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.