Salud Coomeva Magazine - April - May

ISSN 1692 - 5556 April- May 2018 - Issue 140 COOMEVA MEDICINA PREPAGADA THE BONDS THAT UNITE US www.revistasaludcoomeva.com 1



issue 140 MORE TIME FOR YOUApril – May 2018 AND YOUR FAMILYRevista Salud Founder Nowadays, with people’s schedules healthcare sector that offers theseGilberto Lotero Muñoz (q.e.p.d.) busier than ever, it can be challenging types of healthcare platforms.Chairman of the Board to get enough time to do everything we By doing this, we continue to pursueJosé Vicente Torres Osorio need to. With this in mind, along with our mission of offering innovative andExecutive President Of the the wellbeing of our affiliates and their comprehensive solutions to the heal-Cooperativo Coomeva Business Group families, Coomeva Private Healthcare thcare experience by building uponAlfredo Arana Velasco has developed a digital strategy with three important cornerstones: fosteringCEO Coomeva Sector Salud state-of-the-art technology to those we self-care, mental wellbeing and com-Gilberto Quinche Toro serve familiar with our different servi- prehensive care in adults, children andPrepaid Medicine CEO ces, offering more flexibility with the youth. Our goal is for at least 50% ofJorge Alberto Zapata Builes healthcare and solutions we provide. enrollees that are currently using servi-National Director of Strategy With our Virtual Office, self-service ces at our physical branches to changeand New Business kiosks, web and mobile app “My Story: to the virtual options we are offering.Mauricio Castillo Pérez Your Health and Loving Yourself,” and In hopes of helping enrollees toNational Director of Marketing with our mobile devices that use finger- improve their quality of life, we invi-Sector Salud print recognition, we are taking a multi- te you to learn more about our servi-Camilo Ernesto Diusaba Perdomo faceted approach that will soon bringGeneral Manager us to the forefront of the Colombian •ces in this latest edition of RevistaDavid Montes Canal Salud CoomevaEditorial CommitteePascual Estrada Garcés Editorial and Graphic Direction, Magazine General Editor Journalists CommercializationNational Director of Prepaid prepress and printing Paula Andrea Montoya T. Isabel Vallejo Jiménez El ColombianoHealthcare El Colombiano Magazine Editor Ana María López de Mesa Cali: Marisol MonsalveHernán Darío Rodríguez Tel.: (4) 331 5252 Natalia Estefania Botero C. María Antonia Giraldo 310 544 2354MEC National Director [email protected] Graphic Editor Laura Vega Gutiérrez [email protected] Inés Vélez Hugo A. Vásquez E. María Clara Restrepo Bogotá: Ana María EchandíaNational Director of Oral Health Design Photography 3183764776Sandra Viviana Muñoz Rodríguez Luisa Fernanda Vélez García ShutterStock - Cortesía Medellín: Mónica GómezDirector of Epidemiology 312 202 7269Bertha Lucía Varela Rojas [email protected] Nacional Auditoría MédicaMartha Liliana Cifuentes The contents of all Salud Coomeva Medicina Prepagada S.A. magazine articles are illustrative in nature and/or for general knowledge. In no case areCoordinadora Nal. de they meant to replace the advice or guidance of a physician. Readers shall not use this information in order to self-diagnose and/or perform an analysis,Relacionamiento con Prestadores diagnosis or treatment of a disease or health problem without consulting with a certified physician.Julián Villegas The product and service offers made in the ads published in the Salud Coomeva Medicina Prepagada S.A. magazine are the sole responsibility of theNational Chief of Risk advertisers. Also, the company is not liable nor obligated to provide its affiliates the services, procedures or treatments described in the contents ofManagement in Health articles that are not included in the coverage offered by Coomeva Medicina Prepagada S.A., nor shall they be obligated to include them in their plansEditor and services. All rights reserved. May not be reproduced in any form or system. © 2018David Montes CanalEditorial CoordinatorMelissa Arce PérezCollaboratorsMabel Irina CaleroXiomara Iveth CampoViviana Trujillo JiménezClaudia Alexandra GarcíaJairo Bravo MendozaCarlos Andrés LópezAna María CorreaIván YunisJohn Eduard Martínez

TABLE OF CONTENTSApril - May 2018 7 27 49 65( ) ( ) ( ) ( )WITHYOUR MIND WITH YOUR BODY WITHYOUR WORLD CORPORATE8 Couples 28 For her 50 Couples 66 Services The challenges Pregnancy at 40: It takes two to build Integral solutions, of a new family Is age important? strong communication just a click away12 Your generation 32 Little giants 53 Life today 70 Institutional Technology, Eye checks, a vital part The 8-hour life Quick and timely care a strategy for of early childhood connecting families 36 Keep in mind 56 Trends 72 Prevention18 Little giants A healthy waist High-endurance exerci- “My Story,” Asperger’s: It’s all without the extras ses? All in moderation a personalized guide about awareness22 Keep in mind 40 Infographic 58 Harmony in health 74 Directory Keeping panic Healthy portions The power New providers attacks under control of bonding and specialists24 Focus on 42 Grandparents 62 Go natural Alcoholism Making movement Proteins: They are part of your routine all important! 46 For your smile 64 Games A balanced Crossword oral hygiene and sudoku

Protección Radiación La radiación IR Tienen la capacidad Las pieles jóvenes Terapia preventiva a constituye el de penetrar son más susceptibles temprana edad, 50% a capas más profundas al daño solar. generando hábitos de de la piel. cuidado frente a losdel espectro solar. efectos nocivos de los rayos solares.











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WCOITNH TYUOMURENMTIEND( ))your generation LA TECNOLOGÍA, ESE ALIADOQUE CONECTA FAMILIAS TECHNOLOGY, A STRATEGY FOR CONNECTING FAMILIES La idea es que estas herramientas se conviertan en una oportunidad para que padres e hijos pasen más tiempo juntos. The idea is for these tools to serve as an opportunity for parents and children to spend more time together.12

( )CON TU MENTE ASESORA ADVISOR GLORIA HURTADO GLORIA HURTADO Psychologist at Coomeva Medicina Prepagada Psicóloga, adscritaa Coomeva Medicina PrepagadaLas ventajas que nos ofrece la tecnolo- T echnology has an infinite number gía son incontables. Con cada avance of advantages. Each improvement se pone en duda la frase “todo tiempo questions the concept of the goodpasado fue mejor”, pues gracias a los nuevos old days: Are they as good as we thought?desarrollos, nuestra vida es cada vez más efi- With new developments in technology, ourciente. Sin embargo, lo vertiginoso de este lives become increasingly more efficient.progreso puede ser atemorizante, especial- The rapid pace of this progress can be inti-mente cuando los más jóvenes de casa pue- midating, however; especially when theden estar a un paso más avanzado de los youngest ones at home can be one stepadultos, quienes deben guiarlos. ahead of the adults, who are the ones who should be giving them guidance. “No podemos seguir oponiéndonos alcambio del mundo”, dice la psicóloga “We can’t keep fighting change inGloria Hurtado, al reflexionar sobre el this world,” says psychologist Gloriarecelo que despierta entre los padres el Hurtado, reflecting on the uncertaintyhecho de que sus hijos se mantengan that arises among parents when theirconectados en sus dispositivos a través de children use technology to connect toWhatsapp, Facebook, Youtube o applications like WhatsApp, Facebook,Instagram, entre otros. “Tenemos que YouTube or Instagram. “We have toaprender a vivir en el mundo de hoy, no learn to live in today’s world, we can’tpodemos pretender que todo vuelva a ser try to make everything be like it wascomo antes, eso es una utopía”, afirma. before; that would be a utopia,” shePara ella, es necesario reconocer lo bueno asserts. For Hurtado, it is important toy lo malo de todos los fenómenos. acknowledge the positive and negative sides of all forms of change.COMO HERRAMIENTASInternet y sus diferentes manifestaciones, TECHNOLOGY AS A TOOLcomo las redes sociales, tienen cosas positivas The internet and its different manifestations,y negativas, esto depende de cómo las usemos. such as social media, have their pros and theEn el lado positivo, nos ayudan a acercar a los cons; it just depends on how we use them.familiares y amigos que están lejos y nos facili- On the pro side, they help us stay in touchtan un mundo de información que antes no with family and friends that are far away andse podía soñar acceder ni en la más grande de provide us with a world of information thatlas bibliotecas, lo que hace más fácil responder we could never dream of accessing before,a muchos de los deberes escolares. not even in the biggest of libraries, makes most schoolwork much easier to complete. Para Gloria Hurtado, también puedenayudar en la comunicación con los que For Gloria Hurtado, these tools cantenemos cerca: “He tenido gente que se also help improve the communication weconecta como nunca con sus hijos a través have with those we are close to, “I havede Whatsapp, entonces no se trata de des- seen people use WhatsApp to connectconectarse, sino de aprender a usarlas”. with their children better than ever. So, it’sLas redes sociales permiten una conexión not about being disconnected, it’s aboutconstante con los hijos sin ser demasiado learning how to use them.” Social net-invasivos, recordándoles que pueden enta- working allows for there to be a constantblar una conversación cuando quieran y connection with children without beingque los padres están disponibles para too invasive, reinforcing the idea that theyellos, además, de que permiten medir can start a conversation whenever they 13

WITH YOUR MIND( )your generationIDEAS PARADESCONECTARSE► Teniendo en cuenta que estar conecta- mejor las palabras cuando es necesario. want and that parents are there for them. dos a la red no es necesariamente algo El tema se torna negativo cuando no se They also help you choose your words more carefully when you have to use them. negativo, se pueden tener algunas alter- tiene el suficiente apoyo para sobrellevar el mundo virtual tan amplio que se presenta, The issue becomes problematic when nativas para que los adolescentes com- pero esto no es algo que afecte únicamente there is a lack of support to deal with the partan más tiempo en familia. a los adolescentes. Una muestra de ello son ever-expanding virtual world; an issue that is la noticias falsas, que todos podemos reci- not specific to youth. An example of this is► Es necesario conocer los intereses de los bir y que podrían tomarse como verdade- the fake news that we are all exposed to and hijos y no calificarlos de manera negativa. ras. Así como se debería educar a los niños make take to be true. Just how children Tratar de que los compartan con sus en reconocer estas informaciones, es conve- should be taught to recognize this informa- niente enseñar a los adultos para saber tion, adults should also be taught to identify padres. dónde se deposita la confianza. the sources of information they can trust.► Se les deben ofrecer alternativas que les El principio de “no hablar con extra- The tenet, “Don’t talk to strangers,” resulten interesantes. Si esperamos que ños”, que tan útil resultó en tiempos pasa- which has proven to be useful in the past, dos, también debe ser una máxima en la should also be applied to the internet. Parents se integren al grupo de los adultos solos, red. Es importante que los padres y adultos and adults should know who the real and vir- conozcan a los amigos reales y virtuales de tual friends of their children are in order to no lo van a hacer. los niños, para evitar riesgos y tener temas prevent any unfortunate occurrences and► Antes de imponer y esperar obedien- de conversación en común. maintain shared topics of conversation. cia, se debe tener la paciencia para Otro asunto que debe observarse es el de Another matter that should be watched los “me gusta”: “Esperar aprobación o darse carefully are “likes.” As Hurtado states, explicar y pedir esos espacios que importancia a través de las redes es peligro- “Seeking approval or importance from queremos compartir. so, lo que más gusta no es necesariamente social networks is dangerous; that which lo más sano. Tanto adolescentes, como cual- receives the most likes is not always the► El ejemplo siempre es eficiente. Así quier otra persona, deben aprender a no healthiest. Kids, as well as everyone else, como se espera que se desconecten, vivir a partir de estos”, afirma Hurtado. must learn to not live off of ‘likes.’” los padres también deben hacerlo.14

( )WITH YOUR MINDCOMPARTIR TIEMPO Y ENSEÑAR SHARE TIME TOGETHER AND TEACH WAYS TO DISCONNECTEl papel activo de los padres ante los In order for children to have the toolsretos de la crianza es clave para que los they need to deal with daily life, it is key ► Provided that being “connected” is notniños reciban los instrumentos que for parents to play an active role in their necessarily a negative thing, here are anecesitan para enfrentar el día a día. upbringing. Learning and teaching about few alternatives for youth to engage inAprender y enseñar sobre temas que topics that we find on the internet is more family time.encontramos en la red es un ejercicio important and is also an opportunity tonecesario y una oportunidad para com- spend time together. Practicing this can ► Learn what the interests of your chil-partir tiempo juntos. Puede convertirse develop mutual interests and can serve as dren are and do not discredit them.en un interés mutuo y en un punto de a meeting ground that is sometimes diffi- Instead, encourage children to shareencuentro que, con los adolescentes, es a cult to find with youth. them with their parents.veces difícil de encontrar. The psychologist also recommends ► Offer alternatives that are interesting to La psicóloga aconseja fortalecer tam- building children’s self-esteem. “We children. It may be unreasonable tobién la autoestima. “Debemos evitar com- should avoid comparing them with expect them to integrate into a group ofpararlos con otros y no usar frases como ‘te others and not use phrases like, ‘You adults on their own.volviste a equivocar’, ‘tan bruto tú’, ‘no eres messed up again,’ ‘What an idiot,’ ‘Youcapaz’, ‘sigues cometiendo errores’. Mejor, can’t do it,’ or ‘You’re always making mis- ► Before enforcing rules and expectingante las dificultades, usar frases como: ‘qué takes.’ When they are facing challenges, children to be obedient, have the patien-chévere, hijo, ¿pudiste solucionar ese pro- it is better to use phrases like, ce to explain the times we want to shareblema?’ o ‘hijo, este es un momento para ‘Wonderful! You were able to solve that with them, and ask them to participate.aprender, ¿qué se te ocurre?’. Es muy problem?’ or ‘This sounds like a learningimportante entender que nosotros veni- opportunity, what do you think?’ It is ► Lead by example. Just as youmos a la vida a aprender y si es así, lo más very important to understand that we are expect them to disconnect, parentsvalioso de la condición humana son los here on this planet to learn, which is why should do so too.errores”, comenta Hurtado. the most important part of being human, is to make mistakes,” Hurtado explains. Al sentirse más apoyado en casa, el 15

WITH YOUR MIND( )your generation adolescente no recurrirá a la virtualidad By getting more support at home, chil- para suplir los vacíos, ni se refugiará com- dren will not resort to the virtual world to pletamente en sus pares cuando se fill in their voids, nor will they take refuge encuentre ante una situación difícil. completely in their peers when facing a También estará más formado a la hora de difficult situation. They will also be better relacionarse con los otros. La experiencia prepared to relate to others. The experien- de los adultos siempre es una guía que ce of adults is a guide that can be useful if puede resultar útil si se sabe transmitir, it is passed-on well. Instilling confidence además, despertar la confianza en los jóve- in youth is also beneficial to getting to •nes es una ventaja a la hora de conocerlos •know them better and to predicting the mejor y anticipar las dificultades challenges they may encounter COMPARTA NORMAS DE SEGURIDAD CON SUS HIJOS ► Utilizar contraseñas distintas en los diferentes dispositivos, redes sociales y correos. Evite compartirlas con los amigos. ► Si usa computadoras públicas, cerrar las sesiones en las que se estuvo navegando. ► No abrir correos o mensajes con textos sospechosos, ante cualquier duda preguntar antes de hacerlo. ► Pensar antes de compartir y de publicar una foto. Que estas no pongan en riesgo la seguridad e integridad personal. ► Denunciar el contenido inapropiado que se encuentre en Facebook u otro sitio. ► Limitar el acceso al perfil en redes sociales para mantener en privado los datos personales y la información que se publica. ► No compartir información personal importante, como número de teléfono, dirección o nombre del colegio. Fuentes: RedPapaz y Policía Nacional de Colombia. SAFETY PRECAUTIONS TO SHARE WITH YOUR CHILDREN ► Use different passwords for different devices, social networks and emails. Do not share them with friends. ► If you use public computers, close the sessions you were browsing in. ► Do not open emails or messages with suspicious texts. If you have any doubts, ask before doing so. ► Think before you share and post a photo. Do not let this put your security and personal integrity at risk. ► Report inappropriate content found on Facebook or another site. ► Limit access to your social network profile to keep personal data and information that you publish on their pages private. ► Do not share important personal information such as your phone number, address, or school name. Sources: RedPapaz and National Police of Colombia16

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WITH YOUR MIND( )little giantsASPERGER’S:IT’S ALLABOUTAWARENESSHaving support throughoutchildhood and teen years iswhat can make thedifference for a life ofopportunities as an adult. MEDICAL ADVISOR MARÍA ISABEL BETANCUR NAVARRO Psychiatrist, practitioner at Coomeva Private Healthcare In a world laden with standards and overarching qualifiers, where acade- mic, work and social patterns are designed for people to achieve pre-esta- blished goals, places for those who are “different” are hard to come by and, without a doubt, difficult to manage. The way people with Autism Spectrum Disorder (ASD) communicate with the world is what makes them different from others. Socializing and communicating with others are key elements of being able to relate and understand reality, and are the main challenges faced by those who have this disorder. While the control people with ASD have over themselves inhibits their contact with others and res- tricts the development of their social18

HOW TO UNDERSTAND ( )WITH YOUR MINDAND IDENTIFY IT 19 ► Similarities with Autism The term “autism spectrum” refers to the diffe- rent degrees of development disorders there are. Asperger’s is normally hold a high degree of functioning in this spectrum, as it does not affect cognitive or language abilities. The main challenges those with Asperger’s face are with social skills, which can affect one’s performance at school or work as well as one’s ability to have a relationship. ► Characteristics This disorder is characterized by not being able to maintain adequate social interactions. People with this condition are isolated and focus their conversations on their own communication needs without showing much interest in what others have to say; they have a hard time understanding expressions with double meanings as well as non-verbal communication, which is why it is diffi- cult for them to understand the feelings of others. They can also be recognized for their res- tricted and repetitive behaviors.skills, this does not just mean that theyhave a medical condition, it also meansthat they are neurodiverse. While Asperger’s has been includedas part of the autism spectrum in theDiagnostic and Statistical Manual ofMental Disorders (DSM-5), published bythe American Psychiatric Association, avariety of questions and myths persistabout this syndrome. Many have conside-red this condition as independent fromAutism, calling it the “genius gene,” as itis associated with people who are well-known in the sciences, arts or techno-logy. Whether Albert Einstein or BillGates have had this syndrome, orwhether the character of SheldonCooper from the fictional TV series

WITH YOUR MIND( )little giants“The Big Bang Theory” is based on a per- WARNING SIGNSson with Asperger’s Syndrome, are theo-ries that are often discussed by many. ► Abnormal or inappropriate intonation, and unusual vocabulary for their age group.Asperger’s is not a matter of being a ► Difficulty joining in to play games with other children, to the point of not having friends.genius, however. People with Asperger’s ► Aggressive behavior and extreme reactions if their personal space is being invaded.are often known for having an outstan- ► Using accents, gestures or expressions that are not typical of their age group.ding skill due to the characteristic aspect ► Abnormal relationships with adults: they are either too intense or nearly inexistent.of the syndrome called “restricted inte-rest” where they spend most of their ( “They understood that Miguelenergy and time on something they are was different. He was how he chose to be. The factvery interested in. If this skill is streng- that he didn’t jump didn’t make him less of a frog, itthened enough, they may get recognition made him a frog that didn’t jump,” excerpt from Lafor it and accomplish great things, yet rana que no saltaba (“The Frog that Didn’t Jump”),this does not come without the difficul- by Leonardo Caracol.ties of managing their emotions and inte-racting with others and how these havean effect on their cognitive performance. This is when it becomes important toreflect on how to approach the treatment ofAsperger’s. Is the idea to normalize thosewho are different? Or change those whoface these different challenges to makethem fit within a system? While change ispossible, certain realities must beacknowledged. According to psychiatristMaría Isabel Betancur, the goal is for peop-le living with Asperger’s to develop to theirfull potential and adapt as much as possibleto society. To achieve this, transformation iskey; not just for patients but for the diffe-rent individuals that surround them. As thespecialist emphasizes, “Rehabilitation is acollaborative effort that involves family, tea-chers and friends.”CHALLENGES AS A FAMILYGetting a diagnosis within the first sevenyears of life and being prepared to treat itwith the right therapy will aid in a goodprognosis for this syndrome. Asperger’s isnot easy to diagnose, as its symptoms canbe confused with behavioral disorders,but the sooner one can be made, the bet-ter chances are for adapting to it. As Betancur explains, the challenge to20

parents or to people who work with those ( )WITH YOUR MINDwho have this syndrome, is to becomeeducated and thoroughly trained on 21behavioral therapy in order to help bridgethem with reality. For her, “Family musthave realistic expectations that focus onthe person being successful at what theylike to do most and not in all aspects oflife.” This involves educating ourselves torespect the conditions that make us diffe-rent, “Manage your emotions so youdon’t frustrate the child; identify whatthe child struggles with,” she adds. Whileit is important to motivate them andsupport them in developing their poten-tial, expecting someone with Asperger’sto be like the rest or to meet the demandsof society is a heavy load for them to bearin life. In a blog that specializes this disor-der, the Chilean writer Leonardo Farfán(who also has Asperger’s), makes a call toaccept differences, as this is somethingthat benefits us all. “In a world where weare all so alike, being different is a pro-blem, an annoyance and even a punish-ment,” he writes.SUPPORT IS KEYGetting professional and family supportat an early age is key, as the first years oflife are when the brain can be most sti-mulated. It is understandable that asparents or friends, we are not preparedto deal with a disorder that we are unfa-miliar with, which is why it is importantto seek out guidance and get training ondifferent forms of therapy. One suchtherapy is holding therapy, proven to besuccessful for managing times of stressand anger. It is also important forthose with this syndrome to findopportunities to play, try new things oractivities such as music or sports, and•for others to support their ability tointeract with their peers

WITH YOUR MIND( )keep in mindKEEPING PANIC ATTACKSUNDER CONTROL Being able to identify an attack is critical to finding the right treatment and leading an optimal quality of life. MEDICAL ADVISOR more panic attacks, this is the point at hygiene and getting regular aerobic exer- CRISTIAN VARGAS UPEGUI which it is considered a condition that cise. These practices should be done in should be treated and managed by pro- addition to psychotherapy, which can Psychiatrist fessionals,” Vargas adds. help people understand their behaviors and how to change them, as well as helpSome of the most common symp- Some of the clearest physical warning transform the negative or catastrophic toms of a panic attack include a signs of a panic attack are heart palpita- thoughts that occur before and during a fear of losing control, going insa- tions, sweating, trembling, breathless- crisis.ne, dying or having a heart attack. “It is ness, a chocking feeling, chest dis-an experience that is hard to forget, that comfort, nausea and dizziness. Affecting Hereditary factors should not be for-no one would want to repeat,” explains 30% of the world’s population, the gotten, as they can play a significant roleCristian Vargas Upegui, a psychiatrist World Health Organization (WHO) in causing these attacks. Coping withfrom the University of Antioquia. considers panic attacks to be one of the depression can also be a trigger. most common anxiety disorders. This type of crisis often comes unex-pected and if not diagnosed on time, KEEPING A POSITIVE ATTITUDEcan leave those who experience it Despite this unpromising outlook,feeling disoriented. Many patients visita psychiatrist only after years of seeing this disorder can be treated and can bedifferent doctors, cardiologists and kept at bay provided that the personinternal medicine physicians. “Since incorporates certain habits as part oftheir symptoms are similar to those of a her or her daily life. These include redu-heart attack, other conditions must first cing the intake of stimulants such asbe ruled out. After someone has two or coffee, energy drinks, drugs and alcoho- lic beverages; practicing good sleep22

( )WITH YOUR MIND RECURRENT PANIC ATTACKS ► Repetitive panic attacks can change a person’s behavior and performan- ce at home, work or at school. The effects of people’s panic attacks often leave them feeling worried. ► There is no way to predict a panic attack. At least in its early stages, there is no trigger for it. Remembering a previous event can cause such an attack. ► Among its other benefits, patients that receive psychotherapy (cogni- tive behavioral therapy) learn to recognize and replace the thoughts that make them panic; they learn to manage stress and to relax when symptoms arise.(When a panic attack During a panic attack, symptoms nor- has occurred more than once, it is mally worsen for no longer than 30 considered an anxiety disorder. minutes; however, the person that expe- To confirm a diagnosis, see your doctor. rienced it often left with a deep fear that it can happen again at any moment. It is therefore best to become informed about this issue, seek specialized support and continue with follow-up care to prevent a lower quality of life over time. One of the best ways to deal with a panic attack is to •control your breathing and have an understanding of what is happening 23

( )WITH YOUR MIND ZOOM ON ALCOHOLISM( )This condition is the inability to control alcohol intake due to a physically or mentally-induced dependency. MEDICAL ADVISOR MARÍA VICTORIA VÉLEZ RESTREPO Nutritionist that specializes in psychiatry and drug abuse Learn more about alcoholism, at Revistasaludcoomeva.com.24

( )WITH YOUR MIND zoom onFrequent alcohol consumption creates a dependency that As Vélez explains, drinking frequently until becoming intoxi- can affect people’s state of health as well as the priorities in cated can deteriorate reasoning skills, decision-making skills and their life. According to María Victoria Vélez, a nutritionist reduce self-control. “In this state, people’s sexual impulses arethat specializes in psychiatry and drug abuse, these problems can uninhibited, and they demonstrate aggressive behavior thatcause family and social dysfunction, causing the person to enter spurs discussions, fights or sexual abuse, among other issues.”a state of depression. People in these situations can also demons- Preventing this disease is possible when the person is aware theytrate aggressive behavior, leading to domestic violence, gender have it. During the rehabilitation process, which may include theviolence, and unplanned sexual relations. They are also morelikely to have work and traffic accidents. •use of medications to detoxify the patient, having the support of family and loved ones is importantHEALTH 200REPERCUSSIONS DIFFERENT DISEASES ANDProlonged alcohol use increases the chances DISORDERS ARE RELATED TOof bleeding from the stomach or esophagus,inflammation and damage in the pancreas, EXCESS ALCOHOL USE,alcoholic fatty liver disease, poor nutrition, ACCORDING TO THE WHO.esophagus cancer, colon cancer, breast can-cer and cancer in other organs of the body. 25 %COGNITIVE OF ALL DEATHS AND DISABI-EFFECTS LITIES ARE RELATED TO ALCOHOL USE IN PEOPLESome of the most common neuropsychiatriceffects of this disease are behavioral disorders, BETWEEN AGES 20 AND 39,such as aggressive behavior due to not adapting to ACCORDING TO THE WHO.one’s environment. Other effects include differentdegrees of amnesia, cognitive impairment, demen- ACCEPTINGtia, suicide risk, affective disorders, schizophrenia TREATMENTand changes in personality. ► Admitting that you have a problem and seeking 5 professional help is the first step to healing. DRINKS OR MORE AT A TIME, ► During the treatment process, it is imperative PER MONTH OR PER WEEK, that patients follow their treatment plans. MAY BE A SIGN OF AT-RISK ALCOHOLIC BEHAVIOR THAT ► Lead a healthy and balanced diet. ► Be sure that you are getting replenishing sleep. WARRANTS TREATMENT. ► Plan an activity to do each day, which can include going to a support group. 25

Estar contigoes dartemás beneficios ¡Estás en las mejores manos!Por eso, con los programas Oro y Oro Plus de Coomeva Medicina Prepagada cuentas conuna cobertura de medicamentos cuando más lo necesites: • Medicamentos ambulatorios pos – Hospitalarios hasta por $400.000. • Medicamentos por urgencias hasta por $100.000.Accede a este beneficio o solicita más información en la línea 01 8000 911 226, opción 6. Aplican condiciones. Válido solo para usuarios de Coomeva Medicina Prepagada en los programas Oro u Oro Plus.

CON TU CUERPO ( ))WITH YOUR BODY 11 % OF THE COLOMBIAN POPULATION (THE EQUIVA- LENT OF ABOUT 5 MILLION PEOPLE), HAVE DIFFERENT HEARING PROBLEMS, ACCORDING TO THE NATIONAL MINISTRY OF HEALTH.THE RISK OF EXPERIENCING HEARING LOSS AS A RESULT OFLISTENING TO MUSIC DEPENDS ON HOW LOUD THE MUSIC IS,HOW LONG IT LASTS AND HOW OFTEN THE PERSON IS EXPOSEDTO THIS SOUND AND VOLUME.SELF-CARE PREVENTATIVE MEASURES CONSEQUENCESIt is important to practice healthy liste- Protect your hearing by reducing the Early onset hearing loss (presbycusis)ning habits and use quality headphones amount of time you use your headpho- is the main negative consequence ofthat provide quality sound and protect nes. The suggestion is not to exceed improper headphone use, especiallyyour hearing health. 60% of the maximum volume.LAS among children. 27

WCOITNH TYUOCUUREBROPDOY( )for herPISREGANGANECY AT 40:IMPORTANT?Choosing to become New generations of active and indepen- a mother when dent women are facing the dilemma you are older of whether they are truly ready to become mothers. Now, building your career requires planning can take priority over this decision. and preparation. Medically speaking, being pregnant at age MEDICAL ADVISOR 20 is different than it is at age 40. In recent DIANA DE LA MONTAÑA decades, however, scientific advances have allowed for pregnancies that occur at a later Psychologist age to be less risky. This is why pushing back HERNÁN CORTÉS YEPES the age of becoming pregnant seems to be somewhat of a social trend, one that more OB-GYN and more people are starting follow. BETTER PREPARED Prenatal yoga instructor, doula (someone who provides emotional support to women during pregnancy, birth and after birth) and psycholo- gist Diana de la Montaña affirms that babies who are born to older women are, for the most part, truly wanted. “There are a lot of benefits to being this age, as people have a greater sense of determination and responsibi- lity for taking this next step. At this age, peop- le are more aware of the effects of alcohol, diet and exercise,” our psychologist states. There is also a greater ability to accept the sacrifices that come with taking on this new role. “For example, I see that a lot of my patients who are older mothers can look back and reflect on all they have achieved. So, it is less difficult for them to give up certain social activities, which leads to fewer cases of postpartum depression,” de la Montaña28

( )CON TU CUERPOPLANNING IS KEYAccording to the University of Maryland MedicalCenter, certain techniques can help reduce the chancesof complications during pregnancy. These include:► Research the potential risks for having genetic pro- blems (chromosomal abnormalities) and find out what tests can be done during pregnancy to detect them. Consult with a genetic counselor.► Be sure that any preexisting condition (high blood pressure, diabetes, thyroid disease and obesity) is stable and under control.► By taking prenatal vitamins such as folic acid prior to becoming pregnant, you can help prevent neural tube defects, specifically spina bifida. 29

( )CON TU CUERPO explains. “This is very important, as now maternal-fetal medicine, explains that as the with birth control, future mothers are able to years pass, the number of mature eggs a establish a very close connection with their woman has reduces, as about 1,000 eggs are baby, even before they become pregnant, lost during each time she menstruates. This creating a bond that helps them accept their reduces the chances of conceiving, but does role as mothers without feelings of remorse.” not make it impossible. A study conducted by the University “There are several types of fertility treat- of London found that children born to ments. The mother, her partner and the heal- mothers older than age 35 have a 22% thcare professional can decide what type of less chance of getting hurt from an acci- practice can offer the best chances of beco- dent and almost a third of them are less ming pregnant and lead to a healthy preg- likely to be admitted to a hospital before nancy,” Cortés affirms. age three. The study also found that their language development is higher The specialist also believes that at this age, and that there are less conflicts between blood pressure can increase, leading to pree- parents and children. clampsia as well as other problems such as gestational diabetes, miscarriages, being over- THE RISKS OF WAITING weight, genetic problems and the embryo Another important factor to consider is the may have problems growing. It is therefore biological reality of women at this age. OB- best to consult with a specialist from the GYN Hernán Cortés Yepes, a specialist in •moment that the decision to have a child is made in order to avoid complications30

A CONSCIOUS ( )CON TU CUERPO DECISION 31 When a woman decides to become a mother at any age she should be able to examine her motivations for becoming one. This deci- sion shouldn’t be an obligation or be based on social pressure, it should be a sound deci- sion. Psychologist Diana de la Montaña recommends examining and establishing why one wants to become a mother, as well as what their life purpose is.IN VITRO FERTILIZATION,ANOTHER ALTERNATIVE ► This is a type of fertility treatment called assisted reproductive technology. It is based on a process where the egg is mixed with the sperm in order to create an embryo (fertilized egg) that is later introduced into the uterus. ► “Another alternative is to store your own eggs. This can be done at a sperm bank where they are frozen and protected for when you are ready to have children, and if for some reason you cannot conceive, you have the option of using them,” Cortés explains.

CWOITNHTYUOCUUREBROPODY( ))little giantsEYE CHECKS,A VITAL PART OFEARLY CHILDHOODPediatric ophthalmological exams make itpossible to prevent diseases and help ensurethat a child’s vision develops to its fullest.MEDICAL ADVISOR When a baby is born, neither This leads to a serious-enough vision loss LILIANA VÉLEZ their eyes nor their visual sys- that a person may not recover for the rest CORREA tem are completely developed. of their life. Ophthalmologist, The eyes themselves are not solely respon- practitioner sible for seeing. The process that allows us It is therefore important for children to at Coomeva to see occurs through the nerve connec- follow the recommendations for vision tions that connect the eyes to the cerebral checkups during their first years of life. Private Healthcare cortex. These connections develop pro- The purpose of these visits is to prevent gressively over the first seven years of life, the onset of eye problems, and if they are when brain plasticity is at its greatest. already present, they can help to treat During this time, clear images reach the them in a timely matter in order to pre- brain in order for a person’s visual health vent long-term consequences in the futu- to develop correctly. re. The American Academy of Ophthalmology and the American If the nerve pathway that goes from the Association for Pediatric Ophthalmology eye to the brain is not completely develo- and Strabismus recommend children get ped before the child turns seven, amblyo- their vision checked once a year. They par- pia can occur (also known as lazy eye), ticularly emphasize the importance of which is when the affected eye sends a blu- checkups at the following ages, even if no rry image to the brain that confuses it. vision problems are detected. According to pediatric ophthalmologist Liliana Vélez, when this condition is not treated properly, the brain simply stops trying to make a connection with the eye.32

( )CON TU CUERPO SEE AN EYE DOCTOR IF YOU NOTICE THE FOLLOWING SYMPTOMS: (Children under age 3) ► A change in the color or shape of the eyes. ► A pupil that turns white ► If the child rubs his or her eyes constantly. ► If, during the first 8 months of life, you notice the eye deviates from a fixed gaze or, if after this period, other types of deviations appear. ► If the child falls and has many accidents that may be indicative of difficulties in calculating distances or seeing obstacles. ► Watery eyes or constant discharge from one or both eyes. (Children older than 3) ► Reading problems. ► Lack of concentration. ► Poor school performance. ► Interpersonal relationship problems.WHEN TO CHECK A CHILD’S VISIONNEWBORN: Babies should be AGE 1: The purpose of checkup at this AGE 3: At this age, the visual acuity (sharpness)checked for the after-effects of an age is to verify that the eye structure of the child can now be assessed quantitativelyinfectious disease a mother may have is developing properly. It also serves as children at this age are able to use the eyehad during pregnancy such as rubella, to detect whether the child is expe- chart with which the test is performed. The eyemeasles and toxoplasmosis; congenital riencing refractive defects such as exam will evaluate the ability of the child’sdiseases, such as glaucoma and cata- myopia, hyperopia, astigmatism and visual system to distinguish the details of anracts; and tumors such as retinoblasto- anisometropia, where each eye has a object, as well as how sharp they can see. Thisma that, if not diagnosed in time, can different refractive error. exam can also detect abnormalities such aseven take a child’s life. strabismus or refractive problems.AGE 5: Repeating the eye exam at this stage is very important, AGE 7: At this point, the child’s brain plasticity is at itsas children are often starting school and are beginning to read fullest and the development of its visual capacities hasand write, which is why it is critical to make sure children do come to an end, which is why it is the final checkup fornot have eye conditions that can affect their academic perfor- this age group. This exam is a final evaluation thatmance. It is very common for children to experience low aca- determines how the child’s vision will be in the future.demic achievement and even disciplinary problems due to After this age, the American Academy ofpoor eyesight. As a result, they may not understand class Ophthalmology recommends getting general checkupsmaterial or be able focus in class. for visual acuity every two years. 33

WITH YOUR BODY( )X-ray IRON-DEFICIENCY ANEMIA This type of anemia, which is the most common form, can be caused by not absorbing this mineral during digestion, A KEY PART 18 mg chronic bleeding or by an insufficient OF YOUR DIET intake of iron in the diet. Iron is a mineral that is essential to producing red blood cells, which are responsible for providing oxygen to OF IRON IS THE AVERA- your body’s tissues. Mild iron deficiency GE DAILY RECOMMEN- can go by unnoticed, as well as an DED AMOUNT FOR WOMEN BETWEEN increase in this mineral, and can cause AGES 19 AND 50. symptoms such as weakness, fatigue, dizziness, pale skin color, lack of appeti- te, irritability, an inability to concentrate and memory loss, which can affect school and work performance. DIFFERENT CAUSES MEDICAL ADVISOR 6 ÁNGELA MARÍA CABAL PÉREZ The primary cause of this condition is Nutritionist & Dietician, practitioner MONTHS TO FIVE YEARS OF attributed to having a diet that is low in at Coomeva Private Healthcare AGE IS THE PERIOD IN WHICH foods with this mineral. Some strategies for CHILDREN ARE MOST VULNE- increasing your bioavailability (absorption) of (KEEP IN MIND) this mineral include adding lime to your salads, RABLE TO HAVING ANEMIA. combining ingredients and adding moringa WOMEN WHO ARE PREGNANT powder to your beverages (with cau- tion). It can also be caused by can- OR BREASTFEEDING ARE cer-related bleeding or bleeding ALSO VULNERABLE TO IT. caused by certain medications. Digestive system disorders, Try to combine meats with vegetables, such as celiac disease grains or cereals and eat them and Chron disease, along with citrus fruit juices also affect the (a source of vitamin C). body’s ability to absorb iron. Iron from animal products (heme) Iron from plant products (non-heme) can be is obtained from foods such as found in dry grains such as beans, eggs and beef, liver and organ meats, green leafy vegetables. The body absorbs this form of iron less than their animal counterparts. chicken, turkey, fish and seafood.34

( )WITH YOUR BODY 35

WITH YOUR BODY( )keep on mindAWHIETAHLTHOYUWTAISTTHE EXTRASAfter age 40, the body’s metabolismslows, making it easier for fatto build up in this area of the body. MEDICAL ADVISOR ALICIA SOFÍA DONADO DE ROMERO Nutritionist, practitioner at Coomeva Private HealthcareAs the theory goes, overeating leads GET TO KNOW YOURSELF ned sugars, reducing stress and exerci- to a bigger waist and to increased sing on a regular basis are some of the cardiovascular risk. The practice “There is a difference between what is best ways to prevent your waist frombehind this theory, however, involves normal and what stereotypes tell us,” getting bigger and from avoiding thatgetting more calories than you need from explains nutritionist Alicia Sofía Donado. feeling of powerlessness that happensfoods that are high in simple carbohydra- Body mass index, weight, height, and when you can’t fit into your favoritetes such as sugary beverages, and saturated waist size, among others, are the factorsfats such as French fries; this makes it that help diagnose an individual’s state of •pair of pants. The following are a feweasier for fat to be deposited in the waist health. Scientifically-determined figuresarea as well as increases the risk of heart and ranges can also be indicators that interesting facts about this issuedisease. In men, this buildup of fat is more something is wrong, and can help withnoticeable, especially around the waist the early detection of cardiovascular disea-area. In women, this fat tends to concen- ses, fatty liver disease, insulin resistancetrate in the buttocks, thighs and arms. and subsequent diabetes. This physical state is often more “All bodies are different. Some indi-common during middle age (after age 40), viduals have unique physical condi-when the body begins to age and change tions and genetic factors that shouldas a result of the biological conditions and be examined. Hips, buttocks, arms andphysical inactivity that are generally asso- legs are some areas where this fat isciated with this period of life. stored. Fat that is concentrated in these areas does not pose a health risk, A more a simple way of explaining yet concentrations of fat in the waistthis, is that as we age, our metabolism is and back area do,” Donado adds. Thisnot the same, just like our physical is because fat in the stomach areaappearance and cognitive ability. Eating surrounds vital internal organs such ashabits and exercise routines therefore the heart and the liver.become more important to maintaininga healthy figure and diet. Avoiding the consumption of fast foods with high contents of fat and refi-36

(The accumulation of fat ( )WITH YOUR BODY around the waistline contributes to the narrowing and hardening of the arteries, A FEW which does not happen with fat located DIFFERENCES around the hips. Hormonal changes often accele- rate increases in abdominal fat. After menopause (in women) and andropause (in men), the body produces less sex hormones. This change can lead to variations in how fat is stored. WHEN TO BE CONCERNED ABOUT BODY MEASUREMENTS Abdominal girth is an anthropometric measurement (a measure of body size) that determines how much fat is stored in the body. In women, this average measure- ment is 86 cm (34 in) and in men it is 92 cm (36 in). If a person’s waist is higher than this number, their fat con- tent needs to be checked. To take this measurement, the person should be in a standing position, and after exhaling, the measurement should be taken with a mea- suring tape at the level of the belly button. ¿ABDOMINAL OBESITY? ► Gynoid fat: fat that accumulates in the buttocks, thighs and arms. Occurs mostly in women. ► Abdominal or android fat: Fat that accumulates in the waist. Occurs mostly in men. 37





( )CON TU CUERPO Recommendation: 2 to 3 portions a day. Opt for low-fat foods. Good sources of calcium and protein. = =serving1 1 serving UCTS of yogurt of milk 200 cm2 DAIRY PROD Recommendation: Eat 3 servings PHEOALTRHYT I a week. They provide carbohydra- Eating a balanced tes, protein and iron. diet means knowing how to eat the right 60 g1 = =serving1 soup LEGUMES ladle amount of food. of beans of grains MEDICAL ADVISOR Recommendation: 3 portions a ÁNGELA FRANCO day.They are good sources of fiber, Nutritionistvitamins, minerals and antioxidants. 2 1 9serving of FRUITS LITERS OF WATER IS THE SUGGES-= =strawberries TED AVERAGE DAILY AMOUNT. THIS 161 g strawberries IS THE EQUIVALENT OF 110 g1 = = 1serving of EIGHT 8-OUNCE GLASSES. pineapple pineapple round 1 = = 1serving147 gorange of orange MEATS Recommendation: 1 to 2 portions a day They provide proteins, iron and vitamin B complex which help maintain muscle mass. 1 = = 5serving of meat 100 g pound of meat consists of 5 servings40

CON TU CUERPO ( )Receiving the orientation of a nutrition professional is key to when you must gain, lose or(maintain your weight, or when you must follow a strict diet if you have a specific disease. Recommendation: 6 to 10 portions a day.They provide carbohydrates, complex B vitamins, fiber and minerals (phosphorus, zinc and iron). 1 = 1serving of arepa STARCHES 1 = 3an arepa serving of crackersONS crackers Everyone has their own unique 1 = = 1potato dietary needs. Therefore, while 100 g equivalent to portion sizes are universal, they must be adapted as much as pos- the size of 1 tennis ball sible to the nutritional needs of each individual. In order for our bodies to 1 = 1serving function on a daily basis, it is essen- tial for the portions it receives to con- of pasta tain the nutrients it needs. The goal equivalent to the size is to have a balanced diet without of 1 large coffee mug exceeding an average of 2,000 calo- ries a day (this applies to healthy Recommendation: 5 to 6 portions of fat a adults). The following are some recommendations to better unders- day, which are often already incorporated tand this idea: in preparing your food. Fats are a good source of energy and help the body absorb vitamins A, D, E and K. 1 = = 9serving FATS 9g of peanuts peanuts 1 = = 7toasted 8g almonds almods 1 = = 1serving of margarine 5 g teaspoon EGETABLES There is no limitation to how 40 g many vegetables you can consume. OF ICE CREAM ISTHE RECOMMENDED SERVING SIZE, V The minimum portion size is equiva- WHICH IS ABOUT THE SIZE lent to the size of a mug. OF A TENNIS BALL. The recommendation is to have two servings a day. Vegetables provide vitamins, antioxidants, minerals, water and fiber. 41

WITH YOUR BODY( )grandparents MAKING MOVEMENT PART OF YOUR ROUTINE Exercise is a great support to have in old age, as it benefits the cardiorespiratory system and emotional health. Here are a few ways to make it a part of your daily routine.42

Síguenos en: WITH YOUR BODY ( )Comprometidos con tu salud MEDICAL ADVISOR agenda tu cita MARÍA FRANCISCA ECHEVERRI 411 24 21 - 315 502 9534 Geriatrician EXPERTOS EN LAS ÁREASAging does not have to be associated DE MEDICINA DEL EJERCICIO, with people who are crouched over, CARDIOLOGÍA Y NEUMOLOGÍA move slow, are frail in appearance, orwho bear its main characteristic: a lack of Consultas Especializadas Terapiasstrength. Geriatrician María FranciscaEcheverri states that “While we may have Cardiología FISIOTERAPIAvery healthy eating habits, but as we age, it is Medicina del Ejercicio Rehabilitación cardiacanatural for us to lose our muscle mass, and Neumología Rehabilitación Pulmonarfor our body to succumb to body fat. This Fisiatría Acondicionamiento Físicotakes energy away from us and prevents us Reumatologíafrom feeling good about ourselves.” The besttool for compensating for this sensation is Ayudas Diagnósticasphysical activity. Holter 24h Monitoreo de presión arterial Electrocardiograma As Echeverri explains, doing exercise Ecocardiografía doppler color Prueba de esfuerzo Espirometríamakes us move our bodies at a set pace and Ecocardiografía con administración de fármaco Caminata 6 mingives us the ability to go beyond the move-ments we normally do. “With this in mind, Contamos con personal altamentethere is no one exercise routine that the elder- calificado comprometido con tu saludly are prohibited from doing: they can all tryany type of training.” In addition to staying por tu bienestar ofrecemos unawell hydrated, exercise is an effective way to atención oportuna y personalizadamaintain your balance, improve your atten-tion span and memory, have good digestion Estamos ubicados en Laureles,and sleep peacefully at night. en la calle 33a #70a - 175FINDING OPPORTUNITIES TO EXERCISE www.cemde.comALL THE TIMEThe elderly can choose any location to putthemselves to the task, and can exercise athome, for example. “While you are organizingyour house, or while you shower…all of theseactivities get the body moving. In the comfortof your own living room, you can take abroom, hold it horizontally and twist yourtorso from side to side. An umbrella or canecan also be used to do this. I often recom-mend taking two empty water or pop bottlesand filling them with sand or beans. Thesecan turn into a pair of weights, which can 43

WITH YOUR BODY( )grandparents 150 MINUTES OF PHYSICAL ACTI- VITY A WEEK IS THE AMOUNT RECOMMENDED BY THE WHO. THESE EXERCISE ROUTINES CAN BEGIN AT HOME. increase arm strength…It’s about taking sed with an illness or are undergoing medical things one step further, being disciplined and treatment. “They can work out, unless they having a set routine,” states Echeverri. have been advised against doing so do due a lung or heart condition, in which case medi- Our geriatrician also states that another cal supervision is necessary,” states Echeverri. option is cardiovascular training, especia- lly swimming and water aerobics. Body movements can help the elderly “Whether its stretching, walking or jum- become much more independent. When ping in water: we recommend doing elderly people exercise on a daily basis, anything you can do in a pool.” this has shown to improve depressive states and feelings of melancholy, especially For those who are not used to doing exer- when they do it together with their peers. cise and are just beginning, María Francisca “This gives them a mental strength that is recommends doing slow movements, then increasing in intensity. This recommendation •ref lected in the body’s abilities and also applies to patients who have been diagno- energy,” she concludesOTHER ALTERNATIVES: YOGA, DANCING AND BOWLINGThere are alternatives out there that allow the elderly to move With yoga, Echeverri emphasizes that “It’s much more than justtheir bodies in a rhythmic way and stay strong while they learn a about meditating or holding a pose. Practicing yoga improvesnew hobby and meet new people, such as with dance and yoga, for balance, flexibility and brings oxygen to the body. It also includesexample. “Dance is a great way to improve rhythm and motricity. It breathing exercises that are very important.”improves orientation and precision and makes it possible for the Our expert states there are other activities out there, such aselderly to make finer movements. Because of the memory it requi- bowling. While a sport like this may be outdated, “It is actually ares, dance makes them use and train their memory. Ideally, elderly very relevant sport that requires a lot of upper body work, preci-people should dance for two hours a week,” states the geriatrician. sion and helps you calculate distances.”44

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WITH YOUR BODY A BALANCED( )xxxxxxxxx ORAL HYGIENE46 Overbrushing can bring undesired effects. Get a refresher on the basics of proper oral hygiene. MEDICAL ADVISOR CLARA ISABEL BORRERO GUTIÉRREZ Dentist, practitioner at Coomeva Private Healthcare When a dentist asks you how many times a day you brush your teeth, how do you usually respond? As children, we learn that it is essential to brush our teeth three times a day. As the years go by, however, these habits change: for some, this rule is not always followed carefully; while for others, brushing after eating any food turns into a necessity, exceeding the number of recommended times we should brush. Dentist Clara Isabel Borrero reminds us that the objective of brushing your teeth is to remove any remaining food par- ticles, “So, you can brush your teeth as often as five times a day if necessary, but the problem lies with the type of products we use and how much force we apply.” Keeping track of how well we brush is the- refore critical. Some people even take bet- ween 3 to 4 minutes to brush. As Borrero affirms, “Going over your teeth once with

( )WITH YOUR BODY for your smileyour toothbrush is enough to clean the important for patients to go to the dentistsurface of your teeth properly. Brushing and ask to receive a consultation on properfor too long or several times a day can brushing techniques. The dental professio-wear down tooth enamel and cause tooth nal will adjust the method to make sure itsensitivity, which in some cases can expo- fits the skills and needs of each patient.”se the dentine the layer of tooth underour tooth enamel.” As part of this process, what role does choosing the right toothbrush and too- The color of this layer of our tooth is thpaste play? As the dentist explains, thedifferent than that of the enamel. If the size of the brush and how hard its bristlespatient is trying to whiten their teeth, by are, is only important when the patient isoverbrushing, they are just going to make not able achieve proper oral hygiene.them more yellow. “By overbrushing, youwill not get the aesthetic affect you want to The opposite is true for when weachieve,” Borrero adds, who recommends choose toothpaste. We are often over-using a stopwatch to make sure you brush whelmed by the selection of products, weyour teeth and tongue for one minute. are impatient, want immediate results, and we often choose toothpastes that are This does not an excuse to brush your more complex. “There are toothpastesteeth just once or twice a day, however: that advertise that they can whiten your“Removing food particles from your teeth and provide you with long-lastingmouth is necessary. If you don’t do this, and fresh breath; but these often containyou run the risk of developing gum pro- abrasive, chemical ingredients that causeblems, cavities or halitosis.” tooth sensitivity in most patients. This is why your dentist should also help youFINDING WHAT WORKS FOR YOU choose the toothpaste that is right forIt is also important to understand that the you,” Borrero adds.method you use to brush is just as impor-tant as the time you spend doing it. How While there are certain guidelines towe use a toothbrush is similar to how we having proper oral hygiene, there is moreuse a pencil and is related to our motor than just one cause to having an oralskills. “People with greater motor skills are disease. As Borrero states, “There areable to make better movements and can other factors to be aware of that you mustreach areas that are difficult to access in the manage in order to achieve good oralmouth,” Borrero adds. This is why it is so •health such as diet, your environment, and hereditary factors”BEFORE AND AFTER YOU BRUSH► An essential part of brushing is to as plaque is the primary cause of cavi- the gums, control infections or reduce start by flossing first, and end with a ties and gum disease.” tooth sensitivity,” Borrero states. mouthwash. As Borrero explains, ► “As for mouthwashes, there are a ► Given this great variety, dentists should “Floss is the best way to fight bacterial variety of products available on the provide patients with recommendations plaque and keep bad breath under market, each which has a specific use. on what type of mouthwash is right for control. By flossing regularly, your Some are used to prevent cavities and their individual profile and needs. teeth and gums will be much healthier, there are others that used to protect 47

WITH YOUR BODY( )together Fatty liver disease is caused by an accumu- lation of fat in this organ. DIFFERENT LIVER 25 % Among other factors, CONDITIONS this disease is generally OF THE WORLD’S a result of high alcohol There are two main types of this disease: POPULATION IS AFFEC- use, increased calorie nonalcoholic fatty liver disease (NAFLD) TED BY THIS DISEASE, intake, obesity, and and alcoholic fatty liver disease. NAFLD ACCORDING TO THE cardiovascular risk. is classified into simple fatty liver (where U.S. NATIONAL LIBRARY OF MEDICINE. there is fat in the liver, but it does not cause inflammation or cell damage) and nonalcoholic steatohepatitis (which can TTY LEIVAESRE HAVING NUTRITIO- cause fibrosis, cirrhosis or liver cancer). FA IS NAL AWARENESS Alcoholic fatty liver disease, on the other D From a nutritional point of view, hand, is caused by heavy alcohol use. When alcohol is broken down in the body it produces harmful substances, producing swelling and weakening the body’s natural defenses. The stages following this process are alcoholic hepatitis and cirrhosis. most treatment is based on pre- venting people from being over-SYMPTOMS TO 3 weight and obese by maintaining aBE AWARE OF balanced diet; one that avoids a high calorie intake, especially calo-Discomfort in the upper right abdo- ries that come from saturated fats, simple carbohydrates (sugars) andmen can be a symptom of this disea- complex carbohydrates (starches).se, which is often silent. If you are SERVINGS A DAY IS THE Try to eat low fat dairy productsnot sure whether you have this con- RECOMMENDED AMOUNT and avoid sugary beverages,dition, your medical history, a physi- OF STARCHES PATIENTS energy drinks and alcoholic beve-cal exam and a blood test can help WHO HAVE THIS rages, which can affect liver func-make a diagnosis. Getting regular MEDICAL ADVISOR DISEASE SHOULD EAT. tion over time.exercise can help with weight loss DIANA PATRICIAand reduce fat that that has built up MONROY MARTÍNEZin the liver. Another helpful idea is to Nutritionist, practitionerencourage children from when they at Coomeva Privateare young to develop healthy Healthcarelifestyles that last until adulthood. ÓSCAR HERNÁN ROJAS SARMIENTO Internal Medicine Physician48

CON TU MUNDO( ))WITH YOUR WORLD 600 DIFFERENT GERMS, ON AVERAGE, IS THE NUMBER OF GERMS FOUND ON A CELL PHONE SCREEN. THIS FIGURE IS SIMILAR TO THE NUMBER OF GERMS FOUND ON KEYBOARDS, MOUSES, REMOTE CON- TROLS, TABLETS AND OTHER DEVICES. WHERE THE HIGHEST NUMBER OF GERMS ARE FOUND IN A HOUSE CAN BE OBVIOUS, BUT THERE ARE SOME OBJECTS WE FORGET ABOUT THAT SHOULD BE DISINFECTED. STAY CLEAN Toys are a common way for bacteria and viruses to be transmitted. They may live despite being stored for long periods of time and often end up in children’s mouths. CONCENTRATIONS OF GERMS Germs from the kitchen, food and cooking utensils end up on rags and sponges. Knowing how to clean these items properly is important. BEING CONSISTENT The handles or locks of doors, windows or balconies are some of the objects that are touched most throughout a day and must be clea- ned constantly. 49

CON TU MUNDO( )adúoIT TAKES TWO TO BUILD STRONGCOMMUNICATIONWhen a relationship is strong,both partners understand thatto live together peacefully, theymust first know themselves inorder to understand the other.MEDICAL ADVISOR CLAUDIA MARÍA MORENO GÓMEZ - Psychologist, practitioner at Coomeva Private HealthcareEvery relationship is a world in itself, there are no universal Claudia María Moreno asserts that when it is needed, therapy rules that work for everyone. In addition to developing can prevent conflict from getting worse and offers alternatives to your love for each other, it is also important to grow a solid managing conflict in different ways.foundation that is based on honesty, loyalty and respect.According to Claudia María Moreno Gómez, a psychologist with It is also important for each person to have clear expecta-a master’s degree in clinical and family psychology, in order for a tions about what it means to share a life together. “Onerelationship to stay strong, both must work as a team and always thing is to wait for my partner to solve my personal life, andfind a way to coordinate their different life goals. another is to have my partner support me as I grow. Those who think that other people are the solutions to their lives “You can’t say that relationships are not challenging; this is may have problems when it comes to respect, acceptanceimpossible given the human condition. You have to learn that and free will,” she adds.problems are what make this union stronger, and that this lear-ning process leads to a more harmonious life. It is also important UNDERSTANDING AND RESPECTto understand that differences are a vital part of a relationships There is no doubt that sexuality also plays a fundamental roleand are what fuel the uniqueness of each partner.” in relationships. This is about understanding that sex involves romance, playfulness, caressing, affection and a sense of In an article published by the U.S.-based newspaper The New renewal through experiencing different sensations. ForYork Times, John Gottman, a psychologist from New York, sustains Moreno, intimacy is not just about intercourse; while a certainthat there are four foundations to a relationship: sex, finances, degree of freedom should be allotted to sexual behavior, it iscommunication and humor. When one of these areas is lacking, important to understand what the other wants or expects.the couple should seek the support or counseling of a specialist.50