August 2018

HealthLine
AUGUST 2018
www.local4funds.org
INTERNATIONAL UNION OF OPERATING ENGINEERS LOCAL 4
HEALTH & WELFARE PLAN
Dear Health & Welfare
Participant,
THIS EDITION OF HEALTHLINE
FEATURES THE FOLLOWING TOPICS:
• Update on the Livongo for
Diabetes Program
• Wellness Initiative Update
• Your Benefits: 3–D Mammograms
• Keep Us Updated
• Grandfathered Health Plan
UPDATE ON LIVONGO
FOR DIABETES PROGRAM
During June, the Board of Trustees
announced a new approach to diabetes
management. Effective July 1, members
with type 1 and type 2 diabetes are
able to join the Livongo for Diabetes
Program (“Livongo”), a health benefit
that makes living with diabetes easier by
providing members with a connected
meter, unlimited strips, and coaching.
The program is offered at no cost
to covered members and dependents,
ages 18 and older. Coaches provide
one-on-one support by phone, email,
text or mobile app to help members
with questions about nutrition or
lifestyle changes. With each check of
blood glucose using the Livongo meter,
members receive a personalized message
to help them make informed choices
about their health.
Want to learn more or enroll? It’s
as simple as visiting www.welcome.
livongo.com/LOCAL4 or calling
1-800-945-4355. When enrolling,
don’t forget to use the Plan’s registration
code: LOCAL4. Those who enroll will
also be eligible for a monetary incentive
from Livongo, so sign up today!
UPDATE ON 2018
WELLNESS INITIATIVE
The 2018 Wellness Program is in full
swing. Since January, members and
dependents have been taking advantage
of the various challenges. Fifty-four
members enrolled in the Spring Steps
Challenge and netted 24,801,742
steps over a six-week period. The two
members who achieved the highest
(health bits)
To be your best at work,
you need to be well-rested.
Improve your sleep hygiene through
these simple steps: Go to bed and
get up at the same time each day.
Keep your bedroom dark, quiet, and
cool. Avoid eating large meals before
bedtime. And don’t use your phone,
tablet, or computer in bed.
average number of steps at the end of
the challenge won Apple Watches. Of
those enrolled in the challenge, 39%
met their goal to walk an average of
7,000 steps a day and entered a raffle
to win one of ten $100 gift cards.
If you missed the first challenges,
it’s not too late to get started! Visit
www.ahealthyme.com/login and
click on “Click here to sign up” to
register. If you have your annual
wellness visit or any dental cleanings
between January and October 15, each
visit will qualify you for entry into a
raffle to win one of ten $50 gift cards,
redeemable at most major retailers.
Further, if you are 35 or older and
get a mammogram, or 50 or older and
get a colonoscopy by October 15, you
will be entered into a separate raffle to
win one of ten $50 gift cards.
For those who have been trying
to quit smoking but have trouble
going it alone, sign up for the “Breathe
(continued on page 8)
Want to lower your risk
for diabetes? Get enough
vitamin D. A recent long-term
study in the journal PLOS ONE
found that men with healthy levels
of vitamin D had only one-third the
incidence of diabetes. Your body
produces vitamin D naturally when
your skin is exposed to the sun.

2
During
Menopause
TRY TO AVOID THESE FOODS
(recipe)
Naturally Sweet
Lemonade
2 large apples
½ lemon
1½ cups sparkling water (optional)
IF YOU’RE A WOMAN GOING
THROUGH MENOPAUSE, you’re probably
already familiar with some of the
symptoms this time of life can produce.
From hot flashes to mood swings to
trouble sleeping and even difficulty concentrating,
you may experience a variety
of challenging physical and emotional
changes over a period of years. Getting
regular exercise, eating a nutritious diet,
and making sleep a priority may help
reduce symptoms. You may also find that
yoga or meditation helps.
Hot flashes are the most common
symptom of menopause, and certain
foods can trigger them, including:
• Spicy foods
• Alcoholic beverages
• Foods and drinks that contain caffeine.
In addition to coffee and tea, some
other foods can contain caffeine, including
chocolate and ice cream. Some pain
relievers also contain caffeine, so check
the label of any medicine you take.
Slice apples and lemons small enough
to fit into a juicer. Juice apples and
lemon. Whisk together to make sure
they are well-blended. Divide among
three glasses. If using sparkling water,
pour it into the glasses, then stir.
Serves three. Serving size is ½ cup.
Each serving contains about 70
calories, 0 g fat (0 g saturated fat, 0
g trans fat), 0 mg cholesterol, 3 mg
sodium, 23 g carbohydrates, 15 g
sugar, 4 g fiber, and 0.5 g protein.
(test your savvy on … childhood obesity)
1. Over the past four decades,
the childhood obesity rate
has more than doubled.
True False
2. Type 2 diabetes, previously
seen mostly in adults,
is increasingly common
among children. Experts
believe childhood obesity is
the cause.
True False
3. The U.S. Preventive Services
Task Force (USPSTF)
recommends doctors
conduct obesity screenings
for children and teens ages 6
and older.
True False
4. To help your child manage
his or her weight, focus on
providing nutritious meals
and snacks and teaching
healthy food choices.
True False
ANSWERS: 1. False. The childhood obesity rate has more than tripled. 2. True. Your child is considered obese if he or she has a body mass index in the
95th percentile or higher. 3. True. The USPSTF also notes that doctors should offer behavioral interventions as necessary. 4. True. For example, limit
soda and sugary fruit drinks and provide skim milk or water instead.

1Strength training
2Strength train-
3Strength training
4Strength training
4REASONS WHY YOU NEED TO
3
STRENGTH TRAIN
Strength training is an important component to a quality
exercise program. Here are four reasons you need to
strength train.
can reduce your
ing can help you
can improve your
can make every-
risk for diabetes
maintain your
balance, protect-
day things easier,
and heart disease.
joint flexibility.
ing you from falls
such as carrying
Plus, more muscle
and injuries. Aim
groceries.
mass helps your
to perform exer-
body burn calories
cises that hone
faster, making it
in on your lower
easier to control
body to get this
your weight.
benefit.
The best part is fancy gym equipment is not required to perform strength
training exercises. That’s because there are a variety of strengthening moves
you can do that use your body for resistance. Here are some to try:
Try: Abdominal crunches
Why: They can strengthen your core
muscles, which include your pelvis, lower
back, hips, and abdomen. These muscles
work together to keep your body balanced
and stable.
Try: Push-ups on
the floor or against
a wall
Why: Push-ups strengthen your
chest, shoulders, arms, and core.
How much strength training do you need?
2 to 3
sessions
per week
20 to 30
minutes per
session
TAKE YOUR
TRAINING OUTSIDE
You don’t need to stay indoors
to reap the rewards of strength
training. Find a nearby park
at www.nps.gov and practice
stepping up onto a bench, walk
uphill trails that will strengthen
your leg muscles and joints, or
perform push-ups in the grass.

4
SHOULD YOU START
Getting Mammograms Earlier?
SCREENING MAMMOGRAMS ARE
BREAST X-RAYS THAT CAN DETECT
BREAST CANCER BEFORE IT CAUSES
SYMPTOMS. Experts agree that mammograms
save lives. But there’s a difference
of opinion about the best age to
start getting them. In guidelines from
different groups within the past few years,
the recommended starting age varies
from 40 to 50. So when should you get a
mammogram?
BALANCING BENEFITS AND RISKS
Mammograms reduce deaths from breast
cancer. That’s a huge benefit. Yet women
ages 50 and older have the most to gain.
For those ages 40 to 49, the number of
deaths prevented is smaller.
Mammograms have risks as well.
They sometimes produce false positives—
results that appear abnormal when no
cancer is present. False positives can cause
anxiety and lead to more testing.
Another risk is overdiagnosis—finding
and treating noninvasive breast cancer
that never would have caused problems.
This isn’t harmless because unnecessary
treatment has risks of its own.
WHAT THE EXPERTS RECOMMEND
The American Cancer Society says that
screening mammograms should be an
option starting at age 40, and all women
should be getting them by age 45. The
U.S. Preventive Services Task Force,
on the other hand, says that all women
should start mammograms by age 50.
See page 8 of this HealthLine for
information about how you can receive
3–D mammograms annually beginning
at age 35.
LEARN MORE
ABOUT
MAMMOGRAMS
For a video overview, go
to www.radiologyinfo.org.
Search for “your radiologist
explains mammography.”
WE HEAR OFTEN ABOUT THE MANY
HEALTH BENEFITS OF FRUITS
AND VEGETABLES.
But did you know that eating them can
also make you happier and more
satisfied with life? An Australian
study found that people who
increased their fruit and veggie
consumption gained a greater sense
of well-being and happiness.
(health bits)
Atrial fibrillation affects
about 10 percent of people
older than age 65. The easiest
way to detect it? A simple pulse check
performed at rest and before and after
activities. If it’s outside the normal
range (60 to 100 bpm) and you feel
unwell, or if it feels irregular or “jumpy,”
talk with your doctor.

5
WHY DOES
My Hip Hurt?
IF YOU ARE A WOMAN WITH HIP PAIN, FIGURING OUT THE CAUSE IS KEY
TO GETTING THE RIGHT TREATMENT. Here are three common causes of hip
pain in women.
OSTEOARTHRITIS
Osteoarthritis is a common condition that many women develop in middle
age. As cartilage wears away, bones rub together, causing pain, stiffness, and
decreased range of motion. The condition develops slowly over time. Your
risk is higher if you had a previous hip injury, are obese, have a family history
of osteoarthritis, or are over the age of 50.
BURSITIS
Between the bones and soft tissues of your joints there are jellylike sacs
called bursae that act like pillows to reduce friction. Your hip bone has
two major ones—one in the groin area and another at the bony point of
your hip. When a bursa becomes inflamed, it’s called bursitis. The pain
may be sharp and intense at first and then become more of an ache. It is
more common in women and middle-aged and older adults.
HIP FRACTURE
If you fell or experienced a direct blow to your
hip, you may have a hip fracture, a break in
your upper thigh bone. You may feel pain
NEED SURGERY?
in the upper thigh or groin area that gets Could you be a candidate for
worse when you try to rotate your hip.
a total hip replacement? Learn
Women have a higher risk for hip fracture more about this procedure by
than men, especially women who have
watching a video. Go to www.
osteoporosis or cancer.
orthoinfo.aaos.org and search
for “total hip replacement
If you have hip pain, be sure to see your doctor.
He or she will examine you and may ask
procedure.”
for additional tests such as an X-ray, a bone scan,
or an MRI to diagnose what’s causing your pain. The
right treatment approach will help you get the best pain relief.
Low back pain got you
down? You might want to try yoga.
Researchers looked at 12 studies of
more than 1,000 men and women
with nonspecific low back pain and
found that yoga classes improved
back function and reduced symptoms
of low back pain more effectively
than no exercise.
LOOKING TO INCREASE
THE AMOUNT OF
WHOLE GRAINS
YOU EAT? Get a little creative.
Instead of breading, try ground rolled
oats or crush some unsweetened wholegrain
cereal as a coating for chicken
or fish. Popcorn without added salt or
butter also counts as a whole grain.

6
WAYS TO
LOWER YOUR A1c
If you have diabetes, you’ve probably heard
about the A1c test. This blood test assesses your average blood
sugar level over the previous three months. It’s important to know how well your
blood sugar is controlled over time. In the long term, high blood sugar can harm your
heart, blood vessels, kidneys, feet, and eyes.
A1c results are written as a percentage. For many people with diabetes, the goal
is to keep that percentage below 7. But some people have a different goal. Ask your
doctor what’s right for you.
So what should you do if your A1c number is too high? These steps can help lower
your A1c level and reduce your risk for long-term health problems.
1 2 3 4 5
Be more active every
day. Aim for at least
150 minutes per week
of moderate-intensity
activity, such as walking
briskly, cycling, swimming,
and dancing. Ask your
doctor for advice on safe,
effective exercise.
Follow a diabetes
meal plan. Emphasize
fruits, vegetables,
whole grains, beans,
fish, skinless poultry,
lean meats, and
nonfat or low-fat dairy
products. Work with
your health care team to
create your eating plan.
Address your stress
level. Too much stress
can raise blood sugar
levels. When you’re
feeling pressured or
overwhelmed, try
taking deep breaths,
meditating, going for
a walk, or listening to
soothing music.
Take diabetes
medication, if your
doctor prescribes
it. Keep taking your
medicine as directed
even when you’re
feeling fine.
Check your blood
sugar at home,
if your doctor
recommends it.
This lets you track
shorter-term blood
sugar changes.
One final reminder: Don’t forget to schedule your next A1c test. Most people with
diabetes should have the test at least twice per year. If your last A1c number was too
high, however, your doctor may recommend more frequent testing. It’s a great way
to gauge the progress you are making toward better diabetes control.
DISH UP
BETTER
EATING HABITS
Practice making healthy
food choices with an
interactive tool. Go to
www.diabetes.org and
search for “create
your plate.”

7
Love to
Tan?
YOU BEDDER BELIEVE YOU NEED
A SKIN CANCER CHECK
USING A TANNING BED—AND
THE INTENSE ULTRAVIOLET (UV)
RADIATION you’re exposed to while
tanning—puts you at a higher risk for
skin cancer, including melanoma, the
deadliest form, compared with people
who don’t tan indoors.
Getting your skin checked regularly by
your doctor or a dermatologist can help
spot skin cancer in its early, most treatable
stages. In fact, tanning bed manufacturers
have to post this statement on their
devices: “Warning: Persons repeatedly
exposed to UV radiation should be regularly
evaluated for skin cancer.”
IF YOU TAN, GET CHECKED
A recent study in JAMA Dermatology,
however, found that only about 30 percent
of the almost 5,000 indoor tanners
surveyed have ever received a full-body
skin cancer exam by a physician.
A skin cancer check is simple. During
the exam, a doctor or nurse will look at
your skin from head to toe for unusual
moles or other colored areas. If anything
appears abnormal, the doctor will remove
some of the questionable tissue to check
for cancer cells in the lab.
Being proactive can pay off. Melanoma
is easier to cure if it’s found before
it spreads to other parts of the body.
BE ON THE LOOKOUT
Almost 5 million people are
diagnosed with skin cancer
every year. To catch skin
cancer early, see your
doctor or dermatologist for
regular skin checks. Get
to your doctor right away
if you have a mole that fits
any one of the ABCDE
criteria, which are the most
concerning signs of a mole.
Asymmetrical. Half of a mole or
A: birthmark is shaped differently
than the other half.
The mole has borders that are
B: blurred, jagged, or notched.
Uneven color, including shades of
C: brown, black, pink, or blue.
Diameter—the mole is larger than a
D: pencil eraser.
Evolving over time—changing in
shape, color, or size.
E:
Save your skin and yourself
by avoiding tanning
QUIZ TIME indoors and outdoors,
Are you at risk for sun using sunscreen daily
damage and skin cancer? with a sun protection
Take a quiz at factor of 15 or
www.skincancer.org. greater, and staying in
Click on “Prevention,” the shade.
then “Are You at Risk?”
(health bits)
Only 20 percent of ovarian cancers
are found at an early stage. Awareness
of the early signs and symptoms of ovarian cancer
improves the odds of effective treatment. These may
include: feeling the need to urinate often or urgently,
abdominal or pelvic pain, feeling full quickly or having
trouble eating, and bloating. If you have symptoms like
these on a near-daily basis for more than a few weeks,
talk with your doctor.
WANT TO PREVENT
PROSTATE
CANCER? Focus on
maintaining a healthy weight, says
the Prostate Cancer Foundation.
And eat more fish—several studies
suggest lots of omega-3 fatty acids
can help protect your prostate.

IUOE Local 4 Health & Welfare Plan
PO Box 660
Medway, MA 02053-0660
PRSRT STD
U.S. POSTAGE
PAID
LONG PRAIRIE, MN
PERMIT NO. 372
www.local4funds.org
6272M
When it comes to obesity,
what you’re cooking is
obviously important, but so is
what you’re cooking on. Chemicals
found in nonstick cookware are
associated with weight gain,
especially in women, according to
a recent study in the journal PLOS
Medicine. Researchers think these
chemicals, called perfluoroalkyl
substances, slow the body’s
metabolism.
(health bits)
Just because a nutritional
supplement is labeled as
“natural” doesn’t mean it’s safe
or promotes good health. Check
with your health care provider to
find out about possible issues—from
interactions with prescription drugs
to dangers for people with certain
medical conditions.
Feeling stressed? Instead
of turning to destructive coping
mechanisms, like drugs or alcohol,
talk about your problems with
whomever you can: family, friends,
or a doctor, counselor, or clergy
member. Connecting with someone
who cares can help you cope with
stress in a healthier way.
If you think you are an
expert multitasker, try tracking
your time for just one workday. You
might be surprised to find out how
often you get sidetracked. Combining
like tasks that require similar skills and
then dedicating a set time to complete
them might prove to be a more
effective approach.
(continued from page 1)
Easy” smoking-cessation online workshop
during August and September at www.
ahealthyme.com/login. You will receive
support and guidance to quit, and be entered
into a raffle to win one of ten $50 gift cards.
If you have questions about these wellness
initiatives, please call the Plan’s Eligibility
Department at 1-888-486-3524 (option 5).
OUR BENEFITS:
3–D MAMMOGRAMS
The Plan now covers 3–D mammograms
(digital breast tomosynthesis) at no cost to
you, just as with standard mammograms
annually after age 35. Regular screenings
are the best way to find breast cancer at
an early stage, when treating the disease
has the highest success rates. Talk to your
doctor about the benefits and timing of
your mammogram screenings.
KEEP US UPDATED
Let us know if you’ve moved or changed
your phone number or other contact
information so we may update our records
and keep you in the loop on your great
benefits! The Plan sends important mailings
throughout the year. It is vital that your
contact and dependent info is current.
Submit any changes in writing to the
Benefit Funds Office. You may download
a change of address form from our website
at www.local4funds.org and mail it
to: IUOE Local 4 Benefit Funds, P.O.
Box 660, Medway, MA 02053.
If you have recently gotten married
or divorced or welcomed a child into your
family, please ensure you have completed
a new census card as well.
Also, if you have not yet submitted
your email address to us, please consider
going online at www.local4funds.org
to do so. You will continue to receive all
Plan communications via mail for the time
being, but it will provide us with another
way to reach out and stay in touch!
GRANDFATHERED
HEALTH PLAN
Please note that this Plan is a “grandfathered
health plan” under the Affordable Care Act.
For more information, please refer to page v
of your Summary Plan Description, or page
vii of the online version.
Sincerely,
Your Board of Trustees
William D. McLaughlin, Chairman
Nino Catalano
Paul C. DiMinico
David F. Fantini
James Reger
John J. Shaughnessy, Jr.
IUOE Local 4
William D. McLaughlin, Business Manager
Administrator
Gina M. Alongi
Information in the publication is the opinion of the authors. Personal decisions regarding health, finance, exercise, and other matters should be made after
consultation with the reader’s professional advisors. All models used for illustrative purposes only. All editorial rights reserved. Developed by StayWell.