Serving the women of Hampton Roads for over 45 years
OBSTETRICS & GYNECOLOGY Franklin G. Morgan, Jr., MD, FACOG Charles A. Wilkes, MD, FACOG Arlene J. Fontanares, MD, FACOG Nikki Sadr, MD, MPH Rex G. Waterbury, MD, FACOG Laurie Macpherson, CNM Gretchen Jones, MSN, WHNP-BC, CNM Heather Hallberg, RNC, MS, WHNP
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wellness the rundown baby health 7
Your Baby’s Weight Does Matter BY KATHY SENA
Choking Prevention BY KATHY SENA
10 12 17 18 20
How birth weight affects development.
Being proactive can prevent choking dangers.
Flat Heads Aren’t Pretty BY KATHY SENA Flat headed babies aren’t uncommon. Here’s what you can do to prevent it.
Get Your Baby on a Schedule BY ALISON JOHNSON The sooner your baby is on a schedule - the better for you, and baby.
Breastfeeding Basics BY NANCY GEARY The benefits of breastfeeding explained.
How to Choose Your Baby’s Doctor BY LAURA CARSON Finding the right doctor is all about prep-work.
Guide to Ear Imperfections BY ANN SCHWENTKER Ear imperfections can be fixed. Here’s what you need to know.
women’s health 22 26 29 30 34
Heart Healthy Foods BY ARA Foods that keep you going, and they’re good for the ticker.
The Get Happy Diet BY GINA ROBERTS-GREY Mood boosting foods for moms-to-be.
When Menopause Comes Early BY KATHY SENA Know the heart health consequences of early menopause.
Are Tanning Beds for You? BY KATHY SENA Know what the cancer risks are next time you fake bake.
How Cholesterol Works BY KATHY SENA Learn what the numbers mean and what to look for on grocery shelves.
PAGE 2 | WELLNESS GUIDE | SUMMER 2010
Breastfeeding is the best for mom and baby. Page 17
SUMMER 2010 | WELLNESS GUIDE | PAGE 3
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TIDEWATER PARENT is published 12 times a year. Circulation: 52,000. Subscription rate: $24 per year. Distribution of this newspaper does not constitute an endorsement of information, products, or services. Tidewater Parent assumes no responsibility for unsolicited manuscripts or photographs. Those not accompanied by an SASE with sufficient postage will not be returned.
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Judy’s Bottle Holder is a physician-endorsed, hospital-approved and ergonomically correct baby bottle holder. It is a safe alternative to the widespread practice of bottle propping. V i s i t u s a t www.JudysBott l eHol d er . com PAGE 4 | WELLNESS GUIDE | SUMMER 2010
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Overweight babies move later and less – a habit that could last a lifetime.
BY KATHY SENA
hose cute little rolls of fat some infants have may actually slow their
ability to crawl and walk, according to a new study by the University of North Carolina at Chapel Hill. The study, published online in The Journal of Pediatrics, shows that infants who are overweight
may be slower than thinner babies to develop motor skills. “This is concerning because children with motor-skill delays may be less physically active and thus less likely to explore the environment beyond arm’s reach,” says Meghan Slining, a nutrition doctoral student at UNC’s Gillings School of Global Public Health and lead author of the study. The findings are based on observations of 217 first-time mothers who participated in the Infant Care, Feed-
ing and Risk of Obesity Study, a UNC research project funded by the National Institutes of Health. The project is examining how parenting and infant-feeding styles relate to infant diet and the risk of babies becoming overweight. The mothers ranged in age from 18 to 35 and their babies were 3 months old. Researchers visited the mothers and infants in their homes. They weighed and measured
the children at each visit, and also assessed their motor skills at 3, 6, 9, 12 and 18 months. The researchers found that overweight infants were about twice as likely (1.8 times) as non-overweight infants to have a low score on the Psychomotor Development Index test, reflecting delayed motor development. Infants with high subcutaneous fat (rolls of fat under their skin) were more than twice as likely (2.32 times) as babies without fat rolls to have a low score. “There are a number of studies that show that weight status during the infancy and toddler years can set young children on an obesity trajectory that may be hard to change,” Slining says. “Our study shows that there are actually immediate consequences as well.”
SUMMER 2010 | WELLNESS GUIDE | PAGE 7
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PAGE 8 | WELLNESS GUIDE | SUMMER 2010
Jane Henley, MSN, CPNP, IBCLC
CHOKING AAPâ€™s new recommendations aimed at educating parents to prevent hazards.
BY KATHY SENA
Warning labels on foods that pose a
A recall of food products that pose a
high choking risk.
significant choking hazard.
hoking is a leading cause of injury and death among children, especially children 3 years of age or younger. Food, toys and coins account for most of the choking-related events in
young children, who put objects in their mouths as they explore new environments. Because the size, shape and consistency of certain toys and food increase the possibility of being a choking hazard, and because many of the prevention strategies currently in place to prevent choking on toys have not yet been implemented to prevent choking on food, the American Academy of Pediatrics (AAP) now recommends:
The establishment of a nationwide food-related choking-incident surveillance and reporting system.
Food manufacturers should design
new food and redesign existing food to minimize choking risk.
CPR and choking first aid should be
taught to parents, teachers and childcare providers.
Pediatricians should continue to
provide guidance to parents on safe and appropriate food and toy choices, as recommended by the AAP.
SUMMER 2010 | WELLNESS GUIDE | PAGE 9
soft skin, soft skull Baby’s sleep position is big factor in “flat-headedness” BY KATHY SENA A baby’s sleep position is the best predictor of a misshapen-skull condition known as deformational plagiocephaly — or the development of flat spots on an infant’s head — according to findings reported by Arizona State University researchers in the medical journal Pediatrics. Analyzing a database of more than 20,000 children, the ASU researchers found that the number of babies who have developed flat-headedness has dramatically increased since 1992. The increase coincides with the American Academy of Pediatrics’ launch of a “Back to Sleep” educational campaign that recommended parents place their infants on their backs to reduce the risk of Sudden Infant Death Syndrome. “We looked at a number of risk factors, but the largest factor was the sleep position of the baby,” says Brian Verrelli, an assistant professor in ASU’s School of Life Sciences. The condition is thought to occur when babies spend too much time in one position. The research team found that sleep position, and specifically head position, are linked to flat-headedness. Babies who slept on their right side or left side tended to have right-side and leftside flat spots, respectively. The researchers also found that boys were twice as likely as girls to have the condition (a nearly perfect 2-to-1 ratio) and that it is also more common in firstborn infants, babies with low birth weight, those who were in breech and transverse positions in the womb and in multiple births, specifically fraternal twins. “The unprecedented size of the sample in our study allowed us to identify potential factors, such as maternal prenatal conditions and low birth weight, that were previously unrecognized in smaller cohort studies. These other factors need to be explored further before we can begin to piece together the entire puzzle,” says Jessica Joganic, the lead author on the study. However, independent of the biological and environmental factors, the findings showed that sleep position was the best predictor of deformational plagiocephaly, and one that could be addressed by altering behavior, says Verrelli. PAGE 10 | WELLNESS GUIDE | SUMMER 2010
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SUMMER 2010 | WELLNESS GUIDE | PAGE 11
You Can Get Baby on a Schedule T Setting a schedule means being consistent so baby can follow your lead.
hey’re born unaware of day and night, clueless about clocks and sporting appetites that can seem near-constant. So can parents really get babies onto a daily
schedule? No baby is ever completely predictable, pediatricians say, and some fall
into patterns more easily than others. But parents can do a lot to develop routines that make everyone’s life easier, said Dr. Deena Obrokta of Liberty Pediatrics, a Newport News-based affiliate of Children’s Hospital of The King’s Daughters.
BY ALISON JOHNSON PHOTO I L LUST R AT ION BY BARBIE DeSOTO
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“It definitely is possible,” Obrokta said. “Babies only know what Mom or Dad teaches them, so what they learn about sleeping and eating is what their parents show them. And all kids, no matter how young, like to know that their parents are in control.” As any new or expectant parent knows, the supply of advice on getting babies to sleep and eat well is huge - and maddeningly varied. But there are some basics that every parent can follow, beginning with modeling the difference between daytime and nighttime. When the sun is out, parents can stimulate babies moving them around, talking and singing to them and holding
up brightly-colored toys. At night, they should do much less: keep the lights low, the house quieter and feedings as short and efficient as possible. As Obrokta puts it, “Keep it boring.” Parents also should realize that individual babies have built-in patterns of sleep and wakefulness, said Dr. Phillip Snider, a family practice physician with Bon Secours Medical Associates at Virginia Beach. “Some parents get lucky and have a baby that sleeps several hours at a time almost right away,” Snider said. “Others don’t. Their bodies pretty much regulate themselves, but you can make adjustments.” If babies don’t fall asleep at regular intervals, parents can try putting
them down after a few hours of activity - ideally, mid-morning and earlyto mid-afternoon - to see if they’ll nap, especially if there are signs of fatigue such as eye-rubbing, yawning and irritability. Putting babies down when they’re still awake also helps them learn how to fall asleep on their own, Snider said. Infants who are constantly rocked or nursed to sleep are more likely to feel uncomfortable if they wake up without a parent around - and often less likely to fall into a good sleeping pattern. (If babies do fall asleep first, though, don’t be crazy enough to wake them. Instead follow this tip from Obrokta: instead of lowering them into a crib flat
Daytime is playtime. SUMMER 2010 | WELLNESS GUIDE | PAGE 13
on their backs, which triggers a startle reflex that can disrupt sleep, put them shoulder down on one side and gently roll them onto their backs). Establishing a routine before naps and bedtimes also makes a difference, pediatricians and parents say. Danielle Hooks, a mother of four from Newport News, doesn’t recall her children - older kids Phillip, 15, and Jeremy, 14, and younger siblings Jenna, 4, and Peter, 2 - having a reliable “bedtime” until they were toddlers, but she had a set pattern of bath, story, song and bed well before then. “It got them to wind down even when they were very little,” Hooks said. “Kids don’t always want to go to sleep, but I think they like knowing what to expect and what they’re supposed to do.” As for eating, doctors recommend feeding on demand during a baby’s first two or three weeks at home, especially if the mother is breastfeeding and trying to establish a good milk supply. Young babies need to eat every two or three hours because they can only process a
Tidewater Lactation Group
At night, keep it boring.
small amount of food at a time. Past the one-month mark, beginning to delay feedings even for a short time may be smart. “You want to get a baby out of that instant gratification mode,” Obrokta said. “If they’ve eaten recently and want to eat again, try to wait at least 15 minutes. Or if that’s hard, you can start at five minutes and build up to 10 and 15 minutes, and so on.” Many parents make the mistake of overfeeding babies, she added, which can cause pain, belly swelling and reflux. “It’s difficult because we’re programmed to feed and nurture,” she said. “But if the minute babies cry you always think, ‘Oh, I have to feed them,’ you can be doing them a disservice - in addition to making your life more hectic and difficult.” By about 6 months of age, babies may be able to sleep for nine or more hours at night without eating. Should they wake, especially more than once a night, many doctors advise against picking them up right away (even though the crying can be rough to
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hear). They may settle back down on their own or simply need a little soothing talk or a backrub from a parent. Six months also is the point where a shift can come with daytime feedings, Snider said. “You’re still going to need to feed them more often than you do a toddler, but you can start pulling back and getting them on more of a schedule,” he said. Have babies sit with the family at meals, he said, where they can practice with spill-proof cups and, by 8 to 12 months, eat finger and finely-cut foods (with some exceptions for safety reasons). He recommends weaning babies off bottles after their first birthdays. Finally, parents should be aware that babies can fall off a schedule at any time, especially after a major change such as a vacation or first visit to day care but sometimes for no apparent reason. “You just adjust and try your best,” said Hooks, the Newport News mom of four, “because things are never going to be totally smooth.”
SUMMER 2010 | WELLNESS GUIDE | PAGE 15
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Breastfeeding: the best feeding It’s the right stuff for baby
hether to breast- or bottle-feed your baby
is one of the first, and most important,
choices you’ll make as a parent. According to the American Academy of Pediatrics, human milk is the preferred food for all infants, including sick and premature newborns. For the first six months of life, breastfeeding is all that is needed to support ideal growth and development. After six months, parents should begin to introduce iron-rich solid foods such as cereals, vegetables and fruits. Human milk is the most easily digested food your baby can receive. Your baby uses less energy, yet breaks your milk down more completely into its basic ingredients so that they are more available to fuel your baby’s body functions and promote growth and development. The evidence on the benefits of breastfeeding is clear. Breast-fed babies have a lower incidence of diarrhea, respiratory infections and ear infections. Some studies indicate that breastfeeding may even help protect against sudden infant death syndrome. Recently, researchers have found that breast-fed babies are less likely to become obese adults. Breastfeeding helps the mom as well! In moms who breastfeed, the uterus shrinks more quickly after delivery. Research indicates, mothers who breastfeed return to their pre-pregnancy weights faster than mothers who do not breastfeed. They
BY NANCY B. GEARY, EDS, RN, CPNP, SUMMER 2010 | WELLNESS GUIDE | PAGE 17
g Choocstin a do or Don’t wait until your baby arrives to research a pediatrician.
BY DR. LAURA CARSON, CHESAPEAKE PEDIATRICS
S A PARENT, you make countless choices that affect the health and
well-being of your child. Among the most important of these is the selection of your child’s pediatrician. Many new parents assume that they need to wait until the child is born but, for a number of
reasons, it’s far better to select a pediatrician in the months before the birth. For one obvious reason, the time before birth is likely to be a lot less hectic and overwhelming than the time after the child arrives. In the months before birth, you will have more time to consider a number of pediatricians until you find a good fit. For the same reason dad wouldn’t be treated by an OB/GYN, it’s important to take your infant to a pediatrician not a family practitioner. Most pediatric practices welcome expectant mothers and offer get-acquainted visits, where they can see the facilities and meet the doctors. When you make these visits, there are critical questions you need answered. You want to make certain
need help deciding? CHKD offers a Web site and phone number to help parents make an informed selection. Learn about pediatrician and pediatric medical and surgical specialists by visiting www.chkd.org or by calling our Health Line at 668-7500.
that the pediatrician you select is board certified. A board-certified physician has completed training in an accredited pediatric residency program and has passed national board
PAGE 18 | WELLNESS GUIDE | SUMMER 2010
exams in pediatrics. If you have a preference for where you’d like your child’s surgery, lab work and other diagnostic tests to be done or for hospital admission if it becomes necessary, make sure your doctor is a member of the medical staff at that hospital. There are also practical considerations. It can be a real timesaver to find a doctor whose office is located near your home or work. The size of the practice is an important consideration. Larger groups may have better hours and appointment availability, but ask if you’ll be able to see the same physician for your child’s visits. Don’t forget to check to see if the practice’s office hours are compatible with your work schedule. Ask if there is a nurse available to answer routine medical questions during the day as well as after hours. Make certain the doctor accepts your health insurance and is “innetwork” if that’s an insurance requirement.
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SUMMER 2010 | WELLNESS GUIDE | PAGE 19
ALL ABOUT EARS BY ANN SCHWENTKER, MD OST PEOPLE hardly ever think about their ears.
It’s difficult to draw an ear accurately, but we all immediately recognize differences in ear shape or size.
This makes children and adults with ear deformities extremely selfconscious. Luckily, most of these issues can be corrected with surgery, allowing people to regain their self-confidence.
The most common ear deformities are small “skin tags” (really skin and cartilage) attached to or near the ears. If they are tied off in the hospital right after birth the cartilage beneath the skin will always leave a bump. A better solution is a simple surgical procedure to remove all the extra tissue. Another common problem is ear pits, small openings in front of the ears. They can be quite deep and often branch, so they are difficult to remove surgically. Sometimes a white, cheesy paste will come out, but they don’t usually require treatment. They are removed only if they have become infected. Children with ear tags or pits are slightly more likely to have deformities of the kidneys or genitals as well. Birthmarks, hemangiomas, and moles can affect any skin on the body, including the ears. Special care must be taken when removing these to preserve the shape of
the ear and hide any scars. People with prominent ears are often teased. After an otoplasty, an outpatient surgical procedure to create a fold, the ears no longer stick out. A more severe deformity is microtia (little ear), where the ear is very misshapen or even absent. If hearing is affected, an ENT surgeon can help. A pediatric plastic surgeon can reconstruct the outside ear by carving the patient’s ribs, placing the ear carving under the skin! The same techniques that are used to reconstruct a complete ear can also correct minor differences. Keloids are aggressive scars that form when the body doesn’t recognize that healing should be finished. They are most common in people of color and tend to run in families. Keloids can grow to be as big as the ear itself, and are sometimes itchy or painful. Surgery carries the risk of the keloid
PAGE 20 | WELLNESS GUIDE | SUMMER 2010
coming back bigger, so any treatment should be performed by an experienced plastic surgeon. Often the keloid begins with an ear piercing. Sometimes an additional injury, like catching the earring on clothing or an allergic reaction to cheap earrings is the cause. It is not uncommon for earrings to tear through the earlobe. Heavy earrings or lots of time on the telephone may cause earring holes to enlarge. Both of these problems are corrected by surgically repairing the tear. After a few months, the ears may be repierced, either to the left or right of the original hole. Many people are sensitive about their ears. Fortunately, plastic surgery can address most issues with safe outpatient surgery. Ann Schwentker is an Assistant Professor and Pediatric Plastic Surgeon at Eastern Virginia Medical School’s Department of Surgery
Having a baby is an exciting time. But if can also cause anxiety, especially if you have diabetes, are 35 or older, have genetic risk factors, have had a previous miscarriage or are otherwise classified as a “high-risk” pregnancy. Whatever has put you into the high-risk category, we can put you at ease. We have the area’s only practice focused on high-risk pregnancies. And we have the specialized knowledge and experience to help minimize your risk, monitor your baby’s development and welcome your new child to the world.
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SUMMER 2010 | WELLNESS GUIDE | PAGE 21
for heart health
hen you’re paying attention to good nutrition, it’s easy to spend a lot of time focusing on
what not to eat - all the stuff that clogs your arteries and expands your waistline. Now’s a good time to look at the things that you should eat and the things you can do to keep your
arteries healthy, and to fully understand why paying attention to arterial health is important. Some foods pack more punch than others. Here are five foods that have a lot of disease-fighting power, and it’s a good idea to regularly make room for them in your meals. If you would like more helpful healthy living and nutrition articles to keep you on track with proper arterial health, visit the Life Line Screening Blog.
PAGE 22 | WELLNESS GUIDE | SUMMER 2010
Almonds These tasty nuts are a good source of fiber and the antioxidant vitamin E, and the fat they contain is mostly monounsaturated, which is considered a “good” type of fat that can help lower your cholesterol. They may also help control blood sugar and insulin levels. Research has shown that eating 2 ounces of almonds daily for 10 weeks didn’t cause people to gain weight. A daily serving size is the amount that you can fit into two sections of an ice-cube tray, suggests the American Dietetic Association.
Salmon >> As far as seafood goes, this delicious fish is one of your best food sources of heart-healthy omega-3 fatty acids, which can help keep your heart rate steady, lower your triglycerides - a type of blood fat — and slow the growth of atherosclerotic plaque. You can bake it, broil it, roast it, poach it, or enjoy it smoked or in sushi. The FDA recommends that people eat up to 12 ounces of fish weekly.
Broccoli >> It may not rank as the favorite food of kids, but as an adult you can probably appreciate the health benefits that broccoli offers. Its mildly bitter taste comes from chemicals it contains that may provide cancer protection. Experts think anti-cancer substances in the green veggies may act as antioxidants or encourage enzymes that detoxify harmful chemicals in your body, according to the American Cancer Society. Since cooking may destroy some of the helpful compounds, cook it as lightly as possible.
These vivid little orbs are chock-full of antioxidants, which can help lower your risk of heart disease and cancer by neutralizing free radicals, rogue oxygen molecules that can contribute to atherosclerosis and damage your DNA.
<< Green tea This drink contains chemicals called polyphenols, which act as antioxidants. One of these, called EGCG, may encourage cancer cells to die, though more research is needed to show whether drinking green tea can reduce your risk of cancer. However, it may also help control your blood sugar and lower your cholesterol. All these add up to plenty of good reasons to switch some of your daily servings of soda with green tea. Drink it iced or hot. It is delicious either way. SUMMER 2010 | WELLNESS GUIDE | PAGE 23
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SUMMER 2010 | WELLNESS GUIDE | PAGE 25
IF YOU USUALLY look to chocolate to boost your spirits, new research suggests going deeper into your diet to keep things on an even keel. Once considered best for inducing post-Thanksgiving naps, the amino acid known as tryptophan has recently been revealed to elevate your mood, according to studies in Canada. Spinach, oranges, and peanuts have nutrients that can break you out of a slump, too, research shows. How can compounds in food make a difference in your outlook during pregnancy? By targeting your mood center: the brain.
Câ€™mon, Eat Happy Choose your foods, choose your moods
BY GINA ROBERTS-GREY PAGE 26 | WELLNESS GUIDE | SUMMER 2010
swingin’ moods Mood swings are most often experienced during the first trimester, between 6 to 10 weeks, and again in the third trimester as your body prepares for birth.
The link between food and your brain Your body is currently running on an unfamiliar hormonal mix. “During pregnancy, progesterone levels hit lifetime highs and estrogen levels soar,” say Morgan Pritchard, R.N., one of the authors of the Happy Baby, Healthy Mom Pregnancy Journal. Insulin levels go up, too, and the placenta produces its own set of hormones. The results of this tumultuous cocktail? Mood swings and, occasionally, bouts of the pre-baby blues. “All these fluctuating hormones slow activity in your brain, affecting its normal ability to regulate mood,” says Pritchard. Some of the most noticeable aspects of your mood that are affected are your feelings of serenity, optimism, and attentiveness. But, together, a variety of foods, not just one item, help your brain combat your coursing hormones. So how do they do it? By supplying the nutrients needed to build and balance the neurotransmitters (chemical messengers) in your brain that influence how you feel. “Protein-rich foods provide the amino acid tryptophan and B vitamins build serotonin, adrenaline, dopamine, and acetylcholine, all neurotransmitters that affect optimism, alertness, pleasure, and your libido,” says registered dietician Lyndel Costain, co-author of the cookbook Feel-Good Foods for Pregnancy. And, here’s what experts say you ought to be putting on your plate to get and stay happy throughout your pregnancy.
Blue-free breakfast Start your day with a cup of wholegrain cereal and a half-cup milk or a slice of whole grain toast and one egg. These combos, says Pritchard, enhance attentiveness and get your brain running in a positive direction. Plus, Pritchard adds, “The micronutrient chromium in eggs helps curb carbohydrate cravings and keeps your mood on an even keel.” Not up to a full morning meal? Try a few whole-grain crackers first thing and follow-up with a mid-morning snack of one cup of yogurt and a glass of orange juice. Lovin’ lunch On top of feeling like you need a nap courtesy of your churning hormones, you’re stressed from dealing with a cranky co-worker or neighbor. These ingredients for a bad mood, experts say, are why many mamas-to-be find their mood swings tend to peak midday. But, Costain says a lunch packed with magnesium-rich foods to reduce the release of stress hormones, protein to ease anxiety, and vitamin B to improve your disposition, can turn things around. Enjoy a turkey or egg salad sandwich on whole-grain bread and a banana with a glass of milk and Costain says your day won’t seem so bad. For a healthy choice to tide you over between meals, Costain suggests oneand-a-half ounces of cheese and one small handful of pumpkin seeds, peanuts, walnuts, or almonds, for the mood-enhancing elements your brain needs.
Although she wishes that salty chips were recommended pregnancy foods, Gina Roberts-Grey is glad she stuck to eating healthy. Her articles have also appeared in Parents, Glamour, Better Homes and Gardens and Self.
Source: The American Pregnancy Association
Dip-free dinner By the end of a day, Pritchard says it’s normal to feel anxious and tapped of energy. “One slice of whole-grain bread or a fist-sized portion of cooked brown rice or whole-wheat pasta can supply your brain with a surge of energy for you to enjoy the remainder of the day,” says Pritchard. Add foods rich in omega-3 fatty acids to lubricate your brain and buffer it from anxiety and the blues. One piece of flounder, sole, tilapia, or catfish that’s approximately the size of a checkbook, or three to four ounces of shrimp, scallops, clams, oysters, sardines, crayfish, or king crab, two to three times a week gives your body a boost of omega-3s. Pritchard says if seafood’s not for you, three ounces of tofu or lean meat are just as good. And one cup of beans, which boost production of serotonin, and leafy green veggies, which are rich in magnesium, serve as great sides that further protect you from hitting a slump before going to bed. The best sweet treat? “An oatmeal raisin cookie and an eight-ounce glass of milk before turning in satisfy hunger while promoting a good night’s sleep,” says Costain. Don’t worry if a queasy stomach isn’t cooperating with a regular meal schedule. Since you don’t need to substantially increase your calorie intake early in pregnancy, says Pritchard, “Try to eat as many mood-boosting foods as your doctor recommends and your nausea permits.” Fortunately, they’re healthy options for your entire pregnancy and even after you’ve given birth.
SUMMER 2010 | WELLNESS GUIDE | PAGE 27
Action Rhymes Movement Activities Shared Book Readings Rhymes & Songs Infant Toys & Crafts... Sound Like Fun?
Come join Babygarten, a fun, exciting and rhythmic program for infants (ages birth to 24 months) and their caregivers. Babygarten builds vocabulary, develops phonological awareness and print motivation, encourages narrative skills and increases letter knowledge. It enriches a childâ€™s life from the very beginning and provides them with an excellent foundation for the future.
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(Sept. 9, 16, 23 & 30; Oct. 7, 14, 21 & 28; Nov. 4 & 18; Dec. 2, 9 & 16)
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Pretlow Anchor Branch ~ 441-1750 Wednesdays @ 10:30 AM (Sept. 8, 15, 22 & 29; Oct. 6, 13, 20 & 27; Nov. 3, 10, 17 & 24; Dec. 1, 8, 15 & 22)
Barron F. Black Branch ~ 441-5806 Thursdays @ 10:30 AM (Sept. 2, 9, 16, 23 & 30; Oct. 7, 14, 21 & 28; Nov. 4 & 18; Dec. 2, 9, 16 & 30)
Norfolk Main Library ~ 664-7323 Saturdays @ 10:30 AM (Sept. 4, 11, 18 & 25; Oct. 2, 9, 16, 23 & 30; Nov. 6, 13, 20 & 27; Dec. 4)
Horace C. Downing Branch ~ 441-1968 Wednesdays @ 5:30 PM (Sept. 15, 22 & 29; Oct. 6, 13 & 27; Nov. 3, 10 & 17; Dec. 1, 8 & 15)
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Blyden Branch ~ 441-2852 Thursdays @ 10:30 AM (Oct. 7, 14, 21 & 28; Nov. 4 & 18; Dec. 2, 9 & 16)
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Park Place Branch ~ 664-7330 Wednesdays @ 11:00 AM (Sept. 15, 22 & 29; Oct. 6, 13, 20 & 27; Nov. 3, 10 & 17; Dec. 1, 8 & 15)
All Library programs are free and open to the public! PAGE 28 | WELLNESS GUIDE | SUMMER 2010
Menopause and your heart
Hitting menopause on the early side? Talk with your doc about cardiovascular risks
BY KATHY SENA
Women who go through early menopause appear to have more than twice the risk of having a heart attack, stroke or other cardiovascular- disease event later in life than do women who do not experience early menopause, a new study indicates. Early menopause was defined as going through menopause before age 46, either naturally or surgically through removal of both ovaries. “It is important for women to know that early menopause is a potential risk factor for cardiovascular disease — the number one killer of American women. They can then work harder to improve their modifiable risk factors, such as high cholesterol and blood pressure, by exercising and following a healthy diet,” says the study’s principal author, Melissa Wellons, M.D., a fellow at the University of Alabama, Birmingham. Previous research found a link between early menopause and cardiovascular disease in mostly white and European populations, according to Wellons, but the new study had a multiethnic representation of women. Of the more than 2,500 participants, about 40 percent were white, 25 percent were African-American, 22 percent were Hispanic and 13 percent were Chinese-American. At the beginning of the study in July 2000, the women participants were ages 45 to 84. Nearly 28 percent of the women reported that they had experienced early menopause; 446 women had natural menopause and 247 had surgical menopause. Women not yet past menopause were included in the group that did not have early
menopause. Follow-up tracked whether participants had a cardiovasculardisease event, which included a heart attack, non-fatal cardiac arrest (a suddenly stopped heart), angina (chest pain due to narrowed or blocked arteries), probable angina followed by angioplasty or bypass surgery, a stroke or death due to stroke, heart attack or other cardiovascular disease. No one had any such event before age 55. After that, women who had early menopause were more likely to have had a cardiovascular- disease event than women who had not gone through menopause before age 46. Even when the researchers’ statistical analysis controlled for current or previous use of hormone-replacement
therapy or for major cardiovascular risk factors, it did not change the results. Early menopause remained a risk factor on its own, although it is unclear why, Wellons says. “Our study is observational. Therefore, we cannot conclude that early menopause somehow causes future cardiovascular disease,” Wellons says. “However, our findings do support the possible use of age at menopause as a marker of future heart and vascular disease risk.” If you’ve gone through early menopause, this study might be something to discuss with your doctor so that you can be better aware of your cardiovascular risk factors and can take appropriate preventive measures.
SUMMER 2010 | WELLNESS GUIDE | PAGE 29
baked What’s the connection between tanning beds and skin cancer? BY KATHY SENA
Here’s a chance to set a great example for your kids — while protecting your own skin as well: Just say no to tanning beds. The recent increased use of tanning beds by teenagers has contributed to a sharp rise in melanoma rates in young people, says New York City dermatologist Joshua Fox, M.D. The short-term bronzing effects of tanning-bed use are simply not worth the possible long-term consequences of increased skin-cancer risk and premature aging, he adds. “Particularly during the teenage years, continued use of a tanning bed or sun lamp can be quite dangerous,” Fox says. “It can increase your risk of developing malignant melanoma by more than 55 percent, and it can about double your chances of basal cell and/or squamouscell cancer.” And heaven knows our “adult” skin doesn’t need the additional damage that can come from sun or tanning-bed exposure. PAGE 30 | WELLNESS GUIDE | SUMMER 2010
According to the American Academy of Dermatology (AAD) and the American Cancer Society (ACS): • Melanoma now ranks as the most common cancer among people ages 25 to 29. • Each year, more than one million people, many of them teenagers, visit tanning salons. • Over the past two decades, melanoma rates rose 60.5 percent in women and 26.7 percent in men. • Melanoma is linked to excessive sun exposure in the first 10 to 19 years of life, a period during which almost 80 percent of a person’s lifetime sun exposure occurs.
“The reason teens are so at risk is that they are still experiencing such tremendous growth at the cellular level,” Fox explains. “Their skin cells, like every other cell in their bodies, are dividing more rapidly than they do when we reach adulthood. And the more rapidly cells change, the higher the chances
are that they will change detrimentally — particularly when hit by the deleterious affects of the sun — and cancer will develop.” Many surveys have found that people use tanning beds for one reason: vanity. But a study published in the Journal of the American Academy of Dermatology suggests there could be more to it. Researchers found evidence that the UVA rays in tanning beds may stimulate the brain to produce endorphins, those “feel-good” hormones that are released during such positive activities as exercise, but also during such negative behaviors as drug use or cigarette smoking. “The relaxing and reinforcing effects of UV exposure contribute to tanning behavior in frequent tanners, and should be explored in greater detail,” the study’s authors conclude. For we adults, who are already concerned with the aging effects of skin damage from the sun, the evidence is clear, according to the AAD and the U.S. Food and Drug Administration (FDA): UV radiation can also have a damaging
How Does the Sun Change Your Skin? We all want younger-looking, soft, smooth skin. Of course, it’s a whole lot easier to avoid skin damage in the first place than to try to repair the damage after the fact. And we’re talking potentially serious damage. According to the Cleveland Clinic Department of Dermatology, exposure to the sun or the use of a tanning bed can cause: • Pre-cancerous (actinic keratosis) and cancerous (basal cell carcinoma, squamous cell carcinoma and melanoma) skin lesions • Benign tumors • Fine and coarse wrinkles • Freckles • Discolored areas of the skin, called mottled pigmentation • Sallowness, a yellow discoloration of the skin • Telangiectasias, the dilation of small blood vessels under the skin • Elastosis, the destruction of the elastic tissue causing lines, wrinkles
SUMMER 2010 | WELLNESS GUIDE | PAGE 31
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effect on the immune system and cause premature aging of the skin, giving it a wrinkled, leathery appearance. And contrary to what some people assume, not all skin cancers are easily curable. Malignant melanoma, which has a suspected link to UVA exposure, is often fatal if not detected early. The number of cases of melanoma is rising in the U.S. The AAD, FDA and ACS all encourage parents of teens to review the dangers of tanning beds with their children, and to prohibit their use. And remember to set that good example by taking good care of your own skin. There are many safe self-tanning creams, gels and sprays available today that can give the appearance of a natural tan without the possibly devastating side effects of tanning beds or too much sun. - Kathy Sena is a freelance health writer who regrets her habit of sunbathing — while slathered in baby oil — as a teenager in Phoenix, Arizona. Visit her blog at www.parenttalktoday.com.
What’s Your Sunburn and Tanning History? According to the AAD, people with skin types I and II are at greatest risk. Which skin type are you? I Always burns; never tans; sensitive (“Celtic”) II Burns easily; tans minimally III Burns moderately; tans gradually to light brown (average Caucasian) IV Burns minimally; always tans well to moderately brown (olive skin) V Rarely burns; tans profusely to dark (brown skin) VI Never burns; deeply pigmented; not sensitive (black skin)
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What women need to know about maintaining heart health
Cholesterol Basics ou can’t wheel your way down a grocery-store aisle these days without spotting a food label that shouts,
“cholesterol-free!” But cholesterol isn’t all bad. In fact, we need it. The soft, waxy substance, manufactured in the liver, helps produce hormones, vitamin D and the bile acids needed to digest fat.
The catch: It takes just a tiny amount of cholesterol to do all this. It’s that excess cholesterol in your bloodstream that
can lead to arteriosclerosis, a condition in which artery walls can become clogged and narrowed. And arteriosclerosis can cause heart disease or stroke. Despite all the publicity surrounding men and heart disease, women certainly aren’t off the hook when it comes to heart problems, says Linda Ojeda, Ph.D., author of Her Healthy Heart: A Woman’s Guide to Preventing and Reversing Heart Disease Naturally (Hunter House). “The idea that women are immune to heart disease has been exposed as a myth, yet women remain unaware that this disease is shortening our lives in record numbers,” she says. The American Heart Association has reported that only 8 percent of American women think they are in danger of heart disease and stroke, Ojeda adds. But these diseases kill twice as many women as what is perceived as the biggest threat — cancer. So keeping your cholesterol numbers in check is every bit as important as keeping an eye on the speedometer when you’re on the freeway. But it’s a bit more complicated — so here’s help.
BY KATHY SENA PHOTO I L LUST R AT ION BY BARBIE DeSOTO
PAGE 34 | WELLNESS GUIDE | SUMMER 2010
What Do All Those Numbers Mean? Like oil and water, cholesterol (which is fatty) and blood (which is watery) don’t mix well. So cholesterol travels through the bloodstream, together with protein, in packages called lipoproteins. Different kinds of lipoproteins affect your heartdisease risk in different ways: Low-density Lipoproteins (LDL) Often called “bad” cholesterol. Lowdensity lipoproteins carry most of the cholesterol in the blood, and LDL cholesterol is the primary source of artery blockage. The more LDL cholesterol you have in your blood, the higher your risk of heart disease. High-density Lipoproteins (HDL) Often called “good” cholesterol. Highdensity lipoproteins carry cholesterol in the blood from other parts of the body back to the liver, which leads to its removal from the body. So it helps keep cholesterol from building up on artery walls. The higher your HDL level, the better. Triglycerides All fats in the bloodstream, other than cholesterol, are triglycerides. High triglycerides may be a sign of a lipoprotein problem that can lead to heart disease.
Cholesterol Testing Knowing your family medical history helps you determine your risk of developing high cholesterol and possible heart disease, says Rodman Starke, M.D., executive vice president for science and medicine for the American Heart Association. “If your parents, uncle, aunt or other close relative developed heart disease at an early age, you’re in a high-risk group and should be tested,” he says. For a person with a strong family history of heart disease, Starke recommends cholesterol testing (which requires just a simple blood test) beginning in the teens. People with no such family history should be tested at about age 20, he advises. If levels are normal, the test should be repeated every five years. Improving Your Numbers Here are some heart-healthy tips from the Johns Hopkins University School of Medicine and the American Heart Association: Cut the fat. “Looking for ‘cholesterol-free’ foods in the grocery store is not the issue,” Starke emphasizes. Cutting saturated fats is much more important than avoiding foods containing cholesterol, he explains, because it’s saturated fat that raises cholesterol levels in the body. So choose poultry, fish and lean meats. Trim meats and remove chicken skin. Substitute skim milk for whole milk. Use tub margarine or liquid vegetable oils, which are higher in polyunsaturated fat (safflower and corn oils, for example) instead of butter, lard and hydrogenated vegetable shortenings, which are high in saturated fat. Substitute fruit, veggies and whole grains for highly processed fast foods and snack foods. Buy low-fat mayonnaise and salad dressing. And try fat-free cooking techniques such as broiling, steaming and roasting. Lose weight if you’re overweight. “When you’re overweight, you have high levels of fat in circulation throughout the body,” says Audrey Cross, Ph.D., a professor at the Institute of Human Nutrition at Columbia University. Losing weight causes overall circulatory fat to go down, she adds. Plus it reduces the stress on the heart. If you smoke, stop. In addition to causing other serious health problems, smoking can lower HDL levels. Get off the couch. Walking even 20 to 30 minutes a day can lower cholesterol. Women, especially, need to get moving. According to statistics from Johns Hopkins University, almost 90 percent of American women don’t exercise regularly, and at least 17 percent don’t exercise at all (almost twice as many non-exercisers as men). Talk with your doctor. If lifestyle changes do not improve your cholesterol levels, your doctor may want to prescribe a cholesterol-lowering medication.
Kathy Sena is a freelance writer who frequently covers women’s health issues. Visit her website at www.kathysena.com
Your Guide to Fats and Cholesterol Remember the good old days, when all we knew about fat was that mashed potatoes tasted better if they included a “lake” full of butter or gravy? How times have changed. Today, just reading the margarine labels at the grocery store is enough to make your head spin. Need help? Here’s the lowdown on fats, from the U.S. Food and Drug Administration. There are three main types of fats: Monounsaturated. Tends to lower LDLcholesterol levels. Found mostly in plants and seafood. Olive and canola oil are high in monounsaturated fat. Polyunsaturated. Tends to lower both HDL- and LDL-cholesterol levels. Found mostly in plants and seafood. Safflower oil and corn oil are high in polyunsaturated fat. (Sorry, no oil can help raise HDL levels, according to Dr. Cross.) Saturated. Tends to raise LDL-cholesterol levels. Elevated LDL levels are associated with heart disease. Found mostly in animal products such as meat, whole milk, butter and lard. Trans fatty acids. A new term, sometimes called trans fat. “These fats don’t occur in nature,” says Cross. Trans fatty acids often are found in baked goods and other highly-processed foods and should be avoided by anyone trying to lose weight or lower cholesterol.
SUMMER 2010 | WELLNESS GUIDE | PAGE 35
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Learning begins long before a child enters kindergarten. Check out our school readiness video to help your child be prepared for school, and life.
What can you do? · Talk, read and play with your child everyday! · Sign up for the parent newsletter to learn more about your child’s development. · Be an advocate for young kids, call or write elected officials to tell them the early years are critically important.