholesterol, or diabetes puts you at a higher risk for PAD. So follow any recommendations your doctor makes to help lower your blood pressure, cholesterol, or blood sugar.

Reduce Your Risk for Peripheral Artery Disease

For free information and advice on quitting smoking, call 800-QUit

noW (800-784-8669).

Blood vessels. These are the tubes in the body through which blood flows. Arteries and veins are types of blood vessels. The arteries take blood from the heart to other areas of your body and veins bring it back to the heart and lungs.

erectile dysfunction (ed). ED is also known as impotence. It means that a man cannot get or keep an erection. ED can be caused by diabetes, high blood pressure, stroke, or many other causes.

Heterocyclic amines (HcAs) and polycyclic aromatic hydrocarbons (PAHs). HCAs and PAHs are chemicals. They are formed when meat, poul-try, or fish is cooked using high temperatures. This includes fry-ing, grilling, or broiling meat. These types of chemicals may cause cancer.

upper respiratory tract infections. This type of infec-tion affects the nose, mouth, sinuses, and throat. You may have a sore throat or cough, and your nose may be con-gested. A common upper respiratory tract infection is a cold, which is caused by a virus.

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WInTEr 2012 | Healthy Outlook 7

You know that you should cut back on fried foods. But do you know why?

A study in the European Journal of Cardiovascular Nursing looked at the eating habits of people with metabolic syndrome who had undergone heart bypass surgery. A diet high in fried food was associated with worse health.

Frying�Up�Health�RisksSeveral factors may affect the health of fried-food lovers. Frying adds extra fat to food. That means additional calories, which can lead to gaining weight.

Some of the fat used for frying, especially in processed foods and restaurant items, is saturated or trans fat. Both these types of fat can raise cholesterol levels. And that, in turn, increases the risk of heart disease and stroke.

Pan-frying at high temperatures also creates certain chemicals—called heterocyclic amines (HCAs) and polycyclic aromatic hydro-carbons (PAHs)—in beef, pork, fish, and poultry. According to the National Cancer Institute, some studies suggest that there may be a link between eating foods containing these chemicals and an in-creased risk for cancer of the colon, pancreas, or prostate. However, more research is needed before any firm conclusions can be drawn.

Making�Healthier�ChoicesTo say good-bye to fried, and opt for lower-fat cooking methods, such as:❯❯ Baking ❯ Roasting❯❯ Stir-frying ❯ Steaming

In restaurants, look for tasty alternatives to your fried favorites. Instead of fried chicken or fish, order grilled. Instead of french fries, choose a baked potato, brown rice, or steamed veggies. Skip-ping fried doesn’t have to mean missing flavor.

Why Is Baked Better than Fried?

Find low-fat recipes from the American Heart Association at www.heart.org/nutrition.

ingredients1 cup fat free sour cream2 tsp dried dill3 Tbsp scallions, finely chopped2 Tbsp Dijon mustard2 Tbsp lemon juice1 ½ lb salmon fillet with skin, cut

in center½ tsp garlic powder½ tsp black pepperAs needed: fat free cooking spray

directions1. Whisk sour cream, dill, onion,

mustard, and lemon juice in small bowl to blend.

2. Preheat oven to 400° F. Lightly oil baking sheet with cooking spray.

3. Place salmon, skin side down, on prepared sheet. Sprinkle with garlic powder and pepper, then spread with the sauce.

4. Bake salmon until just opaque in center, about 20 minutes.

each serving provides: 196 calories, 7 g total fat, 2 g saturated fat, 76 mg cholesterol, 229 mg sodium, less than 1 g fiber, 27 g protein, 5 g carbohydrates

Baked�Salmon�DijonServes 6

PRSRT❯STDU.S.❯Postage

PAIDPermit❯No.❯965Long❯Prairie,❯MN

“ the healthier i ge t, the be t ter i feel.” | Winter 2012

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Bone Up on Vitamin D 83,000

How can you combat that risk? ask your doctor if including vitamin D or increasing the amount of vitamin D you take is right for you.

researchers studied more than 83,000 older adults to review the effect of vita-min D supplementation on fracture risk. they found fracture risk decreased with higher doses of the nutrient.

a weight loss plan can help. Losing just 10 to 15 pounds can lower blood glucose levels.

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ball, hand weights, exercise DVD, or fitness video game—can boost your motivation. So keep moving! Just because it’s winter doesn’t mean you have to hibernate.

are steps that help prevent or treat both metabolic syndrome and CV.