WISEWOMAN Gardening

Another sure sign of spring is the startup of the WISEWOMAN Entrepreneurial Gardening project. It is still too early to plant a garden in northern Michigan, but it is never too early to plan! Within the next couple of weeks, many of the gardeners will come together in their counties to receive their first nutrition lesson and start planning their gardens.

We at WISEWOMAN are very excited about the project this year. Of course, we are excited about it every year, but this year, Helen DeFlorio from MSU Extension will be playing an even bigger role in the WISEWOMAN Entrepreneurial Gardening Project. Helen led the pilot project in Ogemaw County in 2008 and 2009. Last year, she helped us expand the program into 6 counties by sharing her knowledge, skills, and lessons learned from her experience with the pilot.

This year, Helen will be working as the WISEWOMAN Gardening Coordinator. She will visit each of the participating counties to purchase the supplies the WISEWOMAN gardeners need to get started with their gardens. Helen will coordinate the Nutritionists and Master Gardeners in each county as well as provide support to the participants. It will be great to have someone in the field making sure the women get all of the training and supplies they need to be successful.

Helen has her work cut out for her this year. It looks like we will be adding at least three more counties and we may have as many as 75 WISEWOMAN Gardeners this year! That is a preliminary estimate. I will let you know when we get a final tally.

Another exciting addition for this year is our new WISEWOMAN Gardening Facebook page. I will be providing updates about the project throughout the summer here on the blog, but if you want to get more information between updates, go to Facebook and “like” WISEWOMAN Gardening. While you are on Facebook, be sure to “like” Michigan WISEWOMAN Program if you have not already.

Spring!

Many people in Michigan enjoy getting outside in the winter to go snowshoeing or cross country skiing. While those activities are great fun, most of us tend to stay inside more in the cold weather. Well, the snow in Lansing is gone, except for the big piles, and it is beginning to look like spring might be more than just a faded memory.

When I look out the window, I see more and more people out and about. Here in downtown Lansing, the sidewalks are getting more crowded as people make their way outside after overwintering in their cubicles. Outside my windows at home, I see people walking their dogs, or just walking themselves as they take in the spring air and sunshine.

Yesterday, my daughter and I pulled out our bicycles and went riding for about an hour and a half. The temperature was still a little cool. It was in the low 50’s, but we had mostly sunny skies for our ride. After about half an hour, we had to take off our jackets! It felt great to be outside moving and breathing in the fresh air.

As the days get longer, the ground is getting warmer. Crocuses and daffodils are beginning to make their presence known. (Can tulips be far behind?) The garlic I planted last fall is poking up through a layer of shredded leaves. I am looking forward to tilling the garden and planting tomatoes, summer squash, and herbs. Since it is still way too early for that, I will probably pull out the cold frame and plant some lettuce this weekend. I just can’t wait to start gardening!

Okay, you are probably thinking, what does all of this have to do with WISEWOMAN? The common thread is getting outside and being active, and being active is an important part of WISEWOMAN. Now that the weather is getting nicer, it is much easier to be active.

As you are talking with your WISEWOMAN participants over the next few weeks, remind them that spring is here! Ask them if they plan to take advantage of temperatures above freezing! They do not have to train for a marathon or the tour de France. Encourage them to get outside even if it is just for a few minutes each day. It is amazing what a little sunshine and fresh air can do to make you feel better about life. When you feel better about life, you tend to make healthier choices, and when you make healthier choices, you feel better about life. It is a vicious pleasant circle.

Enjoy the spring!

An Ounce of Prevention

Benjamin Franklin is credited with saying, “an ounce of prevention is worth a pound of cure.” With that in mind, let’s talk about chronic disease prevention. Part of what we do in WISEWOMAN is screen for chronic disease risk factors.

After the clinical screening, we sit down with our participants and talk to them about their risk factors. There are some risk factors we can’t do anything about. You cannot change your age, your family medical history, or your personal medical history. However, there are other risk factors that are modifiable.

The modifiable risk factors we screen for in WISEWOMAN are: overweight/obesity; high blood pressure; high total cholesterol; low HDL cholesterol; elevated glucose; physical inactivity; and smoking. When we talk risk factors, we also talk about lifestyle behavior changes. The behavior change areas we focus on are nutrition, physical activity, and smoking cessation. Making a positive change in one of these areas is generally a healthy thing to do. It can also have a positive impact on specific conditions.

In January, the American Heart Association/American Stroke Association came out with their Guidelines for the Primary Prevention of Stroke. I briefly mentioned these guidelines a few weeks ago in the “Eat Your Veggies” blog posting. After looking over the guidelines more closely, I noticed some recommendations related to WISEWOMAN that are worth mentioning.

1) In agreement with the Joint National Committee (JNC 7) report, regular blood pressure (BP) screening and appropriate treatment, including both lifestyle modification and pharmacological therapy are recommended. – Well, guess what? We do this in WISEWOMAN. Our participants have their blood pressure checked at least every year during their clinical screening.

2) Abstention from cigarette smoking by nonsmokers and smoking cessation by current smokers are recommended . . . . status of tobacco use should be addressed at every patient encounter. – When we identify a woman who smokes, we encourage her to stop smoking when she is ready. We also offer help in the form of the Michigan Tobacco Quitline and other smoking cessation resources.

3) A Dietary Approaches to Stop Hypertension (DASH)-style diet, which emphasizes consumption of fruits, vegetables, and low-fat dairy products and is reduced in saturated fat, also lowers BP and is recommended . . . a diet that is rich in fruits and vegetables and thereby high in potassium is beneficial and may lower risk of stroke. – The WISEWOMAN nutrition recommendations are based on a modified DASH diet. Our focus is on fruits and vegetables, low-fat dairy, and whole grains.

4) Increased physical activity is recommended because it is associated with a reduction in risk of stroke . . . adults should engage in at least 150 minutes per week of moderate intensity . . . aerobic physical activity. – Can you believe it? This is yet another modifiable risk factor we focus on in WISEWOMAN! Many of our women are pretty sedentary when they start, so we do not try to move them to 150 minutes the first week. We encourage them to take small steps. Even 5 or 10 minutes a day for someone who is not doing anything will help.

5) Among overweight and obese persons, weight reduction is recommended as a means to lower BP . . . . (and) as a means of reducing risk of stroke. – WISEWOMAN is not a weight loss program, but we do confront overweight and obesity as a modifiable risk factor. Inevitably when we talk about goals, a woman who is overweight will talk about wanting to lose weight.

What does all this mean? Does it mean if you are in WISEWOMAN you will never have a stroke? Of course, not. It does mean there are steps you can take to reduce your risk of having a stroke, and (not so) coincidentally, much of what WISEWOMAN recommends will help reduce the risk of having a stroke. If you talk with someone who has had a stroke, they will tell you preventing the stroke is better than curing the results. Just read Yvette Fields story.

Other Stroke Resources

American Stroke Association: http://www.strokeassociation.org

Power to End Stroke: http://powertoendstroke.org/

National Stroke Association: http://www.stroke.org

An Oasis in the Desert

Last time we talked about the importance of enjoying your veggies. We said,

learning to enjoy fruits and vegetables is one part of the equation. You also need to have access to them and you have to be able to afford them. Those are issues for another day.

Well, today is the day!

Have you heard the term “food desert?” You can’t talk about access and affordability of fruits and vegetables without talking about food deserts. Here is a definition I found on the web:

The term ‘food deserts’ describes neighborhoods and communities that have limited access to affordable and nutritious foods. The term was first used in Scotland and characterized neighborhoods that can encompass many thousands of people and/or an extensive land area as defined by city blocks or square miles.

In Michigan, when people talk about food deserts, they often talk about the city of Detroit. One study says over half the population of Detroit “must travel twice as far or further to reach the closest mainstream grocer as they do to reach the closest fringe food location, such as a fast food restaurant or a convenience store.”

Low-income urban areas are one place for food deserts, but you can also find food deserts in the low-income rural areas of Michigan. These are rural, sparsely populated areas where people have to drive a long way to buy groceries at a full service grocery store, because the nearby small town can no longer support a grocery store.

I don’t want to spend a lot of time talking about food deserts. I just want to introduce the term, so you will realize many of our Michigan WISEWOMAN participants live in food deserts, whether they are in rural or urban settings. For the women who find themselves living in a food desert, they face a double issue. Because they live in a food desert, they have trouble finding fruits and vegetables, and because of their financial situation, they have trouble affording the fruits and vegetables they do find.

Which issue do you work on first, access or affordability? WISEWOMAN started working on the affordability issue, but in some areas, our Lifestyle Counselors found themselves working on the access issue as well.

In 2009, WISEWOMAN teamed up with the Michigan Office of Services to the Aging to offer the WISEWOMAN Market Fresh Program. It is based on the USDA Farmer’s Market Nutrition Program. WISEWOMAN purchased books of coupons for our participants that could be redeemed for Michigan-grown produce at local farmer’s markets. Each book contained 10 - $2.00 coupons.

The first year of the Market Fresh Program WISEWOMAN participants redeemed over 13,000 coupons. That means they purchased over $26,000 worth of fresh, locally grown fruits and vegetables. When the women received the coupons, they also received nutrition education. In some cases, WISEWOMAN Lifestyle Counselors offered the nutrition education. In other cases, the Lifestyle Counselors partnered with Michigan State University Extension to offer it. The counties with the highest redemption rates were the ones who distributed the coupons at the farmer’s market and provided nutrition education related to what was available at the market that day.

While Market Fresh did not solve the problem of affordability, it at least addressed the problem by helping the participants purchase fresh fruits and vegetables during the growing season. It also introduced many WISEWOMAN participants to farmer’s markets for the first time. I have heard people say farmer’s markets are expensive. There may be a few specialty items that are expensive, but many items cost less than at the grocery store. Plus, you have the added benefit of buying produce that was probably picked that morning!

The Market Fresh coupons helped address the issue of affordability, but we found in some counties, there was still the problem of access. (Remember, these are food deserts.) For example, Lake County did not have a farmer’s market where the women could use their Market Fresh coupons.

The WISEWOMAN Lifestyle Counselor in Lake County, Heather Miller, was able to bring a farmer’s market to the women. She talked to a local couple who owned a farm and convinced them to bring their produce to the Health Department parking lot on clinic days. Heather also worked to get the couple certified to be able to accept the Market Fresh coupons. So, in Lake county, WISEWOMAN addressed access and affordability at the same time.

WISEWOMAN offered Market Fresh coupons again last summer. In 2010, we increased the number of coupons redeemed to almost 20,000! That is almost $40,000 of fresh, locally grown produce in the hands of our WISEWOMAN participants. This was a great boost to the health of the women in our program (not to mention a boost to the Michigan economy).

WISEWOMAN will offer Market Fresh coupons again this summer, and we plan to increase the number of coupons redeemed again. The food desert issue is a large and complex issue that will not be solved just by offering Market Fresh coupons. However, WISEWOMAN is going to continue to do what we can to help our participants find and purchase fresh, locally grown fruits and vegetables whenever we can.

Eat Your Veggies!!

Your mother always said to eat your veggies. Were you one of the kids who enjoyed eating veggies or did you think it was a punishment? Well, it turns out your mother knew what she was talking about. If you learned to eat veggies when you were a kid, you are ahead of the game.

In a recent study, published online in the European Heart Journal, eating at least eight servings a day of fruits and vegetables reduces the risk of death from ischemic heart disease by 22%. Wow! A 22% reduction is pretty good.

Other studies throughout the years have also talked about the benefits of eating fruits and vegetables. Have you heard of the DASH Diet? DASH stands for Dietary Approaches to Stop Hypertension. It was a huge study conducted in the 1990’s. They found that a diet focused on fruits and vegetables, low-fat dairy, and reduced saturated fat helped lower blood pressure.

A report from the American Institute for Cancer Research, Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective, says, “a predominantly plant-based diet may reduce the risk of cancer.”

In January, the American Heart Association/American Stroke Association came out with their Guidelines for the Primary Prevention of Stroke. One of their recommendations states, “A diet that is rich in fruits and vegetables and thereby high in potassium is beneficial and may lower risk of stroke.”

So, eating fruits and vegetables reduces your risk of dying from ischemic heart disease, lowers your blood pressure, reduces your risk of cancer, and lowers your risk of stroke. Those are some pretty good reasons to eat fruits and vegetables! Of course, if you just look at it from that point of view, it sounds like eating fruits and vegetables is like taking medicine.

Think back to the questions I asked in the first paragraph. When you were a kid, did you enjoy eating veggies or did you think it was a punishment? What about now? Do you enjoy eating fruits and veggies, do you avoid them at all costs, or do you dutifully eat your carrots every day, just because you are supposed to?

I love eating fruits and vegetables, especially in the summer when I can get them fresh from my garden or from the farmer’s market. Even in the winter, we store apples, potatoes, onions and winter squash in the basement, and we can always get frozen or canned vegetables from the grocery.

Not everyone is like me. Some people do not enjoy eating fruits and vegetables. (At least they think they don’t.) So, what does it take to get people to change their behavior and start eating at least 8 servings of fruits and vegetables a day? If there was an easy answer to that question, everyone would already be doing it.

Behavior change is hard. If your diet consists mainly of hamburgers, pizza, and Doritos®, it is hard to think about eating even one piece of fruit. To get the health benefits we talked about earlier, you have to make fruits and vegetables part of your daily routine. The best way to do that is to make it enjoyable to eat them. There are many sites on the internet where you can get great recipes and tips for making fruits and vegetables a way of life. Here are a few:

American Institute for Cancer Research Health e-Recipes – You can sign up, and they will deliver healthy recipes to your inbox.

Fruits & Veggies More Matters – It used to be 5-A-Day. They have plenty of recipes, and surprisingly, the recipes focus on fruits and vegetables.

Farmers' Market Recipes – Dr. Preston Maring helped start a farmer’s market at the Kaiser Permanente Oakland Medical Center in 2003. He then started putting together recipes for food you can get from the farmer’s market. This is his collection.

Michigan WISEWOMAN Recipes and Cooking Tips – Of course, you can also find recipes and tips on the Michigan WISEWOMAN website.

Learning to enjoy fruits and vegetables is one part of the equation. You also need to have access to them and you have to be able to afford them. Those are issues for another day. Stay tuned!

2011 Here We Come!

Well, here we are at the close of another year. It’s hard to believe 2010 is almost over. It has been an exciting year for WISEWOMAN. Here are just a few of the highlights.

The inaugural blog posting for A Word From The Wise was posted on March 26, 2010. We have had a few stops and starts, but the blog is a great way to keep people informed about WISEWOMAN.

On May 1, 2010, the Dr. Ron Davis Smoke Free Air Law went into effect. This law helps protect the majority of non-smokers in Michigan from second hand smoke. It may also help prompt some of our WISEWOMAN participants to stop smoking for good.

A few days after the Smoke Free Air Law went into effect, we held the BCCCP/ WISEWOMAN Annual Meeting in Traverse City May 5-7, 2010 at the Great Wolf Lodge. We had some really great sessions and some terrific networking among the local WISEWOMAN staff.

2010 marks the second year of Market Fresh, and it has been a great success. Market Fresh is modeled after Project Fresh and Senior Project Fresh. Project Fresh provides books of coupons to WIC Moms to purchase fresh Michigan fruits and vegetables. Senior Project Fresh provides the coupons to folks over 60. Market Fresh provide those same coupon books to our WISEWOMAN participants. As soon as we get the final numbers for 2010, we will be writing about it here.

This year, we expanded the WISEWOMAN Entrepreneurial Gardening project to five new counties. This partnership between WISEWOMAN and MSU Extension was a win-win for everyone involved.

In August, we kicked off the WISEWOMAN/Body and Soul Lay Health Educator Project. This is a partnership between WISEWOMAN and the American Cancer Society’s Body and Soul in Flint, Michigan. For this pilot, the Lay Health Educators recruit women to be screened in both the BCCCP and WISEWOMAN. The screening takes place through the Genesee County Health Department. After the screening, the Lay Health Educators work with the women to deliver the Health Partnership Intervention. Stay tuned for more information as it unfolds.

This fall Michigan WISEWOMAN added a couple of new local organizations and several new screening sites. Barry-Eaton District Health Department offers WISEWOMAN in Barry and Eaton Counties. McAuley Health Center offers WISEWOMAN in Wayne County. Two of our current organizations expanded into four new counties. That means WISEWOMAN is now available in 34 counties!!

With a year like that, what can we do for an encore? Well, we plan to continue doing great things by brining WISEWOMAN to at least 4,500 eligible Michigan women. We will continue with Market Fresh, the Entrepreneurial Gardening Project, and the WISEWOMAN/Body and Soul Lay Health Educator Project. We are planning another great Annual Meeting, scheduled for May 3-5, 2011 in Traverse City. And, we are working on a few new innovative projects that will impact not only the health of our WISEWOMAN participants, but also the Social Determinants of Health. Keep checking this blog for all the exciting details!

The Michigan WISEWOMAN staff wish you a Safe, Happy, and Healthy New Year!!!!!

Wishing You a Mindful Holiday Season

Normally people wish you a happy, joyous, and peaceful holiday. So, why on earth would I wish you a mindful holiday season? Well, being mindful will help you have a happy, joyous, and peaceful holiday season.

So, what is mindfulness? Mindfulness comes from the Buddhist tradition, but you do not have to be Buddhist to be mindful. In fact, mindfulness is gaining ground in Psychotherapy.(1) According to one definition, “(Mindfulness) is a state of being aware. It is a process of observation and attention in the flow of changing stimuli and perceptions. Mindfulness is ‘in the moment,’ present, engaged awareness. . . that is free of judgment.” (2)

For me, it is a matter of paying attention to what I am doing at this moment. It is being here in front of the computer as I write this post, instead of thinking about what I am going to do when I get home tonight. It is shutting off all the competing thoughts and focusing on what I am doing right now.

I got the inspiration for this blog post from an article in Medical News Today.(3) During the holidays, the writer said, “we eat, drink, and spend more (money) than we would normally do, and regret it come New Year when we step on those scales, or the credit card bill lands on the doormat.”

You might think, “if I spend my time being mindful, I won’t enjoy the holidays, because I will have to give up everything I enjoy.” Mindfulness is not about giving up. It is about being present and aware and truly enjoying the experience.

Think about the holiday gatherings you normally attend. There are people, maybe there are drinks, certainly there are delicious treats. What do you normally do? You fill a plate with food, grab a drink, and stand around talking with people while you eat.

It is great to enjoy the company of other people, but as you stand there talking, you may be putting food into your mouth without thinking. Occasionally, you will eat something really flavorful. You might stop for a minute and savor it. You might even say, “Oh wow, you have got to try this!” However, for the most part, you are probably not really enjoying the food.

Here is another way to experience the situation. Walk up to the food table. Take a minute to look over everything. Notice the beautiful presentation. Pick up a plate. Choose a few things you think you will enjoy, and put them on your plate, being careful not to pile up the food. You want to be able to see everything you are going to eat. Find a place to sit or stand. Take a look at your plate. Notice the cheeses cut into little cubes or stars. Notice the shape and texture of the crackers. See how carefully the cookies have been decorated.

Pick out one thing to eat. Smell the food before you put it in your mouth. Does it smell sweet? Does it smell earthy? Now, close your eyes and put the food in your mouth. Notice the texture. Notice the taste. Does it crunch, or does it melt? Chew it slowly, experiencing all of the flavors.

I know, it seems like a lot to ask at a holiday gathering. There are other people around, and you may not be able to take that much time with each bite. However, you can still think about each bite of food before you put it in your mouth. You can still notice the care and work that went into making the food. The idea is to put yourself in the moment and enjoy the experience. Enjoy the food. Enjoy the beverages, and enjoy spending time with your friends and family. Isn’t that what the holidays are all about?

If you practice mindfulness during this holiday season, you may wind up eating less and enjoying it more. Then, when the new year rolls around, maybe you will not dread stepping on the scales.

For a handout on the principles of mindful eating, visit: http://www.tcme.org/downloads/principles_handout_1_22.pdf

References
(1) Psychology Today: http://bit.ly/i8bA1J
(2) http://www.tcme.org/mindfulness_practices.htm
(3) http://www.medicalnewstoday.com/articles/209760.php