Prostate Cancer Screening

By Dr. Madelyn Fernstrom

If you’re a man or someone who cares about one, you’ll want to pay attention to the updated government panel recommendations for prostate cancer screening in healthy men. A panel of national experts reviewed the risks and benefits of preventive prostate cancer screening using a blood measurement of PSA, an index of prostate problems.

But the evidence is mixed regarding the survival of prostate cancer, as well as its diagnosis. This is a sensitive test, and the problem is that it can reflect other prostate-related medical problems, not just cancer. This means that a higher PSA level might not mean cancer much of the time – what’s called a “false positive” result.

Strategies for “early detection” of any medical illness are always being developed and refined. With prostate cancer screening, the panel reflects the view that this should now be a more personalized health decision, requiring a conversation with your doctor to discuss the pros and cons of screening.
This task force also urged that doctors understand the evidence, but they also individualize decision making for a particular patient or circumstance.

This is another example of medical progress; it should not be cause for alarm or confusion. As more evidence-based information is accumulated regarding the risks and benefits of medical screenings, it’s important to open a dialogue with your doctor about what is best for you.

Population data do not always apply to the individual. Become an informed and empowered health care consumer for yourself and those you care about.

Slimmer Summer Eating

By Dr. Madelyn Fernstrom

The unofficial start of summer begins with the Memorial Day weekend. It’s now time to take advantage of all the seasonal fruits and vegetables. With the expansion of the worldwide food supply, produce is always available throughout the year – but these out-of-season foods usually lack flavor and are extremely pricey.

Now is the time to indulge in all the colorful fruits and vegetables we love. From berries and melons, to deep leafy greens and zucchini, to corn on the cob and green beans – you’ll find them all in the next 12 weeks at local supermarkets, farmers markets, and small stands throughout our region. Most are locally grown and reasonably priced, and you’ll get an amazing flavor and nutritional bang for your shopping dollar.

If you’ve been choosing frozen produce to save money, it’s a great time to look for seasonal and locally grown fruits and vegetables. You’ll find the prices very competitive. Whether raw, cooked, or cut in chunks to grill on skewers (alone or with your favorite meat), seasonal vegetables are great for your wallet and your waistline.

Remember that fruit is nature’s candy, and there’s nothing like a cold, crisp wedge of watermelon to tame your sweet tooth! And don’t forget grilled fruit – peaches and nectarines have an enhanced sweetness with a few minutes on the grill or stove.

What ideas to you have for summer fruits and vegetables?

Paula Deen’s New Advice

By Dr. Madelyn Fernstrom

While the Food Network’s Paula Deen has been a controversial figure in the worlds of both food and health (remember my blog on Obesity and Chefs?), I want to share an interesting interview with her that aired on national TV in which she explained her new commitment to health and a lifestyle that supports it. She detailed the lifestyle changes that helped her shed 30 pounds recently. It was not easy, but she shifted her mindset about eating and food. 

In the interview, Paula shared these useful insights from her experience:

-It’s not any one food that caused my diabetes – it’s my obesity (excess weight).

-My extra weight came from eating my “indulgent” (high in sugar and fat) foods too often, and in oversized portions.

-I still eat my favorites on Sundays, but in much smaller portions – controlled indulgence.

-I love food but realize that I can’t eat in an unrestricted way and sustain a healthy weight.

-My health is a work in progress; while I still smoke, I’m now working on strategies to quit.

-I don’t want to be remembered for “butter,” but as a family person incorporating food into happy and healthy living.

Paula Deen had her own very public “ah-ha” moment, which prompted her to wake up and do something about her weight. I think her messaging is great – and as a public figure strongly connected to indulgent Southern cooking, she has demonstrated a road map for effective change that I hope will motivate others to do the same. 

The Truth About Sea Salt

By Dr. Madelyn Fernstrom

We’re all well aware of the recommendation to trim our daily salt intake and aim for less than 2500 mg per day (1500 mg for those with high blood pressure or related risk factors). As I’ve discussed before, cutting back on processed foods is the first and easiest way to do so. Most boxes, cans, and packages are loaded with sodium, contributing about three-quarters of our daily intake.

And while the salt shaker contributes only about 10% of our daily salt intake, it’s important to make some smart choices here. Herbs and spices contribute loads of flavor, but it’s not the same as the flavor enhancement of salt – and most people have a hard time down-regulating their “salt tooth.”

Used smartly, a little bit of salt added to a salt-free dish can go a long way toward boosting flavor while still keeping your sodium intake in check. That’s where sea salt comes in. While sea salt is not healthier or lower in sodium than regular table salt, it is processed differently, resulting in a difference in taste and texture. Sea salt is produced by simply evaporating sea water. This produces a larger crystal – allowing you to use less of it for flavoring your food. A little sprinkle goes a long way!

And you might be surprised to know that the seas around the world produce differently flavored sea salt. Black salt, pink and red salts, and gray salt are just some examples you might want to try. (Note: These are typically found in specialty food stores.)

Have you tried sea salt? I’d love to know!

Five Ways to Fight Childhood Obesity

By Dr. Madelyn Fernstrom


Last week’s Weight of the Nation meeting in Washington, DC, put a lot of emphasis on fighting childhood obesity – what I like to call “family obesity.” You may not know that UPMC program, the Pittsburgh Healthy Kids Project, was highlighted as a practical, affordable solution to addressing this urgent problem.

We have developed this program – a partnership of the UPMC Health Plan, Children’s Community Pediatrics, and Children’s Hospital – in response to what parents of children struggling with their weight have told us is important to them: (1) involving their pediatrician; (2) insurance coverage; and (3) convenience.

This once-a-month program, offered in the physician’s office and focused on healthy habits for the whole family, has been a rousing success. Since children (unlike adults) continue to gain height, the goal is weight stability, which ultimately results in a slimmer, healthier child. Our five basics of family weight loss, based on recent science, are:

1. Limiting sugary drinks
2. Limiting fast food
3. Eating more family meals together
4. Less screen time (two hours max daily)
5. Being more active.

This is a realistic approach that provides “real world” rather than “perfect world” solutions.

At UPMC, we are pioneers in this field! As a researcher, clinician, and health advisor, I’m thrilled that we’ll be seeing more integrated programs like these for vulnerable children and their families, creating an environment where the point of obesity intervention is early.

What Your Hair Says About Your Health

By Dr. Madelyn Fernstrom


Did you ever stop to think about the connection between your hair and your health? Sure, we all get a positive sense of well-being with a good cut, a color we prefer, or the fact that we have a pretty full head of hair! But here’s a health fact to consider: thinning hair can be a symptom of a lifestyle or medical problem. (It’s not usually the cause for the often-observed male-pattern baldness, with a gradually receding hairline.)

With extreme dieting that includes both calorie and protein restrictions, hair can thin dramatically. A protein-deficient diet is often directly reflected in thinning hair. And a poor quality diet — enough calories, but low in vitamins and minerals — can also be a problem.

Poor stress management is another reason you might be losing your locks. Some of this is hormonally based, as well as the nervous habit of absently twisting and pulling on hair, resulting in loss.

Medical conditions can be related to thinning hair. A major observation of untreated thyroid disease is thinning hair. And some autoimmune conditions, like lupus, produce hair loss.

While these are all reasons for hair loss, here are some myths that do not cause hair loss: too much brushing, shampooing too frequently, or wearing hats.

With a diet rich in fruits and vegetables, heart-healthy fats, whole grains and lean protein (sound familiar?), you’ll find that your hair is healthier too! And keep track of your hair health, as significant change might be an issue to address with your doctor.

NYC Ads Fight Liquid Calories

By Dr. Madelyn Fernstrom

Now here’s a novel way to grab your attention about liquid calories and the amount of sugar in sweetened beverages. The advertisement, coming from the NYC Health Department, shows a man consuming whole packets of sugar to provide a warning about how many packets (one packet equals one teaspoon) a person ingests with a  20-ounce soft drink. It is currently in small-market distribution – but might get national exposure.

The Centers for Disease Control and Prevention (CDC) offered the ad to 39 communities already receiving anti-obesity funds, as a way to support the community-tailored media campaigns already under way.

Do you think this will be an effective way to draw attention to this “hidden” source of calories?

Stay tuned – I’ll soon have more news to share from a meeting I am attending (and presenting at) this week in Washington, DC: the CDC Weight of the Nation Meeting.

Eating After the Race

By Dr. Madelyn Fernstrom

Think you’re all done when your race is finished? After basking in the glow of your accomplishment (congrats!), you’ll want to finish up strong with some smart post-race eating to support your nutritional recovery and sustain your sense of well being. 

Those new to long-distance running might be surprised to learn that you don’t need special energy bars or gels to rehydrate and replenish salts, protein, and carbohydrates. While these are convenient for some people, they’re not a must-have. 

One of the best all-in-one foods is 2% chocolate milk – a combination of fluid, protein, and carbohydrates that is a tasty option for many people. Combos like bananas and peanut butter, hummus on a bagel or wrap, nonfat yogurt and fruit, or a simple PB&J are other great choices.

What’s important is the combination of fluids, sodium, and potassium (body salts), protein, and easily digestible carbohydrates. And don’t feel the need to “overfuel” and compensate for your total energy output with a single post-race snack or meal – that only leads to digestive upset. Listen to your body, and follow your own food preferences to feel content.

What are some of your favorite refueling foods and drinks?

Eating for Race Day

By Dr. Madelyn Fernstrom

Those new to running frequently ask me about special eating needs on “race day” compared with regular training.  Whether you’re running the full marathon or tackling the half this Sunday, there are some basics you’ll want to keep in mind. And you half-marathoners won’t have the fueling demands of the full marathon, so pace your eating and drinking to reflect your mileage.

If you’ve been following a balanced diet of 60% to 65% carbohydrates, 25% to 30% protein, and 10% to 15% fat (wiggle room for personal  preference!), you won’t need much of a change on race day.  That’s why the balance of ingested nutrients all along is key – but your final week of fueling can also be a positive boost to your performance. 

For race day and the night before, it’s best to eat the same way you’ve been eating all along! That blend of carbohydrates, protein, and fat can be taken in several ways. A bowl of oatmeal topped with fresh or frozen berries and a banana can be a good choice for some people. Others may enjoy a short stack of pancakes and Canadian bacon, or a peanut butter and jelly sandwich with fresh fruit or juice. For the egg lovers, skip the cheesy omelet and eat your eggs scrambled or poached with toast and a glass of orange juice or a fresh orange.  

Nix the high-fiber foods the night before, as that might cause gas, bloating, or other digestive upset. And skip the advice from fellow runners about trying new foods you haven’t eaten before. A balanced meal – lean protein and a hearty side serving of a starchy carb (like a baked potato, brown rice or pasta) along with some vegetables and fruit (more carbohydrates) – is the way to go. Avoid that bottomless bowl of pasta to “fuel;” you’ll wind up with an overly full stomach and likely not sleep well. Performance eating is not a one-meal miracle!

Always stay hydrated  with water, and non-carbonated fluids before the race. 

And remember that there will be water, sports drinks (for essential salts), and snacks along the way to help sustain your energy. Pace your eating and drinking along with your running. You’ll know from your training when you “hit the wall” and need to re-fuel for an energy boost. It’s variable for everyone, so know yourself.  

Carry a pack or two of a sports gel or honey for quick energy if you need it.

Other tips from the runners out there?

(Stay tuned for Friday’s blog on post-race eating!)

For more half marathon training tips, check out my guest appearance on this week's episode of My First Half Marathon!