Ask the Expert

We put your questions to the health professionals about eating healthy on the run, mammograms, and the efficacy of flu shots

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Q: I just turned 40. Should I start having annual mammograms now?

experts_story1“Screening mammography is the best way to find breast cancer early when treatment has the best chance of working,” says Dr. Huiming Yang, Medical Director, Screening Programs, for Alberta Health Services. “Although the evidence supports routine screening in women aged 50 to 74 it is less clear that the benefits of mammograms outweigh the risks for women who are 40 to 49 years old.”

As part of a personal breast health plan, women 40-49 are encouraged to consider certain actions, suggests Yang:

  • Know what looks and feels normal for you so you can notice any unusual changes in your breasts. Talk to your healthcare provider if you notice unusual changes.
  • Talk to your health care provider about your risk for breast cancer, as well as the risks and benefits of screening mammograms to help figure out what is right for you.

“Most cases of breast cancer occur in women 50 years and older (about 77 per cent of all cases),” says Yang. “Research has shown that screening women in the 40-49 bracket isn’t as effective as it is in older women (over age 50).”

If you chose to begin regular breast cancer screening at any time in your 40s, you can access screening mammography in Alberta with a referral from your health care provider, adds Yang.

For more information about breast cancer and screening mammograms, you can visit www.screeningforlife.ca/breastcancer.

Q: Can I eat on the run and still eat healthy?

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You can eat healthy on the run – by planning ahead or by making the healthiest choice available, says registered dietician Karol Sekulic, of Alberta Health Services.

And that all starts with the first meal of the day, she says. “If you eat breakfast at work instead of at home, bring some plain instant oats and fruit. Add a plain yogurt and you will have three of the four food groups covered; if you compare that to a yogurt parfait from a coffee shop or fast-food restaurant, you will save yourself added fat, sugar, salt and calories.”

But if you don’t have anything prepared at home, and you frequently grab food on the go, here are some tips from Sekulic to keep that handy snack or meal from doing more harm than good:

For a healthy lunch or supper option, choose a salad with smaller serving of chicken or fish. Skip the white bread, pasta or rice options.

  • Choose foods without breading, toppings or extra sauces. This will likely save you extra fat, sugar and calories.
  • Limit cheese, croutons, bacon, dried fruit or candied nuts as toppings.
  • If you are choosing a sandwich, choose the smallest size available and look for whole wheat or 100 per cent whole grain breads and have a vegetable as a side.
  • For snacks, choose plain vegetables, fruit or a few whole grain crackers with hummus or a few plain nuts.

Don’t forget about what you drink on the go, advises Sekulic, noting there can be added sugar and fat in beverages, too. For this reason, she suggests choose water to drink when possible. “If you choose coffee or tea,” she says, “stick to the plain types and add lower fat milk with two per cent milk fat or less instead of whole milk cream, which can have 10 per cent milk fat or higher.”

Q: Do I need to get a flu shot? I am a little apprehensive because I’ve heard you can actually get the flu from the vaccine.

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“That’s a great question and an important one during flu season,” says Krista Rawson, nurse practitioner with Alberta Health Services, based in Red Deer. “The influenza (flu) vaccine (shot) does not cause the flu!”

Rawson says that though flu shots are made from viruses, they are strains deemed “inactive or not infectious – so you cannot contract the flu from the shot. You should know that every year scientists try to predict which flu will outbreak and make the shot based on their predictions,” she explains.

Of course flu outbreaks can and do happen, and it might not have been the type of flu that is immunized for in the shot, she adds – likening that scenario to buying farm crop insurance against a flood, but instead having a drought that year.

Rawson goes on to say it’s true that every year Canadians die from the flu. “Older adults, those over 65 years, are at greatest risk of complications or death, but so are those with underlying medical conditions such as cancer,” says Rawson, who recommends annual administration of the inactivated influenza vaccine – the flu shot, not nasal spray – for all adult patients with cancer, and especially those on active treatment or who were treated in the past year.

“Now there are two choices of flu vaccine on the market and it is important to know this if you have a diagnosis of cancer,” Rawson says. “The shot (needle) is the vaccine of choice for those who have had a cancer diagnosis. The nasal spray is a live vaccine and is not recommended for those individuals with cancer.”

There are also a few other exceptions to the recommendation to get a flu shot. People who have had or are about to undergo bone marrow transplants or anyone on immune suppression medications should ask their health care provider prior to immunization. In terms of general words to live by, Rawson says: “During flu season, get a flu shot if appropriate for you, wash your hands frequently, stay home if you are sick and don’t hesitate to contact your health care provider for advice.”

Ask our experts questions about general health, cancer prevention and treatment. Please submit them via email. Remember, this advice is never a substitute for talking directly to your family doctor.

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