Monday, 28 September 2015

I Don't Fall for Food or Fitness Myths

Food and fitness myths have grown to an excessive number and causing extreme confusion in the health and fitness arena.  I am a firm believer of debunking all food and fitness myths and their false promises to deliver the perfect body in 10 days or less.  I can really get on a soap box about this subject and sometimes do.  Today seems fitting to fling a little soap around and clean up the "myth mess" created by untrue marketing in the fitness world.

Understand that most of America wants to get fit fast and companies are not dumb in knowing how to market that dream at top dollar.  Store shelves and online sites are crammed with millions of  miracle fitness makers and responding to those are the same amount of consumers.  Add that figure up and you have a several billion dollar industry all focused around you getting fit with a bottle of wonder.  Every time you step up to purchase some blend promising fat to melt off your body, create six-pack abs, build bulging muscles, or drop 7 sizes, please stop and realize those guarantees are myths.  There is nothing in that bottle or bag that is going to provide a fit body.  Supplements and herbal blends are not FDA regulated and promoters can put anything on their bottles to sell the product, and that is exactly what they do.  I do not walk the talk of teaching or selling gimmicks to achieve fitness which is the reason you will never see any endorsements for them on my Blog.  Take a close look at the small writing on most unregulated fitness supplements and you will see "should be combined with a healthy eating and exercise program for results."

Stop right there!  Guess what, if you just starting eating right and exercising you would see results without buying an expensive bottle of "quick fix" hype.   Most all our nutrients can be obtained through eating a wide variety of healthy foods.   Some foods can naturally boost metabolism getting rid of the need for any unhealthy stimulant fat burners.  Getting fit and staying healthy takes a lifestyle that can't be purchased at the store.  You are the secret to your success!  Myths are for fiction story books and fairy tales.

FITNESS MYTH

It would be nice to be able to snap our fingers and make our bodies the way we want them, but that is not life or reality.  It is time to face the truth of what it takes to achieve health and a fit body and get off the "gimmick-go-round" taking you in circles and going no-where.  Getting fit will take a commitment to eating right, consistent exercise, lots of water, and plenty of rest.  Living this lifestyle will provide the results you are looking for and you are the one who can guarantee that by your daily choices.  That sounds like a much better investment of time and money.

Take a look at my latest article on the about.com network and titled, "Eat Clean Food Myths Debunked."  for a few of the latest trends debunked through research.
Eat Clean Food Myths ... READ THE ARTICLE
Stay Healthy Fitness Tip: 
Believing food and fitness myths cause setbacks to reaching your fitness goals.


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Be well and Stay Healthy!
Darla Leal, Fit Over 50

Thursday, 24 September 2015

The Latest Health Wonk Review is Up!

Louise Norris of the Colorado Health Insurance Insider returns with another masterful compendium of wonky insights from the best and the brightest health policy blogs.  There's information here you won't get anywhere else.

Enjoy!

Monday, 21 September 2015

Doing What I Can with what I Got is Good Enough

When it comes to fitness and especially my workouts, I make them my own.  If you have read my "About Me" section,  you are aware of my medical issues requiring modification to certain exercises.  I do what I can with what I got and it is good enough.  I can recall feeling defeated after my injuries and especially during neuro-rehab when I could not even lift my head off an exercise ball. Tears of pain and frustration would flood over those appointments, and almost to the point of giving up.  I would pray every night for things to be different and wake up the same.  Ughhh ... what an ugly place to be, but there I was years ago.  I became so determined to fight, and I did.

Fast forward to now and I am in a much better place physically, mentally and spiritually. Going though tough times builds a tough inner and outer shell. The point of life is not to understand everything that happens to us, but handling it the best we can when "hard" knocks on the door.   Giving up would be easy and so would being angry but what good does that serve ... nothing.  Acceptance of me and what I can do became the focus.  Becoming my best at what I could do to maintain the body I worked so hard for took some creative program planning, but I am all about trial and error and finding what works.



I am in tune and listen to what my body is telling me and there is a difference between a "feel good" sore and this does not feel right sore.  If anything twinges in the "not right" direction, I put on the brakes and immediately modify and do something else.  I do not believe in pushing past something that will hurt my body and land me flat on my back or worse.  I appreciate the gift of what I can do and will not "fudge" this up.  Do I miss certain things ... yes, and I get so excited watching others perform what I used to do and want to jump in and do it with them.  That is just my inner athlete still alive and well, but my outer athlete will dictate what I can do now.  Exercise is about being smart and creating a quality life.  So many do not realize how good they are supposed to feel and accommodate pain day after day.  I am determined to increase my lean mass while decreasing or eliminating pain.  I know what it feels like to be in severe pain and how hard I have worked to achieve being pain free.

My fitness journey is not about doing what others can do, but doing the best at what I can do.  It is about acceptance of my body and the thoughts surrounding it that belong to me.  I believe in adopting a healthy lifestyle to create a quality life which is one of my motto's I teach daily.  It is about doing what I can with what I got and that is good enough.

Thanks for stopping by my blog and head on over to the about network and read my latest article "Holding Water? Herbal Diuretics Can Help."  We all struggle with feeling bloated and puffy from water retention.  The worst part is not being able to fit in our clothes, right?
Reduce Water Bloat with Herbs ... READ THE ARTICLE

Stay Healthy Fitness Tip:  IT'S GOOD ENOUGH
Strive to be your best you each day and do what you can with what you got!

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Thanks for Reading and Stay Healthy!


Tuesday, 15 September 2015

Out for Two Weeks

I'll be out of town with limited internet until September 27th.  Feel free to leave comments, but I won't be able to moderate them until I return.  Sorry for the inconvenience!

Physician Participation in Board of Directors: Transcending the Bottom Line

Two quotes:
Healthcare corporate governance in action

One is from Citizen Kane: "Well, it's no trick to make a lot of money... if what you want to do is make a lot of money."

The other is from a long-past Population Health Blog mentor: "Docs can be good at taking care of patients, or at golf.  The problem is that they can't do both."

The PHB had both in mind while it wrote this just released paper appearing in the American Journal of Medical Quality. Somewhere in the nexus of a) patient care, b) having a sustainable enterprise and c) consumerism, all of the health providers, payers, buyers, vendors, systems and business associates need to know that the bottom line is not about making money and being able to afford a country club membership. 

A low handicap is all well and good, but more is needed.

The message of the paper?

During the era of ascendant managed care in the 1990s, researchers examined the association between physician participation in the governance of health entities and their performance.  The result was several peer-reviewed studies that demonstrated that when there was physician participation on a board of directors, measures of profitability, quality assurance and social performance were higher compared to institutions without a doc in the boardroom.

As PHB readers are well aware, managed care was eventually defanged.  Interest in physician governance waned and the rest is history.

Except things are heating up.  There are millions of newly insured, and healthcare is poised to consume 20% of GDP.  As we look for ways to achieve the Triple Aim, the PHB decided to to dust things off and reexamine the merits of physician governance. 

Here's what it found:

1. Industry Expertise: physicians' broad awareness of health care is just as important financial expertise in the banking sector or educational expertise in university governance.

2. Outcomes: As healthcare organizations participate in public reporting, physicians' familiarity with outcomes data can help their fellow board members provide better oversight of what the numbers really mean and how to improve them.

3. CEO Success: Health care organizations' chief executives don't have to be physicians, but physicians can help them grapple with increasingly complicated marketplace.

4. Diversity: Physicians have been acculturated over their professional lives to skeptically evaluate things for themselves.  While this can be challenging in some settings, the good news is that this independence of thought can be counted on to reduce the risk of corporate "group-think."

5. Credibility: Physicians are still widely admired for their integrity.  This can help set the "tone at the top" as well as diminish the risk that a health care organization is putting profits before patients.

6. Professional Development: physicians' commitment to lifelong learning can act as a role model for lay board members who may be unwilling to commit to the time or the expense of continuing education.

7. Competitive Insights: Physicians are more likely to be aware of the strengths, weakness, turf and politics in their own as well the competitors' organizations.

Given the evidence, it seems that any health care organization without a doc on their board is missing out on an important value proposition that not only adds to, but transcends the bottom line. 

Just sayin'.

One last thought: when any physician ponders participation in governance, he or she will have to deal with three unique barriers: 1) loss of practice income, 2) a time commitment away from the bedside that could erode their clinical skills and 3) the loss of prestige that comes from having a less than 100% commitment to their profession.

More on that in a future post.




Friday, 11 September 2015

Healthy is How You Respond to Life

Being healthy is many things but I feel the biggest player in life is how we respond to it.  We are all hit with situations every day in our marriages, workplace, family or friend drama, getting bad news and right down to the priority of taking care of our body.  It will be in the responses to life's circumstances that creates a healthier, happier, and many times stronger person.

Being healthy encompasses not only the physical and nutritional, but also includes the emotional and spiritual.  If any one of those dominoes are out of place, health is just not complete.  When a problem arises, we can choose to brood about it or problem solve in a healthy way.  Many times issues are out of our control and really, the only thing fixable or controllable is you and me.  We are not responsible for the actions or behavior of others, but what we do have is the actions and behaviors of ourselves.



Life can be made to feel complicated and depressing or carefree and happier simply by how we respond to situations.   The same principle should be applied to how we take care of our body.  Do we nourish it well, exercise it enough, and provide adequate rest for it?   What are your actions telling your body and how is it responding to you?  Are you getting great healthy feedback or receiving messges of fatigue, illness, overweight, depressed, and stressed out?

Our body is a good indicator of how we are living life.  A healthy lifestyle reflects itself from the inside out and if we are doing a great job with eating right, working out, and emotional and spiritual happiness then our body will feel pretty amazing as a whole.  If we choose not to listen to our body indicators to get our act together, guess what?  We will be hit with weight gain, stress, illness, and usually being pissed off at the world for our problems.  It is up to each of us to listen to what our body, mind and spirit is telling us and take appropriate action. It will be the responses in life that create our health.

Lots of exciting health and fitness articles prepared and ready for you to read on my sports nutrition page with the about.com network.  Head on over and check out my Landing Page with my recent release on "Should I Take Stimulant Based Fat Burners?".
Read Great Articles!

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Darla Leal, Fit over 50!
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Be well and Stay Healthy!

The Latest Health Wonk Review is Up!

In our age of expressive individualism. it's only appropriate that we combine brainy wonkiness with our pictorial self-love.  Steven Anderson of the MedicareResources Blog has done just that by posting a "selfie" inspired Health Wonk Review that tackles the latest insights on federal health reform, ACOs, Medicare, the FDA, primary care and public health.


Enjoy!

Tuesday, 8 September 2015

The Majority of Medicare ACO Participants Appear to Have Lost Money in 2014

There's no other way to put it.

Like many wonks, the Population Health Blog glommed onto this recent CMS report report on the 2014 performance of the Pioneer and Medicare Shared Savings Accountable Care Organizations (ACOs). 

While there's some quality reporting data, the PHB decided to focus on the economics.

It ain't pretty.

Briefly, as the PHB understands it:

The 20 Pioneer and 333 Medicare Shared Savings Accountable Care Organizations generated a total of $411 million in savings.

Among the Pioneer participants:

15 out of 20 generated savings.  Only 11 of the 15 earned enough savings to trigger a payment from CMS that totaled $82 million.  The PHB calculates that's an average payment of approximately $7.5 million for each ACO. 

Three of the Pioneer ACOs had to provide clawbacks to CMS of $9 million, or an average $3 million each.

Of the 333 Medicare Shared Savings participants:

92 out of 333 saved $806 million in health care costs.  They received checks totaling $341 million.  The PHB calculates that's a payment of $3.7 million per ACO. 

Another 89 of the Medicare Shared Savings reduced costs, but not enough to trigger a payment from CMS.  That also means that the rest of these ACOs didn't even reduce costs.

The PHB's conclusions:

ACOs in the Pioneer program have about a 50% chance of getting some money back.  Assuming that there are from $2 million to $7 million per year in program support costs - in addition to the all of the foregone billable services - it's not clear to the PHB that the business model is sustainable (for example) for many of the Pioneer participants.  To add downside-risk insult to injury, there's a 15% chance a Pioneer ACO would have to pay Medicare.

ACOs in the Shared Savings program have a 75% chance that they won't be able to generate enough savings to cover the lost of income from fewer billable service or their program costs.

That's a majority of the participating ACOs.

Admittedly, there are several advantages to ACOs.  They 1) are an answer to the threat of rising health care costs, 2) are a laboratory for bundled payments, 3) promote care coordination and 4) are linked to medical homes.

But that's all for naught if the majority of the program participants are losing money in a massive exercise in risk transfer involving hundreds of millions of Medicare dollars.

This is health reform?

++++++++++++++++++++++

Coda: The PHB can't help noting that the title of the CMS report is "Medicare ACOs Provide Improved Care While Slowing Cost Growth in 2014."   That may be technically true, but that title is more about spin than about the science. The findings haven't been submitted to the scrutiny of peer-review, and until it is, the PHB won't really know what to believe.


Wednesday, 2 September 2015

Age is Never the Deal...It's What I am Doing Through the Ages

Age is just a number and I wear 51 proudly. Actually, I do not even think about it unless someone makes a comment.  Inside I feel youthful, energized and can still do the splits.  I recognize my limitations and focus on what I can do to the best of my ability.  Each day is a new chance to make better choices physically, nutritionally, and mentally.  I give time to reflection and am thankful for the many blessings God has given me.  I have been through a tough journey in life and today I am still smiling, extremely happy, and going strong with my fitness.





It really comes down to a state of mind and I refuse to get all "hum-drum" about getting older and instead focus on what I can do to improve my life through the aging process.  Age is never the deal but it is what I am doing through the ages that counts.  I can sit around like a bump on a log, depressed, and seeing my life as half over or embrace that my life is more than half full.  I choose the latter and enjoy the challenge of becoming stronger physically and mentally.






Sometimes aging holds a stigma of "grandma/pa" wearing frumpy clothes with huggable large hips and hair always in a bun. I am not describing this to be offensive and I have to laugh because I am a "Nana" always wearing my hair up because I am either sweating my literal ass off in the gym or teaching clients.  When I am not on the job, I enjoy wearing trendy clothes, letting down my long hair, and adding a bit of makeup.  I do believe in less is more in the makeup application department.  In fact, I do not use foundation at all and prefer a tinted moisturizer with a sunscreen to protect my skin.  I am all about "dump-the-frump" and will never fall into wearing the "Mom's jeans" category.  I am who I am and part of being a fit over 50 woman is being able to wear what I want.



Older, wiser and definitely better is what comes with aging.  It is an honor and privilege to live each day and I refuse to let the gift of life down by not giving the best of me in return.  I believe in a quality life and in quality health.  Eating healthy and exercise are a natural part of who I am and I would feel absolutely out of sorts without it.  I steer clear of drama and try to keep stress to a minimum.  Life is too short to entertain ugly mental stuff that does not nourish my soul in a positive way.





Getting Fit Over 50 IS POSSIBLE!
I will always be a strong motivator for all people and especially those over 50 who think getting fit is not possible.  I am here to say being your best healthy and fit self IS POSSIBLE.  Life hands us all bowls of cherries and it will be how we respond to those cirumstances that will create a stronger, and healthier person.  It is not the time to give up, eat like crap and not exercise because there is some sort of belief that it will solve something.  The result of that behavior is an unhealthy and very unhappy person winding up in the "frump" zone.  Life is short and precious and not taking care of yourself is really wadding up your gift and throwing it on the floor.  It is time to stop wasting time and fight for your fitness regardless of your age or circumstance.  Remember, age is never a deal so stop focusing on the number as if it defines you and start putting in the effort of adopting a healthy lifestyle.  Now, that is what counts!

Enjoy my latest article "Not Losing Fat? These Not So Obvious Reasons Could Be the Culprit" on the about.com network.  I would love to read your feedback by posting a comment below and if you feel comfortable sharing areas in your life the article may have touched on.  We are all works in progress!
Not Losing Fat? Read the Article





Stay Healthy!
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