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THE FACTS ABOUT THE FLU SHOT

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CAN YOU SPOT SEASONAL AFFECTIVE DISORDER?

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WARM, HEALTHY WINTER STEW

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BOOST Your Asthma Awareness!Steps to help you keep asthma in checkPAGE 5

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QUICK TIP: It’s tempting to cut blood pressure pills in half when you lose weight or toss them in the trash. don’t. Always take your medication as prescribed. don’t stop taking it without talking to your doctor first.

HEALTH BY THE NUMBERS22.3 million Number of people living with type 1 and 2 diabetes.

$245 billion Cost of diagnosed diabetes in America.

41% Cost increase since 2007.

1 in 5 Health care dollars spent in the u.S. to care for people with diabetes.

$7,900 Per-person cost of medical care for diabetes.

1 in 3 People who don’t know they have type 2 diabetes.

10 to 14 Number of pounds a 200-pound person, if overweight, could lose to lower his or her risk of developing type 2 diabetes.

FAST FOOD: Still Not a Good ChoiceWhen you see giant posters in fast food windows listing calorie counts for hamburgers and fried chicken, you have to wonder if fast food is getting any healthier. Not a chance. Public health resear-chers studied menus from eight fast food chains for the past 14 years and found that the nutritional quality hasn’t changed much. In fact, nutritional scores measuring milk/dairy and sodium got worse. But you can choose healthier options including salads with dressings on the side, mayonnaise-free sandwiches and grilled options without sauces. Avoid options that are breaded, battered, crispy or creamy, all code words for high-fat items.

WASH UPIt's the simplest way to stop germs.There’s a lot you can’t control when it comes to catching a cold or the flu: who’s in your subway car, the grocery line or your kid’s classroom. But you can control the most effective flu-stopper: How often you wash your hands. Here’s how to do it to stop the spread of cold and flu germs: Soap up not only your palms and fingers but also between your fingers, around your cuticles, on the back of your hands and your wrists. While lathering, clean under your nails by gently scratching them on the opposite palm. Turn rings to make sure you’re clean-ing under them, too. The whole process should take about 20 seconds, or the time it takes to sing “Happy Birthday” twice.

exercise Works at Any Age

Istart exercising? You don’t have to be 18 to start exercising and reap the benefits. An American Heart Association study followed nearly 10,000 adults with an average age of 48 and tracked them for 18 years. Those who improved their fitness levels reduced their risk of heart failure after age 65. The fitter they were, the more they cut their risk. For instance, jogging a 10-minute mile instead of a 12-minute mile cuts a 40-year-old’s heart failure risk almost in half. Start with 30 minutes of exercise a day. Take a stroll to grab a cup of coffee after work. Walking is an easy way to get active. All you need are a good

Follow these tips for lowering your blood pressure before you have to turn to medication.

- Lose extra pounds:The more weight you carry, the harder your heart has to work. dropping 10 pounds can make a difference and make your favorite jeans fit better.

- exercise regularly:Being active for 30 to 60 minutes daily—even for 10 minutes at a time—can lower your blood pressure. For instance, you can save time, and avoid train delays and traffic, by walking a few minutes extra to a more direct train or bus route.

4 Steps to lower Blood Pressure

- Follow a healthy diet:eat whole grains, fruits, vegetables, legumes and low-fat dairy. limit foods high in salt, saturated fats, cholesterol, alcohol and caffeine. Be careful when ordering salads from restaurants, and request toppings that are fresh instead of pickled or canned.

- Stop smoking:Nicotine increases your blood pressure for up to an hour after you use tobacco. And it’s not just health: the money you spend on cigarettes could be used for a vacation, a move from your studio apartment or early retirement. MetroPlus offers pro-grams to help you stop smoking. Call our Case management department to learn more at 1-800-303-9626.

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WASH UPIt's the simplest way to stop germs.There’s a lot you can’t control when it comes to catching a cold or the flu: who’s in your subway car, the grocery line or your kid’s classroom. But you can control the most effective flu-stopper: How often you wash your hands. Here’s how to do it to stop the spread of cold and flu germs: Soap up not only your palms and fingers but also between your fingers, around your cuticles, on the back of your hands and your wrists. While lathering, clean under your nails by gently scratching them on the opposite palm. Turn rings to make sure you’re clean-ing under them, too. The whole process should take about 20 seconds, or the time it takes to sing “Happy Birthday” twice.

exercise Works at Any Age

It’s never too late to start a fitness program. The benefits are significant, whether you’re 19 or 49.do you think you’re too old to

start exercising? You don’t have to be 18 to start exercising and reap the benefits. An American Heart Association study followed nearly 10,000 adults with an average age of 48 and tracked them for 18 years. Those who improved their fitness levels reduced their risk of heart failure after age 65. The fitter they were, the more they cut their risk. For instance, jogging a 10-minute mile instead of a 12-minute mile cuts a 40-year-old’s heart failure risk almost in half. Start with 30 minutes of exercise a day. Take a stroll to grab a cup of coffee after work. Walking is an easy way to get active. All you need are a good

pair of shoes and a safe place to walk. City parks offer a break from city scenery and smooth trails. By starting with a little bit of walking each day, you can work up to longer walks or even running, and every step you take can help to improve your health.

A SAd PatternCan you spot the signs of seasonal affective disorder (Sad)? Symptoms can include:

- daytime fatigue- oversleeping- Weight gain- lack of energy- Hopelessness- loss of interest in normal

activities and socialization

Sad is more than feeling sad about colder weather. People with Sad get depressed when daylight shortens in the fall and winter, and they feel better when there are more daylight hours in the spring. Symptoms can range from craving carbohydrates to suicidal thoughts. But treatments are available if you see your doctor. They might include antidepressant medication and light boxes, providing the illusion of longer periods of daylight.

Those with a personal or family history of depression or Sad are at greater risk. MetroPlus offers programs to help you manage Sad. Just call metroPlus Case Management at 1-800-303-9626.

eat whole grains, fruits, vegetables,

foods high in salt, saturated fats, cholesterol, alcohol and caffeine. Be careful when ordering salads from restaurants, and request toppings that are fresh instead of pickled or canned.

Nicotine increases your blood pressure for up to an hour after you use tobacco. And it’s not just health: the money you spend on cigarettes could be used for a vacation, a move from your studio apartment or early retirement. MetroPlus offers pro-grams to help you stop smoking. Call

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Flu Shot Fact SheetNot sure whether you should get the flu shot this year?

Consider these facts:

- The flu vaccine won’t cause the flu. The flu shot contains the dead virus. The nasal spray vaccine does contain the live virus—so pregnant women shouldn’t use it—but it’s in a weakened form, and the parts of the virus that make people ill are removed.

- The flu isn’t treatable with antibiotics. It’s a virus, not bacteria.

- The flu vaccine is helpful for all age groups. Everyone 6 months and older should get the vaccine. Among high-risk groups, the vaccine is the best chance to prevent sometimes deadly flu complications.

- There is a chance you may still get the flu, but it will not be as severe or last as long.

It’s not too late to be vaccinated. Flu season lasts until spring.

Flu FIgHTErS

Don’t let the flu take down your family this year! Get your flu vaccine and follow these common-

sense tips for staying well.In 2012, the flu season hit early—

and hard. The Centers for disease Control and Prevention (CdC) reported that the number of people with the flu this past fall was 26 times more than the previous year. There were over 20,000 cases nationally between Sept. 30 and dec. 31, 2012, from just under 850 cases during the same period in 2011. Hard-hit cities and states declared public health emergencies, and around the country patients overloaded hospitals.

For most people, the flu is more inconvenient than deadly. But flu-related complications like pneumonia can be serious in high-risk groups: children younger than 5, adults older than 65, pregnant women and people with chronic conditions such as asthma, diabetes or heart or lung disease. Flu complications can result in hospitalization or even death.

Your best protection against the flu is to get the flu shot—each and every year. The vaccine changes each year to protect against the three flu strains expected to dominate that particular season.

The CdC recommends the vaccine for everyone ages 6 months and older. It is available as a nasal spray or a shot. The shot comes in a high-dose version for seniors and an intradermal (into the skin) version using a smaller needle.

Take precautions to avoid getting sick. Wash your hands well and often, using soap and water or an alcohol-based hand sanitizer. To prevent the spread of germs, regularly disinfect doorknobs, keyboards and anything else your hands touch often, and don’t touch your mouth, eyes and nose. Since New Yorkers are always on the go, carry portable hand sanitizing wipes or bottles for when you’re on the subway or after touching grocery carts or baskets.

Avoid close contact with people who are sick. Adults can be contagious for up to seven days of the illness. Children with the flu can pass it on for even longer.

Stay healthy this winter. Get the flu vaccine as soon as it becomes available in the fall, since it takes about two weeks to become effective. Contact your doctor and make an appointment for your flu shot today. or go to nyc.gov/hhc to find a flu shot location near you.

W hile you can’t cure asthma, you can control it. From limiting your exposure

to triggers, to knowing how to use your medication effectively, you can manage your asthma.

Asthma is a chronic respiratory condition. or flare-up, your airways begin to close, you start to cough and wheeze, and you have difficulty breathing.

Since most of the triggers for asthma attacks are airborne, keeping track of air quality is important for people with asthma and their families. of the culprits are ozone pollution and car exhaust. Inside, pet dander, dust mites, cigarette smoke, mold—even cockroaches and household chemicals can cause problems.

Asthma has no cure, but you can manage it. triggers reduces the chance of flare-ups. Keep on top of Air Quality Index ratings in weather reports. When an alert is in effect, try to limit outdoor activities, particularly anything requiring heavy exertion. smoking indoors and keep the house

Boost Your aa

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Testing, testing…Stay ahead of COPD by getting tested.Early chronic obstructive pulmonary disease (COPD) symptoms can be barely noticeable. But COPD is a very serious disease that can result in complications over time, such as blockage of the pathways that carry air in and out of your lungs. However, with early detection, your doctor can offer ways to manage COPD. Detecting the disease early will prevent you from confusing COPD with other illnesses with similar symptoms. Coughing and shortness of breath—two main signs of COPD—are found in many other conditions including asthma, bronchitis and various lung diseases.

How can you find out if you have COPD? Take a spirometry test. A simple spirometry test can help determine whether you have COPD. You’ll be asked to exhale fast and forcefully into a tube connected to the spi-rometer, which measures lung function. Spirometry can detect COPD before symptoms show up.

C recommends the vaccine

W hile you can’t cure asthma, you can control it. From limiting your exposure

to triggers, to knowing how to use your medication effectively, you can manage your asthma.

Asthma is a chronic respiratory condition. during an asthma attack, or flare-up, your airways begin to close, you start to cough and wheeze, and you have difficulty breathing.

Since most of the triggers for asthma attacks are airborne, keeping track of air quality is important for people with asthma and their families. outdoors, some of the culprits are ozone pollution and car exhaust. Inside, pet dander, dust mites, cigarette smoke, mold —even cockroaches and household chemicals can cause problems.

Asthma has no cure, but you can manage it. limiting your exposure to triggers reduces the chance of flare-ups. Keep on top of Air Quality Index ratings in weather reports. When an alert is in effect, try to limit outdoor activities, particularly anything requiring heavy exertion. don’t allow smoking indoors and keep the house

well ventilated using filters, fans and air conditioning. Vacuum and wipe down surfaces often.

You can also help control your asthma through the proper use of medications, most commonly some combination of long-term and quick-relief drugs. long-term medications, known as controllers or preventers, are the most important type of medication for people with asthma. Taken daily, these drugs can help reduce the airway inflammation that can lead to asthma symptoms and flare-ups.

Quick-relief medications, also called rescuers, are for use during an attack. These rapidly relax and open your airways so you can breathe. Although you may need to use a rescuer before physical activity to prevent exercise-induced asthma, you should not be using them on a daily basis. If you are, let your doctor know that you are overly reliant on rescuer medication. Your asthma action plan should be adjusted so flare-ups are better controlled.

MetroPlus has programs that can help you manage your asthma. To find out more, call MetroPlus Case Management at 1-800-303-9626.

Boost Your asthma awareness

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His and Hers HealtH

While his and hers towels are nice, his and hers preventive care can lead to longer,

healthier lives together. Both men and women should talk to their

doctors about the diseases they're at risk for based on their age, gender and overall health. adults should consider the following screenings recommended by the U.S. Preventive Services task Force. and be sure to

always ask your doctors if you need additional tests, especially if you are pregnant or a smoker, or have heart disease in your family. Your doctor may recommend other tests based on your personal and family history.

Women men

Blood Pressure screening

all adults; every two years if blood pressure is under 120/80 mm Hg; every year with sys-tolic blood pressure of 120 to 139 mm Hg or diastolic blood pressure of 80 to 90 mm Hg.

all adults; every two years if blood pressure is under 120/80 mm Hg; every year with sys-tolic blood pressure of 120 to 139 mm Hg or diastolic blood pressure of 80 to 90 mm Hg.

cervical cancer screening

Pap test every 3 years between ages 21 to 29. Between ages 30 and 65, get a pap test every 3 years or a pap and HPV test every 5 years.

not needed.

annual checkuPs all adults. all adults.

screenings for sexually transmitted diseases

all sexually active adults, at least once per lifetime.

all sexually active adults, at least once per lifetime.

testing for colorectal cancer

age 50 and up; time frames range from annually to every 10 years.

age 50 and up; time frames range from annually to every 10 years.

cholesterol testing via a liPid Panel Blood test

age 35 and up, with heart disease, family history of heart disease, or other risk factors such as obesity. time needed between tests varies, so ask your doctor.

age 35 and up, with heart disease, family history of heart disease, or other risk factors such as obesity. time needed between tests varies, so ask your doctor.

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This season, make a resolution to control the calories before the holiday party invitations are delivered. These tips can help you stay ahead of temptation:

1 Set GoalS Make a resolution before the season begins—not after—to control your weight. Stay active or ramp up workouts to account for additional

calories. Bring a calorie journal with you or use a smart phone app to track what and how much you’re eating.

2 BrinG Your own If you’re going to a family gathering or party, bring a dish you can eat on a diet. It’s so hard to resist holiday treats, especially

family favorites, but if you bring your healthful versions, that are baked instead of fried or use more whole grains, they can fill you up with more nutritious and less caloric treats. Just be prepared to share!

3 Be PrePared Don’t go to a party hungry; eat a low-fat yogurt or snack bar beforehand to reduce overeating later. High-fiber foods such as apples can

also help to curb hunger. At buffets and cocktail parties, choose hors d’oeuvres wisely, opting for veggies or fruit over fried foods, pastries, cheeses and cured meats. And remember that alcohol is a prime source of empty calories.

4 enjoY the PeoPle The holidays are about being with family and friends. If you focus on connecting with other people as the main goal of the party,

you may enjoy it even more. A great way to change focus is to think about something you’ve always wanted to know about each person and create a conversation around that. For instance, you can ask about the history of a family picture you’ve always been curious about.

5 Get MovinG Find outdoor activities to do after parties. During the holidays, New York City has some of the most fantastic outdoor activities of

any city on the planet. For instance, you can make an activity out of the Macy’s Thanksgiving Day Parade. Don’t settle for the first spot you find. Check out a few places along the route. You’ll get a better view and burn a few calories walking around. When you’re done, visit the Christmas tree in Rockefeller Center and do some ice skating. If you decide to calorie splurge on a hot cocoa while walking around, remember to also pick up fruit from a cart or one of the many delis.

always ask your doctors if you need additional tests, especially if you are pregnant or a smoker, or have heart disease in your family. Your doctor may recommend other tests based on your personal and family history.

All adults; every two years if blood pressure is under 120/80 mm Hg; every year with sys-tolic blood pressure of 120 to 139 mm Hg or diastolic blood pressure of 80 to 90 mm Hg.

All adults; every two years if blood pressure is under 120/80 mm Hg; every year with sys-tolic blood pressure of 120 to 139 mm Hg or diastolic blood pressure of 80 to 90 mm Hg.

Stay one Step Ahead of weight Gain

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Something to Stew Over

C old salads are the last thing you want in chilly New York City winters, but that doesn’t mean it's time to give up on vegetables. There are plenty of ways to make produce as comforting and as warm as a cup of hot

chocolate. A hearty stew is a simple and healthy way to load up on veggies during the colder months. You can find plenty of root vegetables at New York City farmers markets. Canned tomatoes are also a great winter warming vegetable. This heart-healthy recipe uses plenty of vegetables and some spicy cayenne pepper, for a dish that will keep you warm, fit and well fed.

Winter Vegetable Stew IngredIents- 1 cup onion, cut into 1/2 inch wedges- 1 sweet potato- 2 carrots- 1 winter squash (about 1 pound), such

as butternut, banana or hubbard- 3 to 4 parsnips- 2 garlic cloves- 1 red bell pepper- 2 cups low-sodium broth

(vegetable or chicken)- 1 cup pureed tomatoes- 2 tablespoons lime juice- 1/4 teaspoon cayenne pepper- 1 10-ounce package frozen peas- 1/4 teaspoon salt- 1/8 teaspoon black pepper- 1 bunch cilantro, rinsed, or thinly

sliced green onions

CookIng InstruCtIons- Peel the sweet potato, carrots,

squash and parsnips; cut into 3/4 inch pieces. Peel and mince garlic. Rinse bell pepper; stem, seed and cut into 1/2 inch strips.

- Cook the onions, sweet potato, carrots, squash, parsnips, garlic and 1 cup of broth in a covered pan for 10 minutes, stirring occasionally. Add a few tablespoons of water if the mix-ture begins sticking to pan. After 10 minutes, add 1 more cup of broth, along with the bell pepper, tomato sauce, lime juice and cayenne to taste.

- Bring to a boil, and then reduce heat. Simmer, covered, until the vegetables are tender when pierced, about 12 to 15 minutes.

- If stew sticks to pan or gets thicker than desired, add more broth as needed.

- Add peas and stir occasionally until hot, about 2 minutes. Add salt and pepper to taste.

- Ladle into soup bowls, and garnish with cilantro or sliced green onions.

nutrItIonal InformatIon per servIng: 150 calories, 2 g total fat, 7 g protein, 31 g carbohydrates, 0 mg cholesterol, 390 mg sodium, and 7 g dietary fiber.

Published by McMurry/TMG, LLC. © 2013. All rights reserved. No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not take the place of—the recommendations of your health care provider. Consult your physician before making major changes in your lifestyle or health care regimen. McMurry/TMG makes no endorsements or warranties regarding any of the products and services included in this publication or its articles.

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