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Memory Screening Can Be an Important Early Step in Dementia

By Contributor
Healthcare News

Don’t Ignore the Signs

Like with any disease, Cheryl Moran said, early detection of Alzheimer’s can make a big difference.

That’s why the Atrium at Cardinal Drive in Agawam and Orchard Valley at Wilbraham, both Benchmark mind and memory-care communities, have been hosting a series of memory screenings at area senior centers.

“Over the past 25-plus years, we’ve seen that people and families affected by dementia often delay planning, which makes for a much more challenging situation later,” said Moran, executive director of the Atrium. “By offering this to the community, we want to help ease the burden.”

Alzheimer’s disease and dementia affects nearly 350,000 people in Massachusetts, and the numbers continue to grow.

Cheryl Moran

Cheryl Moran

“Over the past 25-plus years, we’ve seen that people and families affected by dementia often delay planning, which makes for a much more challenging situation later.”

Memory screenings, Moran noted, are appropriate for anyone concerned about memory loss or experiencing symptoms of dementia or who believes they are at risk due to family history. Screenings like the ones being offered at area senior center provide a safe, simple, face-to-face way to check a person’s memory, language, intellectual functions, and other thinking skills using a series of questions and tasks.

Screenings have already taken place at Wilbraham Senior Center and West Springfield Senior Center in April, and the next two are slated for Wednesday, May 17 from 10 a.m. to noon at Agawam Senior Center, 954 Main St.; and Wednesday, May 31 from noon to 2 p.m. at Palmer Senior Center, 1029 Central St. Attendees can register for either event by calling (413) 821-0605 for Agawam or (413) 283-2670 for Palmer.

A screening can indicate whether someone should consult with a medical provider in order to identify what is causing memory loss. If dementia is the cause, early diagnosis can help both individuals and their family members learn about the disease, set realistic expectations, and plan for their future together.

“If they are able to obtain a diagnosis for the cause of their dementia, it can help to better understand what the individual is struggling with and what to expect as the dementia progresses over time,” said Julie Waniewski, executive director of Armbrook Village in Westfield, which has a memory-care neighborhood called Compass. “There are also clinical drug trials that they can partake in to aid in research and hopefully find a cure one day.”

 

What to Look For

According to the Alzheimer’s Assoc., memory loss that disrupts daily life may be a symptom of Alzheimer’s or other dementia. The organization lists 10 signs in particular to keep an eye on:

1. Forgetting recently learned information. Similar signs include forgetting important dates or events, asking the same questions over and over, and increasingly needing to rely on memory aids (such as reminder notes or electronic devices) or family members for things they used to handle on their own.

Julie Waniewski

Julie Waniewski

“If they are able to obtain a diagnosis for the cause of their dementia, it can help to better understand what the individual is struggling with and what to expect as the dementia progresses over time.”

2. Challenges in planning or solving problems. Some people living with dementia may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

3. Difficulty completing familiar tasks. People with Alzheimer’s often find it hard to complete daily tasks. Sometimes they may have trouble driving to a familiar location, organizing a grocery list, or remembering the rules of a favorite game.

4. Confusion with time or place. People living with Alzheimer’s can lose track of dates, seasons, and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

5. Trouble understanding visual images and spatial relationships. For some people, having vision problems is a sign of Alzheimer’s. This may lead to difficulty with balance or trouble reading. They may also have problems judging distance and determining color or contrast, causing issues with driving.

6. New problems with words in speaking or writing. People living with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue, or they may repeat themselves. They may also struggle with vocabulary, have trouble naming a familiar object, or use the wrong name.

7. Misplacing things and losing the ability to retrace steps. A person living with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. He or she may accuse others of stealing, especially as the disease progresses.

8. Decreased or poor judgment. Individuals may experience changes in judgment or decision making. For example, they may use poor judgment when dealing with money or pay less attention to grooming or keeping themselves clean.

9. Withdrawal from work or social activities. A person living with Alzheimer’s disease may experience changes in the ability to hold or follow a conversation. As a result, he or she may withdraw from hobbies, social activities, or other engagements. They may have trouble keeping up with a favorite team or activity.

10. Changes in mood and personality. Individuals living with Alzheimer’s may experience mood and personality changes. They can become confused, suspicious, depressed, fearful, or anxious. They may be easily upset at home, with friends, or when out of their comfort zone.

“There are many warning signs of memory issues or early-stage dementia,” Waniewski said. “Sometimes a person is struggling to prepare meals, which leads to improper nutrition, or they are not taking their medications correctly, the house is unkept, appliances may not be working, or their personal hygiene is not what it used to be. They may also ask the same question repeatedly, which is a sign of short-term memory loss. They may lack interest in previously enjoyed activities or group gatherings, which is usually because they are afraid that others will start to notice that they are struggling cognitively.”

Other warning signs may include piles of unopened mail or shutoff notices, indicating that their executive functioning is declining and finances are becoming difficult to handle on their own, Waniewski added. “Also, their car may have new signs of damage, or they may have gotten lost driving, and the yard may be overgrown and not tended to.”

 

Next Steps

While not every symptom is a sign of dementia, the Alzheimer’s Assoc. stresses the importance of getting screened, as early detection matters.

“If you notice one or more signs in yourself or another person, it can be difficult to know what to do,” the organization notes. “It’s natural to feel uncertain or nervous about discussing these changes with others. Voicing worries about your own health might make them seem more ‘real.’ Or you may fear upsetting someone by sharing observations about changes in his or her abilities or behavior. However, these are significant health concerns that should be evaluated by a doctor, and it’s important to take action to figure out what’s going on.”

Early detection may also open doors to treatments that may provide some relief of symptoms and help maintain independence longer, as well as increase one’s chances of participating in clinical drug trials that help advance research. Waniewski noted that Armbrook Village and its parent company, Senior Living Residences, are affiliated with Boston University’s Alzheimer’s Disease Research Center, which offers clinical trials in which people can participate.

Healthcare News

New Alzheimer’s Drug Awaits Approval, Spurs Hope

By Contributor

Making Progress

 

In January, the U.S. Food and Drug Administration approved Leqembi (lecanemab-irmb) via the Accelerated Approval pathway for the treatment of Alzheimer’s disease. Leqembi is the second of a new category of medications approved for Alzheimer’s disease that target the fundamental pathophysiology of the disease. According to the FDA, these medications represent an important advancement in the ongoing fight to effectively treat Alzheimer’s disease.

“Alzheimer’s disease immeasurably incapacitates the lives of those who suffer from it and has devastating effects on their loved ones,” said Dr. Billy Dunn, director of the Office of Neuroscience in the FDA’s Center for Drug Evaluation and Research. “This treatment option is the latest therapy to target and affect the underlying disease process of Alzheimer’s, instead of only treating the symptoms of the disease.”

Alzheimer’s disease is an irreversible, progressive brain disorder affecting more than 6.5 million Americans that slowly destroys memory and thinking skills and, eventually, the ability to carry out simple tasks. While the specific causes of Alzheimer’s are not fully known, it is characterized by changes in the brain — including amyloid beta plaques and neurofibrillary, or tau, tangles — that result in loss of neurons and their connections. These changes affect a person’s ability to remember and think.

Leqembi was approved using the Accelerated Approval pathway, under which the FDA may approve drugs for serious conditions where there is an unmet medical need and a drug is shown to have an effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit to patients.

Researchers evaluated Leqembi’s efficacy in a double-blind, placebo-controlled study of 856 patients with Alzheimer’s disease. Treatment was initiated in patients with mild cognitive impairment or mild dementia and confirmed presence of amyloid beta pathology. Patients receiving the treatment had significant dose- and time-dependent reduction of amyloid beta plaque, with patients receiving the approved dose of lecanemab every two weeks having a statistically significant reduction in brain amyloid plaque from baseline to week 79 compared to the placebo arm, which had no reduction of amyloid beta plaque.

These results support the accelerated approval of Leqembi, which is based on the observed reduction of amyloid beta plaque, a marker of Alzheimer’s disease. Amyloid beta plaque was quantified using positron emission tomography imaging to estimate the brain levels of amyloid beta plaque in a composite of brain regions expected to be widely affected by Alzheimer’s disease pathology compared to a brain region expected to be spared of such pathology.

According to McKnight’s Long-Term Care News, neurologists in the U.S. have a strong interest in prescribing the Leqembi, with the majority of 73 specialists surveyed saying they would prescribe the treatment if the government fully approves it.

The March 2023 survey, from Spherix Global Insights, found that a healthy proportion of neurologists had already begun prescribing Leqembi within a month of commercial availability, while most have chosen to wait for the FDA’s decision when it reviews the request by Eisai, the drug’s manufacturer, for traditional approval on July 6. If traditional FDA approval is granted, nearly all of the surveyed specialists said they planned to prescribe the treatment, mostly within the year following the greenlight, Spherix reported.

The prescribing information for Leqembi includes a warning for amyloid-related imaging abnormalities (ARIA), which are known to occur with antibodies of this class. ARIA usually does not have symptoms, although serious and life-threatening events rarely may occur. ARIA most commonly presents as temporary swelling in areas of the brain that usually resolves over time and may be accompanied by small spots of bleeding in or on the surface of the brain, though some people may have symptoms such as headache, confusion, dizziness, vision changes, nausea, and seizure.

Another warning for Leqembi is for a risk of infusion-related reactions, with symptoms such as flu-like symptoms, nausea, vomiting, and changes in blood pressure. The most common side effects of Leqembi were infusion-related reactions, headache, and ARIA.

According to Fierce Pharma, while there is another new drug on the market for Alzheimer’s — Aduhelm, which Eisai helped create with Biogen — that drug is commercially non-viable at the moment.

Specifically, the Centers for Medicare & Medicaid Services refused to cover payments of Aduhelm, which was also damaged by the controversial way the FDA approved the drug in 2021. The drug passed the regulatory hurdle despite serious safety and efficacy questions, including from the FDA’s own drug-review experts, who denied its approval at the drug’s advisory committee and were overruled by the FDA itself several months later.

Healthcare News Special Coverage

For Those Caring for Those with Dementia, Education, Understanding Are Keys

By

Living in Their World

Beth Cardillo calls them ‘fiblets.’

These are things that are said to someone with dementia that … well, do not represent the whole truth, or even a portion of it, at least to the person making that statement.

But to that person suffering from Alzheimer’s or one of the many other forms of dementia, it is the truth as they see it in their world. “It’s not a lie,” she said of these fiblets. “It’s an OK thing to tell people with memory issues.”

She offered up an example.

“Let’s say someone’s husband has been dead for 20 years; she might say, ‘I’m not going out shopping, I’m waiting for my husband to get home,’” noted Cardillo. “A fiblet would be … ‘oh, he just called; his tooth is hurting him and he’s going to see a dentist. Why don’t you and I go out for a ride and go to the grocery store?’”

“You’re going to tell someone that their husband died over and over again, every day?” she went on, asking that question rhetorically before answering it poignantly. “I mean, why would I want to do that? It’s cruel.”

Indeed, and fiblets are a good example of how those caring for and simply around individuals with dementia regularly should try to live in their world, rather than constantly try to pull them into the ‘real’ world. It’s also an example of the kind of work that Cardillo has made into a career, or at the least the latter stages of one.

Beth Cardillo

Beth Cardillo

Her latest move comes as a part-time social worker for a unique program called Baystate House Calls. As that name suggests, it’s a program operated by Baystate Health that involves healthcare professionals making house calls to older adults. It includes a physician, nurse practitioner, nurse, social worker, and community health worker, team members who will visit individuals in their home to assess their needs and provide recommendations.

The initiative concentrates on what administrators call the 4Ms — ‘mobility,’ ‘what matters,’ ‘medication,’ and ‘mind.’

It focuses not only on those in need of help and services, but caregivers as well, said Cardillo, adding that her work, and that of her colleagues, takes them to every corner of Springfield. And while she is helping seniors and caregivers with a wide variety of issues from substance abuse to falls to depression, much of her work involves those with memory issues.

And, increasingly, it involves what is known as habilitation therapy (HT), a holistic approach to dementia care that focuses on the abilities that the person still has, rather than what they have lost, and can reduce difficult symptoms.

“It focuses on everything positive — it focuses on people’s strengths, not their weaknesses,” she said of HT, adding that it brings caregivers and patients closer together as they work on daily tasks, makes those suffering from dementia feel respected and valued, reduces stress among caregivers, and creates positive emotional experiences that bring comfort and happiness.

“The reality therapy is for us to learn to live in their reality, not for them to live in our reality of our world. That’s probably the biggest lesson there is.”

Cardillo was recognized by BusinessWest and its sister publication, HCN, with a Healthcare Heroes Award in 2021 in the category of Community Health for her work during her years as executive director at Armbrook Village in Westfield to create ‘dementia-friendly’ communities and help others better understand — and communicate with — those suffering from memory loss.

For this HCN Monthly Feature and its focus on Memory Care, we talked with her at length about the importance of understanding what is reality that for those with dementia — and enabling them to thrive, as much as possible, in that reality.

 

Reality Check

Cardillo told BusinessWest that, years ago, she and others involved with providing memory-care services would offer to those with dementia what was called, by some at least, ‘reality therapy.’

“We would say, ‘no, no, no, you’re wrong — today’s Thursday, or today’s this, and tomorrow is that,’ she said, correcting wrong statements and answers to questions whenever the need arose. “But what we’ve learned is that it doesn’t matter. The reality therapy is for us to learn to live in their reality, not for them to live in our reality of our world. That’s probably the biggest lesson there is.”

Helping others live in the reality of those with dementia is a big part of the work Cardillo has been involved with over the years, especially at Armbrook, but also now as a social worker. She said that to make this leap — and it is a leap for most — it begins with education and an understanding of the disease and how it impacts people.

It robs them of short-term memory and the ability to do certain things — from driving to cooking to reading. But it doesn’t, or shouldn’t, take from them the things that are important to them, and have been important throughout their lives, be it what they did for a living, or travel, music, pets, or a love of the movies.

Cardillo recalled the case of a long-retired college professor who had (and still has) a passion for the New York Times and carries it with her daily.

“Some days, it’s upside-down,” said Cardillo. “But it doesn’t matter; that was her identity. Those are they types of things you don’t want to change; you don’t want to correct people.”

Overall, she said it’s important to treat those with dementia with respect and to not embarrass them with ‘reality’ questions or constant corrections concerning what day it is and what members of the family are no longer alive.

“It doesn’t matter if they say it’s Tuesday and it’s really Sunday. It just doesn’t matter. So, we don’t want to correct people. Does it matter if Mr. Smith thinks it’s a different day? Is that going to change the world? No. If he thinks it’s Christmas tomorrow, that’s OK. Why take that joy away?”

“Just because you have Alzheimer’s doesn’t mean you’re stupid,” she explained. “It doesn’t mean you can’t read people’s emotions. “I know people who will say to family members, ‘what’s my name? What’s my name?’ Why are you saying that to them? It embarrasses them. They know you have a connection. Is it because you think that if they know your name, they’re having a good day and that makes you feel good?

“Because it doesn’t matter if they know your name,” she went on. “It doesn’t matter if they say it’s Tuesday and it’s really Sunday. It just doesn’t matter. So, we don’t want to correct people. Does it matter if Mr. Smith thinks it’s a different day? Is that going to change the world? No. If he thinks it’s Christmas tomorrow, that’s OK. Why take that joy away?”

She recalled the case of a woman who told her that she was pregnant at 66. Instead of correcting her, Cardillo said she simply told her, ‘if that’s true, you’re going to make history.’

“You laugh about it with her, because she tells me these wacky stories,” she went on. “Her parents have been dead, but she’ll say, ‘oh, my mother wants you to come over for dinner.’ “I’ll say, ‘oh, how is your mother? I like your mother; tell her I said hello.’

“Her husband, on the other hand, keeps saying, ‘your mother is dead!’” she continued. “We need to stop that because it doesn’t matter. She doesn’t remember and she doesn’t care, and in in her head, her mother is alive. That’s fine. Who does it hurt?”

Overall, she said it’s important to try to communicate with a positive spin, rather than a negative one.

Indeed, instead of telling someone with dementia that they are not supposed to be going outside, when they suggest that they want to do so, one should instead stay positive and suggest that this person can sit outside when the weather is better.

As she talked about those suffering from dementia and how those caring for them should approach daily conversation and activities, Cardillo said it is important to keep them engaged and to focus “on what they can do, not what they can’t do.”

This brings her back to the concept of habilitation therapy, which, she believes, has benefits, and many of them, for those living with memory loss, their caregivers, family, and friends.

“It’s important to keep people meaningfully busy and not just silly busy,” she told BusinessWest, adding there is a big difference between the two.

Elaborating, she said that television is not a good option.

“We don’t want to put people in front of a TV all day, because it’s … not good,” she said. “It doesn’t make them happy campers. It doesn’t mean that TV is bad, just not as a babysitter all day.”

Instead, such individuals should be involved in activities that speak to who they are, who they were professionally, and what interests them.

“It’s really important to know what people did in their work,” she explained, “because they still retain some of those skills, and it’s still a part of who they are as an identity. For those who were teachers, give them papers to correct; you come up with things that they can do.

“I had someone whose father was a retired electrician,” she went on. “He had a manual of electrical … something; it was bigger than the New York City phonebook. He looked through those pages every day. I don’t know if he knew what was in it — I sure didn’t — but that gave him comfort.”

And some form of comfort is what those caring for people with dementia should be trying to provide each day, she said, adding that this can be done through HT, emphasizing the positive, and, yes, focusing on what those with dementia can do, not what they can’t.

 

 

Bottom Line

Summing up what she tells those caring for people with dementia, Cardillo said it is simply that reality is in the eyes — and mind — of the beholder.

And if we really want to help those with this disease, we have to at least try to live in their world, rather than make them live in ours. It’s not an easy assignment, especially when one is asked the same questions over and over, day after day, but it’s the key to those on both sides of the equation being able to thrive.

Healthcare News

Tackling Issues of Nutrition, Hunger Requires Multi-level Approach

By

All Hands on Deck

 

In the six months since the Biden-Harris administration hosted the second-ever White House Conference on Hunger, Nutrition, and Health, U.S. Rep. Jim McGovern has recognized the significance of the moment — only, he hopes it’s more than a moment.

“The first and only other conference was held more than 50 years ago — in 1969, the year we put somebody on the moon,” McGovern said at a recent virtual gathering with officials from food-justice organizations, farm advocates, public-health leaders, healthcare providers, and other legislators, to discuss the White House event, legislative action that has emerged in its wake, and what is being done in Massachusetts — and what more can be done — to end hunger.

Liz Wills-O’Gilvie

Liz Wills-O’Gilvie

“The only way that we’re going to eradicate hunger and improve health is by centering our work with a racial-equity lens.”

“Out of this conference came an ambitious but achievable roadmap to end hunger and reduce diet-related disease by the year 2030,” McGovern said, adding that the conference has the potential to impact even more change than the 1969 event, which is saying a lot, since innovations like WIC, the modern-day SNAP program, and better food labeling came out of that session.

“There were so many important things,” he went on. “But I think this conference, if we do the follow-through, has the potential to have even a greater impact on this country.”

The March 17 briefing, attended by about 300 people, was co-hosted and organized by the Food Bank of Western Massachusetts, Growing Places, Stone Soup Cafe, CISA, the Springfield Food Policy Council, the Massachusetts Food System Collaborative, Project Bread, and the Western Mass. state legislative delegation, including state Sen. Jo Comerford and state Rep. Mindy Domb.

Liz Wills-O’Gilvie, who chairs the Springfield Food Policy Council, saw the historic nature of the White House event, which she attended, from a unique perspective: her own personal history as “a little Black girl from Springfield who was dependent upon commodities food before food stamps as we know it now existed.

“Our family’s life improved when food stamps emerged out of the last conference,” she recalled, “so I was struck by the significance of the moment I got to be there in that room and hear both President Biden and Secretary [of Agriculture Tom] Vilsack make the comments that they did … that the only way that we’re going to eradicate hunger and improve health is by centering our work with a racial-equity lens.”

To that end, Wills-O’Gilvie called Massachusetts’ Healthy Incentives Program (HIP) — which reimburses EBT card users when they used SNAP benefits for healthy produce from local farm vendors — a tool for racial equity as well as a way to improve the health of families.”

She also called for making universal free school meals permanent in the Bay State, a priority shared by Domb, who also praised HIP, talked up the benefits of food-literacy education, and called for a conversation about hunger on college campuses.

“We need to make universal free school meals in Massachusetts permanent,” Domb said. “It’s terrific that we extended it this year. It’s wonderful that the Legislature in the supplemental budget has included additional money to make sure it continues through the end of this academic year.”

“There’s obviously much, much more that needs to be done in these areas. But we’re off to a good start. And there is finally momentum at a national level behind efforts to end hunger.”

U.S. Rep. Jim McGovern

U.S. Rep. Jim McGovern

But she said expansion of such benefits during COVID demonstrated how important they are to families, even beyond the pandemic. “So we need to make sure that that continues.”

 

One Bite at a Time

McGovern said President Biden has made it clear that the federal government wants to implement an aggressive national strategy to end hunger in the next decade.

“In the months following the conference, Congress has gotten to work on some of the priorities that were laid out in the strategy,” he noted. “We created a permanent summer EBT program to give families with kids $40 per child per month over the summer, when we know that hunger is often worse. It’s a small step in the right direction, but it’s an important step in the right direction. And especially during these times of high inflation and especially in the aftermath of the SNAP pandemic boost being cut, this is really, really crucial.”

He also said lawmakers responded to a recent EBT-skimming problem by requiring benefit replacement for those who had SNAP benefits stolen through no fault of their own, mandated that the Department of Defense screen military families for food insecurity, and passed the Food Donation Improvement Act to make it easier for retailers, manufacturers, farmers, and schools to donate food directly to hungry people.

“And we passed a massive omnibus spending bill that includes the highest level of non-defense spending in history. That translates into robust funding for WIC, farm-to-school grants, school meal equipment grants, among other things,” McGovern went on. “There’s obviously much, much more that needs to be done in these areas. But we’re off to a good start. And there is finally momentum at a national level behind efforts to end hunger. We have people in the administration saying that we want to end hunger.”

He also recently introduced legislation to permanently increase the reimbursement rates paid by the federal government to schools for every breakfast and lunch served.

“We talk a lot about the quality of food that we provide our kids in school, but we also talk about the importance of supporting our local farmers,” he explained. “With a little more money for breakfast and lunch, it gives school districts and people who oversee school meals some flexibility to do some things that, right now, they don’t do because it’s too complicated or it might cost a little bit more.”

Kirsten Levitt, executive chef and co-director of Stone Soup Café, a volunteer-driven, pay-what-you-want meal spot in Greenfield, also attended the White House conference and came away with the belief it will take all sectors of the nation to eradicate hunger, and Western Mass. has the ability to be a national model for its emphasis on farms, food, and nutrition. She added that children will be the best ambassadors for health and nutrition, especially if school meals are funded properly.

Erin McAleer, president of Project Bread, an anti-hunger nonprofit based in Boston, identified five pillars to a statewide strategy on hunger, nutrition, and health: increasing access and improving quality of child-nutrition programs, increasing access and affordability of food for all, integrating food access into healthcare, strengthening and integrating the local food system, and ensuring economic stability and promoting economic opportunities to address the root causes of hunger.

“I never imagined I would be sitting in a room with the president of the United States, and certainly never imagined I would be sitting in the room when he expressed that what I went through my childhood was unacceptable — that food insecurity is unacceptable,” McAleer said.

“When 21% of families in Massachusetts are food-insecure and 33% of the Black and Latino families in Massachusetts are food-insecure, that is a systemic issue. And that requires systemic solutions. Too often, we focus on individualized solutions when it comes to this issue.”

Erin McAleer

Erin McAleer

“What I really appreciated about the plan that was put together by the White House is the focus on systemic solutions,” she went on. “When 21% of families in Massachusetts are food-insecure and 33% of the Black and Latino families in Massachusetts are food-insecure, that is a systemic issue. And that requires systemic solutions. Too often, we focus on individualized solutions when it comes to this issue.”

McGovern agreed that fighting hunger and improving nutrition is a battle that can, and should, be waged on all levels — federal, state, and local.

“There are things that can be done at the local level — things like expanding access to culturally appropriate cooking classes, bringing gardens and hydroponics to every school, and more robust food-recovery partnerships. All of this is going to require close collaboration.”

 

Menu of Activity

On the state level, myriad bills have been filed recently relating to nutrition, hunger, and agriculture: “An Act Relative to Universal School Meals,” “An Act to Promote Food Literacy,” “An Act Protecting Our Soil and Farms from PFAS Contamination,” “An Act Strengthening Local Food Systems,” “An Act Promoting Equity in Agriculture,” “An Act Relative to an Agricultural Healthy Incentives Program,” “An Act Supporting the Commonwealth’s Food System,” “An Act Encouraging the Donation of Food to Persons in Need,” “An Act Establishing the Massachusetts Hunger-free Campus Initiative” … the list goes on.

Comerford said those who organized the March 17 briefing with McGovern wanted participants to be inspired by the White House’s 2030 hunger goals, tackle diet-related diseases like hypertension and obesity in the Commonwealth, and strengthen the region’s food system and farms in the process.

“We also want to help participants take away concrete and timely action steps around critical budget priorities and policy proposals that are going to move the Commonwealth boldly toward ending hunger in just a handful of years.”

 

 

Healthcare News

Experts Reveal Ways to Stay Fit Working from Home

By Contributor

An Active Office

Standing desks are standard at many local companies.

Since COVID-19 swept across the globe, many industries have shifted to fully remote or hybrid working. During the pandemic, 70% of the workforce was working from home, and since then, 62% of companies have planned to incorporate remote work, be it fully remote or hybrid.

With more and more people working from the comfort of their own home, concerns have arisen that this model may be associated with more sedentary lifestyles and, in turn, increased risk of obesity. Most of our calories throughout the day are burned through non-exercise activity thermogenesis, which includes walking and other basic activities. When working from home, sometimes those activities can be even more limited.

Here are a few ideas from online fitness resource Total Shape to stay fit even while working from home.

Standing Desk ($150-$600)

Standing desks have gained popularity over the last few years and have been proven to provide many positive health benefits. Simply put, standing burns more calories than sitting, even if you simply stand still. Research has also shown that 66% of workers felt more productive, and 87% felt more energized, using standing desks. Standing activates the muscles in your legs and core while stimulating circulation, which can help you to burn extra calories (typically 60 to 90 per hour) and build your strength. Standing desks come in a range of styles and cater to many different budgets, meaning this is an accessible option for all.

Desk Treadmill ($200-$800)

Although it is a more expensive option, this is one of the most effective ways to stay fit while working at home. It essentially takes the standing desk a step further by adding the walking element. Studies have shown that walking between 1 and 2.5 mph can lead to an extra 170 to 240 calories burned per hour. Not only have people encountered the physical benefits of getting more exercise, but walking helps oxygenate the brain by stimulating blood circulation. In other words, we think better and more efficiently when we walk. With most people having busy schedules outside of work, it can be difficult to get the recommended amount of physical exercise, which makes this a great way to stay fit while working from home.

Under-desk Bike ($50-$200)

A very similar concept to the desk treadmill, an under-desk bike features a small set of pedals that can slide under your desk so that you can pedal while sitting. The small machines can be altered to have more resistance, which makes it harder or easier to pedal. This type of aerobic exercise is good for staying fit and can help strengthen your legs and joints. Studies estimate that pedaling while seated can burn up to 10 calories per minute, depending on the intensity, which means you could burn up to 600 calories per hour. However, the average gentle pedaling will most likely burn 100 to 300 calories per hour.

Resistance Bands ($15-$40)

Resistance bands are an affordable option to help train your body and get fitter, by helping you build muscle and burn calories (180 to 250 per hour) while seated at your desk. You can perform plenty of passive resistance-band workouts even when you’re doing something at your desk, and in between typing and during brainstorming sessions, your body can keep active alongside your mind. Exercises could include bicep curls, overhead tricep extensions, and shoulder raises. However, there are many variations and other exercises that can be done with resistance bands. A study published in 2022 showed that resistance-band training lowers body fat in people who are overweight better than other forms of training, including free weights and body-weight exercises.

Seven-minute Workout

Searching ‘seven-minute workout’ on an app store will reveal an app that will guide you through various workouts you can do in your own home, which take just seven minutes at a time. The best thing about the seven-minute workout app is that its programs are designed especially for people who are doing the workouts at home, and who have no special equipment. The brief nature of these workouts allows people with busy schedules to fit in exercise and can help break up your workday, which can increase productivity while burning 20 to 50 calories per session. While there are some in-app purchases available, you can use the app completely free, so there’s nothing stopping you from getting started.

Diet

Exercise and living an active lifestyle are obviously important in staying fit and healthy; however, diet is a key contributor to overall health and fitness. People with few distractions at home may find they are more aware of hunger than they would be at the workplace, which can lead to more snacking and possibly an unhealthier diet. By focusing on eating healthy foods and healthy snacks, people who work from home can ensure they are staying fit and keeping their bodies healthy. Studies show that both the overall composition of the human diet and specific dietary components have been shown to have an impact on brain function, which means diet isn’t only going to keep you fit, but it’s going to improve cognitive function, and thus the quality of work produced.

Why It’s Important

A spokesperson from Total Shape noted that “roughly two in three people in the U.S. are overweight, and with many aspects of life becoming more sedentary, it’s important that people try to find new ways to keep fit and healthy. Life has become busy and more expensive, meaning that it’s harder to find the time and money to attend gyms or activities that help us to remain fit. This guide provides a plethora of choices for people on various budgets and with specific preferences to ensure we are keeping ourselves healthy.”

Total Shape is a fitness resource site providing information about workouts, supplements, and fitness to help people reach your goals. Total Shape does not provide medical advice, diagnosis, or treatment.

Healthcare News

Why Many Diets Don’t Stick, and How to Improve the Odds

By Contributor

Set Up to Fail

 

 

“How to lose weight fast” has an average 284,000 monthly search volume in the U.S., demonstrating that Americans are desperate for a quick fix to help shed those unwanted pounds in time for summer.

How to lose weight is one of the most pressing health questions for many people. As many as 95% of dieters fail to reach their body target or quickly backslide and regain the weight they lost once their diet is finished. Because of this, a massive number of people are serial dieters who skip from one eating plan to the next, trying to find best way to lose weight and keep it off.

While there are thousands of diets to choose from, the overall rule is, if you want to lose weight, get toned, build muscle, or even just improve your energy levels, you’ll probably need to change what you eat.

“Provided that your diet of choice meets your caloric needs, it will have the desired effect,” an exercise and nutrition expert at online resource Fitness Volt said. “For example, consume fewer calories than you need, and you will burn fat and lose weight, but consume more than you need, and you will gain weight.

“However, most people fail to stick with their diet long enough for it to work sustainably. They’re strong out of the gate, but soon fall off the wagon and return to their previously sub-optimal eating plan,” the expert continued. “That’s why so many of us lose weight only to regain it shortly afterward, and it seems long-term, sustainable weight loss is rare nowadays.”

According to Fitness Volt, here are six reasons why most diets fail.

 

Foods Are Too Restrictive

Most diets ban certain food or food groups. For example, the paleo diet excludes all processed foods, while keto severely limits your carb intake. Other diets will cut out sugar or alcohol. The problem is, while cutting out certain foods can help contribute to your daily calorie deficit, this technique is also guaranteed to trigger cravings.

Essentially, any diet that bans a particular food or food group will invariably result in cravings, driving you to cheat on your diet. So allow yourself the smallest amount of this particular food or drink to allow your body to feel like it isn’t being deprived of something. In other words, everything in moderation.

 

Ingredients Cost Too Much

It is good to follow a diet of healthy, fresh ingredients, but with food being one of life’s unavoidable expenses, it will be harder for you to sustain this diet plan long-term if you aren’t always financially stable.

For example, some diets specify that you must eat expensive foods and that somehow these products are better for weight loss than those that are more reasonably priced. Organic vegetables and grass-fed beef from free-roaming cattle cost a lot more than the basics you get at Costco, but nutritionally are not all that different. They certainly won’t help you lose weight faster.

For a diet to be sustainable, you need to be comfortable with how much your food costs. For example, if your grocery bill doubles overnight, you’ve got a ready-made excuse for quitting your new eating plan.

 

It’s Too Complicated

To make diets unique, they are often unnecessarily complicated. This complexity can often cause people to make mistakes or just give up after a while.

Food-combing diets are a perfect example of this. Some may say things like “you can’t eat fat and carbs in the same meal,” which looks OK on paper, but makes meal prep far more complicated than it needs to be. Ultimately, for any diet to work, it needs to be simple enough to follow every day.

 

Perfection or Failure

Diets can often be very prescriptive and allow no variation. However, in everyday life, any diet can be difficult to stick to. Perhaps you have a friend’s birthday or an off day, and you decide to indulge in something sweet.

The reality is that your diet doesn’t have to be perfect; it just needs to pretty good most of the time, which is more than enough to reach weight-loss goals.

 

Ignoring the Long Term

Putting a timeframe on any diet sets you up for failure. Some of the most common ways diets are advertised are through their quick-fix timestamp, like “lose 30 pounds in 90 days” or “30-day get-ripped plan.”

Excess body fat accumulates over many years, and no one goes to bed lean and then wakes up fat. Likewise, achieving your body goal could take many months, or even years. To achieve a significant result in just a few weeks, any diet must be very restrictive, and, therefore, it may be unsustainable, as your body will soon put the weight back on that it dramatically lost. Before considering any diet, ask yourself, “can I follow it for the next six to 12 months?”

 

What’s the Science?

Some diets are based on very flawed science or may not be based on any science at all. One example of this is calorie-burning or negative-calorie foods, such as celery. No food burns more calories than it contains, and these claims are very misleading.

Effective diets work by manipulating your calorie balance. Consume fewer calories, and your body will make up the shortfall by using stored body fat for energy. No deficit means no fat burning. There are no shortcuts around this law of thermodynamics.

 

Bottom Line

As a rule, if a diet promises something that sounds too good to be true, it probably is, so don’t fall for it.

“Fortunately, healthy eating doesn’t have to be complicated or unpleasant, and weight management doesn’t have to take over your life,” Fitness Volt’s expert said. “You don’t even have to give up your favorite foods. However, you will need to quit looking for short-term fixes and adopt healthier, long-term habits.”

 

Fitness Volt is a comprehensive online resource dedicated to strength sports. Its mission is to empower readers with tried and tested knowledge and practices surrounding the latest fitness and nutritional information.

Steve Conca
Healthcare News Special Coverage

Fitness Centers Report Renewed Interest in Getting Healthy

By Contributor

Second Wind

By Mark Morris

Steve Conca

Steve Conca says he’s seen a post-pandemic uptick in people wanting to take charge of their health.

Editor’s Note:

These are exciting, challenging, and ever-changing times for healthcare and the businesses and individuals providing it. To better inform and educate its readers about the many issues, trends, and developments in the healthcare sector, BusinessWest will be introducing a new, monthly segment that will present content from its sister publication, Healthcare News (HCN) .

This new resource will be called “HCN Monthly Feature,” bringing news and information on the many health, wellness, and fitness issues and developments of today, from both regional and national sources. Each HCN Monthly Feature will have specific themes and points of emphasis — everything from health and fitness (this month) to behavioral health; from cancer care to a salute to the region’s nurses — and it will be made available online at both businesswest.com and healthcarenews.com, as well as via the daily e-newsletters BusinessWest Daily News and HCN News & Notes, making it readily available to subscribers and consumers in the Western Mass. region and beyond. 

For subscriptions, additional information, and to send us your news and story ideas, please visit BusinessWest  and HCN

Marina Lebo remembers what Healthtrax in East Longmeadow looked like during the pandemic — and is glad it looks a lot different now.

“The plastic barriers are down, and the equipment is all back where it was,” said Lebo, vice president of Operations at the club. “We have more cleaning supplies available, but that’s the only difference.”

Fortunately, that return to normal is manifesting in other ways as well — including an increase in activity.

That’s only natural; at the start of the pandemic in March 2020, fitness centers were forced to shut down. Three months later, they were allowed to reopen at 40% occupancy only after installing clear plastic barriers at the front desk, mandating masks for everyone, spacing out exercise machines, and providing lots more sanitizing wipes to clean the equipment after each use.

With Healthtrax membership back to about 70% of pre-pandemic levels, Lebo’s goal is to keep increasing everyone’s comfort level to encourage going to the club as a normal activity again.

Steve Conca, owner of Conca Sport and Fitness in West Springfield, described the last few years as a whirlwind. He’s grateful his business has survived — and even thrived — since the early days of the pandemic.

“We don’t have a huge membership base, probably around 150, and it’s a very tight-knit community where people support each other inside and outside the gym,” he said.

When everything shut down in the spring of 2020, Conca began meeting with clients outdoors and over Zoom. “Everyone stuck with us, which was great. We didn’t lose too many people once we got back into the swing of things.”

Outdoor gatherings and livestreams were options Ashley Brodeur also used to keep her business going during the height of the pandemic. The owner of Active Lifestyle Fitness in Agawam hosted a private group on Facebook Live to keep her members on a regular workout schedule. While she appreciated virtual classes as a short-term necessity, she said, nothing beats the in-person experience.

In fact, shortly after in-person sessions resumed, Brodeur noticed several members getting easily winded from doing the same workouts they were performing during the livestream sessions. “When I asked why, they admitted that they weren’t doing the entire workout at home.”

So everyone was glad to return, she went on. “There is an accountability in having to show up somewhere and having someone watch how you are exercising.”

 

Wake-up Call

Everyone who spoke with BusinessWest pointed out that the pandemic served as a wake-up call about the importance of good health. As their members return to fitness centers, all agree there’s a new emphasis on getting results.

Marina Lebo

Marina Lebo says the rise of flexible and hybrid work schedules has led to Healthtrax being busy at less traditional times.

“I think a lot of people’s minds shifted during the pandemic,” Brodeur said. “Instead of working out to quickly lose some weight, our typical member now seeks a higher quality of life and to avoid becoming an unhealthy person.”

Lebo noted that the most vulnerable people to getting COVID usually have issues with obesity or struggle with other health problems.

“There’s been a realization that, if you stay in shape, you will be better-prepared for all kinds of ailments, and you’ll be less likely to have symptoms over someone who isn’t as healthy.”

For the past year or so, Conca has seen a resurgence in his West Springfield facility due to people taking more initiative with their own health and wellness — especially older people or those who navigated the pandemic with heart disease, diabetes, weight issues, or other health factors, and now want to improve their outlook.

“They weren’t really paying attention to their fitness or health before,” he said. “These are folks who want to take a much closer look at their health.”

Most of Conca’s members are in their mid-40s through their 60s. “We have some folks in their 30s, but they’re not the majority,” he said. “It’s a nice mix of folks, and no one’s here for vanity reasons like getting ready for bikini season. They want to move better, feel better, take care of themselves. When they go on vacation, they want to be able to go on a hike without pain.”

The demand for more results-oriented workouts has meant growth in the personal training and small-group training programs at Healthtrax. Lebo said the small-group training appeals to people who like a dedicated workout at a scheduled time.

“If you’re a biker, golfer, tennis player, runner, obviously you can’t go as fast and hard and aggressive as you did in your 20s or 30s, but you can still go out and enjoy doing it, at maybe a little less intensity.”

“If you have a goal and you start to see results, you are more likely to stick with the training,” she said. “It’s far more effective than going to the gym for weeks, doing your own thing, and not seeing any noticeable results.”

To establish a starting point for fitness, Healthtrax uses a high-tech body-composition machine known as InBody 570. While the user stands on it barefoot and holds the handles, the machine provides a wealth of fitness information that helps a person understand what type of workout would benefit them most.

“For example, someone who is thin might learn they are not as fit as they thought, and the InBody might also reveal a heavy person has a good amount of muscle, so they can concentrate on exercises that burn fat,” Lebo said.

At Active Lifestyle Fitness, Brodeur offers what she calls a 6 Week Transformation Challenge, with an emphasis on strength, cardio health, and flexibility. She emphasized this is not a quick fix, but a results-oriented approach to a healthy and balanced body.

“We developed this program because people told me, ‘I need help. I don’t want to mess around with my health anymore’” she said. “It’s been successful because it centers around the basics of helping people properly move their body and build strength.”

Ashley Brodeur

Instead of just wanting to lose some weight, Ashley Brodeur says, today’s fitness crowd is looking to improve their quality of life.

An emphasis on long-term health comes with many rewards. Conca noted that, while everyone knows the definition of ‘lifespan,’ he talks with members about ‘healthspan’ — the number of years one spends without being hampered by chronic disease — and ‘playspan,’ the number of years one is able to continue to enjoy favorite activities.

“If you’re a biker, golfer, tennis player, runner, obviously you can’t go as fast and hard and aggressive as you did in your 20s or 30s, but you can still go out and enjoy doing it, at maybe a little less intensity.”

Understanding the value of that playspan, and of maintaining the ability to enjoy quality-of-life moments like getting on the floor to play with a grandchild and easily getting back up, puts a real-life emphasis on fitness goals, Conca said, which are more powerful than the numbers attached to weight-loss goals.

“When they come here, a lot of folks are not in a good place; they’re struggling, and there’s a lot of misinformation out there,” he explained, adding that many people have tried different approaches but lacked proper accountability along the way.

“We really personalize it. I’ve been really blessed to help people and have a team around me who feel the same way. It’s exciting because we’re really helping people.”

 

Opportunity Knocks

Lebo has seen a huge change involving when people choose to access her club. In the past, the hours before and after work were consistently busy, while the club was practically a ghost town in the early afternoon. That’s no longer the case.

“We are busy at all different times during the day,” she said. “With more people working from home or on floating work schedules, they might come in after 9 a.m. or after 2 p.m.”

All-day activity has been a positive development because, in addition to seeing activity all day, members no longer experience those congested times waiting to use the more popular exercise equipment.

“It’s also good for our training classes because we can schedule throughout the day instead of trying to jam everyone in after work,” Lebo said.

Whether it’s through personal training sessions, small groups, open gym time, or an introductory, six-week program called Mastering Your Best Self, Conca emphasizes that fitness should not be stressful. In fact, when done properly, it should reduce other stressors in life.

“Everyone’s dealing with something, whether it’s physical stress, financial stress, or family situations, taking care of someone. Everyone’s got a lot of stuff on their plate. So we try not to make fitness another burden for them,” he said.

“We want people to recognize, they have an opportunity to take better care of themselves, and it’s going to make all those things they are dealing with much more manageable. Fitness can be fun, let’s not make it a punishment.”