Healthy Living

"Stick to taking physical action and getting things done instead of just talking about what you plan to do." This was my horoscope for the day and it really hit home. I cut it out and taped it to my computer.

My husband often reminds me that I have to practice what I preach. I write health columns and try to write about the common health problems we all face, and of course, remedies we can attain. Decreasing stress, eating healthy, and getting the proper amount of exercise are three of the issues we all struggle with continuously.

According to the Centers for Disease Control and Prevention (CDC) seven of the top 10 deadly diseases are chronic lifestyle diseases such as heart disease and diabetes.

My friend and colleague, Setu Vora, MD, is a pulmonologist with Pulmonary Physicians of Norwich and the Medical Director of Critical Care and Performance Improvement at Backus Hospital. He has addressed these key issues as the founder of Health Transformers, Inc. This is a program that helps fight stress and unhealthy habits such as lack of exercise and poor eating habits that are at the root of these killer diseases.

According to Dr. Vora, you are a health transformer, if you believe in the lifestyle prescription of
"MENU-MIND-MOVE." It doesn't require a lot of time, effort, or money to take action and work on those three areas.

MENU: Instead of focusing on what we can't eat, we should all think positively and plan the daily menu and eat at least five servings of fruits and vegetables every day.

MIND: Mindfulness is a buzzword these days, but sitting quietly with eyes closed for 15 minutes and focusing on your breathing is an easy stress-buster that will help improve sleep, heart, and the brain. We can all find 15 minutes to spare to do this.

MOVE: Taking the stairs instead of elevators is an easy way to incorporate exercise. Selecting a parking space far from the entrance and then walking into the store, church or work is another easy one. Move at least 30 minutes a day, whether it’s walking, jogging, lifting, swimming, or even dancing. Be a happy mover.

Dr. Vora generously agreed to share his "MENU-MIND-MOVE" concept as the theme of the Healthy Living Festival on Sept. 12 from 11 a.m. to 3 p.m. on the Norwich Free Academy campus. It's free and open to the community. There will be interactive mindfulness exercises, healthy food samples with recipes, Yoga, Zumba and Jazzercise demos, and more. Dr. Vora will be giving a motivational talk at noon, and this year's theme is Community: Healthy Together.

As my horoscope advised, I won't just talk about it; I'll be joining the fun at the festival, taking action and working towards my goal of living healthier.

Like everybody else, I want to prepare and serve the tastiest and healthiest food for my family. While I know serving organic foods may be the healthiest thing to do, we just can’t afford to go completely organic because it’s too expensive. And luckily, it’s not always necessary. My first suggestion is to buy local. Farmers markets are springing up in every town. Produce is usually freshly-picked and generally contain less pesticides and other toxic chemicals, if they use any at all.

When this is not an option, there is a list called “The Dirty Dozen” identified by the Environmental Working Group (EWG), as highest in pesticides. The mission of the EWG is to make our food supply more transparent in order to help us decide when it's worth spending extra for organic produce. Topping off the list is apples, followed by peaches, nectarines, strawberries, grapes, celery, spinach, sweet bell peppers, cucumbers, cherry tomatoes, snap peas (imported), and potatoes. Local grocery stores often have these items in an organic food section of the store.

Then there are the fruits and veggies with the least pesticides, also known as the "Clean Fifteen.” They are avocados, sweet corn, pineapples, cabbage, frozen sweet peas, onions, asparagus, mangoes, papayas, kiwi, eggplant, grapefruit, cantaloupe, cauliflower, and sweet potatoes. Buying conventionally grown foods on this list is fine, and less expensive, but still considered safe.

My own personal choice is to buy organic milk, meat and poultry as often as affordable, too.

These items can often be found at farmers markets and local farm stands. I am a big proponent of buying local, so say hello when you see me at the local orchards, farms, and farmers markets. I will be the one checking out the apples, spinach and peppers and asking for everyone’s favorite recipes.

“Mother knows best.” We have tossed around this adage for ages, yet I am just recently grasping how true this is as I go through medical school. My mother is a pediatrician at the Norwich Pediatric Group. As I see patients in clinical settings, I have come to realize how important it is to listen to your parents and your pediatrician.

Here are some pieces of advice that my mother gave me from the standpoint of a pediatrician that I am now using in my clinical experiences, and they are also important for parents to know when visiting their children’s pediatrician.

Vaccines are not the enemy
Even though my brothers and I may have found shots terrifying as a child (one brother even hid behind a trash can), my mom always had us vaccinated and because of this we were relatively healthy kids.

Vaccinations are an important way to prevent illness. While some illnesses, like chicken pox, may not have a dire consequence on a teenager, when people choose not to get vaccinated these illnesses can spread to more vulnerable members of the community including infants and the elderly or other populations with compromised immune systems like those undergoing chemotherapy or radiation. In these populations, even something like the chicken pox can have a substantial and sometimes deadly impact.

We need to protect not only ourselves but also the community at large and vaccinations are an important component of that. The U.S. Centers for Disease Control and Prevention has a recommended vaccination schedule for children ages 0-18 that can be found at
http://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf.

Antibiotics are not always the answer
We are lucky enough to live in a time when bacterial infections that used to leave people ill for months or cause fatalities are now simply cured with a small course of antibiotics.

They may taste “yucky” (something I recall telling my mom on more than one occasion), but antibiotics help you overcome illness. That being said, antibiotics will not affect the progression of an illness if it is viral. This means that cold that you or your son or daughter had last month might not have required medication.

In fact, the more we use antibiotics unnecessarily the more we encounter antibiotic resistance. The American Academy of Pediatrics recently published in the July issue of Pediatrics (online edition, print copy in August edition) that there is still a misunderstanding in parent populations, especially of children ages 0-6, as to when antibiotics are truly needed. Trust your pediatrician -- if he or she says a certain illness does or does not require an antibiotic, follow their instructions.

See your doctor regularly
Even if you are feeling symptom-free it is important to keep regular physical examinations to assure that any health problems that might arise can be caught and treated early. It is much more difficult to treat illnesses when they have progressed.

It is important to realize that regular physicals are a way to keep your child up to date on immunizations and that schools often require these examinations and paperwork to be filled out by your a pediatrician. But book early! Pediatrician’s offices get swamped with back-to-school visits so the best way to assure that your child is ready for school is to make an appointment as early as you can and bring any school paperwork with you when you come for the visit.

Health starts in the family
“Monkey see monkey do,” or in other words children learn and do what they see. If parents and family members maintain a poor diet consisting of junk food, and do very little physical activity, chances are that the children will mirror these behaviors.

Try to set a good example for your child. I am lucky in that I grew up with a family that loved to play outside and take the dogs for walks at Bluff Point in Groton. Even now I come home for Sunday morning runs on River Road in Mystic with my parents.

Bring the kids to pick out new healthy foods at a Farmer’s Market or supermarket, which gets them involved and can make eating healthy more exciting. My mom and I recently made purple string beans from a Farmer’s Market with my younger cousins, which we dubbed “magic beans” because they turn green when you cook them. Regardless of how you choose to set healthy examples the bottom line is the health of a child takes the whole family.

No one is perfect, but while we may hate to admit it, our parents often do know what they are talking about, as does your child’s pediatrician.

“I laughed so hard, tears ran down my leg.” This can be a funny image, but it’s no laughing matter to those experiencing true urinary incontinence.

Leakage of urine results from a loss of bladder control and it can happen to anyone. Urinary incontinence becomes increasingly common with age and is twice as common in women as in men, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms can range from mild leaking to uncontrollable wetting.

Most bladder control problems happen when muscles are either too weak or too active. If the muscles that keep your bladder closed are weak, you may have accidents when you sneeze, laugh or lift a heavy object. This is stress incontinence.

On the other hand, if bladder muscles become too active, you may have a strong and frequent urge to void when there is very little urine in the bladder. This is called overactive bladder and can result in urge incontinence. Both problems can be distressing and embarrassing, and are usually under-reported to health care providers.

There are lifestyle changes, exercises, medications, and surgical interventions that can help improve bladder control, according to Urologist Brandon Stahl, MD, of Eastern Connecticut Urology Associates in Norwich.

“Incontinence is a medical problem that can affect people’s social life and emotional well being and should not be viewed as a normal part of aging,” said Stahl, a member of the Backus Hospital Medical Staff. “Sometimes the fix for this can be simple dietary changes such as a reduction of caffeine and alcohol or perhaps pelvic floor strengthening exercises. Other times evaluation and treatment require additional testing in the office before deciding which type of procedure would be most beneficial.”

If you are experiencing this common problem, rest assured you are not alone. The bottom line is, don’t hesitate to discuss it openly with your primary care provider or urologist.

It was hard not to laugh when my friend posted on her Facebook page: “I ate a Greek yogurt for breakfast, a salad for lunch, and then I came home and ate the whole kitchen.” Can’t we all relate to that? As someone who has struggled with overeating for most of my adult life, I sure can.

It all really boils down to portion control and balance. These are the keys to weight loss. Simple as that.

I asked my colleague, Backus Hospital Registered Dietitian Joan Sommers, for some guidelines to keep portions under control without feeling hungry all the time. Joan had some very interesting points to consider.

“If you are hungry, what are you missing from your meal plan? Incorporate more functional foods such as healthy carbohydrates — that’s right — carbohydrates are not bad foods! Carbohydrate foods provide us with fiber, vitamins, minerals, antioxidants, phytochemicals, and many non-starch vegetables can be used to fill us up. I have never in my life as a dietitian said, ‘Slow down on the vegetables.’ I really try to have my clients find delicious recipes incorporating 2-3 servings of non-starch vegetables with their meals. There is nothing wrong with adding a veggie for breakfast. Fiber is found naturally in fruits, grains, and vegetables. I usually prescribe between 25-30 grams per day. But don’t forget, as one increases fiber content, it’s also important to increase water intake.

"Another major nutrient that may be missing is protein. Protein helps keep us full; the need for protein is 1.0-1.2 grams per kilogram of ideal body weight.

Portions are very important and the only way one can identify what they are eating is to measure and weigh your food intake. We can focus on overeating but the reverse can be true. For example, we as health educators may identify a 3-ounce portion of chicken as a deck of cards. I never use this as an example because during my cooking demonstrations I would ask my participants to let me know when they thought I had 3 ounces of poached chicken on my scale. Not one person was able to identify 3 ounces; surprisingly, they all felt that 1-2 ounces of chicken was 3 ounces. So if they did not measure, but just estimated the amount of protein they ate, they may be hungry later during the day.”

Well, I certainly learned a lot from Joan’s guidelines. It’s all “food for thought.”