Some homeowners spend needlessly when it comes to taking care of their homes. Here are the most common home maintenance money wasters...
HIGH-END PAINT...
Repainting is one of the most common home maintenance jobs. And since time and labor — not the paint itself — are the major expenses, many consumers select high-end paints.
Overspending on paint does not necessarily improve the quality or life of a paint job.
An expensive paint might spatter or drip less — but for most of us, that's not enough to justify paying as much as $40 a gallon, rather than $20 or less.
I'm a big fan of store brands, such as Ace Hardware's. I would certainly think twice before buying any paint selling for more than $20 a gallon.
When repainting the exterior: Certain mistakes mean the whole job will have to be redone, biggest problems.
Scraping off loose paint, then failing to coat exposed wood with oil-based primer before repainting.
Painting when the temperature is below 50°F.
DECK REPLACEMENT...
I get many calls from homeowners who want to replace decks that are showing their age. At a typical price of $10 to $12 per square foot, installing a new deck can easily cost $1,500 to $3,500.
To make an older deck look great for another 10 years or more, pull out the nails on the flooring and turn over the boards. The wood's underside is rarely as weathered as the top. Have it pressure-washed, sanded and water-treated.
Since nails pull out of wood over time, consider replacing them with deck screws. This is easy with a cordless drill. Best screws are square-drive deck screws one inch longer than the thickness of the deck board.
NEW FIXTURES...
Repairing or reconditioning bathroom and kitchen fixtures is far cheaper than simply replacing them.
For example: Cast-iron tubs eventually chip or fade — or simply no longer match a redesigned bathroom. Most homeowners replace them with modern fiberglass tubs.
A cast-iron tub was most likely installed before the wall-boards went in — so walls must be torn apart to remove it. The new tub might cost $300—but the cost of removing the old one and installing the new one could easily tack another $1,500 onto the bill.
Better idea: Recoat a cast-iron tub through a process called refinishing. Your local plumbing store should be able to recommend someone to do this for you. Cost: About $300.
Another example: Leaky faucets are among the most common kitchen and bathroom problems. A new faucet might solve the problem—but it's likely to cost more than $100, and it may not match the room and the original unit.
Better: Take the leaky valve cartridge to a local plumbing store. Chances are a 59-cent washer will do the job. If not, the plumbing store should be able to replace the whole valve for $8 to $12.
Refurbishing also can be better for kitchens. It costs $8,000 to $30,000 to redo a typical kitchen. But you can refinish cabinets and replace the countertop and the sink for less than $5,000.
If you have solid wood kitchen cabinets, refinishing might be the only way to avoid taking a step down in craftsmanship. Few modern companies make solid wood cabinets. Check with a local hardware store or a trusted contractor for cabinet-resurfacing recommendations.
RELYING ON WARRANTIES...
Warranties are only as good as the companies behind them.
I'm embarrassed to say that this is a mistake I made a number of years back. I was replacing the thermal pane windows on the second floor of my house, and I decided to use a lesser-known brand. I felt safe because the windows came with a long-term warranty.
Seven years later, the windows began fogging up—the most common form of failure with thermal pane windows. When I tried to use my warranty, I found the company was out of business.
Stick with well-known companies. Most established companies have 10-year warranties and supplies to service older windows at a fraction of the cost to replace them.
Roof shingles are another place where people pay extra for long warranties of questionable value. Most roof shingles come with a 25-year warranty. But you can pay up to double to get shingles with a 40-year warranty. Unfortunately, in most climates, you are unlikely to get more than 25 years on any asphalt or fiberglass shingle.
OVER CLEANING...
Some people take their desire for cleanliness too far and damage their homes. Over cleaning leads to premature aging of components.
For example: Over scrubbing sinks and tubs with abrasive cleansers is a sure way to wear off the finish.
Better: Head to a plumbing store—or a well-stocked home-improvement store—for a bathroom-fixture coating such as Gel Gloss. This provides a protective coating for both fiberglass and ceramics that lasts six to eight weeks. Water spots can be easily removed with a soft cloth.
Another example: Over cleaning carpets. Steam cleaning more than twice a year damages the carpet. If that doesn't provide enough cleaning for you, consider putting inexpensive throw rugs over high-traffic areas.
Also: When replacing carpeting, few homeowners pay attention to the padding underneath. But a poor-quality pad can contribute as much to reducing the life of the carpet as the quality of the carpet itself. I recommend a minimum of six pounds rebound padding—eight pounds is better and should add only $75 to $150 to any job.
HIGH ENERGY BILLS...
Everyone complains about high heating bills, yet few homeowners take the simple home maintenance steps necessary to reduce them.
Mistake: Not putting in enough attic insulation. More heat is lost through inadequate roof insulation than through any other part of the home. Adding attic insulation is an inexpensive and easy job. A professional can blow insulation into ceiling areas for $250 to $750.
Important: Without proper venting, you could get ice damming or attic moisture leading to wood rot. Hardware stores sell Styrofoam baffles that can be slid down into the eaves near where the roof meets the attic floor to ensure the necessary air flow.
Mistake n: Using a furnace made before 1980. Old furnaces were only 67% efficient at best—one-third of the fuel they burned was wasted. Modern furnaces are 90% efficient. A new furnace costs $1,500 to $5,000—but with current energy prices, it is money well spent.
source: Bill Keith, owner of Tri-Star Remodeling in St. John, Indiana, and a 16-year contracting veteran. He is host of the cable-TV program The Home Tips Show, broadcast in the upper Midwest, and has a free remodeling answer service through www.billkeith.com
Saturday, February 28, 2009
Wednesday, February 25, 2009
Protect Your Eyes Against Macular Degeneration
Until recently, there was no way to prevent age-related macular degeneration (ARMD) or halt the disease's gradual—but nevertheless persistent — deterioration of the eye's light-sensitive retina.
Good news: The most current research confirms that a healthful diet and prudent lifestyle choices can reduce your risk of developing ARMD. What's more, new treatments are highly effective at minimizing vision loss in the early stages of the disorder.
WHO'S AT RISK?...
ARMD affects one in three Americans over age 65. In its mildest form, the condition results in blurred vision and difficulty reading. But it can quickly progress to a more advanced form that causes blindness.
The disorder affects the macula, the region of the retina that's responsible for "central vision." This enables us to read, recognize faces, drive and perform other activities that require sharp vision.
Most cases of macular degeneration begin with the formation of drusen — tiny yellow deposits that grow just behind the macula.
Known as "dry" ARMD, this condition can persist for years, usually causing only minor vision problems.
Unfortunately, one in 10 of those who are diagnosed with dry ARMD go on to develop "wet" ARMD. This form occurs when blood vessels under the retina leak fluid and form scar tissue, damaging or distorting the smooth surface of the retina. Wet ARMD can rob a person of central vision.
RISK-REDUCTION STRATEGIES...
Researchers have now identified several factors that contribute to macular degeneration. To curb your risk for this disorder...
Give up smoking. Studies show that smoking is the most significant risk factor for ARMD.
Minimize your exposure to sunlight. Wear sunglasses with amber-colored lenses that block blue-violet light and 100% of UVA and UVB rays. They can be purchased at any good eyeglass store.
Follow a heart-healthy regimen. The same factors that increase heart disease risk — especially high blood pressure and high cholesterol intake — heighten your risk for ARMD.
To protect your heart and eyes: Cut back on saturated fat...get regular exercise...and have your blood pressure checked at least once a year.
Eat plenty of leafy green vegetables. Spinach, collard greens and kale contain the carotenoids lutein and zeaxanthin, which are believed to help fight ARMD. Eat at least five one-cup servings of these vegetables each week.
EARLY DETECTION...
For anyone over age 55, the best defense against ARMD is an annual eye exam by an ophthalmologist. If a parent or sibling has ARMD, have annual eye exams beginning at age 40.
See an ophthalmologist immediately if printed text appears blurry...straight edges of doorways or windows appear wavy...or if a dark —or blank— spot obstructs the center of your vision.
During the eye exam, your doctor will use a handheld lighted instrument (ophthalmoscope) to check for drusen. Fluid under the retina can be a sign of wet ARMD, which requires treatment and evaluation from an ophthalmologist who specializes in disorders of the retina.*
Your doctor should also test your eyesight using an Amsler grid, a chart with lines that resemble graph paper. If lines appear wavy when you focus on a dot in the center of the grid, you may have wet ARMD.
*To find a retinal specialist in your area, contact the American Academy of Ophthalmology at 415-561-8500, www.aao.org.
TREATMENTS...
A number of treatments are now available to reduce the blood vessel damage associated with wet ARMD...
Laser therapy is an effective way to stop the progression of ARMD. During this 30-minute outpatient procedure, a high-powered laser seals off the leaky blood vessel.
Laser therapy is recommended if the blood vessel is clearly visible and located to the side of the retina. This allows the ophthalmologist to control any vision loss that can result from tissue damage caused by the laser therapy.
Photodynamic therapy (PDT), a promising new form of laser therapy that uses a photo-sensitive dye, is available at many teaching hospitals. It causes less tissue damage than traditional laser therapy. For this reason, PDT is the preferred treatment. However, it must be repeated every few months.
For a list of medical centers that perform PDT, go to the Novartis Ophthalmics website at www.visudyne.com/aboutv/centers.html
Clinical trials are also being held to determine the effectiveness of other new treatments.
Submacular surgery removes the blood vessel through a hole in the side of the retina. This procedure is being tested on patients whose damaged blood vessel is located in the center of the retina, which diminishes the success of laser surgery.
Transpupillary thermo-therapy uses a low-temperature laser, which limits damage to the retina and surrounding tissue.
Radiation therapy uses a beam of electromagnetic energy to destroy leaky blood vessels in much the same way that radiation is used to treat cancer. However, results from current trials have not shown a large benefit from radiation therapy.
Antiangiogenesis drugs block the proteins that are critical to the formation of blood vessels that lead to ARMD.
For more information on clinical trials, contact the National Eye Institute, 301-496-5248, www.nei.nih.gov
source: Robert D'Amato, MD, PhD, associate professor of ophthalmology at Harvard Medical School, and an attending physician at the Massachusetts Eye and Ear Infirmary, both in Boston. He is coauthor of Macular Degeneration—The Latest Scientific Discoveries and Treatments for Preserving Your Sight. Walker & Co.
Good news: The most current research confirms that a healthful diet and prudent lifestyle choices can reduce your risk of developing ARMD. What's more, new treatments are highly effective at minimizing vision loss in the early stages of the disorder.
WHO'S AT RISK?...
ARMD affects one in three Americans over age 65. In its mildest form, the condition results in blurred vision and difficulty reading. But it can quickly progress to a more advanced form that causes blindness.
The disorder affects the macula, the region of the retina that's responsible for "central vision." This enables us to read, recognize faces, drive and perform other activities that require sharp vision.
Most cases of macular degeneration begin with the formation of drusen — tiny yellow deposits that grow just behind the macula.
Known as "dry" ARMD, this condition can persist for years, usually causing only minor vision problems.
Unfortunately, one in 10 of those who are diagnosed with dry ARMD go on to develop "wet" ARMD. This form occurs when blood vessels under the retina leak fluid and form scar tissue, damaging or distorting the smooth surface of the retina. Wet ARMD can rob a person of central vision.
RISK-REDUCTION STRATEGIES...
Researchers have now identified several factors that contribute to macular degeneration. To curb your risk for this disorder...
Give up smoking. Studies show that smoking is the most significant risk factor for ARMD.
Minimize your exposure to sunlight. Wear sunglasses with amber-colored lenses that block blue-violet light and 100% of UVA and UVB rays. They can be purchased at any good eyeglass store.
Follow a heart-healthy regimen. The same factors that increase heart disease risk — especially high blood pressure and high cholesterol intake — heighten your risk for ARMD.
To protect your heart and eyes: Cut back on saturated fat...get regular exercise...and have your blood pressure checked at least once a year.
Eat plenty of leafy green vegetables. Spinach, collard greens and kale contain the carotenoids lutein and zeaxanthin, which are believed to help fight ARMD. Eat at least five one-cup servings of these vegetables each week.
EARLY DETECTION...
For anyone over age 55, the best defense against ARMD is an annual eye exam by an ophthalmologist. If a parent or sibling has ARMD, have annual eye exams beginning at age 40.
See an ophthalmologist immediately if printed text appears blurry...straight edges of doorways or windows appear wavy...or if a dark —or blank— spot obstructs the center of your vision.
During the eye exam, your doctor will use a handheld lighted instrument (ophthalmoscope) to check for drusen. Fluid under the retina can be a sign of wet ARMD, which requires treatment and evaluation from an ophthalmologist who specializes in disorders of the retina.*
Your doctor should also test your eyesight using an Amsler grid, a chart with lines that resemble graph paper. If lines appear wavy when you focus on a dot in the center of the grid, you may have wet ARMD.
*To find a retinal specialist in your area, contact the American Academy of Ophthalmology at 415-561-8500, www.aao.org.
TREATMENTS...
A number of treatments are now available to reduce the blood vessel damage associated with wet ARMD...
Laser therapy is an effective way to stop the progression of ARMD. During this 30-minute outpatient procedure, a high-powered laser seals off the leaky blood vessel.
Laser therapy is recommended if the blood vessel is clearly visible and located to the side of the retina. This allows the ophthalmologist to control any vision loss that can result from tissue damage caused by the laser therapy.
Photodynamic therapy (PDT), a promising new form of laser therapy that uses a photo-sensitive dye, is available at many teaching hospitals. It causes less tissue damage than traditional laser therapy. For this reason, PDT is the preferred treatment. However, it must be repeated every few months.
For a list of medical centers that perform PDT, go to the Novartis Ophthalmics website at www.visudyne.com/aboutv/centers.html
Clinical trials are also being held to determine the effectiveness of other new treatments.
Submacular surgery removes the blood vessel through a hole in the side of the retina. This procedure is being tested on patients whose damaged blood vessel is located in the center of the retina, which diminishes the success of laser surgery.
Transpupillary thermo-therapy uses a low-temperature laser, which limits damage to the retina and surrounding tissue.
Radiation therapy uses a beam of electromagnetic energy to destroy leaky blood vessels in much the same way that radiation is used to treat cancer. However, results from current trials have not shown a large benefit from radiation therapy.
Antiangiogenesis drugs block the proteins that are critical to the formation of blood vessels that lead to ARMD.
For more information on clinical trials, contact the National Eye Institute, 301-496-5248, www.nei.nih.gov
source: Robert D'Amato, MD, PhD, associate professor of ophthalmology at Harvard Medical School, and an attending physician at the Massachusetts Eye and Ear Infirmary, both in Boston. He is coauthor of Macular Degeneration—The Latest Scientific Discoveries and Treatments for Preserving Your Sight. Walker & Co.
Sunday, February 22, 2009
Stroke Self Defense
Even if you think you're not at risk, buy a blood pressure monitor, sold at pharmacies, and take your own readings weekly. Learn to check your pulse for irregularities to discuss with your doctor. If you are at higher-than-average stroke risk, check with your doctor before taking any cold or flu medicines.
Remember: Do not smoke... avoid excessive alcohol intake ... monitor your cholesterol... keep weight down... exercise... get eight hours of sleep each night... beware of factors that raise your risk, such as diabetes or family history.
Further information can be obtained from the National Stroke Association, 800-787-6537 ... www.stroke.org.
source: Richard L. Hughes, MD, is chief of neurology at Denver Health Medical Center, 777 Bannock St., Denver 80204.
Remember: Do not smoke... avoid excessive alcohol intake ... monitor your cholesterol... keep weight down... exercise... get eight hours of sleep each night... beware of factors that raise your risk, such as diabetes or family history.
Further information can be obtained from the National Stroke Association, 800-787-6537 ... www.stroke.org.
source: Richard L. Hughes, MD, is chief of neurology at Denver Health Medical Center, 777 Bannock St., Denver 80204.
Thursday, February 19, 2009
Which is important: the coffee or the cup?
A professor agrees to host a ten year reunion for his graduate students during his retirement. The former students see it as an excellent opportunity to catch up on each other and celebrate days gone by.
On the appointed day, everyone shows up and the professor has arranged for a light brunch ending with coffee. There are cups arranged on the table, some of which are elaborate and expensive while other are cheap and disposable.
At the end of the brunch the professor announces that he will be able to accurately predict which of his gather students will go on to great fame and achievement and which of the remaining students will toil for the rest of their lives in mundane, irrelevant jobs. With enormous curiosity the students demand to know which group each of them fall into.
The professor then says, “Look at the cup you are holding. If it one of the expensive cups, then the likelihood of your professional success is very minute.” “Minute?!,” says one student. “I’m a director of research at a prestigious university and I suspect that I’m earning five times the amount you were paid when you were teaching.” The professor listened as others announced their outrage and disappointment that he would predict their failure rather than applaud their accomplishments.
The professor replies that the choice of cup spoke volumes to how each of them viewed their lives. For those who felt that the trappings of success where more important; the large office, the fancy title, they chose an expensive and elaborate cup to hold their coffee. For those students who understand that the journey is more important that the destination or that the purpose of research and intellect is the adventure of discovery, found the cup irrelevant and the taste of coffee of supreme importance.
Which will you chose? An elaborate cup adds nothing to the taste and quality of the coffee. The type of car you drive or size television you own does nothing to how you contribute to the betterment of your community and sense of self. It is the “coffee” of your life which should have value and importance.
On the appointed day, everyone shows up and the professor has arranged for a light brunch ending with coffee. There are cups arranged on the table, some of which are elaborate and expensive while other are cheap and disposable.
At the end of the brunch the professor announces that he will be able to accurately predict which of his gather students will go on to great fame and achievement and which of the remaining students will toil for the rest of their lives in mundane, irrelevant jobs. With enormous curiosity the students demand to know which group each of them fall into.
The professor then says, “Look at the cup you are holding. If it one of the expensive cups, then the likelihood of your professional success is very minute.” “Minute?!,” says one student. “I’m a director of research at a prestigious university and I suspect that I’m earning five times the amount you were paid when you were teaching.” The professor listened as others announced their outrage and disappointment that he would predict their failure rather than applaud their accomplishments.
The professor replies that the choice of cup spoke volumes to how each of them viewed their lives. For those who felt that the trappings of success where more important; the large office, the fancy title, they chose an expensive and elaborate cup to hold their coffee. For those students who understand that the journey is more important that the destination or that the purpose of research and intellect is the adventure of discovery, found the cup irrelevant and the taste of coffee of supreme importance.
Which will you chose? An elaborate cup adds nothing to the taste and quality of the coffee. The type of car you drive or size television you own does nothing to how you contribute to the betterment of your community and sense of self. It is the “coffee” of your life which should have value and importance.
Wednesday, February 18, 2009
Time Bombs — Hidden Salt, Sugar and Fat in Everyday Foods
Even "good" eaters compromise their health with poor dietary habits—and they often don't even realize it. The most dangerous culprits: salt, sugar and fat. Make the appropriate changes to avoid these "hidden" ingredients to reduce your risk of disease.
HIDDEN SALT...
Table salt and high-sodium ingredients flavor and preserve everything—from pudding and cake mix...to salad dressing and frozen entrees...to canned food and condiments.
About 20% of the population is sodium-sensitive, suffering from increased blood pressure or fluid retention due to excess sodium. Excess sodium also causes bones to release calcium and therefore contributes to the development of osteoporosis.
The average American consumes 3,000 milligrams (mg) to 5,000 mg of sodium per day. Aim for no more than 2,000 mg per day. People with congestive heart failure, gout, hypertension and kidney problems should avoid foods with added salt.
Sodium is added in various forms, including monosodium glutamate (MSG)...sodium bicarbonate...sodium chloride (table salt)...and sodium nitrate.
One cup of soup can easily contain 800 mg to 1,000 mg of sodium. A few handfuls of chips can have up to 400 mg. Read labels to compare the sodium content of similar products.
OTHER STRATEGIES...
Buy foods in their natural states. Avoid processed foods. They are likely to have added sodium.
Do not add salt while cooking. If you must add salt, use it sparingly on the surface when you're ready to eat — don't mix it in.
Use lemon juice, lime juice, vinegar and extra herbs and spices to flavor foods. All add punch without extra sodium.
HIDDEN SUGAR...
Refined and even natural sugars are added to everything— from baby food and breakfast cereal...to pasta sauce and processed foods. On food labels, sugar is listed in many ways — as sucrose, fructose, high-fructose corn syrup, fruit juice concentrate, honey, maple syrup, molasses and others. An ingredient ending in -ose is usually a form of sugar.
If you are overweight, eating excess sugar can slow weight loss or even cause weight gain. Dried fruit, fruit juice and foods flavored with added sugar are concentrated in calories. All sugar — whether refined or natural — can contribute to elevated blood triglyceride levels, a risk factor for heart disease.
SUGAR AVOIDANCE STRATEGIES...
Eat fresh fruit Limit processed fruit products, such as fruit juices and canned and dried fruits. I advise patients to eat no more than three servings of fruit a day...or one serving per day for maximum weight loss.
View fruit as dessert Fruit is a good source of vitamins, minerals and health-supporting phytochemicals as well as fiber. Make fresh fruit the sweet ending to a meal. Skip fattening desserts, which are devoid of nutritional benefits.
Add sugar to the surface. As with salt, a little sugar on the surface of food adds flavor without many extra calories. A bowl of cooked oatmeal topped with a teaspoon of brown sugar is satisfying and contains less sugar than many presweetened packaged varieties.
HIDDEN FAT...
Fat is added to processed foods to enhance flavor and texture and blend ingredients. Everyone needs to monitor fat intake. In addition to obesity, consuming dietary fat promotes cancer, coronary artery disease and diabetes. Both animal and plant fats are a concern.
I advise no added fat. Those who need to lose weight should also avoid high-fat plant foods, such as avocados, nuts, olives, seeds and soy products.
Food manufacturers list fat on labels in different ways...
• Mono- and diglycerides. These fats are added to bread andother baked goods to soften them.
Hydrogenated fat (trans fatty acids). Commonly used in margarine and processed foods, it raises blood cholesterol levels even more than butter and cream.
• "Fat-free" Foods that contain less than one-half gram of fat per serving can be labeled "fat-free." The trouble is that many standard "servings" are small by consumers' standards. If you eat several servings of a so-called fat-free food, you may be eating a fair amount of total fat.
• Choice of fats. Foods are often labeled with possible fat sources. A product "may contain soybean and/or cottonseed oil." Manufacturers can then use whichever fat is most cost-effective.
FAT SELF-DEFENSE STRATEGIES...
• Eat fresh foods. Baked potatoes, steamed vegetables and cooked rice do not have any extra fat unless you put it there.
Choose wisely. Eat less meat and fewer dairy products and more whole grains and fresh fruits and vegetables.
• Cook and bake from scratch to control the amount of fat used. examples: Use nonstick cookware...substitute mashed bananas, unsweetened applesauce or prune paste for fat.
source: John McDougall, MD, director of The McDougall Program, a 12-day live-in plan to teach proper nutrition at St. Helena Hospital and Center for Health, Napa Valley, California. He is author of numerous books, including The McDougall Program for Women: What Every Woman Needs to Know to Be Healthy for Life. Plume.
HIDDEN SALT...
Table salt and high-sodium ingredients flavor and preserve everything—from pudding and cake mix...to salad dressing and frozen entrees...to canned food and condiments.
About 20% of the population is sodium-sensitive, suffering from increased blood pressure or fluid retention due to excess sodium. Excess sodium also causes bones to release calcium and therefore contributes to the development of osteoporosis.
The average American consumes 3,000 milligrams (mg) to 5,000 mg of sodium per day. Aim for no more than 2,000 mg per day. People with congestive heart failure, gout, hypertension and kidney problems should avoid foods with added salt.
Sodium is added in various forms, including monosodium glutamate (MSG)...sodium bicarbonate...sodium chloride (table salt)...and sodium nitrate.
One cup of soup can easily contain 800 mg to 1,000 mg of sodium. A few handfuls of chips can have up to 400 mg. Read labels to compare the sodium content of similar products.
OTHER STRATEGIES...
Buy foods in their natural states. Avoid processed foods. They are likely to have added sodium.
Do not add salt while cooking. If you must add salt, use it sparingly on the surface when you're ready to eat — don't mix it in.
Use lemon juice, lime juice, vinegar and extra herbs and spices to flavor foods. All add punch without extra sodium.
HIDDEN SUGAR...
Refined and even natural sugars are added to everything— from baby food and breakfast cereal...to pasta sauce and processed foods. On food labels, sugar is listed in many ways — as sucrose, fructose, high-fructose corn syrup, fruit juice concentrate, honey, maple syrup, molasses and others. An ingredient ending in -ose is usually a form of sugar.
If you are overweight, eating excess sugar can slow weight loss or even cause weight gain. Dried fruit, fruit juice and foods flavored with added sugar are concentrated in calories. All sugar — whether refined or natural — can contribute to elevated blood triglyceride levels, a risk factor for heart disease.
SUGAR AVOIDANCE STRATEGIES...
Eat fresh fruit Limit processed fruit products, such as fruit juices and canned and dried fruits. I advise patients to eat no more than three servings of fruit a day...or one serving per day for maximum weight loss.
View fruit as dessert Fruit is a good source of vitamins, minerals and health-supporting phytochemicals as well as fiber. Make fresh fruit the sweet ending to a meal. Skip fattening desserts, which are devoid of nutritional benefits.
Add sugar to the surface. As with salt, a little sugar on the surface of food adds flavor without many extra calories. A bowl of cooked oatmeal topped with a teaspoon of brown sugar is satisfying and contains less sugar than many presweetened packaged varieties.
HIDDEN FAT...
Fat is added to processed foods to enhance flavor and texture and blend ingredients. Everyone needs to monitor fat intake. In addition to obesity, consuming dietary fat promotes cancer, coronary artery disease and diabetes. Both animal and plant fats are a concern.
I advise no added fat. Those who need to lose weight should also avoid high-fat plant foods, such as avocados, nuts, olives, seeds and soy products.
Food manufacturers list fat on labels in different ways...
• Mono- and diglycerides. These fats are added to bread andother baked goods to soften them.
Hydrogenated fat (trans fatty acids). Commonly used in margarine and processed foods, it raises blood cholesterol levels even more than butter and cream.
• "Fat-free" Foods that contain less than one-half gram of fat per serving can be labeled "fat-free." The trouble is that many standard "servings" are small by consumers' standards. If you eat several servings of a so-called fat-free food, you may be eating a fair amount of total fat.
• Choice of fats. Foods are often labeled with possible fat sources. A product "may contain soybean and/or cottonseed oil." Manufacturers can then use whichever fat is most cost-effective.
FAT SELF-DEFENSE STRATEGIES...
• Eat fresh foods. Baked potatoes, steamed vegetables and cooked rice do not have any extra fat unless you put it there.
Choose wisely. Eat less meat and fewer dairy products and more whole grains and fresh fruits and vegetables.
• Cook and bake from scratch to control the amount of fat used. examples: Use nonstick cookware...substitute mashed bananas, unsweetened applesauce or prune paste for fat.
source: John McDougall, MD, director of The McDougall Program, a 12-day live-in plan to teach proper nutrition at St. Helena Hospital and Center for Health, Napa Valley, California. He is author of numerous books, including The McDougall Program for Women: What Every Woman Needs to Know to Be Healthy for Life. Plume.
Tuesday, February 17, 2009
Protect Yourself From Bone Loss
People taking corticosteroids, such as prednisone, for more than three months should have a bone-density scan every six to 12 months...take calcium supplements and 400 IU to 800 IU of vitamin D daily. Ask your doctor what is best. Monitoring and preventing bone loss are easier than the years of therapy needed to rebuild bone that steroids may weaken.
source: Barbara Lukert, MD, Director, Osteoporosis Clinic, University of Kansas Hospital, Kansas City, Kansas.
source: Barbara Lukert, MD, Director, Osteoporosis Clinic, University of Kansas Hospital, Kansas City, Kansas.
Monday, February 16, 2009
Heart Attack Self-Defense
You've cut back on dietary fat and cholesterol. You've started exercising and lost weight. If you ever smoked, you've stopped. Perhaps you've even taken to drinking green tea.
What else can you do to reduce your risk of heart disease?
Quite a lot, actually. These nine suggestions come from Dr. Dennis Sprecher, a heart attack specialist at the world-renowned Cleveland Clinic...
• Consume more apples, onions and green beans...and more purple grape juice. These foods are rich in the heart-protective antioxidants called flavonoids.
Flavonoids benefit the heart by inhibiting oxidation of cholesterol—a chemical process that promotes artery blockages.
Flavonoids also help dilate the arteries that supply oxygen-rich blood to the heart.
CAUTION: Unsweetened grape juice—at 154 calories per eight ounces—is too calorie-dense to be consumed every day.
Like purple grape juice, red wine contains flavonoids. But given the risks associated with alcohol, men should have no more than two five-ounce glasses a day...women no more than one five-ounce glass a day.
• Boost your intake of omega-3 fatty acids. Fish oil is a good source of omega-3 fatty acids, which are believed to account for the lower incidence of heart-related deaths among people who eat at least some fish.
Omega-3s boost levels of HDL (good) cholesterol and reduce blood pressure by relaxing arteries...stabilizing heartbeats...and inhibiting formation of artery-clogging blood clots. Try to eat fish high in omega-3s, such as salmon and trout, twice a week.
CAUTION: Fish oil is a highly concentrated source of fat calories. Consuming too much of it raises LDL (bad) cholesterol levels.
If you don't like fish, ground flaxseed—sold in health-food stores—is an alternative source of omega-3s. Add it to cereal.
Another little-known source of omega-3s is arugula lettuce.
• Eat more beans and other low-fat foods—and less meat. One cup of black beans provides as much protein as two ounces of lean ground beef. But the beans contain only 1 g of total fat, compared with 12 g for the meat.
Also, beans contain no saturated fat or cholesterol. The meat contains 4 g of saturated fat and a whopping 43 mg of cholesterol.
• Eat more soy- and oat-based foods. Both protect the heart by encouraging excretion of cholesterol circulating in the bloodstream.
Use soymilk instead of cow's milk on high-fiber bran or oat cereal. Low-fat soy cheese and tofu — found in the dairy section of many supermarkets — are other good sources of soy. Or have oatmeal or oat bread instead of sugary cereals.
• Cut way back on salt. It's well known that sodium — found in table salt and many processed foods—can damage the heart by raising blood pressure. Yet the average American still consumes 6,000 mg a day—far more than the recommended 2,400 mg.
To lower your salt intake, follow the diet developed as part of a landmark study known as Dietary Approaches to Stop Hypertension (DASH). More information: http://dash.bwh.harvard.edu .
The DASH diet consists primarily of fruits, vegetables, whole-grains and low-fat dairy products. People who followed the DASH diet experienced a 15% reduction of atherosclerosis (stiff, clogged arteries), a cause of heart attack.
The DASH diet also reduces blood pressure about as much as medications do.
• Eat six small meals a day. Small, frequent meals make it less likely that the body will turn the calories you consume into fat.
If you plan to eat at a restaurant, have an apple or another low-fat snack beforehand. This takes the edge off your hunger so you are less likely to load up on calorie-laden breads or appetizers.
• Work out more frequently. In addition to burning excess calories, physical activity boosts levels of HDL cholesterol. Although most experts recommend exercising 30 minutes three times a week, new research confirms that daily activity yields the greatest benefits.
Jog, walk, run, dance or do some other moderately vigorous exercise for at least 30 minutes a day. If you cannot manage a 30-minute workout, do three 10-minute sessions.
• Curb psychological stress. In response to a stressful situation — be it a traffic jam or a difficult boss—your body produces two key hormones. Epinephrine increases heart rate. Cortisol raises blood pressure.
If your body constantly generates these hormones, you overwork your heart—and that increases your risk for heart attack. When we are under stress, our breathing becomes rapid and shallow. That deprives the heart of oxygen.
To reverse this oxygen-robbing tendency, inhale deeply through your nose for a count of 10 when you feel stress. Then exhale for a count of 10. Repeat twice more.
• Ask your doctor about heart-protecting medication. A daily aspirin helps reduce the blood's tendency to clot. That makes heart attack less likely.
CAUTION: Do not take aspirin to protect your heart without talking to your doctor first. In some people, regular use can cause internal bleeding.
If your total cholesterol is 200 or higher and/or you have a strong family history of heart disease, you should probably take pravastatin (Pravachol) or another prescription "statin" drug.
source: Dennis Sprecher, MD, director of preventive cardiology and rehabilitation at the Cleveland Clinic Foundation. He is a contributing author of The Cleveland Clinic Heart Book. Hyperion.
What else can you do to reduce your risk of heart disease?
Quite a lot, actually. These nine suggestions come from Dr. Dennis Sprecher, a heart attack specialist at the world-renowned Cleveland Clinic...
• Consume more apples, onions and green beans...and more purple grape juice. These foods are rich in the heart-protective antioxidants called flavonoids.
Flavonoids benefit the heart by inhibiting oxidation of cholesterol—a chemical process that promotes artery blockages.
Flavonoids also help dilate the arteries that supply oxygen-rich blood to the heart.
CAUTION: Unsweetened grape juice—at 154 calories per eight ounces—is too calorie-dense to be consumed every day.
Like purple grape juice, red wine contains flavonoids. But given the risks associated with alcohol, men should have no more than two five-ounce glasses a day...women no more than one five-ounce glass a day.
• Boost your intake of omega-3 fatty acids. Fish oil is a good source of omega-3 fatty acids, which are believed to account for the lower incidence of heart-related deaths among people who eat at least some fish.
Omega-3s boost levels of HDL (good) cholesterol and reduce blood pressure by relaxing arteries...stabilizing heartbeats...and inhibiting formation of artery-clogging blood clots. Try to eat fish high in omega-3s, such as salmon and trout, twice a week.
CAUTION: Fish oil is a highly concentrated source of fat calories. Consuming too much of it raises LDL (bad) cholesterol levels.
If you don't like fish, ground flaxseed—sold in health-food stores—is an alternative source of omega-3s. Add it to cereal.
Another little-known source of omega-3s is arugula lettuce.
• Eat more beans and other low-fat foods—and less meat. One cup of black beans provides as much protein as two ounces of lean ground beef. But the beans contain only 1 g of total fat, compared with 12 g for the meat.
Also, beans contain no saturated fat or cholesterol. The meat contains 4 g of saturated fat and a whopping 43 mg of cholesterol.
• Eat more soy- and oat-based foods. Both protect the heart by encouraging excretion of cholesterol circulating in the bloodstream.
Use soymilk instead of cow's milk on high-fiber bran or oat cereal. Low-fat soy cheese and tofu — found in the dairy section of many supermarkets — are other good sources of soy. Or have oatmeal or oat bread instead of sugary cereals.
• Cut way back on salt. It's well known that sodium — found in table salt and many processed foods—can damage the heart by raising blood pressure. Yet the average American still consumes 6,000 mg a day—far more than the recommended 2,400 mg.
To lower your salt intake, follow the diet developed as part of a landmark study known as Dietary Approaches to Stop Hypertension (DASH). More information: http://dash.bwh.harvard.edu .
The DASH diet consists primarily of fruits, vegetables, whole-grains and low-fat dairy products. People who followed the DASH diet experienced a 15% reduction of atherosclerosis (stiff, clogged arteries), a cause of heart attack.
The DASH diet also reduces blood pressure about as much as medications do.
• Eat six small meals a day. Small, frequent meals make it less likely that the body will turn the calories you consume into fat.
If you plan to eat at a restaurant, have an apple or another low-fat snack beforehand. This takes the edge off your hunger so you are less likely to load up on calorie-laden breads or appetizers.
• Work out more frequently. In addition to burning excess calories, physical activity boosts levels of HDL cholesterol. Although most experts recommend exercising 30 minutes three times a week, new research confirms that daily activity yields the greatest benefits.
Jog, walk, run, dance or do some other moderately vigorous exercise for at least 30 minutes a day. If you cannot manage a 30-minute workout, do three 10-minute sessions.
• Curb psychological stress. In response to a stressful situation — be it a traffic jam or a difficult boss—your body produces two key hormones. Epinephrine increases heart rate. Cortisol raises blood pressure.
If your body constantly generates these hormones, you overwork your heart—and that increases your risk for heart attack. When we are under stress, our breathing becomes rapid and shallow. That deprives the heart of oxygen.
To reverse this oxygen-robbing tendency, inhale deeply through your nose for a count of 10 when you feel stress. Then exhale for a count of 10. Repeat twice more.
• Ask your doctor about heart-protecting medication. A daily aspirin helps reduce the blood's tendency to clot. That makes heart attack less likely.
CAUTION: Do not take aspirin to protect your heart without talking to your doctor first. In some people, regular use can cause internal bleeding.
If your total cholesterol is 200 or higher and/or you have a strong family history of heart disease, you should probably take pravastatin (Pravachol) or another prescription "statin" drug.
source: Dennis Sprecher, MD, director of preventive cardiology and rehabilitation at the Cleveland Clinic Foundation. He is a contributing author of The Cleveland Clinic Heart Book. Hyperion.
Saturday, February 14, 2009
How To Escape Common Health Insurance Traps
Health insurance does not cover every medical cost. The average American pays $1,200 out of pocket each year. Here are seven of the most common traps that prevent consumers from getting the most from their health insurance...
TRAP: Failing to appeal a denial for coverage. If your health insurer denies a claim for service, don't assume the battle is lost. Submit an immediate appeal in writing.
Get the name of the insurance company's medical director and send your appeal—by certified mail—directly to him/her. Save copies of all written correspondence. For phone calls, keep a diary. Record the date, the contact name and a conversation summary. In your letter, stick to the specifics of your appeal. If possible, quote from your member contract section of your insurance plan information booklet to back up your appeal.
If your appeal is denied, don't give up. Most states guarantee an external appeal in which a third party objectively reviews your case. Contact your state insurance department for more information.
TRAP: Failing to inquire about "UCR" limits or fee schedules on out-of-network health services. "UCR" stands for "usual, customary and reasonable" medical charges. These are defined as an average cost for a given medical service in your region.
A fee schedule typically assigns a reimbursement value to every service a physician provides. Most health plans use UCR limits or a fee schedule. Unlike HMOs, which restrict your choice of doctors, preferred-provider organizations (PPOs) and point-of-service plans allow users to consult out-of-network physicians. However, the user must pay a percentage of the cost.
BEWARE: The percentage paid by the health plan applies only to the UCR rate or fee schedule for that service.
EXAMPLE: Let's say your plan covers 80% of the cost for a visit to an out-of-network specialist. Let's also say the specialist charges $200, but your health plan has determined that the service should cost $100. The insurer will reimburse 80% of $100—only $80. You must pay the remaining $120 yourself. Before consulting a doctor from outside of your network, find out your insurance company's UCR limit or fee schedule for the service or procedure. If there is a significant difference between the doctor's fee and the reimbursement rate, explain your situation to your doctor. He may be willing to negotiate a lower rate.
TRAP: Failing to keep track of your requests for referrals. Because referrals to specialists are costly for managed-care companies, some may process them slowly. To prevent a long delay, monitor your requests closely.
Do not see a specialist until the referral has been approved. Once your doctor has agreed to the referral, make sure both your doctor and your plan follow through. If you don't hear back within one week, call your doctor's office manager to follow up.
TRAP: Failing to find out which prescription drugs are covered by your plan. Health plans typically have a list of approved medications. If your doctor prescribes a drug that isn't on this "formulary," you may wind up paying for it. Call your insurer's customer service department to make sure a drug prescribed for you is on your plan's formulary before you order it.
If the drug is not covered, talk to your doctor about substituting another drug. If your doctor still prefers the drug, request that he call and ask the insurer to make an exception.
TRAP: Failing to ensure that your treatment is "medically necessary." Most insurers cover only procedures and services they deem "medically necessary."
EXAMPLE: Rhinoplasty—nose reconstruction—for cosmetic reasons typically is not covered. But the procedure may be covered if it is medically necessary to correct a breathing problem.
If you consult a doctor for any health condition, be sure he indicates on your chart the necessity for the medical service or procedure. If your plan denies reimbursement, ask your doctor to write a letter explaining the medical necessity.
TRAP: Failing to use preventive and wellness services covered by your health plan. Many insurance companies offer preventive and wellness services at no cost. These may include flu shots...weight-loss and smoking-cessation programs...cancer screenings...and case management for diabetes, high blood pressure and other chronic health conditions. Read your member handbook carefully and see an employee benefits person at your company.
TRAP: Failing to take advantage of your COBRA options. Few people realize that they can maintain the health insurance they receive through an employer if they lose their job or become self-employed. This right is guaranteed for 18 months under a federal law known as the Consolidated Omnibus Budget Reconciliation Act (COBRA). If you leave an employer that paid for your health insurance, ask the company's human resources department about COBRA coverage. You must pay the entire premium yourself, but the breadth of coverage and corporate rate almost always beat what you can purchase as an individual.
TRAP: Failing to appeal a denial for coverage. If your health insurer denies a claim for service, don't assume the battle is lost. Submit an immediate appeal in writing.
Get the name of the insurance company's medical director and send your appeal—by certified mail—directly to him/her. Save copies of all written correspondence. For phone calls, keep a diary. Record the date, the contact name and a conversation summary. In your letter, stick to the specifics of your appeal. If possible, quote from your member contract section of your insurance plan information booklet to back up your appeal.
If your appeal is denied, don't give up. Most states guarantee an external appeal in which a third party objectively reviews your case. Contact your state insurance department for more information.
TRAP: Failing to inquire about "UCR" limits or fee schedules on out-of-network health services. "UCR" stands for "usual, customary and reasonable" medical charges. These are defined as an average cost for a given medical service in your region.
A fee schedule typically assigns a reimbursement value to every service a physician provides. Most health plans use UCR limits or a fee schedule. Unlike HMOs, which restrict your choice of doctors, preferred-provider organizations (PPOs) and point-of-service plans allow users to consult out-of-network physicians. However, the user must pay a percentage of the cost.
BEWARE: The percentage paid by the health plan applies only to the UCR rate or fee schedule for that service.
EXAMPLE: Let's say your plan covers 80% of the cost for a visit to an out-of-network specialist. Let's also say the specialist charges $200, but your health plan has determined that the service should cost $100. The insurer will reimburse 80% of $100—only $80. You must pay the remaining $120 yourself. Before consulting a doctor from outside of your network, find out your insurance company's UCR limit or fee schedule for the service or procedure. If there is a significant difference between the doctor's fee and the reimbursement rate, explain your situation to your doctor. He may be willing to negotiate a lower rate.
TRAP: Failing to keep track of your requests for referrals. Because referrals to specialists are costly for managed-care companies, some may process them slowly. To prevent a long delay, monitor your requests closely.
Do not see a specialist until the referral has been approved. Once your doctor has agreed to the referral, make sure both your doctor and your plan follow through. If you don't hear back within one week, call your doctor's office manager to follow up.
TRAP: Failing to find out which prescription drugs are covered by your plan. Health plans typically have a list of approved medications. If your doctor prescribes a drug that isn't on this "formulary," you may wind up paying for it. Call your insurer's customer service department to make sure a drug prescribed for you is on your plan's formulary before you order it.
If the drug is not covered, talk to your doctor about substituting another drug. If your doctor still prefers the drug, request that he call and ask the insurer to make an exception.
TRAP: Failing to ensure that your treatment is "medically necessary." Most insurers cover only procedures and services they deem "medically necessary."
EXAMPLE: Rhinoplasty—nose reconstruction—for cosmetic reasons typically is not covered. But the procedure may be covered if it is medically necessary to correct a breathing problem.
If you consult a doctor for any health condition, be sure he indicates on your chart the necessity for the medical service or procedure. If your plan denies reimbursement, ask your doctor to write a letter explaining the medical necessity.
TRAP: Failing to use preventive and wellness services covered by your health plan. Many insurance companies offer preventive and wellness services at no cost. These may include flu shots...weight-loss and smoking-cessation programs...cancer screenings...and case management for diabetes, high blood pressure and other chronic health conditions. Read your member handbook carefully and see an employee benefits person at your company.
TRAP: Failing to take advantage of your COBRA options. Few people realize that they can maintain the health insurance they receive through an employer if they lose their job or become self-employed. This right is guaranteed for 18 months under a federal law known as the Consolidated Omnibus Budget Reconciliation Act (COBRA). If you leave an employer that paid for your health insurance, ask the company's human resources department about COBRA coverage. You must pay the entire premium yourself, but the breadth of coverage and corporate rate almost always beat what you can purchase as an individual.
Source: Paul Lerner and Julie Lerner, brother-and-sister coauthors of Lerner's Consumer Guide to Health Care: How to Get the Best Health Care for Less. Lerner Communications. Paul is an AIDS activist. Julie is a five-year survivor of non-Hodgkin's lymphoma. For more on health insurance, visit www.Iernerhealth.com.
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