Healthy Living

Think cranberries, and you probably think of the holidays. Whatever your association with fall fruit, an impressive body of evidence proves that starting your day with a shot of cranberry juice, or tossing the dried berries in cereal or salads can bring health benefits any time of the year.

Long before the colonists first arrived in the new land, the American Indians were using cranberries. The Native Americans understood cranberries and used them not only as food, but also as dye and for medicinal purposes. Primary among their uses was as a poultice to heal wounds. Although you will not hear the recommendation to rub cranberries on our scrapes and cuts today, you may have heard of drinking cranberries juice to ward off urinary tract infections (UTI’s) or even that they are a good source of antioxidants for cancer prevention or heart health.

Though cranberries are tiny, they are potent. Packed with nutrition, they are also high in fiber, like their relative, the blueberry. They also contain antioxidants in abundance which has antibacterial properties in the body and potentially can help improve cholesterol profiles.

A study conducted at the Harvard Medical School determined that regular consumption of cranberry juice reduced the amount of bacteria in the urinary tracts of elderly women. These researchers concluded that something specific to the cranberry actually prevented bacteria from adhering to the lining of the bladder.

A few years later, researchers from Rutgers University identified the specific components in cranberries that produce health benefits. These condensed tannins or proatnothocyanidins (PACs) from the cranberry fruit prevent Escherichia coli (e.coli), the primary bacteria responsible for UTI’s, from attaching to the urinary tract.

Thus, the bacteria are flushed from the urinary tract rather than being allowed to stick, grow and lead to infection. Cranberries can not be used to treat an existing infection, but, drinking plenty of water every day and consuming cranberries on a regular basis may help prevent reoccurrence.

Most of the research with heart health and the antioxidant flavonoids has involved red wine or tea, not cranberries. The few studies that have been done with cranberries show that they have the potential to increase HDL (good cholesterol) and lower LDL (bad) cholesterol.

Getting the nutritional benefits of cranberries through food is recommended versus taking it in a pill form. Cranberry extract is considered a dietary supplement. Dietary supplements are not regulated, so you can’t be sure what you are getting. If you want the benefit of cranberries, eat the real fruit or drink cranberry juice.

Keep in mind cranberry juice is 100% juice; the cocktail version is about 25% juice and about 75% sugar. Try cranberry juice with other fruit juices if the 100% juice version is too tart for your taste buds.

Dried cranberries are coated with sugar and are caloric dense so keep portion control in mind. 1/3 cup dried cranberries are considered 2 fruits servings with about 130-140 kcal compared to 1⁄2 cup whole berries have only 22 kcal. Try tossing some fresh cranberries into your cereal, salad, or making you own cranberry sauce mixed with apples, pears or oranges. They can be added to muffins, breads or even a fruited salsa.

Fresh cranberries are generally available mid-September through December and most abundant during peak harvest season in October and November. Cranberries can be stored in the refrigerator for up to four weeks. Buy fresh cranberries in season, and then freeze them up to 18 months to enjoy them all year long.

So this holiday season, pick up some cranberries and incorporate them into your diet and grab a couple extra bags to put in your freezer to get you through until next fall. They are tasty, tiny, tart and good for you.

Sarah Hospod is a registered dietitian in the Food and Nutrition Department at The William W. Backus Hospital in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Hospod and all of the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog below.

The H1N1 virus continues to present challenges for the public health community. The Uncas Health District is focusing on three areas: community education, continuity of operations planning and support and public vaccination.

Understandably, the public finds the response to the H1N1 virus to be confusing and frustrating. With information changing daily, reports of high absentee rates in schools, and concern about the lack of vaccine – the public may not be sure what to ask. The following questions and answers may help to clear up some of the confusion.

• Why is there such a limited supply of vaccine and do you think everyone who wants vaccine will be able to get one?
In fact, more doses are being released each week and the first priority groups are beginning to be addressed quite well. Unfortunately, we are not all in a priority group. For those individuals, an additional wait will be necessary. However, the plan is for every individual to be offered a dose.

• What are the current risk groups that are being targeted?
The current risk groups being targeted include pregnant women, household contacts of children less than 6 months of age, children 6 months to 6 years, EMS and healthcare providers, and children less than 19 years old with chronic health issues. These groups are continuing to expand as the vaccine becomes more widely available.

• How do I find out about flu clinics and vaccine availability?
H1N1 clinics have been scheduled by appointment. Please contact your physician or the Uncas Health District office at 823-1189 x113 or email doh@uncashd.org.

• How prevalent is H1N1 now in our community?
Influenza data reviewed from the week ending Oct. 31 reveals a continuing increase in the level of influenza activity being observed in Connecticut as measured by laboratory confirmed test results. Over 100 influenza- associated hospitalizations have been reported to date, with many more people having the disease that aren’t hospitalized.

• Who is most vulnerable?
Data continues to support the hypothesis that young people and individuals with chronic health conditions are at greatest risk.

• How do experts see this playing out? Is there an end in sight?
While it is difficult to predict how H1N1 will pan out, it appears that the H1N1 virus is coming in waves. Keep in mind, seasonal flu typically arrives in November and peaks in January – February. Therefore, it is still going to be important to take precautions into the Spring.

• What about seasonal flu vaccine – will that become available again or is it too late?
It is not too late as the season has yet to truly begin. Unfortunately, the vaccine is an unknown commodity at this point, with public health officials crossing their fingers, right along with the public, hoping it becomes available in great numbers very soon.

• Besides vaccinations, what are other ways to protect against the flu?
Social distancing is an important part of protecting yourself and others. If you are sick, avoid public interaction as much as possible until 24 hours after signs and symtoms have ended without fever-reducing medications. In addition, you should continue to cover your cough, wash hands frequently, eat well, and get your rest. If you do need to fight something off, you want your body to be at its best.

Patrick R. McCormack is Director of Health for the Uncas Health District. This column should not replace advice or instruction from your personal physician. E-mail McCormack and all of the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog below.

As parents we juggle our careers, household upkeep, soccer practice and homework and that’s probably just the tip of the iceberg. We try in vain to manage all these activities and get the kids to bed at a decent hour.

Let’s face it, in today’s busy world, who doesn’t like having someone else do the cooking once in a while? Dining out allows us to slow down a little. It gives us time to sit back and really talk to our kids and perhaps work on that homework while waiting for the meal to arrive.

The challenge that we face, however, is chicken fingers, mac and cheese and fries. Now, if you only splurge once or twice a month in a restaurant this is not such a big issue. But if your family dines out several times per week, your children are eating too much fat, too many calories and not enough vegetables.

Once the decision is made to dine out we are faced with many decisions, including where to go and what to eat. Whether it’s fast food or a sit down meal, there are menu options available for kids that will meet your healthy standards and then of course there is the opposite.

Take, for example, the kids’ turkey mini burgers at Ruby Tuesday, which are 873 calories and 41 g of fat and the kids’ chicken tenders are 704 calories and 34 g of fat. Better choices include the kids’ pasta marinara (490 calories and 6 g fat) or the kids’ chicken breast (217 calories and 9 g of fat) paired with broccoli and the meal is complete. Ruby Tuesday also offers choices such as green beans, baked potato and mashed cauliflower.

Friendly’s, another popular spot to bring the kids, offers a wide selection of choices. While the cheeseburger has 450 calories and 27 grams of fat (fries not included), the grilled cheese sandwich is only 290 calories with 17 grams of fat.

A better choice might be to ask for a grilled chicken breast with a vegetable choice such as broccoli or corn or perhaps the applesauce or mandarin orange slices. Watch out for the kids’ happy ending ice cream desserts, these add an additional 300-860 calories to an already calorie-heavy meal.

As for beverages, stick with water or low fat milk and stay away from soda, juices, flavored milk and lemonades. These choices can easily add 100-350 calories to the meal.

Fast food restaurants can also be a challenge, but don’t despair; you can feel good about the occasional trip to the golden arches. A simple hamburger with a small fry comes in at 480 calories with 20 grams of fat. Skip the fries and choose the apple slices and you’ve just shaved off quite a few calories. Both McDonalds and Burger King offer 1% or skim milk, which always a good choice. Encourage your child to choose the grilled chicken sandwiches or the grilled chicken snack wrap, both of which have fewer calories than the cheeseburger.

If your favorite restaurant doesn’t offer a kids’ menu or you don’t like the choices offered, ask your server for child-size portions from the regular menu.

Spaghetti and marinara or grilled chicken or fish are always healthy choices. Encourage salads or maybe a grilled chicken fajita and if low fat milk is not available, go with water, which is always calorie-free. Keep asking for low fat milk -- my philosophy is if enough requests are made, restaurants will eventually catch on.

Chain restaurants, such as 99, Ruby Tuesday, Subway, McDonald's or Panera Bread provide the nutrition information online. Check out your favorite restaurant’s websites to help you navigate your way through the menu.

Putting it all into perspective:
• Ages 4-8 years: Needs are 1400-1600 calories/day for a moderately active child.
• Ages 9-13 years: Needs are 1600-2000 calories/day for a moderately active female and 1800-2200 calories/day for a moderately active male.
Source: Institute of Medicine, Dietary Reference Intakes macronutrient report, 2002.

Wendy Kane is a registered dietitian and certified diabetes educator in the Backus Hospital Diabetes Management Center. This advice should not replace the advice from your physician. Email Ms. Kane and all the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at www.healthydocs.blogspot.com

Drinking and speeding are two well known causes of serious car crashes.

Now it’s time to add distracted driving to the list.

Locally and nationally, the number of crashes involving distracted driving – which can be anything from programming your GPS to reading or text messaging – is rising.

The federal government estimates that 30 percent of all crashes in the United States involve driver distraction.

As manager of the Backus Hospital Trauma Center, I think that number might be higher. Just in the last few weeks we have seen several crashes that involved distracted driving.

And over the longer term, we are seeing an uptick in crashes due to distracted driving. A growing culprit these days is text messaging. A growing amount of evidence suggests that driving while texting is even riskier than driving under the influence of alcohol or drugs.

Driving while texting is extremely dangerous – we have seen many serious and fatal crashes on our local roadways to prove it. Because texting is so popular among teens, they are also major offenders when it comes to texting and driving.

This is a dangerous combination – inexperienced drivers taking their eyes off the road to read or send text messages. If you add alcohol to the mix it’s even worse.

What can we do? Here at Backus Hospital, we have included distracted driving deterrence into the curriculum of our Be Aware Program, which reaches hundreds of local teens ever year.

Parents should amend their warnings about drinking and driving and speeding to include talk of distracted driving, and remind their children that using a cell phone while driving – whether to talk or text – is against the law.

Gillian Mosier is a registered nurse and manager of the Backus Trauma Program. This column should not replace the advice of your physician. To comment on this or other Healthy Living columns, go to the Healthy Living blog at backushospital.org or e-mail the columnists at healthyliving@wwbh.org.

Halloween is a favorite holiday for many kids. Why? When else do you get to dress up in a cool costume, walk around the neighborhood pretending to be someone or something else, and ring your neighbor’s doorbell in anticipation of a special treat?

As a kid I remember excitedly dumping my bag or plastic pumpkin on the dining room table and surmising all the treasures I had collected.

The bite-size candy bars, bubble gum, Tootsie Roll pops and Twizzlers were among the treats. It seemed like an eternity waiting for Mom or Dad to inspect everything before I could indulge in a few.

To this day I still have a sweet tooth, but know I must limit my candy consumption.
With the epidemic of obesity sweeping the nation, adults and kids need to be sensible with their intake of candy to avoid undesirable weight gain.

In addition, too much sugar can promote tooth decay, leading to more cavities and time spent in the dentist’s chair.

Most importantly, candy is often high in calories and/or fat, (depending on the type), and low in other nutrients. Recently I polled some Facebook moms and dads to ask how they handle the influx of candy their trick or treaters bring home. Here is a summary of what they said:

- Allow kids to have 2-5 pieces or “indulge” a little Halloween night.
- Keep remaining candy in a child’s designated “treat bag” in a place out of their reach (such as a high cupboard).
- Each day allow a designated amount of candy (about 1-2 pieces) after lunch or dinner. Continue this practice anywhere from a few days to a couple months.
- Offer to buy candy from children -- after a price is negotiated one parent “buys” back some of the candy collected. The parent then brings the candy into the workplace to share.
- Separate candy into zip-lock bags; one bag containing candy to be used in future (i.e. Christmas cookies)
- Freeze the candy (note some candies may freeze better than others).
- Toss extra candy or give away.
- Parents eat it themselves.

I also asked a friend (who is also a dietitian) how she limits her kids’ candy consumption. She (like one of the moms that responded to the Facebook poll) sets aside any good candy (namely chocolate bars) and chops it up to make cookies.

She also said that she is lucky that her kids get more excited about dressing up and the act of trick or treating but not necessarily eating the candy.

A good friend of mine mentioned she allows each of her kids three pieces of candy corn per day and that they can choose how they eat it (i.e., a piece after each meal, three before bedtime, etc).

A favorite author of mine is Ellyn Satter, a registered dietitian who has written books on feeding children healthfully. She recommends relegating candy consumption to meal and snack times and that structure is a key component.

Parents take leadership in what other foods are offered at the table. She suggests that children that are able to follow rules should be allowed to keep their stash of candy, and that the parents control the stash for those that cannot.

Satter also advises that once the child shows the ability to control his candy consumption, he should be allowed to keep his stash.

I agree with Satter’s advice that candy should be treated the same way other sweets are and that children need to manage sweets and keep sweets in proportion to other foods they eat.

She cites research studies in which treat-deprived girls were more likely to load up on forbidden foods even when not hungry and that girls who were allowed to eat sweets ate them in moderation (if at all) and were thinner.

Remember too, that “treats” do not have to mean “candy.” Nuts, raisins, sunflower or pumpkin seeds, microwave popcorn or whole grain crackers are other options.

Candy alternatives may include pencils, stickers, scented erasers, party favors or trading cards.

However you and your children spend Halloween, choosing healthier foods more often, limiting sweets and exercising regularly are all steps you can take to limit undesirable weight gain. Trick or Treat!

Catherine Schneider is a Registered Dietitian in the Food and Nutrition Department at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. E-mail Ms. Schneider and all of the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at healthydocs.blogspot.com.

Until it happens to you, you don’t realize how common it is.

One in every three pregnancies ends in a loss, whether it’s miscarriage, stillborn or death shortly after birth.

To bring attention to how common this is, to highlight the help and resources available for those who find themselves in this gut-wrenching situation and to remember babies who have been lost, Remembrance Day is held each year on Oct. 15.

I am a firm believer that being around others who have experienced this kind of emotional loss, and talking about your feelings, helps.

That’s why at Backus Hospital we offer a Pregnancy and Infant Loss Support Group, held the second Tuesday every month from 7-8:30 p.m. in the Backus Medical Office building conference room. As a Backus social worker, I moderate the group and see firsthand how it helps.

But make no mistake about it: The grief associated with the loss of a child during pregnancy or in infancy can linger and cause long-term mental health issues if not dealt with properly.

Remembrance Day, which includes a nationwide candlelight vigil at 7 p.m., and our support group are two ways to properly grieve and heal.

For some, healing involves knowing there are others out there like them. For others, it’s knowing that just because you have one miscarriage doesn’t mean you will have another. Or, just remembering the lives lost can help.

Please join me this Remembrance Day in celebrating these precious lives, and in helping our friends and neighbors make it through these difficult times.

Elynor Carey is a social worker in the Backus Hospital Care Management Department. This column should not replace advice or instruction from your personal physician. E-mail Carey and all of the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at healthydocs.blogspot.com.

Seniors have always been reminded to get a seasonal flu shot, and the advice is still sound this flu season.

Many seniors, however, may wonder why they are not in the priority groups for the H1N1 vaccine when it becomes available.

Federal guidelines call for the new H1N1 vaccine to be given first to pregnant women, those who live with or care for children 6 months or younger, healthcare workers, people ages 6 months through 24 years old, and people with chronic health problems or compromised immune systems.

Only after shots are offered to those groups will the vaccine be available to healthy adults 64 and younger. After that, seniors’ ages 65 and older would be eligible.

The answer to why seniors are being delayed in their receipt of vaccine is twofold: there is a limited supply being made available – some vaccine even being limited further by the vaccine’s contra-indications and usage – and seniors are believed to have a preexisting immunity.

The Centers for Disease Control (CDC) supports its assertion that immunity exists by reasoning that seniors, especially those over the age of 60, might have been exposed to the Spanish influenza in 1918, and Asian influenza in 1957. CDC also points out that from all current H1N1 virus cases in the United States, 64 percent of them were found in people within the ages of 5-24 and only one percent of virus cases were found in people over 65 years old.

So, what can seniors do to stay healthy in the season of influenza – be it seasonal or H1N1? First, get your seasonal flu shot. As much as 20 percent of people nationwide get the (seasonal) flu each year. About 200,000 people experience complications from the flu and have to be hospitalized, and about 36,000 die each year.

Flu symptoms include fever (usually high), headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, muscle aches, and sometimes diarrhea and vomiting. The flu is spread through coughing or sneezing.

Second, you should maintain a sanitary environment by covering your mouth and nose when coughing or sneezing, washing hands, and staying home when you are sick.

Finally, you can protect yourself by helping others. Encourage friends and relatives to get flu shots. Remind them that it is okay to stay home when you are sick. And, seek out information from legitimate resources such as your healthcare provider or the local health department. You are certain to feel less anxiety if you feel in control of your own health, and a healthy mind will lead to a healthy body.

For updates on the flu season, visit www.backushospital.org/flu.

Patrick R. McCormack is Director of Health for the Uncas Health District. This column should not replace advice or instruction from your personal physician. E-mail McCormack and all of the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at healthydocs.blogspot.com.

The discovery of our babysitter driving was one thing. But recently we shared in the excitement of her going off to college. A great loss to us begins a new journey for Jess.

I can’t help but to reminisce on my own experiences as a freshman off to college. Raman noodles, Nescafé and grinders (as I learned New Englander’s call them) were on my weekly menu. It is no surprise that the freshman 15 was real for me. The opportunity to eat whatever I wanted, whenever I wanted, had its ramifications.

According to a study at Cornell University, college students gain an average of four pounds during their first 12 weeks on campus. The cause of weight gain is linked to all-you-can-eat dining facilities, evening snacks and empty-calorie food choices.

So what healthy advice can I give to Jess as she heads off to college? Follow my Eat Your P.E.A.S. advice for college students.

Planning is Power
Sometimes the poor food choices we make on campus come from poor planning. Don’t wait until you’re too hungry to grab something to eat. Chances are that something won’t be good for you.

If your schedule is packed, take a few minutes once a week to come up with a plan (make this one of your easy weekly assignments).

If Monday and Thursdays have back-to-back classes, plan on packing some fresh fruit and nuts to go. Pick up a yogurt on your way by to café to balance it out.

If weekly planning is overwhelming, planning day-to-day can be just as advantageous.
Three meals and two healthy snacks each day is an ideal pattern. Planning ahead can be as simple as taking an extra piece of fruit with dinner to go to save as part of an evening snack.

Eat a Balanced Breakfast Everyday
This is a big one. The Big B! You’ve got to fuel yourself well with breakfast to start a busy day.
If your class schedule is crammed in the morning, giving yourself time to eat is a must. If going to the dining hall doesn’t fit into your day, stock up your “dorm room pantry” with fresh fruit, yogurt, granola or whole grain cereals and low fat milk.

The brain works most efficiently with a steady supply of fuel. So don’t jip your brain from the start. Give your mind and body what it needs.

Appropriate Portions Balanced with Activity
Watch your plate! As a guide try to aim for 1⁄2 your plate as produce, 1⁄4 whole grains and 1⁄4 lean protein.
Also visit http://teamnutrition.usda.gov/Resources/foodforday.pdf and
http://teamnutrition.usda.gov/Resources/howmuch.pdf" for visual guides on portions and balance.

Ask for what you want. Most food service staff members are happy to accommodate you where they are able. Don’t be afraid to ask for something on the side or to hold it all together.

Eat from a plate. Eating straight from the box is a rebel norm in college. But what it does is skew your awareness of how much you are actually eating.

Regular physical activity is another piece of the puzzle. It helps maintain energy as well as manage weight. You need all the energy you can get. Extending your walk to or from class is one easy way to work in a few extra miles. Take advantage of any campus resources like a gym or running track, etc… You get the idea…move more.

Shop Smart to stock up on healthy foods/snacks
Shopping at a grocery store may give you a greater variety of produce than a quick campus market. Shop the perimeter of the store to stock up on produce, whole grains and low fat dairy. Buy in-season produce to save.

Trader Joes is a terrific option to fit a college budget. Visit www.traderjoes.com to see if a location is near campus. Jess is lucky to have one in her neighborhood. You can get everything you need there to stock a healthy dorm room pantry. See my list below.

Check out local resources. Maybe your campus has a local listing of farmers’ markets and restaurants. My university (UNH) now offers an online guide to help navigate your way around eating on campus. If not, check out your city online. Hartford, for example, has an online dining guide, which also lists farmers’ markets in the area.

Good luck to Jess and all those freshman off to college. I’d love to hear from you. Please e-mail feedback or questions to me at healthyliving@wwbh.org.

Dorm room pantry
Your pantry could be as simple as a crate or tote under your desk.
- all-fruit spreads
- rice cake
- dried fruits (raisin, apricots, cherries)
- whole grain baked crackers
- bananas, pears
- cereal (high fiber, low sugar)
- nut butters (almond, cashew, peanut)
- granola bars, granola
- nuts (almonds, walnuts)
- whole wheat bread or English muffins
- seeds (sunflower, pumpkin, sesame)
- graham crackers
- pretzels
- multi-grain tortilla chips

Smart snacks for the refrigerator
A refrigerator in the dorm rooms offers a way to keep perishable items and a wider variety of smart snacks.
- Fruit – grapes, apples, kiwi, clementines
- hummus
- veggies – baby carrots, snow PEAS
- low-fat or fat-free milk or soy milk
- salsa
- yogurt
- string cheese
- light cream cheese

Resources:
http://www.youngwomenshealth.org/college101.html
http://www.freshman15.com/healthy-eating-guide.php
http://www.jhsph.edu/student_affairs/HealthyEating.html
http://www.jhsph.edu/student_affairs/GTWP_Tipbook.pdf
http://www.cspinet.org/
http://www.nature.com/ijo/journal/v28/n11/full/0802776a.html
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2720988

Renee Frechette is a registered dietitian who serves as the outpatient oncology dietitian in the The William W. Backus Hospital’s Radiation Therapy Center. This column should not replace advice or instruction from your personal physician. E-mail Frechette and all of the Healthy Living columnists at healthyliving@wwbh.org or comment on this blog.

Novel H1N1 influenza, or Swine flu, is on a lot of minds lately and it’s not surprising. The chance of it becoming a large public health problem is very real.

Because of this threat, our health officials have worked very closely with pharmaceutical manufacturers to quickly develop, test, and release a specific vaccine aimed at preventing the Swine flu. Does the word “quickly” make you nervous?

Like many things, be it toaster ovens, cars, or medications, the idea of quickly developing something conjures up the thought of cutting corners and not fully testing the final product.

Consumer advocates often caution us not to be the first one to purchase a new model -- you might be the one to discover the bugs the manufacturer failed to find.

In healthcare we have a similar rule of thumb, if possible, wait at least one year after a new medication is released so the medical community can learn more about how it works and what side effects will occur.

I recently had a similar conversation with a co-worker; we discussed how comfortable we were with the news that a new Swine flu vaccine will be available in just a few weeks after only spending a few months in testing and development. Should we be? My simple answer is yes, feel comfortable, because it is not truly a new vaccine.

The H1N1 vaccine is merely the same traditional seasonal flu vaccine made with a new strain of the flu virus. The same exact manufactures using the same manufacturing process that has been FDA-approved and proven safe for many years is being used.

Every year the manufacturers of the seasonal flu vaccine change the viral strains (usually a total of three strains) contained in the vaccine to match what health officials believe will be the major viruses causing illness in the coming fall.

This year, they simply used a different strain -- H1N1 -- in the same process (officially known this year as the A/California/7/09-like virus). Like all flu vaccines, the virus is actually killed by the process and the vaccine cannot give you the flu.

Since the new vaccine is the same as the old vaccine, the same warnings apply. You should not receive either flu vaccines if you have an allergy to eggs or egg products or a history of a life-threatening reaction to the vaccine in the past.

Common side effects of the vaccine include soreness at the injection site, and possibly a mild fever and fatigue, but again, you cannot catch the flu from the vaccine.

Should you get the vaccine? Not everybody needs the seasonal flu vaccine or the Swine flu vaccine. Ask your doctor and pay attention to the many public health announcements that will be released.

Do note that each vaccine is unique, and the seasonal vaccine will not protect you from Swine flu and the Swine flu vaccine will not protect you from seasonal flu. Current recommendations are for adults to receive a single dose for each for protection, children may need two doses.

Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at backushospital.org or E-mail Smith and all of the Healthy Living columnists at healthyliving@wwbh.org.

With school back in session and the homework load getting heavier, the chance for a backpack-related injury is high. Approximately 40 million children head to school each day with backpacks, and about half of them sustain injuries as a result, according to the North American Spine Association.

In recognition of National Backpack Awareness Day on Wednesday, The William W. Backus Hospital’s Rehabilitation Services Department offers these important backpack tips to keep children safe:

Never let a child carry more than 15 percent of his/her body weight. Use a scale to weigh the backpack if you need to.

The heaviest items should be loaded closest to the child’s back. Compartmentalize belongings so all the weight is not in one place. Arrange books/material so they will not slide around.

Check your child’s backpack daily and only include items that are needed for the day’s activities.

If the backpack is too heavy, consider having your child carry a book or item in his/her arms to lessen the load.

Always have your child wear both shoulder straps because if just one is worn it can lead to discomfort and injury.

To avoid tingling in the neck, select a backpack with well-padded shoulder straps.

Shoulder straps should be adjusted so that the backpack rests in the middle of the child’s back and does not hang lower than four inches below his/her waist.

Wear the waist belt if the backpack has one, to help distribute the weight more evenly.

There are many kinds of backpacks that come in different shapes and sizes. Just remember to choose one with multiple compartments, padded, contoured shoulder straps and waist and chest straps. Always try the backpack on before you buy it.

Kristin Hilliard is a physical therapist in the Backus Hospital Rehabilitation Services Department. This advice should not replace advice from your physician. E-mail Hilliard and all the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at healthydocs.blogspot.com.

The days are slowly becoming shorter, the temperatures are falling and our children are back to school.

With school underway parents’ thoughts turn toward bus schedules, homework and report cards. Give your child an extra edge toward better grades by helping them start their day with a nutritious breakfast.

There are many benefits to be had by eating breakfast. This very important meal can provide up to 25% of the recommended daily allowance for key nutrients, such as calcium, protein, vitamins A and B6, magnesium, iron and zinc.

Eating breakfast helps children to perform better at school. This first meal of the day can improve attention, memory and cognitive function. Children who eat breakfast make fewer mistakes and work faster in math and number checking tests. They perform better in vocabulary and better handle frustration. School breakfast programs can lower absence and tardiness rates and improve standardized test scores. Adolescents who eat breakfast tend to have a lower body mass index (BMI) – higher BMIs can indicate obesity.

The challenge with breakfast is that is falls at a very hectic time in the day. Parents are trying to get ready for work while also getting the kids up and out the door to catch the bus. This frenzy is coupled with the last minute drama of “I can’t find my shoes” and, “Where’s the library book?”

With this in mind, keep breakfast simple and plan ahead; prepare as much as possible the night before.

Breakfast should include foods from several food groups to provide the most benefit to children, both educationally and physically. You want to balance protein, carbohydrates and fat. This balance will prevent a drop in blood sugar for several hours. A drop in blood sugar can mean a decline in energy and symptoms of hunger that will distract your child from learning.

The following are some fast breakfast ideas that will help you and your child start the day off right.
• Whole grain cereal with 1% milk.
• 100% whole wheat bread or English muffin with peanut butter and a piece of fruit.
• Hard boiled egg with a small bagel.
• 6-8 oz of low fat yogurt with fresh or frozen blueberries and a 1⁄4 cup of granola.
• 1-2 whole grain frozen waffles, toasted with peanut butter and sliced bananas with honey drizzled on top.
• Oatmeal (made with milk) with sliced strawberries and a tablespoon of sliced almonds.
• Yogurt and fruit smoothie.
• On the fly: Carnation Instant Breakfast made with skim or 1% and a piece of fruit.
• String cheese with a piece of fruit.
• Toasted whole grain English muffin with sliced tomato and a slice of cheese melted on top.

If making breakfast at home still proves to be a challenge, contact your school office to inquire about the School Breakfast Program.

Wendy Kane is a registered dietitian and certified diabetes educator in the Backus Hospital Diabetes Management Center. This advice should not replace the advice from your physician. E-mail Ms. Kane and all the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at www.healthydocs.blogspot.com.

If imitation is the greatest form of flattery, than those in the medical field should be feeling warm and fuzzy as of late. The onslaught of medical shows on both premium and cable television is fast approaching pandemic proportions -- with no cure in sight.

Dr. Kildare made his first house call into American homes in 1961 in what is considered to be the first television medical drama. He would soon be followed by the likes of Marcus Welby, MD, as well as one of my favorite TV docs, Joe Gannon from Medical Center. While these shows were not terribly accurate in their portrayal of the medical field, they did portray the medical community in a relatively respectable light.

It wasn’t until 1972 when M.A.S.H. arrived on the scene that comedy, albeit often times dark, was added to the mix. This trend towards comedy interspersed with drama would be repeated in shows such as Doogie Howser, MD, Northern Exposure, Scrubs and House, M.D. to name just a few.

As a nurse I have enjoyed many of these shows. Yes we have to look past the blatant disregard for reality such as the IV tubing heading to nowhere or, as is the case with House, physicians who single handedly perform every conceivable procedure a patient may require. Over the years the image of nurses has been largely that of a physician’s helper who appears to be mute most of the time. The times they are a changin’ but not in the way the media would have you believe.

Today’s nurse is an active and respected member of the medical team. He or she enjoys a level of autonomy that has been earned by the profession. Many standing protocols allow the nurse to implement a wide variety of tests and procedures before the physician even enters the scene. Job opportunities run the gamut of bedside, administrative, in hospital, out of hospital, military and civilian, medicine, trauma and a whole host of other specialties. It is an exciting time to be a nurse. Why is that not portrayed in the media?

I looked forward to the premier of two new shows in particular; Nurse Jackie and HawthoRNe. Both have proved to be disturbing letdowns. My hope was that these new nurse-centered shows would help to spark an interest in this fascinating field that is so in need of new recruits. Instead they portray offensive and demeaning stereotypes that are an insult to both nurses and women.

In the case of Nurse Jackie I found a show about a drug and sex addicted woman who I certainly would not want to have caring for anyone I love. HawthoRNe seemed to be portraying nurses in a more positive light, though not terribly accurate, when the story line suddenly included a sexual relationship between a nurse and a patient. Is it nurses or the American viewers that these producers have such low opinion of?

Both shows have prompted position statements from the American Nurses Association (ANA). The ANA points out that the negative images portrayed in these shows “erode the highly valued trust of patients who rely on the expertise of nurses… these harmful images also play a role in shaping the values, impressions and ultimately career choices of young people, and may very well contribute to the nursing shortage that is reaching crisis proportions in our nation.”

TNT and Showtime missed a great opportunity; I wonder what Dr. Welby would have prescribed to remedy this.

Cindy Arpin is a registered nurse and Stroke Coordinator at The William W. Backus Hospital. This advice should not replace the advice from your physician. Email Ms. Arpin and all the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at healthydocs.blogspot.com.

There are times in everyone’s lives when it feels hard or even impossible to forgive. Most of us realize the need for forgiveness in order to achieve a release of negative feelings and move on with our lives in a positive direction, but it is often difficult to truly allow ourselves to heal from past emotional injuries.

The first step to forgiveness is recognizing that the act of forgiving is not synonymous with condoning the hurtful event or behavior, nor does it mean you will forget what happened to you. Forgiveness simply means that you understand that holding on to anger and pain doesn’t do you any good. When you can release these feelings and free yourself from the negative energetic connections to an event, place or person, you have achieved forgiveness.

Forgiveness is more easily reached when you feel heard, respected and understood. Take the time to really listen to your hurt and sadness, directly addressing those feelings rather than burying them. Katherine M. Piderman, Ph.D., writes that we need to “recognize the value of forgiveness and its importance in our lives at a given time. Reflect on the facts of the situation, how we’ve reacted, and how this combination has affected our lives, our health, and our well being.”

Meditation is a useful tool that can help us learn to hear and understand what we are feeling. The act of meditation brings our minds to a deep state of relaxation and awareness. Meditation can be practiced in many forms, from the Christian practice of the rosary to Theravada Buddhism, which emphasizes the meditative development of mindfulness and concentration as part of the pursuit of Nirvana. Experiment with different methods to determine what works best for you.

Remember that forgiveness doesn’t always mean reconciliation, and a reunion is not a necessary product of forgiveness. The person may have died, or may have caused you physical or emotional harm. The purpose of forgiveness is to take away the power that the negative connection to that person has over you, and put you back in control of your emotions.

We all choose our own paths in life – those who are unable to forgive may live a lifetime of bitterness, anger and regret. Choosing to actively forgive others, as well as ourselves, helps us to lead lives that are full of joy, peace, gratitude and love. We all have painful events residing in our memories; forgiveness helps to lessen the pain and allows us to enjoy life by learning to focus on the good. Because of the emotional freedom it grants us, forgiveness is one of the strongest healing powers we can develop within ourselves.

Paula Novak, a registered nurse and certified Healing Touch practitioner, is the clinical coordinator for Healing Touch and Integrative Care at The William W. Backus Hospital in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Novak and all of the Healthy Living columnists at healthyliving@wwbh.org, or comment on their blog at healthydocs.blogspot.com.

You’ve decided you want to lose some weight. As long as you burn more calories than you consume, you can shed those pounds.

Just keep in mind that just about everything you eat or drink, except water, contains calories. And everything you do, from intense exercise to sleep, burns them.

There are approximately 3,500 calories in a pound of fat. So if you burn as little as 500 calories more a day then you consume, you can lose one pound a week.

If you attempt vigorous exercise, it may actually backfire. According to the August 2009 issue of Time magazine, exercise can stimulate hunger.

The more intense the exercise, the more we may want to eat. If we consume more calories than we just lost by exercise, any weight loss would be negated. So avoid that temptation of rewarding yourself by eating an ice cream or other calorie-ridden foods after exercising

According to a study in the August 2009 issue of the Journal of the "American Dietetic Association," people who practiced yoga gained less weight over a 10-year period than those who did not. This was independent of physical activity. They hypothesized that a skill, learned either directly or indirectly through yoga – could affect eating behavior.

Of course, exercise has other health benefits such as lowering the risk of heart and other diseases.

There are many tools available on the Internet to help you lose weight and promote good health.

Your ideal body weight can be determined using a BMI (body mass index) calculator, many of which can be found online by searching for “BMI calculator.”

The caloric content of many foods is available on their nutrition labels and on the Internet.

The calories burned for exercises can be determined by using an exercise calorie calculator found on sites such as webmd.com.

The more you weigh, the more calories you will burn with a given exercise. If you’re having trouble losing weight, you may wish to contact your doctor so he or she can check for diseases that can inhibit weight loss.

Dr. Paul H. Deutsch is board-certified in Internal Medicine, a member of The William W. Backus Hospital Medical Staff and in private practice in Norwich. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at backushospital.org or E-mail Deutsch or any of the Healthy Living columnists at healthyliving@wwbh.org.

Acetaminophen, known commonly as the brand name Tylenol and by its chemical abbreviation APAP, is the most widely used medication in the country.

Although considered the safest pain reliever available, it is also the most common cause of liver failure and accidental overdoses kill more than 100 Americans each year.

These two facts are why the FDA recently convened a special panel to take another look at acetaminophen’s safety.

When can acetaminophen become dangerous? It is based on how the liver removes it from our bodies. Acetaminophen is metabolized in our liver to harmless substances that are eliminated in urine.

A single step in the process produces a toxic metabolite that in usual situations is quickly inactivated by a compound called glutathione. In an overdose situation, the body can run out of glutathione. When this occurs, the toxic metabolite begins to accumulate and liver damage can occur in just a few hours.

The question is then how much is too much? For healthy adults, the standard recommendation has always been a maximum of 1000mg per dose and a daily total of no more than 4000mg is considered safe.

Elderly persons, those with liver disease, and those whom consume alcohol on a chronic basis should take less and discuss this issue with their physician. Taking more than 4000mg per day happens all too often – usually the culprit is not keeping track of how much is in the many combination products being used.

Besides being sold over-the-counter (OTC) as a pain reliever and fever reducer in tablets, capsules, and liquids all on its own, acetaminophen is available as an active ingredient in many combination products.

Vicodin, Percocet, Darvocet, Excedrin, Vicks DayQuill, Contac Sever Cold and Flu, and TheraFlu Flu and Sore Throat are just a few of over 50 prescription and OTC products available that contain acetaminophen as just one of its ingredients.

Sometimes acetaminophen is clearly listed in the ingredient chart, other times it is “hidden” as “APAP.” Problems arise when a person uses multiple products at the same time and fails to pay attention to the total amount of acetaminophen they are receiving, an easy thing to overlook when you don’t feel well.

The FDA advisory panel has suggested a number of measures that could help decrease the risk of accidental overdoses.

The recommended amount for a single dose and total daily doses maybe lowered, extra strength tablets (500mg each) may become prescription only, and combination products may not be allowed to be produced any longer.

Each of these recommendations has pros and cons and the FDA has yet to act upon them. In fact they it may choose to not make any changes at all.

How can you protect yourself and your loved ones now?

Remember that acetaminophen is still the safest pain reliever for healthy adults and should continue to be used for mild to moderate pain.

The most important thing is to check each of your medications that you are using for pain or fever relief for the amount of acetaminophen or APAP that is contained in each dose. Add up the amounts and be sure to intake no more than 1000mg in any 6-hour period or 4000mg in 24 hours. Pay special attention when using multiple pain or cough and cold products at the same time.

Staying below these limits will help ensure your safety.

Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at backushospital.org or e-mail Smith and all of the Healthy Living columnists at healthyliving@wwbh.org.

What food has the highest antioxidant content? I am not going to tell you and it probably does not matter.

Antioxidants are found in all plant foods. There are numerous antioxidant compounds -- thousands have been identified including Beta-carotene, Vitamin C, Vitamin E, Selenium, and phytochemicals such as lycopene, lutein, flavonoids, reversitol, anthocyanins.

An orange contains at least 170 known different antioxidants. They are concentrated in the pulp and skins of plants, so whole foods would have a higher concentration than juices or peeled foods.

Some antioxidants are broken down by cooking and heat and some are released from the plant cells by cooking. A good example of this is lycopene in tomatoes.

What is an antioxidant? Antioxidants protect plants for oxidative damage from the sun, damage by insects and from oxygen made inside the plant through photosynthesis.

People are not plants, but antioxidants help them too. The cells in your body burn oxygen, producing free radicals. These are not escaped hippies, but rather unstable molecules that can cause damage to cells and DNA. Antioxidants sweep up these unstable molecules and render them harmless. Ultra violet light and smoking also produce free radicals.

When you cut an apple in half and it turns brown, this is damage from the oxygen in the air to the apple. If you dip the apple in orange juice, the apple will stay white, this happens because the Vitamin C in the orange juice protects the cells of the apple from damage.

Many locally grown and common foods are good sources of antioxidants: Delicious Granny Smith apples, cherries, blueberries, pecans, potatoes (skin on) and dried beans.
Herbs, spices, coco, nuts and tea are also good sources of antioxidants.

Antioxidants are measured in the lab, getting an ORAC rating (oxygen radical absorption capacity).

Each lab’s method differs, making ORAC values vary. ORAC values are based on 100 grams (3.5 ounces of food), not on commonly consumed amounts or recommended portion sizes.

ORAC value of Acai berries is based on a freeze-dried product weighing 100 grams. Think about how much popcorn it would take to weigh 3.5 ounces (about 3 1⁄2 cups); that is why the ORAC value is so high, a huge amount of berries are being measured. Another problem with ORAC ratings is that is does not measure actually usability in the body.

There is much that we do not know about antioxidants. We do not know how much antioxidants per day are needed to prevent disease.

Antioxidants have been linked with lower rates of heart disease, eye health and some types of cancer. We also do not know if the effects are related to the antioxidants alone or the whole plant food.

Fruits, vegetables, whole grains, nuts and seeds have value beyond antioxidant content; they are good sources of dietary fiber, vitamins, minerals and fatty acids. These whole food components likely work together. For this reason getting antioxidants in a pill or supplement form is probably not as beneficial as getting antioxidants from whole foods.

Get your antioxidants by eating whole plant foods and whole grains. Aim for more than five servings of fruits and vegetables per day with an optimal goal of seven servings per day.

Vary the types and colors of plant based foods that you eat. Antioxidant value of processed foods (flavored beverages and yogurts) containing added antioxidants and fruit extracts are more of a marketing ploy than a healthy addition to your menu. Many of these products are high is sugars and calories and just plain do not taste as wonderful as a fresh ripe watermelon or sugar snap peas. Instead enjoy plain yogurt with a fresh peach, a sprinkling of walnuts and a teaspoon of honey.

Homemade iced tea with lemon is a good choice for an antioxidant-rich cold drink. Fill your plate with rainbow colors; greens (kale, broccoli, kiwi) orange (carrots, squash, cantaloupe) yellow (grapefruit, yellow beans) purple (eggplant, plums, blueberries), red (tomatoes, watermelon, cranberries) and white (cauliflower, apples, onions).

Mary Beth Dahlstrom Green is a dietitian at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. E-mail Green and all of the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at healthdocs.blogspot.com.

There are approximately 70 million bicyclists in the United States. Most of these riders agree that helmets are a good idea, yet only about 35% report wearing one “all or most of the time.”

Consider this: A full 66% of all bicyclists’ deaths are the result of brain injury, and studies estimate up to 88% of these brain injuries may have been prevented by the use of a helmet. Clearly we need to, shall I say, use our heads!

Helmets work by reducing the peak energy at impact through the use of a layer of foam, usually expanded polystyrene foam similar to the old white picnic coolers. They also provide a barrier to protect the soft tissue of the head and face. An important fact to remember is that these foam layers are intended to withstand ONE major crash that usually involves two impacts; helmet-to-car, followed by helmet-to-road. So, not unlike car seats, helmets need to be replaced after a collision.

All helmets sold in the U.S. since 1999 must meet basic safety requirements, so some of the work has already been done for you. The less expensive helmets sold at Wal-Mart must meet the same standards as the high end ones sold at bike shops.

In choosing a helmet, fit is everything. In this area, a specialty shop does help – you are more likely to find assistance in getting the right fit. Here are some basics to remember when fitting a helmet:

A proper fitting helmet should:
* Fit level on the head.
* Touch all the way around – no gaps.
* Be snug, not tight. (Look in a mirror while moving the helmet – the movement should cause the eyebrows to move).
* Have a smooth surface – no fancy wings or visors that can knock the helmet loose in a collision.
* Stay put when tugged on.
* Have a strong strap to hold it in place.

White or bright colors are best for visibility. Ventilation will help you stay cooler, but remember – the more ventilation holes you have, the less energy-absorbing foam.

Skateboard helmets are designed for a different type of impact, so they should not be used for bike riding. Also, because the properly-fitted helmet will be snug, it must be removed when a child is not on the bike; it could become a safety hazard when climbing trees or playground equipment.

One of the most important things to remember when choosing a helmet is to make sure the rider likes it. If someone does not like the look and/or feel of their helmet, it will probably not be worn. Let children pick out their own helmets – choose their favorite color and decorate it with reflective stickers. Make having a bike helmet fun!

Cindy Arpin is a registered nurse and Stroke Coordinator at The William W. Backus Hospital. This advice should not replace the advice from your physician. E-mail Ms. Arpin and all the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at www.healthydocs.blogspot.com.

As trauma program manager at The William W. Backus Hospital, I see my share of pedestrian injuries and fatalities.

But what I’ve seen recently is alarming.

There have been at least five serious crashes involving motor vehicles and pedestrians in the past month and a half that have resulted in hospitalizations. This is more than the entire year in 2008.

Nationally, each year there are approximately 4,600 pedestrian fatalities and 70,000 injuries, according to the U.S. Department of Transportation Federal Highway Administration.

Sadly, many of these could be prevented by taking some simple safety steps:
- Look left, right and left again before you cross the road.
- Use sidewalks.
- Cross only at intersections and crosswalks.
- Wear white or reflective clothing, especially at night.
- Stop at the end of the curb before crossing.
- Walk facing traffic.
- Don’t let anyone younger than 10 cross the street alone.
- Make sure drivers see you before crossing.
- Don’t run – walk across the street.

Drivers also have a role to play. They should always yield at cross walks, obey speed limits and never drink and drive. Nearly 50% of motor vehicle vs. pedestrian crashes are alcohol-related.

While many of these safety tips seem like common sense, you’d be surprised to know how many people don’t follow them. More often than not, the results are disastrous.

Gillian Mosier is a registered nurse and manager of the Backus Trauma Program. This column should not replace the advice of your physician. To comment on this or other Healthy Living columns, go to the Healthy Living blog at backushospital.org or email the columnists at healthyliving@wwbh.org.

Stroll down the dairy aisle nowadays and you will find yogurt in all different forms.

Whether it is spoon-free, drinkable, with added toppings or fiber, full-fat, non-fat, soy, custard or whipped – it seems an endless variety fill the dairy case.

Gaining in popularity is Greek yogurt, which is a blend of cream and milk. Here is what you need to know about this latest food craze:

- It has a higher percentage of milk fat (9-10%) compared to regular whole milk yogurt that generally does not exceed 3.5% milk fat.
- It is triple-strained instead of double-strained to remove much of the whey. This extra straining removes more water; resulting in a more dense, firm, and creamy yogurt.
- There are lower fat (2%) and non-fat (0%) varieties of Greek yogurt available also in the U.S.
- It does not contain pectin or other thickeners found in many American yogurts.
- It is often paired with honey and nuts or used to make tzatziki, a yogurt and cucumber sauce.
- Because of the lower whey content in Greek yogurt, it stays fresh longer and is less likely to separate or curdle when heated. For this reason, it makes a good substitute for sour cream on a baked potato.

A benefit of Greek over regular yogurt is its protein content. An average 8 oz cup of Greek yogurt contains 20 grams of protein, compared to 13 grams in 8 oz of the regular variety.

Greek yogurt is also lower in sodium (83 mg per 8 oz) than regular yogurt (175 mg per 8 oz).

One thing to note: If you are depending on yogurt as a calcium source, regular yogurt has three times more calcium in it than Greek yogurt. Regular non-fat yogurt provides 450 mg calcium per 8 oz; compared to 151 mg calcium in Greek yogurt.

What to do? Include both regular and Greek style yogurts in your diet. Choose low- fat or non-fat varieties with a small amount of added sugar and top with fresh fruit, a small handful of nuts, or whole grain cereal.

Another bonus: yogurt is a good vehicle for incorporating probiotics (friendly bacteria offering many health benefits) into your diet.

Make yogurt one of the ways to get your three servings of dairy foods each day.

Catherine Schneider is a Registered Dietitian in the Food and Nutrition Department at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. Contact Ms. Schneider and all the Healthy Living columnists at healthyliving@wwbh.org.

By now many of us have heard about the FDA warning to General Mills that its popular cereal, Cheerios, is “misbranded” in a way that makes it sound like a drug to prevent and treat high cholesterol and heart disease.

The FDA specifically takes issue with the following statements found either on the Cheerios label or the General Mills website:

“Did you know that in just 6 weeks Cheerios can reduce bad cholesterol by an average of 4%?

“Cheerios is ….clinically proven to lower cholesterol. A clinical study showed that eating two 1.5 cup servings daily of Cheerios cereal reduced bad cholesterol when eaten as part of a diet low in saturated fat and cholesterol.”

According to the FDA, a health claim linking soluble fiber from whole grain oats with a lower risk of coronary heart disease along with a statement about lowering total and LDL cholesterol levels is allowed. The FDA cites that the Cheerios label inappropriately separated the heart disease and cholesterol claims.

Another issue, according to the FDA, is that the General Mills web site used language that does not comply with approved health claims.

For example, its approved health claim about heart disease is supposed to mention fiber, fruits, vegetables and a low-fat diet – not just whole grain foods alone.

General Mills was also warned about another statement that links whole grains as part of a low fat diet to a reduced risk of stomach and colon cancers. According to the FDA, this is not an approved health claim.

So what’s all the hype about? Does Cheerios really help lower your cholesterol?

The answer is probably yes, but so do many other foods.

Cheerios’ great taste, low sugar, and fiber content appeal to both adults and kids alike. The National Cholesterol Education Program (NCEP) guidelines recognize fiber for its beneficial effect in lowering LDL cholesterol and include viscous (soluble) fiber (10-25 gm/day) in the Lifestyle Changes (TLC) diet.

What makes Cheerios a good choice for a heart healthy diet? Cheerios is beneficial because it is comprised of oat bran; a source of soluble fiber. But it is important to note that several dietary fiber sources lower LDL cholesterol levels – not just oat fiber alone.

Foods such as apples, barley, beans and other legumes, fruits and vegetables, oatmeal, rice hulls and purified sources like guar gum, pectin and psyllium seed husk, (to name a few) also lower LDL cholesterol. So including a wide variety of these foods/fiber sources in your heart healthy diet makes sense.

Here are some ways you can include soluble fiber sources in your meals and snacks:

- Add kidney beans or chick peas to soups or salads
- Snack on an orange, apple or pear
- Serve brussel sprouts or lima beans for dinner
- Make a pilaf using barley, and lentils
- Substitute oat bran for part of the flour, and prune puree for part of the fat in your favorite muffin recipe
- Consider taking a psyllium husk supplement (i.e., Metamucil) daily.

There are numerous ways to increase your soluble fiber intake. For Cheerios to be effective in reducing your risk of heart disease, as well as total and LDL cholesterol, General Mills recommends having two 1 1⁄2 cup servings of the cereal each day as part of a heart healthy diet.

Although there is nothing wrong with this approach; you may opt for a little more variety in your own diet.

Catherine Schneider is a Registered Dietitian in the Food and Nutrition Department at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. E-mail Ms. Schneider and all of the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at healthydocs.blogspot.com.

The recent removal of Zicam and Hydroxycut products from the market highlights an important aspect of herbal medications: sometimes you don’t know what you are paying for.

Zicam was a popular zinc-based flu remedy that was taken off the market due to many reports of users losing their sense of smell, sometimes permanently.

Hydorxycut weight loss products have been linked to serious liver damage, and were removed from store shelves in May.

There are a multitude of valuable, safe, and effective nutritional and herbal supplements that can be used to improve your health. Unfortunately there is also a large amount of potentially harmful products as well – products that are harmful to your wallet as well as your health.

FDA-regulated medications must prove both safety and efficacy before they are marketed. Although not everything is known about a medication when it does reach the open market, rigorous testing and reporting of the medications’ risks and benefits allow you and your doctor to make informed decisions about what treatments you should use.

In contrast, companies that manufacture and sell herbal and nutritional supplements have very little regulation. They do not have to prove to any regulatory body that these products are safe or that they are effective.

Many reputable companies will perform their own in-house testing to ensure quality, but not all. And most companies do not conduct the type of safety studies demanded by the FDA for medications. Without such rigorous testing, dangerous side effects like those mentioned above can go unknown for years.

The FDA along with Federal Trade Commission have also taken serious action recently against a number of fraudulent internet sites selling Swine Flu remedies.

The manufacturing freedom mentioned above can lead to a lot of old-fashioned “snake oil”-like products.

Unscrupulous businesses tried to capitalize on the nation’s fear and make a quick buck by promoting products as treating or preventing the Swine Flu.

Just like days of old, slick salesmen use all sorts of gimmicks to try and get you to buy their often useless and occasionally dangerous products. Many of these dealers will use endorsements from phony doctors and unscientific studies to try to convince you of their value. Not all of it is on the internet though; some companies use very well produced, high-dollar radio and television infomercials to advertise their products as well.

How can you protect yourself and your family from potentially unsafe products?
* Stay informed and research as much as you can about the products you buy.
* Only buy from reputable manufacturers that have been in business for many years.
* Do not listen to internet or television commercial doctors that are often little more than practiced salesman. Instead, talk to your own doctor or pharmacist about products you are considering and gather objective advice.
* Always inform your healthcare providers about the nutritional and herbal products you do take and stay on the lookout for any safety alerts from the FDA.

Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at backushospital.org or E-mail Smith and all of the Healthy Living columnists at healthyliving@wwbh.org.