My new employer, a local nonprofit, can’t offer health coverage, so when I contemplated leaving The Free Lance-Star to start what feels like a dream job, I had to make sure I could get insurance for myself and my family.

That’s much easier said than done.

Our family, like many others, has some pre-existing conditions—including an irregular heartbeat requiring a pacemaker. Because of that, the first quote we got was for policies costing from $2,300 to $3,300 a month, depending on what deductible we could stomach.

We rarely see a doctor for anything more than the usual—checkups, coughs and the occasional strain or fracture. That pacemaker? It won’t need to be replaced for about 7 years.

But Anthem wanted to charge us as much as $3,300 a month for coverage.

Fortunately, a wonderful insurance agent worked with us to find a policy with another insurer. It’s still not cheap, but it’s great by comparison. And later this year, we can check out the insurance policies being set up because of the Affordable Care Act, to see if they’re more affordable.

It’s a shame so many Americans struggle to find affordable health insurance, and a shame that so many people—even with insurance—suffer under the weight of huge medical bills.

But I digress.

I’m leaving The Free Lance-Star after roughly 20 years in journalism—nearly 13 here—to become director of the Rappahannock Area Court Appointed Special Advocates program. CASA has been near to my heart since my husband began volunteering with the nonprofit about twelve years ago and I started to see the critical role CASA volunteers play in the lives of vulnerable children. (If you’d like to learn more about CASA, and how it advocates for abused and neglected children in court, visit rappcasa.com or send me a note. If you want to know who’s replacing me as health editor, keep reading.)

Leaving journalism is bittersweet. I’ll surely miss the newsroom—full of wit and compassion and brains. And I’ll miss the power of the press—the ability to reach thousands of people at once through our print and digital editions.

I’ve learned a lot as a journalist that I wouldn’t otherwise have learned—what the burn from a lightning strike looks like;  that to search for an avalanche victim, you plunge long, probing poles deeply into the snow; that there’s no way to predict how a person will grieve; that tight deadlines provide great clarity.

Journalism has taken me some wild and unexpected places, including:

• a clown convention, a strip club, and a trailer park where a Komodo dragon roamed free after escaping from its owner.
• a small hotel meeting room where six or seven of us took turns asking former veep Al Gore questions during his presidential bid
• a massive political protest where I talked with Martin Luther King III and Jesse Jackson and heard people singing songs I thought were sung only in the ’60s
• a Pulitzer Prize party (bacchanal might be the better word for it) for an inspiring colleague

Maybe best of all, journalism has taken me into countless living rooms, classrooms, waiting rooms and meeting rooms, where I’ve met wonderful people going about the business of life.

I’m grateful to all those who invited me in, answered my questions and shared their knowledge. Your generosity helped me tell stories that I hope have been informative.

I’m also grateful to the editors who variously chastised, nurtured and ignored me over the years, and to the colleagues who challenged me and who made me laugh. (I’m talking to you, Edie Gross!)

As health editor here, I’ve gotten to pick the brains of doctors and dietitians, nurses and therapists, patients and families. What I’ve learned about how to take care of yourself can be summed up quickly:

• Before you put something in your mouth, think about whether it will nourish you.
• Get some exercise every day.
• Sleep is undervalued; don’t skimp on it.
• Don’t smoke, and go easy on the alcohol.
• Build and nurture a support system.
• If you’re knotted up with worry, ask yourself: Will this matter in a year?
• And by all means, get insurance. You never know when you’ll break a bone—or suddenly need a pacemaker.

Namaste, and thanks for reading.

***

Longtime Healthy Living freelance writer Donya Currie will be taking over as health editor in a few weeks. Donya is a wonderful, veteran health journalist who writes for publications including the AARP Bulletin.

For now, if you have a recipe or other info to contribute to the Healthy Life Virginia newsletter, send it to me at jmarshall@freelancestar.com; I’ll keep putting out the newsletter for a little while after I leave the paper.

For questions about Healthy Living or other sections of the newspaper, send a note to localnews@freelancestar.com.

The FDA said the drug “can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm.”

People most at risk of suffering a potentially lethal reaction to Zithromax, the FDA said, include those already taking certain drugs to treat abnormal heart rhythms, and those with:

• existing QT interval prolongation (a problem in the heart’s electrical system)
• low levels of potassium or magnesium in the blood
• a slower than normal heart rate

“Health care professionals should consider the risk of fatal heart rhythms with azithromycin when considering treatment options for patients who are already at risk for cardiovascular events,” the FDA said.

The news is unsettling given the popularity of the drug, which is often handed out in what’s called a Z-Pak. Many people consider it gentler on the stomach than other antibiotics, and you can complete a full round of it in just five days.

To read the FDA’s warning, click here. To read the study of azithromycin in the New England Journal of Medicine, click here.

Shoveling snow is great exercise. It burns about 422 calories in an hour in a 150-pound person, says a calculator at myfitnesspal.com.

But be careful: Your heart attack risk is higher when you’re shoveling snow. That’s partly because shoveling snow is hard work, and partly because cold weather constricts arteries, which raises blood pressure, the Cleveland Clinic says on its website.

A few tips for safe shoveling:

• Clear snow in chunks rather than doing it all at once.
• Be sure to stay hydrated.
• Take frequent breaks.

If you start suffering chest pain or feeling nauseous while shoveling, stop right away — those are warning signs of a heart attack. Other warning signs include shortness of breath, dizzyness, sudden weakness or heaviness in one or both arms, and uncomfortable sensations in your neck, jaw, back or arms.

You can read more about how to protect your heart while shoveling snow here, in a Harvard Medical School publication. The Cleveland Clinic advises older people and those with heart problems not to shovel at all. (That’s what neighborhood kids are for, right?)

If you see someone suffering from cardiac arrest while shoveling (or doing anything), the American Heart Association emphasizes doing two things right away, said Sharon Allen, manager of the American Heart Association Training Center at Mary Washington Healthcare:

• Call 911.
• Push hard and fast on the center of the person’s chest.

If you’re nervous about performing chest compressions, Allen recommends downloading the association’s Hands-Only CPR app to learn more. You can also get information about hands-only CPR here.

I’ll share more information about CPR, and Allen’s advice, in an upcoming story. For now, shovel safely.

Kids ages 8-15 are encouraged to submit an application to be a vendor for the day; the applications can be found online here. Children chosen to be vendors can sell things like homegrown vegetables and flowers, baked goods or eggs. What they can’t do is pick up boxes of cookies from a store and sell those.

“We’re really encouraging kids to think outside the box. Team up with your brother or sister, a neighbor or friend, and bring a great, homemade product to the market,” Market Manager Gayle Price said in a statement on the market’s website.

Space is limited, and the application deadline is April 15.

The latest word on the exercise-sleep connection comes from the National  Sleep Foundation’s 2013 Sleep in America poll. The poll shows that exercisers and non-exercisers get the same amount of sleep each night, which surprised me a little. But it’s no surprise which group reports better sleep quality.

“Vigorous, moderate and light exercisers are significantly more likely to say ‘I had a good night’s sleep’ every night or almost every night on work nights than non-exercisers,” says a foundation press release.

Vigorous exercisers get the best sleep of all, the poll shows.  Most of them say they rarely or never have symptoms associated with insomnia.  ”In contrast, one-half of non-exercisers say they woke up during the night and nearly one-fourth had difficulty falling asleep every night or almost every night,” the foundation reports.

Also notable: People who don’t exercise report more sleepiness and have more symptoms of sleep apnea, the foundation says.

To read the poll results, click here. Click here to read a story about insomnia that includes tips from Dr. Maha Alattar, a local sleep specialist.

Now, a big study is bolstering the belief that the Mediterranean diet can prevent heart attacks and strokes. Study participants who followed a Mediterranean diet supplemented with extra olive oil or extra nuts were 30 percent less likely to suffer a “major cardiovascular event” than participants who followed a basic low-fat diet.

The study involved about 7,500 people in Spain who were followed for nearly five years.

As The New York Times reported, “The findings, published on the New England Journal of Medicine’s Web site on Monday, were based on the first major clinical trial to measure the diet’s effect on heart risks. The magnitude of the diet’s benefits startled experts. The study ended early, after almost five years, because the results were so clear it was considered unethical to continue.”

Earlier research had suggested the diet was beneficial, but this study provides the strongest evidence yet of the eating style’s protective benefits.

Motl said she was delighted by the study results.

“It’s exciting to get even more definitive proof that the Mediterranean eating style can save lives and can cut the risk of heart disease as much as statin drugs,” Motl wrote in an email. “I’ve been encouraging this eating pattern for years.”

She added:  ”One of the best things about the Mediterranean eating plan is that it’s not a high-minded diet, it’s a way of eating that’s traditional because it tastes fantastic.”

I’ll share more thoughts from Motl, including lots more details about the diet and what study participants ate, in a story in the next few days. For now, you can read the New England Journal of Medicine study article here. And you can read the transcript of a nutrition webchat with Motl and Dr. Christopher Lillis here. You’ll notice that Motl and Lillis recommend the Mediterranean diet to readers over and over again in the chat.

What it made me think was: Here’s another reason to stay in shape.

When it comes to getting older, it’s not just paying bills that people need to plan for. It’s being able to take care of basic needs — grocery shopping, preparing meals, brushing teeth, being able to walk without falling and breaking a hip.

Now, if you break a hip, you will get medical care — a hospital won’t turn you away. But if your problems are less dramatic — maybe arthritis makes food prep frustrating, or you’re a little unsteady on your feet — good luck getting help. Insurance doesn’t cover that sort of non-medical, long-term care. (The exception is long-term care insurance, which most people don’t have because it’s expensive.) And the cost to live in an assisted living center? About 35,000 a year.

Any financial advisor will tell you it’s wise to  invest in your financial future as early and often as possible. The same can be said for your health. Invest now in building up strength and flexibility and balance, with an eye toward not only short-term gains like a fitter body and brighter mood, but toward long-term benefits like being independent and strong for as long as possible.

TOOLS FOR KEEPING FIT

A few days ago, I wrote about “sitting disease,” and the importance of moving throughout the day to ward off health problems that can hurt you now and as you age. You can read that post here.

Since then, several people have sent me ideas for how to get hourly (or periodic) reminders to get up and stretch, walk or otherwise keep moving. Here are a few:

• Use apps or computer software to send yourself reminders that it’s time to get up and do something. There are lots of these, some intended to prevent eye strain, some to prevent repetitive motion injuries like carpal tunnel syndrome. I’ve never tried one, but a web search can point you to several options. You also could set an alarm on your phone, or schedule meetings with yourself using tools like Google calendar.
• Get a gadget like FitBit that tracks your activity throughout the day. Clip it to your waistband and know that it’s monitoring your movements; as one story I read said, “It truly works as a motivator.” A simple pedometer — which counts steps — also can do this, and if you’d like to give one of those a try, let me know; I have a few to give away.
• If you work from home, get a dog. It’s hard to resist their demand for walks. Donya Currie, who writes for Healthy Living, sent me the photo below with a note saying, “Some people have a computer program reminding them to get up from their desk every hour. Or you could try one of these …”

If you’re looking for ideas for quick exercises, read our Healthy Life Virginia newsletter; it includes an “exercise of the day,” with a video demonstration, each weekday.

The key point about “sitting disease,” researchers say, is that it can’t be offset just by doing some pre- or post-work exercise. So even if you run for an hour in the morning, you still need to move throughout the day. What you do now can have short-term perks — weight loss, better sleep — and long-term benefits as well.

It’s ironic that I spend my day doling out health advice while simultaneously engaging in an activity that scientists think may shave as many years from your life as smoking: extended sitting.

Researchers increasingly say that sitting for long stretches of the day is brutal for your body. Worse, they say that even if you start your day with a workout, you won’t do enough to offset the effects of being sedentary most of the day.

It’s depressing. I’ve always been a fidgeter and never been good at sitting still. I walk a few miles a day and do some yoga. But after reading so much about so-called “sitting disease,” and listening to my body — which is screaming at me to move more — I’m vowing to break up my hours of sitting with more quick bursts of exercise.

Want to join me? At least twice each workday, I’ll do either five sun salutations or five minutes of stair walking, whatever floats my boat. I’ll aim to exercise at 11 a.m. and 3 p.m. Feel free to call me to see if I’m up and moving; hopefully, I won’t be around to answer.

Better yet, send me a note about what you’re doing. Each workday, our Healthy Life Virginia newsletter includes an “exercise of the day.” So if you need ideas, and sun salutations and walking don’t appeal to you, try those exercises. I’m including some of my very favorites in the newsletter this week. I’d love to hear your ideas, too.

Any exercise you get before or after work is great. But keep in mind: Even if you exercise for an hour a day, that hour is roughly 1/16 of your waking hours. What are you doing with the rest of your time?

If you want details on why it’s so important to move during the course of the day — and not just during a fixed exercise time — click the links below. And stay tuned: I’ll share more information about the downsides of sitting in future blog posts.

Further reading:

• Why Sitting Is a Dangerous Health Threat
• The Facts: Sitting Disease by the Numbers
• Your Body’s Biggest Enemy

“As currently formulated, Coke, Pepsi, and other sugar-based drinks are unsafe for regular human consumption,” said CSPI executive director Michael F. Jacobson, in a statement posted on the CSPI website. “The FDA should require the beverage industry to re-engineer their sugary products over several years, making them safer for people to consume, and less conducive to disease.”

What’s likely to come of the request? Probably nothing right away. The CSPI has a history of requesting action from the FDA. The groups’ efforts have sometimes yielded results — on things like trans fats — but usually after years of pressure, consciousness-raising and study.

“The lesson from these things is that it takes forever to move things in Washington,” CSPI’s Jacobson said, according to a story in Reuters.

The group’s petition grabbed my attention because just yesterday, I blogged about a new Mountain Dew breakfast drink, Kickstart, that will be available in stores later this month. The drink is made up of 5 percent fruit juice, so it’s considered a “fruit drink,” not a soda. It’s definitely got its share of sugar.

Food writer Emily Freehling, of our Front Burner blog, sent me a link to Kickstart’s nutrition information today. A 16-oz can of Orange Citrus Kickstart has 20 grams of sugar (along with things like sodium hexametaphosphate, yellow 5 and gum arabic.) It’s sweetened with sucralose, an artificial sweetener, and high fructose corn syrup.

Is 20 grams of sugar anything to worry about? It’s less than most sodas contain, but it’s the equivalent of about 5 teaspoons of sugar. The American Heart Association recommends that women get no more than about 6 teaspoons of sugar a day, and men consume no more than 9 teaspoons, according to the association’s website.

If you’re a soda drinker, it’s hard to stay within those limits.

“Just one 12-ounce can of regular soda contains eight teaspoons of sugar, or 130 calories and zero nutrition,” the association says.

I like a can of Coke occasionally, or a glass of ginger ale. There’s nothing good about it beyond the taste, and for me, the first few sips are really the best ones. Soda can lose its appeal if you think of it as a can of liquid with teaspoon after teaspoon after teaspoon of sugar dumped in it.

To read more about CSPI’s efforts to limit added sugars in beverages, click here. To read American Heart  Association guidance on sugar intake, click here. To read another story about CSPI’s efforts to limit sugars, click here.

Kickstart, made with 5 percent juice and more caffeine than the standard Mountain Dew, will go on sale Feb. 25, according to kickstartfirsttaste.com and a story from The Associated Press. The drink will come in two flavors: “Energizing Orange Citrus” and “Energizing Fruit Punch.”

Because the drink has 5 percent fruit juice, it can be called a “juice drink” instead of a soda, according to U.S. Food and Drug Administration guidelines. But don’t kid yourself into thinking that drinking Kickstart is remotely like eating fruit for breakfast.

You’d have to drink about 80 ounces of Kickstart to consume the equivalent of an actual piece of fruit, according to my math (based on the Mayo Clinic’s guidance about fruit juice vs fruit). And if you drink actual fruit juice, less than an ounce provides as much real juice as you’d get in a 16-oz can of Kickstart, registered dietitian Jennifer Motl said.

In other words, if it’s nutrition you’re going for, Kickstart isn’t for you.

Caffeine-wise, Kickstart will have 92 milligrams — “just the right amount,” according to a Pepsi Co. press release. Here’s a glimpse of how that measures up to other 16-oz drinks, according to the  Center for Science in the Public Interest:

• McDonald’s coffee: 133 mg
• Rockstar energy drink: 160 mg
• Mountain Dew: 72 mg

Kickstart is made with artificial sweeteners, which keeps the calorie count relatively low: 80 calories in a 16-oz drink. But local registered dietitian Nancy Farrell said she’s concerned about the use of artificial sweeteners to reduce calorie content because “research is indicating that an increased use of artificial sweeteners is actually predisposing some individuals to develop diabetes.”

“And artificial sweeteners are not necessarily helping the obesity epidemic,” Farrell said.

Now, in one respect, if you’re used to downing a 16-oz cup of Starbucks coffee with lots of sugar every morning, Kickstart might seem like a decent alternative. Starbucks coffee has lots more caffeine than Kickstart, McDonald’s coffee or even Mountain Dew.

But coffee, at least, has some antioxidants, Motl said. And coffee is just coffee; it isn’t a can of “naturally and artificially flavored sparkling juice beverage from concentrate,” as Kickstart’s can says.

‘CHEMICAL STEW’

Specific nutritional information about the drink isn’t yet available on the Pepsi Co. website, the Mountain Dew Facebook page promoting the drink or elsewhere. Kickstart reportedly contains vitamins B and C.

But as Motl said, “Adding small amounts of juice and vitamins does not make it a real food — it’s still a manmade chemical stew.”

There are obviously lots of healthier ways to start your day.

“Like most dietitians, I would encourage people to eat something more substantial for breakfast,” Motl said.

You don’t have to whip up a gourmet breakfast to fuel yourself for the day ahead.

“Even a banana spread with peanut butter served with a cup of coffee and milk can provide vitamins, fiber, protein and heart-healthy fats,” Motl said. “Everyone’s gotta make their own choices, though.”

APPEALING TO TEENS?

The announcement about Kickstart comes less than a year after Taco Bell announced that it was adding a drink called Mtn Dew A.M. to its breakfast menu. That drink — a combination of Mountain Dew and orange juice — has 160 calories and 40 grams of sugar in each 16 oz serving, according to Taco Bell’s nutrition facts information, which don’t include caffeine content.

“Looks like Mountain Dew is trying to get a share of the breakfast market,” Farrell said.

The teen breakfast market, maybe? I’ll go out on another limb and say drinks with “fruit punch” in the name are at least as likely to appeal to kids and teens as to adults. We know kids like caffeine — the American Academy of Pediatrics has issued warnings about the hazards of kids drinking energy drinks.

The AAP’s position: “Because of the potentially harmful adverse effects and developmental effects of caffeine, dietary intake should be discouraged for all children,” says a 2012 AAP report.