Health Insurance Blog and Resources

If you live in a cold and snowy climate, you know that nothing feels better than warming weather and spending time comfortably outdoors. Take advantage of good weather to be outside. Hiking, swimming, running, or even just taking a walk outside supports your physical and mental health. Physical health Taking advantage of nicer weather by exercising outdoors is a great way to boost your physical fitness levels. “During spring you should take advantage of the longer days and improving weather. You could consider joining a running group in the evening. Even a short afternoon stroll during a lunch break could be enough to improve your overall health. It's recommended that as little as 30 minutes of walking a day can improve your cardiovascular health, strengthen bones, and reduce body fat,” says Guiseppe Aragona, MD, Prescription Doctor family medicine doctor. However, it’s important to take some precautions for your health as you move outdoors. Use sunscreen Tsippora Shainhouse, MD, FAAD, dermatologist in private practice at SkinSafe Dermatology and Skin Care“If you have been negligent about wearing it all winter, now is the time to get back into the habit of applying it every morning. Sunscreen is not just for beach days and even 10–20 minutes of unprotected sun every day on your way to work adds up. UV rays can reflect off of water and sand, as well as ice, snow, and concrete, and it can pass through both clouds and window glass. UV rays can directly damage DNA in epidermal cells, trigger unwanted pigment production, and damage structural collagen, which can lead to the development of skin cancers and premature aging, respectively. Look for a light-weight product with broad-spectrum UV protection and an SPF of at least 30. Layer it under your make-up.” Wear sunglasses Rahil Chaudhary, MD Managing Director and Ophthalmologist at Eye7 Chaudhary Eye Center“It may not be summer yet but as we enter spring, the weather will improve and you may want to spend more time outdoors and in the sun. Sunglasses aren’t just fashion accessories. They protect your eyes from UV radiation. The UV radiation from the sun’s rays can damage your eyes in a number of ways. This could include causing blindness or cancer, and you can even get sunburnt on your eyes.” Bring a jacket Jennifer Fidder, M.A. CPPC, Jennifer Alice Training and Coaching LLC mindset coach and personal trainer“Even though it's getting warmer outside, it can be pretty windy and rainy. Everybody who decides to take their workouts outside should make sure to have a jacket they can throw on after exercising. Being sweaty and cold is the perfect basis for the sniffles.” Mental health As you take care of your physical health and stay safe outdoors, remember to take time for your mental health, too. Spend time in the sun Myles Spar, MD, MPH, Vault Health chief medical officer and integrative men’s health specialist“Start getting back outside and soaking up Vitamin D. Vitamin D deficiencies are seen very commonly during the winter months, as we are not exposed to sunlight as much. Vitamin D deficiencies are known to cause a weakened immune system; heavy fatigue and sluggishness; depression; muscle, bone and back pain; and can prevent the body from repairing itself.” Exercise Judy Gaman, Executive Medicine of Texas CEO and Stay Young America! podcast host“When it comes to boosting mental health, we now know that exercise is just as effective, and often more effective than antidepressants. This may be why the change in season can help improve overall mood. We've found that simply tracking movement will cause people to move more. Measuring and monitoring is a great source of self-motivation. That's why we recommend that patients wear a step counter and strive for no less than 10,000 steps per day.” Meditate Haley Neidich, LCSW“In order to improve health and well being this spring, I encourage people to begin a meditation practice. Even just two to three minutes of sitting in stillness daily can have an impact on our health and mental health. People should avoid stress in order to avoid getting sick and to boost their mental health. Meditation helps to combat stress by creating a more peaceful mind. When we meditate, we're able to observe our experiences rather than react to them.”

With the warming of the weather, many people carry on the tradition of spring cleaning to help them refresh their home from the winter. As you're refreshing your home, here's some expert advice to help you spring clean your health in these three areas: Allergies Immune system Nutrition Allergies Avoid bringing allergens indoors Tsippora Shainhouse, MD, FAAD, dermatologist in private practice at SkinSafe Dermatology and Skin Care“Prone to seasonal allergies? Spring is the season for pollen from growing trees, flowers and grasses. It gets on your hair, skin and outerwear from the air, park benches and brushing up against flora. Reduce the risk of bringing the pollen indoors with you by removing exposed items at the door.  Did you go for a run outdoors in the finally warm enough weather? Toss your clothes in the washer and take a shower to remove pollen. Other tricks to reduce exposure is keeping bedroom windows closed and replacing the filter screens in your vents.”  Eat local honey Lisa Richards, nutritionist and The Candida Diet author"Honey is a natural sweetener which can help reduce the amount of added sugar you have in your diet, but can also improve your seasonal and environmental allergies. Integrating local honey into your diet may help reduce allergies because bees make their honey from the pollen you live and work around. Giving yourself a small dose of this on a regular basis can help to build immunity to these typical allergens.” Keep your indoor air circulation clean Mark Dawson, One Hour Heating & Air Conditioning COO“Clean your HVAC registers and vents: All of the air handled by your HVAC system blows through them, so these vents will inevitably get dusty. A flexible duster or the wand attachment on your vacuum should make this an easy job, and it can cut down on the amount of dust blowing through your home. Clean your ceiling fan blades: Just as with your vents, dusty ceiling fans can circulate even more dust around your home. And while you’re at it, reverse your ceiling fan direction so that the blades turn clockwise, creating an updraft. This helps circulate warm air throughout the room and may allow you to set the thermostat a couple degrees lower without sacrificing comfort. Switch your fan to 'on' mode: This strategy is a trade-off: when your fan runs constantly, your indoor air is always being filtered, boosting air quality. But you may see the difference in your monthly utility bills, and it will also increase the wear and tear on your HVAC system’s fan. The secret to healthy home air is striking the right balance when it comes to moisture control. Too much humidity is an invitation for mold – but too little can result in dry air that triggers allergy symptoms.” Immune system Take your vitamins Dr. Nikola Djordjevic, MD, health advisor at healthcareers.co“Vitamin C is an excellent supplement for boosting your immune system. Zinc is a fantastic supplement to take along with vitamin C, that will help you fight viruses faster. A healthy diet with fruits rich in vitamin C — i.e., citruses — will be an excellent way to take vitamins. Still, I suggest taking additional supplements during the seasonal change, to support your organism with little extra nutrients.” And, take your supplements Myles Spar, MD, MPH, Vault Health chief medical officer and integrative men’s health specialist“Set your immune system up for success by staying hydrated. Rethink your beverage choices, lower your alcohol intake, and switch to water and water with lemon to keep your organs healthy and flush out toxins.  Take immune-boosting supplements that help act as anti-virals like Elderberry, Echinacea and NAC (N-acetyl cysteine). Zinc also helps, since it is an antiviral. I like the product by Source Naturals called Wellness Formula.” Watch out for colds and the flu Jocelyn Nadua, registered practical nurse and C-Care Health Services care coordinator“Even though winter might be the worst for cold and flu season, spring would be the next one up. The change of temperature can often fluctuate during the spring, catching many of us off guard in the process. For instance, too often do people catch colds in March because they've been underdressed for the past few days, believing it's warmer outside than it actually is. Since we've been used to freezing temperatures for the last few months, a few degrees above zero can feel as though it's summer. With that being said, once spring arrives, don't dress by gauging the weather by how it feels, dress by the actual temperature.”  Take care of your gut Judy Gaman, Executive Medicine of Texas CEO and Stay Young America! podcast host“Research shows that 70 percent of the immune system is in the gut. Don't wait until you're sick to boost your gut microbiome. Take a high quality probiotic supplement, as well as consume foods that are high in probiotics and prebiotics. For example, sauerkraut, cheese, and other fermented foods are high in probiotics, and fibrous vegetables like asparagus are the food the microbiome feeds off of, also known as prebiotics.” Drink water Dr. Nikola Djordjevic, MD“Don't forget to drink a little more than usual. When seasons change, we tend to dress by inertia, keeping too many warm layers far longer than the temperatures demand. Due to excess of clothes, we sweat more and lose fluids. Increasing your water intake will ensure you don't dehydrate. It will provide optimal conditions for metabolic processes, and support the immune response to viruses that can thrive in the changing, warm weather.” Nutrition Plan ahead Jess Dang, Cook Smarts founder and chief kitchen cheerleader“One of the best things you can do to take control of your health is to get in the habit of meal planning. So many of us have good intentions about eating healthier, but when we're rushed and without a plan in the moment, we make choices we regret. My advice? Take some time on the weekend to think through what you have going on in the week ahead. Know when you'll have time to cook, when you'll need to be able to throw together something quick, and when you want to go out to eat or grab takeout. When you have a plan for each night's dinner that takes into account your actual life, you're much more likely to stick to it!” Choose nutrient-rich food Elliott Upton, NASM-certified personal trainer at Ultimate Performance“While there are no such things as ‘weight loss foods’ or foods that are somehow inherently ‘fattening,' there are certain types of foods over others that are more conducive to weight loss and will make it easier sticking to your diet. These are invariably meals that are high in protein, with nutrient-dense vegetables and good quality fats and carbohydrate sources that support general health and well-being, above calorie-dense, nutrient-poor processed foods.  There are plenty of foods that fit this mold for spring — grilled lean meats, fresh fish, low fat dairy for good sources of protein, green vegetables, crisp salads and general non-starchy vegetables to fill you up for less calories, healthy fats from things like olive oil drizzled on salads, nuts for added crunch or avocados for texture, along with small portions of carbs with a lower glycemic load, like brown rice or sweet potato, to keep you full and your blood sugar levels more stable.” Eat green things Pam Sherman, personal trainer and The Perfect Balance CEO“Have you been surviving on soups and comfort food this winter? Try swapping these out for lighter dishes that better reflect the new season, like salads or fish. The greenery that is starting to emerge around you may inspire you to add green foods into your diet more often.” Eat fruits and veggies Myles Spar, MD, MPH“Switch up your diet. A recent study shows prominent results indicating that a high intake of fruits and vegetables promotes higher levels of optimism and self efficacy, reduces psychological distress, reduces cancer fatalism, and protects against depressive symptoms in adults.” Visit the farmer’s market Jennifer Fidder, M.A. CPPC, Jennifer Alice Training and Coaching LLC mindset coach and personal trainer“Spring is also a great time to check out your local farmer's market. In the United States, all sorts of lettuce, leafy greens, as well as asparagus are in season this time of year.”

Part two of a two-part series. Read part one here. If you're having a hard time fitting physical activity into your daily life, you're not alone. Overall, the Centers for Disease Control and Prevention (CDC)'s report on physical activity levels in U.S. states and territories shows that activity levels could be improved in most areas. The first article in this two-part series took a deeper look at the report and reviewed possible reasons for the striking differences the report found across regions and ethnicity. The CDC's initiative Active People, Healthy NationSM has great resources for organizations and community leaders working to encourage physical activity in their communities. These are helpful for addressing these physical activity trends from a larger scale. While broader trends and barriers to fitness are usually better addressed at a societal and community levels, it's possible to incorporate more physical activity into your life even with existing barriers. Active People, Healthy NationSM also has helpful advice and resources for individuals and families. Joining the initiative can also connect you with other people becoming more active and keep you up-to-date on the movement. We reached out to experts for tips on overcoming barriers to fitness. Whatever barriers you face when it comes to regular physical activity, working to overcome them will benefit you. Where to start As you plan to increase your physical activity, you’ll need to determine your end goal, identify potential barriers, and plan ways to be successful. As you think about your end goal, keep in mind that visualization won’t be enough to help you achieve. “Surprisingly, it has been found that visualizing isn’t enough and maybe even harms the process! That’s because visualizing can give us a feeling of reward right on the spot within our brain. Imagine saying “Ah, imagine if I’ve written that book . . .”  It feels great and then that was enough!” says Alexandra Miller, Psy.D, Host of Psychology America with Dr. Alexandra Podcast and Director of Live Well Psychology. Making a clear, doable plan can help. “The first thing is to not try and change too much too soon. What I mean by this is often someone is aware they should be more active and believes they need to start going to the gym every day and change their diet all at the same time. What happens more often than not is one will start off by going to the gym five or more times a week. This is too much to start off with,” recommends Anthony Treas, MPH, CHES, Men's Life Coach for STRONG Men Coaching, LLC. Pacing yourself and gradually increasing your physical activity levels will help you be more successful with your goals over time. “When I coach someone who would like to add physical activity in their life, we start by just adding just a few days a week. If they can do more, that is fine, but the goal for the first few weeks is to participate in physical activity for a few times a week. Then gradually work to adding more days to eventually be doing some sort of physical activity everyday. Once they have a good routine, then it is time to start changing the diet,” continues Treas. Another key to achieving your fitness goals? Finding something you like to do. “The second thing is to find a physical activity that is enjoyable. Doing something enjoyable will help someone to stay consistent and consistency is the key to receive the health benefits of physical activity. Although, it is important to add in strength training, flexibility, and functioning exercises, doing something you enjoy is the most important for longevity,” advises Treas. Even if you have a clear plan and an activity you look forward to, you can always change your mind in the moment. Miller has advice to counteract this:  “What we need to do according to recent research is consciously think of our biggest internal barrier to making our goal (i.e. increased activity) happen. This often comes in the form of one sentence we tell ourselves and will be unique to each person. For my patients it’s often 'I’ll do it tomorrow,' or 'I don’t have the energy' or 'I don’t have the time right now.' Once we come up with this sentence, we then make a plan of how to overcome this barrier. The play may be in the form of a sentence paired with an action, such as 'It’s now or never . . . and then I put on my running outfit.'  This method has a fancy title: ‘Mental Contrasting with Implementation Intentions,’” she says. How to overcome barriers Anticipating and planning to work around barriers will help you achieve your goals. “Make a list of how incorporating physical activity may be difficult for you. Identify these areas and then find a way to make it easier to incorporate physical activity. It will require some changes, but the health benefits are worth it,” suggests Treas. Specific barriers you face will vary in their type and intensity, so your plans to overcome your difficulties will likely be different from someone else’s. Below are some tips for overcoming common barriers. Weather Kristen Burris, LAc, MSTOM, Acupuncturist and Master Herbalist for Eagle Acupuncture“If weather is a challenge: either too hot or too cold, finding activities indoors will be your saving grace. In the dead of winter, going to a gentle warm heated yoga class sounds abundantly more appealing than walking in the windy city with snow all around.” Amber Nash, fitness expert and founder of Fit Healthy Best“Try 20-second exercise snacks to improve fitness and boost motivation in cold months. Researchers found that just 20-seconds of stair climbing a few times per day improved the subjects' cardiovascular fitness. This can be done easily indoors all winter or when someone does not have access to physical activity.” Michael Groesch, PT, DPT Clinical Manager of Menorah Park Center for Senior Living“Ice skating, skiing, and winter hiking can be a great way to beat the winter blues and avoid gaining the extra weight we may experience in colder months.” While these tips focus on colder weather, you may need to find indoor activities if the summers in your area are too hot.  Money Jennifer Ellis, ACE Certified Group Fitness Instructor and Life Enlightenment CEO“Just move. Many people I find feel like they have to join a gym, sign up for a class, walk a certain number of steps per day, etc in order to be active. I tell my students — just move! I don’t care what you do or for how long; any amount of movement will be beneficial — do a set of squats while brushing your teeth, park farther from wherever you are going and walk, if you are a parent with time constraints turn on some music and dance around the house with your kids. Those are a few of many easy examples I share with my students.” Michael Groesch“Even while watching TV, one can stand, do squats, lift light weights, (if you don’t have dumbbells try using books, filled bags, or canned goods for weight) do leg extensions, toe touches, and jumping jacks. Workout videos are entertaining, high energy, and can be done any time, and anywhere that you have access to a computer, TV, or phone with YouTube. Most are found free on the internet. Before bed, gentle stretching can be part of your nightly routine. Try sitting toe to toe with your partner and stretching back and forth.” Kristen Burris“Many community centers offer classes for free or for only a few dollars. Write down on a calendar each week a new activity you'd like to try from tai chi to yoga to square dancing to Pilates to weight training to snowshoeing to pickleball to flying a kite or riding a bike. Figure out what you like. The things you dread, avoid. If taking on activities feels too daunting, walk more, drive less, park further, carry more, take the stairs not the elevator, and start slow. The other option is to YouTube exercise for beginners or a 10-minute workout. All you need is a phone, Wi-Fi, and 10 minutes.” Time Sandra Crawley, RN, BSN and Mom Loves Best medical consultant“If someone puts in long hours working and comes home to take care of the family, then has to travel to a different location to be able to be physically active, chances are the first thing to go is physical activity. When time and money are limited, take small steps to become more active. Dance while doing chores — don’t just sit and watch the kids, get up and join them. Take a walk after dinner and explore your neighborhood. Find your support person. No matter what the perceived barriers are, there is always a way around them.” Gaye Groover Christmus, MPH of CalmHealthySexy“One of the easiest ways to get more physical activity is to work it into your daily life. Every day, think about your schedule and ask yourself, 'How can I move more today?' Wear an activity monitor, set a step goal, and add short periods of walking throughout the day. Walk at your children’s sports practices and lessons. Walk and talk with a colleague, rather than sitting and talking. Take 20 minutes of your lunch hour to walk.” Michael Groesch“If you can’t join a gym or health maintenance program, you can get your activity in at a local mall; it’s a great place to walk! Also, multi-level office and apartment buildings have steps to each floor, which provides great cardio. A 10-minute walk during your lunch break can do wonders for your energy level, cardio health, lowering blood pressure, and de-stressing.” Ways to stay on track Keeping yourself accountable will help you stay on track. You can hold yourself accountable to yourself or find a friend to work with are great options. If personal accountability works for you, you can use fitness technology, like Fitbits, to keep yourself going towards your goals. “Invest in some tech. Wearable devices that track your activity have been shown to be very effective. Setting an active goal and using technology to track your progress throughout the day is a great way to remind yourself to keep moving,” suggests Samantha Clayton, vice president of sports performance and fitness for Herbalife Nutrition. If tech is beyond your budget, you can use a calendar, journal, or make your own tracker. You can also keep track on your phone. Social support can also help you succeed. “To help increase activity levels, people should find some support, either from family, friends, or a group. People are more apt to be physically active if they have another person be active with them and the extra support will keep you motivated,” suggests Crawley. Finding a friend or family member to work-out with or even just to go on walks with can help you stay on track for your activity goals. You may even be able to find support groups by joining the CDC's Active People, Healthy NationSM. If you have a health plan, your insurer may offer rewards or programs that make it easier to be active. For example, Cigna offers a Healthy Rewards® program that provides discounted fitness club rates to plan members among other discounts.  With a workable plan and the right support, you can be successful and increase your activity. Explore Health Insurers Learn more about member benefits and fitness incentives offered by top health insurance companies with their plans. View Top Health Insurers

Part one of a two-part series. Read part two here. Did you make an exercise goal for a New Year's resolution? Are you having difficutly meeting it? If you are, it might not just be you. There may be some external factors at play. In January, the Centers for Disease Control and Prevention (CDC) released data on adult physical inactivity in the United States and several U.S. territories using data collected from 2015 to 2018. Overall, the report shows that over 15 percent of adults in U.S. states and territories did not participate in any physical activity outside of their job. Most states and territories had 20 percent or more adults reporting no leisure time physical activity in the past month. Keep in mind that even doing one leisure time physical activity during the last month would have changed the results. Being physically active once a month is a pretty low bar when it comes to evaluating fitness levels. By and large, the report indicates that adults in the United States need to be more physically active. Since the report measures leisure time physical activity, here's our first question: Does discounting job-related physical activity make this an unfair representation of fitness levels and overall health in the United States? The CDC also created maps that show hot zones of inactivity by state or territory. There are several maps that show differences in activity levels by region and ethnicity. These differences are striking. “When you go through the CDC report, there are two main points that stand out. The first is that Southern states and the Northeast states have one of the highest inactivity levels. The second fact is that non-white Hispanics and non-Hispanic black adults got the least amount of exercise,” observes Dr. Dheena Sadik, Consultant Nutritionist and Dietician for Tea Leafed.  So, the second question: What barriers exist preventing leisure time physical activity? And, to wrap up this two-part series: What can people do to increase their activity levels regardless of the barriers they may face? We reached out to health and fitness experts and looked at research studies to learn more about these questions. Read on to get their insight. Does discounting job-related physical activity make the results an unfair representation of fitness levels and overall health in the United States? While some experts noted that job-related physical activity contributes to overall health and fitness, others had compelling reasons for it not being an unfair statistic.  Here’s why: 1. Active day jobs may not affect everyone’s fitness levels the same way. Kristen Burris, LAc, MSTOM, Acupuncturist and Master Herbalist Eagle Acupuncture“Oddly, in 20 years of practice, I have not noticed a correlation with active day jobs equating fitness. You would think every housekeeper in America would be underweight and muscular from the demands their job ask of them; however, it is not true. Leisure activity is key.” 2. Job-related activity is different from fitness. Dr. Dheena Sadik“A study conducted by Netherland researchers found that individuals who worked in construction and similar jobs were actually at risk for dying earlier. It appears that physically demanding jobs require a different type of physical activity. This, coupled with the fact that these workers don’t get as much rest could be doing their cardiovascular system more harm than good. So, in that way, even people with such jobs may need to work out during their leisure time as well.”  Jasmine Marcus, PT, DPT, CSCS of McCune and Murphy Physical Therapy“I'm a physical therapist and strength and conditioning specialist. I do think it's important to overlook the physical aspects of work, because your body becomes used to this level of activity, and to truly benefit from exercise, you usually have to overload the body and do more than what it is used to.  Additionally, while a job may require heavy lifting, it probably isn't adequately lifting all the muscle groups that need strengthening. Additionally, everyone needs both cardiovascular activity and strength training, and even an active job may not hit both of these goals.” 3. The purpose of physical activity matters. Samantha Clayton, Vice President of sports performance and fitness for Herbalife Nutrition“All activity counts in terms of assessing people’s sedentary lifestyle behaviors. However, there is a big difference between doing purposeful exercise with the aim of improving your fitness level with dedicated time, versus simply moving your body doing activities of daily living or work.  All activity is important, but intentional activities done for the purpose of decompressing or health improvement has a greater impact on our mental health and this, in my opinion, makes the report truly accurate. It’s for this reason that more people are prioritizing self-care wherever possible. Stress relief is needed in our busy lives and physical activity has so many positive health benefits.” All of this is to say: having a physically active day job doesn’t mean your body is getting what it needs.  As you evaluate your physical activity level, keep in mind that your activity levels also need to hit recommended levels to get the health benefits. "An important thing to remember is the recommendation of 150 minutes of moderate-intensity aerobic exercise per week, so although your activity during the day is beneficial you want to make sure it is enough to raise your heart rate to get the benefits of exercise,” says Michael Groesch, PT, DPT Clinical Manager of Menorah Park Center for Senior Living. What barriers exist preventing leisure time physical activity? While the study also shows exercise rates across states and ethnic or racial groups, regions and ethnicity may not be the best way to interpret the findings. There are other factors that may have more of an effect. Sadik remarks: “The one thing that the CDC study didn’t take into account was socioeconomic factors. However, if you were to take a closer look, this could be the missing piece to show why non-whites were getting less activity outside of their jobs.” Socioeconomic factors likely have more of an impact on physical activity levels than anything else.  In fact, the states with the highest poverty levels almost exactly match up with the states with the lowest activity levels when you look at the Overall Physical Activity Map from the CDC’s report and compare it to The Percentage of People in Poverty for the United States and Puerto Rico: 2018 map (Figure 2 in Poverty: 2017 and 2018 of the American Community Survey Briefs, issued November 2019). When you consider that disparity in socioeconomic outcomes and poverty rates in the United States are different across racial and ethnic groups, it’s not surprising to see that these outcomes affect health. For example, the Kaiser Family Foundation has data from 2018 that shows poverty rate differences across racial groups. The overall U.S. poverty rate for Whites is 9 percent. In contrast, the poverty rates for Blacks (22 percent) and Hispanics (19 percent) are both double the poverty rate for Whites. If you look at the states with the highest poverty rates for each group, they generally match the states that have 25 percent and higher reported inactivity levels in the CDC's report. While there are a few exceptions, these trends are telling. “Across our nation, we see that the lower economic areas have the highest rate of a sedentary lifestyle. Many of the rural areas lack the simple amenities already mentioned, but have the added barriers of the lack of funds to join a gym, take classes, or buy the perceived necessary equipment. Inner-city areas have plenty of sidewalks but may be unsafe and lack outdoor green space,” says Sandra Crawley, RN, BSN and Mom Loves Best medical consultant. These differences indicate a relationship between socioeconomic factors and physical health. While there is evidence suggesting a strong correlation between poverty rates and leisure time physical activity, regardless of race, ethnicity, and region, there are other regional factors to consider. These include geography, weather, and climate. For example, areas with hiking trails and nicer weather may make it easier for people to get outdoors and be active. Colder weather and storms can make it harder to get outside or even drive to a recreation center. Experts we talked to also identified other potential barriers. Some of the barriers mentioned below are socioeconomic factors. Each potential barrier listed below may be experienced differently based on identity and location. Weather Amber Nash, fitness expert and group exercise instructor of Fit Healthy Best“I live in Kansas City and getting outside from December through February is very difficult, which is common across the entire Midwest.   Even on the days when there is no precipitation, you have to really bundle up to get out and be active. This can be harder for people with limited resources to buy warm layers or for parents with very young children.  On top of that, if you have limited financial resources and don't live close to a public rec center, your options for physical activity during these three months are severely limited.   According to my fitness tracker, even though I aim to be active all winter, my activity levels do plummet during these months.  It's simply so much easier to just walk outside during the spring, summer, and fall in the Midwest and get in some movement than it is during the harsh winter months here.” Fatigue and expectations around exercise Alysa Boan, NASM Certified Personal Trainer at MyTennisLessons and RealFitnessMaven“Physical activity can be daunting. Oftentimes we are not confident in the gym so we avoid it. Or we are so exhausted from our day, exercise gets pushed to the bottom of the priority list. What we must recognize is that exercise and a healthy diet are proven to increase energy levels, decrease stress, and improve sleep. All of which help to battle exhaustion and lack of motivation. Increasing exercise can be a strong indicator for improving overall health and wellness.” Work-life balance Michael Groesch“Other barriers include time constraints and access to exercise equipment.  A lot of people have difficulty with finding a balance between work, responsibilities at home, and physical fitness.” Samantha Clayton“The main barrier that I see while traveling is that many people struggle to find a work/life balance. Technology as well as the expectation to be constantly connected to work is preventing people from making their health and activity a priority. In most major cities around the world, time stuck in traffic or commuting each day also interferes with recreation, family time, and food prep time. People are then reduced to having to pick up takeout or skip the gym. A way to manage this is to try to beat the traffic, get to work early and squeeze in some exercise, use your lunch time to move or workout close to work, or use your time wisely after work to allow the traffic to die down. This way you can reduce your stress while also getting in your fitness activity for the day.” Pain Michael Groesch“A large barrier we see in my profession to physical activity is pain. If pain is limiting your ability to be physically active this can impact your health substantially.  Consulting with a physical therapist is a great way to help you overcome this barrier and get back on track with your exercise.” Read the second article in the two-part series: "More Than Willpower: Overcoming Barriers to Fitness"

Taking care of your physical and mental health can help make life more enjoyable. Now is the time to get prepared and make necessary changes as the season changes to get the most out of fall. Physical health Fitness is an important part of maintaining physical health. But there's more you can do to stay in good physical health, like preventing disease and making necessary adjustments for seasonal changes. Disease prevention Germs spread easily. It's a good idea to take precautions, like washing your hands and getting a flu shot. “Prepare for flu season. According to the CDC, flu season can start as early as October and end as late as May. This means that for more than half of the year, you are at risk. It is recommended that you receive a flu shot sometime in September or October before flu season gets underway. Other measures you can take to protect yourself include washing your hands frequently, eating a healthy diet to boost your immune system, covering coughs and sneezes, and staying away from others who are sick,” says Jack Burke, Community Outreach Coordinator forhims.com. It’s also important to get enough rest and listen to your body. “One main thing to be cautious about during the fall months is to take care of yourself. If you feel an illness coming on, listen to your body and rest as you need to,” cautions Melissa Morris, ACSM certified exercise physiologist and ISSN certified sports nutritionist and writer for Exercise.com. Giving your body what it needs will help keep it in good health and make it easier to recover from illnesses. Seasonal changes and adjustments The transition from fall to summer makes adjustments for cooler and drier weather necessary. “Autumn may not bring the frigid temperatures and harsh weather of winter, but temperatures still dip enough to have an effect on your health. Cold, dry air can cause dry, cracked skin, as well as cold sores,” says Burke. Many people associate the heat of summer with sunscreen, sunburns, and aloe vera. However, it’s not the heat that causes sunburns, it’s the sun. “Even though there is less sun in the fall, you are still at risk from UV rays, so any products should contain SPF,” adds Burke. Seasonal changes can also affect your hair. Alisha Lawson, Product Development Expert for Shiny Leaf, has some tips for keeping your hair and skin healthy. “Protect your hair and skin by using nourishing hair and skin care products. The best products are infused with natural oils like argan oil and castor oil. These oils come from seeds that are rich in essential fatty acids, necessary for maintaining moisture and glow,” she suggests. You should also be prepared to make minor adjustments for your sleeping schedule. “As the seasons change and daylight gets shorter, you may find yourself feeling sleepier than before. This is because your circadian rhythm changes based on your exposure to light, affecting your internal clock. Try giving yourself a little extra sleep, and solidify the habit by going to bed and waking up at the same time each day,” advises Nina LaRosa, Moxie Media Marketing Director. Consistent, regular sleep will help you function better during the day. Just be careful if you’re starting to sleep excessively. “If you find yourself oversleeping, consider talking to a doctor and investing in artificial light sources. You may be one of the many individuals whose moods and energy levels are impacted by the changing seasons,” says LaRosa. Being mindful of how cooler weather can affect you will help your body transition smoothly between the seasons. Mental health  Reema Beri, PhD, licensed clinical psychologist at Great Lakes Psychology Group, identifies three challenges that the transition from summer to fall presents for mental health. The end of summer means shorter days and less sunlight. Fall is prime-time for people to begin to feel "down" or "low" due to our decreased exposure to sunlight. Summer allows us all, no matter where we live, to access the outdoors. Fresh air and sunlight are a great stress relief, and the incoming colder weather begins to limit our outdoor access. Fall represents "back-to-school" time, and back to the routines of school, sports and extracurriculars. It can be a jarring change from the lazy, relaxed, sun-soaked days of summer. For all of these reasons, you may find yourself susceptible to the "fall letdown" which is experienced by many and also completely normal. Being aware of these specific challenges can help you plan ways to meet them and have a smoother transition between summer and fall. Below are three things you can do to boost your mental health during the fall. Spend time outside Reduce stress Practice self-care Spend time outside  Luckily, fall weather is still great for being outdoors in many places. As a bonus, it’s not nearly as hot as the summer months. “Whether it’s going for a walk at lunch or a hike on the weekends, it’s important to go outside and get a daily dose of natural light. Furthermore, you can still exercise outside if you dress to protect against the elements,” advises Burke. Once fall weather begins moving towards winter weather, it can be harder to spend time outside. “If you're missing the sun, try using a sun lamp. These lamps have a light that is comparable to sun rays and even has multiple settings to vary light intensity and color. Sun lamps also emit vitamin D so you can feel like you're sitting outside soaking up some vitamin D from the actual sun.” suggests Renata Trebing, Founder and Recipe developer for Nourish With Renata. Purposefully taking time to connect with nature or just to be outdoors is an important way to take care of your mental health. If you start having bad fall weather or if it’s too cold, a sun lamp can help give you some of the benefits of being outside. Reduce stress  Your stress levels affect your mental health. Whatever is causing the stress, you can take action to reduce your stress by slowing down and making a plan. Even if you’re in a fast-paced environment, you can plan time to take a break and slow down. “De-stress yourself to keep your hormones flowing naturally, supporting your natural rhythms. Try meditating, writing in a gratitude journal, or deep breathing. If you’re traveling, spend some time reconnecting with nature and turn off your electronics,” suggests Anna Cabeca, MD, author of The Hormone Fix. Practicing gratitude and meditation can help you develop a positive outlook on life, which will also support your mental health. “By incorporating meditation into your daily routine and simply sitting in a quiet place, without interruption, and becoming aware, you open yourself to the feeling of love and reflection. Reflect on your day with gratitude and look optimistically toward tomorrow,” says Cabeca. When you have a lot on your plate, it can be overwhelming. Identifying urgent tasks and determining a plan to get them done can help you reduce stress. “At work and at home, if you’re feeling stressed, make sure your space and tasks are organized. Many businesses experience an uptick in work following the summer slowdown, and fewer hours of sunlight at home may make it harder to finish certain chores or projects. Once you have a list of everything you need to do, prioritize what needs to come first to help reduce stress and boost productivity,” LaRosa confirms. Practice self-care  Slowing down and taking time for yourself is an important part of self-care, but it’s not the only thing you can do. You should also be mindful about how you treat yourself. “Be good and kind to yourself, and do not beat yourself up when you suffer, fail, or feel inadequate. Treat yourself the way you would your best friend — speak loving truths to yourself and do some positive coaching,” says Cabeca. Treating yourself kindly will help you feel better. It’s also important to make sure that you’re treating your body well. “Self-care includes developing or maintaining good sleep habits, exercising regularly, and eating wholesome and nutritious foods,” says Beri. And don't underestimate the power of connecting with people and having fun. “Doing things you enjoy, such as seeing and spending time with friends, and taking time out for yourself on a weekly basis, is also essential. Doing all of these things may have felt effortless during the summer months, but moving into fall means actively taking steps to engage in regular self-care. It will take intentional work, but it is doable!” Beri suggests. Being intentional about self-care and taking time to enjoy life will help you have good mental health. Physical and mental health hacks Taking steps to reduce your exposure to germs and getting enough sleep will help keep you well physically. Being intentional about self-care, spending time with people, reducing stress, and going outside will help you maintain good mental health. Looking for more fall health hacks? Check out Fall Health Hacks for Your Nutrition and Fitness.  

Maintaining good health is important year-round. As each season changes, it's a nice opportunity to evaluate your habits and make changes. Because of harvest season, fall is a great time to add more vegetables and fresh fruits to your diet. It's also a good time to prepare for winter fitness and try new fitness routines. The following fall health hacks will help you make this season your fittest yet: Nutrition Our diet fuels our body, so it’s important to make sure that we eat the nutrients our body needs. “Nourish your body. Most of us do not receive nearly enough vitamins and nourishment daily. Choose a diet and lifestyle that promotes a healthy balance and keeps you feeling happy and energetic,” says Anna Cabeca, MD, The Hormone Fix author. Healthy food choices year-round is important, but fall poses some challenges because of the holidays and warm comfort foods many of us enjoy. The following four suggestions can keep your nutition on track as you anticipate the cooler months: 1. Add fresh, seasonal produce One of the biggest advantages of the end of summer and beginning of fall is that it’s harvest season. There are lots of fresh fruits and vegetables to choose from. “Try to incorporate some delicious fall seasonal vegetables into your eating plan like broccoli, beets, bell peppers, cauliflower, sweet potatoes, kale, or green beans. They are full of nutrients, priced well, and tasty when they are in season,” advises Melissa Morris, ACSM certified exercise physiologist and ISSN certified sports nutritionist and writer for Exercise.com. Some of this produce may not be a normal part of your diet. Adjusting recipes and finding new ones is a great way to mix-up your typical diet and get good nutritional value from your meals. “Just like wardrobe selection, your diet changes with season too! Take advantage of the seasonal food choices available during fall. Enjoy delicious recipes with root vegetables like carrots, squash, pumpkin, and sweet potato. A warm soup with vegetables and legumes or grains will comfort you through the cold temperatures. They are healthy and nutritious too!” says Alisha Lawson, Product Development Expert for Shiny Leaf. Grocery shopping has other health advantages, especially if you take advantage of farmers markets.“A great way to maintain health during the fall months is to get out of your house and go to a farmers market. Being outside will give you some much-needed vitamin D and the wide array of seasonal produce will be a great addition to your diet,” says Jamie Bacharach, licensed alternative medicine expert. Taking advantage of farmers markets doesn’t just give you the opportunity to be outside. It also offers safer food choices with health benefits beyond the nutrients in fresh produce. “It's no secret that eating seasonal fruits and vegetables is a great way to stay healthy and have a well-balanced diet. Eating locally grown produce is also a great way to minimize unhealthy pesticides and preservatives that are on many mass-produced produce. It is also a great way of supporting your local farming community. Furthermore, research has found that eating local, naturally farmed foods can help prevent neurodegenerative diseases. This is particularly true regarding berries, which are high in polyphenols — a phytochemical which has been shown to help prevent dementia and Alzheimer's,” adds Bacharach. 2. Find good substitutes to make recipes healthier It’s hard to beat a warm bowl of macaroni and cheese during fall months. No one wants to skip out on mashed potatoes or pie on Thanksgiving either. But, some of these comfort foods are high in fat and sugar. Finding some good substitutes can make your comfort foods healthier while preserving the flavor and taste. “Most fall and winter dishes have a higher caloric intake because of the increased use of cream, butter and sugar. Try to find healthier alternatives for these ingredients, such as greek yogurt, coconut oil, or monkfruit sweetener,” suggests Renata Trebing, a recipe developer. You can also adjust recipes to make them healthier. “There are simple changes that can be made to these comfort fall foods that will help boost their nutrients and reduce their calories. Switching those dense soups for a lighter version that is broth based rather than cream based is a great first step. Choose vegetable loaded soup options over meats. Curb your Halloween sweet tooth with sweet fruits or low sugar baked goods,” recommends Lisa Richards, Nutritionist, The Candida Diet. 3. Make good snack choices Making sure that you eat nutritional meals is a great place to start. It’s also important to make sure that you’re eating good snacks. “If you snack in between meals, start incorporating healthier, more satisfying options, such as fresh fruits, vegetables and low-fat dip, unsalted or lightly salted nuts, or unbuttered popcorn,” suggests Nina LaRosa, Moxie Media Marketing Director. 4. Evaluate your diet Consider the foods you’re eating and decide what things you want to add and what things you want to reduce. Be creative by adding seasonal vegetables and making substitutions for some ingredients. “Channel your inner Marie Kondo and think about your own eating habits and food choices. Do they spark joy? Or do they spark anxiety, misery, or frustration? Choose what you’ll eat, and how much, based on tuning in and listening to what your body needs — what would feel good and spark joy for you? This means you might have to lower the caffeine, sugar, and alcohol intake,” suggests Cabeca. Fitness “Just because the days are getting shorter, it doesn’t mean that we need to change anything about our exercise, nutrition, or mental wellness habits. If you are feeling bored with your exercise routine, mix it up! Try a new fitness class, practice meditation, workout with a friend or partner, sign up for a 5K race, or find a new workout plan,” says Morris. Keep these three tips in mind as you think about exercising and maintaining fitness during the fall season:1. Exercise regularly If you have a gym membership at a fitness center, colder weather is a great time to take advantage of it. If you haven’t found one that you like, it’s a good idea to explore what’s available in your area. You can do this by asking friends for recommendations, researching online, and taking advantage of trials.Fitness classes are also a great option to explore. “Use the colder weather as an opportunity to try some indoor workout classes that you haven't tried before! Indoor rock climbing, boxing, or zumba are great options to add variety into your workout routine,” says Trebing. If you want to attend classes as several different gyms, a ClassPass membership can be helpful. “ClassPass will help people to find dynamic fitness classes that fit their schedule. We now offer classes from over 22,000 studios and gyms in over 20 countries,” suggests Mandy Menaker, Senior PR Manager. If it’s difficult to make it to a gym or class regularly, you can also workout at home. You can buy workout videos yourself or try online classes to get some variety. “YouTube is such a great platform with thousands of workout videos you can easily follow and do at home. Rather than just spending your time watching television the whole day, start with a jumping jack warm up. Once you feel your body is ready, hormones called dopamine are released and pushes you to train more. This is a sneaky way to stay in shape while at home,” says Lawson. 2. Incorporate movement into your day While setting aside time for serious work-outs is an important part of taking care of your body, it’s important to mix-in movement throughout your day as well. “When it’s cold out and you’re spending more time indoors, you may find yourself getting less exercise. It can be easy to fall into a sedentary lifestyle, so make a conscious effort to get up and move around. Consider using a standing desk at work and doing periodic stretches or exercises to get your blood flowing,” suggests LaRosa. Beyond making sure that you have breaks while sitting behind a desk, you can even be creative when setting meetings with clients or colleagues. “Instead of meeting up with your local colleagues at a coffee shop, over a meal or chatting with them on the phone, meet them for a walk so you can catch up while you are getting some exercise, too. You'll feel great after, the time will fly, and it will be a fun activity to share,” says Paige Arnof-Fenn, founder and CEO of Mavens & Moguls. Movement throughout the day can keep you engaged and help break-up your work. For more helpful information about how moving can improve your well-being, check out Fall Health Hacks for Your Physical and Mental Health. 3. Spend time outdoors While fall brings cooler temperatures, it’s not winter yet. It’s still possible to exercise comfortably outdoors. As you start preparing for cold weather, it’s a good idea to make sure that the air in your home is good. “Americans spend the vast majority of their time indoors, never having been educated of the potentially harmful effects that are associated with poor indoor air quality. In fact, what we often come across in our line of work, is a resounding misconception that indoor air quality is vastly superior to outdoor. From worsening of allergies to dry skin and respiratory issues, the hidden affects of a home's indoor air quality are prevalent, says Steve Truett, President of Aire Serv, a Neighborly company. Truett recommends the following to keep the air in your home clean: Change your HVAC filter monthly Regularly dust and vacuum Avoid chemicals use indoors Utilize existing spot ventilation (e.g. bathroom and kitchen vents and fans) Replace or clean your furnace’s air filter every three months Check that your home has good ventilation Run an air cleaner Making sure that the air in your home is high quality will make it a good space to work-out, meditate, and be during cold weather. Trying new workouts, finding time to be outside, and finding ways to fit movement into your normal day activities will help you maintain and even improve your fitness levels. As you prepare for even colder weather and spending more time indoors, be sure that your home has proper ventilation to ensure that you’re breathing clean air. The bottom line Fall brings a lot of great seasonal foods and produce. It’s a great time to improve your diet and nutrition with fresh fruits and vegetables and make recipe adjustments as necessary. If you've worked hard to establish good fitness routines during the spring and summer, don't let all your effort go to waste. It’s still warm enough to spend time outdoors and keep any outdoor exercise habits going. It’s also a good time to start exploring other indoor activities that will help you keep your fitness up.

Guest Post by Dr. Indra CidambiWith the spread of the drug epidemic from urban to suburban and even rural areas, addiction in the workplace is not uncommon anymore, and it is a serious issue. Not only is the loss of productivity from alcohol and drug abuse significant, it has negative implications for safety in the workplace, both of which raise business costs. Over 77 percent of illicit drug users are employed1 and business leaders need to know how to address substance abuse by their employees effectively.To get a handle on the scope of the issue, consider this: in 2013, roughly 25 million2 Americans, or 9.4 percent of the population, had used an illicit drug in the past month and 33 million3, or 12.7 percent of the population, were classified as suffering from alcohol use disorder. It also appears that no profession is immune: dependence on drugs and alcohol among nurses is roughly 10 percent4, in-line with the general population; as per a 2016 study, 1 in 5 lawyers5 reported that their use of alcohol or drugs was problematic sometime in their lives; in law enforcement, 1 out of 4 police officers6 on the street have a problem with drugs or alcohol; and, a survey7 of teachers discovered higher abuse rates of alcohol, amphetamines, and tranquilizers than the national average. Extrapolating the numbers above it is safe to say that at least 1 in 10 employees in the workplace is impacted by substance abuse. Drug and alcohol abuse negatively impacts productivity and safety in the workplace and drives up costs. Alcoholism alone is responsible for 500 million lost work days8 each year.Signs of substance abuse among employees, while not obvious, can be spotted with some informed observation. General signs (depending on the kind of work) include an unkempt appearance, inappropriate clothing (long sleeves in hot weather), frequent bathroom breaks, perennially sniffy or runny nose, mood swings, isolating from colleagues, volunteering for overnight or holiday work (especially among nurses), higher than normal absenteeism or tardiness, poor job performance and workplace theft.It is important to realize that addiction is a disease, not a moral failure, and treatment is needed. Although it took time, addiction is now largely recognized by the treatment community as a chronic disease and quitting requires more than good intentions and a strong will. Drugs change the brain in ways that make quitting hard and, therefore, treatment is needed. Fortunately, treatment options have widened to include ambulatory detoxification (for all substances of abuse) and medication assisted treatment (MAT) which have delivered better results. Nevertheless, it is not easy to have this conversation with an employee.The best approach would be to first document each instance where the employee’s behavior was unusual. If possible, include it in the employee performance records as well. Then approach a professional alcohol and drug counselor or a physician who specializes in addiction, not only to make sure you are on the right track, but also to get educated on treatment options. If you utilize the services of an Employment Assistance Program (EAP), you may want to hand over the documentation to them and let them address the issue with the employee and help him or her obtain treatment. If you have to do it yourself, approach the employee as a concerned colleague rather than as an overbearing boss. Detail the instances where you have noticed behavior that was off and delve into the causes of such behavior. Explain why such behavior is impacting workplace productivity, safety, or morale. Make the employee understand that you believe that addiction is a disease that needs treatment. Show that you want to work with the employee and offer support if he or she wants to address the issue through treatment. Educate the employee about the treatment options available and explain that it is possible to live sober. Hopefully, the employee will choose to leverage the support and seek treatment. Addiction is a chronic disease that usually does not spontaneously remit over time. Treatment interventions are needed. If the employee is not amenable to seeking treatment, the issue has to be dealt with under company policies and other disciplinary rules. Indra Cidambi, M.D., Medical Director, Center for Network Therapy, is recognized as a leading expert and pioneer in the field of Addiction Medicine. Under her leadership, the Center for Network Therapy started New Jersey’s first state licensed Ambulatory (Outpatient) Detoxification program for all substances nearly three years ago. Dr. Cidambi is Board Certified in General Psychiatry and double Board Certified in Addiction Medicine (ABAM, ABPN). Dr. Cidambi is the Vice President of the New Jersey Society of Addiction Medicine. Notes: National Household Survey on Drug Use National Institute on Drug Abuse (NIDA) JAMA Psychiatry National Council of State Boards of Nursing The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys; Krill, Patrick R. JD, LLM; Johnson, Ryan MA; Albert, Linda MSSW Police On-Duty Drug Use: A Theoretical and Descriptive Examination – Kraska, Kapeller;  On the Front Lines – Hepp. A 1990 study by the Journal of Drug Education, which surveyed 500 teachers in Texas U.S. Department of Labor

Guest Post by Dr. Bruce Pinker February is Women's Healthy Heart Month for a very good reason: According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for females in the United States. According to the American Heart Association, nearly 80 percent of cardiac events can be prevented through education and lifestyle change. Genetics plays a role, but diet and exercise are major factors that have been proven to help reduce heart disease in women, as well as in men.As a board certified podiatrist and foot surgeon, I see many patients each day who suffer from foot pain that prevents them from running or walking. Without exercise, many run the risk of diminishing health. Regular exercise can promote cardiac health and overall wellness. Getting my patients back into pain-free activity is my number one goal. Plantar fasciitis One of the most common foot ailments is plantar fasciitis. An inflammatory condition affecting the bottom part of the foot, usually in the inferior heel region, it is often caused by overuse.  Due to excessive stress on the plantar fascia ligament, which spans from the heel to the toes, it stretches and snaps back, much like a rubber band. Regular stretching exercises can be performed to prevent it, coupled with the usage of supportive footwear, but this disorder sidelines millions of individuals every year. Whether or not you are very active is not necessarily a factor, as it affects people of all different ages and activity levels. Prolonged standing or walking can lead to plantar fasciitis. In many cases, a heel spur accompanies this painful foot condition.Various successful approaches can address plantar fasciitis, and most are conservative.  Physical therapy and orthopedic strappings are usually very beneficial, especially in cases diagnosed in early stages. Cortisone injections can be helpful, as well, and custom orthotics are usually instrumental in providing long-term relief. Custom orthotics can retrain the plantar fascia ligament, maintaining a proper arch that does not overstretch or contract. In the more challenging cases, high energy shockwave therapy (ESWT) or surgery can be performed.  Approximately 90 percent of all cases of plantar fasciitis can be successfully treated conservatively, based on my experience. Upon the onset of inferior heel pain, it is best to roll your foot over a frozen 20 ounce water bottle several times. If this attempt is not successful in reducing pain, it is important to see a podiatrist for proper evaluation. Bunion deformities and hammertoes Bunion deformities are also a common foot concern. A bunion deformity, referred to as hallux abducto valgus, is a structural foot condition, often caused by improper biomechanics. Some may be born with a bunion deformity, but most are acquired, often subject to the footwear that is worn; narrow or pointy-toed shoes and high heels are known to lead to bunion deformities if worn frequently. As the great toe points toward the second toe, and the first metatarsal points inward, excessive stress is placed upon the great toe joint. The stress leads to the growth of the typical "bump" right near the great toe as the ligaments stretch on the inside of the joint, and tighten on the outside. Tendons in the great toe region provide unbalanced forces that further the deformity.  As the "bump" enlarges, it presses against a nerve, leading to discomfort. While wearing shoes, the nerve can become sandwiched between the bones and the footwear, causing pain and difficulty walking. Some bunion deformities, if mild, can be addressed conservatively, with physical therapy, orthopedic strappings, and oral anti-inflammatories or Tylenol.  However, most bunions need to be surgically corrected for long term relief. Several bunion procedures are available, most requiring three to four weeks of healing, in my experience. They are performed as an outpatient procedure, and the correction lasts for many years. It is best to avoid footwear that puts the feet under unnecessary stress. However, rest assured, most bunions can be addressed successfully, either conservatively, or surgically. Most bunion surgeries are covered by health insurance plans.Often accompanying bunion deformities is the hammertoe. When a toe is contracted, it may point upwards at the first joint, and then downward at the second joint, thus illustrating a hammertoe. Improperly fitted footwear can cause hammertoe deformities. Pain usually develops on top of the toe, as it contacts the toe box of the shoe that is worn. The skin can thicken on top due to shoe irritation, and in some cases, can become a wound. The wound can get infected, leading to potential complications. The discomfort can be debilitating, so most hammertoes need to be corrected. Some can be treated conservatively with toe covers or spacers, but definitive correction through surgery is usually necessary, also performed as an outpatient procedure.  These procedures are typically covered by health insurance plans, and recovery time is usually just two to three weeks. Neuromas Neuromas are inflammatory conditions of the nerves in between the toes. Commonly brought on by tight or narrow footwear that is worn repetitively, neuromas can also be addressed conservatively and surgically. Most patients elect for cortisone injections to start, usually performed in a series. If unsuccessful in providing relief, custom orthotics can also be utilized.  Surgery is reserved for the more challenging cases, and usually results are long-lasting. Recovery from neuroma surgery is usually two to three weeks, performed as an outpatient procedure, and often covered by health insurance plans.                      Your feet need to last a lifetime, so taking good care of them is vital. Realizing that exercise is important for promoting cardiac health, it is essential to address foot pain when it occurs. Keeping your feet healthy can be pivotal for improving your overall wellness and heart health.  Don't let your feet break your heart! Dr. Pinker is a professional foot and ankle health and wellness speaker who delivers many original seminars annually, such as “Diabetes & Your Feet: The Winning Combination,” “Exercise Safe to Lose Weight,” and “Keep On Running.” He is a graduate of the New York College of Podiatric Medicine (NYCPM) in New York City. Dr. Pinker strongly believes the fusion of fashion and function is essential for footwear today, as the modern man and woman needs to look great and feel great. This is his motivation for his company: Dr. D-LuCS: Doctor Designed Luxury Custom Shoes. 

The new year often begins with motivation to make changes that will improve life. New Year's resolutions can be about education, finance, health, or more personal goals.According to a 2019 poll by Branded Research, 38 percent of U.S. consumers made a New Year's resolution in 2019.The age groups with the most people making resolutions are ages 18-24 (with 59 percent making resolutions), ages 25-34 (with 48 percent making resolutions), and ages 35-44 (with 45 percent making resolutions).The most common primary resolutions were health-related, with 28 percent overall with a primary fitness-related goal and 25 percent overall with a primary diet-related goal.Health goals were followed by finance-related goals, which 18 percent of U.S. consumers reported as being their primary goal.Of those who made a resolution, only 28 percent report that it is very likely that they will keep them. About 38 percent say somewhat likely, and 34 percent say not likely.If you've been struggling to keep your New Year's resolutions, you're in good company.We've compiled some expert tips on keeping your motivation going throughout the year so that you can stay excited about your goals and keep them. 1. Remember why If there are some resolutions that you're having difficulty keeping, it's a good idea to evaluate why you set that goal in the first place. Declan Edwards, founder of BUCoaching.org, says, “Revisit why the resolution matters in the first place. Human behaviour is driven by feeling. We rarely do what we logically know is good for us, we do what we feel like doing and one of the best ways to tap into feeling is to revisit our why.” There may be many reasons that you set a certain goal, and these reasons can be powerful motivators. John Gilmer, PhD, Vice President of Research and Development at Active Iron, says, “If you have something that you are passionate or firm about changing, decide why, because this, not the resolution, will drive you when you hit the wall and want to quit.” Whether or not you set a goal for the sake of having New Year’s resolutions, there may be additional reasons why you want to achieve that goal. Dannie De Novo, author, attorney, coach, entrepreneur, and podcast host, agrees. She says, “My best advice is to remind yourself often of why you made your decision. Take a piece of paper, write out your resolution in big letters at the top, and under your resolution list all the reasons why you are going to accomplish it. Make these statements positive. Then put that paper somewhere you will see it every morning, like your bathroom mirror. Make yourself read it and really reflect on the reasons why you started on this journey and why it is so important to you to continue.” 2. Evaluate barriers It’s now February, so you may have already encountered some obstacles along the way in your quest to keep your New Year’s resolutions. Instead of getting frustrated with yourself, focus on what you’ve learned about those obstacles and make a plan to overcome them. Gilmer says, “Eliminating obstacles is imperative, or you will constantly be tempted. Granted, this is easier done if you are cutting fat from your diet than if you are a smoker trying to quit, but no matter the gravity of the resolution, removing triggers is essential.” Some obstacles are harder to get rid of than others. In some cases, it may work better to make flexible plans. Eric and Ryan Johnson, founders of HOMAGE say, “When it comes to your training and nutrition, forecast ahead. By planning out your calendar at the beginning of the week, you won’t be caught off guard by any surprises. This will help you make the necessary adjustments to keep you on track.”  “For example, if you know you have a dinner scheduled for Thursday night, you can adjust your nutrition from Monday to Wednesday, so when Thursday comes around, you can enjoy yourself without any unnecessary guilt. The same goes for your training; if you have a particularly busy day scheduled, you can make it a rest day for training rather than stressing out how you’ll be able to fit it into your day,” they say. Other times, it can be just as effective to make small changes to your surroundings. Itamar Shatz, author of Solving Procrastination, says, “Making changes to your environment can help you pursue your goals. For example, if your goal is to drink more water instead of coffee, placing a glass of water next to your bed can help you make sure that that's the first thing that you drink in the morning when you wake up, which will make it easier to stick with your resolution. Similarly, you can also take a water bottle to work with you, and refill it throughout the day, in order to help make sure that you stay dedicated to your goal even when there are many temptations around.” 3. Make a plan Matt Edstrom, CMO of GoodLife Home Loans, says, “One of the best ways to make and stick with your New Year’s Resolutions is to create short term plans for your long term goals. Goals that you’ve planned to stick to for a full 52 weeks are going to seem incredibly daunting, especially if they have to do with something like food, something that we all interact with on a daily basis. Start new goals at the beginning of each month. Having new goals each month will help keep you motivated, hold you accountable, and keep you on track.” Chris Beavers, senior personal trainer at Ultimate Performance, agrees and recommends even shorter timeframes. He says, “Set bite-sized performance goals every week. Set a series of smaller and more achievable performance goals along the way to achieving your bigger goals. This is a great way to keep your training fun and challenging, and keeps you motivated as you achieve smaller wins on the way to your ultimate goal.” For some goals, you may need to break the steps down even further. Edwards says, “Success is driven by habits, not by giant leaps. If your resolution is to become healthier and fitter this year, your first step is not to go to the gym five times per week (especially if you weren't already doing that). Your first three steps would be to set the alarm in the morning, get out of bed when it goes off, and then get dressed in your gym gear. By the time you're out of bed and dressed, you're incredibly likely to follow through on the rest and show up to the gym. The decision to skip the workout is usually made while you're still in bed.” As you make your plans, it’s important to set achievable goals. Dan DeFigio, author of Beating Sugar Addiction for Dummies, says, “Be realistic so you don’t succumb to all-or-nothing thinking. If you make unrealistic promises or set unattainable intentions, you’ll most likely fail quickly, and end up right where you used to be. Instead, make yourself a more doable promise, such as “I will put exercise time in my calendar three days per week,” or “I will limit myself to one dessert each weekend.” 4. Set reminders There are many kinds of reminders — alarms, schedules, posters, lists, ect. You have to figure out what works best for you. Edstrom says, “A visual reminder can be a document where your goals are written down or a dream board or an item that reminds you of what you’re working towards. A visual reminder will help you stay motivated and remind you of the reasons why you set the goal in the first place. Don’t pick a visual reminder that’s going to point out what you don’t have yet in your life.” Hassan Alnassir, founder and owner of the kids’ toy business Premium Joy, agrees. He says, “If you want to stay motivated and retain the new year's resolutions, an effective trick is to always keep the end result in mind. Try to consistently imagine what difference it will make and how it will feel when you have finally achieved your health goal. Visualizing the outcome will help push you to keep going and take action toward accomplishing your desire.” For more specific reminders, Milana Perepyolkina, international best-selling author, says, “The best way to keep a resolution is to add it to your calendar. Treat it the same way you would treat an important appointment. Create one resolution per month and add it to every weekend (delete it after completion). Share your resolutions with social media; this will improve your accountability.” These reminders can be as frequent as you need them to be.  Eric J. Anderson, co-founder and Organizational Development Manager at ElMejorTrato.com, says, “Dedicate a special time to keep that resolution. Make it your time of day. For example, the first thing you do every day. If it is something very difficult to achieve, and you carry it out first, then the day is won. You have already beaten yourself.” There are also apps that can help remind you of your goals and keep track of your progress.  Lydia Noyes, health and wellness reporter for HighYa.com, uses HabitHub. She says, “This ultra-simple app lets you track the days that you complete predetermined goals, and multiple days in a row start to create visually appealing streaks. After a few days with this app, I started to get excited about how long I could make my streaks go, so sleeping in and skipping yoga started to have a higher mental and emotional cost than getting up and doing it. As simple as it sounds, this app truly changed my brain's approach to morning yoga and made me commit.” 5. Track progress and create rewards “Not seeing results from all your hard work in the gym often kills off that initial New Year motivation, and it's easy to just quit and fall back into bad habits. So, if you don't consistently track your progress, you won't be able to see the progress you're making,” says Beavers. Finding a way to track your progress will help you see the results of your efforts every day. It can be easy to focus the success of a goal based on results. However, that can lead to frustration and diminishing motivation. DeFigio says, “Two important tips for keeping resolutions: 1. Resolve ACTIONS, not OUTCOMES. For example, a common New Year’s resolution is to “lose weight”, or even more specifically “to lose 20 pounds.” These are worthy goals, but they are too diffuse because you are looking to an OUTCOME, not resolving to DO something. You have resolve to do the ACTIONS required to get the outcome. It’s better to resolve “not to eat after 7:00 pm”, or to promise yourself that you’ll bring healthy snacks to work, so you’re not at the mercy of whatever’s in the break room. These are ACTIONS that you can reliably perform that will get you where you want to go.”As you determine what to keep track of and how to measure progress, make it something that is in your control. You can keep track just for yourself or even share it with a friend. Gilmer says, “If you are accountable to someone, you will not only be more responsible, but more engaged as well. Studies show that accountability may be the single most important thing in goal setting and resolution. In addition, having some accountability will also ensure support, which is an equally important part of making important changes.” As you hit your smaller goals and make progress, plan ways to celebrate. Christian Koshaba, personal trainer and owner of Three60Fit, says, “People are so caught up with the end goal, they forget about the mile markers along the journey. This will make your wellness endeavor more of a lifestyle, rather than an end goal. Celebrate and be proud of your accomplishments, no matter how small. Find rewards to treat yourself with. A weekend vacation, a new outfit, trendy haircut, etc.” Celebrating even small successes also increases motivation.Maggie Schott, CEO of McKeating Solutions, says, “Our brains are engineered to reward us for accomplishments. When we achieve a goal or celebrate an accomplishment, our brains release those "good feeling" chemicals.  When we fail, not so much.  So our minds become patterned to seek out accomplishments.  When they're too few and far between, we can become discouraged.  Creating micro goals or mini wins, will help to give us this release and fuel us to keep working towards our overall goals.” 6. Deal with failure As you plan to celebrate your progress, it’s also a good idea to deal with failure in a constructive way. One way to do this is to practice self-compassion.Edwards says, “When you fall off the bandwagon with your resolutions, it’s all too easy to end up blaming yourself and calling yourself a failure. This just demotivates you from trying again. Try speaking to yourself more like you would speak to a close friend if they had fallen off the bandwagon with their resolution. Maybe January didn't go to plan, but don't throw out the remaining 11 months of the year just because one month didn't play out how you thought it would.”Another way to confront failure is to focus on the present and what you can do now.De Novo says, “Not dwelling in the future is as equally important as letting go of the past. Do yourself a favor and stop thinking three to six months down the road. Set your attention on today. What can you do in the present moment to help further your goal? What can you achieve today in the furtherance of your resolution?” Looking for more tips on keeping your New Year's Resolution? Check out: "New Year's Resolutions: Don't Give Up"

For many people, the holiday season means shopping, decorating, and wrapping gifts. These activities can cause foot and back pain, and in some cases may lead to injury. Below are a few suggestions from experts on avoiding foot and back pain this holiday season: Foot pain Dr. Bruce Pinker, DPM, AACFAS, FAPWCA, DABPM, a podiatrist and foot surgeon, says, “I see many patients with foot pain this time of year. One of the most common foot pain conditions is called plantar fasciitis. It is typically brought on by overuse — excessive walking or standing, or even running or jumping. Think of those waiting on line at airports or retail stores this time of year. With improper support in footwear, overuse worsens this condition. The pain can be so severe that it can prevent individuals from walking.” If you’re doing a lot of in-store shopping or participating in outdoor holiday activities, you’ll want to take especially good care of your feet. Fortunately, there are some simple ways to prevent this pain by being kind to your feet. Pinker says, “To prevent it, one should stretch the feet regularly. Rolling feet over a frozen 20 oz water bottle is helpful. One should also wear supportive footwear.”Neel Anand, MD, professor of orthopaedic surgery and director of spine trauma at Cedars-Sinai Spine Center, also recommends wearing good shoes.  “Make sure you’re wearing a comfortable pair of shoes with cushion and support for your feet when you shop because it will provide the same cushion and relief for your lower back,” he says. If your foot pain worsens despite these preventative measures, there are other ways to treat it.  “In most cases, plantar fasciitis can be treated conservatively by physical therapy, stretching, orthopedic strappings, cortisone injections, or anti-inflammatory meds. Many also benefit from custom made orthotics. Some, in the more challenging cases, require shockwave therapy (ESWT) or surgery,” Pinker says. Back pain Over the holidays, many people do a lot of bending and lifting as they shop, decorate, and wrap presents. Carrying shopping bags for long periods of time strains your back. “Getting in a good stretch before and after a shopping trip will loosen up your muscles and relieve some stress and stiffness, making you less prone to the post-shopping soreness that can lead to further injury,” Anand says. Another way to avoid shopping-induced back strain is to do all of your shopping online. Then, everything is delivered to your front door. Just be careful as you lift the boxes and take them inside. With decorating or any kind of bending and lifting activity, Anand says, “Be mindful not to bend at the waist when lifting those heavy boxes or string of lights. ALWAYS bend at the knees, and try to avoid twisting when you have your hands full.” Another common holiday activity that is hard on your back is wrapping gifts. Many people wrap gifts on the floor. However, doing so is not good for your back.  “Set yourself up at a table with a comfortable chair instead of sprawling out on the floor (this will prevent you from hunching) and wrap only a few gifts at a time allowing yourself plenty of breaks in between,” Anand says.