The Unprocessed School Lunch

Author: Rosetta Danigole, Lead Dietitian at UMC

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Planning School Lunches

The school year is upon us.  Now is the one of the busiest times for both parents and kids as they settle into new schedules and routines. For many, a big part of that experience is thinking about and planning school lunches.

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In today’s society more children suffer from obesity, autoimmune disorders, Autism spectrum, ADHD and gut sensitivities and allergies.  Parents have to consider these concerns as well as how to pack not only a healthy school lunch but also an economical one as well.

Processed Foods

The processed food craze has certainly contributed to these disorders with the addition of the preservatives, other chemicals and gluten that some children may be sensitive to.

The summer is the time when parents may be more lenient about food choices but hope to get their kids back on track with the school year.

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Some Recommendations

Remember to always keep the school lunches balanced with lean protein such as poultry, fish, lean beef, eggs, nuts or other meat alternatives.

Make lunches fun by making sure you use some of your kids’ favorite foods and be imaginative by including fun shaped sandwiches, a nice note from you, and maybe some stickers.

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Here are some ideas for the Unprocessed School Lunch with special consideration for gluten free if needed for those kids with digestive complaints.

  • Fresh Raw produce such as apples, berries, cherries, bell peppers, and carrots.  Cut them up in bite sized pieces and add a fun dip such as hummus or a nut butter (check school policy regarding nuts in school lunch boxes)
  • Dried fruit such as raisins, craisins, and apple chips are also great options.
  • Hummus or Avocado dips- You may be surprised the number of kids like these “dips”.  Try adding carrots for a crispy treat.
  • Gluten free Granola Bars or protein bars- This makes a great snack for your kids.  You can find those made with dried fruits, coconut, and flax held together by honey.
  • Popcorn- This is always a healthy snack and treat and makes a tasty crunchy treat instead of potato chips.
  • Protein options- Try boiled eggs, fresh sliced turkey, or homemade chicken strips for the protein items.  Kids may also eat grass fed turkey or beef jerky for a change. If you make a sandwich you can try pita bread, bagels or gluten free bread if preferred and needed.
  • Homemade soup in a thermos- This is an old-fashioned wonderful option for your kids.  Nothing like mom’s homemade soup when it comes for lunch.  If gluten sensitive you can always use rice noodles and add nut floured crackers on the side.
  • Yogurt- Try adding a low sugar yogurt or a piece of string cheese for a calcium boost.

Most important when you have the chance introduce kids to new foods and make sure the dinner meal is full of healthy vegetables, complex carbohydrates and lean protein.

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About the Author

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As the lead dietitian at University Medical Center New Orleans, Rosetta Danigole manages clinical dietetic operations. She is a member of the Academy of Dietetics and Nutrition and belongs to the clinical dietitian practice group. She has been a dietitian for 35 years.

 

Tobacco and Heart Disease

Author: Johnny d’Aquin MS, RRT, RPFT, UMC Pulmonary Services Director 

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May 31, 2018 is World No Tobacco Day, an annual program of the World Health Organization, and I can’t think of a better day than that one to quit smoking.

The focus of World No Tobacco Day 2018 is “Tobacco and heart disease.” The goal is to raise awareness on the link between tobacco, and heart and other cardiovascular diseases (CVD), including stroke, which combined are the world’s leading causes of death.

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The Truth About Tobacco and Heart/Cardiovascular Disease

The American Heart Association (AHA) says diseases caused by smoking kill more than 440,000 people in the U.S. each year.  Smoking puts people at high risk of lung disease, including lung cancer and emphysema. Smokers also have increased risk for heart disease and stroke.

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Cardiovascular diseases (CVD) kill more people than any other cause of death worldwide, and tobacco use and second-hand smoke exposure contribute to approximately 12% of all heart disease deaths.

  • One out of every 5 smoking-related deaths is caused by heart disease.
  • Women older than 35 who smoke and take birth control pills are at much greater risk for heart disease or stroke.
  • Cigarette smokers are 2 to 4 times more likely to get heart disease than nonsmokers.
  • Cigarette smoking doubles a person’s risk for stroke.

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How Does Smoking Change the Heart and Blood Vessels?

Smoking:

  • Causes an instant and long-term rise in blood pressure.
  • Causes an instant and long-term increase in heart rate.
  • Reduces blood flow from the heart.
  • Reduces the amount of oxygen that reaches the body’s tissues.
  • Increases risk for blood clots.
  • Damages blood vessels.
  • Doubles the risk of stroke (reduced blood flow to the brain).

Smoking has also been linked with depression and stress.

The good news is that quitting smoking can reduce the risk of heart disease.

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According to the AHA, stopping smoking reduces the risk for heart disease, the risk for repeat heart attacks, and death by heart disease by half.

GettyImages-672597012.jpgGet Help/Quit Smoking

UMC is partnering with the Smoking Cessation Trust to help people quit smoking.

If you smoked just one cigarette before September 1, 1988 and are a current Louisiana resident, you are eligible to register with the smoking cessation trust and get free help.

You can get free smoking cessation medications, doctor visits, quit-line coaching and counseling. Call our office at (504) 702-4636 or enroll online.

Why Wait Another Day?

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Know Your Numbers

Authors: Alan Gatz, MD and Kendria Holt-Rogers, MD, UMC Primary Care Physicians

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Today,  many people are aware of the need to focus on the effect of risk factors and life choices on overall health and wellness. Health professionals speak to patients about cholesterol, blood sugar, blood pressure, BMI (body-mass index), and hemoglobin A1c, but many individuals become overwhelmed and do not totally understand all of the information as presented.

Here’s a condensed and simplified description of the above mentioned health determinants.

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Cholesterol

This term actually should be changed to lipids, which includes the entire family of proteins sub-divided into three major subcategories:

  1. LDL (low density lipoprotein) cholesterol
  2. HDL (high-density lipoprotein) cholesterol, and
  3. Triglycerides (TG).

The two numbers the majority of people need to remember are their LDL and HDL levels.

A simple way to understand the concept of reducing heart and vascular disease is to keep the low low and the high high. LDL level above 150 mg% increases the risk of developing blood vessel blockage while HDL above 50 mg% helps protect against the development of this problem.

High triglycerides also can affect a person’s health including development of pancreatic disease.  Any intervention – including lifestyle changes and medications –  that will improve the overall cholesterol readings will also improve the total TG.

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Interventions to improve the cholesterol numbers and reduce risk of cardiac disease:

  • Exercise – 30-45 minutes 3 times per week
  • Diet – increase fiber, reduce fat and sugar
  • Weight loss – even 5 pounds will affect the level
  • Medication – effective but comes with risk of side effects

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Blood sugar (Glucose)

Important in the proper functioning of most all body systems, if the blood level is too high, many of the major organs can be damaged irrevocably, most notably the heart, kidneys, circulatory system and eyes. Normally, people think of getting a blood sugar reading by having their finger lanced to obtain a drop of blood.  This “spot” reading will give an idea of current glucose level but the Hemoglobin A1c (Hgb A1c) is much better at allowing us to determine average blood sugar level over several weeks.

Without getting too scientific, the higher the average blood sugar, the higher the level of Hgb A1c.  In general we strive to get the level below 7%.

Ways to improve Hgb A1c :

  • Take your medications as prescribed
  • Prescribed exercise program
  • Improve diet and control your weight

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Body Mass Index

This number is determined by a patient’s height and weight.

The ideal BMI is between 18.5 and 25.  Below 18.5 is considered underweight with 25-30 being overweight.

Those individuals above 30 are classified obese.  The importance of BMI lies with the effects of stress on the heart, circulatory system, joints, muscles and metabolism.  Severe obesity with BMI greater than 36 increases the individual’s risk for hypertension, myocardial infarction (heart attack), stroke, diabetes, degenerative arthritis, decreased independence.  Obviously we cannot affect the BMI by growing taller but anything we can do to reduce weight will improve the BMI.

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Blood Pressure

The measurement of blood pressure is important in determining the stress the heart experiences pumping the blood through the thousands (approximately 60K) of miles of blood vessels in the body. Like a body builder the heart, if faced with greater weight (pressure), will grow to meet the challenge.  But, also like the body builder, there can be too much growth (the heart becomes muscle bound) which results in the heart failing to “lift the weight”. The result is heart failure which many times causes permanent disability and death. 

We don’t have the time or space to discuss the effects of blood pressure on the kidneys,  but suffice it to say untreated blood pressure is a leading cause of kidney failure and need for dialysis.

Remember these numbers – Systolic 135, Diastolic 80. 

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If your readings fall above these numbers you should seriously consider speaking with your health care provider about intervention.

Interventions to improve blood pressure:

  • Reduce weight
  • Reduce alcohol intake
  • Reduce salt in the diet
  • Exercise with emphasis on aerobic activity
  • Adequate rest – sleep 6-8 hours/night
  • Stress reduction – yoga, meditation, therapeutic massage

Hopefully, this primer will help you manage your health with greater confidence and purpose.

Dr. Gatz and Dr. Rogers look forward to being your partner in wellness. To schedule an appointment, call the clinic at 504-962-6120. Visit www.umcno.org/primary-care to learn more about UMC’s Primary Care Center and its services.

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A Healthy Plate is a Happy Plate: 20 Ways to Enjoy More Fruits & Veggies

Author: Academy of Nutrition and Dietetics staff registered dietitian nutritionists

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Building a healthy plate is easy when you make half your plate fruits and vegetables. It’s also a great way to add color, flavor and texture plus vitamins, minerals and fiber. All this is packed in fruits and vegetables that are low in calories and fat. Make 2 cups of fruit and 2 ½ cups of vegetables your daily goal.

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Try the following tips to enjoy more fruits and vegetables every day:

  1. Variety abounds when using vegetables as pizza topping. Try broccoli, spinach, green peppers, tomatoes, mushrooms and zucchini.
  2. Mix up a breakfast smoothie made with low-fat milk, frozen strawberries and a banana.iStock-485076210.jpg
  3. Make a veggie wrap with roasted vegetables and low-fat cheese rolled in a whole-wheat tortilla.
  4. Try crunchy vegetables instead of chips with your favorite low-fat salad dressing for dipping.
  5. Grill colorful vegetable kabobs packed with tomatoes, green and red peppers, mushrooms and onions.
  6. Add color to salads with baby carrots, grape tomatoes, spinach leaves or mandarin oranges.*
  7. Keep cut vegetables handy for mid-afternoon snacks, side dishes, lunch box additions or a quick nibble while waiting for dinner. Ready-to-eat favorites: red, green or yellow peppers, broccoli or cauliflower florets, carrots, celery sticks, cucumbers, snap peas or whole radishes.
  8. Place colorful fruit where everyone can easily grab something for a snack-on-the- run. Keep a bowl of fresh, just ripe whole fruit in the center of your kitchen or dining table.iStock-832079576.jpg
  9. Get saucy with fruit. Puree apples, berries, peaches or pears in a blender for a thick, sweet sauce on grilled or broiled seafood or poultry, or on pancakes, French toast or waffles.
  10. Stuff an omelet with vegetables. Turn any omelet into a hearty meal with broccoli, squash, carrots, peppers, tomatoes or onions with low-fat sharp cheddar cheese.
  11. “Sandwich” in fruits and vegetables. Add pizzazz to sandwiches with sliced pineapple, apple, peppers, cucumber and tomato as fillings.
  12. Wake up to fruit. Make a habit of adding fruit to your morning oatmeal, ready-to-eat cereal, yogurt or toaster waffle.
  13. Top a baked potato with beans and salsa or broccoli and with low-fat cheese.iStock-140256741.jpg
  14. Microwave a cup of vegetable soup as a snack or with a sandwich for lunch.
  15. Add grated, shredded or chopped vegetables such as zucchini, spinach and carrots to lasagna, meatloaf, mashed potatoes, pasta sauce and rice dishes.
  16. Make fruit your dessert: Slice a  banana lengthwise and top with a scoop of low-fat frozen yogurt. Sprinkle with a tablespoon of chopped nuts.
  17. Stock your freezer with frozen vegetables to steam or stir-fry for a quick side dish.iStock-530627641.jpg
  18. Make your main dish a salad of dark, leafy greens and other colorful vegetables. Add chickpeas or edamame (fresh soybeans). Top with low-fat dressing.*
  19. Fruit on the grill: Make kabobs with pineapple, peaches and banana. Grill on low heat until fruit is hot and slightly golden.
  20. Dip: Whole wheat pita wedges in hummus, baked tortilla chips in salsa, strawberries or apple slices in low-fat yogurt, or graham crackers in applesauce.

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*See “Color Your Plate with Salad” at www.eatright.org/nutritiontipsheets for more tips on creating healthy salads

For a nutrition consultation with our dietitians, please call (504) 702-5700 to schedule an appointment.

 

 

To learn more about healthy lifestyle choices, visit our new Primary Care Center at 2003 Tulane Avenue or www.umcno.org/primary-care.

 

 

For information about the UMCNO Cancer Kitchen, which happens every other month at Simplee Gourmet, email Laura Kerns or call her at (504) 702-3691.

 

 

 

Out With the Old: Why It’s Important for Seniors to Get Moving

Author: Maryann Vicari, UMC Physical Therapist

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How do we age well and gracefully? This question has been on the mind of human beings for ages. We have all been searching, to some extent, for the fountain of youth or a way to slow down the aging process. Unfortunately, that fountain has yet to be discovered, and no scientist has come up with a formula that will keep time from aging the body.

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Nevertheless, there is some good news. We, as humans, can improve our aging process and increase the number of “healthy” years by doing something that humans have been doing for centuries – MOVE! That’s right, moving the body is one of the best ways to age well and to help reduce the risk of developing heart disease, diabetes and obesity, which are a few of the main causes of death and poor aging among older adults.

Evidence has shown that regular physical activity is safe for healthy and even frail older adults (ages 65 and older). 

This physical activity can range from low intensity walking to more vigorous sports and resistance exercises, depending on the individual’s preference and physical ability.  Basically, for older adults, some form of physical activity is better than nothing at all or a predominantly sedentary lifestyle.

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According to the Centers for Disease Control (CDC), older adults need at least 2.5 hours of moderate intensity aerobic activity (think brisk walking) every week, which is about 30 minutes a day, and muscle-strengthening activities on two or more days a week that work all major muscle groups (legs, hip, back, abdomen, chest, shoulders, and arms).

This may sound like a lot, but please do not be discouraged; you don’t have to start here.  If you have never worked out before or have been inactive for some time, you can safely work your way up to this point by joining a local wellness center or YMCA.  There, you can find trained professionals that can help you work towards your goal of achieving a healthy and physically active lifestyle.  As always, you should consult your physician before beginning any sort of exercise routine, especially if this is new to you or if you have a pre-existing heart or metabolic disease, such as diabetes and hypertension.

To make an appointment for a consultation with one of our primary care physicians, click here.

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Keep this in mind: If you want to improve your health or if you want to maintain the level of health you have for years to come, your best bet is get or stay as active as you can.  The more active you are as you age the less likely you will be to develop debilitating diseases, which can only work as catalysts to age you beyond your years.

So, get out there and move your bones!

 

References:

https://www.cdc.gov/physicalactivity/basics/older_adults/index.htm

McPhee, J., et al.  Physical activity in older age: perspectives for healthy aging and frailty.  Biogerontology. (2016). 17: 567 – 580.

Tell It to My Heart: The Effects of Emotions on the Heart

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Since ancient times, the heart has been a symbol of our emotions. But, scientists have uncovered a physical link between emotions and heart health.

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What the Research Shows

Science suggests an association among stress, depression, and heart disease. Several studies strongly suggest that certain psychosocial factors such as grief, depression, and job loss contribute to heart attack and cardiac arrest. Stress may affect risk factors for heart disease such as high blood pressure. Stress may also affect behaviors that increase risk such as smoking, overeating, drinking too much alcohol, and physical inactivity. Managing and treating these conditions is important to reduce your overall health risk.

Our primary care physicians are trained in doing just that.

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Stress and Your Heart

Emotional stress causes a negative chain reaction within your body. If you’re angry, anxious, tense, frustrated, frightened, or depressed, your body’s natural response is to release stress hormones. These hormones include cortisol and adrenaline. They prepare your body to deal with stress. They cause your heart to beat more rapidly and your blood vessels to narrow to help push blood to the center of the body. The hormones also increase your blood pressure. This “fight or flight” response is thought to date back to prehistoric times, when we needed an extra burst of adrenaline to escape predators.

After your stress subsides, your blood pressure and heart rate should return to normal. If you’re continually stressed out though, your body doesn’t have a chance to recover. This may lead to damage of your artery walls.

Although it is not clear that stress alone causes high blood pressure or heart disease, it does pose an indirect risk and also has a negative effect on your general wellness.

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Stress and Your Reactions

You can manage stress in both healthy and unhealthy ways. Unfortunately, many people deal with stress by smoking, drinking too much, and overeating. All of these unhealthy habits can contribute to heart disease. But using healthy ways to keep your stress under control allows you to better protect yourself against heart disease. Try these ideas:

  • Exercise. When you are anxious and tense, exercise is a great way to burn off all that excess energy and stress. Go for a walk, a bike ride, or a swim, or go to the gym for your favorite class. Plan to exercise for 30 to 40 minutes of moderate to vigorous intensity, 4 to 5 days a week to relieve stress and improve your heart health.
  • Breathe deeply. Yoga is not only good for your body, but for your mind, too. The meditative, deep breathing done in yoga is calming and relieves stress, especially if you do it regularly.
  • Take a break. When your stress level rises, take a few minutes to escape your surroundings. Spend a few quiet moments alone, read a short story, or listen to your favorite music. Cultivate gratitude. Make a list of what you’re grateful for in your life to focus on the positives.
  • Get together with friends. Social media is no substitute for being with people you love. Create some weekly rituals with your friends. If they live far away, try volunteering or joining a local group of people with similar interests to yours. Research suggests that people with frequent social connections enjoy better protection against high blood pressure.

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Research is ongoing to look more closely at the link between emotional health and heart health. But the existing evidence is consistent enough to prove that you should take its potential effects on your heart seriously. Exercise regularly and keep your emotional health in check, and you’ll build a stronger buffer against heart disease.

To learn more about Heart and Vascular Services at UMC, click here.

 

A Resolution for a Revolution: How to Stay True to Your New Year’s Goals

 

Author: Alan Gatz, MD, UMC Primary Care Physician

Most people have good intentions when making a resolution, but oftentimes, they set themselves up for failure by setting unrealistic goals or not being fully invested in the proposition.

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For example:  “I resolve to transform this overweight, middle-aged couch potato into the new and improved Adonis 2.0.” Okay, you caught me. This has been my standard resolution for the past two decades. After 20+  years, I have yet to achieve this unrealistic, yet admirable result. If I had to guess, I would say that most who read this post have made similar nebulous resolutions.

Well, what’s past is past: I’m vowing to make 2018 different.

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Rather than talking the talk, I’m endeavoring to walk the walk — and you should, too! The days of written vows that never live to see the light of day should be rendered passé. Instead, we should take oaths that describe defined, attainable goals supported by specific actions to reach those goals.

Only in doing that can we measure our success — because we’ll actually have metrics. This tangible action will improve our success significantly by serving as a physical reminder and reinforcement of our commitment.

With that in mind, I present to you my personal oath for 2018.

I vow to take charge of my health and well-being by:

  • Establishing a relationship with a primary care physician
  • Exercising at least 3 times per week for 45 to 60 minutes
  • Developing healthy eating habits and limiting consumption of fast food
  • Working with my physician, dietitian, and exercise physiologist to attain and maintain a weight that reduces my risk for developing diabetes mellitus, cardiovascular disease and degenerative arthritis

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Each of these actions can be observed/measured and the results, documented. There exists no excuses.

Now that I have not only spoken — but transcribed — the vow for all to see, I guess I better follow through! Just don’t expect Adonis as the end result. Record of my progress will be kept and updated via this HealthyU Blog, so check back often!  I will report the results of my efforts and, hopefully, demonstrate the positive benefits of committing to a healthy lifestyle.

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UMC remains committed to the well-being of its staff and all who present themselves for care. To this end, the Primary Care Clinic, located at 2003 Tulane Avenue, opened on December 20th for all who wish to establish ongoing care with a primary care specialist.

If you desire to make the commitment to improve your health by losing weight and reducing your risk for developing serious medical conditions, please contact the office for an appointment. Dr. Rogers and I look forward to partnering with you in your quest for better health. Call the clinic directly at 504-962-6120.

A belated Happy New Year to all!

Give It Your Heart and Sole

Experts have known for a while that certain healthy habits are essential to good heart health. Even simple changes can reduce your risk for heart disease – and lifestyle changes have even been shown to help reverse damage in people already diagnosed with a heart condition.

Heart disease is this country’s No.1 killer, but according to the American Heart Association New Orleans, many deaths from heart disease can be prevented each year by adopting a heart-healthy lifestyle.

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Find time to exercise

Doing some form of exercise – whether it’s working out at the gym, taking the stairs instead of the elevator, or starting a walking program – can improve heart health, according to the AHA. Walking at least 30 minutes of day can help lower your blood pressure, improve your cholesterol profile and help you reduce your risk of coronary heart disease. A recent eight-year study of 13,000 people found that those who walked 30 minutes a day had a significantly lower risk of premature death than those who rarely exercised

Thousands of people will be taking this critical message to heart, and making a commitment to leading a heart healthy life at Saturday’s AHA New Orleans Walk in Champion’s Square.

At this annual event, participants join with others and generate a renewed commitment to heart-healthy living through walking.

In addition to a commitment to daily exercise, other lifestyle changes can reduce the risk factors for heart disease, heart attack and stroke.

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Eat a healthy diet

A healthy diet is one of the best weapons to fight heart disease, according the AHA. Foods consumed can affect risk factors such as high cholesterol and high blood pressure. Eating fatty foods plays a part in the buildup of fat in your arteries, which can lead to blocked arteries of your heart and to the risk of a heart attack. A healthy diet consisting of lean proteins, vegetables, fruit and whole grains can help improve heart health. If you’re overweight, set weight-loss goals. Even losing a small percentage of your body weight reduces your risk for heart disease.

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If you smoke, stop.

The American Heart Association (AHA) says diseases caused by smoking kill more than 440,000 people in the U.S. each year. One out of every five smoking-related deaths is caused by heart disease.

Smoking causes an instant and long-term rise in blood pressure, increases heart rate, reduces blood flow from the heart, damages blood vessels and doubles the risk of stroke.

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Top 3 Recommendations for a Healthier Heart

  • Find time to exercise: Brisk walking for as little as 30 minutes a day has proven health benefits, such as providing increased energy and circulation, as well as reduced risk of heart disease.
  • Eat a healthy diet: Eat more fruits and vegetables, whole grains, low-fat dairy, fish, poultry, and nuts. Cut back on sugary foods like soda and on red meat. In general, stay away from foods high in salt, cholesterol, saturated fat, and trans-fat.
  • If you smoke, stop: Smoking can seriously damage blood vessels and increase your risk for heart disease.

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Tips for sticking with your heart healthy lifestyle changes:

  • Start small. Make promises that you can keep. Rather than trying to go the gym every day, aim go three times a week and add more walking each day. Instead of overhauling your entire diet, try replacing sugary treats with healthier options, like fruit.
  • Take a gradual approach. Making lifestyle changes may take time. Don’t expect miracles overnight. Try replacing one unhealthy behavior at a time.
  • Don’t go it alone. Talking about your resolutions and finding support can help you reach your goals. Try forming a group or take a class with others who have common goals. Having support and being able to talk about your struggles can make sticking to your plan less overwhelming.