Do you know your numbers?
Blood pressure reading for the average adult:
Less than 120/80 = ideal
Greater than 140/90 = high

You can have your cake, but should you eat it, too?
Are you at risk? Nearly 6.2 million* Americans are unaware they have type 2 diabetes. Early diagnosis and treatment of diabetes is essential to prevent serious problems later.

Who said quitters never win?
Studies indicate that people who participate in smoking cessation programs have a better chance of success*.

Keep your cholesterol under control.
Recommended cholesterol levels*:
• Total cholesterol less than 200 mg/dL
• Triglyceride levels less than 150 mg/dL
• LDL (bad) cholesterol less than 100 mg/dL
• HDL (good) cholesterol
Women: greater than 50 mg/dL
Men: greater than 40 mg/dL

Does your day start like this? The alarm rings and you’re off, with no time for breakfast. Even if you’re not in a rush, breakfast foods may not appeal to you. Or you think skipping breakfast will help you lose weight. Whatever the reason, you may be missing out on more than a meal.

There are at least three great reasons to have breakfast:
• You need the energy. Imagine trying to start your car with no gas in the tank. That’s what it’s like when you begin your day without breakfast. When you eat something in the morning, your body converts the food to fuel, which gives you energy.

• It’ll keep your mind sharp. A morning meal can help improve your mood, concentration and ability to solve problems. Studies show that students have higher test scores and pay attention better in class when they eat breakfast. That’s why many schools offer breakfast programs.

• You may lose weight. In one study, people who ate breakfast consumed less fat and ate fewer snacks on impulse than those who didn’t eat anything in the morning. In another study, researchers surveyed 2,959 people who had successfully lost weight and found that 78 percent of them ate breakfast regularly.

You can take some simple steps to make breakfast part of your routine:

• Make something you enjoy. Breakfast can be cereal, fruit and milk, but it can also be a turkey sandwich or leftover spaghetti.

• Make it easy but special. Set the table the night before and plan the menu with your family. Having breakfast yourself sets a good example.

• Make it nourishing. Some people consume fruit and milk only at breakfast, which can make it the most important meal for vitamins C and D and for calcium.

• Make small moves to start or improve your breakfast menu. Have some juice. Add some yogurt. Try half a bagel or a piece of toast.

• Buy high-fiber, whole-grain cereals. Read the labels to learn serving sizes, calorie content, sweeteners and nutrients — including about 5 grams of fiber per serving.

• Make it portable. If you don’t have time to sit down, take breakfast with you. Pack a homemade muffin and a container of milk. Try the recipe featured at right for a nutritious, portable breakfast.

Reprinted with permission from Blue Cross Blue Shield of Michigan.

From time to time, almost everyone has a night when sleep just won’t come. And for those occasions, an over-the-counter sleep aid can be a safe and effective solution.

Chronic use of sleep aids has two main drawbacks:
   • The pills start to lose their effectiveness.
   • When you stop taking the pill, it becomes even harder to sleep.

Most OTC sleep aids contain antihistamines. Also used in many sinus medications,  antihistamines dry up respiratory secretions, so they can make your nose, mouth and eyes dry. This can be a serious side effect in a lot of respiratory conditions.

Antihistamines can also make people feel groggy the next morning.

Prescription sleeping pills are different. Starting in the 1970s, the most common were benzodiazepines, such as valium. They work with brain chemicals to help quiet brain activity and allow sleep.

But today, doctors are more likely to prescribe a newer class of medications called sedative/hypnotics (such as Ambien® and Sonata®). Used to treat insomnia, they have fewer side effects than benzodiazepines.

If you take a prescription or OTC sleep aid, don’t ever take more than the recommended dose. Don’t drink alcohol while taking it, either, and don’t combine different kinds. Pregnant women should talk with their doctors before taking any sleeping pills.

Reprinted with permission from Blue Cross Blue Shield of Michigan.

WHEN JODI DAVIS DECIDED to begin an exercise program, she chose walking and found out that it worked to help her lose weight. It worked so well, in fact, that Davis, of Colona, Mich., lost 162 pounds in 16 months.

And even though she has already reached her weight goal, Davis still laces up her walking shoes every day and goes for a walk.

Walking is the ideal exercise for a lot of people. It helps you reduce your risk for heart disease, high blood pressure, diabetes, some cancers and stroke. “It’s also easy to do
and requires very little cost beyond a good pair of walking shoes,” says podiatrist Arnold Ravick, M.D., a spokesman for the American Podiatric Medical Association.

The right shoe is the most important part of foot care for walkers. Your footwear can make the difference between pleasure and pain on your stroll. “The ideal walking shoe
should be stable from side to side, well-cushioned and enable you to walk smoothly,” says Dr. Ravick.

Walking shoes should be lightweight but with good cushioning in both the heel and ball of the foot, adds the American Orthopaedic Foot and Ankle Society. The sole should be slightly rounded so you can easily shift your weight from heel to toes.

Arch support is important, too. The higher your arch, the less susceptible you are to pronation — the foot’s natural, inward rolling motion. For flat feet, you want a rigid shoe to help control pronation. For a high arch, you need more cushioning to avoid jarring joints and ligaments.

You get what you pay for — to a point. If you stay with the brand names you’ll be fine, the APMA says.

“When buying new shoes, go to the shoe store late in the afternoon when your feet are slightly swollen, and wear the same socks to the store that you’ll wear while walking,” Dr. Ravick says.

Have your feet measured, while standing, each time you buy shoes. Dr. Ravick suggests you try on at least four pairs. Put on and lace both shoes of each pair (one foot is often larger than the other), and walk around for a minute or two.

When the shoes are on your feet, the heel should be snug and you should be able to wiggle your toes. There should be a half to a full thumb’s width between the end of the longest toe on your longer foot and the end of the shoe.

If you have bunions, hammertoes or other foot problems, ask a podiatrist about the best shoe and walking routine for you.

Copyright 2007, BCBSM, used by permission.

Exercising at home can be just as effective and enjoyable as taking a walk or a bike ride. It can also save you time and money compared with joining a health club. But it’s important to find the right equipment. Here are some guidelines that can help as you shop.

What’s right for you?
Ask yourself these questions before you buy exercise equipment:
• What do you enjoy doing? If you like walking or running, consider a treadmill. If you prefer to bicycle, shop for a stationary bike.
• What are your goals? For aerobic training or weight loss, a treadmill, stationary bicycle, stair climber or ski machine is a good bet. To strengthen muscles, try free weights or a weight machine.
• What is your budget? How much are you willing to spend? Keep in mind that you will have this equipment for years.

Take a test run
Once you know what type of equipment you want, shop around. Try the equipment before you buy it.

Many stores have floor models that you can test for a few minutes. If family members will be using the equipment, give them a turn. Go back and try the equipment a few times. Ask yourself:
• Is the equipment comfortable? For example, with a stationary bike, make sure you can reach the handlebars and pedals.
• Will the machine fit in your home? Measure your doors and the space where you plan to use your purchase. Go to the store and measure the equipment.
• Do you have the right type of power supply? Some equipment requires a special electrical supply or outlet.

Other things to consider
Make sure the equipment will stand up to wear and tear. When deciding between similar machines, buy the one with the better warranty. Find out if the store provides in-home repairs. No matter what equipment you choose, check with your health care provider before you begin an exercise program.

Copyright 2007, BCBSM, used by permission.

Need more reasons to quit smoking? Just smile. Tobacco use affects your oral health as well as your overall health.

Oral, throat and neck cancers are often linked with tobacco use. Despite advances in medical treatment, oral cancer still has a dismal five-year survival rate of just 50 percent.

Dentists screen for cancer of the mouth and neck as part of a routine dental exam. If caught early, oral cancer can be cured and survival rates are a lot higher. Oral cancer is extremely aggressive, and people who survive often suffer facial disfigurement and require long-term reconstruction.

Tobacco use can also cause gum disease. Gum tissue may become red and puffy and form pockets that trap bacteria. Gum tissue may also draw back and expose the tooth roots, leading to sensitivity or tooth decay on the root surfaces. Tobacco use also delays healing after oral surgery.

Finally, tobacco can ruin your smile. Tobacco stains your teeth and can cause your gums to recede, making your teeth look longer than normal. Even if you bleach your teeth,
the whiteness fades more quickly if you smoke.

What’s the easiest way to prevent oral cancer and periodontal disease? Don’t smoke — and see your dentist for regular dental exams.

Reprinted with permission from Blue Cross Blue Shield of Michigan.

Ten ways to fit in exercise:
1. Get off the bus a stop or two early and walk the rest of the way.
2. Use the stairs instead of the elevator whenever you can.
3. Go for bike rides with your children.
4. Take family walks after dinner.
5. Do your own yard work and gardening.
6. In bad weather, walk around inside the shopping mall a few times.
7. Plan active outings, such as hiking, on weekends.
8. Ride a stationary bike or use hand weights as you watch television.
9. Take the dog (or a neighbor’s dog) for a walk.
10. Wash and wax your car.
Source: American Medical Association Family Medical Guide

Reprinted with permission from Blue Cross Blue Shield of Michigan.

Chocolate lovers, rejoice. Antioxidants in dark chocolate can help slightly lower blood pressure. But you must limit your portions to 30 calories a day — slightly more than one Hershey’s Kiss.

Eating unlimited quantities of the flavanol-rich cocoa in dark chocolate won’t work because “the potential blood pressure reduction contributed by the flavanols could be offset by the high sugar, fat and calorie intake with the cocoa products,” German researchers warn.

They based their advice on an 18-week study of 44 adults ages 56 to 73 whose blood pressure was at the high end of normal or the low end of high.

Copyright 2007, BCBSM, used by permission.

A mechanic might be able to repair a car without a wrench or a screwdriver, but it would be a lot more efficient with the right tools. And you might be able to make the changes you need to make to help you live a healthier lifestyle without any special help, but wouldn’t it be easier to have some tools to help you along the way?

Blue Cross Blue Shield of Michigan offers you a suite of health and wellness resources that provide you with the tools to help you meet your health goals.

BlueHealthConnection®
BlueHealthConnection is our comprehensive wellness and care management program for members. If you have BlueHealthConnection, it offers an array of Web-based
resources, including tools you can use to manage and understand your health. These include:

„X A health risk appraisal that gives you a comprehensive picture of your current health status and risks. It shows you what health areas need attention and provides recommendations for minimizing health risks.
„X An online health coach that can provide you with online programs that could benefit you the most. These programs include fitness, nutrition, stress management, weight loss, smoking cessation and more.
„X Online tracking tools that can help you keep track of your exercise, weight, walking and stress.
„X A personal health record that helps you organize your health information.
„X Interactive calculators that help you learn your key numbers for body mass index, calories burned, target heart rate and the cost of smoking.

BlueHealthConnection’s Web site also includes a section on healthy lifestyles. With a few mouse clicks, you can get information about fitness, nutrition and safety. You can also use the Web site to find out more about certain diseases
and read about dozens of other health topics.

In addition, BlueHealthConnection features a 24/7 nurse phone line and an audio health library.

To see all of the BlueHealthConnection Web tools, go to hcbo.com, log in, click on More Links on the right navigation menu, and go to BlueHealthConnection. To access the 24-hour nurse phone line or the audio health library, call 800-775-BLUE (2583) or 800-240-3050 (TTY).

Quit the Nic
Quit the Nic* is BCBSM’s telephone-based program to support your efforts to quit smoking. You’ll work with a nurse health coach who will help you enroll in the
program. Then you’ll get started by setting a quit date and discussing how to prepare for that day. The nurse will also work with you as you’re quitting to help you prevent a relapse. To enroll in Quit the Nic, call 800-775-BLUE (2583).

*Available to members who have BlueHealthConnection as a benefit.

Naturally Blue^SM
Naturally Blue offers members discounts on a wide range of complementary health services, natural health products and magazines. You can show your card and save as much as 30 percent on complementary and alternative health services when you visit a practitioner in our national Naturally Blue network. You can receive discounts on:
„X Acupuncture
„X Diet and supplement advisors
„X Exercise and movement services
„X Massage and bodywork services
„X Mind and relaxation techniques
„X Wellness facilities

You can also receive discounts of up to 25 percent on vitamins and natural health supplements through Integrative Therapeutics Inc. In addition, Naturally Blue offers you substantial savings on select health and fitness magazine subscriptions.

Through the Naturally Blue Web site, you can access WholeHealthMD.com*, where you can find information about complementary and alternative medicine, find healthy recipes, visit an online reference library, get the latest news about complementary and alternative medicine and more.

To find out more about Naturally Blue, go to hcbo.com, log in, click on More Links on the right navigation menu and click on the Naturally Blue link. You can also call 800-775-BLUE (2583) or 800-240-3050 (TTY).

Healthcare Advisor^TM
Healthcare Advisor is an online decision-making support resource that provides information to help you manage your health and make better health care decisions. With Healthcare Advisor you can:

„X Research a hospital
„X Research a doctor
„X Learn about a medication
„X Research treatment costs

To access Healthcare Advisor, go to hcbo.com, log in, click on More Links on the right navigation menu, then click on Healthcare Advisor.
 
*BCBSM does not control this Web site or endorse its general content.

Copyright 2007, BCBSM, used by permission.

You say you don’t have the time or energy to work out? You’re wrong.

The benefits of exercise are many — equaled in number only by our excuses for avoiding it.

Just one in four U.S. adults works out at low to moderate intensity for 30 minutes most days of the week or at vigorous intensity for 20 minutes three days a week.

“People will find any excuse for not exercising,” laments Heather Moreno, author of Achieving Physical Wealth.

Some of those excuses — I weigh too much, I’m too old, I have too many health problems — are in themselves strong arguments for increasing physical activity.

Moreno and California fitness motivation coach Gillian Hood-Gabrielson suggest these ways to work around the most common excuses:

• I don’t have the time – With the demands of work, family and other obligations, it seems plausible. Except when you consider that lack of exercise — and the poor health that follows — greatly affects quality of life. To overcome it:
     o Make exercise a priority. Make exercise as important as brushing your teeth, and you’ll find time.
     o Avoid the “all or nothing” trap. If you can’t find 30 minutes to work out, do three 10-minute blocks — or even one. A little exercise is better than none.
     o Incorporate movement whenever you can. Walk instead of driving. Climb stairs instead of riding the elevator. Exercise while you watch television.
• I don’t have the energy – Exercise gives you more energy. To overcome this excuse:
     o Gauge your true energy level. Plan to exercise for five minutes, and if you don’t have the energy to go on, stop. Most likely you’ll feel better and keep going.
     o Ditch less-essential activities.
     o Get more sleep. Don’t watch TV or read in bed. Reclaim time for what you truly need: slumber.
• I don’t like exercise – Think back to childhood. “When we were kids we ran and jumped and played, and then we grew up and it became exercise,” Moreno says. To overcome it:
     o Add movement to something you like to do. If you play golf, walk the course. If you like music, listen to your favorite tunes as you walk. Stroll with friends.
     o Connect exercise to something you value. “Being a good parent or being productive at work is easier when you exercise because you handle stress better and have more energy,” Hood-Gabrielson says.
• I don’t know what to do – Information overload is confusing. To overcome it:
     o Do what you already know. Start with walking.
     o Buy a heart monitor or pedometer to track your progress. You should see a moderate rise in your heart rate during 30 minutes of exercise; you can walk about 10,000 steps in that time. That’s your baseline. Shoot for gradual improvement.
     o Hire a personal trainer for two or three sessions. Learn resistance training or a cardio routine.
• I don’t see results – This means, “I’m not losing weight fast enough and, I am losing motivation,” Moreno says. To overcome it:
     o Stay away from the scale. A study found women who exercised to lose weight spent 40 percent less time exercising than women with other motives.
     o Stick with it. Real change tends to happen slowly.
• It’s too cold, wet or hot – Don’t let the weather sideline you (see tips on page 12). To overcome it:
     o Invest in home exercise equipment. This can be as simple as a jump rope and exercise bands.
     o Buy an exercise video.

Copyright 2007, BCBSM, used by permission.

Parents can find ways to help their children avoid this threat to their health.

Even the smallest Americans are getting bigger. An estimated 9 million U.S. children older than six are considered obese. Many will carry the extra weight into adulthood, along with the health risks that come with it.

Obesity is second only to smoking as a cause of preventable U.S. deaths. Its toll includes chronic diseases such as asthma, heart disease, diabetes, high blood pressure and sleep apnea. Three out of five obese children already have at least one heart disease risk factor. Type 2 diabetes, once rare among children, is soaring.

While genetics plays a role, most researchers blame the increase in childhood obesity on lifestyle trends. Children are increasingly inactive. Time outside playing has been replaced by time indoors watching television, playing video games or using computers. Meanwhile, many schools have reduced physical education.

At the same time, children’s diets are higher in fat and calories. Families and schools often rely on fast and convenient foods. Studies estimate about 30 percent of children older than four eat fast food daily — while more than half eat less than one serving of fruit per day.

But you can help children forge healthy habits:
• Offer children a variety of healthy foods from all food groups. Keep plenty of low-calorie, nutritious snacks on hand, such as fruits, vegetables and yogurt.
• Plan a regular mealtime at home. Allow children to help plan and prepare meals.
• Encourage children to drink water or low-fat milk. Limit soft drinks or replace them with low-calorie drinks.
• Limit television viewing to no more than two hours a day and set limits on other sedentary activities.
• Plan family outings and vacations around active pursuits, such as in-line skating, hiking or bicycling.
• Encourage children to participate in an active hobby, such as gymnastics, basketball or soccer.

THE BLUES SUPPORT EFFORTS TO CURB CHILDHOOD OBESITY

As part of its unique nonprofit mission, Blue Cross Blue Shield of Michigan is doing its part to help curb the childhood obesity epidemic, which can be attributed to poor nutrition and lack of physical activity.

Our Building Healthy Communities grant program provides money to schools throughout Michigan to help them improve student and community opportunities for physical activity and good nutrition. BCBSM will fund grants to approximately 15 schools in 2007. These schools are in areas of the state that have high rates of obesity. Each school that receives a grant must make its facilities available to the community. Schools will use the grant money to fund walking paths, fitness areas, climbing walls, activities that promote healthy nutrition, and more.

In addition, BCBSM is working on a physician information kit that includes resources for addressing pediatric obesity.

BCBSM’s commitment to Michigan makes us different from other health insurance companies doing business here. We’re dedicated to providing affordable, quality health care and doing all we can to create a stronger, healthier Michigan. That has been our mission for nearly 70 years.

Copyright 2007, BCBSM, used by permission.