Global research finds 10 risk factors that account for
90 percent of all strokes

Joanna Hayden, PhD, CHES

The results of a study of almost 27,000 people from 32 countries around the globe found that if 10 risk factors were controlled, 90 percent of all strokes could be prevented. They are: high blood pressure (140/90 or higher),  blood fats (cholesterol), obesity, poor diet, smoking, high or heavy alcohol use, diabetes, stress, heart disease, and physical inactivity. Of them all, high blood pressure accounts for almost half (48%) of all strokes. The study was published online July 15, 2016 in the medical journal Lancet.

A summary of this study is at: https://medlineplus.gov/news/fullstory_159902.html

The journal abstract is at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30506-2/fulltext

Use this news

The results of this study are sobering – that 90% of strokes world-wide can be prevented if people change some basic health behaviors. And luckily, changing a few of them impacts many of them.  For example, a healthier diet can lead to weight loss which often reduces high blood pressure and gets type II diabetes and high blood fats under control. Quitting smoking helps to reduce high blood pressure and the risk of heart disease. Being more physically active helps with weight control, heart disease risk and stress management.  Reducing alcohol consumption contributes to weight loss and decrease heart disease risk. Stress management decreases blood pressure, helps in managing weight, and decreases heart disease risk and using physical activity as one means to do so, addresses five of the risk factors.

Since high blood pressure was found to account for almost half of all strokes, it would be wise to begin with lifestyle changes that help lower your blood pressure if it’s high, or reduce your risk of it,  if it’s still within normal limits. The Mayo Clinic offers the following recommendations to reduce blood pressure without medication:

·         Eat a diet high in whole grains, fresh fruits and vegetables.

·         Lose weight if you are overweight or obese

·         Get 30 minutes of exercise 5 days a week – walking, cycling, 
          dancing, swimming are all good.

·         Keep sodium intake to less than 1500 mg a day – read food
           labels, avoid processed foods, don’t add salt to your food.

·         Limit alcohol – for women and men over 65, one drink a
          day, for men younger than 65, 2 drinks a day.

·         Quit smoking

·         Reduce caffeine intake

·         Manage stress

Doing all of these at once is overwhelming. So, pick one to start with and when you’ve made that change, pick another. Any change is better than no change, start slowly and be patient.

For more information:

National Institute of Neurological Disorders and Stroke
            Preventing Stroke

           Healthy Living Habits to prevent high blood pressure


National Stroke Foundation –
         What is Stroke?

Let Associates for Health Education and Behavior help you get started, keep you on track, support you through all of the behavior changes you want or need to make to live a healthier lifestyle. 

Call today to make an appointment for your free consultation.



About one in 12 of us is contributing to antibiotic resistance. Are you one of the ones?
by Joanna Hayden, PhD, CHES

Antibiotic resistance is a growing public health concern with overuse, misuse and self-diagnosis contributing to the problem. A study published this month in Antimicrobial Agents and Chemotherapy found that 14% (about 1 in 12) of the people surveyed had a supply of antibiotics in their house left over from prescriptions not taken as directed, obtained from friends and relatives, or purchased outside of the country. One in 20 used these antibiotics to treat self-diagnosed viral illnesses like the flu and colds, even though antibiotics don’t work on viruses.  One in four said they would use any antibiotic they had in the house to treat a sore throat, cough and runny nose.

(Source: Dallas, M. E. Many Adults Use Antibiotics Without Consulting Doctor, Survey Finds.[Internet] HealthDay; 2016 July 11, 2016 [cited 2016 July 17, 2016]. Available from https://medlineplus.gov/news/fullstory_159803.html)

 Summary at:  https://medlineplus.gov/news/fullstory_159803.html

Journal article abstract at: http://aac.asm.org/content/early/2016/06/22/AAC.00528-16.abstract?sid=bcc5e128-c160-4b60-b5aa-0d90be5c9eb4

 Use this news

Antibiotics are powerful drugs used to treat infections caused by bacteria. Misuse and overuse, which includes taking antibiotics for viral illnesses, taking the wrong antibiotic for the bacteria causing the infection, not taking all of the doses prescribed, leads to antibiotic resistance.

The CDC offers this explanation as to how antibiotic resistance develops:

When we take antibiotics, not all of the bacteria maybe killed. Some of the bacteria can survive because they:

·          “neutralize” the antibiotic by changing it in a way that 
             makes it harmless.

·         develop the ability to pump an antibiotic back outside of
          their cell before it can do any harm.

·         change their outer cell structure so the antibiotic has no
          way to attach to the bacteria it is designed to kill.

·         change their genetic code (mutate) and develop resistance

If even one bacterium becomes resistant, it can multiply and replace all the bacteria with ones that are resistant to the antibiotic that killed the others off.

When resistant bacteria are passed to another person, stronger antibiotics have to be used to kill them. In some cases, bacteria develop resistance to all of the available antibiotics, which results in fatal infections.

Not all antibiotics work on all types of bacteria, of which there are many.  The specific antibiotic needed to treat an infection depends on the type of bacteria causing the problem. This is why only the antibiotic prescribed by a health care professional to treat the specific infection diagnosed should be taken.

Antibiotics need to be taken as directed for the full time specified. If the prescription instructions are for 10 days, then that’s the length of time they need to effectively kill the bacteria causing the illness.  Taking antibiotics for less than the prescribed number of days or taking fewer doses, so you can have some left over for the next time, means some of the bacteria will not be killed, which contributes to the development of resistance. If you’re taking ‘left over’ antibiotics from the last time you were sick, even if it is the right antibiotic for the infection, you won’t have enough of them to do the job.

 The National Library of Medicine provides the following guidelines for the proper use of antibiotics:

  •  Only take antibiotics if they are absolutely necessary to 
     treat a  bacterial infection

                               Antibiotics do not work on illnesses caused by a 
                               virus cough, cold, flu, bronchitis.

  • Take them as prescribed.

                              Take all of the pills your health care provider
                               prescribes, even if you feel better after a few
  •   Take them with water rather than with juice, milk or
       alcohol, unless otherwise instructed. 
                         For some antibiotics:

                                  dairy products like milk, yogurt, ice cream
                                  and cheese, interfere with how the body
                                  absorbs them

                                 grapefruit juice and calcium supplements may    
                                  make them less effective

  • Take then at the intervals/times prescribed.

                                    Some antibiotics need to be taken before 
                                    meals, some after, and some with meals.

                                     Some have to be taken at the same time every                                      day to maintain an effective blood level.

                                    For those taken  multiple times a day,                                                    spread them out evenly over the 24 hours                                             to keep blood levels constant. For example, if                                     your antibiotic is taken three times a day,  take                                     it every 8 hours instead of with breakfast        
                                    lunch and dinner, unless otherwise        

  • Inform your health care provider and pharmacist of other medications you take.

                                   Some antibiotics cannot be taken with other                                        medications. For example, some make birth                                         control pills less effective or interfere with                                             blood thinners and antacids.

 If you have a stash of antibiotics in your house, bring them to a pharmacy for proper disposal.  DO NOT flush them in the toilet or put them in the garbage. They end up in streams, rivers and landfills where they contaminate the environment, which also leads to resistance.

For more information:

National Library of Medicine

  Using antibiotics correctly

 Centers for Disease Control and Prevention  -

 Antibiotic resistance: Questions and Answers

  Antibiotic resistance - http://www.cdc.gov/drugresistance/about.html

National Health Service (UK)

Antibiotics: Interactions with other drugs



July 11th, 2016


Is your sunscreen doing what it should, and are you?
 Joanna Hayden, PhD, CHES

A study published in the JAMA Dermatology last week found that 4 out of 10 sunscreens don’t meet the sun safety guidelines of the American Academy of Dermatology, regardless of their price. The biggest problem – the sunscreens didn’t meet even the minimal 40 minute water and sweat resistant criteria.

The complete article is at:

Use this news

In order for a sunscreen to protect our skin from the damaging effects of the sun’s UVA and UVB rays, according to the American Academy of Dermatology (AAD) and the Skin Cancer Foundation  (SCF) it should be:

  •  Broad spectrum:  This means the sunscreen contains ingredients to protect your skin from UVA and UVB rays. To protect against UVA, it should contain a combination of some of these: zinc oxide, titanium dioxide, avobenzone, ecamsule, and oxybenzone. 

  • SPF 30 - 50: SPF – Skin protection factor, is length of time a sunscreen will protect skin from UVB rays. An SPF of 30 theoretically will allow you to stay in the sun 30 times longer without burning than you would otherwise. According to the Skin Cancer Foundation,  an SPF 15 blocks about 93% of UVB rays, an SPF 30 blocks about 97%, SPF 50 blocks about 98%. Above that, there is no real advantage.

  • Water resistant:  This means the sunscreen will stay on wet or sweaty skin for a short time before you need to reapply. If the product is water resistant, it must state for how long, 40 or 80 minutes. If it doesn’t include this information on the label, then it isn’t water resistant, not all sunscreens are.
If your sunscreen meets all of the above criteria, it still won’t do you much good if it’s not used correctly.  To properly apply sunscreen:

Use at least two tablespoons (one ounce) to cover the entire body, including the face head and lips

        Because facial skin is thin and exposed, it is particularly                 important to apply sunscreen there liberally. If you are                     hesitant to use the same sunscreen for both your body and             face, many facial moisturizing creams contain sunscreen.

        If you have thinning hair or are bald, apply sunscreen to                 your scalp or wear a hat.

        Use a lip balm with SPF 15 for your lips and reapply                         regularly.       

Apply it one-half hour before going outside.

        It takes at least 15 minutes for the skin to absorb it.
         Rub it thoroughly into the skin
         Use spray sunscreen for hard to reach areas.

Re-apply it every two hours or immediately after swimming or heavy sweating.

        Sunscreen breaks down in the sun and is washed or rubbed         away with sweat or during swimming

Many sunscreens have an expiration date which is typically two to three years. To keep yours good for next summer, store it in a cool place, since heat gradually breaks it down. (SCF, 2016,  AAD, 2016)

For more information…

Skin Cancer Foundation

Guide to sunscreens http://www.skincancer.org/prevention/sun-protection/sunscreen/the-skin-cancer-foundations-guide-to-sunscreens

American Academy of Dermatology
              General information https://www.aad.org/public

               Video - How to apply sunscreen - https://www.aad.org/public/spot-skin-cancer/learn- about-skin-cancer/prevent/how-to-apply-sunscreen

Suicide rates on the rise
Joanna Hayden, PhD, CHES

A report published by the Centers for Disease Control and prevention in the July 1 issue of Morbidity and Mortality Weekly Report, shows suicide rates for people age 16 and over increased by 21% between 2000-2012. The occupations with the highest rates overall were farming, fishing, and forestry followed by construction.

The complete report is at: https://www.cdc.gov/mmwr/volumes/65/wr/mm6525a1.htm?s_cid=mm6525a1_w

Use this news

Suicide accounts for approximately 40,000 deaths per year in our country, making it the 10th leading cause of death. Although there is no single cause, it is preventable. According to the American Foundation for Suicide Prevention (AFSP), it most often occurs when life stressors are greater than a person’s coping capacity coupled with a mental health issue, usually depression. 

Knowing what increases the chances of suicide, the warning signs and what to do, can saves lives.

Following are factors from the National Suicide Prevention Lifeline  that are known to make it more likely for someone to consider, attempt or die from suicide:
  • Mental health issues, particularly mood disorders (depression), schizophrenia, anxiety disorders and certain personality disorders
  • Alcohol and other substance use disorders
  • Hopelessness
  • Impulsive and/or aggressive tendencies
  • History of trauma or abuse
  • Major physical illnesses
  • Previous suicide attempt
  • Family history of suicide
  • Job or financial loss
  • Loss of relationship
  • Easy access to lethal means
  • Local clusters of suicide
  • Lack of social support and sense of isolation
  • Stigma associated with asking for help
  • Lack of health care, especially mental health and substance abuse treatment
  • Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma
  • Exposure to others who have died by suicide (in real life or via the media and Internet)
The following are warning signs of suicide. If you or someone you know shows any or all of these signs, get help as soon as possible.

  • Talking about suicide
                    for example, saying "I'm going to kill myself," "I wish  
                    I were dead" "I wish I hadn't been born"
  • Getting the means together –
                    buying a gun, stockpiling pills
  • Withdrawing from family, friends, social interaction - wanting to be left alone
  • Having mood swings
                   being emotionally high one day and deeply
                   discouraged the next
  • Being preoccupied with death, dying or violence
  • Increasing use of alcohol or drugs
  • Changing normal routine, including eating or sleeping patterns
  • Engaging in risky or self-destructive behaviors
                     using drugs, drinking more, driving recklessly
  • Giving away prized possessions
  •  Getting affairs in order when there is no other logical explanation for doing this
  • Saying goodbye to people as if they won't be seen again
  • Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above
    (Mayo Clinic, 2015)
If someone you know shows any of the signs above in a way that makes you believe he or she might attempt suicide, here are some dos and don’ts :


Talk - Be direct and talk openly. Ask questions.

    o   How are you coping with what's been happening in your    
           life lately?

    o   Do you ever feel like just giving up?

    o   Are you thinking about hurting yourself?

    o   Are you thinking about suicide?

    o   Have you ever thought about suicide before, or tried to
           harm yourself before?

    o   Have you thought about how or when you'd do it?

    o   Do you have access to things you can use to harm yourself?

Listen.  Allow expressions of feelings and accept the feelings.

Care.     Offer support, be available, show interest. 

Act.        Remove means, such as guns or stockpiled pills.

                                  HELP  the person get help!   
                 Call the National Suicide Prevention Lifeline at
                               800-273-TALK (800-273-8255)


           debate whether suicide is right or wrong, or whether        
           feelings are good or bad.

            lecture on the value of life.

            dare him or her to do it.

            act shocked.

            be sworn to secrecy.
             (Mayo Clinic, 2015)

      If someone you know attempts suicide: 

                                                Call 911          

                      Don't leave the person alone!


For more information

National Suicide Lifeline
Lifeline 800-273-TALK (800-273-8255)

Mayo clinic – What to do when someone is suicidal.

Teen Suicide prevention video - https://www.youtube.com/watch?v=3BByqa7bhto

American Foundation for Suicide Prevention – Risk factors and Warning signs