Resolutions:

Make your
mark on the
new year
3 Be a hero by giving blood 7 How to survive the night shift
January 2008










C
e
lebrating 30 Yea
rs o
f

H
e
l
p
in
g
P
eople Stay Health
y
did you know?
Only 5 percent of the people
who are eligible to donate
blood are regular donors.
American Red Cross
smoking
increases risk
of eye disease
Smokers are four times
more likely than
nonsmokers to develop
late-onset age-related
macular degeneration
(AMD), a leading cause of
blindness, according to an
Australian study. And,
people who used to smoke
are three times more
likely to develop the
disease than people
whove never smoked,
researchers say.
When combined with
smoking, having a low
HDL cholesterol level (the
good kind of cholesterol)
or eating little or no sh
appeared to bring an even
greater risk of AMD.
Archives of Ophthalmology
My seventh-grade daughter feels lef out of the
cliques at school. How can I help her adjust socially?
Making friends is very important for children at this age.
However, cliques and friendships arent the same thing.
Cliques ofen are like clubs, with codes of behavior based
on maintaining status and popularity. Kids may worry they
wont be accepted into a clique. Once accepted, they may do
things to stay in the group that they ordinarily wouldnt do.
True friendships, on the other hand, should be based on
mutual respect. Friends accept each other as they are. It might
be helpful to explain these diferences to your daughter in a way
that shell understand.
Ask your child about her interests and which classmates
she thinks share those interests. Maybe her school, house of
worship or a youth group ofers some extracurricular activities
she would enjoy, where she could meet like-minded kids.
Parents also can try reinforcing the positive friendships
their child has. Invite those children over to the house or out
for fun events with your family. Tese actions can help teach
your child that the best way to make a good friend is to be a
good friend.
portion-control plates may help you lose weight
Portion-control plates, which are marked to indicate serving sizes, may help
with weight loss, according to a clinical trial of 130 people. The six-month
study compared obese people with Type 2 diabetes who used portion-control
dishes with those who didnt. On average, the portion-control group lost
1.8 percent of their body weight, compared to 0.1 percent in the other group.
The special dishes are available online and sold under such brand names
*
as
Diet Plate

, Portion Plate

and Healthy Plates

.
Archives of Internal Medicine
*Taking Care neither endorse nor promotes any particular product.
quick takes
Questions are answered by Phyllis D. Cross, M.D., M.P.H., in conjunction
with the Taking Care medical advisory board and medical contributors.
This publication provides general information and isnt a substitute for professional health care. Be sure to discuss with your doctor any health strategies or medical treatments.
YOU THINK you know the people
you love. But, a person with borderline
personality disorder (BPD) can go from
happy to hostile so fast, you may think
youre in a relationship with a stranger.
BPD can disrupt the persons work,
career plans, family and friendships.
Symptoms include:
l
Fear of abandonment and frantic eforts
to avoid even short separations
l
Intense mood shifs
l
Impulsive spending, impulsive sexual
behavior, substance abuse, reckless
driving or binge eating
l
Anger for no apparent reason
l
Suicide attempts or threats
l
Patterns of intense, stormy relationships
If you suspect your loved one has
BPD, its important for that person to see
a mental health professional. People dont
get better by themselves, and theres a lot
families and friends can do to help.
Recognize that the person is struggling
and that he or she isnt at fault. Ten:
l
Go slowly. Remember that fear of
abandonment plays a major part in
BPD and can lead to a relapse. As the
person shows signs of improvement,
dont assume your work is done
and withdraw your understanding
or support.
l
Keep things calm. Any type of stress
may be difcult to tolerate for a
person with BPD. Tone down both
disagreements and praise.
l
Maintain family routines.
l
Dont get defensive. Keep your cool in
the face of accusations and criticisms,
no matter how unfair.
l
Be a good listener. Let the person
express intense feelings, and dont try to
make the feelings go away.
BPD can be difcult and frustrating.
But, its also very treatable.
Stranger in my house
Blood donation: Your gift of life
GOT AN hour? Be a hero. In the time it takes to watch an
episode of ER, you can save up to three lives, just by
donating blood.
Teres nothing to it, really, says longtime blood donor
Rod Murphy, 50. You sit in a comfortable chair, chat with
some friendly people and get a free snack. And, you leave
feeling pretty good about yourself.
Millions of Americans donate blood every year, according to
the American Red Cross. To keep the blood supply safe, donors
must be in good health, be age 17 years or
older and weigh at least 110 pounds. For more
eligibility information, go to www.redcross.org
or ask at your local blood collection center.
Donation usually takes only 10 minutes
or so [for a whole-blood donation], and apart
from a little sting when they put the needle
in, its painless, Murphy says.
Needles, bags and other blood collection
supplies are sterile and discarded afer each
use, making it impossible to get infectious
diseases from giving blood.
Afer the blood is drawn, youll be asked to sit for a few
minutes, drink some juice and eat a small snack before you
leave. You can donate again in about two months.
Although donors arent paid, they do have the satisfaction of
knowing they helped others.
Its nice to know you can contribute even if you dont have
a lot of money to give or a lot of time to volunteer, Murphy
says. As long as youre willing to donate blood, you can make
a diference.
on your mind
platelets: another way you can donate
Platelets are a component of blood that helps control bleeding.
Donating platelets takes a little longer than giving whole blood, but
its simple and safe. You can donate as frequently as every 48 hours,
but no more than 24 times a year. To schedule an appointment,
contact your local American Red Cross at 1-800-GIVELIFE.
TAKI NG CARE
|
JANUARY 2008 3
OUT WITH the old, in with the new. Sure, it may
be a bit clichd, but January is a great time for
resolutions and fresh startsfor you and your entire
family. As you look ahead to the possibilities of a
new year, how about setting a few goals for better
health, too? Here are eight ideas for 2008:
1
Color plates with nutritious foods. Are you
getting enough whole grains? Are your children
flling up with fruits and veggies? A nutritious, well-
balanced diet is essential to good health. Consider
these pointers:
l
Resolve to put more servings of fruits and
vegetables on the table and in lunches every day.
Tink variety, including dark green and other
colorful veggies.
l
Choose whole-grain breads and pastas.
l
Limit high-fat foods. Check food labels to choose
foods low in total fat, saturated fat, trans fat and
cholesterol, as well as added sugars and salt.
l
Serve cooked dried beans several times a week.
2
Move, move, move. Tune your family into
exercise rather than TV. Try taking walks
togetheror head to a roller-skating or ice-skating
rink. Warmer weather and longer days are great for
bicycling, swimming and other activities.
On a personal level, you can get your exercise
in 10-minute bouts if you fnd yourself strapped
for time. For example, taking a brisk walk in the
morning, at noon and in the afernoon at least
fve days a week can help you meet the current
exercise recommendations. You also should try
to ft in strength-training exercises twice a week.
However, check with your doctor before signifcantly
increasing your activity level.
3
Lose weight the right way. Forget fad diets.
Weight loss comes down to eating fewer calories
than you burn. Aim for small, lasting changes, such
as watching portion sizes and exercising more.
4
Stop smoking for good. Cancer, heart disease,
emphysemathe list of reasons to quit is
long. If youre ready to stop, mark the date on your
calendar. Decide whether to use a nicotine patch
or other nicotine-replacement aids, and remove all
tobacco from your home. Ask your doctor for help.
5
Get adequate sleep. Restful sleep can make a
big diference in how family members feel and
perform at work or school. Adults typically need
seven to nine hours of shut-eye every night, and
children need more. Try these tips:
l
Stick to a schedule for going to bed and getting up.
l
Avoid cafeine late in the day.
l
Keep bedrooms dark, quiet and comfortable.
6
Talk with your doctor about screenings. Is
it time for a cholesterol, blood pressure or
blood sugar check? Are your familys immunizations
up-to-date? Now is a great time to check, says
Jim King, M.D., president of the American Academy
of Family Physicians.
h
e
a
l
t
h

r
e
s
o
l
u
t
i
o
n
s
8 for 08
Chart your course for a healthier year with these ideas
4 JANUARY 2008
|
TAKI NG CARE
Make your resolutions stick
Keeping New Years resolutions is easier said than done.
But, that doesnt mean you cant create lasting habits. A
little planning can help you put your good idea into action,
says Deb Galuska, Ph.D., M.P.H., acting chief of the obesity
prevention program at the Centers for Disease Control and
Prevention. For example:
Set realistic, specic goals. Dont expect to shed 20
pounds by February or run a marathon right away. Aim for
something ambitious but also reasonable and achievable,
Dr. Galuska says. If your goal is to walk 30 minutes ve days
a week, maybe start by walking twice a week. But, keep it
specic. Dont just say, Ill exercise this year.
Write it down. Put your goals on paper so you can see
exactly what you will do and how you will get there.
Partner up. Invite family and friends to join you in your
quest to be healthy. Youre more likely to show up for those
morning workouts if someone is counting on you.
Reward your progress. How about a new pair of jeans
for losing 5 pounds?
Dont let setbacks stop you. Whether youre quitting
smoking or cutting calories, a slip-up doesnt mean youve
failed, says Jim King, M.D., president of the American
Academy of Family Physicians. Forgive yourself and start
again, he says.
Depending on your age, personal and family
history and other factors, your doctor may
recommend screenings for colorectal, breast, cervical
or prostate cancer.
7
Get a handle on stress. While some stress
is part of life, too much of it can take a toll.
Physical activity may help. When people work
a regular exercise program into their lives, stress
seems to get better, Dr. King says.
Also, stress ofen stems from having too much
to do and too little time. Consider what you might
be able to take of your plate. And, dont be afraid to
reserve some relaxation time for yourself.
8
Stay safe in 2008. While youre improving
your health and the health of your family,
renew your commitment to safety. A few reminders:
l
Make sure your home has working carbon
monoxide and smoke detectors near bedrooms.
l
Keep cleaning products and medicines in a
locked cabinet.
l
Always wear safety belts and observe speed limits.
l
Never drink and drive.
l
Make sure your family wears proper protective
gear, such as helmets when bicycling.
January is a great time for resolutions and fresh starts
for you and your entire family. Set some health goals.
TAKI NG CARE
|
JANUARY 2008 5
eating well
W
HEN YOU think of adding favor to foods,
salt may be your frst thought. Unfortunately,
excessive sodium intake can cause health
problems for some people. Herbs and spices provide a
great alternative. Tey add a burst of favor without the
sodium. You can relish your food and still eat healthfully.
Common herbs and spices include basil, oregano,
thyme, cinnamon, ginger and nutmeg.
While the words herbs and spices usually go together,
theyre not the same thing. Herbs are the fragrant leaves of a
plant. Spices come from bark, roots, seeds, buds or stems.
Sometimes, an herb and a spice can come from the same
plant. For example, the seeds of the coriander plant are a
spice, while the leaves, called cilantro, are an herb.
Practice makes perfect
It takes practice to use herbs and spices properly. Here are
some tips from the American Dietetic Association:
l
Herbs can be dried or used fresh. Just remember that
drying concentrates the favor. One teaspoon of a dried
herb is equal to one tablespoon of a fresh herb.
l
If the food youre preparing takes a long time to cook,
add herbs toward the end to preserve their favor.
l
Toast spices in a dry, nonstick skillet to enhance favor.
l
Try sodium-free seasoning blends, which are mixtures
of diferent herbs, spices or seeds ground together. Some
examples are curry, Chinese fve-spice and Italian.
l
Many herbs and spices are quite favorful, so use them
carefully. Add a little at a time, especially if youre using
an unfamiliar seasoning.
l
Crumble dried herbs between your fngers, or fnely chop
fresh herbs to release more favor.
l
Experiment with something unusual. Use a sweet spice
on meat or poultry or an herb in a dessert.
Te key is to have fun trying diferent combinations
of herbs and spices to create your own unique blends.
In the process, you may discover that salt seems rather
unimaginative and even boring compared to
the variety of favors available from herbs
and spices.
Storing your
herbs and spices
Herbs and spices wont last forever. To get the
most avor out of your seasonings, make sure
to store them correctly. Heres how:
l
Put dried herbs and spices in tightly
covered containers, and store them in a
cool, dry place.
l
Dont keep seasonings near sources of
heat, moisture or light.
l
Use dried herbs within a year of
buying them.
l
To keep fresh herbs longer, treat
them like a bouquet of owers. Snip
the ends, stand them in water, cover
with a plastic bag and place them in
the refrigerator, changing the water
every few days.
l
Freeze, dry or add the
herbs from your
garden to oils or
vinegars so you
can use them
during the
winter.
Source:
American Dietetic
Association:
Complete Food
and Nutrition Guide,
Third Edition
A matter
of
thyme
6 JANUARY 2008
|
TAKI NG CARE
MORE THAN 15 million Americans work evening or night
shifs. Some are law enforcement and health care workers.
Others drive trucks, fy airplanes or process phone calls from
customers around the globe. But, the thing many of them
share is a lack of sleep.
Shift workers at risk
According to the National Sleep Foundation (NSF):
l
Six out of every 10 shif workers are likely to have insomnia.
l
Tree feel excessive daytime sleepiness.
l
One or two report falling asleep on the job.
Unfortunately, lack of sleep increases the risk of:
l
On-the-job injuries
l
Car accidents caused by drowsy driving
l
High blood pressure and heart disease
l
Catching colds and the fu
l
Stomach problems, such as indigestion and heartburn
Tips for better rest
Adjusting to a nighttime schedule is tough because were
naturally programmed to sleep, not work, when its dark
outside. Te body operates on a 24-hour cycle, and the greatest
desire for sleep typically occurs between midnight and 6 a.m.
Set the stage
for sleep
If you need to sleep when
the sun is out, it may help to
prepare with these tips from the
National Sleep Foundation:
Wear sunglasses on your way
home from work.
Ask your family to help create a
quiet environment. This means
no vacuuming or blasting
the stereo or television while
youre trying to snooze.
Put a do not disturb sign
on the front door.
Turn off the phone ringer.
Keep your bedroom as dark as
possibleconsider installing
light-blocking window shades if
necessary. Also, adjust the room
temperature for comfort.
Try eyeshades and earplugs.
As many a bleary-eyed worker will attest, altering this rhythm
is challenging. Following these tips from the NSF may help you
get more rest:
Go to bed as soon as possible following your shif.
Avoid cafeine for at least fve hours before bedtime.
Dont drink alcohol. It may seem to relax you at frst, but
alcohol actually disturbs your sleep.
Eat a light snack. Dont go to bed too full or too hungry.
Dont exercise vigorously for at least three hours before going
to bed. Working out may leave you feeling too alert to sleep.
Be careful with over-the-counter sleep medicines. Tey may
leave you feeling drowsy afer you wake up. And, if you use
them too ofen, they may stop working.
Talk with your doctor if you regularly have problems
sleeping. A physician may prescribe medicines or have
additional suggestions.
Its been a hard days night
The body operates on a 24-hour cycle,
and the greatest desire for sleep typically
occurs between midnight and 6 a.m.
self-care
TAKI NG CARE
|
JANUARY 2008 7
Taking Care

Helping People Stay Healthy Since 1978

M-25729
O
2
W
2
1
3
6
6
Taking Care

January 2008 | Vol. 30, No. 1

E-mail: takingcare@uhc.com
If you have an address change, send
it directly to the entity through which
you receive the newslettersuch as
your employer or health plan.
Taking Care is dedicated to helping
people have healthier lives. However,
this publication does not replace
the necessary and individualized
medical care offered by a health
care professional. Not all treatments
mentioned in Taking Care are covered
by your health plan. Please check
with your health plan regarding
covered services.
Unless otherwise noted, all models are
used for illustrative purposes only.
2008 Optum

Michael W. Rosen, M.D.

National Medical Executive,
Health Solutions Group
Joseph R. Carcione Jr., D.O.,
M.B.A.
Medical Director, Healthcare
Services, Oxford Health Plansa
UnitedHealthcare Company
Gail Borgatti Croall, M.D.
National Medical Director, Health
Care Decision Support, Optum
Phyllis D. Cross, M.D., M.P.H.
Medical Consultant, Optum
Tanise Edwards, M.D.
Medical Consultant, Optum
Cheryl Lewis, R.N.
Medical Consultant, Optum
Virginia Lund, M.A., L.P.,
C.E.A.P.
Mental Health Consultant, Optum
Richard A. Zabinski,
Pharm.D.
Vice President, Pharmaceutical
Solutions, Health Solutions Group
Taking Care adheres to stringent clinical standards and
is reviewed by the following medical professionals:
OPTUM

NURSELINE
SM
SERVICES
Do you have questions?
Optum NurseLine registered nurses are available to
answer your questions and provide health information.
This page of your Taking Care newsletter features
examples of the kinds of questions people askas
well as the kinds of helpful answers they receive.
What are trans fats, and how do I avoid them?
THE FATS you consume in your diet are a bit like the title of
an old movie: Te Good, the Bad and the Ugly.
Polyunsaturated and monounsaturated fats are considered
good fats and can be found in saf ower, sesame, corn,
olive and canola oils, as well as in nuts, seeds and avocados.
Polyunsaturated fats play a part in reducing the buildup of
cholesterol in your blood vessels, possibly lowering your risk of
heart attack or stroke. Monounsaturated fats may ofer similar
benefts if your diet is low in saturated fats.
Saturated fats are the bad fats most ofen found in
foods that come from animals, such as meats, eggs and dairy
products. Tey can raise your level of LDL cholesterol
the type that contributes to clogged arteries, heart attacks
and strokes.
Trans fatsfound in many baked goods, some
fried fast foods, and stick margarines and shortening
are the ugly fats. Like saturated fats, they can raise your
Fats: The good, the bad, the ugly
LDL cholesterol level. Furthermore, they may lower your level
of benefcial HDL cholesterola type of cholesterol that helps
remove the harmful LDL from your body.
To avoid trans fats, pay attention to nutrition labels and
look for foods with little or no trans fat listed. You also can
look at the list of ingredientsif partially hydrogenated oil
is listed, the item has trans fat. It may be best to steer clear of
these foods. Te American Heart Association advises limiting
the trans fats in your diet to less than 1 percent of your total
daily calories. Tats no more than about 2 grams, or 20 calories,
in a 2,000-calorie-a-day diet.
Call Optum

NurseLine
SM

Services
1-800-267-3907
Registered nurses are available to answer your health-related
questions 24 hours a day.