The Care Group, P.C.
The Employer’s Guide: 10 Steps to Better Health
By Gerard L. Guillory, M.D.
Individual consumers in Colorado and other states are increasingly responsible for medical costs and related decision-making as employers, facing a healthcare affordability crisis, continue to raise premiums, co-pays, deductibles and co-insurance amounts.
Hewitt Associates, which annually surveys large employers regarding health-care costs, reported this fall that the average health cost per employee for major companies will increase from $7,982 in 2007 to $8,676 in 2008.
As costs continue to escalate, some employers have dropped health-care coverage altogether, while others have begun placing employees in consumer-directed health plans. These plans feature unusually high deductibles and, as a tradeoff, access to tax-advantaged savings accounts that help the employee cover higher out-of-pocket costs.
Some employer groups are going a step further and are basing individual employees’ premiums on such questions as whether the employee smokes, is overweight and/or has high cholesterol.
As employees undergo this forced march into the ugly realities of health-care costs, employers can go one step further. They can help employees succeed. Education is perhaps the most important weapon that employers can give their workers.
Over the past few years, I have helped a number of employer groups educate employees on 10 simple but often-overlooked steps toward better health. Here’s a brief overview:
1. Add probiotics to your diet. If you find your digestive tract grumbling more than you think it should, you might want to replenish your gut’s probiotics. Probiotics are living, beneficial bacteria that occur naturally in the human intestinal tract and are essential to healthy digestion. A growing body of evidence suggests that probiotics help treat and prevent various forms of diarrhea, ulcerative colitis, Crohn's disease, irritable bowel syndrome, small-bowel bacterial overgrowth, and lactose intolerance. Probiotics also may help prevent colon cancer.
Probiotics are essential to the maintenance of the lining of the intestine, as they block the invasion of disease-causing bacteria. When an imbalance between "bad bacteria" and "good bacteria" exists, the lining of the intestine allows larger food and bacterial particles to be absorbed into the bloodstream. The immune system activates as the body fights these invaders. Many people who report apparent food intolerances may be experiencing symptoms arising from an imbalance of bacteria.
Replenishment of the gut with viable, beneficial bacteria—a number of affordable commercial products are available at health-food stores—may have multiple positive effects. A good probiotic to try is Sensitive Colon Support from New Chapter, available at most health-food stores.
2. Beware MSG and aspartame. If you regularly experience severe headaches, dizziness, muscle aches and digestive discomfort, the cause may lie in your diet. Monosodium glutamate and aspartame are common food additives that are culprits in many common medical complaints. MSG contains glutamic acid, and aspartame contains aspartic acid. These substances, both of which are neuroexcitatory amino acids, have been associated with headache, nausea, impaired ability to concentrate, attention deficit disorder, dizziness, flushing, muscle aches, digestive complaints and more.
Many “diet” products such as diet soda contain aspartame, a sugar substitute, and are labeled accordingly. But MSG is harder to identify, as labels may indicate only that a “flavor enhancer” has been added. MSG is commonly found in packaged gravies, ready-made salad dressings, flavored chips, canned soups and many other highly processed foods. In addition, restaurants frequently put MSG in soups, gravies, sauces and salad dressings. Steer clear of both MSG and aspartame for a month, and note the results.
3. Avoid trans fats. Trans fats may be the worst thing you can eat but, if you live in Colorado and other states that don’t regulate these dangerous food additives, you probably aren’t even aware that you’re eating them. Trans fats were engineered by food scientists who wanted to boost the shelf life of processed foods by reducing rancidity. This is achieved by adding hydrogen atoms to vegetable oils, rendering the fat more rigid and stable. When you ingest trans fats, your body tries to incorporate the rigid fats into its cell walls, causing damage in the process. The damage occurs because trans fats aren’t pliable like normal fats. Metabolizing them is like forcing the square peg into the round hole.
The health implications are serious. Trans fats increase the risk of cardiovascular disease by increasing LDL (bad) cholesterol, lowering HDL (good) cholesterol and raising triglycerides. Trans fats also increase inflammation, which accelerates many age-related disorders, including cancer, diabetes, Alzheimer's and arthritis.
The federal government requires that trans fats be listed on nutrition labels, but this applies only to interstate commerce. As is the case with MSG, trans fats are hidden in many foods; for example, many deli and bakery items at the local supermarket. If there is a label on the packaging, it may say only that the product contains partially hydrogenated oils. What it won’t say is that partially hydrogenated oils are trans fats.
4. Take appropriate supplements. Americans spend more than $17 billion a year on nutritional supplements, but few of us know what we are getting for our money. Quality standards tend to be hit-or-miss among supplements manufacturers, and individual consumers don’t always know what kinds and amounts of supplements they need. The kinds and amounts of supplements you take should be based on your individual health status, which your physician or nutritionist can help you gauge, and on your budgetary requirements. Too often, I encounter patients who are spending large sums on supplements that they simply don’t need or on supplements of low quality. Don’t hesitate to ask a health-care practitioner who has training in nutrition.
5. Take Omega-3 fatty acids. Some fats are essential to good health; for example, the Omega-3 fatty acids found in fish oil, cod-liver oil and flaxseed oil. According to some experts, the most serious problem with the American diet today is the scarcity of Omega-3 fatty acids in our foods. Omega-3 deficiency has been associated with anxiety, depression, attention deficit disorder, cardiovascular problems and arthritis.
6. Take supplemental vitamin D. Another common deficiency involves vitamin D; in fact, some medical experts are referring to this as an epidemic. Recent studies have linked vitamin D deficiency to a range of medical problems such as diabetes, chronic fatigue, osteoporosis, hypertension, multiple sclerosis, at least 16 types of cancer, and other diseases, including influenza. Vitamin D is unlike other vitamins in that our bodies manufacture it when touched by sunlight. Yet many of us spend little time in the sunlight, especially in the winter and early spring. When warmer weather arrives, we apply sunscreen in order to prevent skin cancer. Without supplemental vitamin D, few of us are likely to get as much as we need. The current recommended daily allowance for vitamin D, most experts say, is woefully inadequate. How much you should supplement is in debate.
7. Get your blood tested. If you suspect that you have vitamin D deficiency, ask your physician to perform a simple blood test and, based on the results, to help you determine how much vitamin D your body needs for optimal health.
You also might want to undergo a blood test to determine whether your hormones are balanced. This is crucial for patients who are taking statins (medications that reduce cholesterol) as both vitamin D and the sex hormones are synthesized from cholesterol.
One other test you might consider: Researchers are finding that gluten sensitivity is more common than previously thought. A blood test can determine whether you are gluten-sensitive. Symptoms may include auto-immune disorders and diabetes.
8. Reduce inflammation. Inflammation is a natural and vital part of the body’s response to injury, helping fight infections and ward off cancer, but it can go awry. Poor diet, lack of exercise and ineffective responses to stress contribute to the problem. Many age-related illnesses and obesity arise as a result of excessive, chronic cellular inflammation. Reducing chronic inflammation can help delay or, in some cases, reverse the aging process. Changing your diet, engaging in regular exercise and managing stress more effectively are critical parts of any plan to achieve these goals.
Some foods are pro-inflammatory and others are anti-inflammatory. Knowing the difference and choosing healthier foods will help you look and feel better. Generally, foods have four distinct properties that merit consideration:
• Type and amount of fat. Foods that contain saturated fats and trans fats are pro-inflammatory. Some fats are essential to good health—for example, Omega-3 fatty acids—and help reduce inflammation.
• Glycemic index. This measures how rapidly the body converts food to sugar. The faster it does so, the more pro-inflammatory the food. Avoid foods that contain sugar or that are rapidly converted to sugar in the body. Examples include white-flour products, white potatoes, pasta and other low-fiber, starchy foods.
• Phytonutrient content. Phytonutrients are vitamins, trace elements and micronutrients found notably in plants, grains, nuts and fruits. They promote healthy cellular growth and reduce inflammation.
• Anti-inflammatory compounds. Some herbs, spices and other food items contain natural anti-inflammatory substances. Turmeric and ginger, for example, fight inflammation. Cinnamon also has beneficial properties and helps prevent rapid rises in your body’s blood-sugar level.
9. Listen to your physician. Don’t overlook the value of all the usual advice that physicians and other health-care professionals offer: stop smoking; work out regularly and appropriately; learn to manage stress more effectively; keep your weight within recommended limits; and get a good night’s sleep.
10. Make the most of your office visit. One of the most important things you can do is to make the most of the time you spend with your doctor. A few suggestions:
If you’re a new patient, check out your doctor’s Website, which should include forms you will need to bring on your first visit. Fill them out at home and bring them with you. If your doctor doesn’t have a Website and hasn’t sent you any forms to fill out, visit our Website at www.thecaregrouppc.com and review the forms we provide to new patients. Feel free to fill these out and take them to your doctor, who probably will ask for the same information. Some other suggestions:
• Before you call for the appointment, list and prioritize the issues you hope to address. When you make the call, mention all the reasons for the visit. This will help the staff allocate an appropriate amount of time for your visit.
• Make a list of your medical conditions and your medications (and doses). Also make a list of any vitamins and supplements you take.
• Keep a diary regarding your health, medications and life events. Often, the onset of medical problems coincides with other changes—a new prescription or supplement, a change in diet, new sources of stress.
• At check-in, let the medical assistant know whether you need refills for any prescriptions. Often, he or she can begin to take care of this while you are seeing the doctor.
• Bring your insurance card.
Finally, if you recently changed primary care physicians, consider seeing your old doctor, even if he or she isn’t a part of the network with which your health plan contracts. Many plans cover out-of-network care; the patient simply pays a higher co-payment. It may be worth the extra expense to hang onto a relationship built over many years.
Gerard L. Guillory, M.D., is board-certified in internal medicine and has been practicing in Aurora, Colo., since July 1985. As an assistant clinical professor of medicine at the University of Colorado Health Sciences Center, Dr. Guillory is actively involved in teaching medical students, resident physicians, and nurse practitioner students. He has lectured extensively on the role of nutrition and disease. Over the years, he has fostered an interest in patient education and has authored three books on digestive troubles. He also has served as medical director of a Colorado-based health plan and as a health consultant to employer groups.
830 Potomac Circle • Suite 150 • Aurora, CO 80011
(303) 343-3121 FAX (303) 343-3514