Salud Coomeva Magazine - August - september

COOMEVA MEDICINA PREPAGADA DESCUBRIENDO LOS SABORES DISCOVERING NEW FLAVORSISSN 1692 - 5556 Agosto - Septiembre 2018 - Edición 142www.revistasaludcoomeva.com 1



COOMEVA MEDICINA PREPAGADA DESCUBRIENDO LOS SABORES DISCOVERING NEW FLAVORSISSN 1692 - 5556 Agosto - Septiembre 2018 - Edición 142www.revistasaludcoomeva.comIssue 142 BREASTFEEDING:August - September 2018 A VITAL PRACTICERevista Salud Founder Breastfeeding is the biggest gift of type 2 diabetes and being overweight.Gilberto Lotero Muñoz (q.e.p.d.) love a mother can give to her At Coomeva Private Healthcare, we newborn. It is a vital practice that also support this practice and welcomeChairman of the Board helps form a bond that will last for the rest our enrollees and their families to beJosé Vicente Torres Osorio of their lives. The World Health familiar with it and its long-term bene- Organization suggests that infants should fits. We also believe it is important toExecutive President Of the breastfeed exclusively for their first six lead a healthy lifestyle including eatingCooperativo Coomeva Business Group months of life. After this point, safe and healthy, having good mental health andAlfredo Arana Velasco age-appropriate foods can be introduced, doing regular exercise starting in early but breastfeeding should continue until childhood. By doing this, people canCEO Coomeva Sector Salud they turn two as a way to ensure the change, modify or improve their routi-Gilberto Quinche Toro infant is getting the nutrients they need to nes to be healthier and to have a better grow and develop in a healthy way. quality of life, one that is passed on toPrepaid Medicine CEO Children that breastfeed during their first those you love most: because we knowJorge Alberto Zapata Builes 1,000 days of life are less likely to develop that Your Health and Loving Yourself go infections, allergies, and diseases such asNational Director of Strategy •hand in handand New BusinessMauricio Castillo Pérez Editorial and Graphic Direction, Magazine General Editor Journalists Commercialization prepress and printing Paula Andrea Montoya T. Isabel Vallejo Jiménez El ColombianoNational Director of Marketing El Colombiano Ana María López de Mesa Cali: Marisol MonsalveSector Salud Tel.: (4) 331 5252 Magazine Editor Natalia Ospina 310 544 2354Camilo Ernesto Diusaba Perdomo [email protected] Natalia Estefania Botero C. Liliana Klinkert [email protected] Graphic Editor Ingrid Cruz Bogotá: Ana María EchandíaGeneral Manager Hugo A. Vásquez E. Diana Milena Ramírez 3183764776Xiomara Iveth Campo Medellín: Mónica Gómez Design Photography 312 202 7269Editorial Committee Carolina Alzate Jiménez ShutterStock - Cortesía [email protected] Estrada Garcés Anabell Maya TorresNational Director of PrepaidHealthcare The contents of all Salud Coomeva Medicina Prepagada S.A. magazine articles are illustrative in nature and/or for general knowledge. In no case areHernán Darío Rodríguez 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,MEC National Director diagnosis or treatment of a disease or health problem without consulting with a certified physician.Blanca Inés Vélez 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 Director of Oral Health advertisers. Also, the company is not liable nor obligated to provide its affiliates the services, procedures or treatments described in the contents ofSandra Viviana Muñoz Rodríguez 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 plansDirector of Epidemiology and services. All rights reserved. May not be reproduced in any form or system. © 2018Bertha Lucía Varela RojasJefe Nacional Auditoría MédicaMartha Liliana CifuentesCoordinadora Nal. deRelacionamiento con PrestadoresJulián VillegasNational Chief of RiskManagement in HealthEditorXiomara Iveth CampoEditorial CoordinatorMelissa Arce PérezCollaboratorsMabel Irina CaleroAlexandra Arango RojasViviana Trujillo JiménezJairo BravoAlexandra JuradoGustavo Adolfo Daza

TABLE OF CONTENTSAugust - September 2018 7 27 49 66( ) ( )( ) ( )WITH YOUR BODY WITH YOUR WORLD WITH YOUR MIND CORPORATE8 For her 28 Keep in mind 50 Prevention 68 Prevention Source of There are always How to prevent Caring for your heart nourishment two sides to life obsessive thoughts to live a healthier life10 Little giants 32 For him 54 Harmony in health 70 Institutional Nutrition More spontaneous The benefits of yoga Sara, our virtual for life single parents for expecting mothers assistant18 Focus on 34 Go natural 58 Your generation 72 Campain Environmental Know your Choosing natural The ups and downs pollution lifestyle sugars, choosing right of a first relationship20 Prevention 36 Trends 60 Keep in mind 74 Directory Endometriosis, a Calories: Should we People who can put New providers hidden cause of be afraid of them? themselves in the menstrual pain position of another and updated 40 Grandparents22 For your smile Want to be a good 64 Games contact information Teeth: more than just caretaker? All you Crossword puzzle part of a nice smile need is love and sudokus24 Keep in mind 44 Infographic Angina: Crawling without A warning sign? limits





( )CON TU CUERPO )WITH YOUR BODY 48 HOURS AFTER THE INJURY IS THE PERIOD IN WHICH THE PERSON MAY EXPERIENCE A COMPLICATION.A HIT ON THE HEAD CAN DEVELOP INTO A SERIOUSSITUATION SUCH AS A SKULL FRACTURE, CONCUSSIONOR TRAUMATIC BRAIN INJURY.A SIGN THAT SOMETHING IS NOT RIGHT HELP AND TREATMENT SENSITIVE AREASSome common warning signs include a Once the injury occurs, check to see the The forehead and the scalp are areas thatloss of consciousness, disorientation, person is breathing, hold the person still, receive a strong supply of blood. This isdizziness, a loss of balance, repeated call an ambulance and pay attention to why injuries here cause bleeding that gene-vomiting and a severe headache. what else the patient might need. rally turns into bruising and inflammation. 7

WITH YOUR BODY( )for herA BOND THAT SERVESAS A SOURCE OFNOURISHMENTBreastfeeding exclusively during a child’sfirst six months of life can help ensure thatthey develop in a healthy way. ADVISORS 3 ADRIANA PATRICIA OSORNO GUTIÉRREZ Clinical Pediatric Nutritionist HOURS IS THE AVERAGE FRE- MANUEL ALONSO ALEJO RIVEROS QUENCY FOR BREASTFEEDING, AS Pediatrician THIS IS THE TIME FRAMEBabies that breastfeed receive all the THROUGH WHICH THE BABY nutrients they need and also bene- GOES THROUGH GASTRIC EMP- fit from their mother’s presence. TYING AND BECOMES HUN-Through breastfeeding mothers play a spe-cial role in their lives by forming a loving GRY AGAIN.and emotional bond that is critical totheir development process. Breastmilk has needs of each child. “The composition ofbeen proven to be one of the most com- breastmilk depends on the baby’s age, orplete and most complex forms of nourish- more specifically, on the stage of breastfe-ment that humans have access to. If it is eding each child is at. The breastmilk thatsuch a natural practice that is so benefi- a child receives when they are newborns iscial, however, why does it continue to be a not the same as the breastmilk they gettaboo? And why are there barriers to after they are five days or after a month;breastfeeding, especially in public? If all its composition is even different of thepeople promote this practice, it can be baby is premature.” Babies should besustained, helping to ensure that breastfed as they request it and without anewborns survive and have less chances of set schedule. As the child grows, they willdeveloping infections, allergies and chro- want to feed more and their greatestnic diseases. period of growth generally occurs in their first two years of life. According to Adriana Patricia Osorno,a nutritionist from the Pediatric Clinic at To better understand the “magic for-the San Vicente Foundation University mula” of breastmilk, the following is someHospital in Colombia, this form of information that all of society shouldnourishment adapts to the nutritional •know and share8

( )WITH YOUR BODY1 PROVIDES 4 QUENCHES NUTRIENTS THIRST Breastmilk always maintains the same When a baby breastfeeds, the first thing number of calories, proteins and fats; they receive is sugar water containing car- however, this depends on the mother’s bohydrates and lactose to quench their diet. Breastmilk is a stable form of thirst. As nutritionist Adriana Patricia nourishment in terms of its composition. Osorno explains, “This is why you should It adapts to the development of the not provide the child with other liquids. baby’s gastrointestinal system and in heal- When they finish breastfeeding, the child thy children, it ensures they are not over- has mainly received a good source of fat, nourished or undergo deficiencies. helping them to grow and develop, promo- ting their neural development and quen-2BUILDS THE IMMUNE SYSTEM 5ching their thirst.” HEALTHY Breastmilk contains antibodies that are not MOTHERS found in baby formula that protect babies’ immune systems. “The function of antibodies 5. While the quality and quantity of is to protect children from certain diseases breastmilk depends largely on the throughout their lives, which gives breastmilk mother’s diet, experts suggest that the an advantage over artificial milks. It is also mother maintain her diet similar to when beneficial to their neural development, the she was pregnant, including all the food development of their immune system and groups in order to meet her needs and their blood-forming organs,” states pediatri- ensure that she is producing milk. She cian Manuel Alonso Alejo Riveros. should lead a healthy, balanced, comple- te, and plentiful diet.3IT IS A 6 STIMULUS “SMART FOOD” AND QUANTITY3. To provide a baby with all it needs, 6. Producing enough breastmilk not only dependsit contains several different elements: on the total amount of liquid the mother drinks,whey proteins that aid in digestion but also on how often she breastfeeds.and in the absorption of nutrients; “Sometimes, in the first 24 to 48 hours, motherstaurine, which enhances the child’s produce very little, but their production increasesneurological development; iron, which on the third day. During this period, colostrum is– despite the low levels it contains – generally produced and the baby can be fed withallows for greater bioavailability and it, benefitting from its multiple properties. Theeasier absorption; essential fatty more often babies are placed on their mothers’acids; lactose (also in low levels); and breasts, the more a hormone is stimulated thatlipase to aid in digesting fats. makes the mother produce more breastmilk,” explains pediatrician Manuel Alonso Alejo. 9

WITH YOUR BODY( )little giants ALIMENTACIÓN PARA EL RESTO DE LA VIDA NUTRITION FOR LIFE

Con paciencia es posible integrar al pequeñoa las comidas familiares y así lograr que dé elsalto esperado hacia una nutrición completa.With a little patience and by including children infamily meals, children who are nursing can make thelong-awaited transition to a complete diet. ASESORA Después de los seis meses de vida, el At six months, a baby can sit upNELLY PATRICIA niño ya se sienta con apoyo, contro- with support and hold up their la su cabeza y cuello, tiene erupción head and neck, their teeth start CASTILLEJO dentaria y aparecen pericias tan importan- to come in and they master important PADILLA tes para su supervivencia como morder y basic survival skills such as biting and masticar. Es el momento de la vida preciso chewing. This age is the perfect time for Nutricionista para que sus padres lo introduzcan con parents to introduce children to the paciencia en el mundo de los alimentos y es world of food. It is also an opportunity ADVISOR la oportunidad para que ese ser conozca for them to become familiar with fla-NELLY PATRICIA sabores, texturas y olores, y asuma la auto- vors, textures and smells to gain the nomía necesaria a la hora de comer. independence they need to eat. CASTILLEJO PADILLA A los 182 días de nacido, el niño ya Once children hit the 182-day mark empieza a demandar otros complementos after they are born, they need other food Nutritionist nutricionales, más allá de la leche materna supplements besides breast milk or formu- o de fórmula, porque su carga energética la. They begin to gain more energy as they aumenta al tener más actividad física y start becoming more physically active and minerales como el hierro le son fundamen- receive minerals such as iron, both of tales para que su curva de desarrollo física y which are essential in order for their cerebral sea la esperada. “La leche materna bodies and brains to develop as expected. seguirá siendo importante, pero su consu- “Breast milk continues to be important, mo exclusivo ya es insuficiente a los seis but after six months of age, exclusively meses de nacido. Así que debe combinarse relying on it is not enough and it must be con otros nutrientes”, explica Nelly Patricia consumed with other foods,” explains Castillejo Padilla, nutricionista y docente Nelly Patricia Castillejo Padilla, nutritio- de la Universidad CES. nist and professor at Universidad CES. Poco a poco, carnes como pollo y pes- Little by little, you can begin to include cado e inclusive el huevo, el arroz, la papa meats such as chicken and fish in the y la yuca empiezan a integrar el menú del child’s diet and even eggs, rice, and pota- menor que, por recomendación de toes or yucca. Castillejo suggests not intro- Castillejo Padilla, no debe alejarse de lo ducing foods that are not a part of daily que a diario se come en su casa. “Los ali- household meals, “Food is a part of a mentos dependen de la cultura alimenta- family’s food culture, of their financial ria de la familia, de la capacidad adquisiti- situation and of where they live. All types va, de dónde viva, todos los alimentos son of foods are valid, and it is not worth it to válidos, y no vale la pena estresarse por stress out and buy specialty items that are

WITH YOUR BODY( )little giantscomprar cosas diferentes y especializadas, different than what the family eats. DE 6 A 8 MESESlos niños necesitan nutrientes, calidad; no Children need nutrients and quality, notmarcas”, agrega. brand names,” she adds. ► Se recomiendan: hígado de pollo, pescado y huevo para reforzar el hie- Lo ideal es que este proceso de adapta- Ideally, this process of adapting to the rro y evitar la anemia. Para cubrir lasción a la alimentación familiar esté super- family diet should be guided by parents or calorías, arroz, papa, avena, pastas,visado por los padres o acudientes, quie- caregivers who can involve the child in plátano y yuca, frutas de consistencianes podrán involucrar al pequeño cada eating habits with daily activities such as blanda como mango y y banano. Devez más en este hábito a través de situacio- eating breakfast, lunch or dinner together dos a tres raciones al día es suficien-nes tan cotidianas como desayunar, at the dinner table or in their highchairs te, el resto lo cubre la leche materna.almorzar o cenar juntos en el comedor; él while adults sit in theirs. The idea is to geten su silla y los adultos en las suyas. Se them interested in the example you set, so ► Cómo presentar los alimentos: atrata, de alguna manera, de enamorarlo that they eat in a natural way, allowing través de papillas espesas y alimen-con el ejemplo, para que se alimente de them to explore, play, add toppings to tos aplastados, no licuados, evitarmanera natural, permitiéndole que explo- their food and make decisions without uso del tetero. Involucrar al niño conre lo suficiente, juegue, se unte y elija sin being restricted. This is also an opportu- el uso de la taza, la cuchara, el plato.restricciones. Una oportunidad, también, nity for the family to share experiencespara que la familia intercambie experien- and learn how to eat in a healthy way. ► Beneficios: ejercita la masticación ycias y aprenda a comer de manera saluda- This is not just as a way to prevent being se estimula la erupción dentaria.ble, no solo para evitar el sobrepeso, sino overweight, this is a way to avoid diseasespatologías asociadas a largo plazo como that develop over time such as cancer, dia-cáncer, diabetes e hipertensión arterial. betes, and high blood pressure. FROM 6 TO 8 MONTHS ► Recommended foods: fish, eggs and chicken liver boost iron levels and pre- vent anemia. Sources of calories include rice, potatoes, oats, pasta, plantains and yucca; and soft fruits such as mangoes and bananas. Two to three servings a day of food is enough, the rest of their nutrients can be provided by breast milk. ► How to introduce foods: avoid using baby bottles by introducing blended or mashed food. Get the child involved by using cups, spoons and their dishes. ► Benefits: this allows them to chew and stimulates the eruption of teeth.

WITH YOUR BODY( )preventionENDOMETRIOSIS,A HIDDEN CAUSEOF MENSTRUAL PAINThis condition consists of thepresence of uterine tissue foundin other parts of the body.Following through with atreatment plan is important. ADVISORLUZ MARÍA CARVAJAL RESTREPO GynecologistWhile it may be asymptomatic common to any woman of childbearing treat the disease. The disease is then or silent, the warning signs of age, experienced by an estimated 2 to 10 diagnosed and classified in order to endometriosis include: inten- of every 100 women. determine what type of treatment shouldse, chronic pelvic pain, both in general be used to improve symptoms and pre-and especially during menstruation; “Endometriosis is diagnosed when vent it from progressing. Initially, hormo-painful intercourse, infertility, heavy endometrial tissue – the lining of the ne treatment is administered.periods, gastrointestinal issues and uterus – is found in different areas ofeven lung problems at its advanced sta- the uterine cavity, causing these areas to “The purpose of this treatment is toges. If these situations are not treated scar – fibrosis, when the tissues harden – temporarily stop menstruation throughon time, they can affect the quality of and adhesions. Its health implications combined oral contraceptives, oral proges-women’s lives. mainly include pelvic pain and inferti- terone (a hormone that counters estro- lity,” explains gynecologist, Luz María gen), or long-term contraceptive devices,” In this vein, clinical evidence shows Carvajal Restrepo. states Carvajal.that this disease is more common inwomen who have an obstructed uterus GETTING A MEDICAL If warning signs worsen, persist or theor cervix, heavy or frequent periods, or ASSESSMENT IS KEY woman has tried to become pregnant forwho have a family history of the disease. To diagnose the disease, a visual confir- over a year, a complete exam should beIt can also occur as a result of environ- mation is needed as well as a pathologi- performed with a gynecologist.mental factors related to high levels of cal study. This study is performedindustrialization, or because of hormo- through surgery, which usually consists Generally, symptoms disappear ornal reasons. This condition is also of an initial laparoscopy to explore and improve after menopause because the ova- ries stop producing estrogen, a female hor- •mone involved in causing the disease

DE 9 A 11 MESES 1 AÑO► Se recomiendan: los mismos alimentos, pero LA META en mayor cantidad, de 3 a 4 comidas al día. Lo mínimo es medio vaso o medio plato. En esta etapa, el niño tiene más dientes, por lo que la carne molida, por ejemplo,► Cómo presentar los alimentos: darles ali- puede ser más desmenuzada, los trozos mentos blandos y finamente picados, para más grandes, para finalmente incorporarlo que los agarre y juegue con ellos, evitar en los hábitos alimentarios familiares. los productos pequeños porque puede “Que coma de la misma olla”, dice la ahogarse. Incluir alimentos aplastados con nutricionista. Por esto es tan importante trozos más grandes de fruta, de carne o que la dieta familiar sea saludable. de papa para que se familiarice con lo sólido. Continuar con la lactancia comple- ta en la noche para que empiece a mane- jar su ciclo de sueño.► Beneficios: autonomía para compartir en la mesa familiar. FROM 9 TO 11 MONTHS 1 YEAR► Recommended foods: the same foods mentioned THE GOAL above are recommended, but in a greater quan- tity. A child should eat 3 to 4 meals a day, consis- The child has more teeth at this phase, ting of at least half a glass or half a plate of food. so it is okay for ground meat, for examp- le, to be finely grounded or served in lar-► How to introduce foods: give them soft foods ger pieces -including the child in the and food cut into small pieces, so they can grab family’s eating habits. “Let them eat what them with their hands and play with them. Stay you are eating,” the nutritionist says. This away from smaller foods that may choke them. is why it is so important for the family to Include mashed fruits with larger pieces of fruit, have a healthy diet. meat or potatoes so they become familiar with solids. Continue breastfeeding at night so they may begin to manage their sleep cycle.► Benefits: children can participate at the family dinner table independently.

WITH YOUR BODY( )little giantsPAUTAS ADECUADAS► Brindarle al niño porciones pequeñas, de esta ► Practicar pautas de higiene a la manera también se evita la obesidad. hora de preparar alimentos.► Establecer horarios de alimentación y no ► Evitar la comida chatarra. darle una comida tras otra. ► Ofrecerle primero verduras que frutas para► Si el menor no quiere comer, retirar el plato tras media hora evitar que las rechacen por su sabor. de espera y ofrecerle otro alimento tres horas después. ► A los 9 meses, iniciar con yogur y queso blanco.► Evitar el té, el café y las aromáticas, no son bebidas Darle leche de vaca, después del primer año. seguras hasta después de los dos años de edad. ► No premiar ni castigar al niño con la alimentación. ► Servir en platos de colores claros, para que lo que les► Incluir, en pequeñas cantidades, el azúcar y la sal hasta después del primer año. atraiga sean los alimentos y no los dibujos del plato. ► Propiciar un ambiente agradable a la hora de► No usar, hasta antes de los dos años, endulzantes artificiales, así como la miel. comer y evitar sustituir las comidas por un biberón. GUIDELINES ► Serve the child small portions, as ► Use good food hygiene practices this can help prevent obesity. when preparing meals. ► Establish an eating schedule ► Avoid junk foods. and do not give them one ► Offer children vegetables before meal after another. fruits to prevent the child from ► If the child does not want to eat, being turned off by their flavor. take the plate away from them after ► At 9 months, start with the yogurt 30 minutes of waiting and give and soft cheese. Only give them them a new food 3 hours later. cow’s milk after their first year. ► Do not reward or punish ► Avoid giving the child caffeinated the child with food. teas, coffee or herbal teas. ► Serve foods on light colored dishes These beverages are not safe so that they are attracted to the until after they turn two. food and not the images on the dish. ► Try to provide a comfortable envi- ► Include sugar and salt in small ronment when eating and avoid amounts only after they turn one. replacing food with a bottle. ► Do not use artificial sweeteners or honey before they turn two.

10% OF ALL CASESOF ENDOMETRIOSISARE PROGRESSIVE.CLASSIFIED KEEP IN MINDBY STAGES The word endometriosis comes from the word “endometrium.”The disease is classified into four stages Endo means “inner” and metrium means “womb,” where a babydepending on how compromised the organs develops inside the mother. Doctors commonly use the word “endo-are, and the extent and depth of the disea- metrium” to refer to the tissues that cover the lining of the uterus.se. There are also three variations:► Ovarian endometriosis: May be super- DOES IT CAUSE INFERTILITY? ficial or deep. Currently, due to their professions, occupations or various► Superficial (peritoneal) endometriosis: personal goals, women are trying to become pregnant at an increasingly older age, which can compromise the quality of Can be located on the tissue that their eggs and, as a result of this, the natural fertility process. covers organs. May also be superficial Endometriosis is a potential cause of this infertility due to or deep. how it distorts the pelvic anatomy. Its adhesions can affect► Adenomyosis: Is always deep and is the release of the ovum and how the fallopian tube receives the most serious type in terms of or passes the ovum. In such cases, surgical treatment is used symptoms and difficulty treating it. to try and recover the body’s reproductive function by elimi- nating the endometriosis sites and reconstituting the pelvic anatomy that has been affected.

¿SI HAY ALERGIAS? “Hay muchas alergias y mitos, pero tam- bién estudios que indican que entre más temprano se introduzcan los alimentos, menos alergias hay. No hay peso científico claro sobre el tema”, explica la nutricionis- ta. Es importante, sin embargo, que al introducir los nuevos alimentos se hagan uno por vez, esto para saber qué fue lo último que se comió en caso de que se presente una alergia, que puede desem- bocar en erupción cutánea, diarrea, dificul- tad para respirar (es el síntoma más grave y requiere de atención inmediata), rosá- cea, rasquiña o urticaria y vómito. Frente a cualquier señal, consultar al médico. También hay que tener en cuenta que las intolerancias pueden ocurrir por los aler-•genos de la tela, la almohada o la ropaWHAT IF THE CHILDHAS ALLERGIES?“While there are many allergies andmyths out there, there are also studiesthat indicate that the sooner you introdu-ce foods, the less chances there are forallergies. There is not clear scientific evi-dence about the issue,” the nutritionistexplains. It is important, however, to intro-duce new foods one at a time. This helpsidentify the last food the child ate in casethey do have an allergy. Allergies cancome in the form of skin rashes, diarrhea,shortness of breath (the most serioussymptom that requires immediate medicalattention), rosacea, itching or hives andvomiting. If any of these signs appear, youshould consult with your doctor. Is alsoimportant to remember that allergies cancome from the allergens found different•materials, pillows or clothes

WITH YOUR BODY( )together VIRUSES 10 If the symptoms of nasal AND NASAL allergies and common colds CONGESTION DAYS IS THE MAXIMUM do not improve after 10 days, DURATION OF A COLD. they can lead to an infection When you are sick with a virus, ANY PERIOD LONGER your nasal cavities and the lining THAN THIS MAY LEAD in the paranasal sinuses, a TO COMPLICATIONS. condition more commonly of your nose become inflamed, known as sinusitis. Diagnosing producing more nasal discharge this condition is not easy than normal. At first, this dis- because it requires being charge is clear and watery, but familiar with the symptoms. after a few days, it can become SINUSITIS PARANASAL thick and turn a yellow color INFECTION until it nears the end of conges- 5 When inflammation persists for tion and becomes clear again. longer than 10 days, the ope- Symptoms are at their worst bet- IS THE YOUNGEST ning of your paranasal sinuses AGE IN WHICH A PER- becomes blocked, which is why ween the third and fifth day. your nasal mucus becomes After this point, the severity of SON CAN DEVELOP trapped and bacteria, fungi or SINUSITIS, AS THE viruses begin to grow, causing symptoms should reduce. sinusitis. Patients may have a FRONTAL SINUSES DO fever for several days and mayEASY NOT DEVELOP UNTIL experience severe headachesTO TREAT THIS AGE. in the area behind or surroun- ding their eyes.To calm the headaches caused by sinu-sitis, use warm washcloths or cloths onthe face as well as painkillers or anti-inflammatories. Cold air humidifiersand saline solution nasal sprays canalso help reduce nasal congestion. Ifbacteria are the cause of sinusitis, yourphysician will prescribe you an oralantibiotic and provide you with treat-ment recommendations.SOURCEAMERICAN ACADEMY OF PEDIATRICS16

WITH YOUR BODY( )for your smileTEETH:MORE THAN JUST PART OF A NICE SMILEEach tooth has a different function. While thisfunction can be obvious, it also affects how we digest. ADVISORCLARA ISABEL BORRERO GUTIÉRREZ Dentist, practitioner at Coomeva Medicina PrepagadaEach tooth plays a different role. mouth needs all of these groups for them The incisors are found in the Instead of working independently to be well maintained,” Borrero states. front part of the mouth. There of each other, however, they are all are four above and four below,part of a system referred to as our oral It is therefore important to monitoranatomy. As dentist Clara Isabel Borrero whether they are performing the func- and as their name indicates,Gutiérrez explains, “This is a complex tion they are designed for, as poor teeth they are used for their sharpsystem that is classified into soft and can lead to digestive problems, problemshard tissues. Its soft tissues include the in the jawbone or chewing issues. and flat shape: to cut.tongue, cheeks, lips and the intraoralmucosa. The hard issues include the In order to prevent mouth or toothbones and the teeth.” pain, see your dentist for preventative care at least once a year. Practicing good Spread throughout the alveolar bone brushing habits and using dental floss(alveolar process), our 32 teeth are classi- are also important. Having good oralfied into four groups: molars, premolars, health is a practice that has a direct effectcanines and incisors. “Because of how on a person’s overall health, which willthey contribute to preparing the bolus, the not only help improve your smile, it will •make you smile more

( )WITH YOUR BODY 17

( )WITH YOUR BODY FOCUS ON ENVIRONMENTAL POLLUTION Poor air quality negatively affects the( )health of your eyes and skin and can lead to fertility problems. ADVISOR ANDRÉS PAREJA Professor and Lead Scientist at the In Vitro Toxicity Unit at CES University, Colombia For more information about environmental pollution, visit revistasaludcoomeva.com. Source: World Health Organization (WHO).18

a 1 b c 2 d ePARTS OFA TOOTH1. Crown. The external part where the 2. Root. The internal partfollowing layers are located: (inside the bone). It hasa. Enamel. Has a transparent tone. two layers:b. Dentin. This is what gives teeth color. d. Cementum.c. Pulp. The tooth’s blood vessels and e. Pulp.nerves, which make it a living structure. A little smaller than the The molars are the largest molars and located between teeth and are located the canines and the molars, the eight premolars are the towards the back of the teeth designed to shred what mouth, both on the right is inside the mouth. and left sides. They are responsible for grinding Canines perform the function of tearing and crushing food. There are twelveapart hard and fibrousfoods. This is the sma- in total, including the wisdom teeth. llest group, as it only includes four teeth.

( )WITH YOUR BODY focus onC onstant exposure to environmental pollution is a worrisome is particulate matter, which are the particles that health hazard. Taking measures to improve air qua- remain floating in the environment. Depending on their size, lity is one way of preventing future health problems they can enter the nose, larynx and bronchi, pass through thesuch as strokes, lung cancer, and chronic and acute lung walls of the lungs and reach the bloodstream,” explains Andrésdiseases such as asthma. Pareja, biology professor at CES University in Colombia. Some particulate matter comes from the combustion of petroleum, Air pollution is mainly related to the quantity of motor vehic- gas and carbon which may or may not cause irreversible damagele emissions and waste products produced by industries and such as fertility and genetic problems, or which over time, canhomes. “There is a wide variety of gaseous pollutants such asnitric oxide, sulfur compounds and heavy metals; the most •affect the eyes, airways, ears and body functions in generalSKIN PROTECTION 20The skin acts as a barrier to the environmental TIMES SMALLER, IS HOW MUCHaggressors it is exposed to from poor air quality. SMALLER PARTICULATE MATTERPoor air quality accelerates the skin’s biologicalage by increasing the production of free radicals CAN BE THAN YOUR PORES,that cause wrinkles and a lack of firmness. It is WHICH IS WHY IT CAN PENETRA-important to counteract the effects of this bywashing your face daily, using sunblock and eating TE THEM EASILY AND CUASEa balanced diet in order for your skin to receive THEM TO BECOME PLUGGED.the nutrients it needs. 79 %EYE HEALTH OF PARTICULATE MAT-The eye’s surface has direct contact with the TER EMISSIONS COMEenvironment. Eye irritations are therefore FROM THE BURNING OFcommon such as itching, stinging, dry eyes, irri- FOSSIL FUELS. MEDELLÍNtant conjunctivitis, intolerance to contact lenses, IS THE MOST POLLUTEDincreased allergy symptoms or an inflamed cor-nea. While you are outdoors, use eyedrops to CITY IN COLOMBIA,keep the eyes hydrated and use sunglasses that FOLLOWED BY BOGOTÁ.protect from UV rays. TAKE PRECAUTIONS 2 To prevent the effects of pollution: MILLION CHILDREN UNDER ► Use public transportation or carpool. AGE FIVE DIE FROM INDOOR ► When you go for walks, choose green spaces AND OUTDOOR AIR POLLU- TION, SECONDHAND SMOKE, that are removed from traffic. ► When you play sports outdoors, try to do so AND CONTAMINATED OR POOR WATER QUALITY, early in the morning. ACCORDING TO THE WHO. ► If possible – especially with children, the elderly and pregnant mothers – avoid polluted areas that are indicated on environmental risk maps. 19

10 % AMBIDEXTROUS to become right-handed. If this correction is made, the only thing it will lead to are ON AVERAGE, IS THE PERCEN- While the majority of people are behavioral problems; causing frustrations, TAGE OF LEFT-HANDED PEOP- born right-handed and a smaller damaging self-esteem and preventing the percentage are left-handed, there development of the child’s cognitive facul- LE IN THE WORLD. are also those who can develop ties,” Torres states. their laterality after they are born: Whether you are right or left-handed, just 1% of the world’s population. Parents can discover the laterality ofwith brain development, it is important to This population is referred to as their child when they are little by obser-respect the body’s laterality, both in order ambidextrous: people that are not ving their movements and by noticingto strengthen the skills a person may have classified into either category, but how they land their weight on one side oras well as to prevent disorders. rather have the ability to develop another. Whether they are right or left- either hemisphere. handed, becoming aware of this detail can “In my office, I still see some parents “When parents discover that their help children improve their skills and feelwho want help for their left-handed child child has the same strength in their right side as their left side, •happier as they grow or that they grab things or kick a ball with equal strength on both sides of their body, this means they are ambidextrous,” our psy- chologist explains. Torres adds that a child with this unique skill should receive support to determine the laterality they will have as well as to streng- then one of their hemispheres, as this condition can lead to ambigui- ties that make cognitive processes more difficult.

WITH YOUR BODY( )keep in mind 30 YEARS IS THE AGE IN WHICH MEN MAY BEGIN TO EXPERIEN- CE ANGINA PECTORIS.ANGINA:A WARNING SIGN?Not all chest pain means you have a heartproblem. To prevent a heart attack, knowingthe symptoms is key ADVISOR When the heart does not receiveSEBASTIÁN NARANJO enough blood, this lowers the amount of oxygen this muscle Cardiologist needs to operate correctly. As a result, this may produce the chest pain that is associa- ted with angina pectoris (commonly known as angina). The most common form of angina occurs because the heart has to work har- der than usual. This is not a threat to your health, it only requires rest and medica- tions prescribed by a specialist. Angina can also be the primary symptom of a heart attack, however. Those with cardio- vascular risk factors must therefore be aware of the following warning signs of a heart attack.

5 WARNINGS: TYPES OF ANGINA 1 A tight, burning STABLE or pain sensation in the chest. This is referred to as chronic angina. Its symptoms are almost always predictable 2 Pain that radiates to the and are not necessarily connected to the shoulder and left arm (can chance of having a heart attack. also occur in both arms, the stomach and back). ► What triggers it? It is often a response to a physical effort or 3 Pain that expands strong emotion that is as equally as intense. to the neck, jaw and throat. ► What does it feel like? Symptoms last between 1 and 15 minutes and4While they are not always noticed, tend to disappear after the stressor that cau- cold sweats, nausea or feelings of sed the angina has gone away. The pain is a weakness and confusion are war- response to a predictable action and is the nings of a heart attack. same every time it occurs. If symptoms change, get worse, do not impro-5 Difficulty breathing or shortness ve with rest, last longer than normal or if they of breath (these symptoms are return, this could be a sign of a heart attack. most common in older adults and women). UNSTABLE (SIGN OF A HEART ATTACK)(The main difference between angina pectoris and a heart attack is that heart This is the most dangerous type of angina as attack symptoms do not disappear after the the onset of symptoms is unpredictable and stressor that triggered it is gone. it can lead to a heart attack or cardiac arrest. ► What triggers it? It generally occurs as a result of a lack of oxygen to the heart, caused by the accumula- tion of fat along the arterial walls. ► What does it feel like? Unlike stable angina, unstable angina has no specific pattern. It can even occur when you are resting. The pain lasts for more than a few minutes or continually appears and disappears. If symptoms do not go away, even if the person rests; they may also have a difficult time breathing, have cold sweats, nausea or feel lightheaded. If you notice any of these warning signs, go to an emergency care facility immediately •or call 123 (the emergency telephone num- ber in Colombia)



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( )CON TU MUNDO )WITH YOUR WORLD IN ADDITION TO PROPER NUTRI- TION AND REGU- LAR EXERCISE, GETTING ENOUGH EXPOSURE TO NATURAL SUN- LIGHT CAN ALSO IMPROVE YOUR QUALITY OF LIFE. NOT ENOUGH EXPOSURE The consequences of not getting enough exposure to the sun include a reduced ability to fight viruses and vitamin deficiencies, which can lead to the onset of Alzheimer’s and dementia. AFFECTS MOOD It can also cause seasonal affective disorder (SAD), a condition related to depression that occurs when the weather changes. PROVIDES NUTRIENTS Spending a half-hour a day in the sun, two to three times a week, is enough to replenish the body with vitamin D, benefitting the health of the bones.10 % OF THE TIME THAT A PERSON IS AWAKE IS SPENT OUTDOORS, ACCORDING TO A STUDY FROM THE UNIVERSITY OF ALICANTE IN SPAIN. 27

WITH YOUR WORLD( )for himMORE SPONTANEOUSSINGLE PARENTSOne of the best approaches to being asingle parent is to allow the relationshipwith your child to flow, without beingafraid to ask for help when you need it. ADVISOR CLAUDIA MARÍA MORENO GÓMEZ Psychologist, practitioner at Coomeva Medicina PrepagadaWhen people talk about single parents, we tend to hear more about single mothers than aboutsingle fathers, and there are plenty of statisticsto demonstrate this. For example, 6 of every10 women in Colombia are the heads of theirhousehold. But one about men? There is noofficial report in Colombia that gives anaccount for single fathers in the country. Butit happens. Whatever the reason may be,fathers also must take on a parenting rolewithout the support of a partner. Accordingto psychologist Claudia María MorenoGómez, there should be no difference bet-ween women or men who suddenly find theymust take on this responsibility. “Fathers first tend to question howthey will replace the role of the mother,but more than anything, the most impor-tant thing is that they take on their ownprimary role. There are certain laws ofnature, such as love and understanding,that do not have to be expressed througha specific characteristic trait such as gen-der,” she states.32

WITH YOUR WORLD( )keep in mind If medicine had not developed so dras- tically over the last century, many pre- judices about certain attitudes or cha- racteristics of some people would conti- nue to grow deeper and damage lives. It wasn’t until just a few decades ago, that left-handed people were considered – even by their families – to be a population with a characteristic that needed correc- ting. This group of people, representing 10% of the world’s population, no longer suffers from this sort of “inquisition” against the natural manifestations of their bodies. Today, doctors even consider this group to be very gifted. While scientists are still studying why some humans are born right-handed and others left-handed, they have discovered THERE ARE ALWAYS TWO SIDES TO LIFE A person’s laterality – whether someone is born right-handed or left- handed – has a direct effect on their individual development. ADVISOR JULIANA TORRES UPEGUI Psychologist and clinical neuropsychologist

that they each have a different effect onhow the brain functions and on our neu-ral abilities. Dr. Juliana Torres Upegui, a clinicalneuropsychologist, explains that there areclear differences between right and left-handed people as a result of a phenome-non called cerebral laterality: the locationof certain functions in both hemispheresof the brain. “Functions such as motricity, cognitiveabilities, attention, and spatial localiza-tion, among others, are located in theright hemisphere; while memory, percep-tion, balance and language are located inthe left hemisphere,” she explains.GREY MATTERAccording to our expert, these functionsmake a left-handed person predisposed topossessing greater language skills, beingmore extroverted, having greater mathe-matical logic skills, as well as having morebalance and strength. A right-handed per-son, on the other hand, may have a grea-ter ability to develop artistic forms such aspainting and music, may have an easiertime controlling their emotions and they intelligence. “Grey matter is actually atend to be more introspective. substance where our neural activity takesAcknowledging these differences can aid place, which is responsible for processingin dominating a variety of areas in order for information. A left-handed person cana person to improve their talents and per- process information faster than a right-formance in different activities, or to help handed person,” she states.them choose certain jobs or professions.“When a person has a medical condi-tion, it is also important to consider theperson’s laterality to know how to developan occupational therapy plan through cli-From when they are little,nical neuropsychology,” Torres explains. Another brain characteristic that canaffect left-handed people’s predispositionto better develop certain activities is the(location of what is commonly known asgray matter, which is associated with our children can be encouraged to develop certain activities or talents, accounting for whether they are right or left-handed.

( )WITH YOUR WORLDWHAT IF I DIDN’T WANT TO BE A FATHER?For a variety of reasons, a person may have not chosen to be in a situation wherethey are a single father. However, once this stage is accepted and their role hasbeen taken, they will understand that being alone with this responsibility hasnothing to do with the temporary or permanent circumstances in which they live,and they will learn to value this state. The advice of Moreno is that a father IS IT THE SAME IFshould never take on the role of a mother THE CHILD IS Aor try to replace her natural abilities. The BOY OR GIRL?more spontaneous their actions are, thebetter the relationship will be with their Whatever their gender may be, thechildren. This helps prevent a situation relationship should be the same. Asfrom becoming burdensome and turning our psychologist recommends, ofout to be contrary to their intention, where course topics will arise involving theirtheir role is seen as an obligation and not physical growth and developmentfor what it truly is: an act of genuine, where the father-son relationship willfatherly love between a father and his child. flow better than the father-daughter relationship. In such cases, theDON’T GIVE INTO SOCIAL PRESSURE suggestion is to ask for parenting gui-Sometimes, single fathers are subject to delines, depending on the case.social pressures that encourage them totake on the role of the mother; this can be their children, being a single father mayproblematic, however. “If the person tries lead the father to want to establish ato fulfill those ideals, this is when the most friendship relationship with them; whilemistakes are made, as they will be preten- this isn’t a negative thing, they should notding to be something that does not come forget that their role continues to be thatnaturally to them,” the expert sustains. of someone who can guide and raise them, and set clear limits and rules. Moreno suggests not being afraid toask for help if you need it, as people often “As an adult, I am a source of guidancefind themselves in this situation unexpec- and development, so I must take on andtedly and it can therefore be difficult to maintain this role, providing my childget used to. Having a support system of with guidance at all times,” she adds.family members or of people who are Most importantly, affection should alwaysclose to you is therefore very important. be available to them, allowing emotional aspects to flow naturally for the good of “It’s not the same to be with somebody the relationship and for the future of thatelse who can share this responsibility withyou, as doing it alone. This can mark the •child and adultdifference when a man is surprised with anew situation.” Because of the trust they establish with 33

( )CON TU MUNDO CHOOSING NATURAL SUGARS, CHOOSING RIGHT Opt for foods Sugar is an important carbohydrate Gómez recommends reducing the exces- with unrefined that provides us with the energy we sive consumption of glucose, instead of sugar, watch the need for the day, it benefits the avoiding it. The World Health amount of sugar development of our brain function and Organization suggests needing no more you add to your aids in muscle contraction. In general, than 8 to 10 teaspoons of sugar a day, coffee and keep the majority of foods we include in our less than 10% of a person’s total calo- the desserts you diets have it, either naturally through ries: “This includes both added sugar eat under control. fruits – which are rich in fiber, water, vita- and when it is used as an ingredient,” mins and antioxidants – or through milk, Moreno states. ADVISOR a good source of essential proteins and SANDRO GÓMEZ minerals such as calcium. Sugar can also The National Cancer Institute indi- come in the form of added sugar through cates that a diet that is high in sugar Dietician boxed cereals, sodas, chocolate, ketchup, can lead to weight gain and contribute and candy. It is also commonly found in to cardiovascular risk. Some may then34 our diets, especially in the diets of ask what type of sugar is suggested: refi- Colombians: bread, rice, pasta, plantains, ned sugar, brown sugar, organic sugar potatoes and yucca. Together, these foods or panela (unrefined whole cane are a significant source of sugar. sugar)? With all of these options, they should be consumed in moderation. While it appears as though it may be Read on for a more detailed descrip- difficult to escape, dietitian Sandro •tion of these sugars

WITH YOUR WORLD( )grandparents WANT TO BE A GOOD CARETAKER? ALL YOU NEED IS LOVE Becoming informed and getting the support of an interdisciplinary team helps guide children to dealing with this stage of life. ADVISOR EDWIN ETAYO RUIZ, geriatrician and internal medicine doctorGenerally, parents are the ones who HOW HAS CARING FOR strictly monitoring the conditions care for, protect and meet the THE ELDERLY CHANGED? patients develop after they turn 35 that needs of their children. It is less “We come from a culture of nuclear fami- are highly prevalent and harmful to a per-common to hear people talk about what lies where people had a lot of children son’s health. With such conditions, chil-happens when the roles reverse: when and there was always one – often a woman dren should form a support network sochildren take care of their parents as they – left as the caretaker. With the phenome- the patient sticks to their treatment andage. While this transition can bring fear, non of changing demographics, lower leads a healthy life.”uncertainty and sometimes family con- birthrates, a greater elderly populationflict, educating yourself about this phase and a 77-year-old life expectancy in major WHAT SHOULD A CHILD BE AWARE OFis the best tool to dealing with it. cities, we now have families without chil- WHEN THEY BECOME A CARETAKER? dren or with just one or two who are res- “The key is to keep strong values of respect, For Edwin Etayo Ruiz, Director of the ponsible for caring for their elderly mem- gratitude, patience, and most importantly,Group for the Comprehensive bers without enough of a primary support love. Often times the love an elderly parentManagement of Chronic Diseases, how the network, such as close family members.” receives depends on how the parent was withelderly with some type of impairment are their child and on if they were a responsibletaken care of in Colombia is completely HOW SOON DOES THIS CARE START? father or mother. In our experience, we havebased on trial and error, “People don’t know “You don’t necessarily have to wait for an seen fathers who have been psychologically,how to prevent bedsores, dermatitis caused elderly person to develop a disability or sexually and physically abusive or who haveby using adult diapers or breathing food chronic disease for them to need the pro- had severe personality disorders; and wheninto the lungs; nor do they know how to tection of their family. Laying the founda- they get old, they ask for the love of theirtransport or move a patient. The children tion for their care begins early on. This is family. These cases are difficult for childrenand grandchildren that care for them learn called preventive geriatrics and is a pro- who have been abused, for example, to wanthow to do so by trial and error, but they cess that manages risk factors to prevent to care for their parent. While there areshould actually have a basic understanding disability or chronic disease that has nega- exceptions, when there is no love, the firstof how to treat them.” Below, Etayo answers tive health implications. This requires thing you have to do is identify the cause.”some questions about this stage of life:40

WITH YOUR WORLD ( ) )CON TgUo nMatUurNalDODIFFERENT TYPES OF SUGAR► Refined sugar: This is a pure ► Brown sugar: While it con- ► Organic sugar: Organic sugar ► Panela: This is the juice that comes sugar extract, more techni- tains more or less the same is produced without agro- from sugar cane that is crystallized cally referred to as sucrose. amount of calories, this chemicals as it does not use through an evaporation process. It does Refined sugar is a disaccha- type of sugar is less pro- certain fertilizers, pesticides not undergo any process to refine it, so ride consisting of two sugar cessed and refined than or antibiotics. Despite this while it still contains calories, it is one of cane molecules, one glucose white sugar, so it maintains production process, it con- the purest forms of sugar and is rich in and one fructose. Refined more nutrients. The diffe- tains the same amount of nutrients. Panela maintains its essential foods provide empty calo- rence is that it provides a calories as other sugars and minerals such as calcium, magnesium, ries, meaning they do not small amount of B vitamins its nutritional properties are iron, potassium and vitamins such as contain a proper amount of in addition to minerals such also identical. Organic sugar vitamins B1, B2, B3 and vitamin C. nutrients. This type of sugar as calcium, magnesium, producers must follow the When purchasing panela in Colombia, is usually found in pro- sodium and potassium, stipulations of an organiza- make sure it complies with Invima regu- cessed foods, which also which is why it is conside- tion that certifies its produc- lations, Colombia’s food and drug admi- contain many saturated fats: red healthier. Reducing tion complies with the nistration. Panela can be described as cakes, desserts and ice your consumption is also appropriate methods for not very sweet, not very clear, and its cream. recommended, however. organic certification. texture is not very grainy.KNOW HOW TO READ THE LABEL Honey is rich in► Balance. A product is high in sugar if it contains more than 15 g of sugar per 100 g of the product’s total weight. It is low if it con- sists of less than 5 g. For example, a container of packaged(applesauce can have about 14 g of sugar per 100 grams. antioxidants, fiber, minerals and vitamins that can serve as a sugar substitute because of its natural► Be informed. All words ending in -ose such as glucose, sucrose, processing conducted by bees.fructose, dextrose and maltose, have sugar.► Check. Read the ingredients list to see what type of sweetener ithas, if it is different from sugar. Generally, labels do not include apercentage, but the ingredients are ordered from highest tolowest in terms of their quantity in the product. For example, ifthe second ingredient in a beverage is sugar, you can expectthere to be a higher sugar content.► Differentiate. Light products are low in calories, but they are notalways sugar-free.► Learn. There are foods that say no added sugar on the label,which means that processed sugar did not get added to the pro-duct’s natural sugar. 35

WITH YOUR WORLD( )trendsCALORIES:SHOULD WE BEAFRAID OF THEM?Calories provide the body with energy,but too many can lead people to beoverweight or obese.ADVISORS ÁNGELA FRANCO, nutritionist 1 serving of whole-wheatCLARA LUCÍA VALDERRAMA ARZAYÚS, nutritionist and dietician bread: overTo a greater or lesser extent, almost all foods contain calo- 100 calories ries; the idea that it is possible for healthy food pro- ducts to be calorie-free, isn’t necessarily true. 1 serving of fruit:Calories are found in dairy products, legumes, fruits, 50 caloriesmeats, vegetables, fats, and starches. Keeping 1 handful of nuts:these foods in mind, the goal is to avoid over- 4 tablespoons 45 caloriesconsuming those foods that contribute of oats:too many calories such as saturated 89 caloriesfats and refined flours. As nutritio-nist Clara Lucía ValderramaArzayús indicate, “There is noneed to be afraid of calories.What we should do, is know whatthey have to offer and what function they 1 serving of vegetables: 27 caloriesserve. The three macronutrients of caloriesinclude proteins, fats and carbohydrates, whichare all part of a regular diet.”IN BALANCE 1 serving of granola: 1 cooked egg:As Ángela Franco states, nutritionist and dietician, “Thefunction of calories is to provide the body with energy. A lack 100 calories 155 caloriesof calories can cause malnutrition or leave people thin, withlow energy or too few nutrients. In excess, they can cause AVOIDING EXTREMESpeople to be overweight or obese.” Franco suggests that eachindividual get an assessment to determine how many calories Counting calories has become a trend, which is why many peoplethe person should consume, burn, and needs to be healthy: use this information to decide what foods to eat. When calculating“If I need 2,000 calories a day and I eat 3,000, the extra calo- these calories becomes an obsession, however, this can lead tories are stored in the body in the form of fat. If I need 2,000 eating disorders, which can range from not eating to eating toocalories and I consume 1,000, the body not only uses fat as a much, leaving out the essential nutrients you receive through food.source of energy, but muscle mass as well.” On average, adultsneed 2,000 calories a day, but this amount can be greater orlesser depending on the person’s height, age, physical activity,•body composition and dietary needs36

( )WITH YOUR WORLDWHAT ALTERNATIVES ARE THERE IF THECHILDREN CANNOT BE THE CARETAKERS?“While children are the primary supportnetwork, when they cannot take on the roleof a caretaker, they can resort to other net-works: people who are close to the familyyet are not related to the patient such asfriends, institutions, both, or even assistedliving care facilities.”HOW TO AVOID HAVING TO SAYYOU ARE “BURNED OUT?”“It is important to take an interdisciplinaryapproach managed by a geriatrician who canplan for problems the patient may have, poten-tial complications, what their care should looklike and that includes a way to distribute res-ponsibilities. The members of this team shouldmake a thorough assessment to ensure that allmedical, functional and mental health guideli-nes are being followed to help prevent careta-kers from getting burned out, as they often endup more ill than the patient. Pre-establishedbreak periods should be scheduled for eachday, week, month and throughout the year. 41

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WITH YOUR WORLD( )grandparentsSAY GOODBYETO BURNOUTAccording to the Spanish Society of Geriatricsand Gerontology, caretakers can implementthe following measures to help prepare forand prevent feeling overworked:► If you consider it appropriate, ask family members and friends to help with the caretaking or for support.► Look for external sources help that can provide additional psychological support such as consulting groups, at-home care, daytime adult assistance, food provision programs or substitute care.► If your loved one is hostile or difficult, do not take it personally.► Take care of your own physical, emotional, recreational, spiritual and financial needs.4 TIPS FOR TAKING CARE OF THE ELDERLY 1 1. It is best to have at least some 2 2. When a patient is having feelings of guilt basic knowledge about how to hand- or expresses the desire to die because le these types of patients. Not having they feel they are a burden, this must be this type of information, may lead the addressed with the doctor and help caretaker to unintentionally engage in should be sought to avoid complications poor practices. or unexpected events. 3. If the person cannot be cared for by 4. Identify any age-related physiological 3 their children or family members and 4 changes in order to ensure the patient gets must be left in the hands of someone the right treatment. For example, as with whom there is no kinship rela- humans age, our caloric intake lowers tionship, this person must be trained and we need less sleep. Recognizing and evaluated for their ability to provi- these changes helps prevent the use de care. This helps to prevent psycho- of any unnecessary medications or logical or physical abuse. •interventions42



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WITH YOUR WORLD( )infographicCRAWLINGWITHOUT LIMITSWhether babies crawl on their tummies, use just one leg, start atseven months, after a year, or if they never do it – whatever route theytake – none of these options indicate a problem. ADVISOR CAROLINA GÓMEZ Pediatrician WHAT YOU NEED TO KNOW 18 % How babies crawl is an option, not a must. While OF CHILDREN DO NOT CRAWL not all babies crawl the conventional way, all babies manage to find their own way to move around BEFORE THEY WALK ACCORDING before they walk. TO 2016 FIGURES FROM THE Different schools of thought have raised controversy by arguing whether the child’s psychomotor development SPANISH PRIMARY CARE may be affected if they do not crawl; however, pediatrician Carolina Gómez explains that “Recent developments that PEDIATRIC ASSOCIATION. are more respectful of the child’s development process occurring at their own pace are questioning this.” The child’s motor development largely depends on the stimulus they receive from their parents and through playful activities such as rocking, swinging and facilitating a jumping motion.Source of graphic: Scientific journal, “Developmental constraints ofquadrupedal coordination across crawling styles in human infants.” J Neurophysiol. 2012

IMPORTANT 3Mes They can bear the Using baby walkers can make crawlingMILESTONES weight of their head. more difficult, as this prevents them orFOR MOTOR doesn’t give them enough consistentDEVELOPMENT: 18Mes They begin to walk. opportunities to move about on their own. If these activities do not begin before these timelines, the child may be experiencing in a neurodevelopmental delay and a specia- list should be seen. CONVENTIONAL CRAWLING The baby gets on their hands and knees and moves their right hand forward as they move their left knee forward and alternates with their other side. BEAR CRAWL (HANDS AND FEET) Similar to the previous one, but instead of using their knees, they use their feet.HYBRIDThis is a mix of the two types of crawlingdescribed above. They move with one legstretched out and their weight on their foot,and the other leg is bent with their weighton their knee.BELLY CRAWLThe baby moves with their belly on thefloor, uses their hands to move andextends their legs. Some move on toanother type of crawling and othersstart to walk directly. BOTTOM SCOOTER While sitting, the baby bends their knees to move forward making small scooting movements by stretching out their legs again and starting at their initial position. ONE-HANDED CRAWL The baby starts by sitting on one leg and moves forward by putting their weight on their knee, then on the foot of the other leg and uses one hand to move forward and repeats this cycle.

WITH YOUR MIND( )preventionHOW TO PREVENTOBSESSIVETHOUGHTSWhen a person becomes distracted, ruminates orfantasizes, this can form mental habits that changehow a person thinks, preventing them from usingtheir ideas creatively. ADVISOR SUSANA CEBALLOS Psychologist

( )CON TU MUNDO WORKING TOGETHER AS A COUPLE IS POSSIBLE When a couple decides to work couples are business partners, is when there together at the same place, there are is mutual trust that allows them to believe in few tips to keep in mind in order for each other and good communication that both people to be successful at work. allows them to be productive colleagues. Each person in a relationship should recog- ADVISOR lly in order to not create differences among nize their own skills as well as those of the ILSE MARGARITA OROZCO them, treating their partner with the same other so that they can be best used by the expectations and respect as the others. To company. Another tip is to identify respon- Psychologist, practitioner preserve this type of working relationship, sibilities to be clear about who will be in at Coomeva Medicina Prepagada the partner should not ask for preferential charge of different activities and following treatment, and when he or she gains access through with them. This will allow them toW orking together does not have to to privileged information unintentionally be a proactive team and serves as a way for be problematic if both people are as a result of this connection, the partner them to constantly support each other so clear about the different roles they should maintain complete confidentiality. that both people continue to develop.play and respect the relationship each person Problems are growing opportunities thathas with their work, regardless of being in an If the couple has similar positions, the can be a benefit to the business. It is therefo-intimate relationship. This creates an oppor- recommendation is the same: to not con- re important to listen to each other andtunity to strengthen the bond they have with fuse work issues with relationship issues, understand why criticism arises in order toeach other and to share something that is and to respect the competencies and make it a constructive problem. A couplepart of two different areas of their lives, while duties that each person has in their job, should also keep each other’s interests, plea-avoiding mixing them together. acting as coworkers. sures and hobbies in mind in order to do them outside of work. Whether you take Psychologist Ilse Margarita Orozco OTHER ASPECTS vacations, do activities outdoors, go out towarns that when someone is a boss, they A structured relationship, especially when dinner, go to a movie or eat ice cream, formust treat all members of their team equa- example, it is important to continue doing activities both people enjoy where work mat- •ters are not mentioned46

( )CON TU MUNDO BEING BUSINESS PARTNERS TOGETHERIf a couple decides to start a business together or already hasone, the following recommendations may be helpful:► Make it legal. When you are going to start a business as a couple, it is important to make it legal through contracts, sche- dules, vacation time and by applying legally-mandated benefits to both people.► Plan. Organize the financial resources you have and keep the financial support you expect to have in a structured way so that the business does not negatively affect the family’s finances, but rather benefits from it.► Plan. Lay out the goals you have and how you will achieve them.► Work as a team. Both partners should act as team members where each is an important part of reaching the company’s goals. BE EFFICIENT AND HAVE FUNWorking together as a couple has its advantages, such as sha-ring a space and a job together with the person you love. Onceyou establish boundaries and makes mutual agreements, yourwork duties will function better and be more enjoyable.Providing mutual support to each other and respecting theresponsibilities that each person has helps make for a betterwork environment. 47

When you are falling in love, you DISTRACTION often hear the romantic expres- sion, “I think about you all the This is a mental state in whichtime!” However, someone that you obsess the person thinks aboutover on a day-to-day basis goes beyond something that is completelyliking or loving them, as over time, it can different than what they areharm a person’s emotional and physical doing, instead of being present.health. When people become distracted, It is when you lose your train ofruminate or fantasize, mental habits form thought about something youthat change how they think and limit would expect to be focusedthem from applying their ideas in a way on. As our minds become dis-that is creative, sustainable or useful for tracted, whether they are rightthemselves or others. or wrong, those thoughts that we are conscious of, are sha- According to Susana Ceballos, a psycho- ping our lives and taking con-therapist and mental health specialist that trol of our decisions.practices self-realization psychology,“Thought is an idea or mental representa-tion. We can have millions of ideas a dayand our bodies experience them in the formof energy. Someone that you obsess over issomeone that steals your cognitive energyand your potential to process the informa-tion in your head as best as possible.”KEEPING THINGS UNDER CONTROLFactors such as self-deprivation, denialand minimization are the pathwaysthrough which obsessions operate, mani-fest or stay. Self-deprivation is a mentaland emotional pattern in which the per-son suppresses feeling something in orderto avoid establishing the strong bondsthat lead to pain and suffering. Denial is a mental and emotional ten-dency of not acknowledging, whetherconsciously or unconsciously, thatsomething is there in order to manageand deal with it. Last, minimization canbe understood as cognitive economics,“…which isn’t a negative thing because itactually allows us to keep information to aminimum and make connections thathelps to process it better,” states Dr.Ceballos. Read on to learn more aboutwhat happens when we are distracted,ruminate or fantasize.

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