Tuesday, August 26, 2008
Healthy grilling can go on all year long
There is probably no better time of the year to barbecue than the summertime, but just because Labor Day is around the corner doesn’t mean it’s time to cover up the grill– especially with the unpredictable New England weather. Warm spells are common during the fall and not out of the question even in the winter.
My grill stays out throughout the fall to enjoy late harvest vegetables, including eggplant, butternut squash and leeks. As some of us are grilling up our favorite vegetables, most of us are probably cooking some animal sources for our plates as well.
Backyard cooks should be aware: Some research is suggesting that cooking muscle meats at very high temperatures creates a chemical that increases cancer risk. Heterocyclic amines (HAs) are formed when amino acids, building blocks or proteins, and creatine, found in muscles, react at high cooking temperatures. Muscle meats are defined as meat, pork, fowl and fish.
Four factors influence HAs formation: cooking method, time, temperature and type of food. Frying, barbecuing and broiling produce the largest amount of HAs. Oven roasting and baking are done at lower temperatures, so lower levels of HAs are formed, however gravy from drippings does contain substantial amounts.
Foods cooked for a long time, “well done” instead of “medium,” will also form slightly more of this harmful chemical. It is best to grill or broil on an area without a direct flame as the temperatures directly above the flame can reach as high as 500 -1000 ºF. At less than 325ºF, the formation of these compounds is very low.
More HA's form when a food is in very close proximity to a heat source. Flame grilling is perhaps the best example of a food coming into direct contact with a heat source. Less contact with the heating element lowers the formation.
On the other hand, in deep frying there is less HAs creation due to relatively low temperatures and indirect exposure to the source of heat (although deep fat frying involves its own set of health concerns).
Again the culprit is muscle meat: meat, pork fowl and fish. Tofu, other soy products and beans, such as in the form of burgers, are great alternatives.
If you want to try healthy barbecuing, you can do so by:
Not eating any charred or blackened parts of grilled or char broiled foods.
Keeping the portions small and lean (3 ounces on average = size of deck of cards).
Trimming away all excess fat.
Thinking of meat as the side dish.
Pre-cooking the meat in the oven or on the stove ahead of time and finish it on the grill.
Cooking meat thoroughly, but not so much that pieces are charred.
Enjoying grilled meats with plenty of vegetables, fruits and grains.
Making a meal out of grilled vegetables: grill your favorite vegetables; add pesto or an olive spread to make a great sandwich.
Happy grilling!
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 the blog at backushospital.org.
My grill stays out throughout the fall to enjoy late harvest vegetables, including eggplant, butternut squash and leeks. As some of us are grilling up our favorite vegetables, most of us are probably cooking some animal sources for our plates as well.
Backyard cooks should be aware: Some research is suggesting that cooking muscle meats at very high temperatures creates a chemical that increases cancer risk. Heterocyclic amines (HAs) are formed when amino acids, building blocks or proteins, and creatine, found in muscles, react at high cooking temperatures. Muscle meats are defined as meat, pork, fowl and fish.
Four factors influence HAs formation: cooking method, time, temperature and type of food. Frying, barbecuing and broiling produce the largest amount of HAs. Oven roasting and baking are done at lower temperatures, so lower levels of HAs are formed, however gravy from drippings does contain substantial amounts.
Foods cooked for a long time, “well done” instead of “medium,” will also form slightly more of this harmful chemical. It is best to grill or broil on an area without a direct flame as the temperatures directly above the flame can reach as high as 500 -1000 ºF. At less than 325ºF, the formation of these compounds is very low.
More HA's form when a food is in very close proximity to a heat source. Flame grilling is perhaps the best example of a food coming into direct contact with a heat source. Less contact with the heating element lowers the formation.
On the other hand, in deep frying there is less HAs creation due to relatively low temperatures and indirect exposure to the source of heat (although deep fat frying involves its own set of health concerns).
Again the culprit is muscle meat: meat, pork fowl and fish. Tofu, other soy products and beans, such as in the form of burgers, are great alternatives.
If you want to try healthy barbecuing, you can do so by:
Not eating any charred or blackened parts of grilled or char broiled foods.
Keeping the portions small and lean (3 ounces on average = size of deck of cards).
Trimming away all excess fat.
Thinking of meat as the side dish.
Pre-cooking the meat in the oven or on the stove ahead of time and finish it on the grill.
Cooking meat thoroughly, but not so much that pieces are charred.
Enjoying grilled meats with plenty of vegetables, fruits and grains.
Making a meal out of grilled vegetables: grill your favorite vegetables; add pesto or an olive spread to make a great sandwich.
Happy grilling!
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 the blog at backushospital.org.
Thursday, August 21, 2008
The science behind organ donation
I recently came across a troubling article in “Celebrate Life” magazine titled “Organ Donation: The Grim Harvest.” The author espouses that the deaths of some organ donors are hastened based on the need for their vital organs.
Nothing could be further from the truth. His report typifies the difference between those who sit back and theorize about a situation as opposed to those who are actively involved in what is a solemn and painstakingly meticulous event.
The first step in determining brain death is for a neurologist or neurosurgeon to perform a clinical examination of the patient. If there is no evidence of primitive brainstem reflexes such as breathing, eye blink after either eye is touched with a piece of cotton, or a pupillary narrowing response to a bright light, a series of confirmatory tests can be carried out.
These painless tests include an electroencephalogram (a test of electrical brain waves), radionuclide brain scan, CT scan, and MRI. Further medical evaluations are performed to support a clinical examination that shows no evidence of brain function.
None of these crucial tests are detrimental to the overall health of a patient. After a minimum of six hours has passed and these tests confirm no detectable brain function, the neurologic exam is repeated.
An ethics committee consisting of medical personnel and members of the clergy oversees the entire process.
It is important to note that this process is the same for any patient in an irreversible coma. The issue of being an organ donor is not relevant until all criteria are met and a discussion between the treating physician and family takes place.
The choice to be an organ donor is a personal one. What better way is there to “celebrate life” than to donate vital organs so that someone else may live?
Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital with a private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Alessi and all of the Healthy Living columnists at healthyliving@wwbh.org. Comment on their blog at healthydocs.blogspot.com.
Nothing could be further from the truth. His report typifies the difference between those who sit back and theorize about a situation as opposed to those who are actively involved in what is a solemn and painstakingly meticulous event.
The first step in determining brain death is for a neurologist or neurosurgeon to perform a clinical examination of the patient. If there is no evidence of primitive brainstem reflexes such as breathing, eye blink after either eye is touched with a piece of cotton, or a pupillary narrowing response to a bright light, a series of confirmatory tests can be carried out.
These painless tests include an electroencephalogram (a test of electrical brain waves), radionuclide brain scan, CT scan, and MRI. Further medical evaluations are performed to support a clinical examination that shows no evidence of brain function.
None of these crucial tests are detrimental to the overall health of a patient. After a minimum of six hours has passed and these tests confirm no detectable brain function, the neurologic exam is repeated.
An ethics committee consisting of medical personnel and members of the clergy oversees the entire process.
It is important to note that this process is the same for any patient in an irreversible coma. The issue of being an organ donor is not relevant until all criteria are met and a discussion between the treating physician and family takes place.
The choice to be an organ donor is a personal one. What better way is there to “celebrate life” than to donate vital organs so that someone else may live?
Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital with a private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Alessi and all of the Healthy Living columnists at healthyliving@wwbh.org. Comment on their blog at healthydocs.blogspot.com.
Tuesday, August 12, 2008
Using multiple pharmacies to save money is not worth the risks
Saving money is on everybody’s mind nowadays. My wife will spend the time and energy to go grocery shopping at three different stores in one day to save a few bucks. I of course think she’s nuts but am glad that she does it.
But saving a buck or two in the short run is not always the best thing to do. Think of your medications. Do you buy them all at one pharmacy? Get prescription medications one place and over the counter medications at another? Or do you go to extremes and get vitamins, herbal products, and medications all from multiple places to get the best deal on each?
Though you may be saving a few dollars, you are putting your health at risk as well. There are many advantages to using just one pharmacy for all your prescription and over the counter product needs, including economics.
Pharmacies of different companies do not share medication records. If you are using multiple pharmacies, then there is a good chance that neither of them have a complete record of the medications you take. When you take your new prescription to one of the pharmacies, they can only do a drug interaction check on those medications they know you take. If your new medication has an interaction with a drug from another pharmacy, they will not know it, and neither you nor your doctor will get notified.
Using just one pharmacy means the pharmacist there can check your new prescriptions for drug interactions against all of your medications. Also, they are there to answer any questions you have about over the counter drugs, herbal products, and vitamins, all of which could have drug interactions with your prescription medications as well.
You may have to pay a bit more now, but the savings down the line can be great. A single drug interaction will often result in trips to the emergency room, days out of work, doctor visits and co-pays, and of course, another prescription or two.
The amount of competition today for your prescription business is great. This means that most pharmacies have competitive prices that are similar to each other. If you look closely, you might find that you really were not saving much money at all by using multiple pharmacies.
If you absolutely must use multiple pharmacies to save money, make sure you follow a few simple tips to keep it safe.
Make sure each pharmacy has a current and complete list of all medications, herbal products, and over the counter drugs you use.
Notify each pharmacy of all of your medical conditions and reasons for the medications you take. This will allow them to accurately and completely screen any new medication for drug interactions.
Now excuse me as I as go and check how much gas my wife uses driving to those three stores.
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 other health topics, go to the Healthy Living blog at backushospital.org or e-mail Smith and all of the Healthy Living columnists at healthyliving@wwbh.org.
But saving a buck or two in the short run is not always the best thing to do. Think of your medications. Do you buy them all at one pharmacy? Get prescription medications one place and over the counter medications at another? Or do you go to extremes and get vitamins, herbal products, and medications all from multiple places to get the best deal on each?
Though you may be saving a few dollars, you are putting your health at risk as well. There are many advantages to using just one pharmacy for all your prescription and over the counter product needs, including economics.
Pharmacies of different companies do not share medication records. If you are using multiple pharmacies, then there is a good chance that neither of them have a complete record of the medications you take. When you take your new prescription to one of the pharmacies, they can only do a drug interaction check on those medications they know you take. If your new medication has an interaction with a drug from another pharmacy, they will not know it, and neither you nor your doctor will get notified.
Using just one pharmacy means the pharmacist there can check your new prescriptions for drug interactions against all of your medications. Also, they are there to answer any questions you have about over the counter drugs, herbal products, and vitamins, all of which could have drug interactions with your prescription medications as well.
You may have to pay a bit more now, but the savings down the line can be great. A single drug interaction will often result in trips to the emergency room, days out of work, doctor visits and co-pays, and of course, another prescription or two.
The amount of competition today for your prescription business is great. This means that most pharmacies have competitive prices that are similar to each other. If you look closely, you might find that you really were not saving much money at all by using multiple pharmacies.
If you absolutely must use multiple pharmacies to save money, make sure you follow a few simple tips to keep it safe.
Make sure each pharmacy has a current and complete list of all medications, herbal products, and over the counter drugs you use.
Notify each pharmacy of all of your medical conditions and reasons for the medications you take. This will allow them to accurately and completely screen any new medication for drug interactions.
Now excuse me as I as go and check how much gas my wife uses driving to those three stores.
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 other health topics, go to the Healthy Living blog at backushospital.org or e-mail Smith and all of the Healthy Living columnists at healthyliving@wwbh.org.
Friday, August 08, 2008
Blueberry season brings an array of healthy alternatives
One of my favorite times of the year is when blueberries are in season. The high bush variety can be harvested from mid April through October, reaching its peak in July.
Fresh blueberries will keep 7-10 days in the fridge and frozen for up to one year. My favorite way to freeze them is to spread unwashed fresh berries on a cookie sheet, and cover with plastic wrap. After a few hours I transfer the frozen berries into plastic freezer bags, date, label and freeze. This prevents the berries from sticking together and I think more “user friendly.”
These little blue globes of goodness are a win-win in my book. Not only are they delicious and bursting with flavor — they pack a powerful antioxidant punch.
According to the U.S. Highberry Blueberry Council these succulent fruits host many health benefits. Compared to 40 other fresh fruits and vegetables, researchers at the USDA found blueberries rank #1 in antioxidant activity.
Think of anti-oxidants as chemicals that “combat the rust.” They reduce stress from oxidation that can cause damage to cells and lead to diseases such as cancer and heart disease, and help to combat the effects of aging.
Based on the premise that oxidative stress may lead to the age-related decline in brain function, scientists investigated whether blueberries could improve memory function and motor skills in aged laboratory rats and mice — and found they did. Researchers are now studying how blueberries may improve brain function by looking at the chemistry of the brain.
Another benefit of blueberries is that they contain proanthocyanidins, which are substances that may help prevent urinary tract infections by preventing harmful bacteria from adhering to the walls of the urinary tract. The rationale is that if the bacteria cannot attach, they cannot multiply to cause infection.
Also, the anti-oxidant anthocyanin (and the reason blueberries are blue) may help reduce inflammation and ease eye fatigue.
Besides housing these anti-rust chemicals, blueberries are nutritious for other reasons, too. They have high water content so they are naturally low in calories (1 cup of fresh blueberries provides about 80 calories and 4 grams of fiber).
They are also a source of beta-carotene, Vitamin C, potassium, Vitamin K.
In addition to this, blueberries are a versatile fruit. From beverages to jams to quick breads to desserts or sauces, they add sweetness and vibrant color to a variety of foods.
Use them as a colorful addition to fruit salad or a delicious topping for yogurt or cereal. Blend them with ice cubes, skim milk and yogurt to make a healthy breakfast smoothie. The possibilities are endless.
One of my favorite ways to enjoy them is in blueberry pancakes. Here is a recipe that my husband and I especially enjoy: The whole wheat pastry flour provides a source of whole grain and fiber and tenderness to the pancakes.
Whole Wheat Blueberry Pancakes:
1 large egg (I use Omega 3 fortified eggs)
1 Tbsp lemon juice & skim milk to equal one cup of liquid
1 Tbsp. Canola oil
1 Tbsp. honey
1 cup whole wheat pastry flour
2 tsps. Baking powder
½ tsp. Baking soda
1 cup fresh or thawed frozen blueberries, drained
Mix lemon juice with enough skim milk to equal one cup — let sit for five minutes. Mix milk mixture, egg, oil and honey. In a separate bowl combine the dry ingredients, then add the blueberries. Combine both mixtures just until blended and wet ingredients are moistened-batter will be lumpy. Using ¼ cup batter for each pancake, cook on pre-heated griddle at 400° F that has been sprayed with non-stick cooking spray. Makes 2-4 servings.
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.
Fresh blueberries will keep 7-10 days in the fridge and frozen for up to one year. My favorite way to freeze them is to spread unwashed fresh berries on a cookie sheet, and cover with plastic wrap. After a few hours I transfer the frozen berries into plastic freezer bags, date, label and freeze. This prevents the berries from sticking together and I think more “user friendly.”
These little blue globes of goodness are a win-win in my book. Not only are they delicious and bursting with flavor — they pack a powerful antioxidant punch.
According to the U.S. Highberry Blueberry Council these succulent fruits host many health benefits. Compared to 40 other fresh fruits and vegetables, researchers at the USDA found blueberries rank #1 in antioxidant activity.
Think of anti-oxidants as chemicals that “combat the rust.” They reduce stress from oxidation that can cause damage to cells and lead to diseases such as cancer and heart disease, and help to combat the effects of aging.
Based on the premise that oxidative stress may lead to the age-related decline in brain function, scientists investigated whether blueberries could improve memory function and motor skills in aged laboratory rats and mice — and found they did. Researchers are now studying how blueberries may improve brain function by looking at the chemistry of the brain.
Another benefit of blueberries is that they contain proanthocyanidins, which are substances that may help prevent urinary tract infections by preventing harmful bacteria from adhering to the walls of the urinary tract. The rationale is that if the bacteria cannot attach, they cannot multiply to cause infection.
Also, the anti-oxidant anthocyanin (and the reason blueberries are blue) may help reduce inflammation and ease eye fatigue.
Besides housing these anti-rust chemicals, blueberries are nutritious for other reasons, too. They have high water content so they are naturally low in calories (1 cup of fresh blueberries provides about 80 calories and 4 grams of fiber).
They are also a source of beta-carotene, Vitamin C, potassium, Vitamin K.
In addition to this, blueberries are a versatile fruit. From beverages to jams to quick breads to desserts or sauces, they add sweetness and vibrant color to a variety of foods.
Use them as a colorful addition to fruit salad or a delicious topping for yogurt or cereal. Blend them with ice cubes, skim milk and yogurt to make a healthy breakfast smoothie. The possibilities are endless.
One of my favorite ways to enjoy them is in blueberry pancakes. Here is a recipe that my husband and I especially enjoy: The whole wheat pastry flour provides a source of whole grain and fiber and tenderness to the pancakes.
Whole Wheat Blueberry Pancakes:
1 large egg (I use Omega 3 fortified eggs)
1 Tbsp lemon juice & skim milk to equal one cup of liquid
1 Tbsp. Canola oil
1 Tbsp. honey
1 cup whole wheat pastry flour
2 tsps. Baking powder
½ tsp. Baking soda
1 cup fresh or thawed frozen blueberries, drained
Mix lemon juice with enough skim milk to equal one cup — let sit for five minutes. Mix milk mixture, egg, oil and honey. In a separate bowl combine the dry ingredients, then add the blueberries. Combine both mixtures just until blended and wet ingredients are moistened-batter will be lumpy. Using ¼ cup batter for each pancake, cook on pre-heated griddle at 400° F that has been sprayed with non-stick cooking spray. Makes 2-4 servings.
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.
Friday, August 01, 2008
Painful arthritis can be managed
I was in India a few ago to see my parents. My dad has been complaining of knee pain for years. I decided to review the various options he has for his knee pain, which was caused by the most common form of arthritis – osteoarthritis.
So what is Osteoarthritis (OA)?
It is the most common joint disorder affecting middle-age and older people. Nearly 27million people in America are affected by this condition that can become progressively worse.
It starts with damage to the cartilage – the cushion pads that are in between the bone and this then causes changes in the structures around the joint. These can be a result of injury or in some cases overuse. Some patients have fluid accumulation, bone overgrowth and weakness in the muscles and tendons around the joint.
Most common areas are the weight-bearing joints – knees, hips and spine. Symptoms start as early as the 40’s with just some mild pain in the joint, which progresses slowly through the years. In the area of weight-bearing joints, it can result in difficulty walking and even standing.
When the spine is involved, this results in stiffness and pain and in some cases, significant disability because of chronic pain.
OA can also affect fingers and joints with previous injuries. Patients who have arthritis in the hands usually have a family history.
Because of injuries from extreme sports, we are now seeing arthritis in other joints that we classically did not see before because of injuries.
How is it diagnosed?
Physical examination is very helpful with joint crepitus (creeking), some joint deformity, and fluid on the joint. X-rays and MRIs are commonly used to document OA, and MRIs are also used for evaluating cartilage injuries.
Treatment options include:
1. Physical measures: guided exercises, support devices and thermal therapy are an integral part of managing OA. Acupuncture and chiropractic therapy have a role in treating certain patients.
2. Drug therapy: Topical agents and oral agents are available, as well as inflammatory and pain medications. Anti-inflammatory medications help with the swelling and in some patients we use pain medications.
3. Injections: Options include cortisone injections and hyaluronic acid agents.
4. Surgery: Arthroscopy and/or joint replacement are considered for patients with seriously damaged joints or patients with intractable pain.
5. Supplements: Many nutritional supplements have been used for treatment of OA, but most lack good research data to support their effectiveness and safety.
Your primary care physician, rheumatologist and orthopedic surgeon can help you with decisions regarding the plan of care for this very common pain condition. There is currently no medication that can reverse the process, but with the right treatment plan your quality of life can be improved.
Sandeep Varma, MD, is a rheumatologist and Medical Director at the Backus Arthritis Center at the Backus Outpatient Care Center in Norwich. This column should not replace advice or instruction from your personal physicia. E-mail Varma and all of the Healthy Living columnists at healthyliving.
So what is Osteoarthritis (OA)?
It is the most common joint disorder affecting middle-age and older people. Nearly 27million people in America are affected by this condition that can become progressively worse.
It starts with damage to the cartilage – the cushion pads that are in between the bone and this then causes changes in the structures around the joint. These can be a result of injury or in some cases overuse. Some patients have fluid accumulation, bone overgrowth and weakness in the muscles and tendons around the joint.
Most common areas are the weight-bearing joints – knees, hips and spine. Symptoms start as early as the 40’s with just some mild pain in the joint, which progresses slowly through the years. In the area of weight-bearing joints, it can result in difficulty walking and even standing.
When the spine is involved, this results in stiffness and pain and in some cases, significant disability because of chronic pain.
OA can also affect fingers and joints with previous injuries. Patients who have arthritis in the hands usually have a family history.
Because of injuries from extreme sports, we are now seeing arthritis in other joints that we classically did not see before because of injuries.
How is it diagnosed?
Physical examination is very helpful with joint crepitus (creeking), some joint deformity, and fluid on the joint. X-rays and MRIs are commonly used to document OA, and MRIs are also used for evaluating cartilage injuries.
Treatment options include:
1. Physical measures: guided exercises, support devices and thermal therapy are an integral part of managing OA. Acupuncture and chiropractic therapy have a role in treating certain patients.
2. Drug therapy: Topical agents and oral agents are available, as well as inflammatory and pain medications. Anti-inflammatory medications help with the swelling and in some patients we use pain medications.
3. Injections: Options include cortisone injections and hyaluronic acid agents.
4. Surgery: Arthroscopy and/or joint replacement are considered for patients with seriously damaged joints or patients with intractable pain.
5. Supplements: Many nutritional supplements have been used for treatment of OA, but most lack good research data to support their effectiveness and safety.
Your primary care physician, rheumatologist and orthopedic surgeon can help you with decisions regarding the plan of care for this very common pain condition. There is currently no medication that can reverse the process, but with the right treatment plan your quality of life can be improved.
Sandeep Varma, MD, is a rheumatologist and Medical Director at the Backus Arthritis Center at the Backus Outpatient Care Center in Norwich. This column should not replace advice or instruction from your personal physicia. E-mail Varma and all of the Healthy Living columnists at healthyliving.
