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Health Navigator Newsletter December 2018

Using meditative movement to reduce stress, effects of chronic illness

group doing a yoga pose

Today’s fast-paced and demanding world can take a toll on our health. There are pressures in virtually every aspect of life, from the workplace to relationships with family and friends, and health concerns. These stresses in life have been found to contribute to the onset of chronic diseases, such as depression and heart disease.

Meditative movement — exercises like yoga and Pilates that focus on breathing and a cleared state of mind aimed at a deep state of relaxation — has been found to be an effective way to combat chronic illness and aide in the healing process for patients undergoing surgery or cancer treatment.

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“These exercises focus on synchronizing your breathe with the movement and being very aware of your body at that moment. This activates the parasympathetic nervous system,” says Dr. Chiti Parikh, an internist and co-director of the Integrative Health and Wellbeing program at NewYork-Presbyterian in collaboration with Weill Cornell Medical Center. “The nervous system is split in two — the fight-or-flight response, which is the sympathetic system, and the relaxation response, which is parasympathetic system. During the course of the day, we constantly go back and forth between the two. But for most of us, throughout the day, are stuck in that fight-or-flight response. ”

This paralysis, she says, can increase blood pressure, heart rate, mood, stress hormone level, and affect brain wave patterns.

“When you breathe a certain way it activates the vagus nerve that controls the relaxation response. By breathing a certain way, you are manually stimulating that nerve and putting your body in the relaxation phase and out of the fight-or-flight response,” Dr. Parikh says.

Research studies have shown that the regular practice of yoga, an ancient Indian spiritual practice, may produce many health benefits, including weight loss, improved cholesterol, and lowered blood pressure. It also helps improve flexibility, increase muscle strength and tone, and is an effective weight loss method. Pilates, an exercise system that was initially created for bed-bound World War I survivors, has been found to help with chronic back pain.

“Pilates is mostly focused on core strengthening, a lot of back pain actually happens because the core is weak. So Pilates is good at core strengthening and not just abs. The back is actually the biggest part of the core muscles,” Dr. Parikh says. “It is also interesting to see that Pilates has been shown to be very good in the elderly population, specifically muscle strength, balance, and gait. So it decreases the risk of fall and has been shown to help with osteoporosis or bone density.”

The Integrative Health and Wellbeing Program at NewYork-Presbyterian offers guided yoga and Pilates courses for members of the community and patients. These courses can be customized to the individual needs of the participants, particularly for those with injuries or certain medical conditions.

“The Integrative Health and Wellbeing Programs focuses on a more holistic model where all types of care are integrated under one roof. What we do is combine the best of conventional medicine with top-notch doctors along with these integrative modalities,” she says. “We’ve taken a lot of care in assembling a team that has a lot of experience, especially in a clinical setting. So to have a Pilates instructor who knows how to work with cancer patients or a yoga instructor who knows how to work with someone who has had knee surgery or osteoporosis is very important.”

Located in the David H. Koch Center at NewYork-Presbyterian, the Integrative Health and Wellbeing program’s spa-like environment and services compliment medical therapies that clients are undergoing. The center has courses specifically designed to help patients heal following surgery and during cancer treatment. Participants in the “Prepare for Surgery, Heal Faster™” course have been found to have less anxiety before surgery, use 23 to 50 percent less pain medication after surgery, and heal faster than those who do not take the course.

The center also offers classes for strength and balance, mindful meditation, and revitalizing flow yoga.

“No matter where you are on your health journey — whether you’re a 30-year-old trying to work on your abs of steels or a 70-year-old trying to work on your balance — we can help you create that customized health plan to reach your end goal,” Dr. Parikh adds.

Join us for a class!

Monday, December 17, 2018
Vinyasa yoga @ 7:10 am 
Revitalizing flow yoga @ 12:00 pm 
Mat Pilates @ 5:00 pm, 6:00 pm 
Mindfulness meditation @ 6:00 pm 

Tuesday, December 18, 2018
Yoga for those living with cancer @ 2:00 pm 

Wednesday, December 19, 2018
Vinyasa yoga @ 7:10 am
Strength & balance @ 11:00 am
Revitalizing flow yoga @ 12:00 pm
Mat Pilates @ 5:00 pm, 6:00 pm

Friday, December 21, 2018
Restorative yoga @ 11:30 am

Friday, December 28, 2018
Restorative yoga @ 11:30 am 

Visit nyp.org/integrativehealth for the full listing of upcoming classes.

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Give a boost to your health by lowering your salt intake

salt pourer

Here we are, nearing the start of a new year — a fresh start and a renewed opportunity to do things better than before. Topping the list of many people’s resolutions: living a healthier lifestyle, which typically starts with diet. Katie Campbell, RD, CDN, a registered dietitian at NewYork-Presbyterian Lawrence Hospital in Bronxville, discusses how something as simple as reducing sodium intake can boost your health by lowering your numbers — everything from blood pressure to weight.

Why should reducing salt intake be part of a healthy eating plan?
Even if you currently don’t have high blood pressure, it is important to monitor your sodium intake to prevent a rise in blood pressure that can occur naturally with age. High blood pressure can lead to a multitude of other health conditions so taking preventative measures are essential in living a long and healthy life.

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What are the health dangers of too much salt?
A diet high in salt can cause a host of conditions, particularly high blood pressure, which can lead to heart attack, stroke, heart failure, kidney disease, and osteoporosis. Too much salt in the diet also makes the body retain water, which gives us that bloated feeling and can contribute to weight gain.

What are the latest USDA guidelines for daily sodium intake?
The average American should have less than 2,300mg per day and ideally less than 1,500mg per day, especially if you already have hypertension or prehypertension. The guidelines do not differ per age or gender.

Why is some salt/sodium important in the diet?
Sodium is a mineral that is essential for life but your body only requires 500mg per day, which is easy to achieve.

Which foods are typically high in salt and should be avoided?
Let’s face it: salt tastes good and helps bring out the flavor in foods. But it’s significant to note that seventy-five percent of the sodium we, as Americans, consume comes from processed, prepackaged foods and restaurant food. The American Heart Association also identifies the “Salty Six” — bread and rolls, pizza, soup, sandwiches, cold cuts and cured meats and poultry. Limiting these foods by cooking at home and incorporating more fresh ingredients, can drastically reduce sodium intake. Remember, it’s impossible to completely eliminate sodium, but the goal is to make healthier, more mindful choices to reduce your overall intake.

Can you offer some tips for reducing salt in the diet – without sacrificing flavor?
Here are some effective ways I always recommend:

  • Always read labels and try to stay within the 2,300mg per day guideline
  • Prepare your own foods and avoid purchasing convenience foods such as canned soups, frozen dinners, instant cereals, and gravy sauce mixes.
  • Purchase fresh items – fresh fruits, vegetables, whole grains and meat and seafood products. Check the packaging on meat and seafood to see if salt water or saline has been added.
  • Choose condiments wisely. Many condiments are packed with sodium. Read labels and always look for the reduced or low sodium versions.
  • Buy unsalted snack items.
  • Drain and rinse canned vegetables and beans.
  • Always use low sodium versions to cook with such as low sodium chicken stock.
  • If you go out to eat, specify how you want your food prepared, for example, ask for sauce or dressing on the side. And look for key words such as pickled, brined, cured, smoked, soy sauce or teriyaki sauce — these words mean the food will be higher in sodium content.

Try a homemade spice blend with no salt. Two examples:

Cajun Spice Blend
2T Cumin
2T Coriander
2T Paprika
1 1/2t Black Pepper
Cayenne Pepper to taste
1T Dried Oregano
Use on chicken, fish, shrimp, steak, & thick cut veggies

Greek Spice Blend
1T Garlic Powder
1T Dried Basil
1T Dried Oregano
1-1/2t Black Pepper
1-1/2t Dried Parsley
1-1/2t Dried Rosemary
1-1/2t Dried Thyme
Use on veggies, chicken, pork, beef, or lamb

To try more tasty and nutritious recipes, visit nyp.org/nutrition. To find a primary care doctor, please call 877-697-9355.

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Aging gracefully: How to cope with chronic conditions

mature woman holding wrists

Chronic conditions can take many forms. Some, like osteoarthritis of the knees, affect a small area of the body but may have a large impact on your quality of life. Others conditions, such take many forms. Some, like YOU as diabetes or cancer, can have head-to-toe effects on the body and significantly influence daily living. But, chronic diseases and their related symptoms do not have to be defining.

“When people are diagnosed with a long-term illness, they often ask how their lives will change,” says Dr. Emil Baccash , attending physician in internal and geriatric medicine at NewYork-Presbyterian Brooklyn Methodist Hospital. “The key to living well with a chronic illness is adapting to it.”

Whether you have lived with a chronic disease for years or received the diagnosis just last week, the following tips will allow you to adjust your habits and your self-care routine for a higher quality of life.

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Lean on your primary care doctor

Of those working with you to manage your health, your primary care doctor plays the most important role in helping you maintain the richest possible quality of life. He or she is your go-to resource for safe exercise recommendations, dietary suggestions, and answers to any questions that you have about living with a chronic illness. You might need to know whether it is safe to travel with cardiovascular disease — it typically is — or how to modify your home if you have chronic obstructive pulmonary disease (hint: keep frequently used items within easy reach).

Your primary care doctor can address these concerns and keep a close eye on your overall health, coordinating with other medical specialists, if necessary, to help you manage any changes.

Take an active approach

Exercise is powerful medicine for many chronic diseases — it can reduce the risk of osteoporosis-related fractures, mitigate osteoarthritis pain, and boost the spirits of people who are experiencing depression, among many other benefits. The key is to find a variety of safe, enjoyable activities that you are likely to stick with. Walking your dog or riding a stationary bike are low impact options that are easy on your joints and get your heart pumping. To reap the full rewards of exercise, incorporate range-of-motion activities like chair yoga and muscle-strengthening activities like wall push-ups.

Add spice to your exercise routine by trying a new activity, such as water aerobics if you are looking for a fitness activity that isn’t hard on your knees or yoga if better balance and muscle strength is important.

Feed your wellness

The staples of a healthy diet — whole grains, lean proteins, and a colorful array of fruits and vegetables — are important for managing a chronic condition, but did you know that you could use food to target symptoms or promote specific aspects of health? Fish like salmon, herring or mackerel, which are rich in omega-3 fatty acids, can help reduce inflammation associated with arthritis.

Read up

Knowledge is more than power — it is peace of mind. The more you remove the element of mystery from a chronic disease, the less intimidating it may become. Spend time learning about the condition you have, which will better prepare you to face any challenges it may present and provide helpful ideas for how to live well with it. As you gather information, ask your primary care doctor and specialists for resource recommendations.

Stress be gone

Stress and chronic illness often feed off one another, each making the other worse. That makes managing stress one of the most important things you can do for your health. Decreasing stress is a highly personal process — no two people go about it precisely the same way. To form a de-stressing habit, make time each day for an activity that you find soothing. This might mean listening to a particular genre of music, visiting an art gallery or taking a walk outside. Whatever it is, the activity should leave you feeling calmer than before you started it.

Stay social and seek support

Your relationships with family and friends can be deeply therapeutic, especially when it comes to avoiding depression, which is a common complication of chronic illness.

“Depression can make a chronic disease worse by reducing motivation to exercise, eat healthy and follow treatment recommendations,” says Dr. Anna Gorelik, attending physician in geriatric medicine at NYP Brooklyn Methodist. “Make it a point to call, video chat or visit with family often, and keep up with friends by going out to lunch or getting together for a weekly walking group.”

Sometimes, the most valuable form of support comes from those who are walking the same path as you.

“Joining a disease-specific support group is a great way to meet new people whose fellowship and encouragement can enrich your life,” Dr. Baccash says. “Plus, they can be a great source of advice.”

Maintaining social connections is also a great way to build a network of support you can call upon if, for example, you need help running errands after treatment or an extra set of ears at a specialist appointment.

To learn more about aging, visit our health library. To find a primary care doctor, please call 877-697-9355.

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Six ways to strengthen your relationship with your children during the holidays

mother and child holding donation clothes and toys

Parents play a vital role in the lives of their children—one that impacts their physical, mental and emotional well-being into adulthood.

“Our relationships with our children serve as a blueprint that guides their relationships with others throughout their lives,” says Jo Hariton, PhD, of the Social Skills Training Program for Children and Adolescents at NewYork-Presbyterian Hospital Westchester Division. “Having a positive connection with parents helps children feel good about themselves, and serves as a building block to help them form healthy relationships with others.”

Sometimes, however, relationships go awry for a host of reasons. The good news is that it’s never too late to make inroads to repair them. “Teaching a child that mistakes can be made and then corrected shows them that parents are not perfect; everyone can make mistakes. But the most important lesson it shows is that you are committed to your relationship to your children — and they will sense this from your actions,” notes Dr. Hariton.

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Our brains are wired to connect with those around us, and parents can serve as positive role models in strengthening those connections, particularly within the family. Despite the demands associated with the holidays, it is a good time to jump-start everyone’s yearning for a warm and inviting family environment.

Some tips:

  1. Create holiday rituals: This can be anything from making holiday cookies, wrapping presents, picking out the tree, having game night, or relaxing after a holiday meal when the whole family is present. Put aside your cell phones and spend real time on creating positive family dynamics.
  2. Uphold family traditions: Kids love to hear stories about how the holidays were celebrated when their parents were growing up. Don’t worry if these stories are repeated, as they become part of family lore that kids love to know about. Let them ask questions, show them photos, and talk about the extended family that is a part of their heritage.
  3. Give back to the community: Helping children learn the value of community service can be a regular tradition at holiday time. Helping in a soup kitchen or packing warm items for the homeless, selecting a charity that they would like the family to give to, or contributing to an environmental cause are all ways to instill the idea that they are part of a broader community. Depending upon their age, the kids can do some research to select the charity for their gift list. Their choices should be celebrated and talked about as a family.
  4. Practice the art of conversation: Given these turbulent times, the family is even more important as a safe haven in an insecure world. Let the kids express their worries and help them develop perspective. Make room for this type of discussion even in a season when everyone thinks they should be merry. Children feel more secure when they feel listened to and guided.
  5. Take time to de-stress: If you, as caregiver, become stressed by all there is to do, take time to relax, so that your stress does not become misdirected toward your children.
  6. Make space for family time on a regular basis: In the big picture it is the most important gift that you can give your children. Learn to recognize your child’s expression of emotions as a way to help them connect with others. A weekly family meeting can be a good way to keep communication open and to problem solve when needed.

Finally, Dr. Hariton notes, “There is always room to grow with regard to good parent/child relationships. Following these simple tips can prove very effective in creating a family dynamic that is positive and productive for all involved.”

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