June 2019

HealthLine
JUNE 2019
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:
• Men’s Health Week
• New Local 4 Members’
Assistance Coordinator
• Osteoporosis Screenings
• Newborns’ and Mothers’ Health
Protection Act
MEN’S HEALTH WEEK
Each year since 1994, the week leading up
to Father’s Day in June has been recognized
as Men’s Health Week. The purpose of this
week is to heighten awareness of preventable
health problems and to encourage early
detection and treatment of diseases.
Your Plan makes it easy to visit your
doctor and have screenings, vaccinations,
and other evaluations. For starters, please
take advantage of your annual well visit to
check in on any maintenance issues you may
be having, such as high cholesterol, high
blood pressure, or diabetes. Your well visits
are also a chance for you and your doctor to
speak about other concerns you may have,
such as depression, diet and exercise, or
alcohol and tobacco use. Your doctor may
If you suffer from depression,
exercise can help improve your
symptoms. But it can be difficult to find
the motivation to move when you’re
already feeling depressed. Here are some
tips: Find an activity you enjoy doing. Try
different workout classes, videos, and
routines. Choose the type and intensity of
exercise you like best. That way, you’ll be
more interested in the activity and more
likely to get moving.
(health bits)
also perform testicular and hernia exams,
two quick tests that can help with early
detection of problems. Your annual well
visits, and any lab work related to the well
visits, are at no cost to you.
Your Plan also covers important cancer
screenings, which look for cancer before
you experience any signs or symptoms.
Colorectal cancer screenings are covered
every five years via sigmoidoscopy or every
10 years via colonoscopy. Some tests can
help prevent colorectal cancer by finding
and removing polyps before they become
something worse, and other tests can
identify the cancer earlier, when treatments
are more likely to be successful. Colorectal
cancer tests, when performed as part of
routine screenings, are at no cost to you.
Further, the Plan covers routine prostate
cancer blood tests (PSA) each year after age
40, which can help with early detection and
treatment, also at no cost to you. Finally,
the Plan covers lung cancer screenings for
adults with a higher risk of lung cancer, at
no cost to you. You have a higher risk of
lung cancer if you are between the ages of
55 and 80, have a 30-pack-per-year smoking
history, and currently smoke or have
A new study in The Lancet suggests that
high levels of dietary potassium
may help protect against the
risk for cardiovascular diseases
associated with high salt intake. In the
study, rates of cardiovascular death, stroke,
and total mortality decreased as the amount
of potassium in people’s diets increased.
The takeaway: Eating more potassium-rich
foods, like fruits and vegetables, may help
protect against heart disease and stroke.
quit within the last 15 years. Please speak
with your doctor about the screenings or
evaluations that may be appropriate for you.
NEW LOCAL 4 MEMBERS’
ASSISTANCE COORDINATOR
Opioid abuse is rampant in the U.S., where,
on average, 130 people will die every
day from an overdose. Abuse issues are
even more prevalent in the construction
industry, where our members frequently
suffer from musculoskeletal pain because
of the very nature of their work. Your
Plan has already taken steps to combat this
trend by reducing the number of opioid
pills that may be dispensed per fill and by
installing a stringent prior authorization
process. The Plan has also partnered with
Modern Assistance Programs (MAP), which
since January 1, 2018, has had oversight of
inpatient substance abuse claims so that our
members and their families receive one-onone
personal attention and close-to-home
treatment at high-quality facilities.
Local 4 is going one step further to
ensure that our members and their families
can get quick access to care at their time of
greatest need. Andy Franzen, an instructor
(continued on page 8)
Work can be stressful, even
if you love what you do. So how
can you manage work-related stress?
The American Psychological Association
recommends you track your job
stressors for a week or two to see which
situations are the most stressful and how
you respond. Then, have a chat with your
supervisor so you can come up with a
plan to manage your stressors together.

2
WHAT’S THE
BUZZ ABOUT
Matcha?
(recipe)
IT’S SAFE TO SAY THAT MATCHA
MADNESS IS TOTALLY A THING RIGHT
NOW. In addition to being widely available
as a beverage, the nutrient-packed green
tea is also popping up as an ingredient in
everything from ice cream to muffins and
more. What exactly is this Kermit-colored
powder, and what’s behind all the hype?
MEET YOUR MATCHA
Matcha is a type of green tea. After the
leaves are harvested, they’re steamed
and ground into a powder. Unlike a
traditional tea bag, you consume the
actual powdered tea leaves.
Matcha contains more caffeine as
well as higher concentrations of the
amino acid L-theanine than other green
teas. The combination of caffeine plus
L-theanine can make you feel alert yet
relaxed at the same time, research shows.
In addition, matcha contains much
higher concentrations of the antioxidant
epigallocatechin gallate compared with
other types of green tea. The compound
may protect against many different
diseases, including cancer, studies show.
GET YOUR FROTH ON
Want to try the tea? Start by getting some
matcha powder in a store or online. Heat
water until just before it boils. In a bowl
or cup, combine about 1 teaspoon of
matcha powder with 6 ounces of the hot
water. Using a matcha whisk or electric
frother, blend together until the matcha
becomes frothy. Then it’s ready to drink!
Baked Chicken
and Cauliflower
Croquettes
2 oz. boneless, skinless chicken breast,
cooked
1 cup frozen cauliflower “rice,” thawed
2 tbsp. minced fresh onion or 1 shallot
1 tsp. white or red wine vinegar
1 tsp. salt-free Italian seasoning
½ tsp. Dijon mustard
¹⁄8 tsp. sea salt
1 egg white, whisked
1 tbsp. plus 1 tsp. chickpea flour
Olive oil spray
1. Preheat oven to 350 degrees. Puree
together chicken breast, cauliflower,
onion, vinegar, Italian seasoning,
mustard, and sea salt in a food
processor fitted with a standard blade.
2. Form mixture into a ball. Squeeze
excess liquid from the ball, then
form 12 1½-inch croquettes.
3. Dip croquettes in egg white. Then roll
croquettes lightly in chickpea flour.
4. Line a cookie sheet with a silicone
baking mat, then spritz with olive oil
spray. Place croquettes on the sheet,
evenly spaced apart, then spritz again
with olive oil spray.
5. Bake for 10 minutes, then gently
flip over to other side. Bake for five
minutes more.
Makes three servings. A serving is four
croquettes. Each serving provides
60 calories, 1 g fat (0 g saturated fat,
0 g trans fat), 20 mg cholesterol,
160 mg sodium, 5 g carbohydrates,
2 g sugar, 1 g fiber, and 9 g protein.

3
ARE YOU OBSESSED WITH
HEALTHY EATING?
MAKING HEALTHY FOOD CHOICES IS
SMART. But can you take healthy eating
too far? If you’re obsessed with eating
only the foods you consider to be healthy,
you may have an eating disorder called
orthorexia.
ORTHOREXIA SIGNS AND SYMPTOMS
People with orthorexia fixate on the
nutritional quality of their food and
obsess about healthy eating to the
point where it actually damages their
well-being. It’s not clear exactly what
contributes to orthorexia. One factor may
be a need to improve self-esteem or regain
a sense of control. Orthorexia is not
officially recognized as a mental disorder.
But awareness about it is on the rise.
Signs you may have orthorexia include:
• Compulsively checking nutrition
labels and ingredient lists
• Cutting out an increasing number
of food groups, such as all sugar,
dairy, or carbs, to the point of harm
• Eating only a small group of foods
on your “healthy” list
• Worrying for hours about food that
will be served at upcoming events
• Feeling very distressed when “healthy”
foods are not available
• Obsessively following food and
healthy lifestyle posts on social media
THE PROBLEM WITH FOOD
RESTRICTION
If you limit the amount and variety of
foods you eat, your body may not get the
vitamins and minerals it needs to
function properly. One of the main
problems associated with orthorexia is
malnutrition. Orthorexia can also cause
many other issues, including:
• Bloating, stomach pain, and
constipation
• Difficulty concentrating and sleeping
• Decreased levels of sex hormones
• Breakdown of muscle tissue
• Dry skin and brittle hair
• Iron deficiency
• Fewer white blood cells for
fighting infections
HELP IS AVAILABLE
If you or someone you love has
orthorexia, it’s important to seek
professional help. Programs for eating
disorders help people overcome
problematic beliefs and learn how to eat
well again. Love and support from family
and friends are also important to recovery.
(health bits)
EATING DISORDERS, SUCH AS ANOREXIA,
BINGE EATING, AND BULIMIA, ARE
SERIOUS, POTENTIALLY LIFE-THREATENING
ILLNESSES—but they can also be treated. Look for
these common signs of an eating disorder: an obsession with body weight or
appearance, going to extremes to limit food intake, or a lack of control over
the amount of food consumed. If any of these symptoms apply to you or
someone you know, consult a medical professional.
GET HELP
Contact the National
Eating Disorders
Association Helpline
at 800-931-2237.

4
PREGNANCY
Discomforts:
WHEN TO CALL THE DOCTOR
BEING PREGNANT CAN BE A WONDERFUL EXPERIENCE, BUT IT MAY ALSO
BRING SOME UNCOMFORTABLE CHANGES TO YOUR BODY. Most of these ills
—including backache, constipation, and morning sickness—aren’t worrisome.
During pregnancy, be sure to watch for signs of the following complications,
which do require medical attention:
1 Ectopic pregnancy: Bleeding and spotting are common and don’t always
mean there’s a problem, but they can be a sign of a serious complication,
including ectopic pregnancy. This occurs when the fertilized egg implants
outside of the uterus—usually in one of the fallopian tubes. In addition to
vaginal bleeding, other signs may include abdominal, pelvic, or shoulder
pain. Because an ectopic pregnancy could endanger your life, tell your
doctor right away if you experience any of these symptoms.
2 Urinary tract infection: It’s normal to urinate more often
while you’re pregnant. However, if you experience pain or a burning
sensation during urination, feel the need to go again right after
urinating, or notice blood in your urine, you may have a urinary tract
infection (UTI). It’s vital to seek treatment for a UTI because it may
lead to a kidney infection—which could trigger early labor.
3 Gestational diabetes: If you’re feeling excessively
thirsty, hungry, or tired, tell your doctor. You may have
gestational diabetes, a type of diabetes that affects only
pregnant women. Left untreated, it can boost the risk
for pre-eclampsia and premature birth. It can also
increase the chance that your baby will be born
with low blood sugar and breathing problems.
4 High blood pressure: Between 6 and
8 percent of U.S. women ages 20 to 44 will
experience high blood pressure during
pregnancy. Gestational hypertension
typically begins after week 20 and
goes away after childbirth. The
condition makes it difficult for the
baby to get enough oxygen and
nutrients and can lead to preterm
delivery and low birth weight. And
pregnant women with high blood
pressure have a higher risk for
pre-eclampsia and placental abruption
(when the placenta separates from the
wall of the uterus).
BANISH BACK PAIN
To relieve back pain during
pregnancy, keep a small pillow at
your lower back for support when
sitting. At night, try sleeping on
your side with a pillow between
your legs or under
your stomach.

5
DON’T GIVE CERVICAL CANCER A CHANCE:
Vaccinate Against HPV
PARENTS NEVER WANT TO SEE THEIR
CHILDREN IN HARM’S WAY. Yet
according to recent data, 51 percent of
adolescents have not received all the
recommended doses of the HPV vaccine.
HPV, or human papillomavirus,
causes almost all cervical cancers.
Learning about the vaccine—and
encouraging your kids to get it—can
reduce their risk for infection and
HPV-related diseases.
VACCINATION LEADS TO
BETTER HEALTH
The HPV vaccine does an excellent
job of vanquishing the virus. Clinical
trials show the shot provides nearly
100 percent protection against
precancers. It also offers a potent
defense against the strain of HPV
that causes genital warts.
What’s more, the side effects from the
vaccine are typically mild and include
arm swelling, fever, and headache. And
because the shot contains only one
protein from the virus, it can’t cause
HPV infections or cancer.
FACTS ABOUT HPV
HPV is spread through sexual contact.
Almost all sexually active people will
eventually catch at least one of the more
than 40 strains if they don’t get the
vaccine. In fact, nearly 80 million
Americans currently have HPV.
Nine out of 10 times, these infections
go away on their own—and many cause
no symptoms at all. Most people never
even know they have HPV. But one in
10 infections will eventually cause
health problems. Besides cervical cancer,
these include:
• Anal, vulvar, vaginal, or penile cancer
• Genital warts
• Cancer in the back of the throat
Every year, cancer caused by HPV affects
about 19,400 women and 12,100 men.
And it’s estimated that one in 100
A SHOT AT GOOD HEALTH
What other vaccines might your preteen need?
Visit www.cdc.gov to find out. Click on “Healthy
Living,” then “Vaccines & Immunizations.”
sexually active adults in the U.S. has
genital warts at any given time.
THE TIME TO ACT IS NOW
Your preteen’s health care provider may
ask you about the shot. You might be
surprised that he or she asks, especially
if you don’t think your child is sexually
active. But the HPV vaccine works best
in people who haven’t yet been exposed
to the virus through sexual contact.
Current recommendations advise that
all boys and girls ages 11 to 12 get two
doses of the HPV vaccine spaced at least
six months apart. But even older teens
and young adults can benefit. Women
can get the vaccine until age 26, and men
through age 21. Some men, such as those
with compromised immune systems, can
catch up on the vaccine through age 26 if
they weren’t vaccinated earlier.

6
Walk This Way:
HOW TO GET STARTED WITH A WALKING PROGRAM
WALKING IS THE IDEAL
WORKOUT FOR MANY
PEOPLE. It’s easy, accessible,
inexpensive, and virtually
injury-free.
Besides helping you lose
or maintain weight, a regular
walking program can help
lower your risk for heart
disease, high blood pressure,
diabetes, high cholesterol,
and osteoporosis. You should
see a health care provider
before you begin walking if
you have a chronic condition
or if you’re older than age 40
and have been inactive. But
you’re ready to start once
you’ve taken that precaution.
GET EQUIPPED
All you need for walking is a
good, supportive pair of shoes.
Walking shoes should be
lightweight and breathable,
with a well-cushioned heel
(where you land as you walk).
When selecting a shoe, test its
flexibility by trying to bend it
with your hands—bendable
shoes help your foot easily roll
forward and push off with the
toes. Also look for good arch
support and nonskid soles. But
the most important thing is
that you wear a shoe that fits.
Tip: Try on shoes with the
socks you plan to wear while
walking.
START EASY
Always do less than you think
you can when you begin; your
muscles and heart need to get
used to the movement.
Initially, try to start out
walking 15 minutes a day. If
that’s more than you can do
right now, do what you can.
Focus on sitting less and
moving more—even a few
minutes of physical activity
is beneficial.
Don’t worry if you last 1
mile or less. It takes time to
build strength and endurance.
GET WITH THE PROGRAM
Need some guidance? Check out
a walking program from the
American Heart Association. Visit
www.empoweredtoserve.org
and search for
“walking program.”
(test your savvy on … family fitness)
1. Children need more exercise than adults. ■ TRUE ■ FALSE
2. For the most benefits, children should participate in organized
sports, and adults should exercise separately in a gym setting.
■ TRUE
■ FALSE
3. Flying a kite, visiting the park, taking the dog for a walk, or
playing tag are family-friendly activities that count toward
your daily exercise goal. ■ TRUE
■ FALSE
4. You should set aside an hour each day just for your family to
exercise. ■ TRUE ■ FALSE
ANSWERS
instead of driving.
and go for a walk after dinner, or bike around the neighborhood
time. Find ways to fit in fitness wherever you can—turn off the TV
4. False. You don’t have to get all your exercise for the day at one
3. True. Fitness can be fun—any activity counts!
make the habit stick.
beneficial. Getting the whole family involved in an activity can help
2. False. Exercise doesn’t have to be traditional or structured to be
each week.
day to stay healthy. Adults should get at least 150 minutes of exercise
1. True. Children need at least 60 minutes of physical activity each

7
5 Ways Busy Parents Can Achieve
BETTER BALANCE
BUSY. HURRIED. OVERWHELMED. If you have kids and those sentiments sound familiar, you’re not
alone—more than 80 percent of parents say they frequently feel rushed. Between jobs, school, homework,
sports, and more, these five tweaks can help you strike a better balance as you try to juggle it all.
1.
MASTER the SLOW COOKER.
Prep your ingredients the night before,
refrigerate them in the removable insert,
plop it into your slow cooker, and hit “start”
in the a.m. A hot meal will be waiting for
you when the day is done.
2.
SEIZE the NIGHT.
Before the morning gets
going, take some time to
prep what you can the night
before, such as laying out
clothes for yourself
and your kids and
packing backpacks.
5.
TACKLE CHORES TOGETHER.
Involve your family in household
responsibilities such as cleaning up
after dinner or tidying the house on
weekends. You’ll knock them out
more quickly and free up time for
other activities.
4.
3.
CREATE
LUNCH LISTS.
Sit down with your
kids and make a list
of different proteins,
grains, fruits, veggies,
and snacks that they
enjoy. Use the list
as your guide to
streamline the lunchpacking
process and
ensure you’re sending
a balanced meal.
LET SOMETHING GO.
You might make it to the grocery store
tonight, but laundry will have to wait until
tomorrow. Maintaining realistic expectations
is key for managing a hectic schedule.

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
(health bits)
It may be tempting to work
off anger or other strong
emotions at the gym, but a study
in the journal Circulation concludes that
it significantly increases your risk for
a heart attack. Looking at more than
12,000 heart attack cases in 52 countries,
researchers found that people who were
angry or emotionally upset in the hour
before they exercised were more than
three times as likely to suffer a heart
attack. Exercise is generally beneficial for
your heart, but make sure you are in a
good emotional place before working out.
Whole grains provide more
fiber than refined ones, but
sometimes it can be difficult
to tell which kind of grain you
are eating. Just because bread is
brown, for example, doesn’t mean it’s
made of whole grains. Molasses or other
ingredients can create the darker color.
Look for foods labeled “whole grain”
and not “cracked wheat,” “multigrain,”
“stone-ground,” “seven-grain,” or “100
percent wheat,” which probably
indicates a refined grain product. Fun
fact: Popcorn is a whole grain. With little
or no butter and salt, it makes for a
healthy whole-grain snack.
A persistent sore and pain in
the mouth are two of the
most common symptoms of oral
cancer. Mouth pain or a sore that
lasts for more than two weeks can be a
sign of many noncancerous conditions
as well. An exam by a health care
professional can help determine the
true cause.
(continued from page 1)
Andy Franzen,
instructor, Local 4
Training Center
at the Local 4 Training
Center and a proud Local
4 member for over 20
years, has been trained
to serve as a conduit between our members
and their families and the higher level of care
that is available at MAP. Andy is a highly
respected member of the Local 4 community,
and he is devoted to serving our members
with the greatest degree of confidentiality
and care. Andy will have Narcan available if
necessary, but our hope is that members and
their families come to Andy before they have
a life-or-death emergency, so that he can
listen, provide support, and steer them in the
right direction before they become one of that
day’s 130 fatalities. Andy has a strong working
relationship with MAP and its great team of
professionals and will work with MAP to
ensure that his brothers and sisters in crisis get
the highest level of care and attention.
Andy can be reached at 781-364-6322 or
by email at afranzen@local4training.org.
OSTEOPOROSIS SCREENINGS
The U.S. Preventive Services Task Force has
revised its recommendations for screening
for osteoporosis. Currently, the Plan covers
routine screening for osteoporosis in women
age 65 and older at no cost share, whereas
women under age 65 must provide a co-pay.
However, as of June 1, 2019, the benefit
has been expanded to include screening
for postmenopausal women under age 65
who are at increased risk of osteoporosis,
also at no cost share. The risk factors for
osteoporosis include parental history of
hip fractures, smoking, excessive alcohol
consumption, and low body weight.
NEWBORNS’ AND MOTHERS’
HEALTH PROTECTION ACT
This act requires group health care plans
to provide a minimum hospital stay for
the mother of a newborn child of 48 hours
after a vaginal delivery and 96 hours after
a cesarean section. Federal law does not,
however, prohibit the mother’s or newborn’s
attending physician, in consultation with
the mother, from determining that a shorter
length of stay is appropriate. The Plan
requires admission certification of your
maternity stay only if the minimum length
of stay (48 or 96 hours, as applicable) is
exceeded. A stay exceeding the minimum
length requires authorization and is subject
to review for medical appropriateness.
Under the Plan, a pregnancy-related hospital
stay is treated like an illness, as required by
federal law.
Sincerely,
Your Board of Trustees
William D. McLaughlin, Chairman
Angelo Colasante
Paul C. DiMinico
David F. Fantini
David Marr, Jr.
James Reger
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.