We Moved!

By Dr. Madelyn Fernstrom

My blog now has a new home! Come check us out at www.upmcmyhealthmatters.com.

We hope you like the new look! Please remember to OPT IN to our mailing list since we can't carry over our present email subscribers. 

At our new site, you'll still find my twice weekly "MyHealth Matters Blog." We are also introducing some additional bloggers from our health team. From time to time, you'll be hearing from two of our health coaches, and two physicians who will be covering topics from preventive health to physical activity to recipe makeovers. 

With our new interactive site, we hope you’ll provide feedback and comments on our blogs to expand our health dialogue with you. And feel free to suggest some topics you’d like to hear about.

Walking 101

By Dr. Madelyn Fernstrom

College credit for walking? That’s what the University of Georgia offers as one of its fitness classes for students. Whether this is a good sign or bad sign for our nation’s fitness is debatable. 

Most of us are very familiar with the public health message about the multiple benefits of walking. A daily 20- to 30-minute walk supports cardiovascular health, weight control, and stress management. But how many of us actually follow that advice? The results might surprise you.

Nearly 40% of Americans report that they “do not exercise.” This percentage has remained stable for many years. National recommendations for daily physical activity are actually quite modest: a minimum of 150 minutes of moderate activity per week. This translates to about a half hour of brisk walking five days a week. Some recent evidence using more sophisticated activity sensors (instead of self-report information) suggests that only around 4% of adults meet that goal.

Why is it such a challenge for us to move more? There are many behavioral strategies used to engage people in lifestyle changes that can be both initiated and sustained, and these ideas have been translated to making physical activity a “habit.” This is a big help to many people. 

But I also believe we sometimes over-think the concept of moving more. When we think too much about being physically active – creating the time and determining the activity – it can sometimes be too daunting and discouraging. I’d like to borrow the iconic line from Nike: “Just do it.” 

Just do what, you might ask? Become a more active person in everything you do – what I call the “activity of daily living.” Be mindful of taking more steps in your day. Stand instead of sit, have a walking meeting, and be less efficient in your home so you make multiple trips up and down the stairs. 

Small steps – literally – add up to big change. How have you tried to boost your activity in everyday ways?

Holiday Season Energy Boosters

By Dr. Madelyn Fernstrom

With the holiday season adding extra activities to our already busy lives, we all sometimes feel we’re running low on energy. And this lack of energy can become a barrier to enjoyment. Below are three of my favorite strategies for boosting holiday energy in a healthy way.  I hope they’ll also work for you!

Structure Your Eating.  Make sure to pre-plan your eating day; avoid skipping meals. No time for lunch? Try a protein bar or shake along with fruit if you’re on the run. Carry a small bag of nuts and/or dried fruit with you for a quick emergency energy boost, especially in the late afternoon. When you avoid getting “over-hungry” it’s much easier to resist the holiday treats on every desk and in office break rooms! 

Don’t Skimp on Sleep. While it might be tempting to cut back on your sleep to lengthen your active day, fight that urge. Aim for at least seven hours nightly during this busy season. When you’re rested, you’ll be much more efficient with your time the next day and you’ll get more accomplished.  

Actively Manage Your Stress. Most of us accept that high stress levels go along with the holidays and believe there’s no solution. There are many stressors you can control to support a happier and less frazzled season. Learn to say NO. You don’t have to say yes to every holiday request. When you do say yes, make the request work for you. Asked to bring cookies for your child’s holiday party? Don’t add the pressure of baking; visit a local bakery. Or offer to bring napkins and plates instead of food. 

And avoid the “energy booster” drinks on the market. Loaded with caffeine, sugar, and often other stimulants, chugging down these drinks can be risky to your health.

Watch the video below and let me know what tips you have for boosting your holiday season energy. At this time of year, we need all the help we can get!

The “Fat Tax” in Denmark

By Dr. Madelyn Fernstrom

There’s a lot of debate about whether high-calorie “junk” foods should be taxed to help stem the obesity epidemic in our country. Maybe we can gain some insights from the recent policy change in Denmark.

About a year ago, Danish lawmakers instituted a fat tax — a surcharge of foods high in artery-clogging saturated fat. The Danish tax ministry has now repealed that decision, citing a negative effect on both businesses and consumer buying power.

So what went wrong? Perhaps one problem was taxing a whole category of nutrients (fat) rather than specific foods. The bigger problem seems to be that consumers just bought these foods elsewhere. They went to neighboring countries where prices were lower to buy their favorite butters and ice creams.

Most of us are familiar with the “soda tax” issue in our country. Most recently, a bill that would have imposed taxes on sugary drinks was defeated in California. 

The Danish legislature has now cancelled plans for a tax on sugar. 

Is taxing food a good way to improve the health of a nation? What do you think?

Don’t Mix These Meds with Grapefruit!

By Dr. Madelyn Fernstrom

Grapefruits are one of nature’s perfect fruits – low in sugar, rich in fiber, and a great source of vitamin C. But this fruit also contains a compound that can interfere with the activity of some prescription medications. A new study published this week in the Canadian Medical Association Journal reveals that the number of these drugs has significantly increased over the past few years. Researchers estimate that there are 43 drugs (26 having been introduced to the market in the past 4 years) that have been shown to cause serious harm in susceptible individuals when mixed with grapefruit.

There are three major categories of drugs that can have serious negative effects when combined with grapefruit:

- Cholesterol lowering statins

- Some heart drugs, like beta-blockers

- Some antibiotics

While food and drug interactions are printed on every label and stated on package inserts, many people do not take these warnings seriously.  The best step is to talk with your doctor, or stop in and speak with the pharmacist where you fill your prescriptions to see if grapefruit (or other foods) interact with your medication.  For some medications, grapefruit can increase the apparent dosage substantially due to grapefruit’s impact on drug metabolism. Grapefruits contain compounds called “furanocourmarins” that inhibit the normal metabolism of a medication, producing higher levels of medication in the bloodstream. 

This is of particular concern for seniors,  who generally take more medications and cannot tolerate higher dosages.

Importantly, most drugs do NOT interact with grapefruit, so it’s important to know which medications might put your at risk.  

And all citrus is not created equal when it comes to  medicine interactions. Oranges appear to have an effect, but to a much lower degree. Always check with your doctor or pharmacist for all food and drug interactions that might impact on your overall health.

Fat Burning Soda?

By Dr. Madelyn Fernstrom

PepsiCo has just launched a new soda in Japan, claiming to burn fat and support weight loss. It’s called “Pepsi Special” and the “special weight loss ingredient” is the addition of dextrin to the standard Pepsi formula. Dextrin is a non-digestible fiber, used in baked goods and other food products. Scientific studies have documented that fiber can help bind small amounts of dietary fat, and this metabolic observation is the sole “science” upon which this claim is based.

Americans have a love-hate relationship with soda, and soda consumers are always happy to hear of some redeeming health benefit that helps justify consumption. This is not the first time soda has made a weight loss claim. In the U.S., you might be familiar with a soda named “Celcius” containing 200 mg of caffeine (the amount in a large mug of coffee) claiming to burn fat and raise metabolism. And Coca Cola’s Fuze Slenderize energy drink, containing a special blend of minerals, promises to help you slim down.

Don’t expect Pepsi Special on U.S. shelves anytime soon. The Food and Drug Administration (FDA) regulates health claims of foods and beverages and does not permit nutrient fortification (like fiber) of soda or candy. The Japanese food regulatory process is more lenient.

As with all claims related to weight loss, if it sounds too good to be true, it probably is.  

Do You Have “Eaters Remorse”?

By Dr. Madelyn Fernstrom

You might be surprised to hear that the day after Thanksgiving can be a big barrier for many people when it comes to sticking with a healthy lifestyle over the holidays. This is the day most people make the decision to indulge smartly and adjust their eating and activity patterns to adapt to the culinary treats of the season, or disconnect from mindful eating until January and “worry about it later.”

The first step in this decision starts with what I call “eater’s remorse” – feeling bad about your overindulgences of the previous day. It’s easy to get stuck in the mindset that you’ve gotten off track, and there’s no hope for your diet, so why not just keep eating until New Year’s Day. 

Today is the day to adjust your thinking for weight control success. No more guilt! 

Thanksgiving is just one day of eating, even if you’ve eaten way more than you intended. Don’t feel guilty about your past eating. Learn from your eating behavior, to see how you can take better control for the rest of the holiday season. One of the best ways to do this is to plan ahead for special holiday meals. If you tackle your vulnerable eating situations head on, you’ll set yourself up for holiday eating success. Modify your goals when it comes to holiday weight loss and stick with weight stability from now until the end of the year. Just don’t gain.

Over the next few weeks, I’ll be providing some easy tips that will help support healthy holiday eating without feeling deprived. I’m a big fan of the “3 Fs” of the holidays: family, fun, and food.

What tips do you have for enjoying a healthy holiday season?

Fun Facts About Turkey

By Dr. Madelyn Fernstrom

Today I’d like to share some interesting facts about turkey in honor of the day most often associated with eating this bird – Thanksgiving! Here’s a list of my favorites:

• Nearly 95% of Americans eat turkey on Thanksgiving. That translates to 45 million birds!
• Turkey has more protein, ounce per ounce, than chicken or beef.
• White meat and dark meat turkey have almost the same number of calories per serving. Dark meat has four calories more per ounce, or 24 calories in a six-ounce serving
• A 15-pound turkey has 70% white meat and 30% dark meat.
• Eating turkey does not put you to sleep. While the old wives’ tale about the sleep-promoting effects of tryptophan-containing turkey remains active, it’s not true. The metabolic explanation is that the large caloric load consumed with the Thanksgiving meal drives more energy to the digestive tract, often causing drowsiness.
• Benjamin Franklin originally proposed the turkey as the official bird of the United States, instead of the bald eagle.
  

A happy and healthy Thanksgiving to all!

Good News for “Yo-Yo” Dieters

By Dr. Madelyn Fernstrom

If you’ve lost and gained the same 20 (or 30, 40, 50+ pounds) for years and believe that you’ve “wrecked” your metabolism and can’t maintain successful long term weight loss, there’s very good news for you!

A recent article in the scientific journal Metabolism followed more than 400 women for one year. About 40% of the participants classified themselves as “weight cyclers,” defined as losing (and regaining) at least 10 to 20 pounds at least three times. Participants were assigned to one of four treatment groups: (1) reduced calorie diet only; (2) reduced calorie diet plus exercise plan; (3) exercise plan alone; (4) no intervention, served as the comparison group. 

Now here’s the good news! There was no significant difference for the total amount of weight lost between women who were yo-yo dieters and those who weren’t. That’s a reassuring message for the millions of women (and men) who feel their efforts are sabotaged by their past weight cycling history.

If you’re trying to avoid the problem of yo-yo dieting altogether, start with setting modest, realistic goals for yourself. Slow and steady wins the weight loss race. Small short-term goals add up to long-term success. 

Coconut Oil: Health Friend or Foe?

By Dr. Madelyn Fernstrom

You might have seen advertisements or read magazine articles and health books touting the health benefits of coconut oil. We’re often led to believe that there is a new health secret to using this oil – that adding it to your diet is definitely a good choice. But what’s the truth about coconut oil? 

Coconut oil is a vegetable fat - it comes from a coconut after all. But unlike most vegetable fats, coconut oil has a lot of saturated (artery clogging) fat. The saturated fat in coconut oil is no different from any other saturated fat and it raises the “bad” LDL cholesterol (think “L” for Lousy). But coconut oil is different from other saturated fats because it also raises the “good” HDL cholesterol (think “H” for healthy).

It’s not really clear what impact coconut oil has on overall heart health because studies show that it raises both good and bad cholesterol. So is it healthy? I’d stick with the other vegetable oils like soybean, canola, or olive that do not raise bad cholesterol but do raise good cholesterol. 

Skip the hype of coconut oil as a health promoter. If you like it, use it now and then, as an alternate to butter. But don’t confuse it with the documented health benefits of most other vegetable oils.

And when it comes to fats and oils of any type, they ALL have around 120 calories per tablespoon, so be mindful of your serving size. Don’t have a tablespoon handy? It’s about the size of the tip of your thumb. Not much, but a little goes a long way.

Do you have an opinion about coconut oil? I’d love to hear it!

Potassium: The “Other” Salt

By Dr. Madelyn Fernstrom

When it comes to food, when we hear the word “salt,” most of us automatically think about sodium. The emphasis on lowering sodium intake to promote heart health is important and well documented.  But there’s another important salt in the dietary picture: potassium. Getting the right balance of sodium and potassium is another key component for heart health.

According to a recent study published in the American Journal of Clinical Nutrition, 90% of a group of of 12,500 people consumed more than 2,300 mg of sodium daily, the upper limit from the American Heart Association (AHA). While sodium intake was up, potassium intake was down. This group consumed only about half of the AHA recommendation of 4,700 mg/day per day.

How does this finding translate into what you should eat? Because nearly three quarters of daily sodium intake comes from the consumption of processed foods (food contained in boxes, cans, and bags), cutting back on these items can drastically reduce sodium intake.

But what about boosting potassium intake? Is that easy to do? In a word, YES! Bananas are one of the top sources of potassium in foods, along with potatoes. Dates, raisins, and beans are also rich sources. These are all easy foods to eat as a “stand alone,” or to add to main dishes, salads, and desserts.

If you take prescription medications for high blood pressure, make sure to talk with your about any additional dietary changes you might need to make in your sodium and potassium to maintain a healthy balance.  Potassium requirements can increase with certain medications, and you’ll need advice on whether foods, or a potassium supplement might be most appropriate for you.

November Is National Healthy Skin Month

By Dr. Madelyn Fernstrom

Three cheers to the American Academy of Dermatology for designating November as “National Healthy Skin Month.” This makes a lot of sense since November brings the arrival of colder, drier air as the winter months approach. Their main goal is to raise awareness of healthy skin care throughout the year, as well as provide some specific tips for protecting your skin all winter long. 

Keeping your skin hydrated and protected isn’t just important to reducing the visible signs of aging, it’s also a preventive measure for avoiding long-term skin damage. Follow these five easy steps for a healthy skin year-round!

- Wear sunscreen. You know by now that I’m a big advocate of year-round sun screen. Cloudy and cold conditions do not block the rays of the sun, although the heat is less intense in winter. Remember to coat the skin on your hands (unless you’re wearing gloves) and your lips to avoid chapping.

- Use milder soaps and scrub lightly. Washing the skin removes natural oils. Try less drying bar soaps like Dove, Aveeno, Oil of Olay, or similar milder soaps.

- Moisturize. You don’t need expensive lotions or creams. After a shower or bath, while you’re still damp, rub your whole body with baby oil or a drugstore moisturizer of your choice (like Lubriderm or Vaseline Intensive Care). 

- Shower less often in winter. Skip a daily shower unless you have been very physically active on your job or you have just completed an intense workout. Most people can shower every other day and avoid drying out their skin. Rather than hot showers, which might feel refreshing but are very drying to your skin, stick with warm showers. 

- Choose a healthy diet. Include plenty of fruits and vegetables, which are hydrating to your skin and other body organs. Eating heart healthy fats (even if you’re dieting) also support soft and supple skin. Include nuts, fatty fish (like salmon), avocados, and olive oil when you can.

Other tips you’d like to share? 

Get More Sleep This Weekend!

By Dr. Madelyn Fernstrom

For those of you who skimp on sleep because of “too much to do,” this weekend is meant for you. It’s the end of daylight savings time, and we turn our clocks back one hour at 2 a.m. Sunday morning. It’s time to “fall back” and gain an extra hour!

While you might be tempted to pack more activity into this extra hour, how about using that time for an extra hour of sleep? Many people tell me they can’t make the time to sleep 7-8 hours every night. With our busy lives, sleep is often at the bottom of the “to do” list.

Lack of adequate sleep is increasingly becoming a risk factor for our long term health. Chronic lack of sleep is associated with weight gain, hormonal shifts, mood changes, and lack of work productivity.

One extra hour won’t make up for weeks and months of inadequate sleep, but it’s a start. It’s a big step for increasing personal mindfulness of your own sleep schedule.

Pleasant dreams!

Four Facts About Candy

By Dr. Madelyn Fernstrom

With Halloween on the horizon, I thought it would be fun to provide a little “candy trivia.” If you choose to indulge, stick with the “fun size” servings at around 100 calories, and you get to eat the whole thing! Here are some of my favorite candy facts. 

1. Nearly half of the 200 million pounds of candy sold in America is at Halloween. Most of the other half is sold at Easter and Valentine’s Day.

2. The top selling candy in America is candy corn. But we don’t know how much we eat, and how much we use for crafts and decorations. 

3. Candy does not cause weight gain and often supports weight loss. The Swiss are among the biggest consumers of chocolate (about 2 pounds per month per person) in the world, yet they have an overweight/obesity rate of around 7%! In the United States, about 35% of the population is overweight or obese. Allowing yourself a small amount of chocolate or candy can be an indication of good control over food, not the opposite! 

4. The mood elevating effects of candy occur within minutes. The mood changes reported after candy consumption include happiness, a sense of well-being, and feeling great or less depressed. But the immediate benefits of candy consumption are connected to the pleasantness of the taste (sensory stimulation from your taste buds) and your own anticipated views of how the candy makes you feel – not a change in brain chemistry. Many foods, including candy, can be a source of pleasure because we’ve received a lot of positive reinforcement for eating them.

Do you have any candy facts you’d like to share? 

Happy Halloween!!

Lose Power in a Storm? Keep Your Food Safe

By Dr. Madelyn Fernstrom

Power outages often accompany big storms. While Hurricane Sandy might not knock out your electricity this time, it’s good to know the basics of food safety related to your refrigerator and freezer.

If you don’t already have a refrigerator thermometer, run – don’t walk – to get one at any store selling kitchen gadgets (including most supermarkets). This is a key step to following my four-hour/40 degree food safety rule. 

All food in your refrigerator is safe to eat after a power outage, if the temperature remains below 40 degrees. An ideal range for food safety is 36–38 degrees. At 40 degrees or higher, bacteria start to multiply quickly and can easily cause food-borne illness. 

If you have a thermometer, your food might be good for much longer than four hours (that’s with the door closed!). If you don’t have a thermometer, stick with the four-hour rule and toss most foods from your refrigerator. Don’t use the taste or smell test to determine food safety — it’s not reliable. My motto with food safety? When in doubt, throw it out! 

Should You Save or Throw? After four hours, or for a refrigerator with a temperature of 40 degrees or more, use the following guidelines:

         1. Protein: Meat, Poultry, Seafood, and Eggs

SAVE: NOTHING!

THROW: raw or leftover cooked meat, poultry, seafood, tofu, and raw or cooked eggs

2. Dairy

SAVE: Butter, hard cheese, and processed cheese

THROW: soft cheeses, milk, cream, and shredded cheese

3. Fruits/Veggies

SAVE: Fresh whole fruits, fruit juice (opened), canned fruits, and raw vegetables

THROW: cut-up fruit, bagged salad, vegetable juice (opened), and cooked vegetables

4. Condiments/Dressings

SAVE: ketchup, mustard, pickles, peanut butter, and jam/jelly,

THROW: open mayonnaise, tartar sauce, and horseradish

5. Leftovers

SAVE: NOTHING!

THROW: All cooked foods — even those that are "save" in other categories above. 

And what about your freezer? With a freezer that is half full, if you keep the freezer door closed, your food is good for about 24 hours. With a freezer is full, you’ll have about 48 hours of safe freezer foods. 

You can refreeze foods if there are still ice crystals remaining in it and the temperature is below 40 degrees.

Where Do You Store Your Medicine?

By Dr. Madelyn Fernstrom

If you’re like millions of people in our region and across the country, the typical answer to that question is, “in the medicine cabinet in my bathroom.” And who doesn’t love extra storage space in their bathroom? 

But if you’re keeping your prescription or over-the-counter medications there, you’ll want to change the location! The bathroom turns out to be the worst place to store medications because there are constant changes in room temperature and humidity caused by hot showers and baths. Too warm or moist of an environment over time can reduce the potency of your medicines. 

Keep your medications in a cool, dry place. For daily prescription medications, be sure to keep them where you are likely to see them. “I forgot,” is one of the biggest reasons people give for being non-compliant with prescription medicines. Keep your daily medications and dietary supplements (like vitamins and minerals) at your bedside or on the kitchen table – both serve as important visual reminders to take your daily dose. 

Sometimes it’s a small change that can boost your overall health. Have you made any small changes that promote your own healthier living?

Is the Soda Ban Illegal?

By Dr. Madelyn Fernstrom

The debate on whether the serving size of a soda should be regulated by the government is continuing to heat up. I’ve been writing about this controversial ban on selling soda with a limit of 16 ounces because this is a prime example of how food regulatory policies could be used help stem the obesity epidemic. The question remains: is this an effective strategy? It’s important to follow these new developments, as these decisions will likely impact implementation of policies like these in our region, and throughout the country.

In response to the NYC Health Department’s ban on selling sodas larger than 16 ounces in places like movie theaters and restaurants, a lawsuit aimed at overturning this ban was filed by a consortium that includes the American Beverage Association, the National Restaurant Association, the soda workers union, and movie theatre owners. The argument is that such a ban would hurt small businesses and burden consumers, and it could even affect movie theatre prices (sale of concessions help keep ticket prices down).

Critics call this ban a prime example of the “food police” and an attack on personal choice, while supporters call it a much needed step in the right direction to change consumer behavior to healthier eating. And healthier eating should lead to obesity reduction.

Now this debate has moved out of the health arena, and into the courts for some further answers.

Do you think this next “legal” step will help or hurt the effort to limit the consumption of liquid calories?

Try ‘Dining Smart’ for Everyday Healthy Eating

By Dr. Madelyn Fernstrom

If healthy eating is a daily challenge, this post is definitely for you! You know by now that I’m a huge champion of eating in moderation, and my motto is “no bad foods, just bad portions.” 

When it comes to healthy eating, the biggest challenge we all face is not what to do, but how to do it. That’s where UPMC Health Plan’s Dining Smart program comes in.

Our team took several years to develop the Dining Smart program to come up with some real world — not perfect world — guidelines that support healthier eating. Small daily improvement in food choice is the best way to sustain long-term change.  

Dining Smart food choices and guidelines are available at all UPMC sites, and we’re expanding our program to support healthy eating throughout the region. One example is a dinner this weekend in honor of the One Young World event in Pittsburgh. The dinner celebrates healthy eating. Spearheaded by Chef Jamie Oliver, this event is intended to raise awareness about childhood obesity and to support healthy eating for all.  

Here are some highlights of the Dining Smart program:

• Main dish items have 400 or fewer calories
• Soups, side dishes, snacks and desserts have 220 or fewer calories 
• Fat is limited to one-third of total calories in a dish, or less
• Cholesterol is limited to 100 mg or less per item

For more about One Young World, click here. 

Is Breast Cancer Preventable?

By Dr. Madelyn Fernstrom

October is National Breast Cancer Awareness Month. While there are no specific instructions for breast cancer prevention, there are many things you can do to reduce your risk. Here are six lifestyle steps that research shows contribute to reducing breast cancer risk. 

Manage Your Weight. Overweight and obesity increase the occurrence of breast cancer, especially after menopause (when breast cancer occurs most often). Healthy eating and physical activity likely contribute most to risk reduction by promoting weight loss.

Limit Your Alcohol Intake. As alcohol intake rises, so does breast cancer risk. If you do consume alcohol, limit intake to one drink daily from all sources (a 12-ounce beer, 5 ounces of wine, or 1.5 ounces spirits).  

Breastfeed. The longer you breastfeed, the greater the protective effect. Breastfeeding for one year appears to provide the greatest effect.

Avoid Hormone Replacement Therapy. Using hormone replacement therapy for menopausal symptoms can raise your risk. Avoid progesterone containing therapy (stick with estrogen), and limit use to less than three years. Talk to your doctor about non-hormonal ways to manage menopausal symptoms. And “bio-identical” hormones have the same risks as any others.

Conduct a Monthly Self-Exam. Get to know your own breasts. A monthly self-exam (one week after your period) can detect changes like lumps, skin changes, or nipple discharge. With any changes, schedule an appointment with your doctor.

Schedule a Yearly Medical Exam. Combine your lifestyle plan with a yearly visit to your gynecologist or primary care doctor to discuss a personalized plan for additional breast cancer screening. In addition to a physical exam, you can discuss the timing of mammograms and other screenings that support optimal risk reduction.

All About Caffeine

By Dr. Madelyn Fernstrom

Caffeine is one of the most widely consumed compounds in the world. Nature’s original stimulant, caffeine is found in coffee beans, tea leaves, and cola nuts. Because caffeine boosts mental focus and alertness, it was an important survival tool in caveman days, when our ancestors had to run away from  predators and search for food.

But nowadays, when it comes to caffeine consumption, a little goes a long way. The LESS you consume, the better it works when you need a boost. Too much caffeine makes your body resistant to the positive effects and can result in health negatives, including rapid heart beat, stomach upset, and jitteriness. When it comes to caffeine, less is definitely more.

Most adults should limit caffeine intake to about 300 mg daily. That’s about two mugs of coffee or five cups of tea. An added  “turbo shot” from a coffee house adds another 100 mg or so. 

Caffeine is well known to help athletic performance, so a large cup of coffee before exercising can help support energy and endurance by directly influencing muscle activity as well as boosting mental focus. Make sure to stick with coffee or tea, and don't take caffeine-containing pills (like No-Doz).

If you want to start decreasing your caffeine intake, you can go cold turkey, but you’ll likely get a headache for a few days. To avoid that headache, try cutting your intake in half every few days. Or, make your coffee half-decaf and drink herbal teas and caffeine-free sodas.

Make sure to check with your doctor if you are “caffeine sensitive,” have a medical condition, or take medications (like asthma medicines) that might mean you need to cut back on caffeine beyond the general health recommendations.

Fighting Back From “Weight Bullies"

By Dr. Madelyn Fernstrom

When did the idea become acceptable that the personal weight issues of other people are somehow everybody’s business? Many people feel entitled to comment and judge others about whom they know nothing. They are who I call “weight bullies.” Weight bullies are occurring with increasing frequency, and I believe they are a big step in the wrong direction! 

Here is a case in point: an overweight television anchor in Wisconsin received an email from a viewer commenting on her obesity. The remarks included (1) surprise that her physical condition had not improved over the years, (2) that she should present and promote a healthy lifestyle, and (3) that she was a poor role model, especially to girls.

While many overweight and obese people are judged – both intentionally and accidentally – the usual response is silence and hurt feelings. Many patients have told me they feel obesity is the last “acceptable” area for open criticism and that they are not only hurt by comments, but feel they are somehow less worthy or deficient as human beings. 

This courageous TV anchor, Jennifer Livingston, fought back. She used the negative email she received as an opportunity to speak out against weight bullies. Talking directly to viewers while on the air, Ms. Livingston addressed all people who are not only struggling with their weight, but with other physical and emotional issues. Her message: “Don’t let your self worth be defined by bullies.” You can watch the entire four-minute broadcast of her inspiring words on YouTube by clicking here. 

Have you experienced weight bullying? I’d love to hear your thoughts on the topic!

Lady Gaga’s Weight

By Dr. Madelyn Fernstrom

It’s not often that a rock star offers us an important public health message. Lady Gaga – real name Stefani Germanotta – is perhaps best known for her outrageous outfits (including her dress made from red meat!) and amazing singing voice. We know her as very thin, but she is now carrying an extra 25 pounds.

Media buzz about the reasons for her weight gain abounds. She revealed that she has been a frequent guest at the restaurant her parents have recently opened. But she also revealed that she has struggled for years with an eating disorder, and that it was time to address and resolve the problem.

This is a courageous and unusual step for such a public figure. Now, Lady Gaga’s focus is on getting to a healthy weight that she can maintain with healthy eating. And her message to millions of women (and maybe men) is that the desire for the “perfect weight” can get out of control and become a health negative.

Her take-home message is that choosing and sustaining a healthy weight is a work in progress for all of us. No matter where you are on the scale, it’s not easy to maintain that “sweet spot” of a healthy weight. But it IS all about health and feeling good about yourself.

Are you trying to get started on your journey to lose weight? Learn to fill your weight management toolbox with the right tools for you. I call this process building your BEAM box – with tools for (B)ehavior, (E)ating, (A)ctivity, and (M)edical Care. Don’t be afraid to reach out for help with friends, family, or your doctor when needed. It is working for Lady Gaga and it can work for you too!

More on Limiting Sugary Drinks

By Dr. Madelyn Fernstrom

Here’s an update on the sugary drink debate and size limits that I wrote about back in June. New York City’s leadership proposed a ban on the sale of sugary drinks larger than 16 ounces. A huge debate followed, ranging from personal choice and cost issues to the increasing presence of the food police. All of this was speculation until the Board of Health voted on this hot button issue. You might be surprised to hear that this ban was recently approved. 

The ban covers sodas and sugary drink blends, not 100% juice. Also excluded are dairy-based drinks containing at least 50 percent milk.

Having thought a little more about this controversy, I wonder if size limit is really the issue – 16 ounces is two full cups (around 200 calories). Could the real issue be the idea that someone wants to limit personal food choice? It’s not like Americans are unaccustomed to smaller serving sizes. If you’re over 40 years old, you can recall a time when 16 ounces was considered a huge serving! Now, we are so used to seeing super-sized servings everywhere, the 16-ounce serving looks puny by comparison.

Do you think this will become a national phenomenon? Many people never thought a bill like this one would pass. Is this a nod to more “mindful eating” or an intrusion of personal rights? 

Please share your thoughts on this controversial issue.

Coming Soon to Your Local McDonald’s: Calorie Postings!

By Dr. Madelyn Fernstrom

You might have heard about calorie postings on fast-food menus in New York City, and elsewhere, and wonder if it will hit our region anytime soon. The answer is a definite YES. McDonald’s is taking a bold step in posting the calorie counts of all menu items, along side the prices. This will be in all restaurant locations across the nation. If you think this will make the signage a little cluttered, you’re right. Although it’s a lot of information to “digest,” it is very helpful to becoming an informed patron. 

Opinions vary widely about this new policy. Advocates say it empowers consumers who want easy access to this information. Opponents find it to be a waste of time, especially when no one wants to know this information. 

I say it’s a step in the right direction and can only help those who want to be more mindful. Those who are not interested can just ignore it. And that’s just what focus groups have found.  

What do you think about calorie postings on menus? I’d love to know!

The Debate on Fish Oil

By Dr. Madelyn Fernstrom

Fish oil continues to be a hot health topic, and it’s front page news yet again. A new study suggests that fish oil supplements provide no ”value-add” to your health. 

This study, called a meta-analysis, accumulated the information from multiple single studies, and compared the results of all of the studies.  The analysis documented that, overall,  people taking fish oil supplements did not live longer, nor have fewer illnesses, compared to individuals who did not take fish oil supplements. 

When this study came out, many cardiologists and health experts were quick to point out that fish oil in the form of FOODS – fish (like salmon) and walnuts – both rich sources of dietary omega-3-fats were an important part of a healthy diet. The addition of supplemental pills/capsules of fish oil does not seem to provide the same kind of health plus as the dietary sources, as a general guideline. 

Does that mean that fish oil provides no health benefits? No! It is important to read beneath the headlines for a little more information. If you currently take fish oil, be sure to include dietary sources of the heart healthy omega-3-fats. There is no harm in taking the supplements, but they do not replace a healthy diet. 

Because population data do not always apply to what an individual should do, it’s important to have a talk with your doctor about whether fish oil supplements should be part of your heart-healthy tool box. 

Today is National Run at Work Day!

By Dr. Madelyn Fernstrom

Are you one of those people who never can find the time to exercise? Are you so busy with your daily activities that a regular run or walk isn’t even on your radar? If so, the national campaign called Run At Work Day might interest you.

It’s a day of raising awareness about the importance of daily physical activity in supporting good health, a “call to action” to make room for physical activity in your life. And you don’t have to be a runner to participate. The goal, for both adults and children, is to include at least a 30-minute walk some time during your day. 

While we all know the benefits of exercise on cardiovascular health, a mid-day boost of physical activity has other health benefits. A 30-minute walk can be the perfect stress reliever. Walk with a friend or listen to your favorite music.

Feeling some late afternoon fatigue? Instead of a coffee break, take a walk for some fresh air (and maybe some sunshine!) for an energy boost. 

If you don’t have 30 minutes at one time, break up your activity.  Even a 10-minute walk is helpful. Aim for three 10-minute bouts and you’ll achieve similar health benefits to a single 30-minute period.

What ideas do you have to celebrate National Run at Work Day? 

Feed Your Pets Right

By Dr. Madelyn Fernstrom

While pets are regarded as members of the family, you shouldn’t always feed your dog or cat like one! You might not know that certain foods beloved by humans – like chocolate – can be dangerous if consumed by your pet. The ASPCA has some suggested guidelines for the healthy feeding of your dog or cat. Below are some of the highlights:

Replace the beef and chicken bones. 
These can splinter and cause digestive track damage or damage to your pet’s teeth. Look for treat bones specifically made for dogs and cats.

Avoid dairy products. 
Adult animals don’t have the digestive enzymes (lactase) for this. Consumption can lead to diarrhea.

Skip the chocolate. 
The caffeine and other methylxanthines (chemical family of the active ingredient) is not metabolized well by dogs, especially.  Higher concentrations when consumed can produce the same symptoms as in people, like heart palpitations and tremors. 

Lose the booze. 
Don’t use alcohol to “relax” your pet, or to share in a celebration.  Alcohol is a nervous system depressant for your pet, and the dose you’re providing is unknown, especially with smaller animals.

Watch out for highly seasoned, spicy foods (including onions and garlic). 
Don’t worry about your pet having food that is too bland.  Highly seasoned foods in large amounts, regularly, can contribute to cellular damage.

Keeping your pet healthy with an appropriate diet and regular exercise also maintains a healthy weight. And, your dog can be the best “exercise buddy” around. 

How do you feed your pet? Is maintaining a healthy weight for your dog or cat a challenge?