Revista Salud Coomeva

ISSN 1692 - 5556 Diciembre 2019 - Enero 2020 - Edición 150 ASEGURARLES UN BUEN SUEÑO 1 Make sure your children get a good night's sleep www.revistasaludcoomeva.co



ASEGURARLESISSN 1692 - 5556 Diciembre 2019 - Enero 2020 - Edición 150 UN BUEN SUEÑO QUALITY TIME Make sure your children get a good night's sleep Marco Montes Martínez www.revistasaludcoomeva.co General Manager of Coomeva Private Healthcare Issue 150 December 2019 - January 2020 There is a time to reap and a time human potential in others. Currently, to sow. There is a time to set according to the World Health Magazine Founder new goals and another to eva- Organization (WHO), more than 23% The late Gilberto Lotero Muñoz luate them. Christmas and New Year’s of adults and 80% of teens do not do season – a time to be with family and enough physical activity. In a state- Board of Directors to be thankful for all you have been ment released in July 2019, this orga- José Vicente Torres Osorio given – is also a good time to do nization indicated that not following checks and balances, and reorganize the current recommendations for Executive Chair of Grupo your priorities in order to make sure physical activity leads to 5 million Empresarial Cooperativo Coomeva the time you spend with others is qua- deaths worldwide every year, in all Alfredo Arana Velasco lity time. This can help you achieve age groups. This is a powerful figure greater balance and more fulfillment that can be reversed by doing small General Manager in your family life, life as a couple and activities daily as family. Therefore, on of the Coomeva Healthcare Sector in your self-care; and is also a sign of behalf of Coomeva Private Gilberto Quinche Toro having a good relationship with your- Healthcare and our initiative Cuidarte self, your body and your mind. es Quererte, we encourage you to General Manager of Coomeva Nankurunaisa is a beautiful Japanese make changes that have a greater Private Healthcare word that means “everything will work impact on those that surround us, on Marco Montes Martínez out in the end.” It refers to the ability our families and on ourselves. It is to live and act in the present moment time to take on old habits and move Camilo Ernesto Diusabá Perdomo without forgetting about the future. forward with the task of being healthy Department Manager of This is the season to learn from each and balanced. Merry Christmas and a Healthcare Sector Marketing life experience and see the good and •happy new year to all! Sandra Yanira Ocampo Sarmiento National Manager of the Editorial and graphic management, Macroeditora ECestudio. Journalists Advertising Human Resource Management prepress and printing Content Agency Laura Jaramillo Arango El Colombiano Healthcare Sector Andrea Lozano Cali: Marisol Monsalve El Colombiano Paula Andrea Montoya T. Ángel Orrego Arenas 310 544 2354 General Director of Tel.: (4) 331 5252 Editor Natalia Ospina Vélez [email protected] Revista Salud Coomeva [email protected] Andrés Velásquez Bogotá: Yulieth Acosta Galvis Xiomara Iveth Campo Natalia Estefania Botero C. Ingrid Cruz 315 479 7045 Graphic Editor Paola Cardona Medellín: Viviana Barrera Editorial Committee Diana Milena Ramírez 310 411 6018 Pascual Estrada Garcés Hugo A. Vásquez E. Photography [email protected] National Medical Director Design ShutterStock Blanca Inés Vélez Anabell Maya T. National Director of Oral Health Frank Jaramillo P. Diana Cristina Sánchez Ramírez National Customer Experience Director Bertha Varela Rojas National Director of Medical Audits Julián Villegas National Director of Health Risk Management Mabel Irina Calero Chief Brand Officer Martha Liliana Cifuentes National Coordinator of Provider Relationships Sandra Viviana Muñoz Rodríguez National Epidemiologist Contributions Marco Emilio Ocampo Ana María Correa Montaño Alexandra Arango Rojas Érika Ximena López Macías Juan Pablo Barba Castañeda Viviana Trujillo Jiménez Hugo Ricardo Campo Cardona Dyllan Camilo González El contenido de los artículos de la revista Salud Coomeva Medicina Prepagada S.A. está destinada a la ilustración y/o conocimiento general. En ningún caso deberá sustituir el asesoramiento o las indicaciones de un médico. El lector no podrá usar esa información para diagnosticar y/o realizar el análisis, diagnóstico o tratamiento de una enfermedad o problema de salud sin consultar a un médico certificado. Las ofertas de producto y servicio realizados en los avisos publicados en la revista Salud Coomeva Medicina Prepagada S.A. son responsabilidad exclusiva de los anunciantes . Así mismo, los contenidos de los artículos que describen servicios, porcedimientos o tratmientos que no estén incluidos en las coberturas que ofrece Coomeva Medicina Prepagada S.A. no obligan a la empresa a prestarlos a sus contratantes o a incluirlos dentro de cal- quiera de sus planes y servicios. Todos los derechos reservados. Prohibida la reproducción parcial o total bajo cualquier forma o sistema. © 2019

TABLE OF CONTENTS December 2019 - January 2020 q FOLLOW THE PATHWAY TO Cuidarte es quererte 7 27 51 73 ( )( )( ) ( )WITH YOUR MIND WITH YOUR BODY WITH YOUR WORLD CORPORATE 8 Couples 28 Harmony is health 52 Nutrition 74 Institutional Making a network Taking care of your For the love Coomeva Private of friends heart starts at the of chocolate Healthcare on the table road to growth 12 Harmony is health 56 Infography Pain: when the 32 For her Long flights without 76 Interact with us body talks Saying “Yes” to exerci- adverse effects Connect to our video se during your mens- channel 14 Little giants trual cycle 58 Prevention Sleeping is also Health starts with 78 Keep in mind a learned skill 38 Grandparents your shopping cart The importance Be fearless about of collagen 20 Focus on working out Vertigo 44 Foryoursmile 62 Keep in mind 80 Directory 22 Your generation Being there for the Don’t wait to feel pain Keeping track of your Our network teenage years to go to the dentist exercise routine of providers 4 46 Keep in mind 66 Trends 82 Institutional Fighting excessive Sharing a bed with Towards a digital sweating your baby and cultural trans- formation 48 For him 68 Go natural Gain muscle volume Celebrating a healthy the right way Christmas and New Year

5

¿NECESITAS VACUNAR A TU PELUDITO? HAZLO CON NOSOTROS Los programas Oro y Oro Plus de Coomeva Medicina Prepagada te brindan este beneficio y muchos más: Asistencia mascotas Para conocer más escanea el código QR: ORO ORO PLUS PLAN PLAN FECHA NACIMIENTO INICIA FECHA NACIMIENTO INICIA Cuidarte es Quererte CuidarteesQuererteOficial CuidarteesQuererteOficial Aplican condiciones. Servicio exclusivo para los Programas Oro y oro Plus.Asistencia con límite de eventos.

)WITH YOUR MIND ( )CON TU MENTE 5 MINUTES OF TAKING DEEP BREATHS, THREE TIMES A DAY, HELPS YOU FEEL YOUR BODY AND STIMULATES POSITIVE THOUGHTS. YOU CAN TRAIN YOUR MIND TO ACHIEVE GREATER WELL-BEING. FOSTERING POSITIVE THINKING CAN HELP. A CONSTANT FLOW GOOD THOUGHTS POSITIVE PERSONALITY A person has 12,000 to 60,000 thoughts a You can encourage yourself to have Some of the qualities of having a positive day, a good percentage of which are nega- good thoughts. Having an encouraging personality include tive or catastrophic. While these thoughts and positive talk with yourself is a admiring others, believing in others, forgi- are inevitable, they must be channeled off. start, as well as assessing negative per- ving quickly and having the ability to enjoy. ceptions in a rational way. Cuidarte es quererte 7

( )CON TU MENTE MAKING A NETWORK OF FRIENDS 8

(( )WCITOHNYOTUURMMENINTDE couples Besides having an intimate partner, there are several forms of company that can keep you happy. Developing these relationships, without reaching extremes, is key to leading a fulfilling life. ADVISORS LUCIO GONZÁLEZ ORTEGA - Psychiatrist, master’s in Psychoanalysis, practitioner at Coomeva Private Healthcare MARÍA VICTORIA ORREGO - Clinical psychologist, specialist in Neuropsychology, practitioner at Coomeva Private Healthcare At each stage of life, humans build It is about keeping the balance of love in emotional bonds that form net- equilibrium: you don’t have to reduce the works of people to discover, deal world to just one person, or be excessive and enjoy daily life with. While it is impor- and include thousands of people in your tant to foster all types of relationships, life, because in the end, affection is a finite some people focus all their attention on energy, and when you give all of yourself their partners, develop greater attachment away, this leads to emotional exhaustion to them and restrict the notion of having including voids and the thought of recei- others in their lives when they are around, ving less than what you give. so that when their partner is gone, they experience loneliness. HEALTHY TIES According to psychologist and specialist in The first step to preventing this neuropsychology María Victoria Orrego, feeling is to understand that you can be “Bonds are what keep motivation and happier and strengthen your emotional balance afloat with other aspects of life,” well-being by opening the doors to other which is why those who foster healthy rela- types of companions that can comple- tionships are more emotionally stable, they ment several aspects of life: friends, pets, tend to a resolve challenges assertively and co-workers and even yourself. are open to change. “When a person builds a broad social The clearest example of the benefits network full of different people, it is that relationships with friends can provide because they have made the decision to is, “…the neurotransmitters that are activa- share their love with several individuals. ted with friends that foster positivity and While some may receive more than help prevent anxiety and depression; these others, the key is consciously having seve- neurotransmitters also stimulate your ral supports to go to for any situation, memory and help people to live longer,” whether positive or negative. Mentally, Orrego states. This does not mean that this provides people with peace of mind they are the only crutch to be relied on as and security,” explains Lucio González social beings. There are other equally bene- Ortega, clinical psychologist. 9

( )CON TU MENTE ficial options, other than friends, that are OTHER FORMS OF COMPANY worth including as part of your lifestyle. For psychiatrist Ortega González, it is important to symbolize attachment and Pets are extraordinary companions, not deposit your love in those hobbies and only because they happily reciprocate the passions that allow the body to express love that they are given, but because of the itself freely. “From when you are little, it is changes they make in their owners – important to learn to love many things, getting them out of their routines with acti- whether it is a sport, an instrument or any vities such as going to the park, feeding other activity that – as you grow – beco- them and taking care of their health. Each mes another healthy bond that the person of these activities goes from being an obli- can rely on to take a load off and lift up gation to being an act of mutual support their positive emotions,” she states. where caring for them becomes an exchan- ge for bursts of immediate happiness, as In contrast, there is another type of when this happens, dopamine and seroto- company that is often not accounted for nin are activated in the brain, which are and that is the type of company that is clo- responsible for sparking feelings of happi- sest to you and is the most unconditional: ness. Compared to other types of interac- yourself. “Understanding that I am my tions, contact with animals is freer and own partner” is a process that requires when it comes to expressing emotion, they giving yourself the opportunity to be unleash them without any inhibitions. alone, to delve into your personal motiva- tions and discover your true self. These (Bonds are what keep are the times when your self-esteem rises, motivation and balance afloat everything is more enjoyable, and when you establish a solid foundation for dea- with other aspects of life. ling with a society of stereotypes. As Orrego puts it, “The idea is to begin to consider other forms of company as alter- natives and not as something you need. This is the base to having emotional •balance: being there for yourself.” 10

( )CON TU MENTE A NETWORK FOR HEALTH People who have stable and healthy supports in their lives: Produce less cortisol and 1 Therefore, better regulate their hormonal response to stress. 2 Easily activate the neurotransmitters that make them happy through the release of norepinephrine, which is associated with pleasure, fulfillment and peace of mind. Produce more dopamine, 3 which increases a person’s motivation, creativity and their feeling of well-being. 4 Have less health conditions such as diabetes, obesity and high blood pressure. 11

WITH YOUR MIND ( )harmony is health PAIN: WHEN THE BODY TALKS The beginning of this warning sign is worthy of attention. When it comes to treatment, you have to learn to identify whether it is chronic or acute. ADVISOR TIBERIO The manifestations of pain vary – it There are two types of pain: acute or ÁLVAREZ may tingle, itch, burn, cause dis- chronic. Acute pain occurs from one comfort and, often, it is inexplica- moment to the next and its cause is easy to Anesthesiologist and ble. The medical field is constantly detect and treat. Chronic pain occurs over Pain Relief specialist working so that both patients and doctors time and is not necessarily curable. learn how to identify, explain and treat it. “Among other causes, acute pain is cau- A single person may experience more sed by trauma, an injury, surgery, or a frac- or less intense, uncomfortable or unbea- ture, and is easier to treat. It does not cause rable pain throughout their life. This is as much depression as chronic pain and why each individual is said to have a generally, after correcting the cause that different pain threshold, which in short, produces it, there is hope for rapid reco- is “A measure of a person’s ability to very,” Dr. Álvarez Echeverri states. react to any stimulus. Everyone has a different threshold, which depends on In contrast, pain is considered to be many factors. Some patients may be weak chronic when it lasts for more than three because they have a chronic disease, and months without relief; such as the pain that generally have a low threshold,” says patients experience with cancer, tumors, anesthesiologist and pain relief specialist, arthritis or certain neurological diseases. Tiberio Álvarez Echeverri. Although the medical classification for pain In situations like those described generally includes “an unpleasant feeling” in above, the specialist explains that some both types, sometimes people who experience pain thresholds are so low that they are pain also go to the doctor’s office without an considered to be cases of hyperalgesia, explanation, which is commonly known as which is an extreme sensitivity to pain “psychological pain.” “Not finding the cause that reacts to any stimulus, including does not mean that the person should go touch with clothing, for example. without treatment. To relieve their pain, it is important to know about and offer different TYPES OF PAIN treatment programs,” says our anesthesiologist. When a person begins to feel pain, it is because the body is expressing that EXPLAIN AND FEEL THE PAIN something is not right, and it is important to Because pain is a warning sign, Álvarez learn to identify what causes it to know how to best explain it to a specialist. recommends getting a medical appoint- ment as soon as possible to determine the causes. “For some, as we know, waiting for 12

an appointment is not an option, it is an ( )WITH YOUR MIND urgent necessity.” www. Getting successful treatment depends on how the pain is explained during the soleecenfermeria appointment. It is therefore important to tell the truth, to try to clearly identify .com the type of feeling it creates and to iden- tify when it began. NSCueoernvsoitccriooess Answering all the doctor’s questions Programa de Hospitalización can help you identify the cause. “This is Domiciliaria (PHD) what is known in medicine as anamnesis, Programa Integral de Cuidado which is when the patient is questioned Domiciliario to gather information on when, where Cuidado y Acompañamiento and how the pain began. Verbal descrip- Hospitalario tors arise during these conversations that Centro de Cuidado del help narrow down what the cause may Adulto Mayor be,” explains the doctor. Procedimientos de Enfermería Terapias Domiciliarias Similarly, Dr. Álvarez reminds his colleagues of the importance of palpating Llámanos ahora and of treating the signs of pain that come from touch, such as with facial gestures 523 5883 and groans, among others. “With patients 310 759 7925 - 314 357 6541 who are in pain, you always have to be res- [email protected] pectful and understand that for each per- son that is in pain, there may be suffering, www.hogardepaso.c13om •anguish or fear” THROUGHOUT HISTORY While different civilizations throughout history have researched the understanding of pain and pain relief, this study began to take a greater role in the mid-1960s, when the first clinics for treating pain were crea- ted. “Between the 60s and 70s, what you could call a ‘silent revolution’ in pain relief began, which has evolved to the point where today we can now talk about this area as a specialty field,” says Dr. Álvarez Echeverri.

( )CON TU MENTE A DORMIR TAMBIÉN SE APRENDE Por salud física, mental y emocional, garantizar un buen sueño a los más pequeños es prioridad, especialmente en los primeros años de vida. ASESORES BLAIR ORTIZ GIRALDO - Pediatra y neurólogo infantil OLGA ROCÍO VÁSQUEZ GUERRERO - Pediatra, adscrita a Coomeva Medicina Prepagada Para los niños dormir es casi como Es importante saber que cada hora de 6 perderse todas las cosas que pasan o sueño de un niño debe ser de calidad para podrían pasar en el mundo exterior, que cumpla con sus funciones, lo que signi- AÑOS ES LA EDAD PROMEDIO pues su visión de vida está en el presente fica que debe dormir de manera ininte- EN QUE LAS SIESTAS y no en el futuro. Aquí comienza uno de rrumpida para que las fases se den en el los retos para los padres: garantizar un orden correspondiente. Estudios COMIENZAN A DESAPARECER buen sueño a sus hijos, como un pasapor- demuestran que un sueño óptimo tiene Y LAS HORAS DE SUEÑO te a una buena salud. impacto sobre el aprendizaje, la atención, NOCTURNO SON MÁS el humor y, por supuesto, el desarrollo. IMPORTANTES. Blair Ortiz Giraldo, neurólogo infantil y pediatra del Hospital Universitario San Las nuevas dinámicas y ritmos actuales Vicente Fundación de Medellín, explica de vida llevan a que se pierda poco a poco que mientras los niños duermen se sinte- esa cultura de buenos hábitos de sueño, tizan una serie de proteínas que permiten incluso en los más chicos. “La era tecnoló- restablecer funciones y recuperarse del gica, en la que hay pantallas por todos agotamiento causado durante la jornada lados, hace que los niños estén expuestos diurna. “Es en el sueño profundo donde a ellas a edades cada vez más tempranas. se da el aprendizaje de lo experimentado Todos los hábitos de sueño son aprendi- durante el día. Solo aumentamos de esta- dos a través del ejemplo de los padres. La tura en las primeras dos décadas de la vida falta de este hace que tengamos niños más y ese crecimiento es mayor en los primeros vulnerables a trastornos de comporta- años. En el sueño se libera la hormona del miento y aprendizaje, que tengan altera- crecimiento y otras que restablecen el ciones en el desempeño escolar y la con- equilibrio, entre ellas el cortisol, para que centración, porque es mientras duermen el cuerpo esté preparado para el estrés, cuando se da la consolidación de la hormonas que funcionan a nivel de órga- memoria, la maduración cerebral, la recu- nos sexuales internos y externos, otras que peración de la energía y de las funciones regulan el balance de iones, agua y azúcar biológicas”, señala la pediatra Olga Rocío en la sangre, por mencionar algunas”. Vásquez Guerrero. 14

(( )WICTHONYOTURMMENINTDE little giants SLEEPING IS ALSO 6 A LEARNED SKILL YEARS OLD IS THE AVERAGE For their physical, mental and AGE IN WHICH CHILDREN TEND emotional health, make a priority of your little ones getting good sleep, TO STOP NAPPING AND IS especially in their first years of life. WHEN THE TIME THEY SLEEP AT NIGHT BECOMES MORE IMPORTANT. ADVISORS BLAIR ORTIZ - Pediatrician and Pediatric Neurologist OLGA ROCÍO VÁSQUEZ - Pediatrician, practitioner at Coomeva Private Healthcare Because their perspective of life is regulate the balance of ions, water and set in the present and not in the our blood sugar, to name a few.” future, for children, going to sleep is almost like losing out on everything It is important to understand that that happens or could happen in the every hour of a child’s sleep must be outside world. This is one of the challen- quality for it to fulfill its functions, ges parents face, as making sure their which means that sleep must be uninte- children get good sleep, is like a passport rrupted so that its phases take place in to good health. the right order. Studies show that getting good sleep impacts how we learn, As pediatric neurologist and pediatri- our attention spam, our mood and, of cian at the San Vicente Fundación course, our development. University Hospital in Medellín, Blair Ortiz Giraldo explains, a series of pro- The latest dynamics and our current teins are synthesized while children pace of life are leading to a gradual loss of sleep, allowing them to restore different this culture of good sleep habits, even functions and recover from the exhaus- among children. “This era of technology tion they have accumulated from their where screens are everywhere exposes day. “Deep sleep is the period when you children to them at increasingly younger learn from what you have experienced ages. All sleep habits are learned from the during the day. We only grow in the first example set by parents. Not having these two decades of life, and that growth is sleep habits makes our children more sus- greatest in our first years of life. When ceptible to behavioral and learning disor- we sleep, we release growth hormones as ders, where problems with school perfor- well as other hormones that restore our mance and with concentration can occur balance – including cortisol – so that the – as sleeping is what strengthens our body is prepared for stress. These hormo- memory, allows our brain to mature, and nes function at the internal and external helps us to recover our energy and biolo- level of our sexual organs, while others gical functions,” says pediatrician Olga Rocío Vásquez Guerrero. 15

( )WITH YOUR MIND FORMAR HÁBITOS Está claro que los efectos de un mal dolores de cabeza, inseguridad, timidez, mal Es ideal no interrumpir el espacio de des- sueño se traducen en enfermedades que carácter y baja tolerancia a la frustración. canso, crear una buena higiene del sueño, aparecen con el tiempo. El Instituto de establecer una rutina para ir a la cama a Medicina del Sueño en España señala que, Vale la pena destacar que, en muchas la misma hora, incluso, los fines de sema- en el caso de los niños entre dos y cuatro ocasiones, los pequeños con problemas na. “A los cuatro meses, los niños ya años, dormir mal incrementa los síntomas de sueño son diagnosticados con déficit deben tener consolidada una rutina del de otitis, rinofaringitis y orina nocturna. de atención e hiperactividad, “lo que sueño”, sugiere la pediatra Vásquez. Aquí También se habla de déficit en el aprendiza- ocurre en esos casos es que como el niño algunas recomendaciones: je, el lenguaje, problemas de crecimiento, no está aprendiendo, se torna impulsivo • Los recién nacidos deben dormir mayor probabilidad de obesidad infantil, y lo que tiene de fondo es un gran pro- blema de sueño”, concluye Ortiz. siempre boca arriba para evitar el ries- go de muerte súbita. En los primeros (Está demostrado que el contacto con la luz de meses la cuna puede estar en la pantallas como tabletas o celulares, antes de ir a la misma habitación de los padres, cama, estropea el sueño y genera resistencia para ir a luego el consejo es que los recién dormir. Eso se conoce como insomnio conductual. nacidos duerman en espacios diferen- tes. “Hasta los tres meses de edad, el 17 12 riesgo de muerte súbita es alto. Cuando el bebé comienza a desarro- HORAS HORAS llar su estímulo motor y busca su pro- pia posición no se deben interrumpir 17 HOURS 12 HOURS sus movimientos normales”, explica la pediatra. 15 14 • Evitar que el bebé tenga actividades muy pesadas antes de llevarlo a la HORAS HORAS cama. La última alimentación debe ser liviana, cerca de tres horas antes. 15 HOURS 14 HOURS • Para los menores de un año que se levantan en la noche a comer, se reco- mienda que no sean los padres quienes los despierten, sino que sea el bebé quien interrumpa por sí mismo su sueño. Tampoco se aconseja acostum- brarlos a la alimentación nocturna. • Buscar ambientes sin luces tenues, pantallas o música de fondo. El niño debe dormir en espacios que sean lo más natural posible. Advierte Vásquez que, en menores de dos años las pantallas en las habitaciones están contraindicadas. • Descartar estímulos como películas con contenidos densos. “La hora del sueño no debe estar condicionada a actividades intensas o a programas de televisión, se pueden usar cuentos de contenido tranquilo”, aconseja Ortiz. 16

( )WITH YOUR MIND little giants FORM HABITS • Newborns should always sleep on age. When the baby begins to develop its motor skills and seeks out having Try not to interrupt their rest periods, their backs to avoid the risk of sudden its own position, its normal move- ments should not be interrupted,” our create good sleep hygiene practices and death. In their first months of life pediatrician explains. • Avoid doing very intense activities establish a routine for going to bed at the their crib can be in the same room as with your baby before putting them to sleep. Their last feeding should be same time, even on the weekends. “At four their parents. Afterwards, the recom- light, about three hours before bedti- me. months, children should already have an mendation is for newborns to sleep in • For those under age one who wake up at night to eat, the recommendation is established sleep routine,” Vásquez says. their own space. “The risk of sudden not for their parents to wake them up, but to let the baby be the one to inte- The following are some recommendations: death is higher up to three months of rrupt their sleep on their own. Night feeding is also not recommended. (It has been proven that contact with the • Seek out sleeping environments light from screens before going to bed, such as without any lights (even dim lights), tablets or cell phones, disrupts sleep and makes screens or background music. The people resistant to going to sleep. This is known as child should sleep in spaces that are as behavioral insomnia. natural as possible. Vásquez recom- mends against having screens in the 11 9 rooms of children under age two. • Eliminate stimuli such as movies with HORAS HORAS complex contents. “Do not let chil- dren get used to doing intense activi- 11 HOURS 9 HOURS ties or watching television programs at bedtime. Instead, read calming stories with them”, Ortiz advises. It is no secret that the effects of poor sleep lead to the gradual onset of diseases over time. As the Sleep Medicine Institute of Spain indicates, with children between ages two and four, poor sleep increases the symptoms of otitis, rhinopharyngitis and bedwetting. It is also associated with lear- ning, language and growth problems; a greater chance of childhood obesity; hea- daches; low self-esteem; shyness; a bad atti- tude; and a low tolerance to frustration. It is important to emphasize that chil- dren with sleep problems are often diag- nosed with attention deficit disorder and hyperactivity, “In these cases, because the child is not learning, they become impul- sive due to the main underlying issue: a sleep problem”, Ortiz states. 17

WCOITNH TYUOMURENMTIEND ( ))little giants CLAVES PARA UN THE KEYS TO GOOD SLEEP BUEN SUEÑO There is an expected number of hours children need to sleep, De acuerdo con la edad, los niños tienen un número estimado depending on their age. In their first two years of life, for examp- de horas para dormir. En los dos primeros años de vida, por le, babies spend more than 70 % of their time sleeping and the ejemplo, los bebés dedican más del 70 % de su tiempo a esta more they grow, the less time they spend sleeping. Experts función y a medida que crecen, las horas disminuyen. Al respec- recommend the following guidelines: to, los expertos dan una guía: ► Newborns: Newborns can sleep 17 hours a day, mostly intermi- ► Recién nacidos: pueden dormir 17 horas al día, la mayor parte ttently, for 2 to 6-hour periods. de manera discontinua en períodos de 2 a 6 horas. ► Infants: From 3 to 6 months of age, the amount of time they ► Lactantes: de los tres meses y hasta los seis, su tiempo de sleep is approximately 15 hours a day for 4 to 5-hour periods. sueño es de, aproximadamente, 15 horas diarias en lapsos de 4 a At six months, this decreases to about 14 hours, 12 of which are 5 horas. A los seis meses disminuye a cerca de 14 horas, 12 de at night with brief periods when they awaken and naps in the ellas en la noche con despertares breves y siesta en la mañana y morning and afternoon. en la tarde. ► 1 to 3 years: 13 to 14 hours per day, ► 1 a 3 años: de 13 a 14 horas por día, incluidas siestas. including naps. ► 4 a 5 años: de 10 a 13 horas diarias. En ciertos casos, la siesta tiende ► 4 to 5 years: 10 to 13 hours a day. In some cases, they stop a desaparecer, pues en esta época algunos están escolarizados. napping, as some children ► 6 a 12 años: De 10 a 12 horas diarias. go to school at this age. ► 13 a 18 años: De 8 a 10 horas diarias. ► 6 to 12 years: 10 to 12 hours a day. ► 13 to 18 years: 8 to 10 hours a day. ATENCIÓN A LAS SEÑALES Para saber si un niño duerme bien o no, además de las manifestaciones externas como ojeras y dormirse fácilmente en cualquier lugar, esté aten- to a la aparición de una o varias de estas señales: resistencia a la hora de levantarse, (este es un pro- ceso de no más de 10 minutos), que despierte malgeniado, sin energía, que esté desatento, irrita- •ble, exprese cansancio o haya atraso escolar PAY ATTENTION TO THE WARNING SIGNS In order to know whether a child is sleeping well or not, in addition to their external manifestations such as bags under their eyes or falling asleep easily anywhere, look out for one or several of the following warning signs: being resistant to waking up (if it takes longer than 10 minutes), waking up in a bad mood, having low energy, being distrac- •ted or irritable, hearing statements that they are tired, or being behind in school 18

( )CON TU MENTE 19

( )WITH YOUR MIND FOCUS ON VERTIGOThe onset of vertigo can come alone or come with dizziness, instability, lightheadedness, disorientation or blurred vision. Read on to ( )learn more about this condition. ADVISORS JOSÉ MARIO JALIL HINCAPIÉ - Ear, Nose and Throat (ENT) doctor, practitioner at Coomeva Private Healthcare VERÓNICA RODRÍGUEZ RIVERA - Ear, Nose and Throat (ENT) doctor, specialist in Otoneurology Learn more about vertigo at Revistasaludcoomeva.com. 20

( )WITH YOUR MIND focus Balance is a bodily function that involves organs such as itself is not a disease, it is a symptom that gives you the hallu- the brain, cerebellum, the posterior columns of the spi- cinatory sense that your surroundings, or you yourself, are nal cord, the eyes and the inner ear. When any of these moving. As ear, nose and throat doctor Verónica Rodríguez parts of the body are compromised, this can affect how the explains, “The person feels they are constantly spinning, simi- body functions, manifesting in symptoms such as vertigo, dizzi- lar to how a roulette wheel, carousel or blender spins, or some- ness and instability. It is important to emphasize that vertigo •times it presents as a zigzag feeling” OTHER SENSATIONS 2 According to Robert B. Daroff in IS THE NUMBER OF TYPES OF VER- Harrison’s Manual of Medicine, from a TIGO THERE ARE: PERIPHERAL functional point of view, the dizziness AND CENTRAL VERTIGO. THE that comes with a mobility condition is classified into three categories: faint- FIRST IS A CONDITION OF THE VES- ness, vertigo and feeling different sen- TIBULAR SYSTEM, WHICH IS WHAT sations in the head. HELPS SPATIAL ORIENTATION AND POSTURE. THE SECOND IS DUE TO A BRAIN CONDITION. TAKE PRECAUTIONS 80 % If you suffer from vertigo, avoid accidents: OF THE POPULATION HAS 1. Ask your doctor if you can drive. HAD AN EPISODE OF VERTIGO 2. Avoid walking in the dark. 3. Do not wear shoes with heels. If neces- IN THEIR LIFE, ACCORDING sary, use a cane. TO THE SPANISH 4. If there are stairs in your house, put rai- lings or handrails on. OTOLARYNGOLOGY SOCIETY. 80 WHEN TO TAKE MEDICATION IS THE AGE IN WHICH THE PREVALENCE OF Ear, nose and throat doctor José Jalil Hincapié VERTIGO INCREASES. explains that vestibular suppressant medications, which fight vertigo and dizziness, can negatively affect the balance of the ear system if used for a prolonged amount of time, so they should only be prescribed by a specialist. If you experience any discomfort, it is important to see your doctor. 21

( )CON TU MENTE ADVISOR OMAR SALAZAR - Psychiatrist BEING THERE FOR Although adolescence is a THE TEENAGE phase marked by uncertainty, YEARS due to the changes it brings and because everything seems to go Accepting change faster, having the right strategies to and being support young people in this process understanding are can make this journey towards adul- factors that are thood more enjoyable. helpful to young people at this According to the psychiatrist Omar stage of life. Salazar, the first key to supporting them is to avoid being quick to judge them and to break down the myths about them. “Teenagers are said to be difficult or rebellious, but in reality, most of them adjust well and have a good relationship with their parents.” However, we must bear in mind that during this stage, changes occur that can cause some emotional instabi- lity, most of which corresponds to the hormonal influence that comes with 22

(( )WCITOHNYOTUURMMENINTDE your generation puberty. “In women, estrogen increa- CHOOSING YOUR BATTLES my appointments, for example, I ses the likelihood of having anxiety, Our psychiatrist also suggests knowing recommend parents read a lot about entering a depressive crisis or expe- what battles to choose in order to avoid adolescence so they can understand riencing emotional instability, especia- constant confrontation. Also, try to be what this stage is about. The better lly before menstruation. And the tes- more flexible about certain rules, remem- prepared they are, the more these tosterone in men can cause an increa- bering that a teenager can no longer be changes will not take them by surpri- se in aggressiveness, but these changes treated like a child. “You have to avoid se,” Salazar affirms. do not imply very serious changes in being too strict. You can’t clash with them behavior,” our psychiatrist states. all the time because they have a messy FORMING HABITS room or because they use the slang that Preparing to go through adolescence In response to these situations, young people use, for example, because with your children does not start just another strategy that works in dea- that’s how they talk and it’s normal. It’s when they begin to experience the ling with adolescents is tolerance. okay to demand respect at home, but transitions of this stage. More effective When there is a greater capacity for don’t fight with them.” support is truly achieved when habits understanding, emotional instability are formed from childhood, such as will not affect home life and it can Other areas where you can give in a litt- being disciplined and responsible. be managed on a daily basis. le is with bedtime and mealtimes, especia- lly because with these changes, sometimes “During this pre-adolescent period, “When conflict involves physical their appetite goes away or they may be in it’s important to encourage indepen- aggression, a communication brea- a bad mood, “One thing not to tolerate is dence and autonomy. They should kdown, a very difficult home life, the consumption of drugs and alcohol,” take on responsibilities that are appro- poor academic performance, or our psychiatrist states. priate for their age and have obliga- when the teen struggles with social tions and commitments at home so adaptation, it is time to seek the Similarly, in order to understand boys that when adolescence hits, they are advice of a professional. However, in who are going through adolescence, it is already quite independent,” Dr. general terms, these behaviors are helpful to learn about and be familiar with Salazar explains. By them being inde- not serious,” Salazar states. the characteristics of this stage of life. “At 23

( )CON TU MENTE pendent, parents can slowly give freedom to UNDERSTAND EACH STAGE them and adapt their rules for discipline accor- ding to the stage they are at. According to the specialist, adolescence – which is the process of changes between childhood and young adul- AGREEMENTS thood – has three stages to it: During adolescence, the desire to socialize also increases. It is therefore necessary for there to be 1 Early adolescence: Physical changes that manifest first in agreements between the parents or adults responsi- women. This stage occurs between ages 12 and 14 ble for giving them permission to go out, “It’s about negotiating what gatherings they are allowed Middle adolescence: Psychological changes are common to attend and until what time,” Salazar states. 2 during this stage, such as having existential-like attitudes, sear- It is important to be prepared for the begin- ning of emotional relationships and to foster ching for an identity, being somewhat rebellious, taking a marked good communication and sex education, “This interest in socializing, establishing social groups and wanting to will allow young people to make sound deci- belong to others. This stage occurs between ages 14 and 16. sions about their sexuality. And when the teen states that they are sexually active, or when the Late adolescence: This stage comes with social changes, parents suspect it, it is important to make the appropriate contraceptive methods available to 3 such as seeking out a vocation, finishing high school, begin- them,” our doctor affirms. ning to work or going to college, among others. It occurs While the characteristics of today’s teenagers after age 16, but the line between this stage and young make them different from previous generations, adulthood is blurry. giving them support is easier from a place of love and understanding. “They are not better or worse than adults, they are just different,” con- •cludes Dr. Salazar 24

( )CON TU MENTE 25

WITH YOUR MIND ( )trends KNOW MORE MENTAL HEALTH EDUCATION IN AT WORK EMOTIONAL According to the Pan American INTELLIGENCE Health Organization (PAHO), approximately one in five people ► In addition to intellect, there are other have mental health problems at types of intelligence such as emotional work, such as depression, stress intelligence, which helps build strong and anxiety. Sometimes stigmas and relationships, make good decisions and a lack of information prevent timely deal with challenges. To develop this treatment. PAHO identifies mental intelligence, the Nemours Foundation, health-friendly workplaces as those which focuses a section of its that value diversity, promote poli- educational content on parents, cies and programs for physical and recommends the following: mental health, and that offer trai- nings on related topics. The annual ► Be more aware of your emotions and global cost of mental health pro- recognize your own feelings as they arise. blems is estimated at $2.5 billion dollars, and by 2030, they are ► Try to understand others. Empathy is the expected to reach $6 billion. ability to form bonds and good relationships. 20 % ► Keep your emotional reactions under OF SMARTPHONE USERS SPEND 4.5 control, which means knowing when, HOURS A DAY ON THEIR PHONES, where and how to express yourself, in the ACCORDING TO DATA FROM THE best way possible. APP RESCUETIME. ► Try to decide what the most appropriate mood is for a given situation. BEING ADDICTED TO MORE SELF-CONFIDENCE YOUR PHONE LEADS (KEEP IN MIND) TO STRESS The magazine PLOS One published a study conducted by several British univer- To help your teen deal with “The compulsive use of cell phones can make sities that found a relationship between anxiety, try to have constant, you have less friends and more stress,” says self-esteem and having relationships with Antonio Hidalgo, professor at the Higher others. In the study, people who were open and honest Technical School of Industrial Engineering overconfident showed a tendency to be communication with them. UPM and one of the authors of a paper more generous in their assessment of the published in the magazine Social Science rest of the participants. Computer Review, in a summary made by the Sinc agency. More than 400 people were followed for a year for the study, and its con- clusions indicated that the addiction to technology promotes social isolation. 26

)WITH YOUR BODY ( )CON TU CUERPO 190 LITERS OF BLOOD ARE HOW MANY LITERS THE KIDNEYS PROCESS A DAY, ACCORDING TO THE NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES. AS CLEANING MACHINES, THE KIDNEYS ARE ABLE TO REMOVE ABOUT TWO LITERS OF WASTE AND WATER FROM THE BLOODSTREAM A DAY, WHICH IS MADE INTO URINE. KIDNEY FUNCTION BASIC CARE WATCH OUT FOR KIDNEY STONES This refers to how efficiently these The urinary system depends on the pro- While kidney stones are associated with organs filter the blood. The kidneys can per functioning of the kidneys, so it is genetic and environmental factors, peop- be compromised by congenital condi- important to take care of them by drin- le with diets that are high in salt and low tions, or by conditions such as diabetes king enough water, getting exercise and in liquids are more susceptible to them. or high blood pressure. leading a balanced diet. Cuidarte es quererte 27

WCOITNH TYUOCUUREBROPDOY ( )harmony is health TAKING CARE OF YOUR HEART STARTS AT THE TABLE Choosing the food that goes on your plate and having good alternatives to season foods is key. ADVISORS LINA MARCELA LÓPEZ Nutritionist and dietitian SANDRO GÓMEZ Nutritionist A broken heart doesn’t only come from heartbreak. What is pleasing to the palate can harm it, weaken it and even put it at risk. For a long time, it has been said that we are what we eat; but being smart about what we put on our plate requires knowledge and resourcefulness. According to Lina Marcela López Gómez, a nutritionist and dietitian, about 50% of all cardiovascular disease can be prevented by making changes to our diet. To do so, it is important to eat certain foods in moderation, know what the pro- perties of different foods are and opt for eating non-processed foods. LEARN TO MAKE CHANGES There are many ways to achieve this. According to the WHO, the strategy with sodium is to reduce your consump- tion of preserved foods, and use condi- ments that are low in sodium in order to replace the need for salt. The suggestion is to try using pepper, paprika, mint, nutmeg, garlic, lemon, rosemary, thyme, oregano, bay leaves, vinegar or cinna- mon, to name a few. As our nutritionist states, lowering your sodium intake can prevent high blood pressure in about 20% of people who are at a higher risk of it and can 28

also reduce your need to use medications ( )CON TU CUERPO for high blood pressure for people who have a high cardiovascular risk. 29 As for fats and ultra-processed foods, there are several alternatives. With fats, consuming oily fish regularly (such as sal- mon), reducing your intake of red meats, and increasing your intake of chicken, for example, are good places to start. The same goes for olive oil, which accor- ding to our nutritionist Sandro Gómez Maquet, is recommended “…for sautéing foods or for using it as a salad dressing. The key is to not bring it to high temperatures in order to preserve its properties.” As for foods made with processed ingre- dients, the solution is simple: go natural. The reason for this is because these ingredients often contain substances such as starches, sugars, oils, salt and some food additives. These ingredients can raise your cholesterol, your blood pressure and contribute to insulin resistance, which increases your risk for the onset of diabetes. What are ultra-processed foods? These include products like packaged snacks, cer- tain breakfast cereals, granola bars, energy drinks, instant soups, bouillon cubes, pro- cessed meats, ready-made pizzas and packa- ged baby food. When it comes to sugar, the best alternati- ve is fructose, which comes directly from fruit itself. The sugar that comes in soft drinks, fruit juices and certain candies can be harmful to your health, increasing triglyceri- des, cholesterol, uric acid and blood pressure. Learning how to read the labels is important when it comes to making the right decisions at the supermarket.

WCOITNH TYUOCUUREBROPDOY ( )harmony is health A SMART EATING PLAN According to the nutritionist Sandro Gómez Maquet, the American Heart Association suggests a plan known as the DASH plan, which is an eating plan to lower high blood pressure and cho- lesterol, decrease the risk of having a heart attack and, of course, lose weight. “It’s based on eating fiber – which means fruits and vegetables – reducing your fat intake, choosing lean meats, and reducing your intake of fried foods and your portion sizes.” According to the U.S. National Library of Medicine, the DASH diet involves consuming a lot of vegetables, fruits and non-fat or low- fat dairy products; eating whole grains, fish, poultry and lean meats; reducing your intake of salt, red meat, candy and sugary drinks; and reducing or avoiding alcoholic beverages. CARDIOPROTECTIVE FOOD The following is the latest group of the foods that, according to different studies, are good options for taking care of your cardiovascular health. 1 Olive oil. Because it is high in polyunsaturated fatty acids, is a 4 Tea. . Its positive effects are associated with it being rich in good source of phytosterols and antioxidants, consuming olive flavonoids (antioxidants), as it prevents the oxidation of LDL oil is considered to reduce the risk of developing first-time myo- (commonly referred to as bad cholesterol) therefore preven- cardial infarctions (heart attacks) by 70%. According to nutritio- ting cardiovascular risk. nist Lina Marcela López, consuming 54 grams a day, about 3 tablespoons, can bring health benefits. 5 Dark chocolate. Similar to tea, this food is also high in flavo- 2 Fruits and vegetables. Because they are low in fat and rich in noids, which allows it to have a cardioprotective effect due to its antioxidant, antiplatelet and anti-inflammatory actions, hel- fiber and nutrients such as sterols, carotenoids, vitamin C, ping to keep your blood pressure under control. magnesium and potassium, fruits and vegetables help reduce cardiovascular disease. 6 Fiber. As López explains, due to its cardioprotective, antihyper- 3 Nuts. This food group is a good source of calories consisting tensive and antithrombotic effect, fiber helps keep your choles- terol under control and moderates your blood sugar levels after mostly of unsaturated fatty acids, which have cholesterol- eating food. It can be found in foods such as wheat bran, legu- lowering effects and can help replace saturated fatty acids. The benefits of nuts come from their high content of fiber, •mes, fruits, vegetables, soy, oats, barley and some yeasts. folic acid, vitamin E, vitamin B6, and minerals that help pre- vent high blood pressure such as calcium, magnesium, potas- sium, zinc and antioxidants. 30

( )En 2020 un nuevo espaCcOioNpTaUraCsUeEgRuPirO CUIDÁNDOTE SÍGUENOS: 31 PBPXB.X(.4()4)44444400001919//(4(4))33225577007700 wwwwww..cceeddiimmeedd..ccoomm Medellín - Colombia

( )WITH YOUR BODY SAYING “YES” TO EXERCISE DURING YOUR MENSTRUAL CYCLE Contrary to what some women believe, doing physical activity when you are on your period has both physical and emotional benefits. Knowing what to do and at what stage is key. ADVISORS FIORELLA D’CROZ - Physical therapist and specialist in Therapeutic Physical Exercise JAMES MADRID - Sports medicine doctor, practitioner at Coomeva Private Healthcare Doing exercise and having your is to modify loads, duration and inten- period don’t have to be mutually sity,” D’croz states. exclusive of one another. In fact, the idea that exercise cannot be done WEEK BY WEEK during a menstrual cycle is inaccurate. It is While the symptoms of each woman’s important to note that menstruating every periods are different, the most common month is a symbol of being healthy and not ones include pain, changes in mood and having disease, as it is a sign of the body even changes in the skin, which is why having a good hormonal environment. sports activities can be adapted from time to time. To do this, our physical therapist While the benefits of doing exercise at suggests factoring in the phase the woman any age and stage of life have been proven, is in and planning exercise accordingly. the only change that should be made during a menstrual cycle is with the type • Week 1: When your period comes, and intensity of the exercise. As Fiorella your blood vessels dilate, your iron D’croz Brusatin indicates – Olympic deposits decrease and there is less of triathlete, physical therapist and specialist flow a of oxygen, which is why short, in Therapeutic Physical Exercise – hormo- light and recovery-type exercises are nal fluctuations in the body work diffe- suggested. rently depending on what part of the menstrual cycle the woman is in. “The • Week 2: Once you’re bleeding has recommendation is not to change the finished, your mood improves and sport that the woman plays according to your estrogen levels balance out. the phase she is in, the recommendation Progesterone levels decrease, allowing 32

( )WITH YOUR BODY for her for the load and intensity of the exer- • Week 4: It is common to feel dis- endometrium detaches during the mens- cise to feel better. “During this phase, comfort during this stage, due to trual cycle and bleeding begins, inflamma- women are more explosive, stronger, retaining liquids and to a feeling of tion can occur, which can be painful for and they are no longer bloated, which heaviness. As our physical therapist some women. If the woman has a low per- is when higher intensity workouts are explains, this is the least recommen- centage of muscle, and a high percentage recommended in order to take advan- ded week for doing high-intensity of fat, inflammation will be greater. tage of the hormonal environment to workouts. Doing frequent exercise helps increase do this type of activity, D’croz states. muscle mass, making for less fat and less • Week 3: During these days, estrogen EXERCISE, THE BEST PAINKILLER inflammation.” and estradiol levels begin to decrease, In addition to its normal benefits, they Dr. Madrid also encourages women to while progesterone levels rise, which is exercise while on your menstrual period drink more water when they do exercise why it is still a good time for regular, but helps relieve pain and inflammation. and are on their period: 100 to 200 ml of less intense workouts, as certain women According to sports medicine doctor water (about 1/2 to 1 cup) for every 15 may experience sadness. “You have to be James Madrid, different substances are minutes of activity. “After one hour, the very creative during this week with trai- released when doing physical activity recommendation is to drink beverages ning so that it is fun, dynamic and not including interleukin, which regulates that rehydrate, as the loss of sodium is sig- too intense, as with many women, it can pain and keeps inflammation under con- nificant and it cannot be replaced easily be difficult to adjust their moods.” trol. As Dr. Madrid explains, “When the through food,” Dr. Madrid states. 33

WITH YOUR BODY ( )for her PAY ATTENTION TO YOUR DIET (It the first and second day Due to the decreased levels of iron in the of bleeding are very painful, not doing exerci- blood that results from the physiological se brings more benefits than doing a strong loss of blood, specialists recommend workout, as this can cause fatigue days later, increasing the consumption of foods that and in some cases, mood swings. are rich in iron such as: meat, fish, green vegetables and beans. It is also recom- mended to not fall in the trap of following hypocaloric diets or altering your hormonal cycle. “These practices cause amenorrhea, which is the absence of menstruation, and can pose a health risk because with the absence of fatty acids, hormones become unbalanced, estrogen levels decrease, calcium is poor- ly absorbed and women become prone to premature osteoporosis.” As women, we have to eat a balanced diet that includes all the food groups according to our calo- •ric needs,” states D’croz ACTIVATE YOUR MUSCLES The sports medicine doctor James Madrid recommends decreasing impact-based physical activity the days you are on your period. Instead, he suggests women do different types of stretching or balance exer- cises, or exercises to activate the stomach muscles. The following are a few alternatives: Do joint mobility exerci- Stretch each muscle for 30 seconds in 1 2 3 4ses for your ankles, Do balancing exerci- Strengthen the muscles of the abdomen ses on a stable or uns- with activities like holding a plank pose, hips, upper extremities, table surface (such as where the body is stationary on the floor order to lower your fingers, hands, elbows, with a bosu ball) in and is held up by the toes and forearms. heart rate, blood and middle and lower order to work your Bridge poses are also suggested, where pressure and any back. Activate each upper or lower limbs. your belly is up, and your body is soreness after you area 10 times to promo- supported by your hands and the work out. te well-being. bottom of your feet. From that position, you raise your pelvis up to form an arc. 34

( )WITH YOUR BODY 35

WITH YOUR BODY ( )sets 150 Including physical activity MINUTES A WEEK OF in your daily routine helps to MODERATE EXERCISE IS interrupt sedentary lifestyles in order HOW MUCH IS NECESSARY IN ORDER to prevent multiple diseases and TO RECEIVE HEALTH therefore improve your self-esteem. BENEFITS FROM IT. TAKING ON PHYSICAL WELL-BEING ACTIVE INACTIVITY BREAKS Sitting for a long time in front of a computer is one of the most common behaviors of a sedentary lifestyle. This physical inactivity is the fourth highest risk factor of mortality in the world, given that those who are sedentary are 30% more likely to suffer from diseases than those who exercise. It is there- fore important to prioritize doing sports and getting movement to keep the body and mind active, regardless of your age. IMPROVE 10 Feeling comfortable and healthy is YOUR MOOD essential to performing efficiently at MINUTES OF JOINT AND work. To achieve this, the recommen- Even low intensity movements impro- MUSCLE MOVEMENT EVERY dation is to do short exercises and ve your feeling of well-being by THREE HOURS HELPS IMPROVE take short breaks. This not only relieve increasing the production of neuro- YOUR PHYSICAL CONDITION. fatigue caused by maintaining the transmitters in the brain, commonly same position during the day, it also known as endorphins. When they are reduces the risk of having a muscu- released, your mind lets go of con- loskeletal disorder and prevents cerns and of thoughts that feed stress, which is the best way to achie- depression and anxiety. Exercise can ve greater well-being and to break up easily be used as a healthy strategy those hours of immobility. to regulate emotions and therefore cope with difficult situations. SOURCES: World Health Organization (WHO) Colombian Ministry of Health 36

( )WITH YOUR BODY 37

WITH YOUR BODY ( )grandparents BE FEARLESS ABOUT WORKING OUT With a physical, older adults can establish workout routines that fit their conditions and needs. ADVISORS IVÁN LEONARDO DUQUE VERA- Sports medicine doctor, practitioner at Coomeva Private Healthcare MARGARITA MARÍA COVELLI SUÁREZ - Physical therapist, practitioner at Coomeva Private Healthcare Strength, balance and flexibility in importantly, exercises that improve your the arms and legs are some of the lung capacity, known as cardio training.” physical abilities that exercises for older adults should strengthen. Their EVERYDAY LIFE workout routines should therefore focus As physical therapist Margarita María on functional exercises that include Covelli Suárez emphasizes, the key is in daily activities as part of their exercise choosing to do functional exercises routine such as picking something up where you work on different skills, “The from the floor, climbing stairs or elderly lose strength, balance, perception carrying a somewhat heavy object from and flexibility over time; the idea with one place to another. their workouts is to include improving or reconditioning all these physical skills.” The need to work different physical To do this, it is important to emphasize skills becomes very important as people doing everyday movements, using light age, as these skills tend to diminish over weights and slowly working your way up. time. According to sports medicine doctor Iván Leonardo Duque Vera, training regi- “Ideally, they should work all their physi- mes should therefore include respiratory, cal skills using very simple movements. It is stretching and strengthening exercises. also important to take their individual cha- racteristics into account,” Covelli states. Dr. Duque recommends doing exerci- ses that are a common part of everyday WITH SUPERVISION life, as routine and well-guided activities The physical therapist recommends can include exercises that keep the body getting a physical when creating workout active, “There should be several different plans in order to identify the activities aspects to your training plan, working on that will be done and to account for the resistance, strength, flexibility, and most 38

( )WITH YOUR BODY person’s physical conditions. “Group or generalized exercises sometimes do not meet the elderly’s needs, who have to be more careful of their physical activity. It is also important to take each condition into account through an initial evaluation that analyzes how their physical capacities, cardiovascular condition, stability, abdo- minal and core strength is. Based on these results, a workout plan can be made that is tailored to improving their physical cha- racteristics,” Covelli explains. After getting a physical, the recommen- dation is to establish a routine. “As the World Health Organization suggests, in order to see changes, the exercise must be done progressively six times a week. For those who are not as disciplined, the suggestion is three times a week,” as •Covelli states CREATING HABITS THROUGH A ROUTINE Through the guidance of a professional, try focusing on doing three groups of exercises. 1 Hiking. Walking briskly, walking or 2 Biking. Biking on an exercise bike, 3 Swimming. Doing jogging, and running – if possible – conventional bike or elliptical exercise routines in is one of the best options because bike all meet the requirements the water and it is part of what makes up our for being cardio activities and swimming (if the per- human nature. The intensity levels they have the added advantage son knows how) are of these exercises are also of exercising the joints, similar to also good alternati- something to explore. walking or running. ves for the elderly. 39

WITH YOUR BODY ( )x - ray INCREASE YOUR FIBER INTAKE 8 Fiber is an important ally BENEFITS FOR DIGESTION GLASSES OF WATER to keeping your cholesterol under control A DAY HELPS PROTECT and to regulating blood sugar, it also helps Soluble fiber attracts YOUR INTESTINAL manage your weight. The key is in complex water and turns it into a FLOW, HELPING AVOID ABDOMINAL DIS- carbohydrates. Find out why. gel during digestion, COMFORT. which causes the digesti- ve process to slow down. It is found in oats, wheat bran, barley, nuts, seeds, beans, lentils, peas and some fruits and vegetables. SIMPLE 20 g MEALS A DAY IS THE RECOM- To include fiber in your daily diet, MENDED DAILY try soaking oatmeal overnight in milk or in another plant-based milk AMOUNT OF FIBER in the fridge. At breakfast, add a FOR ADULTS. portion of banana, berries and cocoa nibs to add flavor and textu- re, which are also foods with great nutritional properties. It’s better to eat fruit than fruit ADVISOR Less hunger: Fiber has an effect that juice: Choose eating orange slices LINA MARCELA ZULETA makes you feel full, which helps pre- over orange juice, as this elimina- Periodontist vent you from eating more fre- tes the fiber. quently throughout the day. (KEEP IN MIND) For your nutrition plan, increase how often you get vegetable pro- tein from legumes, such as with beans, lentils or chickpeas. 40

( )WITH YOUR BODY 41

( )CON TU CUERPO 42

( )CON TU CUERPO 43

( )WITH YOUR BODY DON’T WAIT FOR PAIN TO GO TO THE DENTIST As with all health issues, prevention is key. Proper oral hygiene and two visits a year to the dentist can help you maintain this goal. ADVISOR ANA CRISTINA MANRIQUE General Dentist, practitioner at Coomeva Private Healthcare. Going to the dentist and having appointments on a regular basis is important to help maintain proper oral hygiene and prevent disease. For Ana Cristina Manrique, general dentist, when patients are in pain, this is a clear sign they should see a specialist. A problematic tooth or a tooth fracture are certainly good reasons to see a den- tist. However, there are many silent oral diseases that can develop without the regular necessary checkups. “With pre- vention, problems can be avoided not only for our oral health, but also for our general health.” Among those silent ailments, as Dr. Manrique men- tions, are bleeding gums, which may be a sign of a condi- tion in the tooth’s bone and supporting tissue. “It is a warning sign for us to be careful in that area and avoid, at an older age, the all too well-known, periodontitis, which can cause tooth loss.” Pigmentations – which are spots in the oral cavity that the dentist can detect in their checkups – are another sign of attention to diseases such as oral cancer. Halitosis or bad breath is also a reason to see an expert. Even a constant 44

headache or a cervical headache may be a symptom of an ( ( )WITHWYIOTHURYOBOURDY occlusion problem (bite or connection with the upper for your smile teeth). “If detected on time, any disease that is occurring in the mouth, as with any part of our body, can have a solu- THREE KEY tion,” the dentist emphasizes. ASPECTS OF ORAL HYGIENE Sensitivity is another common cause to visit the den- tist. “This is commonly associated with the wear of the 1 Brush at least three times a day, and set tooth’s enamel or external surface, often caused by bru- xism (teeth grinding). Even the nourishment we give our- aside the most relaxing time, such as selves must be taken into account. When a patient with nighttime, to do a more detailed and sensitivity arrives, I ask them about their diet, and if they conscious process. say they love lemon, I explain that it is very abrasive and that it removes tooth enamel, which is why it causes sen- 2 As for dental floss and brushing, it is sitivity,” Dr. Manrique states. not about strength, it is about TWICE A YEAR technique. If these practices are It is best to go to the dentist twice a year to get a deep clea- harsh, there will be negative ning and to follow up on any necessary issues. During these consequences on the teeth and gums. visits patients will also receive instruction on the proper ways for taking care of their oral health. “It is important to 3 It is not necessary to cover the entire go in order to learn how to use dental floss and how to brush, to brush well without harming yourself, and where toothbrush with toothpaste. Use the you should brush more, according to each patient’s case. amount and ingredients The main key to proper oral hygiene is flossing. While seve- recommended by the dentist. ral factors are involved, if you don’t floss you will have ble- eding problems and the supporting tissue will be affected. 45 This is one of the aspects that we must work on when edu- cating our patients, making this a habit, at least once a day,” adds Ana Cristina Manrique. While many fear going to the dentist, Dr. Manrique belie- ves that people, especially younger generations, are beco- ming increasingly aware of the importance of taking their children to the dentist, “If you start with children from a young age, in a friendly way, often through play, they will grow up having internalized this. It will not be a source of panic for them and they will get the checkups they need” • If you are an affiliate of Coomeva Private Healthcare: You have access to the Dental Elite program and everything you need to take care of your oral health. Learn more at: medicinaprepagada.coomeva.com.co

( )CON TU CUERPO FIGHTING EXCESSIVE 46 SWEATING When a person sweats excessively, this can affect their social life. Treatment is possible, however. ADVISORS ANA MARÍA ZAPATA RESTREPO General practitioner ELINA BEDOYA BETANCUR Dermatologist Regardless of the weather, even with the cold for example, peop- le with the condition called hyperhidrosis experience excessive swea- ting on the palms of their hands, the soles of their feet, their armpits and, in some cases, on their face. It is important to emphasize that sweating is one of the body’s mecha- nisms for regulating its temperature. Normally this response occurs after pla- ying a sport or experiencing physical exertion, being in very hot environments or at other times or circumstances that generate tension, stress or anxiety. “The most serious problem is when it occurs in the armpit area, for example, because apart from hyperhidrosis, bromhi- drosis occurs, which is the bad odor and is more cause for concern for patients,” sta- tes Dr. Ana María Zapata Restrepo.

( )CON TU CUERPO ten en cuenta TYPES effects last a maximum of one year and it According to dermatologist Elina is very expensive, so it is not recommen- ded.” Bedoya Betancur, there are two types of hyperhidrosis. “One is the primary or As Dr. Zapata points out, surgical treat- focal type, which is considered hereditary ment “is recommended when the hyperhi- and affects 3% of the population. It drosis is very intense and symptomatic.” affects both men and women equally, and This surgery is called a sympathectomy is called focal because the sebaceous and is performed by thoracic surgeons. glands are hyperstimulated – which “Its side effects may include increased synthesizes the sebum that lubricates and paradoxical sweating, which is sweat that protects the skin – due to a very active occurs elsewhere, but this is not always sympathetic nervous system.” the case. Surgery is very helpful, especially with palmar hyperhidrosis as this is the The specialist adds that with this type most socially-isolating type as it is an of hyperhidrosis, symptoms “increase with outpatient treatment.” stress and there is no clear cause.” In some families, some members may all Dr. Zapata affirms that it is important to experience excessive sweating. address the causes, as this also improves the response to treatment. This is about finding The other type is secondary or generali- the root of the problem, for example in zed hyperhidrosis and is related to other cases where anxiety is what is triggering the underlying diseases such as diabetes, condition. With such cases, the recommen- menopause, thyroid disease, hypoglyce- dation is to address both the underlying mia, some types of cancer, heart attacks cause and the physical condition in order to and certain types of infections. Sometimes it can also be associated with drug withdra- •reach a permanent solution wal, especially with patients who take cer- tain medications such as opioids. IS THERE HOPE FOR A CURE? SIDE “Generally, aluminum chloride-based EFFECTS antiperspirants are used, which are the Some of the complications that arise most well-known, with or without a pres- from hyperhidrosis include: cription. The problem is that they can be • Infections: People who sweat severely irritating and, in some studies, they have been linked to breast cancer, so profusely are more likely to have they are not highly recommended and are skin infections. not indicated for long-term use,” states • Social and emotional impacts: This dermatologist Bedoya Betancur. condition can be embarrassing and can affect a person’s search for Other methods that can be used for work and their educational treatment that can help reduce excess objectives, for example. sweating, such as medications; however, they should always be used under medical supervision. Therefore, before taking any measures, consult a specialist first. With regard to the botulinum toxin, as Bedoya explains, “This medication is widely used especially in palmar and axi- llary hyperhidrosis, but its side effects include pain and muscle weakness. Its 47

( )WITH YOUR BODY GAIN MUSCLE VOLUME THE RIGHT WAY If your goal is to develop muscle mass, a proper diet for working out or playing sports is important. Protein supplements are not for everyone. ADVISORS JASBLEIDI BUITRAGO URIBE Nutritionist and dietitian CAMILO BECERRA Professional athlete, former Olympic swimmer 48

( )WITH YOUR BODY for him While proteins help people gain le composition, and your diet is the founda- include several nutrients. This usually muscle mass, they are not the tion in order for your workouts to function. consists of a protein that can be easily only nutrient that can do so. To You can also do strenuous sports activity, absorbed (such as yogurt or a glass of develop a muscle, a balanced diet is key, but if you do not follow with the right diet milk) together with any type of car- which includes eating foods that help the you will not develop muscles.” bohydrate, except for concentrated sugars. body to function properly. As nutritionist and dietitian Jasbleidi Buitrago Uribe PROFESSIONAL ATHLETES If you do physical activity in the afterno- highlights, food items that are part of a The professional athlete and former on, around 3:00 pm, you should eat lunch food group should be consumed that Olympic swimmer from Colombia, Camilo before. If you are going to be active after you include other nutrients in addition to pro- Becerra Velasco, also highlights the value of exercise, you should eat. Try to have a good tein, “This point is very important, it’s leading a healthy diet when playing a sport meal one to two hours after working out, not about a food or a nutrient, it’s about either as an amateur or professional. when you begin to feel hungry again. If you the balance between them, according to “Depending on the phase of training a per- exercise at night, you should have eaten well your needs,” Buitrago states. son is in, more or less carbohydrates and during the day. proteins should be eaten. This usually con- She adds that more intense physical acti- sists of a balanced diet with more protein, BE CAREFUL WITH SUPPLEMENTS vity is necessary for training your muscles. which helps repair the fibers that are ‘dama- As nutritionist Buitrago explains, protein “Actually, exercise is what determines musc- ged’ from physical exertion. Similarly, car- supplements lack natural properties, so they bohydrates are key because they provide the do not function the way the body needs. If a energy for supporting high loads of activity.” person does mild or moderate sports acti- vity, or goes to the gym for an hour, the When you are in competition mode, recommendation is to avoid them. “Protein Becerra Velasco adds, your diet should chan- powders work in isolation as they only pro- ge with a lighter intake of protein, such as vide protein; while the proteins found in with fish or chicken. In some cases, red meat food come with other substances such as car- is eliminated and is supplemented with bohydrates or fiber, among others. Because other nutrients. “This for high performance they are part of a meal, digestive processes athletes. For the average person who swims, will naturally improve their absorption, the- for example, a balanced diet is more than refore maintaining metabolic balance.” enough,” Becerra clarifies. Thus, for high performance athletes or WHEN TO EAT for athletes who need high amounts of The best recommendation is to make sure protein, these supplements are important; there is some source of energy in the body however, in order to make them part of before doing exercise, regardless of the your exercise routine, they should be time of day you do it. It is also good to taken according to the suggestions and •evaluation of a professional 49

WITH YOUR BODY ( )prevention KNOW MORE STAYING UP TO DATE WITH VAC- STAYING CONNEC- CINES, A MATTER TED, BUT TO SPORTS OF PROTECTION The initial findings of a study conducted ► While the mortality rate for measles by the Gasol Foundation of Spain on worldwide fell by 84% between 2000 physical activity and physical inactivity and 2017, according to the WHO, it is levels in children and adolescents suggest still common in developing countries. that more than 60% of the children surveyed do not do the recommended ► According to a recent study in the amount of exercise, and about 80% of magazine Science Immunology, measles them exceed screen use time (2 hours a makes it difficult for the immune system day as recommended by the WHO). This to respond to other infections, increa- has affected the increase in cases of sing the risk of secondary diseases. children who are overweight and obese. The solution available to parents and ► “Our study has huge implications for educators is to encourage children to do vaccinations and public health as we sports at school and also make it part of a show that not only do measles vaccina- family and social routine. It is also tions protect people from measles, but important for parents to support good they also protect people from other nutrition in order to foster positive habits infectious diseases,” said one of the from an early age. study’s authors, Colin Russel of the University of Amsterdam, according to a 74 °C quote from the EFE news agency. IS THE TEMPERATURE AT WHICH CHICKEN (KEEP IN MIND) SHOULD BE COOKED TO PROTECT YOUR- SELF FROM FOOD POISONING, ACCOR- Colombia’s vaccination schedule set by the Ministry of Health DING TO THE MAYO CLINIC. protects children from 25 different diseases. THE IMPORTANCE OF BREASTFEEDING This practice provides babies with the FOLLOW THE GUIDELI- nutrients they need for their future deve- NES FOR ANTIBIOTICS lopment and strengthens their emotional bond with their mother. The WHO recom- As indicated by research published in the mends that babies drink breastmilk exclusi- journal Clinical Infectious Diseases, the indis- vely for their first six months of life, as indus- criminate use of antibiotics is a major factor trial milk is difficult to digest. During their first in the rise of antimicrobial resistance. It is weeks of life, babies should feed every two to therefore only appropriate for people to use three hours and mothers should increase them when recommended by their doctor, to their consumption of protein (eggs and meat, follow their instructions and to not share for example) in order to provide their babies them with other people. with quality nourishment. 50