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Navigating the flood: healthy eating for a lifetime

Dr. Lia Gass Rodriguez, Chief Medical Officer

March 3, 2023

Most of the major health issues affecting our country today can be tied to an unhealthy diet. Eating a diet that is rich in fruits, vegetables and whole grains can help lower your risk for some chronic conditions. It’s also important to avoid foods high in salt, sugar and saturated fat, as these can increase the risk of heart disease.

Putting that into practice isn’t always easy. There are a lot of terms on food labels and in food advertising that can make it seem like a food is healthier than it is. For example, if the first ingredient in your bread isn’t whole grain flour, it’s not as “whole grain” as you might think. “Low sugar,” “low fat,” “lite” and “light” actually have specific definitions manufacturers have to meet, but most people don’t know what they are. And those terms might not actually equal healthier.

To add to the confusion, there’s a disconnect between recommendations from trusted sources of information. The internet has given us easy access to dietary recommendations from governments and health agencies all over the world, but they don’t always align. The Dietary Guidelines for Americans recommends no more than 12 teaspoons of sugar per day for adults,1 but the American Heart Association recommends about half that amount for adult women.2 American guidelines align with Canada’s in many ways. For example, making about half your plate fruits and vegetables. However, they differ as well. Canada recommends a more plant-based approach to eating and doesn’t recommend that adults drink milk.

Some practical, common-sense tips can help you design a healthy dietary pattern for a lifetime.

So how do we make sense of this flood of recommendations? Some practical, common-sense tips can help you design a healthy dietary pattern for a lifetime.

  • Be aware of how much sugar you’re getting in your food and drinks. We need some sugar in our diets as fuel, but we should lean more heavily on the naturally occurring sugars that come from fruits and vegetables. They also give us much-needed vitamins, minerals and fiber. Many processed foods include sweeteners added for flavor that don’t enhance the nutritional content. You can use spices, like cinnamon and vanilla, to boost your food’s flavor without adding sugar.
  • Step away from the saltshaker. Generally, we get far too much sodium in our diets. Some of it occurs naturally in foods, like sugar. Companies add more during processing, we add more during cooking and then we add more again at the table. Try to limit the amount of highly processed foods you serve, and if you’re going to keep salt on your table, try not to cook with it. Flavorful herbs and spices, not to mention citrus, can help you build a meal that’s a treat for the senses without adding salt.
  • Cook with healthier fats. Yes, butter can be delicious, but cooking with too much of it isn’t good for your heart or your waistline. Instead, reach for healthier fats like olive oil. It’s widely available and can be part of a heart-healthy diet. It also doesn’t smoke as quickly as butter does, which can make cooking a more pleasant experience.
  • Don’t just think of the foods you shouldn’t eat – think of those you should eat more of! Find fruits, vegetables, nuts, grains and legumes you enjoy and find creative ways to add more of them in your day-to-day eating!

Whatever changes you decide to make, try to set realistic goals. If your family enjoys eating meat, becoming fully vegetarian overnight could be unsustainable. Instead, you can choose lean meats, like fish and poultry. You can also set aside a couple of days a week for meatless meals. Just be sure to check the labels if you’re using a meat substitute. Some of them are also highly processed, and that can be its own problem.

When you do make that luscious Beef Wellington, make it an event and feed your spirit. Dress the table, light the candles and really enjoy the whole experience. There’s nothing like sharing a delicious meal with people you love. Enjoy!

1Dietary Guidelines for Americans 2020-2025. Available at https://www.dietaryguidelines.gov/. Accessed February 24, 2023.

2American Heart Association. Added Sugars. Available here. Accessed February 24, 2023.

This is not medical advice or intended to be a substitution for proper medical advice given by a licensed provider.

In their own words: hear from ActiveHealth members

February 9, 2023

What does healthy mean to you?

Whether our members are working one-on-one with a coach, joining live group coaching sessions or using digital resources, the impact is clear. Watch this short video to hear what ActiveHealth members have to say.

Give your heart some love

Dr. Lia Gass Rodriguez, Chief Medical Officer

February 2, 2023

It’s February and hearts are all around and not just because of Valentine’s Day.   February is also National Heart Month.   I want to focus on the importance of heart health for women, particularly considering the unfortunate fact that heart disease is the leading cause of death in women in the United States.  That’s why it’s crucial for us to be aware of our heart health and take steps to maintain it.

How can we take care of ourselves when it comes to our hearts?

Heart disease is a term used to describe a range of conditions that affect the heart, including coronary artery disease, heart attacks, heart failure, and arrhythmias. Risk factors include high blood pressure, high cholesterol, smoking, obesity, lack of physical activity, poor diet, and a family history of heart disease. Certain medical conditions, such as diabetes, can also increase the risk of heart disease.  It is often called the silent killer because many people don’t know they have it until they’re in the midst of a cardiac event. Even then, they may not recognize the signs and symptoms of an attack. Classic symptoms of pain in the chest and arm are often present in men, but women can have more subtle symptoms. Nausea, shortness of breath and back or jaw pain are all symptoms of a heart attack in women.  Unfortunately, these symptoms are also all easily mistaken for other medical issues. According to one study, more than 60% of female participants had more than three non-chest pain symptoms. And 53% of female participants said their health care providers didn’t think the symptoms were heart related.1

Not only are heart symptoms harder to identify in women, but cultural factors can also make women less likely to react to them. Women often adopt the role of caregiver, prioritizing the needs of others and downplaying their own health needs.   However, it is always important to remember that caring for yourself, however that manifests, is not selfish. It could be spending time with friends, doing something you enjoy or just soaking in a hot bath. It’s also getting your preventive health care, noticing new symptoms, and acting on them if they appear. There is a reason why, in airline safety demonstrations, they say put your own oxygen mask on before helping others. If you are not safe and healthy yourself, you can’t successfully care for others.

So how can we take care of ourselves when it comes to our hearts? By adopting a healthy lifestyle, managing medical conditions, and seeking prompt medical attention if symptoms arise, women can reduce their risk of heart disease and maintain a healthy heart.  Here are some tips that can help.

  • Choose heart-healthy foods: whole grains, fruits and vegetables and lean proteins. Avoid foods high in salt, sugar and saturated fat.

  • Get your heart pumping with at least 30 minutes of moderate-intensity activity such as brisk walking, cycling, swimming, or dancing most days of the week.

  • Limit alcohol and quit smoking. Your doctor can help and you can also find free resources at smokefree.gov.

  • Look for ways to manage your stress, like yoga, meditation or a hobby you enjoy. And aim for 7-9 hours of good quality sleep each night.

  • Get regular check-ups. Your doctor can spot early warning signs of heart disease and help you work to correct them.

  • For ActiveHealth members, go to our secure member site, MyActiveHealth.com, for more information about making heart-healthy changes.

One last tip – spend time with people you care about. Strong relationships and a supportive community can play a significant role in maintaining a healthy heart. Studies have shown that women with strong social support have a reduced risk of heart disease, while social isolation can increase the risk.2 So, make sure to surround yourself with positive, supportive friends and family and nurture those relationships.

Taking care of yourself in mind, body, and spirit is the best way to ensure that you’ll be around to care for the people you love when they need it. In a way, taking care of your own heart is a beautiful act of love!

1Healthline.com. Bahl, R. Doctors Missed Heart Attack Signs in Women 50% of the Time. September 18, 2018. Available here. Accessed December 23, 2022.

2Golaszewski NM, LaCroix AZ, Godino JG, et al. Evaluation of Social Isolation, Loneliness, and Cardiovascular Disease Among Older Women in the US. JAMA Netw Open. 2022;5(2):e2146461. Available here. Accessed February 1, 2023.

This is not medical advice or intended to be a substitution for proper medical advice given by a licensed provider.

Healthier choices don’t change who you are

Dr. Lia Gass Rodriguez, Chief Medical Officer

January 18, 2023

Welcome to the new year! We’re coming out of a season of celebration that’s often marked by cultural and family traditions. Many of these traditions include delicious foods tied to childhood memories. I can remember my grandmother – now in her 90s – stirring her famous black beans with love every year.  They simmered for hours to be later served atop a heaping serving of white rice and alongside roasted pork shoulder.  In my own family, we are making new memories and traditions by baking my mother-in-law’s decadent cookies. These cookies have three sticks of butter and four egg yolks, but they are so good.

The start of a new year is often full of reflection.  It’s common to think about the goals you want to accomplish in the coming months.  Oftentimes these goals involve how and what we eat. As a doctor working in the area of population health, I’m very much in favor of people thinking about their health and how to improve it.  Healthful eating can prevent and even treat many chronic diseases.  We generally recommend eating plenty of vegetables, fruits, legumes, whole grains, nuts and seeds, limiting dairy and eggs and avoiding sugary drinks, processed foods and red meats.   However, the goals we set and the changes we make to our nutrition need to fit within our understanding of who we are. Food, especially, can be a big part of that identity.

I’m someone who loves the whole experience of food, the sight, smell and taste of it.  I love finding new foods as I travel. Whether I’m in a new country or a new region of our own, so much of the culture of a place is present in the food. And because food is an integral part of culture, and how we fit within it, it can be difficult to change eating patterns established over a lifetime. Just ask a Texan how they’d feel about giving up barbecue entirely.

As we set our goals around making healthier food choices, I like to suggest we look for the small changes we can make that still respect our cultures and traditions.  These small changes are more sustainable in the long run. That Texan I mentioned doesn’t have to give up barbecue entirely, but they could eat it once a week instead of several times. And it isn’t just about what we reduce in our diets – it is often about what we add.  Incorporating daily servings of fruits, vegetables and whole grains into the meals we already enjoy can have a lasting impact on our health.

In my own life, I try to make healthy choices that make an occasional indulgence possible. I’m serving more plant-based and whole foods in family meals.   My 3-year-old has declared roasted “crunchy” chickpeas her favorite side dish. I also look for ways to make substitutions in recipes that I love.  I use olive oil in my cooking instead of butter and I make my grandma’s picadillo with ground turkey instead of beef.  Some recipes I just don’t want to change. I can’t imagine making my mother-in-law’s cookies without all that butter, so I don’t, but I don’t make them all the time. In a way, that makes them all the more special when we make them during the holidays.

So, as you look at the year ahead and think about your nutrition – what small changes could you make while respecting your cultural traditions?  My grandma’s black beans atop a heaping plate of quinoa sounds really delicious!

 

This is not medical advice or intended to be a substitution for proper medical advice given by a licensed provider.

An unbiased approach to identification

Larry Siegel, Executive Vice President, Reporting & Informatics

January 18, 2023

When designing any clinical program, a critical part of development is deciding how you’ll find people who would benefit from it. Depending on the program you’re designing, you may be interested in a specific condition or set of conditions, clinical complexity or urgency. Many programs include goals for both improving health outcomes and reducing health care costs. It might be tempting to include past health care cost as an identifier, but to quote Warren Buffet, “It takes 20 years to build a reputation and five minutes to ruin it.”

In a completely equitable world, we’d all be able to achieve our best health.

In a completely equitable world, we’d all be able to achieve our best health. Doctors would be available to people in rural, urban and suburban settings. People would all be able to find and use reliable information to make decisions about their health. Cost wouldn’t be an impediment to care. But we’ve long known that health disparities are widespread. Low health care costs or a lack of claims doesn’t necessarily indicate good health.

Organizations that have used claims data as an identification strategy have found their pool of potential participants skewed toward people with access to health care. They’ve also found them to be lacking in diversity. At ActiveHealth, our mission is to help people achieve their best health in body, mind and spirit. To do that, we need to know as much as possible about our members in order to provide a highly personalized experience. We use a multi-dimensional approach to identification that includes information from multiple sources, including self-reported data. We look at clinical markers, gaps in care and social risk factors during the identification. Then we craft a plan to address both clinical and non-clinical barriers to health improvement.

Since inception we’ve been confident that this multi-dimensional approach helps to limit identification bias. However, we run an analysis periodically to confirm it. Our most recent analysis shows that we continue to identify a rich, diverse pool of members for our clinical programs. Variance in identification for some conditions clearly align with higher prevalence of these conditions within populations. After adjusting for these higher rates of incidence, we are pleased to see that our identification rates are similar across groups of the population.

At ActiveHealth, we believe that conscientious use of data – first in identification and then in engagement – is critical to helping each person achieve their best possible health.