Healthy Living

Healthy Living: Reusable Grocery Bags- Shades of Green?

Updated 4 years ago

By- Dr. Amy MoviusEnvironmental awareness has increased dramatically in recent years – globally, nationally, politically and in about any other way one can think of. Some years ago, reusable shopping bags made their appearance. They are now a common sight – ready for purchase along side the tabloids and candy bars – at checkout counters of many grocery stores. As these bags have become more popular, they have become more fashionable and can be found in a variety of colors and designs. Attention has recently been directing toward an unwitting consequence of these bags: that some may contain significant amounts of lead.Earlier this month, a newspaper in Florida reported a story in which 2 dozen different reusable bags were obtained from the largest grocery stores in state. Each bag was tested for lead content twice. Some of these bags had lead levels that were quite high. These results are concerning as lead toxicity is no small manner. Lead is a neurotoxin and has been found to harmfully affect children’s IQ. This is why lead level screening of young children has been standard for many years.The (possible) presence of lead in reusable shopping bags poses 2 major concerns. The first is for contamination of food carried in these bags. There is good news on this count! Fortunately, the form the lead takes in these shopping bags is not easily extracted or leached, so the food carried should be unaffected.The second concern is, ironically, environmental. As these reusable bags wear out and are eventually disposed of, the lead can be released into the environment. The lead content of some of these bags was of a level at which the EPA would generally require further testing before accepting as suitable for landfill. There will undoubtedly be more information on this topic to come. In the meantime, however, it is still possible to be an environmentally conscious reusable bag shopper by following the “less is more” rule. In the Florida newspaper article, high lead levels were found in the more elaborately decorated shopping bags, especially those containing yellow or green paint. In contrast, plain nylon bags with little in the way of embellishment from multiple stores had lead levels near zero. If this isn’t reassuring enough, one can always ask for (and then recycle!) paper bags.

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Healthy Living: Health Benefits from Sitting Down to Family Dinners

Updated 4 years ago

By- Dr. Jonathan WoodFor some, the term “family dinner”conjures up a picture of Beaver Cleaver and his parents, Ward (in his necktie) and June (with her pearls). That picture is probably pretty dated, but family dinners are thankfully not a thing of the past. It turns out that the number of families who eat dinner together at least 5 times/week has remained pretty constant at around 60% over the last 10 years. And according to Columbia University’s “Center for Addiction and Substance Abuse”, there are numerous apparent benefits for teens that are associated with this habit.The study, which has been revised and repeated six times since 2001, compares two groups:• Parents and teens who have dinner together 5 or more times each week• Parents and teens who have dinner together 2 or fewer times each weekIn the 2010 study, over 2000 teens and almost 500 parents were surveyed to generate these results.Teens from families who infrequently eat dinner together had significantly increased experience with substance use:• Twice as likely to have used tobacco• 89% increase in having used marijuana• 50% increase in having used alcohol• Much more likely to report friends who:o Use marijuana (58% increase)o Use Ecstasy (63% increase)o Abuse prescription drugs (50% increase)o Use LSD, cocaine, or heroine (25% increase)Additionally, increased family dinners have a clear positive correlation with improved academic performance. Higher academic performance, in addition to the obvious benefits, is in itself consistently associated with lower rates of substance abuse.Families that eat together on a regular basis report higher rates of general discussion about all aspects of child and adolescent life, including discussions of current events, school and sports, friends and social activities, and family issues or problems.Family dinner also seems to improve general relationships and the sense of wellbeing within families. 70 percent of teens who eat dinner with their parents 5-7 times/wk report that their parents are proud of them compared with 48 percent of teens who dine with their families 2 or fewer times/wk. Furthermore, nearly three quarters of teens (72%) report that eating dinner with their parents is either “fairly important” or “very important”.Whether true “cause and effect” or simply association, these results are too impressive to ignore. Something happens at the dinner table when the opportunity is offered and that “something” is generally very positive. It is too simple to not take advantage of, so think about it.For more information, visit the National Center for Addiction and Substance Abuse website:www.casacolumbia.orgFor the full 2010 report, “The Importance of Family Dinners VI”:www.casacolumbia.org/templates/publications_reports.asp

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Healthy Living: Vitamin D

Updated 4 years ago

The New Wonder Vitamin?By- Dr. Joan Marie PellegriniMost of us learned in school that Vitamin D is important for our bone health and that we get it from being in the sun. This is true. The sun on our exposed skin, along with our liver and kidneys, acts to convert the inactive molecule to the active vitamin. We can also get the active vitamin in our diet. Many foods, including milk, are supplemented with vitamin D. Vitamin D is critical in regulating our calcium metabolism. We have known for decades that vitamin D is critical for bone development. However, there is now increasingly significant research into the other biologic actions of this vitamin. These include the immune system (both the innate and adaptive), pancreas (i.e. diabetes) and metabolic homeostasis, heart-cardiovascular (heart disease and hypertension), muscle and brain systems (i.e. dementia), as well as the control of the cell cycle, and thus of the disease process of cancer.I have been telling my patients for years that if they have a problem with colon polyps, that taking Caltrate (calcium) and aspirin my help to reduce the number of polyps. New evidence shows that these same patients would probably also benefit from Vitamin D supplementation.Several conditions such as tuberculosis, psoriasis, eczema, Crohn’s disease, chest infections, wound infections, influenza, urinary tract infections, eye infections and wound healing may benefit from adequate circulating vitamin D levels.Scientists and nutritionists from many countries agree that at present about half of elderly North Americans and Western Europeans and probably also of the rest of the world are not receiving enough vitamin D to maintain healthy bone. This despite very well publicized national guidelines and supplementing our milk and orange juice. It is unclear exactly why our vitamin D levels are low. It could be from reduced dietary intake or less sun exposure or, more likely, a combination. We all live in a northern climate and this means we have less sun exposure than people living near the equator. Also, we tend to use sun screen which blocks the sun’s ability to help our skin make vitamin D.So, should you take a vitamin D supplement? You should evaluate how often you are outside when it is sunny. Is it at least 10 minutes a day without sunscreen? How much vitamin D are you getting in your diet? Dietary sources that are high in vitamin D are milk, orange juice (if the carton says it has added vitamin D), and fatty fish (such as mackerel and salmon). If you think you may not be getting enough, then a supplement of 1000 IU a day during the summer and 200 IU during the winter may be beneficial. If you are someone who seems to get every virus that goes through your office of school, then some experts believe this may be a sign of being relatively vitamin D deficient and that you’d benefit from taking extra vitamin D. If you are on medications or have liver or kidney disease, then you should discuss this issue with your physician before starting vitamin D supplementation.

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Healthy Living: Tree Stand Safety

Updated 4 years ago

By- Dr. Joan Marie PellegriniHunting season has arrived and already we have seen hunters seriously injured because of falls from their tree stand. A quick Google search of tree stand accidents will quickly tell you that this is a common problem. Depending on where you live, up to 1/3 to ½ of all hunting accidents are a result of falling off or out of a tree stand. Of these accidents, 75% result in injury because the hunter was not using a harness or was using a harness improperly. This is really unfortunate because all commercial tree stands come with a fall restraint system (FAS). Also, this topic is covered in all hunter safety courses.Most falls happen when transitioning into the stand or out of the stand. Also, stands must be maintained and examined for wear and tear. Unfortunately, many falls are also related to alcohol intoxication.I have attached a list of safety tips from the Treestand Manufacturers Association and from the Tennessee Wildlife Resources Agency.1. Always wear a safety harness while hunting from a tree stand, including while ascending and descending. Make sure you understand how the harness should be properly used. Do not use a harness that looks worn or is not certified for your weight.2. Never climb into a permanent stand you have not built yourself or carefully checked out. 3. Always hunt with a plan and a buddy. Let someone know where you are going to be and when you plan to return.4. Always have an emergency signal device such as a cell phone, walkie-talkie, whistle, etc.5. Never hunt from tree limbs and make sure the tree is healthy and alive. Dead trees do not make sturdy supports for stands.6. Be sure the commercial stand you have is safe. Practice with it before using it in the woods. 7. Never climb a tree that is too small or too large for your stand to fit safely. 8. Be sure your stand is level at the height you wish to hunt. 9. Always stand up slowly and be sure of your balance. 10. Be sure you are steady and braced before shooting. 11. Always use a line haul line for your gear. Never climb with your equipment. 12. Be more careful than you think you need to be.

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Healthy Living: Sugar Sweetened Drinks

Updated 4 years ago

There’s More Than SodaBy- Dr. Amy MoviusChildhood obesity has been recognized as a very important topic in recent years.  An estimated 17% of teenagers and children have a BMI-for-age that is greater than or equal to the 95%ile.  Many public health efforts have been made to understand and try to address the epidemic of obesity in our nations youth, such as Maine’s “Keep ME healthy 5-2-1-0″ campaign.The amount of Sugar Sweetened Beverages (SSBs) consumed by our children is recognized as important factor contributing to obesity.  Adolescents have more than doubled their daily SSB intake since 1977: it now accounts for an average 10-15% of total daily caloric intake! Drinking one 12 ounce can of SSB a day results in up to 15lb of weight gain per year.  Also, studies have shown that drinking SSB has displaced (healthy) milk drinking.Sugar Sweetened Beverages are often equated with soda, but actually include any drink that contains a caloric sweetener such as sugar or high fructose corn syrup.  This includes a LARGE variety of carbonated and noncarbonated Flavored and Sports Beverages (FSBs) as well as soda.A study in the upcoming October issue of the journal Pediatrics (released online yesterday, September 27th) evaluates how food and activity choices of adolescents correlates with SSB consumption, and also evaluates the effects of soda and FSBs separately.  More that 15,000 8th or 11th graders middle and high school students – from public schools across Texas participated.   They reported how many SSBs (0, 1, 2, 3) they drank in the previous day and also answered questions about healthy food intake (fruits/veggies/milk), unhealthy food intake (fried meat/fried snack/dessert), physical activity (PE, organized sports, own activity) and sedentary habits (hours of TV, computer, video games).Alarmingly, 28% of all the teens drank 3 SSBs per day.  All of the SSBs (soda + FSB) were associated with eating unhealthy foods and sedentary habits i.e. the more SSBs you drank, the more unhealthy foods you ate while being sedentary for more hours a day.  However, whereas drinking soda was also associated with less physical activity and less healthy food intake, drinking FSBs was associated with MORE physical activity and MORE healthy food choices.  This means teens who drank more FSBs tended to do more physical activity and eat more healthy foods.  The positive association between drinking FSBs, physical activity and fruit/veggie/milk consumption suggests that FSBs are viewed as being consistent with a healthy lifestyle.  This pattern is also seen with consumption of 100% fruit juice (which is not a SSB).  The presumed explanation is that these products have been successfully marketed as relatively healthy.  In fact, a 20 ounce bottle of a popular sports drink contains almost 9 teaspoons of added sugar.  Public health efforts to date have discouraged intake of all artificially sweetened beverages without making much distinction between different types.  Clearly, health professionals need to be more specific.  In the meantime, encourage those around you to know exactly what they are drinking if it isnt milk or water.Reference:  Ranjit et al. Dietary and Activity Correlates of Sugar-Sweetened Beverage Consumption Among Adolescents.  Pediatrics Volume 126, Number 4, October 2010. 

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Health Watch: Social Phobia

Updated 4 years ago

By-Dr. David PrescottSocial Phobia is a type of Anxiety Disorder: Phobias are intense, excessive fears about certain objects or situations. While most people experience heightened anxiety in some situations, people with phobias find their fears to be debilitating. One common type of phobia is termed social phobia, or social anxiety. Typically, symptoms of social phobia are first evident in the early teenage years. Social phobia impacts about 15 million Americans, and it causes everyday social situations to become fraught with anxiety and embarrassment. Social Phobia is one type of anxiety disorder along with problems like panic disorder or obsessive-compulsive disorder. Together, anxiety disorders impact nearly one in every five people. Defining Social Phobia: Social Phobia was long associated with being shy or timid, and its impact on people’s lives was minimized. However, in the early 1980′s, psychologists and other researchers began to focus on how social anxiety could be debilitating for some people. The essence of Social Phobia is:· Overwhelming anxiety and self-consciousness when a person interacts with others. · Intense, chronic fear of being watched and judged by others. · Extreme fear of doing things that will cause embarrassment during a social interaction. · Intense physical and subjective anxiety in most social situations: for example, feeling sick to your stomach, sweating, or racing heart. Brain Activity and Social Phobia: Recent research on social phobia highlights the fact that mental health problems involve a complex interaction of brain chemistry, thinking patterns, and behaviors. Brain images of people with social phobia were compared to a control group after receiving a critical comment such as “You are ugly.” The people with social phobia exhibited significantly higher levels of brain activity in brain areas responsible for emotional arousal and areas responsible for self-evaluation. Thus, it appears that people with social phobia experience a heightened brain response to criticism, which likely contributes to their fear of social situations. “Caught Between a Rock and a Hard Place:” Getting a Person with Social Phobia to Seek Help. The struggle to seek help with a psychological problem is especially difficult for people with Social Phobia. Like all social interactions, the thought of meeting with a counselor is likely to cause intense anxiety and fear of embarrassment. Family members and friends can help by providing extra support, perhaps by accompanying the person to their first visit. Treatment for Social Phobia: All anxiety disorders, including Social Phobia, have an excellent change of improving with treatment. People with social phobia often would like to be with other people more often, or would like to reach out to friends. However, when the moment comes, they typically experience extremely high levels of anxiety and feel compelled to change their plans. Treatment can help people with social phobia overcome this pattern of fear and avoidance. The types of treatment that are effective include: · Cognitive Behavioral Therapy: Cognitive Behavioral Therapy involves identifying and changing thinking patterns which cause and perpetuate anxiety. These thinking patterns, and the behavior that follows, can be changed to break the cycle of escalating anxiety and avoidance of social interaction. · Medications: The most commonly used medications for social phobia are anti-anxiety medications, such as Klonopin, or a class of antidepressant medications called SSRIs (selective serotonin reuptake inhibitors) often help make anxiety more manageable. Medications are often a helpful adjunct to “talk” therapies. · Behavior Therapy: Behavior Therapy, like systematic relaxation training, can be used to teach specific skills to reduce anxiety. For More Information: Acadia Hospital www.acadiahospital.org National Institute of Mental Health www.nimh.nih.gov/health/publications American Psychological Association www.apahelpcenter.org

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Healthy Living

Updated 4 years ago

Why do you get a beer belly when you drink beer?By- Dr. Joan Marie PellegriniThere is nothing particularly special about beer that makes it cause a beer belly. A “beer belly” is nothing more than just being overweight. Any type of extra calories will lead to a beer belly although it does seem that alcohol has a tendency to cause fat to accumulate around the midsection. Most people don’t seem to notice the calories in a drink as much as they notice what they eat. A couple of beers will run you on average about 300 calories. But some beers can have as much as 200-300 calories per serving. Now add in the munchies that go along with a beer and you could easily be up to 600 calories or more. That is a dangerous trend when the caloric need of an average sedentary adult is only 2000 calories or less. In general, it takes an extra 3500 calories to store a pound of fat. If you eat your necessary calories each day and then add only one beer (average 150 calories) a day for a year, you will add 15 pounds to your waist if you don’t offset with exercise. A “light” beer has less alcohol and therefore has less calories. However, even a light beer has about 75 calories. All beers have “empty” calories. This is a term that nutritionists use to label a food that does not offer any nutritional benefit such as protein, fiber, or minerals and vitamins.Men are more likely to get the “beer belly” look because of the way they distribute fat. Men tend to put fat inside their abdomen whereas women are more likely to put fat under their skin. Strong abdominal muscles can help a man “suck in” the abdomen and hide the extra fat that is being stored inside. A beer belly will also become more noticeable as we age because we lose some of our muscle and the skin becomes less tight. People who drink a lot of beer tend to be people who do not exercise. Most of us exercise less as we age and this contributes to gaining a beer belly. There are also some hormonal reasons why we accumulate fat around our midsection as we age.

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Healthy Living: Making a Psychologically Healthy Adjustment to School

Updated 4 years ago

By- Dr. David PrescottTimes of transition are often both rewarding and stressful. The transition to the new school year, while much anticipated, may bring particular challenges for some children and families. Knowing the early signs of common school adjustment problems can help parents, students, and teachers adjust to a difficult transition without letting a relatively small difficulty grow into a major problem. Three common issues which may require extra attention during the start of a new school year include: 1) anxiety about going to school (“school phobia”): 2) difficulties in peer relationships and bullying: 3) academic difficulties/risk for school dropout.School PhobiaWhat are the signs? It is normal for children and teenagers to worry. A recent study reported that 70% of children say they “worry every now and then.” In children, phobias or anxieties are often displayed through avoidance, behavior problems like tantrums, or physical symptoms like stomach aches or headaches. Children who have school phobia may say that they are worried about what may happen to their parents while they are in school, or find other reasons that they shouldn’t go to school. They may ask for excessive reassurance about going to school. Suggestions for coping with school phobia • For children of all ages, show interest: Listen, give encouragement, and ask questions. • For younger children, get on the bus with a friend. This can help children not feel so alone. • Organize the night before. If your child is anxious about going to school, try not to make the trip out the door full of stress and last minute running around. • Talk to a mental health professional or school counselor if your child begins missing school or leaving early due to stress or worry. Peer Relationships and BullyingWhat are the signs? Bullying is a form of aggressive behavior in which someone intentionally and repeatedly causes another person injury or discomfort. Bullying can take the form of physical contact, words or more subtle actions. Research suggests that about one in five (17%) of school age children report being bullied sometimes or often. There is no single profile of a bully, such as the stereotypical tough on the outside/insecure on the inside child. Many bullies are extremely popular with their peers and, surprisingly, popular among teachers and other adults.Suggestions for coping with peer relationship problems and bullying:• Listen to the problem: Many times, listening to your child’s problem in a patient, relaxed manner can help them feel better immediately, and can help your child start to think of solutions. • Enlist the help of school counselors and administrators: Many schools have worked hard to reduce bullying. A chat with the principal or guidance counselor will help you support your child in a way that is consistent with what they experience at school. • Provide Perspective and Look for Strengths: Try to help your child keep a long term perspective on peer problems. Things don’t always turn around in a day. While you are figuring out how to make things better, don’t forget to help your child focus on what they do well. Academic Struggles and Risk for School DropoutWhat are the signs? Let’s focus for a moment on children in early adolescence. Research suggests that children normally become more self-critical and negative in their opinion of themselves as they enter their early teenage years. As schoolwork becomes more difficult, young teenagers may be filled with doubt about their abilities and skills. Poor grades may be one sign of this. Sometimes teenagers may express dislike for a subject or teacher partly due to their own self-doubts. Helping them overcome these struggles has significant benefits in terms of future work and self-esteem. Suggestions for Coping with Academic Struggles and Risk for Dropout• Effort matters: Even though it may just sound like a saying, research shows that there is a positive correlation between effort and performance in school. Keep in mind that, at least in this case, hard work does appear to pay off. • Look for improvement, not perfection: Try to help your child make improvement, rather than perfection, their goal. • Enlist help: Improving in schoolwork requires both emotional and technical support. Friends, teachers, parents, and siblings can all provide different types of support. Help your child feel like they aren’t isolated in dealing with their struggles. For More Information: Acadia Hospital: www.acadiahospital.orgAmerican Psychological Association Help Center: www.apa.org/healthcare

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Healthy Living: Male Pattern Baldness

Updated 4 years ago

For millions of american men, with age, hair can thin or fall out and never come back. TV5 health expert Doctor Eric Steele is here to talk about male pattern baldness.

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Healthy Living

Updated 4 years ago

How much cancer risk is there in getting a CAT scan?By- Dr. Joan PellegriniThis is a very difficult question to answer. However, there is a growing concern about what that answer may be because of the extensive use of x-rays in medicine. There is a growing concern that the increasing use of radiologic studies may lead to an increase in our cancer rates. Plain x-rays do not use much radiation but CT scans use much more. Since the 1980′s there has been a rapid rise in the use of CT (Computed Tomography) scanning in the medical field. CT scans use a form of radiation in order to produce images. Doctors order CT scans frequently in order to give us information to aid in diagnosis or to prepare for a surgical procedure. A CT scan can tell a medical professional about what an organ or tissue may look like without actually performing surgery to look. There are obvious benefits to using x-rays and CT scans. Unfortunately, there is also a risk because of the exposure to radiation. The Radiological Society of North America (www.radiologyinfo.org) publishes information on how much radiation exposure happens with various x-ray studies.To put the amount of radiation it in perspective, the average American is exposed to about 3 mSv (a mSv is a measure of a type of radiation) per year of background radiation (basically everything around us is at least a little bit radioactive). Most of our exposure comes from the radon in our homes. In contrast, a CT scan of the stomach exposes a patient to 10 mSv (about 3 years’ worth of ambient exposure). A chest x-ray only exposes us to 0.1 mSv (about 1/100th that of a CT scan). Cell phones have hit the news lately because of the accusation that extended use may cause brain cancer. Cell phones, power lines, computers, microwaves, etc emit a non-ionizing radiation which is less damaging than the ionizing radiation of x-rays because it does not penetrate the skin and cells as easily. Therefore, one cannot easily compare this type of equipment and radiation with medical imaging radiation.Another concern is airport x-ray machines. For the most part, these are used on the luggage and not on the passengers. The new total body scanners do use radiation that amounts to approximately 0.001 mSv (1/1000th of a chest xray). The type of radiation is called “backscatter” and is weak and bounces off the skin. It is not strong enough to penetrate tissues and therefore is no more risky than sun exposure. TSA states on their website that this amount of radiation is equivalent to two minutes of flying on a jet. Metal detectors use a magnet and no radiation. So, from the numbers above, it becomes clear that CT scanning exposes a patient to a significant amount of ionizing radiation. We know that too much ionizing radiation will increase a patient’s risk of developing cancer. What we don’t know is how much is too much and how increased is the risk? Some experts would contend we are seeing increasing rates of cancer in patients who frequently undergo CT scanning. Although this is debatable, I would suggest that caution be used. CT scans should only be ordered if there is likelihood that it will yield useful information and if that information will be used by a medical professional to tailor treatment. In other words, a CT scan should not be done just to see if it shows anything. This is an important concept because many patients and physicians have the mistaken belief that it won’t hurt to order a CT scan and see if it shows anything wrong. One CT scan is probably not worth worrying about. However, it may be concerning if someone has several CT scans over several years. A classic example would be a patient who gets a CT scan every year or two to look for a kidney stone, evaluate for appendicitis, or look for a cause of abdominal pain.The current recommendation from radiologists is that a patient and medical provider discuss why the imaging study is being ordered and what information is expected to be obtained. Also to be discussed is what other diagnostic modalities are available and how will treatment change based on the radiology results. A patient should understand the concept of accumulating radiation exposure and accumulating risk.

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Healthy Living: SPF Sunscreens

Updated 4 years ago

By- Dr. Amy MoviusIf you’ve gone sunscreen shopping this summer (and I hope you have!) the options available are mind-boggling. A few years ago, it was rare to find a sunscreen SPF (sun protection factor) rating of more than 45: now there are many products with ratings of 70, 80, 90 and even 100! But what, exactly, do these ratings mean?Let’s start with what the Sun Protection Factor does. An SPF rating refers to the sunscreen products’ ability to block ultraviolet B, or UVB, rays. UVB rays cause sunburn and contribute to the risk of skin cancer. Now, for what SPF doesn’t do. SPF sunscreens do not block UVA or ultraviolet A rays. About 95% of the UV rays we are exposed to are UVA. UVA rays are closely linked to deeper skin damage (wrinkle causing) and also contribute to the risk of skin cancer. SPF rating measures time. A SPF rating of 10 means you would be protected from sunburn causing UVB rays 10 times longer when using the product than without using the product. As shown below, UVB protection does not increase in direct proportion to the SPF number:SPF UVB rays blocked15 94%30 97%45 98%Accordingly, SPF 15 products are generally fine if used correctly, but few people apply sunscreens as heavily or often as they should. Some providers recommend SPF ratings of 30 or so for this reason alone. No product blocks 100% of UVB rays, so distinctions between SPF 45 to 100 are tiny. In fact, the FDA is working on a new labeling system to limit SPF product claims to 50.Finding a sunscreen that protects against UVA rays is just as important, but a lot harder to do. Many sunscreens that block UVA rays often do so by chemical filters (avobenzone or Mexoryl). However, the protection may be marginal as these chemicals break down quickly and lose effectiveness in the sun, unless stabilized. Few companies have been able to prove they can stabilize these chemicals. Barrier sunscreens containing zinc oxide or titanium are preferred by some dermatologists but many people dislike the thick, pasty and opaque products that are over-the-counter. There are some medical-grade sunscreens that contain these barriers in a micronized form that isn’t so thick or visible.No sunscreen will be effective, however, if not used properly. A water-resistant formula is recommended and should be applied generously about a half hour before going outdoors. It should be reapplied at least every 2 hours, or after swimming, drying off, or sweating. For more information on sunscreens, including specific products, go to www.wedmd.com, High-SPF Sunscreens: Are they Better?

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Healthy Living: Eating Disorders

Updated 4 years ago

How to Talk About These ProblemsBy- Dr. David PrescottEating disorders continue to be a major concern in America, as people struggle to find a balance between increasing rates of obesity, developing a positive body image, and healthy lifestyles. Friends and family often are the first people to develop concern that a loved one has an eating disorder. The following are some tips for starting a conversation about eating disorders, and helping people with eating disorders get professional treatment.How do I start a discussion about a possible eating disorder? The first time you raise a concern about an eating disorder with a family member or friend, realize that the conversation may be a starting point rather than an ending point. Some useful strategies for having the first conversation include: 1. Learn about eating disorders and treatment options before you talk: Having an understanding of the behaviors, feelings, and treatment options for eating disorders will help you to feel more confident and supportive. 2. Express your concerns without focusing on the eating behavior: Try to express your concerns for the other person without making statements like “you are putting on weight” or “you are getting too thin.” Rather, statements about your experience of what it is like to be around them (“a lot of times I think you are sad or unhappy”) may be a good starting point. 3. Ask if the person has considered that something is wrong, or if they are open to talking with a health professional: Gently asking whether a person has considered that they have a problem, or if they have thought about talking to a health professional will often yield surprising answers. Typically, people with eating disorders have given the issue a great deal of private thought. 4. Take a break if things get too stressful: Remember, control is usually an important issue in eating disorders. Don’t be afraid to take a break in a non-confrontational way. Insisting that a difficult conversation be finished “here and now” can often lead to a control battle. Coming back to the conversation in a supportive way shows your commitment and willingness to have some give and take. What are the Types of Eating Disorders? There are three major types of eating disorders. 1. Anorexia Nervosa involves having a distorted body image where a person sees themselves as overweight even when they are dangerously thin. People with anorexia have an intense fear of gaining weight, and often develop unusual habits such as refusing to eat around other people. Anorexia usually occurs in women, and is often accompanied by infrequent or absent menstrual periods. 2. Bulimia Nervosa involves eating excessive quantities of food, sometimes in secret, then trying to purge the body of the food and calories by using laxatives, vomiting, exercising or diuretics. People with bulimia nervosa usually feel ashamed and disgusted as they binge, yet also feel relieved of tension once the binge-purge cycle is complete. 3. Binge Eating Disorder involves frequent episodes of excessive, out-of-control eating. However, there is no attempt to purge the body of excess calories. How do I know if I am at risk for an Eating Disorder? Obviously, the determination of when concerns with food, eating and body image cross the line from “normal concern” to “psychological problem” varies from person to person. However, if you answer “yes” to any of the following questions, it may suggest that you are at risk for an eating disorder: – Are you constantly preoccupied with weight and intense fear of becoming fat?- Do you believe that your body weight needs to be below what is recommended by physician or dietician? – If you are a woman, have you skipped or stopped a menstrual period when you were losing weight? – Do you frequently feel out of control when you eat? – How much of your eating is secretive or hidden from others? – Have you tried, or strongly considered, trying to lose weight by vomiting, using laxatives, or exercising according to how much you eat? Is Treatment for Eating Disorders Necessary? The sooner that treatment starts for an eating disorder, the easier it is to treat. Eating disorders don’t usually go away by themselves. And, if left untreated, eating disorders can cause serious physical problems (like anemia, tooth decay, and hair and bone loss) as well as severe emotional distress, getting help is vitally important. Treatment often involves working with a licensed psychologist or therapist, dietician, and physician. Where else can I find help? Information about eating disorders is available at:• American Psychological Association (www.apa.org)• National Institute of Mental Health (www.nimh.nih.gov)• National Eating Disorders Association (www.nationaleatingdisorders.org)Information about mental health and substance abuse, including eating disorders is available at: • Acadia Hospital – 1-800-640-1211 or www.acadiahospital.org

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Healthy Living

Updated 4 years ago

Keeping Your Cool: Understanding Heat Related IllnessBy- Dr. Amy MoviusTourists flock to Maine for the glorious summers: natives wait all year to enjoy it. However, when the temperature cranks up as in recent weeks, we all need to be careful not to get “too much of a good thing”.Heat related illness, often called “sunstroke”, occurs when the body has increased heat production and decreased heat transfer to the environment. Heat related illness can be fatal in its most severe form, heatstroke. The body usually cools itself by sweating, but in very hot temperatures it may not be enough – especially when it is also humid (Maine!). Risk factors for getting ill from the heat include being in the heat too long, exercising, being old or young, being sick to begin with, and being overweight. Because the consequences are so dangerous, it is important to recognize when you, or someone else, is developing heat related illness.Heat Cramps. Muscle pain/spasms can be one of the first signs of heat related illness. Stomach, arm, and leg cramps are most common and often happen during strenuous activity. They are most frequently seen in children. If someone develops heat cramps, follow the steps below: 1. Bring person to a cool place. 2. Give him/her water or sports beverage to drink. 3. Massage affected area gently. 4. Insist he/she wait SEVERAL HOURS after cramping is gone before doing any physical activity. 5. If cramps last more than 1 hr, seek medical attention.Heat Exhaustion occurs when the body has lost excessive water and salts from sweating. In addition to muscle cramps, victims will have profuse perspiration, cold and pale and clammy skin, fatigue and weakness, headache, dizziness, fainting, nausea/vomiting, rapid & shallow breathing, and a fast &weak pulse. If someone develops signs of heat exhaustion, follow the steps below: 1. Follow the same steps as heat cramps listed above. 2. Take victim’s temperature (preferably rectal). If greater than 103.1 treat as for heatstroke (section below). 3. Give patient a cool bath (tub or sponge) or shower. 4. If symptoms worsen or last more than 1 hr, seek medical attention. An immediate trip to the emergency room may be needed.HeatStroke occurs when the body temperature rises so high that cells are damaged. It is estimated that 12% of adults with heatstroke die. Body temperature can rise to 105o F or more in only 10 to 15 minutes. Victims of heatstroke cannot sweat well. Symptoms include temp 103.1oF or more, red & hot & dry skin, fast & strong pulse, nausea, dizziness, headache, confusion, loss of consciousness. If someone develops signs of heatstroke, follow the steps below: 1. Immediately call for Emergency Services and begin cooling the victim as described below. 2. Move to a cooler place. 3. Remove clothing . 4. Put cool water on the skin. This can be done by immersing in tub/shower, doing a cool sponge bath, even spraying with a garden hose. 5. Direct fan or air conditioner at victim if available. 6. Take temperature every 5 minutes, continue actively cooling until it is less than 102oF. 7. Don’t give the affected person anything to drink or put anything in their mouth. If they vomit or have a seizure, simply turn their head to the side.As always, prevention is the best strategy. On hot days, drink plenty of fluids, replenish salt and minerals with sports drinks or other intake, and limit time and exertion in the sun – especially during the hottest midday hours.References:1. HeathlyChildren.org – Heat Related Illnesses2. Jardine. Heat Illness and Heat Stroke, Pediatrics in Review. 2007:28:249-258. doi:10.1542/pir.28-7-249

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Health Watch: Binge Drinking – Short and Long Term Consequences

Updated 4 years ago

By- Dr. David PrescottBinge Drinking and Alcoholism: Most of us are well aware of the risks associated with excessive alcohol use. Over 14 million people abuse alcohol at any given point in time. More than 20,000 people die each year directly from alcohol related health problems, while many more are killed or injured in accidents where alcohol use is a contributing factor.It can be tempting to think of people with alcohol problems as primarily people who drink every day, develop dependence on alcohol, and begin to organize their lives around drinking. However, recent research suggests that binge drinking may be as much of a problem as chronic alcoholism. What is Binge Drinking? Binge drinking is defined as heavy drinking within a limited period of time: 5 or more drinks for males, 4 or more drinks for females. Obviously, drinking this much puts a person over the legal limit of blood alcohol content for intoxication. It well known that alcohol intoxication puts people at high risk for motor vehicle and other accidents that lead to death and serious injury. But, the risks of binge drinking are not limited to accidents. Short Term Problems with Binge Drinking: Short term problems with binge drinking include: • Risk of alcohol poisoning: For some people, binge drinking leads to alcohol poisoning and may cause death. • Impaired Ability to Drive: Recent research suggests that the majority of motor vehicle accidents that involve alcohol are caused by people who binge drink, rather than people who are alcohol dependent (“chronic alcoholics”).• Impaired ability to make good judgments: Not only does binge drinking impair your ability to drive, or do any complex activity, but your own judgment of how well you can perform is impaired when you binge drink. • Pressure to Binge Drink related to Events or Milestones: More and more research suggests that major events, like 21st birthdays, are increasingly associated with expectations that binge drinking will occur. Long Term Problems with Binge Drinking: • Binge Drinking Beginning at Younger Ages: One of the most startling statistics about binge drinking concerns the early ages at which binge drinking first occurs. One in ten sixth graders report at least one episode of binge drinking. One in three high school seniors have consumed 4 or more drinks at one time in the past month. These statistics highlight that problem drinking begins well before the legal age to purchase alcohol. • Increased Risk for Problems In Adulthood: Research suggests that people who binge drink as teenagers are 60% more likely to develop alcohol dependence, 70% more likely to drink heavily as adults, and are twice as likely to have a criminal record. Getting Help for Alcohol Problems: People for whom alcohol has become a significant problem often downplay the role of alcohol in their life. Denial is often viewed as a defining characteristic of alcohol addiction. So, if you try to point out to someone that they have an alcohol problem it is likely that they will disagree with you. Nevertheless, overcoming an alcohol addiction is usually very difficult to manage without help. Some simple tips for getting help include: • Keep in mind the risks associated with binge drinking and alcohol dependence. These include accidents which occur after drinking, short and long term health problems, and difficulties at school or work. • Talk with a mental health professional. A psychologist, social worker, or licensed professional counselor can help look at whether or not alcohol use is a problem in your life, and can help you understand better the factors that contribute to alcohol abuse. • Talk with a doctor or primary care physician. For some people, talking to your family doctor is more comfortable than seeking help from a counselor. Most primary care doctors have basic training in evaluating alcohol related problems, and can help you decide if you need further help. • Alcohol Addiction may be masking other problems. People who abuse alcohol may be trying to cope with an underlying psychiatric problem like depression or an anxiety disorder. Or, getting drunk may be a short term way to cope with family problems or a troubled relationship. Usually however, using alcohol makes it more difficult to sort out the original problem. Talking with a mental health professional can help you find some other ways to cope. Want More Information? American Psychological Association Help Center: www.apahelpcenter.orgSubstance Abuse and Mental Health Services Administration – Center for Substance Abuse Treatment: www.csat.samhsa.gov/faqs.aspx

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Healthy Living

Updated 4 years ago

CHRONIC PAIN MAY NEED A NOVEL THERAPEUTIC APPROACHBy- Dr. Joan Marie PellegriniMany of us probably know someone with chronic pain. If you do, then you may also be familiar with the difficulty in adequately treating pain in these individuals. Acute pain is the immediate pain that we feel as a warning sign to tell us to stop doing something or to tell us that something is wrong. Chronic pain is pain that continues even when the injury has healed and may be referred to as “pathologic pain”. Often this chronic pain is really a neuropathic pain. Neuropathic means that the nerve is disordered and may be sending pain signals when it should not be. One standard approach to pain is to treat with “pain killers”. These drugs are known medically as narcotics. Narcotics work on the neuron to dim the pain signal.Scientists have known for a very long time that nerve cells are surrounded by other cells called “glia”. The glia are support cells that regulate nerve activity. They maintain the chemical environment surrounding neurons by delivering energy, sopping up the neurotransmitters and releasing healing factors. New research is showing that it may the glial cell that is more important in the cause of chronic pain. This is important because narcotics do not treat disorders of the glia. In fact, glia may be responsible for the narcotics losing their effectiveness over time (a phenomenon known as tolerance). The drugs that have an effect on glia are very different. For instance, one drug is a type of antibiotic (minocycline). Marijuana is not a narcotic and acts on receptors in the glia to dim the pain response. This is part of the reason why marijuana is being used to treat some cancer patients with chronic pain. Research is focusing on several new drugs that are very early in the development phase.This new research will have a very important impact. For one, it will be important not to prescribe narcotics for a neuropathic pain if they are not going to be effective. Narcotics can have serious side effects. Also, there will be many patients who have lived with pain who are in dire need of new and better treatments.

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Healthy Living

Updated 4 years ago

Calcium & Vitamin DCalcium is critical to health through all stages of life. And Vitamin D is critical to maintaining calcium balance.And yet we do not get enough of either…!Calcium Calcium is critical to bone health. Most of us know that. But what other questions might you have?Q: Do our dietary behaviors in adolescence affect such things as osteoporosis in middle and old age? A: Yes. Those behaviors are critical. Adequate calcium intake in adolescence directly influence bone health in later life. Taking calcium through life prevents bone loss in later life. Q: Is calcium important for anything other than “bone health”?Y: Calcium is critical to heart function, nerve transmission, blood clotting, and the function of virtually every cell in the body. Adequate calcium intake may also prevent high blood pressure, prevent colon cancer, and help people diet successfully. This last fact is being increasingly studied in light of our increasing realization that avoiding obesity is critical to overall health.Q: How much calcium do I need?Y: At least 1000 mg/day after age 8. During the critical periods of adolescence and after 50 years old, 1200-1300 mg/day is recommended.Q: Do I need to take pills?A: Not necessarily. Dairy products are an excellent source of calcium – – 8 oz of milk/yogurt or 1.5 oz of cheddar cheese each contain about 300mg of calcium. Other calcium-rich foods include green leafy vegetables, broccoli, fish, almonds, oats, and fortified foods such as orange juice or tofu. If diet doesn’t provide adequate calcium, supplementation is simple. Calcium carbonate is the best: one “extra strength” antacid tablet (Tums or generic) contains 750mg. Or take a multi-vitamin. In both cases, be sure to check the label. % Daily Value is based on 1000 mg/day.Vitamin D We get vitamin D from two sources:(1) through diet or (2) through synthesis in the skin in response to sunlight.Sun exposure is limited by a number of things including skin pigmentation, latitude, sunscreen use, and air pollution. All this make sun exposure an unreliable source of vitamin D. Diet, therefore, is critical. Older children and adults tend to get enough through supplements, but should be aware of the recommended daily intake for all ages: 400 IU/day.Infants are not so lucky. Q: Why is sunlight a particularly poor way for infants to get vitamin D?A: The American Academy of Pediatrics and all other medical societies is clear on the need to avoid sun exposure in infants and children. Sunscreen is uniformly recommended and therefore precludes sun exposure as a means of getting vitamin D.Q: Is there a particular challenge associated with dietary vitamin D in infancy?A: Yes. · Breast milk does not contain vitamin D meaningful amounts· Formula is fortified, but intake must be 34 oz/day to meet requirements, an amount rarely reached in infancy· Baby foods do not provide the needed vitamin D.Q: Are infants and children at particular risk?A: Vitamin D deficiency in infancy and childhood affects bone development. In the most severe cases, it can cause softening and weakening of the bones, impair growth, cause developmental delays, and even result in lethargy or seizures.Q: Is there a solution?A: Yes. Infants need supplementation with vitamin D. This needs to be part of a daily routine and not seen as a “medicine”. Despite recommendations to receive 400 IU/day, physicians continue to not provide this for infants. A recent study (April 2010) showed that in breast fed or combined breast-milk/formula fed infants, less than 15% were receiving the recommended dietary vitamin D. And complete formula fed infants were not much better at less than 35%. Supplementation is not happening!Q: Why don’t physicians supplement infants?A: Studies show that many physicians think vitamin D deficiency only happens to dark skinned infants or that breast milk contains adequate vitamin D or that infant receive enough sunlight. All these suppositions are wrong!Parents: you must ask your infant’s physician about vitamin D supplementation. Adequate vitamin D is essential to healthy bone development and to normal childhood development!For more information about calcium and vitamin D supplementation, consult the American Academy of Pediatrics website: www.aap.org

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Healthy Living

Updated 4 years ago

National Drinking Water Safety WeekBy- Dr. Joan PellegriniEvery year the Federal Government, along with organizations such as the Centers for Disease Control (CDC) and the American Water Works Association, kicks off a week-long awareness campaign about our drinking water supply. This week many of us are aware of the issues because of the recent oil spill in the Gulf of Mexico and the water main break in Boston. The motto for this week is “Only tap water delivers”. This motto is intended to highlight the importance of public water supply and safety and the need to reinvest in our water supply infra-structure. Americans have the luxury of a very safe and abundant water supply. However, this does not come without hard work and expense. Some of our infra-structure is aging and will require expensive upgrades and repairs. Very few Americans ever have to worry about turning on their faucet and getting contaminated water or not getting any water at all. That is because our local water companies work diligently to provide a clean and safe water supply. As a consumer, though, we need to do our part to protect our water supply and to support funding initiatives to keep our systems in good repair. We can protect our water supply by respecting our reservoirs and aquifers. This means not polluting around them and obeying the laws about land use around the reservoirs. It also means limiting some activities such as fertilizing, spraying pesticides, dumping near reservoirs, and using gasoline or other types of engines on our reservoirs.Tap water is very safe and often safer than well water. It may even be safer than some bottled water. It has the added benefit in most communities of providing a source of fluoride. Bottled water is generally not recommended because of the impact on the environment from the wasted bottles. It also is far more expensive than tap water. There is no data that bottled water is safer or better for you than tap water in the US or Canada. There also is only minimal data that fluoridated water poses any risks. Certainly, we have seen a decrease in dental decay because of fluoride.Up to 20 percent of New Englanders have a well for their water source. The well water is usually tested when the well is first drilled and again if the house is sold. However, it is recommended that the well water be tested more frequently in order to check for contamination. Below, I have an address for Maine’s website on well water information.Below are some websites for further information:This is a PDF put out by the Federal Government to explain many of the issues that affect our drinking water supply. There are also resources listed for obtaining information on water safety.http://www.epa.gov/ogwdw/wot/pdfs/book_waterontap_full.pdfThis is the Center for Disease Control’s website on drinking water:http://www.cdc.gov/Features/DrinkingWater/Maine also has a website for information on how to get your well water tested and what to do if you think there is a problem with your well:http://www.maine.gov/dhhs/eohp/wells/mewellwater.htm

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Spanking: What are the Potential Effects?

Updated 4 years ago

By- Dr. David Prescott – Acadia HospitalThe Controversy Around Spanking: Arguments about the potential benefits and drawbacks of spanking as a means of child discipline have been ongoing for decades. Research shows that a majority of Americans do not oppose spanking as an occasional way of stopping undesirable behavior. And, most people agree that spanking can cross a line to where it constitutes physical abuse. However, answering the question of whether or not spanking truly causes problems in children has proven to be complex and difficult. Recent Research on Negative Effects of Spanking: A soon to be published study conducted at Tulane University examined the impact of spanking 3-year old children, following them until they were 5 years old. Results showed that children who were spanked more frequently at age 3 were more likely to show aggressive behaviors by age 5. The study was unique in that it attempted to sort out the impact of spanking from other potential factors which could cause aggression, such as levels of aggression/violence between parents, neglect by parents, or stress/depression in the mother. When the impact of these other factors was removed, it still appeared that children who were spanked frequently were more likely to be aggressive. Children who were spanked more than twice a month at age 3 were 50% more likely to commit aggressive acts at age 5. Researchers also found that the differences were not accounted for by children’s natural level of aggression. That is, it did not appear that children who were naturally more aggressive were simply more likely to be spanked. Are There Benefits to Spanking? Both research and surveys of parents show that the primary benefit associated with spanking is its immediate effect on undesirable behavior. Spanking is typically highly effective in getting an action to stop right away. The drawback cited by those opposed to spanking is that corporal punishment creates an environment where new learning is unlikely to occur. Stated another way, children who are spanked are typically at such a high level of emotional arousal that they are unlikely to learn more appropriate behaviors. It is only when emotions have calmed that learning “the right thing to do” can occur. What do Professionals Recommend? Most pediatricians and psychologists are in agreement that repeated use of spanking causes more harm than good. The American Academy of Pediatrics takes the following position: The American Academy of Pediatrics strongly opposes striking a child for any reason. If a spanking is spontaneous, parents should later explain calmly why they did it, the specific behavior that provoked it, and how angry they felt. They also might apologize to their child for their loss of control. This usually helps the youngster to understand and accept the spanking, and it models for the child how to remediate a wrong.What to Do Instead of Spanking? Psychologists and other health professionals have developed many techniques to help children learn more appropriate and desirable behaviors without using corporal punishment. Strategies such as using time out, rewarding positive behavior, and teaching non-aggressive ways of coping with anger and frustration have benefitted many parents and children. Many parenting books, as well as the web sites of the American Psychological Association, the American Academy of Pediatrics, and the American Academy of Child and Adolescent Psychiatry, offer guidance on these approaches. For more Information: American Psychological Association: www.apa.org/topicsAmerican Academy of Pediatrics: www.aap.orgAmerican Academy of Child and Adolescent Psychiatry: www.aacap.org

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Healthy Living

Updated 4 years ago

Keeping your Facts – and Fats – StraightBy- Dr. Amy MoviusMost of us know that a healthy diet is rich in fruits, vegetables, whole grains, and fiber – and low in fat. In fact, it is recommended that fats make up no more than 25-35% of our daily calories. Keep in mind that fat contains more than twice the calories, gram for gram, than carbohydrate or protein. Then there is consideration of the type of fat in question: trans fats, saturated fats, unsaturated fats, hydrogenated fats, omega 3 fatty acids?? It can certainly be confusing, but the particulars are worth getting to know as the differences can have a huge impact on your health.Saturated Fats (Bad Fats)Saturated fats are perhaps the easiest to understand, since these are fats that come from animals – think meat and dairy. Saturated fats contain cholesterol. There are a few plant sources such as coconut and palm oil.Unsaturated Fats (Good Fats)Unsaturated fats come in two varieties, polyunsaturated and monounsaturated. These fats are found in fish, nuts, seeds, and oils from plants. These fats may help to reduce cholesterol, especially when used in place of their saturated counterpart. Omega 3 is a type of polyunsaturated fat.Trans Fats/Hydrogenated Fats (Good Fats gone BAD!)Hydrogenation is a process, used on unsaturated fats (good fats), that produces hydrogenated or trans fats (very bad fats). Hydrogenation produces products such as margarine, shortening, and cooking oils (partially hydrogenated and hydrogenated vegetable oils). Trans fats are insidious in our diets: they sneak their way into many baked goods as well as fried foods. In a large study of women, the most common sources of trans fat were margarine, beef/pork/lamb as main meal, cookies, and white bread. Though they do not contain cholesterol, they still cause bad cholesterol to rise, maybe even more than the cholesterol-containing saturated fats. To add insult to injury, they may also decrease good cholesterol. It is recommended that trans fat constitute no more than 1% of our diet. Since 2006, trans fat content must be listed on nutrition labels. This can be enormously helpful when shopping: my family discovered a formerly beloved pancake mix contained trans fat. Eating out can still be perilous, however, as there is no labeling requirement at this time. Hydrogenated vegetable oil is typically used for commercially fried foods. Keep in mind these products can still be labeled as “cholesterol free’ and “cooked in vegetable oil”. One order of fast food French fries easily exceeds the daily recommended intake of trans fats by several times!Now that you know the skinny on different fats, use the following American Heart Association guidelines to keep your family eating and feeling well.1. Use naturally occurring, unhydrogenated vegetable oils such as canola, safflower, sunflower or olive. 2. Avoid saturated fat in your diet. Limit total fat to between 25 and 35% of calories, mostly from unsaturated sources (fish, nuts, seeds, vegetable oils)3. Read labels and select processed foods made with unhydrogenated oil rather than partially hydrogenated or hydrogenated oils, or saturated fats.4. Use soft margarine instead of butter and choose liquid or tub varieties over harder stick forms. Look for “0g trans fat” on label.5. Don’t eat fried or baked goods often as they tend to be high in trans fat. French fries, doughnuts, cookies, cracker, muffins, pies and cakes are examples.6. Limit commercially fried foods and baked goods as they are usually very high in fat in general, and it is often hydrogenated or trans fat.7. Avoid fried fast food. They are usually cooked in hydrogenated products and are very high in trans fat.8. Use fat-free and low-fat dairy products.Again, a diet rich in fruits, vegetables, whole grain and high–fiber foods is also recommended. The American Heart Associated has a lot more great information on keeping you and your family healthy at www.americanheart.org.

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Healthy Living: Irritable Bowel Syndrome

Updated 4 years ago

By- Joan Marie Pellegrini Irritable bowel syndrome (otherwise commonly known as “IBS”) is a condition of the colon. We do not know what causes it and therefore it is very difficult to know how to cure it. The current most common medical theory is that IBS is a disorder of the nerves that control the function of the colon. IBS causes abdominal pain, bloating, gassiness, diarrhea, and/or constipation. The symptoms can be so severe that it limits one’s activity and ability to work. A doctor may diagnose IBS by the classic set of symptoms and by ruling out other common disorders. The doctor may order tests to rule out a malabsorption disorder such as lactose intolerance or celiac disease. Sometimes a colonoscopy is indicated in order to evaluate for inflammatory bowel disease. Once a patient is given a diagnosis of IBS, there is a four-pronged approach to treatment. The four prongs are: dietary modification, stress reduction, exercise, and (lastly) medications. Dietary modification: A person with IBS should keep a food journal in order to determine which foods cause the most symptoms. Common foods to avoid are milk products and foods high in fat. Also, it is important to add fiber. There are many types of fiber on the market and most of them will cause less gas and bloating than the fiber found in foods. Many people find that the soluble fibers cause the least amount of symptoms. I usually recommend to my patients that they use a combination of soluble (inulin) and insoluble (psyllium) fibers along with increasing the fiber-rich foods in their diet. If someone has diarrhea, then it is usually recommended to avoid or limit caffeine intake. On the other hand, caffeine can benefit the person with constipation. Stress reduction: Just about everyone with IBS notices that their symptoms are worse with stress. In fact just about every disease is worse with stress. There are many components to stress reduction with include psychological evaluation, counseling, breathing exercises, biofeedback, acupuncture, yoga, prayer, etc. Exercise: The colon is fairly responsive to exercise. Many people notice that their constipation is much improved with aerobic exercise. It is not quite understood how exercise benefits the bowel but it is a well known fact that it does. Exercise can also be a source of stress reduction. Medications: This is generally considered the last resort. There are medications that treat the symptoms such as laxatives for constipation, anti-diarrheals or anti-spasmodics for diarrhea, simethicone for the gas, and pain medication for the pain. In general, narcotics are least effective for bowel-related pain. Anti-depressants also may be effective. Finally, there are two drugs on the market for IBS (Lotrenex and Amitiza). These drugs have fairly serious side-effect profiles. If you or a loved one have been given a diagnosis of IBS, the goal is to manage the symptoms and not allow the disease to control your life. There is no cure but there is promise in the future as more reseach is done on bowel motility disorders. Just about every patient who embarks on a well-rounded treatment program will experience significant relief. However, most of the options listed above will need to become part of a person’s lifestyle in the long run. The following is one of my favorite sites for information on IBS:http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106

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