Tuesday, May 27, 2014

May is national Osteoporosis (OP) month

Blog contributed by Renu Joshi, MD,  Endocrinology

Osteo means bones and porosis means holes. As the name suggests we have bone loss which can lead to Bone fractures.

It is a silent disease and does not cause any pain until Fracture occurs.

Did you know that 50-65% of women between 50-75 suffer from Osteopenia / osteoporosis and 50 % of white women will suffer from Fracture due to Osteoporosis.  25 % of patients with hip Fracture will die within the first year. Incidence of Hip fracture is higher than combined Breast cancer, Heart attack and stroke in Females.


Men can also suffer through OP but it starts at age 70 or higher.

While we all get screening for other things the screening for OP still remains very low. A 5-minute screening test for OP is the U/S of the heel, which almost picks up > 70 % cases of OP and it is free.

We as women are always taking care of others but we can be better care taker if we take care of ourselves
SO Be In charge of your health!!!

You can prevent OP by these simple things:
  1. Take 1000 -1500 mg calcium  (diet and supplement combined) daily
  2. Vitamin D at least 800 units daily
  3. Exercise both aerobic and Muscle strengthening (by lifting weights) at least 3 times weekly 
  4. Drink < 3 caffeine beverages (including Coffee and sodas)
  5. Getting screened early after Menopause so treatment can be given appropriately 

  Let’s do it together so we can save Fractures!!!

Monday, May 12, 2014

How to Eat Healthy at Home and at Work


Patients typically tell me about one struggle or the other: “I have a hard time eating healthy at home” or “I have a hard time eating healthy at work”. With obesity on the rise, as a whole we have got to learn to do better at both! I believe the keys to healthy eating are knowledge, discipline and preparation.

Knowledge. Being educated. Being an aware consumer. Knowing how many calories are in food items. Knowing what are healthy choices and what are not.

Discipline. Being determined to eat healthy the majority of the time. Being able to say no to junk food the majority of the time. Choosing unsweetened drinks over sweetened ones.

Preparation. Planning ahead for meals and snacks. Having a list before you go to the grocery store. Not allowing yourself to become too hungry, resulting in binge eating. Having water on hand.

I feel like most people get the first two points, it’s more a matter of applying them. The third point, preparation, is what I want to focus on. Being prepared sets one up for success. Start with a list. What are healthy food items you would like to purchase on your next trip to the grocery store? This list must include variety, snacks, and meals. As far as meals go: The internet holds a plethora of recipes (do people use cook books anymore?! Ok…kidding, but seriously). Try to avoid recipes with white flour/pasta, the word “fried”, and cream sauces/a lot of cheese.  And when you find those tasty, healthy recipes…make extras! Then you have leftovers for work! I try to avoid casseroles and make soups (broth-based) or stir-fries instead.
When you get home from the grocery store, rinse and prepare whatever you can. Cut celery sticks. Wash lettuce and prepare veggies for easy salads. Cut up fruits that need it. Put snack items into baggies/containers. Hard-boil eggs. Get the junk food out of the house. If it’s not there, it can’t be consumed!

Get your lunch/snacks ready for work the night before. If you plan for your meals, you are less likely to grab unhealthy food on a whim. May I suggest salads in a jar: dressing on the bottom, other items such as low-fat cheese/egg/chicken/nuts/seeds/fruit/other veggies next, then lettuce on the top. When you are ready to eat, just turn it onto a plate and the dressing is on the top and nothing is soggy. Another idea is  fruit and yogurt parfaits with plain yogurt (check out how many grams of sugar are in flavored yogurt!). Use fruit as your sweetener and add some low-sugar granola, oats, or nuts. Be careful of cereal, flavored oatmeal and bars, as they often contain high amounts of sugar!

At home, I make a baked oatmeal, bran muffins or quiche weekly. That way there is always something in the fridge to grab for breakfast that is healthy. I use very little to no sugar in my recipes and add lots of extras: fruit, cinnamon, nuts, etc. I load up the quiche with veggies and omit the crust. These are also good options for lunch or a snack at work.  It is also helpful to have nuts, carrot sticks, or an apple in the car to keep you from making a stop for some less-nutritious choices.


And one last point: choose foods that will fill you and not leave you hungry soon after. Protein and healthy fats (like nuts and avocados) can really help with satisfaction. 

Friday, May 2, 2014

Why are we seeing Measles again?

Blog contributed by Kathleen Zimmerman, MD,  Pediatrician

In recent news there have been a multitude of stories on increasing outbreaks of measles.   Measles was almost eradicated by the year 2000, so why are we seeing measles again?

Measles is spread by a very contagious virus.  The virus is spread as easily as influenza virus.  Therefore once a case comes into a community, it quickly spreads to those who have not been vaccinated. Widespread vaccination against measles creates “ herd immunity”.   This is the best protection a community can have from measles outbreaks.  Herd immunity stops isolated cases of measles from spreading into an epidemic.

Vaccination rates have declined in certain areas of the United States and these are the areas that have “holes” in the herd immunity and these are the communities that are having increasing outbreaks of measles.   California’s cases went up from 4 last year to 58 as of this month (and will be higher by the time you see this blog).

Vaccination refusal and delays are most commonly due to misconceptions about vaccine safety.  Also many young parents have never seen measles before and they do not understand that just 50 years ago there were 500,000 Americans infected with measles per year with 48,000 hospitalizations and 500 deaths each year.   The near eradication of this deadly disease 14 years ago was achieved by vaccination.  The return of this disease in exponential numbers is occurring because of vaccine refusal.

It’s important for parents to realize that when they refuse or delay vaccines for their child, they are not only putting their own child at risk, but also their whole community.   This couldn't be exemplified more clearly than in what we are seeing unfold in our country with the current measles outbreaks.