Healthy isn?t something you are or aren?t. It?s a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It?s a balance between living well and taking care, and you can start right where you are.
A blog by Christina Elston
Healthy isn't something you are or aren't. It's a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It's a balance between living well and taking care, and you can start right where you are.


Archive for March, 2011

Ask An Expert: Not Quite 20/20?

Thursday, March 31st, 2011

Steve asks: My 10-year-old daughter was told by our optometrist that she needs glasses for her near-sightedness, and because she’s been that way for a while the best they can do is get her to 20/40 for now. Is this the doctor’s way of making me feel guilty about not getting annual eye exams or is there a logic to progressively bringing her vision with glasses to 20/20?

Health-E responds: We took your question to Mark S. Borchert, M.D., head of The Vision Center at Children’s Hospital Los Angeles. He was kind enough to answer. But first, a little vocabulary:

  • Myopia/Near-sightedness: Vision is clear up-close but blurred at a distance.
  • Astigmatism: Focus problems caused by the cornea, the clear, front part of your eye.
  • Diopter: A measure of the corrective lens needed for proper vision.

Now on with Dr. Borchert’s answer …

borchert_markTen-year-olds with pure myopia (mild to moderate near-sightedness without significant astigmatism) in both eyes can almost always be fully corrected to 20/20 with the first pair of glasses. High myopia (more than 6 diopters) in both eyes that has been present for years may not be fully correctable to 20/20 but should still receive the full power in their glasses as the vision might gradually improve to 20/20 with this prescription. Other potential causes should be sought for vision that cannot be corrected to 20/20 in a 10-year-old who does not meet these criteria. In such cases consultation with a pediatric ophthalmologist is recommended.

Got a question about your family’s health? Click here, and we’ll find an expert to answer it!

Families’ BPA Levels Plunge With Food Handling Changes

Wednesday, March 30th, 2011
Monica Laurlund and her family  joined the study to learn first-hand if BPA was in their diet and if it was possible to remove the chemical.

Monica Laurlund and her family joined the study to learn first-hand if BPA was in their diet and if it was possible to remove the chemical.

Hormone-disrupting chemicals in water bottles and other food packaging have been getting lots of press in recent years amid worries that they can leach into our food – and our bodies. But families, it turns out, can reduce their levels of BPA and phthalates dramatically in a matter of days.

Researchers from the Breast Cancer Fund and Silent Spring Institute – nonprofit organizations dedicated to eliminating environmental toxins – took over the diets of five California families for three days. Each family of four was provided with freshly prepared organic meals and snacks stored in glass and stainless steel containers. Nothing they ate was packaged in plastic or canned.

Before the “intervention,” the parents’ levels of Bisphenol A and phthalates – as measured by urine samples – were a little higher than the average U.S. adult. Levels for the children (each family had two, ages 3 to 11) were about average.

After three days on the intervention diet, the families’ levels of BPA dropped an average of more than 60 % and their levels of phthalates were cut in half. When the families returned to their normal diets, urine levels of these chemicals shot back up.

There isn’t yet enough clinical data to determine the exact health benefits of the change, but Connie Engel, Ph.D., program coordinator for The Breast Cancer Fund and study co-author, points out that families are exposed to these chemicals on a constant basis. BPA is used to make plastics, including the lining of food cans. Phthalates are used to make plastics flexible, and are found in many food packages. The chemicals have been shown to interfere with hormones in the body, and have been associated with effects on the developing brain and reproductive system.

Engel says these effects have been found at levels below the exposure limits set by the Environmental Protection Agency, making it worth families’ time to limit exposure. “You’re reducing exposure to a chemical that’s constantly being linked to health problems in laboratory studies and research,” she says.

Though the families in the study had their BPA-free meals catered, Engel says most families could change their habits and reduce exposure easily, a little at a time.

• Switch from plastic water bottles to glass or stainless steel.

• Reduce your reliance on canned foods. Fatty, salty or acidic foods seem to absorb the most BPA and phthalates. The Breast Cancer Fund tested more than 300 products and named coconut milk, soup, meat, vegetables, meals (e.g. ravioli in sauce), juice, fish, beans, meal-replacement drinks and fruit as their top 10 to avoid.

• Switch from plastic to glass or stainless steel for food storage.

• Switch from plastic to glass for microwaving.

The switch from packaged to fresh foods, Engel points out, is healthy in other ways as well, and better for the environment. Cost wise, she says, “it kind of balances itself out.” Glass food containers, for instance, cost more but will last longer. And while fresh vegetables are more expensive than canned, dried beans are cheaper.

“When kids are young, before puberty, is when it’s most valuable to make these changes,” says Engel, as that is when hormone disruptors can do the most harm. “Even going one less can-based meal a week can be a start.”

But study authors don’t want to put the burden of change on families. “We need some systemic changes from companies and in how our government regulates what’s in food packaging,” Engel says. Via the Take Action link on the Breast Cancer Fund’s page dedicated to the food packaging study (www.breastcancerfund.org/foodpackagingstudy) families can contact their political representatives to express concerns about BPA.

The peer-reviewed study appears today in the journal Environmental Health Perspectives.

Podcasting Kids’ Health

Monday, March 28th, 2011

kids-healthcastThe pediatric residents at the Indiana University School of Medicine are learning about children’s health – and for the past year they’ve been broadcasting helpful news and tips via their Kids Healthcast pediatric podcasts.

The half-hour audio segments are available free through the iTunes store, or at http://kidshealthcast.org. Parents looking for a hands-free way to catch up on topics ranging from transitioning babies to solid food, teen driving, seasonal allergies and constipation can listen on their iPhone, iPad or computer. The current episode, in honor of the first anniversary of Kids Healthcast, is entirely devoted to childhood obesity, with news about a healthy school lunch program, information about the impact of childhood obesity, and tips for parents facing challenges with their child’s weight.

The website even features a “Call Me” link that lets parents use Google to call in toll-free and leave a voicemail question for the residents to answer.

Check it out …

Choose Your Poison

Wednesday, March 23rd, 2011

pillsSome pills look like candy. And some public health campaigns look like a game.

“Choose Your Poison,” a free iPhone app from the California Poison Control System (CPCS) marks the organization’s 50th year as the statewide provider of free advice – from pharmacists, doctors and nurses – about what to do in cases of poisoning or exposure to toxic substances. (It also marks National Poison Prevention Week, which is this week.)

The game, available in the Apple app store, focuses on the fact that many types of medicines and vitamins look like popular brands of candy. Players choose between two similar-looking groups, dragging the medication to the “skull.” After each guess, the game reveals which pile is breath mints and which is ibuprofen, for example. It’s fun to see how many you can get right, but the real point is to point out that we should all pay attention to how we store medications and other potentially dangerous stuff we keep at home.

Of more than 2 million poisonings reported every year in the U.S., the CPCS estimates more than 90% happen at home, many to children under age 6.

The app also makes it easy to add the U.S. Poison Control Helpline (800-222-1222) to your phone’s contacts, and to follow the CPCS on Twitter. No smart phone? You can play the game online at www.pillsvscandy.org.

Carseats: Keep ‘em Rear-Facing Until Age 2

Tuesday, March 22nd, 2011

carseatParents have traditionally turned their infants’ rear-facing carseats around at the first-birthday milestone. But the American Academy of Pediatrics now recommends waiting until age 2 – or until your baby reaches the maximum height and weight for their seat.

Rear-facing seats distribute the force of collisions over the entire body, and so offer better support for the head, neck and spine of infants and toddlers. This means they are 75 percent less likely to die or be severely injured in a crash, according to a 2007 study in the journal Injury Prevention.

The recommendation also advises that most kids will need to transition from a carseat to a belt-positioning booster, which they should use until they are 4 feet 9 inches tall, and age 8 to 12.

All children should ride in the back seat until they are 13 years old, according to the AAP.

Don’t Worry (About Radiation, Anyway)

Thursday, March 17th, 2011

radiationThe message from the L.A. County and California departments of public health: Don’t worry about radiation from the quake-damaged Fukushima Daiichi Nuclear Plant in Japan; get prepared for the next natural disaster that strikes here at home.

“We understand people’s concern. Radiation is scary stuff,” said interim California public health director Howard Backer, M.D., at a media update today, but radiation is a natural part of our environment, and any that managed to travel the distance from Japan would be at such low levels that it wouldn’t endanger anyone’s health. “We’re 5,000 miles away, which would have a major dispersion effect on any radiation that reaches the atmosphere,” he said. Even following severe disasters such as Chernoble, there was no trace of radiation at that distance.

Backer told reporters that no increase in radiation has yet been detected by any monitors along the West Coast, and that it would be difficult to predict when any remnants released from the Japanese plant might reach us. But even in a “worst-case scenario,” he insisted the public would be safe.

Jonathan Fielding, M.D., Director of Public Health in L.A. County, said reports that passengers flying into the U.S. from Japan had set off radiation detectors were also not cause for alarm. The equipment, he said, is so sensitive that it can detect even minute levels of radiation. “The fact that we can detect this does not mean that it is problematic.”

Backer also noted that FDA is already screening all shipments of food coming in from Japan. Our ports were already screening containers for radioactivity as part of antiterrorism efforts.

Both men cautioned the public against taking potassium iodide, a common treatment for radiation exposure. Many in the U.S. seem to have been stockpiling supplies, which are sold over the counter. But the medication has side effects, including upset stomach, rash, possibility of allergic reactions, and inflammation of the salivary glands.

Rather than spending time and money trying to protect yourself against radiation from Japan, Backer and Fielding suggest preparing for local emergencies and natural disasters by making a plan to reunite with loved ones if you are separated, and stockpiling three days’ worth of food and water and other emergency supplies. (Visit www.publichealth.lacounty.gov for instructions.) Got cash to spare? Reach out to one of the many reputable agencies (the American Red Cross, for example) collecting aid for those in need in Japan.

Tips For Kid-Friendly Mediterranean Eats

Thursday, March 17th, 2011

Here’s a guest post from Dena Herman, Ph.D., of  the UCLA School of Public Health. She is a pediatric dietitian and Co-Director of the National Children’s Study for the Los Angeles-Ventura Study Center (NCS-LAVSC). Her concern about growing rates of childhood obesity and the challenge families face in improving their diets inspired these tips:

dena-hermanThe percentage of overweight children in the United States has reached epidemic numbers. In fact, one third of our nation’s kids are carrying too much weight as a result of a poor diet high in unhealthy fats and simple sugars and a sedentary lifestyle. Besides these much talked-about causes, experts believe there could be other, less obvious factors that influence the development of, obesity, but also diabetes, high cholesterol and high blood pressure. Although more research is being done to gain a better understanding about these diseases, improving our children’s diet and helping them increase their physical activity will significantly reduce their chances of becoming obese and, if their Body Mass Index (BMI) is already high, will help them reach a healthy weight.

One of the best ways to improve our childrens’ diet is by following the Mediterranean diet, which consists in consuming healthy fats such as olive oil and nuts, lean meat, fish, whole grains and plenty of fruits and vegetables. Although these guidelines are widely known, most parents find it difficult to convince kids to consume these products because they are not as popular among their peers and parents do not always have the tools to prepare fresh foods tastefully. Nonetheless, there are plenty of ways to use these nutritious options to create delicious, quick meals and snacks that the little ones will enjoy. The following are a few tips to get you started:

- orange Encourage kids to eat fresh fruit instead of drinking fruit juice for a better source of fiber, which is often lacking in their diets. Have cubes of melon, grapes and other fruit choices easily available when kids come home from school and are hungry for a snack. In the summer, place fruit cubes in the freezer for a refreshing afterschool snack or blend up some fruit and freeze it as popsicles! You can also try giving kids “crudités,” which are cut-up vegetables consumed raw. Not only does the name sound cool but, when served with a creamy bean dip made from cannellini beans, these veggies will have them asking for more. Good options include grape tomatoes, baby carrots and sugar snap peas.

- Get the kids involved in what they eat and make your own trail mix. Ask kids to choose a few of their favorite nuts, seeds and dried fruits on the next grocery shopping trip. Home-made trail mixes are great for lunches and snacks, and packed with healthy omega-3 fatty acids that are excellent for healthy brain function and getting homework done quicker.

- fishFish is brain food – that is why they travel in schools. Try to include fish as part of a healthy family dinner at least twice a week. Fish such as mahi-mahi, cod or halibut make great choices. Experiment with flavorful Mediterranean marinades using herbs like oregano, basil and garlic as well as fresh lemon or orange juice. You can also slice and bread the fish into sticks and bake it in the oven – instead of frying it – for a healthy, kid-friendly dish.

- Sandwiches are easy school meals but they can get tiresome. Rev up the flavor and interest by spreading homemade pesto or tapenade instead of mayonnaise on crusty, whole-wheat, toasted bread. Finely slice, marinate and grill chicken or turkey breasts for a tasty alternative to deli meats.

- cupcake Who needs cupcakes for school birthdays? Surprise the kids by making delicious fruit skewers with a variety of fruits – and yes, you can dip the strawberries in dark chocolate for a phytonutrient punch they won’t forget. If your kids can’t pass without the cupcakes or other sweet treats, look for healthier, less processed options or dig for a lower-fat, lower-sugar recipe alternative and bake a limited amount.

- Work with your children’s tastes but try to expand their palates. If your kids’ favorite foods are pizza and pasta, try creating healthier versions of their favorite meals by making substitutions and adding vegetables or fruits. For example, substitute pepperoni in pizzas for barbecue chicken and add fresh tomatoes and garlic. Peas and pearl onions add taste and dimension to plain pasta but don’t forget to add the parmesan cheese. Eating meals as a family offers the opportunity for children to learn and experience new foods as well as eating memories they will never forget.

Remember, the goal is not to eliminate all treats and favorite foods from your children’s diet, but to teach them healthier habits, including moderation. If you have a busy schedule that does not allow you to make dishes from scratch, most supermarkets have a wide variety of healthy options, such as pre-cut vegetables and fruits or whole-wheat pizza crust, that will help you save time in the kitchen. For additional resources and ideas, ask your pediatric dietitian, visit an official healthy eating website (e.g., www.eatright.org) or just have fun with it and experiment! Your children’s health will benefit enormously.

Great Stories of Down Syndrome

Tuesday, March 15th, 2011

March 21 is World Down Syndrome Day, and more than 400,000 people in the U.S. are currently living with the condition. They work, go to school, play sports, sing, dance, act … and they have stories to tell. The National Down Syndrome Society is giving them that opportunity with the My Great Stories project. Take a look. Read about the dreams and accomplishments of people with Down Syndrome, and share your own tale or the story of someone you know. Learn more …

Break Your Fast

Friday, March 11th, 2011

kleinmanIt’s National School Breakfast Week, and whether your kids eat at school or at home, pediatrician and nutrition expert Ronald Kleinman, M.D., chief of pediatric gastroenterology and nutrition at Massachusetts General Hospital thinks it’s important that they eat.

Health-E: What do you eat for breakfast?

Dr. Kleinman: My favorite breakfast is scrambled eggs with whole-grain toast, some type of fresh fruit, fresh orange juice and a glass of 1%  milk, and I usually have some or all of those foods. Parents should think about a healthy cereal (Cheerios, oatmeal), fresh fruit, yogurt and lowfat or fat-free milk. An egg and toast is a great idea as well, along with fruit and milk.

Do you ever skip?

I do occasionally skip breakfast, because very early meetings often have me running out of the house to be on time without first having something to eat. I do feel better, however, when I start the day with a good breakfast.

Why does the body need breakfast? What happens physiologically when you skip?

Dissect the name and you literally get the phrase, “break fast.” That’s exactly what breakfast does, it breaks your overnight fast after you sleep. There can be 12 hours between a child’s dinner and breakfast and when you skip, you’re not breaking that fast. When you’re in the state of fasting, your metabolism slows down and breakfast helps wake it up. That’s why people who eat breakfast tend to have healthier body weights.

Furthermore, eating breakfast gives you the fuel to power through your day. Ever notice how difficult it is to focus when you’re hungry? Starting the day off with nothing is bad news for growing boys and girls, especially considering all the data that show little ones who eat breakfast have better attention spans, perform better in school and have fewer absences and tardies. Lastly, breakfast is one of the three main eating events of the day and provides essential nutrients growing bodies need.

What makes up a good breakfast? What are the components?

A good breakfast should include cereal, toast or a muffin that is whole grain-rich, fruit and lowfat dairy foods (such as milk or yogurt). Eggs are rich in nutrients as well and are an excellent breakfast food. Some examples of meals that provide this important mix are breakfast cereal with skim milk and berries, with a hardboiled egg on the side; Greek yogurt topped with granola and diced peaches; or a vegetable frittata with a slice of toast.

Besides skipping breakfast, what are some mistakes people make with their morning meal, or when feeding their kids?

With such busy lives, I think parents don’t cook as much at home as they did in the past and rely too much on restaurant food, where they don’t have as much control over whether the foods purchased are as healthy as they should be for growing boys and girls. A little planning can really go a long way if parents plan out family meals ahead of time. Whether eaten at home or packed for on-the-go, simple meals prepared at home are excellent healthy options for the whole family.

What’s the fastest “good breakfast” you know?

Whole wheat toast with peanut butter and banana slices, washed down with a glass of lowfat or skim milk. It’s perfect for at home or on the go!

In the Air: Teenage Lungs

Thursday, March 10th, 2011
Lee Outlaw plays football at his South L.A. high school -- and has asthma. So do half a dozen teammates.

Lee Outlaw plays football at his South L.A. high school -- and has asthma. So do half a dozen teammates.

Lee Outlaw was near the end of an 800- meter race last season, running for the Manual Arts High School Toilers track team. Suddenly, he went down, collapsed flat onto the track. “Out of nowhere he just had no air,” says his mother Rolanda Richard, who was watching from the bleachers that day.

Outlaw is 16, a junior at Manual Arts, and has had asthma since he was a baby. He got so used to going to the hospital for steroid shots to help him breathe that they didn’t even make him cry. He says that when he started high school, the chance to play sports – track and basketball, and his true love, football – motivated him to get his asthma under better control, to take his medication on schedule. Before that? “It was painful because I was always going to the hospital,” says Outlaw. “And if I wasn’t in the hospital, I would be at home sick.”

Manual Arts is barely half a mile from the Harbor Freeway in South Los Angeles. Outlaw plays running back and corner back there, and at least five other players on the football team have asthma. Some have to bring their nebulizer machines onto the sidelines during games. But Outlaw says his asthma is better controlled now. He uses his FloVent inhaler every day, and Albuterol when his asthma acts up, usually when he gets sick.

christopher

Dr. Vanessa Neal of St. John's Well Child & Family Center examines Christopher White.

That is in large part due to the efforts of Vanessa Neal, M.D., one of the pediatricians at nearby St. John’s Well Child & Family Center. Neal, who sees about 500 patients a month at St. John’s, says asthma can definitely get in the way of what a teen wants to do, “especially the kids that are really active.” Experts are increasingly trying to get kids off the sidelines to combat burgeoning childhood obesity rates, but asthma can interfere with sports – and sleep, and schoolwork.

It’s one of a host of breathing problems that can plague teens living and learning near L.A.’s vast network of freeways – and these problems can follow them throughout life. With traffic cris-crossing into every corner of SoCal, few families in any part of town are immune to the risk.

Kids’ lungs experience a major growth spurt between fourth grade and high school graduation. Boys’ lungs during that time grow an average of 115%, while girls’ grow roughly 70%. “It’s a very steep growth curve, and it’s very much timed with puberty,” says Jim Gauderman, Ph.D., USC professor and expert in the long-term effects of pollution on children’s lungs. And once that spurt is over, kids don’t get another. Read on …