Health Articles

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20 Healthy Snack Ideas for Diabetics

November is national Diabetes awareness month. Viverae will spend the month focused on awareness, Type 2 prevention, and preventive care options for Diabetics. The following article was written by Kristi Hatfield (MS, RD, LD), a member of Viverae’s Clinical Team and the Viverae Care Center.

20 Healthy Snack Ideas for Diabetics

The goals of these healthy snacks are to maintain a blood sugar level within normal limit and to combine a protein source with a carbohydrate when choosing a snack. This combination allows for slowing the digestion and absorption of carbohydrates into the bloodstream, improving blood sugar levels and increasing satiety with snacks.

The following snack portions include 1 carbohydrate choice and 1 protein choice:

  1. ¼ cup low-fat cottage cheese with ½ cup pineapple

  2. 1 cup cubed cantaloupe or raspberries with 6 oz. light vanilla yogurt

  3. 6 oz. light yogurt and ¼ cup low-fat granola or 3 Tbsp. of wheat germ

  4. 6 whole grain crackers with 1 oz. low-fat cheese

  5. 6 whole grain crackers and 2 medium sardines, 1 lemon wedge

  6. 3 cups light microwave or air popped popcorn sprinkled with reduced-fat parmesan cheese

  7. 2 sheets of graham crackers with 1 Tbsp. natural peanut butter or almond butter

  8. 1 cup raw veggies (i.e., celery, carrot sticks, broccoli, cherry tomatoes, cucumber, red pepper) with 1/3 cup hummus dip

  9. 12 small pretzels with 1 oz. light cream cheese

  10. 1 small apple with 1 mozzarella string cheese stick

  11. 2 sugar-free rice cakes with 1 Tbsp. natural peanut butter

  12. 12 baked tortilla chips and ½ cup salsa and spicy bean dip

  13. ¼ cup trail mix (i.e., raisins, dried cranberries, peanuts, almonds, dry cereal)

  14. ½ whole wheat bagel with 1 oz. light cream cheese

  15. ½ toasted whole grain English muffin with 1-2 Tbsp. tomato sauce and 1 oz. mozzarella cheese

  16. ½ turkey sandwich with lettuce & tomato & mustard

  17. ½ cup tuna salad with 1 tsp. light mayo and 6 whole grain crackers

  18. 1 hard boiled egg or 2 egg whites and 1 slice whole wheat toast

  19. Bean & Cheese Taco – 1 (6 inch) whole wheat tortilla with ¼ cup low-fat vegetarian refried beans, 1 oz. low-fat cheese and 1 Tbsp. hot sauce

  20. Chocolate-Banana Shake (blend: 1 cup low-fat chocolate soy milk, ½ frozen banana, and dash of cinnamon)

The Viverae clinical team is made up of in-house registered dietitians and registered nurses. They interact on a daily basis with members who have the highest health risks. Kristi Hatfield is a special contributor to the Viverae Blog.

Have a snack suggestion or comment regarding this article? We would love to here from you!

Viverae Health Specialist Expert Tips: 5 Ways to Improve Your Running Form--Day 5

Day 5 in the weeklong Viverae Expert series: 5 Ways to Improve Your Running. Click here to start on Day 1

Wear Appropriate Gear

Your running gear, just like your shoes, can have an impact on your efficiency, speed and comfort level during a run. There are a lot of choices out there at every price level. The most important consideration is for gear that is made of a moisture wicking fabric. These materials will remove sweat and keep you comfortable for longer periods of time. Cotton may be the fabric of our lives—but it holds sweat which increases the weight of the clothing, can cause chafing, and generally do not flow as well as the new synthetic materials during movement.

Dress for the weather and conditions outside. If it is cold, don’t assume your body will warm itself up as you run. The best ways to keep warm are to cover your head and hands since those are where we can lose a lot of our heat. In hot weather, dress in light clothing. If you like running at night, make sure your clothing has reflective properties or wear a reflector. Just because you can see a car coming doesn’t mean they can see you.

Keep your shoes dry! Do not run in wet running shoes as when they get wet they stretch and lose the ability to provide proper support. Also, while shoe care is being discussed: Your running shoes are for running. Not for walking around the house, going out to the store or any other non-running activity. This will increase the life of the shoe and insure that you receive the utmost support and protection each time you run.

Finally—never wear a brand new piece of gear for a long run without testing it out first. It is always exciting to get a new shirt, shorts or socks. However, every body is unique and each article of clothing will behave differently on you. If you are racing, make sure you have spent ample time in each piece of gear—trust me on this.

Whether you are training for a marathon or trying to lose weight, following these simple guidelines will help you to get the most out of your runs and to enjoy your workouts more.

Have fun out there, stay safe and keep running!

Bradley is a health and fitness specialist at Viverae and specializes in exercise and fitness education. He was 4-Time Collegiate Track and Field All- American and has experience in Personal Training and Injury Rehabilitation. His education background includes a B.S. in Exercise Science as well as being a National Strength and Conditioning Association- Certified Personal Trainer.

Viverae Health Specialist Expert Tips: 5 Ways to Improve Your Running Form--Day 4

Day 4 in the weeklong Viverae Expert series: 5 Ways to Improve Your Running. Click here to read Day 1 , Day 2 or Day 3

Day 4: Switch Up Your Workouts

We have discussed the need for proper shoes, how to correct your running form, and nutrition/hydration—now its time to start running! It doesn’t matter whether you are training for a marathon or running to lose weight—putting a workout plan in place will help you reach your goals. I suggest laying out a day-by-day plan at the beginning of the week so each individual run and workout goal is set ahead of time. Remember to keep a variety of workouts in the mix! Doing the same thing day after day gets boring and makes you less willing to want to complete the workout. Be creative and add variety to your schedule—your mind and body will thank you!

I know what you’re thinking, “I am too busy to be creative; I just need to get up and go.” Adding variety to workouts is not as complicated as some people think. It can be as simple as switching up the distances and speeds that you run each day. Try to plan your week with a mix between long, slow runs and shorter, faster paced runs. You can also do tempo training, alternating between fast and slow paces during a single run. A great example of this is running for 3 minutes and walking for 1 minute over the course of your entire run. A third option for variety is to add in a hill workout (find a couple of hilly streets in your neighborhood) or trails at a park or lake.

Cross training is a great way to improve your fitness level and gives your legs a break from the beating they can receive from running every day. Some examples of cross training are swimming, biking, and playing sports that involve some form of running or plyometrics. Working out should not be all work and no play, and cross training is a great way to have fun and get a workout at the same time.

Finally, don’t forget to add resistance training. Resistance training helps strengthen muscles and is a key component of your overall health and fitness. The obvious way to add resistance is weight lifting; however there are numerous ways to add resistance training without going to the gym. Dumbbells, resistance bands and medicine balls are all fairly inexpensive and can be used at home, work or at your local park. Be creative with your workouts and it will keep you from getting bored. Your running workouts will thank you!

Final Post Tomorrow: Day 5: Wear the Right Gear

Bradley is a health and fitness specialist at Viverae and specializes in exercise and fitness education. He was 4-Time Collegiate Track and Field All- American and has experience in Personal Training and Injury Rehabilitation. His education background includes a B.S. in Exercise Science as well as being a National Strength and Conditioning Association- Certified Personal Trainer.

Viverae Health Specialist Expert Tips: 5 Ways to Improve Your Running Form--Day 3

Day 3 in the weeklong Viverae Expert series: 5 Ways to Improve Your Running. Click here to read Day 1 or Day 2

Day 3: Eat Healthy, Stay Hydrated, and Rest

Day 1 discussed the importance of the right running shoe. Day 2 focused on improving our running form. We have to be ready to start running, right?... Not yet—but very soon! Before we hit the pavement you need to make sure you have enough energy and are adequately hydrated. Dehydration and excessive fatigue are all too common during running, especially since they can both be prevented by eating right, drinking water and getting enough rest.

Let’s start with the diet first: Eating plenty of carbohydrates prior to your runs will help delay the onset of fatigue by giving you more energy. Yes, I said “Eat your carbs!” Some good sources of carbohydrates are most pastas, white rice, potatoes, breads, and vegetables, just to name a few. Also, discuss adding a multivitamin with your doctor. A multivitamin is an easy way to be sure you are getting the adequate nutrient intake to keep up with your body’s needs.

On to hydration: Drink plenty of water before, during, and AFTER your runs. Do not stop drinking fluids just because your run is over. Your body needs to replenish what it lost during the run. Drink pure water or sports drinks-but make sure you avoid beverages containing caffeine (soda, tea or coffee) because caffeine will act as a diuretic and contribute to dehydration. As a general rule, try to drink a small bottle of fluid per each pound (half kilogram) of body weight that you lost while running.

Remember that the majority of sports drinks on the market have a significant amount of sugar and sodium. Water should always be your first and top choice!

Listen to your body, don’t overtrain: Get enough rest in between workouts. This doesn’t just mean sleeping (even though sleep is very important); it also means allowing your body enough time to recover from your run. Overtraining can lead to injury, weight gain, and declines in performance. Try a few workouts and see how they make you feel the next day. If you are overly sore or have pain, take some time off and adjust the intensity of your workouts.

Remember: it is better to start too easy and work your way up than to start too hard and up injured.

Up next: Day 4: Switch Up Your Workouts

Bradley is a health and fitness specialist at Viverae and specializes in exercise and fitness education. He was 4-Time Collegiate Track and Field All- American and has experience in Personal Training and Injury Rehabilitation. His education background includes a B.S. in Exercise Science as well as being a National Strength and Conditioning Association- Certified Personal Trainer.

Viverae Health Specialist Expert Tips: 5 Ways to Improve Your Running Form--Day 2

Day 2 in the weeklong Viverae Expert series: 5 Ways to Improve Your Running. Click here to read Day 1 .

Day 2: Correct Your Running Form

Day 1 was all about finding the right shoe. Now that you have replaced your old shoes with a brand new pair of properly fitted running shoes lets hit the pavement—right?? Nope. Before you start training, we need to make sure you have the correct running form.

Running with the correct form can improve the length and time of your runs, prevent injuries and make you a more efficient runner. Efficiency means that you use less energy during each step. And when running a 5K or something as lengthy as a half marathon, it is the little things that make the difference in the long run (no pun intended!). When running, your torso should lean slightly forward with a flat back. The heels of your foot should never land in front of your body; they should land directly beneath you. Keep your hands and shoulders relaxed at all times with your elbows maintaining a 90 degree angle.

I know this seems like instruction overload—so try to think about each instruction as a progression:
1. Am I leaning forward?
2. Is my back flat?
3. Where are my heels landing?
4. Are my shoulders relaxed?
5. Am I holding my elbows at 90 degree angles?

A general rule when determining if your hands are in their correct positions is to remember “ear to pocket”. Your hand should start at the pockets of your pants and go no higher than your ears. Experiment with this new form to find out what is most comfortable for you. If you are serious about changing your form you can practice upper body motions while looking at a mirror, or have a friend video you while you jog to see what areas need improvement.

For Wednesday: Day 3: Eat Healthy, Stay hydrated and Rest

Bradley is a health and fitness specialist at Viverae and specializes in exercise and fitness education. He was 4-Time Collegiate Track and Field All- American and has experience in Personal Training and Injury Rehabilitation. His education background includes a B.S. in Exercise Science as well as being a National Strength and Conditioning Association- Certified Personal Trainer.

Viverae Health Specialist Expert Tips: Five Ways to Improve your Running

Lately, it seems that whether you are at the office, hanging out with friends, or even just talking to someone in line at the grocery store, you can find at least one person training to run a 5k, half marathon or even a full marathon. Whether it’s for a cause, a special event, or simply to get in better shape, competitive distance running is becoming more and more popular. Even if racing is not for you, just taking the time to enjoy a jog outside is a great way to get off the couch, get outdoors, and relieve stress all while getting the exercise you need to stay healthy.

As a former Track and Field athlete and Personal Trainer I always get the same question: “How can I become a better runner?” Over the next five days I will be providing 5 tips that you can use to help improve your running--no matter your level or distance!

Day 1: Find the Right Running Shoe

Before we even begin to think about running we need to be sure we have the right equipment. Finding the right running shoe for your type of foot and step pattern is essential to becoming a better runner. The best way to do this is have your doctor take a look at your feet on your next appointment so he can evaluate your type of arch: (i.e. low arches, high arches, or sometimes collapsed arches) It is important to find a shoe that matches your arch - otherwise you increase your chance for excessive fatigue and injury.

Next, examine your gait, or step pattern to determine whether you pronate or supinate during your runs. The most accurate way to do this is to get tested by an expert. Since not all of us have the time or money to hire an expert to examine our gait, a good trick is to look at your old running shoes and see which side of the shoe the tread has been most worn down on. A normal tread pattern should begin at the back of the foot and cross the shoe so that you push off the ground with the big toe. If the outside of your shoe is worn down, then you supinate during your runs. If the inside of your foot is more worn down, then you pronate, and you should look into buying shoes accordingly.

If you are still unsure, take your old running shoes to a store that specializes in running shoes and apparel. Often, these stores are staffed with an in house expert who can evaluate your shoe needs.

Tomorrow: Day 2: Correct Your Running Form

Bradley is a health and fitness specialist at Viverae and specializes in exercise and fitness education. He was 4-Time Collegiate Track and Field All- American and has experience in Personal Training and Injury Rehabilitation. His education background includes a B.S. in Exercise Science as well as being an National Strength and Conditioning Association- Certified Personal Trainer.

This weeks 5 Health Articles You Must Read!

Mark Head CSO at Viverae, provides a weekly post on his top Health, Health Care, Wellness, Insurance and Benefits articles

Are employers ready for the 9/23 health reform changes?

Although this article is targeted to brokers, it’s a nice, succinct list of key changes that are effective for plan years beginning on or after 9/23/2010. Included are recaps on the provisions regarding (1) grandfathering, (2) appeals process, (3) annual plan limits, (4) dependent coverage extension, (5) lifetime limits, (6) pre-existing conditions, (7) preventive care, and (8) coverage rescissions.

Deloitte: Mobile PHRs 'game-changing' for self-care

Paul Keckley, Executive Director of the Deloitte Center for Health Solutions, says "The personal health record embedded in mobile communication devices - mPHR - is the _”killer app' that may change the game for providers, consumers and payers." _ We concur. Clearly, people have become highly dependent on mobile devices: they are small, convenient, and intimate. Our ability to opt-in to receive relevant information directly to our fingertips, and our ability to publish out where we are, what we’re doing, and add information to various personal records “on-the-fly,” is already reshaping social, business, and health experiences worldwide.

Physicians use photos from patients' cell phones to deliver 'mobile health'

Emergency room physicians at George Washington Hospital in D.C. have been 90% accurate in diagnosing patient wounds using photographs sent over cell phones by patients. Such “telemedicine-type” uses of mobile devices (see article above), will continue to transform the practice of medicine, as well as the logistics of care delivery. These kind of innovative uses are already beginning to take costs out of the system.

Prescription drug use on the rise in U.S.

This trend is not at all surprising, but it’s not encouraging. While it’s desirable for people with chronic conditions to be sure to take the meds they need, for nearly half of all Americans to have taken a prescription drug in the previous month is, from several vantage points, disturbing. As Dickens might have said, “It is a far, far better thing that I do, than I have ever done, to become healthy enough not to need any prescription drugs of any kind.” In particular, note the percentage of our children taking prescription drugs, and that antidepressants were among the most common type of drug for people age 20 – 59.

Healthcare wastefulness is detailed in studies (Free registration)

In the wake of health reform’s expansion of coverage to 40+ million more people, there are many people concerned about the burden on, and shortage of, primary care physicians (PCP’s). The Times article recaps a study published on Tuesday 9/7 in Health Affairs, which found that half of 354 million physician visits for acute care needs (fevers, stomachaches, coughs, etc.) were not with the patient’s PCP, and a quarter were in the ER._ Another study in the same Health Affairs issue revisited the issue of “defensive medicine,” which often results in unnecessary or redundant care due to fear of lawsuits.

_Be sure to check back next week for another round of Must Read Articles! If you have an interesting article we should read, or want to discuss then leave a comment or send the link to our twitter handle:_@viveraehealth

Health and Wellness Articles You Should Read-From the Desk of Mark Head, CSO

Mark Head, CSO at Viverae, provides a weekly update on articles that affect the Health Care, Health Management, Corporate Health and Wellness and the Benefits industry. Mark also provides a quick write up on each article.

Hospitals posting ER wait times on ER billboards and via text messaging

ER usage is a type of utilization targeted by companies and health care reform both. We’ll continue to monitor _how mobile media is making inroads into the delivery of both care and information. _ In this post, wait times are explored, and how hospitals are using texting to try to minimize delays, and trying to keep patients in the loop as well.

Who wins and who loses under Health Reform?

Paul Keckley, Executive Director of the Deloitte Center for Health Solutions, says it’s too early to tell, but offers a quick take on some of the issues affecting various health care sectors – worth the quick 3 minutes it will take to get his handle on things.

Patients forego needed care and medicine to save money

This is bad news, but not surprising. Employers have long relied on “cost-shifting” to contain health plan expenses. But, as the cost of health care for the employee/patient increases, the more likely it is that they’ll scrimp, and we’ll see statistics like these increases as well:
• 39% of people say they economized on some form of health care in the last year
• 23% said they had postponed a doctor’s visit
• 16% said they had declined a medical test because of cost
Real health care cost savings come from needing less health care, and that requires getting healthier, or at least managing existing conditions more effectively.

Social media continues to explode in the healthcare arena

Patients are sharing their experiences, what works, what doesn’t, their concerns and kudos for physicians and hospitals, and even easing their own stress burden. When the concerned inquiries about Jenny Scott’s daughter’s condition got overwhelming, “she referred her loved ones to the blog and asked them to stop calling. ‘I could not tell the story 12 times a day,’ Scott says today. ‘It was physically and emotionally draining.’”
Also check out this burgeoning site: patientslikeme.com

Critical illness cuts family income by $12,000 in first year

Recent MetLife research looked at the links between major illness, ability to work, and income levels. It’s scary stuff. We all know about the high costs companies are incurring for major illnesses, chronic conditions, and unhealthy employees, but the financial impact on the employee/patient has been much less transparent. MetLife has an interest in selling critical illness insurance coverage, but that doesn’t change the human concerns associated with high medical costs: other studies show that something on the order of 50% of bankruptcies are driven by medical expenses.

Do you have an article that should be included in this list? Let us know by leaving a comment or contact us on Twitter: @viveraehealth

Featured Health and Wellness Articles-From the Desk of Mark Head, CSO

Mark Head, CSO at Viverae provides a weekly update on articles that affect the Health Care, Health Management, Corporate Wellness and Benefits industry. Mark also provides a quick write up on each article.

Hewitt survey: most employers expect to lose "grandfathered" status by 2014

Ninety percent of 466 companies said they expect to lose their grandfathered status by 2014, with the majority expecting to do so in the next two years. Large employers don’t expect this to have a huge cost impact, but we’re not so sure. And small- to medium-size companies are more likely to feel the crunch as health reform’s “minimum requirements” expand coverage limits and reduce employers’ and health plans’ ability to place any new restrictions on coverage.

New University of Michigan study finds long-term wellness programs savings

The perennial question regarding wellness programs has been “what’s the ROI?” Despite large numbers of individual employer studies and “meta-studies,” (studies of studies), the question persists, I think largely because there have been large variances in the program components, reward levels, and group demographics. Besides, if you’re an employer about to embark on your own wellness journey, you’re more interested in knowing what your ROI possibility is. Of course, no one can predict the future ROI – nor should they really try. It can be illustrated, even illustrated over a longer-term period. This article goes to one of the most credible long-term observers and analysts of wellness programs, the University of Michigan. Over nine (9) years – even though workers were aging, this Midwest utility company saved $12.1 million against $7.3 million spent.

Health insurance brokers - are they teed up properly for the post-reform world?

Beverly Beattie worked in the physician recruiting business and the health system business before becoming a broker. She sees both key opportunities and significant threats to brokers based on whether they are able to evolve into ever-more-strategic advisors to their employer clients. In all instances; she sees wellness and health management programs as an integral plank in long-term benefit management success.

Benefit claims costs jump following layoffs

OCI, a data integration and software provider in Denver, found over a 32-month study, that claims costs for workers comp, LTD & STD, and health plans all went up. They found that increased stress can increase injury rates, that the fear of being let go can accelerate the utilization of benefits, and that complex and high-risk claims are also more likely actually to be incurred, indicating additional value from early case management interventions.

Why all the fuss about social media?

It’s become common knowledge that social media is revolutionizing our social interactions and, increasingly, our business interactions. The convergence of social media, mobile devices, and healthcare continues to explode, and the implications for healthcare are literally staggering. In this post, Paul Roemer of HealthcareIT Strategy offers some simple but compelling insights into why and how hospitals can get on board.

Do you have an article to share, or an idea that would make a great topic for discussion? Please contact us through twitter @viveraehealth or leave a comment!

Health Management and Wellness Articles from the desk of Mark Head, CSO

Mark Head , Chief Solutions Officer at Viverae, provides a weekly update on important and relevant articles for the Health Management and Wellness Industry. Mark also provides a short commentary on each article. Enjoy!

Indiana University hopes 'wellness incentives' cut insurance costs revised link 8/23

More and more employers are moving to outcomes-based wellness program incentives. It is inevitable and, from my perspective, fair and necessary. Although some people will continue to harp that such programs “unfairly penalize the unhealthy,” outcomes-based programs, by law, have to have alternative standards, so there will always be inherent mechanisms actually to protect the “unhealthy.” What’s not fair is to say “I get to live however I want to and when my body breaks, you pay for it, not me.” Indiana University employees who do not participate in their wellness program will pay $480 to $1,920 more in payroll deductions for family coverage in 2011.

Advocate seeks to bring mental health awareness to classrooms, business

What we see in claims data is that up to 6 times as many people are taking anti-depressant drugs as have been diagnosed with depression. Think about that: if people would rather pop a pill than get an appropriate mental health intervention, how might that impact general employee engagement efforts, much less health improvement efforts through wellness programs. Ben Harrington is seeking to do something about it, and he’s also addressing this type of issue on the front-end, in the schools.

Accountable Care Organizations (ACO's) - ready for prime time? and another article Here

The entire healthcare system is seeking to improve overall patient care, thus improving overall health outcomes for people, and saving the country, the government, communities and companies big bucks. Last week one of our article links recapped the success of Boeing’s Medical Home pilot program. This week, Health Affairs presents a point and counterpoint on ACO’s. ACO’s – like so many other ideas for improving patient care – seek to coordinate services rendered by primary care docs, specialists and hospitals. Since ACO’s are sanctioned under health reform, they’re here to stay. As to whether they’re ready for prime time, well, time will tell.

"Biosimilar" drugs could save billions

Health reform created an approval pathway for “biosimilar” drugs. Mark Armstrong of Epstein Becker & Green says Such drugs have “no clinically meaningful differences…in terms of safety, purity and potency of the product.” Biosimilars are not generics because they aren’t exact replicas of the original, but are claimed to be similar enough to produce the same kind of positive results. Proponents project the U.S. can save over $70 billion over the next ten years.

Patient Reported Outcomes (PRO’s) are bolstering effectiveness measurement

What a novel idea: ask the patients themselves how well their treatments have worked for them. Surveys doing just that are becoming more common, and measure eight domains of a patient’s health: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional and mental health.

We are always interested in your feedback. Contact us at @viveraehealth on twitter with comments, suggestions or links to articles!