ProHealth report, 1988

S ProHealth

3S1.77 report, 1988
M2 6phr

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ITATI DOCUMENTS COLLECTION
APR 10 1990

1988

O - R

D

Presented by the Montana State Personnel Division of the Department of Administration in conjunction with LileCare, at Saint Vincent Hospital and Health Center. Billings. Montana.

Editors: Steve Shandere and Linda Kaiser.

Inside:

ProHeatth lifestyle
assessments summary

1988. Saint Vincent Hospital and Health Center. Billings. Montana

ProHealth
Project a
Success

by Steve Shandera, RT., Lifecare
Manager, Saint Vincent Hospital,
Billings

JUST HOW HEALTHY ARE
YOU? WHAT ARE YOUR
HEALTH RISKS?

Over 6,000 of you, and your spouses,
learned the answers to these questions
by participating in the ProHealth
Lifestyle Assessment Program. Since
January, 1987, Saint Vincent Hospital
and Health Center's LifeCare profes-
sionals coordinated the most com-
prehensive health screening ever offered
to employees of the State of Montana.

From Miles City to Missoula to Malta,
you provided information about your
family health history and lifestyle, under-
went a series of screening tests and
received a personal, computer-gene-
rated report of your current health status
and future health risks.

Health professionals were available to
discuss results with you and answer
questions on how to begin developing
a healthier lifestyle. All of you were made
more aware of your health risks and

became motivated to make lifestyle
changes. Keep up the good work— it's
showing!

prohealth conclusion:
exercise more

eat less,

Data gathered as part of the statewide
health screening suggests that state
employees could decrease their health
risks by exercising more and eating less.
Over half (57%) were found to be at risk
because of inadequate exercise, and
almost half (46%) were at risk due to
being overweight.

For most people, regular exercise
goes hand-in-hand with getting rid of un-
wanted pounds forever Getting started
is the first big hurdle. Start slowly and
build up both the amount and speed at
which you exercise. Sticking with a pro-
gram of regular exercise can be im-
mensely rewarding. Get out your will-
power and determination and dust them
off — they're always ready to go to work
for you!

Percent of ProHealth Participants
at risk by risk factor

HEALTH RISK

RISK LEVEL

Exercise

Moderate

Serious

Total

38%

19%

57%

Seat Belt Use

18%

35%

53%

Weight

20%

26%

46%

Cholesterol

11%

13%

24%

Hypertension

14%

6%

20%

Smoking

6%

13%

19%

Alcohol

4%

2%

6%

cardiovascular fitness

ARE YOU ll\l SHAPE?

Consider yourself in good cardio-
vascular shape if you meet the following
criteria:

• You are content with the way you look.

• Your weight is in the normal range.

• You are usually relaxed and calm and
you sleep well at night.

• You have enough energy to do the
things you want to do.

MONTANA STATE LIBRARY

S 351.77 M2ephr 1988 0.1
ProHealth report 1988 /

3 0864 00061674 1

Killer
Stalking

State
Employees

Are you one of them?

by Kathie Shandera, LifeCare,
Saint Vincent Hospital, Billings

The ProHealth screening program of
6,200 state employees revealed that
24% are at risk of developing heart
disease due to high blood cholesterol.

This insidious killer, a fatty wax-like
substance, may be building up in your
arteries as you read this article! Over
time, cholesterol can harden and narrow
your blood vessels, leading you down
the path to a stroke or heart attack.

There are no warning signs of high
cholesterol. Only a blood test can deter-
mine who is at risk. Employees whose
blood was tested through the screening
received information stressing the impor-
tance of periodic blood cholesterol
checks.

Some blood cholesterol is manufac-
tured naturally by our bodies, and we
add more through the foods we eat. For
most people, eating too much fat and
foods high in cholesterol will result in
high levels of cholesterol. Some have a
hereditary form of elevated cholesterol,
which is not a direct result of diet.

Tips for lowering fat and cholesterol
in your diet: choose low fat and low
cholesterol foods: skim milk, fruit, cereal,
beans, whole grains and vegetable oils.
Trim all fat from meats and remove
poultry skin. Grill or broil meat and limit
meat portions to pieces about the size
of a deck of cards. Exercise, use non-
caffeine drinks (or limit caffeine
beverages to two a day). Above all,
recognize that changing a health habit
takes time and patience. Take each day
one at a time, and do the best you can.

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Stress-p^hat^a Mess!

Stress. A fact of life. Stress is always
with us. Happy stress — weddings, first
dates, birthi and sad stress— death, lay-
off, work — are all a part of normal, every-
day life. Keep in mind that everyone has
stress. How you handle it is up to you
and though some of us encounter more
stress than others, the way we perceive
and react to it is more significant than
the amount of stress we face. Here are
some stress-busters to put to work when
you feel the pressure mounting:

STRESS-BUSTERS

Say no. Get up 20 minutes earlier
tomorrow to allow for some spare time
for you. Put on comfortable clothes-

even if they're what you wore yesterday!
Write down everything you need to do
today then cross them off as you com-
plete them, invest in 2 jars of spaghetti
sauce and a couple of bags of spaghetti
—dinner's done, and it'll taste great,
especially with a little cottage cheese
mixed in! Have things to do while you
wait in line: balance your checkbook,
prepare a grocery list, read a paperback,
write a thank you note. Wall< for 10
minutes on your lunch hour, even if it's
around the block twice. Remember this:
the sun is going to rise and set today
anyway and there's nothing you can do
about it. Except enjoy it more!

F EXERCISE GUIDELINES

• Check with your doctor before be-

• Work up gradually and stick with

ginning an exercise program if you
are over 50 and/or have a heart
problem.

your program for at least 8 weeks.

• Allow time for warm-up and cool
down.

• Choose activities that you enjoy
and vary your routine.

• Exercise continuously for at least
30 minutes per session, at least 3

• Schedule your exercise at the same

times a week.

time everyday and try to exercise
with a friend when possible.

Ci

start training
to stopsmoi<ing

Smoking, once considered glamorous
— Bette Davis, Lauren Bacall, Humphrey
Bogart— is out. A danger to health,
fitness and beauty smoking is also one
of the greatest risk factors for cancer

Now is the best time to stop smoking.
It can be easy if you prepare to quit, well
in advance. Give yourself a month to
"train." Think of yourself as an athlete,
preparing for a 10K, and use this
strategy:

Eat well. Fresh veggies, fruits, grains.

Cut down on animal fats, sugar, salt and

caffeine. Eat lightly and eat more than

three times during the day

Sleep. Lots of heavenly refreshing

sleep. Before, during and after you quit

smoking.

Over 19% of employees
screened are at risk
because they currently
smoke.

Exercise. If you don't have a favorite ac-
tivity, commit to walking briskly every
day for 10 minutes. If you're already on
a program, increase the length of your
workouts.

Drink plenty of water. Everyone needs
8 glasses of water a day Not soda, not
juice, but water It's so good for all your
organs, especially your skin. If you think
you retain water, it's because your body
holds on to all it gets, which isn't much.
Keep the water coming through to
cleanse your system. When you get the
urge to smoke, have a glass of water
instead!

Picture yourself a non-smoker.
Visualize yourself without the cigarette
monkey on your back. The more you
think of yourself in a healthy, active
lifestyle, the better off you'll be. Mind
over matter

At the end of the month, you'll feel
and look better You'll have treated
yourself to a healthy program. What bet-
ter time to stop smoking. . good luck!

GOVERNOR'S

CUP

RESULTS

Ellen Feaver and Dean Hersey.

Over 250 state employees ran, walk-
ed, jogged and sweated in the annual
Governor's Cup Race in Helena on June
4. Nineteen agencies participated in the
State Government Competition. Partici-
pation increased significantly from last
year The winners were:

AGENCY TEAM EVENT

1st Place: Institutions — Jim Pomroy
Bobbie Dixon, Dean Hersey, Carrie
Froehereich, Doug Weisenberger, Dan
Hoy

2nd Place: Fish. Wildlife & Parks— David
Clark-Snustad, Mary Anne Aafedt, Dick
Mayer, Rich Milspon, Rich Clough.

PARTICIPATION EVENT

Legislative Fiscal Analyst— 59%

participation.

Legislative Council — 49% participation.

INDIVIDUAL RUNNER EVENT

1st Place— Dean Hersey— Dept. of Insti-
tutions Based on a percentile score, i.e.,
percentage of same age, same sex run-
ners in event which the runner finished
ahead of, adjusted to eliminate walking
scores.

Runners above the 90th percentile:
Charlotte Fuson — SRS; Jim Pomroy —
Institutions; Jeff Miller — Revenue; Bob-
bie Dixon — Institutions, Women's
Marathon winner; Steve Wilson —
Administration.

Remember, you only have a year to
get in shape for next year's
competition!

Are

for High
Cholesterol?

C.« a ^>"'^'"^-"^^';f prescribe stringent
£rS:;s^U>i^a,.necess.rv,bv

drug therapy.

.• Hioh (200 to 239 mg/dl)

levels.

„,.,,„ familv history of

•'^'^^ ^^Thean dSse, sn^oking.
premature hea« ^^^^^ ^.^j,^^,,

Desirable (less than 200 mg/dl)

Recheck within five years or with regular
exams.

NOTE: mg/dl: milligrams per deciliter.

Source: .National Institute of Health Report
of the Expert Panel on Detection.
r.\aluation and Treatment of High Blood
Cholesterol in Adults. 19H" Inlike
previous NIM guidelines, risky cholesterol
levels arc no longer dependcni upon age.

American Health January/l-'ebruary '88

12500 copies of this public document
were published at an estimated cost
of $.20 per copy, for a total cost of
$2495.00, which includes $2447.50 for
printing and $47.50 for distribution.

Top Illness:
High Blood Pressure

Also known as hypertension

Lori Ryan, R.N., LifeCare, Saint Vincent Hospital, Billings

In the good old USA, hypertension,
known to many of us as high blood pres-
sure, is the number one adult illness.
Usually, there are no signs or symptoms
at all. That's why a blood pressure check
was part of the ProHealth Program
Health Risk Assessment. Twenty percent
of the participants were found to be at
risk because of high blood pressure. The
good news is that high blood pressure
can be treated and controlled.

If your blood pressure is over 140/90,
you are at risk and need to take steps
to bring it under control. If your blood
pressure is over 160/100 you must see
your doctor The following changes will
improve your blood pressure:

Quit smoking. 10-20 minutes after
you smoke a cigarette, your blood
pressure goes up and your heart beats
faster and harder If you smoke a pack
a day you have two times the chance

of having a heart attack than a
non-smoker

Lose weight if you are overweight.

Excess weight puts an extra burden on
the heart by forcing it to pump more
blood.

Exercise regularly. We can't stress
this one enough!

Reduce alcohol and caffeine in-
take. If you have 3 or more drinks or
cups of coffee each day you are more
likely to have high blood pressure than
if you limit yourself to one or two.

Reduce saturated fats in your diet.

Read those labels! Get in the habit of
knowing what you're putting into your
body.

Reduce salt. Salt, or sodium, sneaks
into your diet in many ways. Avoid salted
snacks and cured foods — bacon,
pickles, olives.

What Are Your HDLs and LDLs?

There are two types of cholesterol:
1) high density lipoproteins and 2)
low density lipoproteins. Your body
produces HDLs which are considered to
be the "good" cholesterol and contain
the smallest amount of cholesterol and
the greatest amount of protein. HDLs are
known to sweep away the cholesterol
plaque from your arterial walls. High
levels of HDL are usually found in peo-
ple who exercise regularly, don't smoke

and maintain their weight. Low density
lipoproteins are considered to be the
"bad" cholesterol because they contain
the greatest amount of cholesterol and
the smallest amount of protein. LDLs
deposit on the arterial walls and in-
crease your risk of heart disease.

Take yourself off the heart disease "hit
list" by knowing your blood cholesterol
level and working to maintain it in a
healthy range.

Find the Fat

Here's a simple math procedure that
can help you determine the percentage
of calories that come from fat— from
frozen dinner to canned vegetable. You
just need to know the amount of fat and
the number of calories per serving —
both easily found on a nutrition label.

Example: A frozen Chinese dinner
that has 20 grams of fat and 340 calories
per serving. Multiply the number of
grams of fat (20) by the number of
calories per gram (1 gram =9 calories.)
The total number of calories from fat per
serving is 180. Next, divide the number
of fat calories (180) by the total calories
(340) and multiply by 100. Your answer:
the percentage of calories that comes
from fat is 53%.

Fat Quiz

Find the percentage of calories from
fat in the following examples:

1. Lowfat cottage cheese: 1 gram
fat, 90 calories per serving.

2. Mayonnaise: 11 grams fat, 100
calories per serving.

3. Graham crackers: 3 grams fat,
120 calories per serving.

4. Non-dairy creamer: 1 gram fat,
12 calories per serving.

Answers: 1 10% 2 99% 3 23% 4 75%

Fat Reminder: Beware food labels
that read "no cholesterol" without
spending more time determining the
calories from fat figure.

What to look for when you purchase an exercise
video or participate in an exercise program.

By Nancy Colton

Assistant Professor of Physical Education, Department of Health and Human Development, Montana State University

Reprinted with permission.

So you've decided to develop some
type of fitness routine — you know the im-
portance of becoming fit either from the
media, your physician or your best friend
who has lost "x" number of pounds this
past year and who radiates with new
found health.

This isn't the first time you've initiated
a fitness routine— each year your well
meaning intentions have lasted a week,
a month, six months and then an injury
or lack of motivation caused you to drop
out.

This time you've decided an exercise
video might be the key to a successful
workout. Let's face it, popping a video
into the VCR in the privacy of your home
has much to offer You can:

1. work out anytime day or night;

2. wear comfortable clothes and you don't
have to dress up in silly leotards with the
legs cut out up to your waist;

3. save your pennies; a $16.95 video is con-
siderably cheaper than membership to a
health club;

4. improve self-esteem by NOT being sur-
rounded by 18 year olds with 9 inch
waists who drop their noses to the floor
during a flexibility warm-up exercise;

5. turn it off when you've had enough in-
stead of going into overdrive to please an
instructor or to keep up with the 18 year
olds.

TO BUY OR TO RENT IT

Before purchasing a video, check with
local video retail stores to see if you can
rent it. Preview the video keeping in
mind the following pointers:

1. Do you enjoy the personality of the exer-
cise leader?

2. Do you like the music?

3. Is the video produced for the theatrical
effects, i.e., participants whooping it up
unrealistically to "sell" how much fun
they're having.

THE RIGHT STUFF

Next, whether it be a video, an exer-
cise class or you undertake your own ex-
ercise routine, these points need to be
considered:

1. You need to have a good pair of support
shoes. If the exercise leader on the video
doesn't wear shoes especially during
aerobic or weight bearing/bouncing
movements, don't follow their example.

2. Make sure you're wearing clothing that
is comfortable and non-restrictive.
Because participants on the video are
wearing flashy leotards, don't be

Over 57% of employees
screened are at risk due to
lack of exercise.

pressured into wearing something like
this if it's uncomfortable.

3. If you are over 40 years of age and have
been inactive, a check with your physican
is warranted. If pregnant, you must follow
your ob-gyn recommendations.

4. Don't set high unattainable goals or ex-
pectations. If weight loss is desirable, a
sensible diet in combination with exercise
is the key This will take time — months.

5. Intensity, duration and frequency of the
workout are the keys to fitness
improvement.

A) Intensity— Karvonen's Formula:
Subtract your age from
220 = maximum heart rate — do not
exercise at this rate.

Subtract resting heart rate and multi-
ply by .60 = heart rate reserve.
Add your resting heart rate = target
heart rate— maintain this during
exercise.

Can you carry out a conversation
while exercising? If out of breath, slow
down.

B) Duration— at least 20 minutes at the
intensity described above. Start out
even less and gradually build up. Too
much too soon will result in muscle
soreness, or, worse injury.

C) Frequency — the ACSM suggests
three times a week on a non-consecu-
tive day pattern. Don't overdo in your
zest for fitness. This leads to fitness
dropouts.

6. Never perform exercise that are ballistic
(bouncy). Never hyperextend your knees
(lock your knees backward) while in a
standing position with your head over
your knees. Always keep your knees over
your feet, not out to one side. Don't arch
your back or hyperextend it while doing
exerices on all fours. Never assume the
yoga plow position. In doing abdominal
exercise, push the small of the back into
the floor, never arch it or raise legs upon
top of a bench to achieve a 90 " angle.
Often the instructors and participants in
videos are poor examples of correct body
mechanics. Don't follow their model.

7. If you experience a burning sensation or
the exercise hurts, ease up. Hold the less
strenuous position and if you feel the
muscle, relax, then go down a little fur-
ther Exercise leaders that encourage you
to "burn, baby, burn" are in reality say-
ing "injury, baby, injury!"

8. In performing aerobic exercises, never
work out on a cement surface even if it
is covered with carpeting. The best sur-
face is a wood floor or carpeting over
wood.

9. A good exercise program consists of a
warmup (5-10 minutes), an aerobic phase
(20-30 minutes) and a cool down (5-20
minutes). Another variety is to add a
calisthenics segment (15-20 minutes), i.e.,
abdominal work, hip flexor, and quadri-
cep strengthening, after the first cool
down and add a second cool down (7-10
minutes). Each video is varied in its pro-
gram. See attached chart. You may have
to include additional time to these
segments if the video you choose runs
short. All three components are very im-
portant. Initially, .pend more time warm-
ing up and cool ig down and only 10-12
minutes on the aerobic segment. This
can gradually be increased (about 1.0%
a week) until you work for 20-30 minutes
on the aerobic component.

10. In any aerobic workout, make sure when
making contact to the floor that the ball
of your foot hits first and then roll through
to your heel. Most video exercise leaders
constantly land on the balls of their feet
and never roll through. DO NOT model
their example.

11. Do you know the credential of the exer-
cise leader of the video? An actor, model
or someone that claims to be a fitness
lover/teacher for "x" amount of years,
doesn't mean they are qualified to teach
fitness. In Montana, as in every other
state, one must be licensed to cut or color
hair and yet exercise leaders are exempt
from licensing. There are two nationally
recognized certifying agents for exercise
leaders, the American College of Sports
Medicine (ACSM) and International
Dance-Exercise /^sociation (IDEA). If
your instructor has passed the re-
quirements of either of these groups or
has a degree in physical education, you'll
be exposed to quality, medically sound
instruction.

"Fitness cannot be bestowed
or bought; like honour, it must
be earned."
(Big Sky Winddrinkers)

Exercise videos are available from the
State Wellness Program for employees
who would like to establish an on-site
group exercise program. Contact Vi
Pigman of the State Personnel Division
for information — 444-3871.

Show You Care by the Belt You Wear

Safety bet leelly do wok!

Reprinted courtesy of the fJlontana State Higfiway Patrol.

The Safety Belt Issue

Each year over 200 Montanans lose
their lives as the result of motor vehicle
accidents and another 8,700 are injured.
Yet, 92% of the accident victims failed
to wear seat belts, resulting in occupant/
vehicle, occupant/occupant collision and
passengers being thrown from the
vehicle.

Auto accidents in Montana are the
major cause of paraplegia and quadri-
plegia from damage to the spinal cord,
and the largest contributor to new cases
of epilepsy (from head injury).

The costs related to motor vehicle ac-
cidents are staggering. Montana econo-
mic costs due to the 17,398 reported ac-
cidents in 1985 resulted in $134 million

—insurance payments, health and medi-
cal costs, lost wages, and property
damage.

Safety belt studies over the past 22
years have shown conclusively that safe-

ty belts reduce the risk of death and
serious injury by over 50%. Despite the
proven effectiveness of safety belts, less
than 21% of the population of Montana
use them regularly.

Over 53% of employees
screened currently are at
risk because they do not
use seat belts. Studies
Indicate that safety belts
reduce the risk of death
and serious Injury by
over 50%!

Responsibility

Motor vehicle accidents result in road
related trauma and economic costs. Our
society is realizing that much of the cost
related to traffic accidents is a burden
shared by everyone. Our society cannot
continue to let this costly activity go on.
Therefore, it is the responsibility of all
Montanans to take prudent and reason-
able steps to reduce death, injury and
related costs. One step is to wear safety
belts in motorized vehicles.

the bribe tbat worked!

Linda Kaiser, Wellness Coordinator, State Personnel Division

The State Wellness Program "bribed"
you to make healthy lifestyle changes
and many of you rose to the challenge.
You've made the commitment and are
well down the path to a healthier you.

We are particularly pleased that we
have reached beyond those employees
who already recognize the importance
of and habitually pursue a healthy
lifestyle. Over 80% of employees apply-
ing for a reimbursement had identified
health risks including elevated
cholesterol, high blood pressure, excess
weight or smoking.

By reducing these risks we reduce the
chances of personal and family catas-
trophe, and we reduce costs to our
health benefit plan. Not bad for some-
thing that makes us feel healthier and fit.

Here are a few comments from "satis-
fied customers" in the Bribe Program;

"/ have lost 30 lbs. and many, many
inches and am feeling terrific — thanks!"

"I am continuing the program in an ef-
fort to maintain my newly acquired
health status."

"I'm going to be a skinny person yet!"

". . . the aerobics program is really
great!"

"I appreciate the Wellness program
helping me with this (kicking the smok-
ing habit)."

THE ONGOING BRIBE

We had such a good response to the
"Bribe" Program, we plan to continue it.
Here's how the reimbursement works for
the new fiscal year (July 1988 — June
1989):

IF YOU: Attend 75% of the sessions of an
approved, introductory cardiovas-
cular fitness program for three
months. . .

WE WILL: Reimburse $35.00 of the cost of
the program.

IF YOU: Are a smoker and attend 75% of
the sessions of an approved
smoking cessation program

WE WILL: Reimburse 75% of reasonable
costs for the program.

IF YOU: (1) Are identified as "high risk""
through the PRO HEALTH
SCREENING because of
elevated cholesterol (240mg or
greater), elevated blood pressure
(140/90 or greater) or excess
weight (20% over recommended
weight for you height) and
(2) Attend 75% of the sessions of
an approved cholesterol/blood
pressure reduction program
and/or weight control program or
an introductory fitness program

WE WILL: Reimburse 75% of reasonable
costs for TWO programs for the
new fiscal year

TO GET IN ON THIS OFFER
TAKE THE FOLLOWING STEPS

1. Obtain a Wellness application from the
Employee Benefits Office in the State Per-
sonnel Division by calling 444-3871.

2. If the program you wish to attend has not
been approved, also obtain a Wellness
Program Information Form and have it
completed by the provider and returned
to the Employee Benefits Office.

3. After you have received notice that your
application and the program has been ap-
proved, participate in the program and
upon completion submit the following for
reimbursement:

(a) copies of attendance sheets

(b) proof of payment.
Remember, the reimbursements are
limited by available funds. Funds will be
committed on a first come basis. Pro-
grams must also meet established criteria
to be approved for reimbursement and
program costs may not exceed establish-
ed cost ceilings.

We've approved over 60 programs
statewide in Billings, Anaconda,
Missoula, Kalsipell, Havre, Poison,
Great Falls, Dillon, Glendive, Helena,
Wolfpoint, Boulder, Libby, Butte,
Superior and Lewistown. We'd like to
approve more — contact us if you
would like to see a program approved.

Sign up today for the "Bribe". You
have nothing to lose but some bad
habits!