Shoes, Uniform, Ball … Mouthguard?

Mouth-Guard

By Polly Blake Buckey, D.D.S., M.S.

 

Mouthguards are a vital, often overlooked, piece of equipment in the athlete’s arsenal, particularly when competing in contact sports.  This is not an outrageous claim, considering that dental injuries are the most common type of injuries sustained in sports.  Anyone participating in a contact sport has at least a 10 percent chance of sustaining an orofacial injury.  You are 60 times more likely to be injured when not wearing a mouthguard.

The teeth most often traumatized by these facial injuries are the central and lateral incisors (front four teeth), which account for four-fifths of all cases.  A total of five million teeth are knocked out each year.  If these teeth are not properly preserved and replanted, dental costs to treat these traumatized teeth can range from $10,000 to $15,000 each, not including the costs of treating the gums and bone around the teeth.

Mouthguards prevent teeth from perforating soft tissues, such as the lips, tongue and cheeks.  They also play a crucial role in stabilizing the temporomandibular joints and are helpful in preventing jaw fractures.  However, the biggest asset of wearing a mouthguard may not be the protection that they offer to the teeth; a properly designed mouthguard reduces the incidence of concussion by absorbing the majority of the impact dealt to the mandible during a sharp blow.

 

Three types of mouthguards available:

  • Stock mouthguards are fairly rigid shells designed to be worn without further modification.  Often they have adequate mechanical properties, but the generally poor fit hinders speaking and breathing.  This likely leads to low user compliance.
  • Mouth-formed guards tend to be bulky and deteriorate fairly quickly.  These guards are formed by boiling the material in water, cooling it slightly and biting into it to adapt it to the teeth.  Initially the mouthguard may fit, but repeated usage causes lost retention as the unit slowly hardens.
  • Custom-made mouthguards are fabricated by the dentist by molding thermoplastic sheets to a cast of your child’s mouth.  This type of mouthguard provides the most optimal comfort and fit, with the close adaptation allowing for ease of speech and breathing.  The only drawback to custom mouthguards is a greater cost.

The success of the mouthguard speaks for itself.  In sports where the use of a mouthguard is mandated, there are simply fewer injuries than in other sports where no such rule exists.  But why are orofacial injuries not completely eliminated?  Often it is not a lack of rules, but a lack in enforcement of the rules.  In college hockey, a referee will not stop play simply because a player isn’t wearing his mouthpiece; however, referees in NCAA football watch for mouthguard use and will throw the penalty flag if there is an infraction.

Mouthguards should be introduced to children, as they are more willing to comply with usage and can develop positive attitudes about wearing them in order to reduce the number of orofacial injuries sustained during their athletic endeavors.  As a child’s mouth continues to change in size and number of teeth, a new custom-made mouthguard will need to be fabricated.  Check with your child’s dentist to see if he or she recommends a mouthguard to help protect your child while playing a sport.

 

Polly Blake Buckey, D.D.S., M.S., is a pediatric dentist.  She graduated from the University of Michigan’s School of Dentistry in 2000 and earned a master’s degree in pediatric dentistry from the University of Michigan in 2002.  She was the director of the dental clinic at Kosair Children’s Hospital from 2003 to 2006.  She loves working with children and making sure every child has the best care possible. 

Turkey Black Bean Zucchini Chili

turkey-zuchinni-chili

By Barbara Day, M.S., R.D., C.N.

When you are busy working and managing your kids, you need a quick and easy dinner for a family on the go. Here’s an easy recipe that can be made on the stove top or in a crock pot. It can be cooked in 30 minutes or simmered all day while you are at work.

Nutritional Information Per Serving:  235 calories, 17 grams protein, 3 grams of fat,  42 grams of CHO,  11 grams dietary fiber,  1599 mg sodium.

Preparation Time: 15 minutes  Cook Time:  30 minutes

Slow Cooker Time: 7 to 8 hours on low, or 4 to 5 hours on high.

Serves: 8

Ingredients

  • 1/2  pound ground turkey, extra lean ground beef, or ground bison
  • 2 – 14.5 ounce chili or fired roasted tomatoes
  • 2 – 15.5-ounce black beans, rinsed and drained
  • 3 medium zucchinis (about 1-pound) diced
  • 2 medium onions, diced
  • 1 6-oz tomato paste
  • 1 16 oz bag of frozen corn
  • 2 cloves garlic, minced or ½  tsp minced garlic
  • 1 tbsp chili powder
  • 1 tsp dried oregano
  • 1 ½ tsp salt
  • ½ tsp black pepper

Optional: a dollop of Reduced fat sour cream, cut-up avocado and chopped fresh cilantro before serving

Instructions

Brown meat in a 6-quart sauce pan. Then add tomatoes, beans, zucchini, onions, tomato paste, frozen corn, garlic, chili powder, oregano, salt and pepper.  Cover and cook over medium until the vegetables are cooked tender about 20 – 30 minutes.

 

Optional: You can make this a slow cooker meal. Put all the ingredients in a 6-quart slow cooker on low for 7 to 8 hours or on high for 4 to 5 hours. Make sure the meat is cooked thoroughly and the vegetables are tender.

 

Shopping List

  • ½ pounds ground turkey, extra lean ground beef, or ground bison
  • 2 – 14.5 ounce diced tomatoes
  • 2 – 15.5-ounce black beans
  • 3 medium zucchini (about 1-pound)
  • 2 medium onions
  • 1 can tomato paste
  • 1 16-oz frozen corn
  • 2 cloves garlic or dried minced garlic
  • chili powder
  • dried oregano

Image from: http://www.sweetsavorylove.com/2011/10/turkey-chili-with-zucchini/

 

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHealthWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 13 grandchildren.    

 

Be Wise Portion Size when Eating Out

family_at_diner_200

By Barbara Day, M.S., R.D., C.N.

 

Below are a number of strategies to help you make healthier low calorie choices when you are eating out. Be wise and portion size when you are eating out.

Eating Out Strategies:

  1. Go online to see what choices you have available to help you manage your waist.
  2. Be assertive.
  3. Get the Doggie Bag with dinner, split the meal before eating it.
  4. Don’t feel guilty about eating.
  5. Eat slowly and taste every bite.
  6. Eat till you feel full not stuffed!
  7. Concentrate on the atmosphere.
  8. Don’t drink your calories!
  9. Make appetizers the meal.
  10. Breads are fattening but the added butter is.
  11. Salads aren’t always low calorie fare.
  12. Beware of Reduced Calorie salad dressings.
  13. Always ask for your dressing served on the side of the salad.
  14. Vinegar like balsamic, red wine & tarragon, no calories.
  15. Split an Entrée & have an extra salad.
  16. Share a dessert if you must.
  17. Order the luncheon  or Appetizer  Portion

 

Know Menu Terminology

  1. Leaner ways to cook meats & vegetables: broiling, roasting, char grilling, grilling, poaching, stir-frying, boiling & steaming.
  2. Restaurants may brush or baste meats with fats during or after the cooking process.
  3. Some meat may be marinated in oil or a high fat substance.
  4. The term PRIME means very high in fat due to marbling

 

 

Terms that Indicate High-fat, High Calorie Prepared Food

Fried

Pan-fried

Hollandaise

Crispy

Escalloped

Creamed

Creamy

Stewed

In its Own Gravy

Buttery

Casserole

Au Gratin

In a Butter Sauce

Hash

Parmesan

In a Cream Sauce

In a Cheese Sauce

Pot Pie

 

Choose These Foods Lower Calorie Prepared Food

Baked

Barbecued

Blanched

Broiled

Charbroiled

Grilled

Herbs & spices

Marinated

Plank-grilled

Poached

Roasted

Rotisserie

Sauteed

Steamed

Stir -Fried

Tomato Sauce

 

Hamburger Fast Food Green Light Choices

  • Single hamburger or cheeseburger
  • Grilled chicken sandwich
  • Grilled chicken salad
  • Baked potato with chili or broccoli
  • Small order French fries
  • Garden and side salad – use light dressing
  • Frozen yogurt

 

Mexican Green Light Choices

  • Black bean, tortilla soup or gazpacho
  • Mexican or taco salad (don’t eat the fried shell)
  • Arroz con pollo (chicken and rice)
  • Burritos and Enchiladas
  • Fajitas
  • Soft tacos
  • Black or pinto beans (not refried beans with cheese)
  • Mexican rice
  • Pico de gallo
  • All hot sauces

 

Chinese Restaurant Green Light Choices

  • Wonton, egg drop or hot & sour soup
  • Teriyaki beef or chicken
  • Chop suey or chow mein
  • Vegetarian stir-fry dishes

Italian Restaurant Green Light Choices

  • Marinated vegetable salad
  • Minestrone soup
  • Shrimp cocktail
  • Pasta with tomato sauce or marinara sauce
  • Chicken or veal cacciatore, light wine or light tomato sauce
  • Chicken or shrimp primavera (no cream in sauce)

American Food Restaurant Green Choices

  • Broth-based soups
  • Chili (hold the cheese and sour cream)
  • Peel and eat shrimp
  • Salad with light or fat free dressing on the side
  • Salad with grilled tuna or chicken
  • Teriyaki or BBQ chicken breast
  • Fajitas

 

 

Applebee’s

Oops!

Fiesta Lime Chicken with Sauce, Cheese, Tortilla Strips, Salsa & Rice

1,285 calories, 47 g fat, 1,443 mg sodium

Grilled Steak Caesar Salad with Toast

1,295 calories, 82 g fat, 2,199 mg sodium

Southwest Philly Roll-Up with Salsa

1,605 calories, 121 g fat, 2,338 mg sodium

Smart Options but…

Grilled Cajun Lime Tilapia with Black Beans & Corn Salsa

310 calories, 6 g fat, 1,250 mg sodium

Crispy Buttermilk Shrimp with Potatoes & Toast

843 calories, 34 g fat, 1,563 mg sodium

Teriyaki Steak & Shrimp Skewers

370 calories, 7 g fat, 1,475 mg sodium

Arby’s

Oops!

Roast Beef & Swiss Market Fresh Sandwich

810 calories, 42 g fat, 1,780 mg sodium

Chicken Salad w/Pecans Sandwich

789 calories, 39 g fat, 1,240 mg sodium

Santa Fe Salad

773 calories, 52 g fat, 1,823 mg sodium

Smart options but…

Grilled Cajun Lime Tilapia with Black Beans & Corn Salsa

440 calories, 19 g fat, 1,061 mg sodium

Chicken Cordon Bleu Sandwich

488 calories, 18 g fat, 1,560 mg sodium

Martha’s Vineyard Salad with Light Buttermilk Dressing

339 calories, 14 g fat, 923 mg sodium

Jimmy John’s

Oops!

Turkey Tom w/Alfalfa Sprouts, Tomatoes, Lettuce, & Mayo

555 calories, 26 g fat, 1,342 mg sodium

Pepe Sub-Ham, Provolone, Lettuce, Tomato, Mayo

684 calories, 37 g fat, 1,659 mg sodium

Gourmet Veggie Club-Provolone, Avocado, Cucumber, Alfalfa, Lettuce, Tomato, Mayo

856 calories, 46 g fat, 1,500 mg sodium

Smart options but…

Turkey Breast Slim Sub w/Alfalfa Sprouts, Tomatoes, Onion, Cucumber & Avocado Spread

426 calories, 2 g fat, 1,439 mg sodium

Totally Tuna Sub

507 calories, 20 g fat, 1,279 mg sodium

Vegetarian Sub w/Avocado Spread, Cucumber, Lettuce, Tomatoes, Alfalfa Sprouts

290 calories, 1.5 g fat, 628 mg sodium

 

Chick-Fil-A

Oops!

Chicken Caesar Cool Wrap

480 calories, 16 g fat, 1,640 mg sodium

Chick-fil-A Chicken Sandwich

420 calories, 16 g fat, 1,300 mg sodium

Chick-fil-A Chick-n Strips Salad with Buttermilk Dressing

800 calories, 60 g fat, 1,745 mg sodium

Chicken, Egg & Cheese on Sunflower Multigrain Bagel

500 calories, 20 g fat, 1,260 mg sodium

Smart options but…

Chick-fil-A Nuggets (8-pack) with Barbecue Sauce

305 calories, 13 g fat, 1,020 mg sodium

Chick-fil-A Southwest Chargrilled Salad with fat-free honey mustard dressing

360 calories, 8 g fat, 1,170 mg sodium

Biscuit & Gravy

330 calories, 15 g fat, 970 mg sodium

Fazzoli’s

Oops!

Spaghetti with Marinara Sauce & Spicy Italian Sausage w/ Caesar Side Salad

1,030 calories, 53.5 g fat, 2,040 mg sodium

Baked Spaghetti with Meatballs

940 calories, 40 g fat, 2,370 sodium

Original Submarine

940 calories, 58 g fat, 3,040 mg sodium

Parmesan Chicken Salad with Ranch Dressing

580 calories, 39 g fat, 1,270 sodium

Oops!

Spaghetti with Marinara Sauce & Spicy Italian Sausage w/ Caesar Side Salad

1,030 calories, 53.5 g fat, 2,040 mg sodium

Baked Spaghetti with Meatballs

940 calories, 40 g fat, 2,370 sodium

Original Submarine

940 calories, 58 g fat, 3,040 mg sodium

Parmesan Chicken Salad with Ranch Dressing

580 calories, 39 g fat, 1,270 sodium

KFC

Oops!

KFC Famous Bowl with Mashed Potatoes & Gravy

740 calories, 35 g fat, 2,350 mg sodium

Popcorn Chicken – Individual

400 calories, 26 g fat, 1,160 mg sodium

Crispy Caesar Salad w/Creamy Parm Caesar Dress w/ Croutons

670 calories, 48 g fat, 1,755 mg sodium

Apple Pie Minis (3)

370 calories, 20 g fat, 260 mg sodium

Smart options but…

3 Crispy Strips, Green Beans, & 3” Corn on Cob

470 calories, 22 g fat, 1,775 mg sodium

Honey BBQ KFC Snacker

210 calories, 3 g fat, 530 mg sodium

Roasted BLT Salad w/Fat Free Ranch Dressing

235 calories, 6 g fat, 1,290 mg sodium

Sweet Life Oatmeal Raisin Cookie

150 calories, 5 g fat, 135 mg sodium

Olive Garden

Oops!

Stuffed Chicken Marsala w/Garlic Parmesan Mash Potatoes

1,315 calories, 86 g fat, 2,550 mg sodium

Mixed Grill w/Vegetables & Mashed Potatoes

839 calories, 43 g fat, 1,541 mg sodium

Pork Filettino w/Potatoes & Bell Peppers

1,011 calories, 57 g fat, 2,479 mg sodium

 

Smart options but…

Linguine Alla Marinara with a Breadstick

691 calories, 9.5 g fat, 1,040 mg sodium

Shrimp Primavera

706 calories, 18 g fat, 1,220 mg sodium

Chicken Giardino

448 calories, 11 g fat, 1,670 mg sodium

 

Outback Steakhouse

Oops!

Ayers Rock Strip Steak w/Sautéed Mushrooms & Loaded Jacket Potato

1,450 calories, 85 g fat

Outback Special (11 oz) w/Sautéed Mushrooms

960 calories, 61 g fat

Half a Bloomin’ Onion

1,155 calories, 67 g fat

Smart options but…

Prime Minister’s Prime Rib w/Fresh Veggies & Sweet Potato

730 calories, 39 g fat

Victoria Filet (9 oz) with Steamed Vegetables

639 calories, 45 g fat

Half an Order of Shrimp on the Barbie w/Bread

330 calories, 21 g fat

PF Chang’s

Oops!

Sriracha Shrimp Salad

1,130 calories, 46 g fat

Salt & Pepper Calamari

770 calories, 50 g fat

Kung Pao Chicken

1,240 calories, 80 g fat

Spicy Green beans

 

Smart options but…

Wild Alaskan Sockeye Steamed with Ginger

750 calories, 50 g fat

Seared Ahi Tuna

260 calories, 6 g fat

Ginger Chicken & Broccoli

660 calories, 26 g fat

Sichuan-Style Asparagus

200 calories, 6 g fat

Quizno’s

Oops!

Small Honey Mustard Chicken Sub

550 calories, 30 g fat, 1,140 mg sodium

Small Prime Rib Cheesesteak

680 calories, 42 g fat, 1,070 mg sodium

Small Turkey Ranch & Swiss Sandwich

450 calories, 22.5 g fat, 1,380 mg sodium

Smart options but…

Small Honey Bourbon Chicken on Wheat Bread

310 calories, 4 g fat, 920 mg sodium

Small Black Angus Sandwich

520 calories, 16.5 g fat, 1,550 mg sodium

Small Tuscan Turkey

390 calories, 14 g fat, 1,185 mg sodium

Red Lobster

Oops!

North Pacific King Crab Legs with Melted Butter w/Rice Pilaf

883 calories, 35 g fat

Snow Crab Legs w/Melted Butter & a Cheddar Bay Biscuit

611 calories, 34.5 g fat

Crab Alfredo

1,170 calories, 66 g fat

Smart options but…

Live Maine Lobster (1.24 lbs) w/Cocktail Sauce & Seasoned Broccoli

288 calories, 3 g fat

Garlic Grilled Jumbo Shrimp

329 calories, 5 g fat

Broiled Flounder w/Lemon Juice & a Garden Salad w/Red Wine Vinaigrette

344 calories, 10 g fat

Romano’s Macaroni Grill

Oops!

Chicken Caesar

920 calories, 69 g fat, 1,660 mg sodium

Chicken Portobello

1,020 calories, 66 g fat, 7,300 mg sodium

Grilled Salmon Teriyaki

1,230 calories, 74 g fat, 6,590 mg sodium

Half Order of Mozzarella Fritta

Smart options but…

½ Pizza Margherita & Caesar Della Casa w/Low Fat Caesar Dr

645 calories, 24 g fat, 1,665 mg sodium

Pollo Magro

330 calories, 5 g fat, 770 mg sodium

Simple Salmon

590 calories, 40 g fat, 1,390 mg sodium

Half Order of Mozzarella Alla Caprese

260 calories, 21 g fat, 410 mg sodium

Ruby Tuesday’s

Oops!

Turkey Burger with Fries

1,171 calories, 58 g fat

Parmesan Shrimp Penne

1,221 calories, 64 g fat

Southwestern Spring Rolls (4 rolls)

708 calories, 40 g fat

Broccoli & Cheese Soup

443 calories, 34 g fat

Smart options but..

7 oz Top Sirloin w/Baby Green Beans & Baby Portabella Mushrooms

464 calories, 24 g fat

Creole Catch w/Couscous w/Baby Green Beans

580 calories, 26 g fat

Asian Dumplings (4 dumplings)

440 calories, 20 g fat

White Bean Chicken Chili w/Tomato & Mozzarella Salad

370 calories, 15 g fat

Taco Bell

Oops!

Baja Beef Chalupa

410 calories, 27 g fat, 780 mg sodium

Zesty Chicken BORDER BOWL

640 calories, 35 g fat, 1,800 mg sodium

Grilled Stuff Chicken Burrito

640 calories, 23 g fat, 2,160 mg sodium

Caramel Apple Empanadas

290 calories, 14 g fat, 300 mg sodium

Smart options but…

Two Grilled Steak Soft Tacos, Fresco Style

320 calories, 9 g fat, 1,100 mg sodium

Chicken Fiesta Taco Salad w/out Shell

470 calories, 24 g fat, 1,780 mg sodium

Two Spicy Chicken Soft Tacos

340 calories, 12 g fat, 1,160 mg sodium

Cinnamon Twists

170 calories, 7 g fat, 200 mg sodium

Sonic

Oops!

Chicken Club Toaster Sandwich

690 calories, 35 g fat, 1,900 mg sodium

Jumbo Popcorn Chicken Salad

490 calories, 28 g fat, 1,440 mg sodium

Fish Sandwich

640 calories, 31 g fat, 1,1180 mg sodium

Large Hi-C Fruit Punch

290 calories, 0 g fat

Smart options but…

Sonic Burger with Mustard

540 calories, 25 g fat, 730 mg sodium

Grilled Chicken on Ciabatta w/BBQ Sauce

375 calories, 9 g fat, 1,310 mg sodium

Grilled Chicken Wrap

380 calories, 11 g fat, 1,300 mg sodium

Junior Banana Split

200 calories, 4.5 g fat

Wendy’s

Oops!

Roasted Turkey & Swiss Frescata w/Med Fries & Med Coke

1,100 calories, 40 g fat, 1,950 mg sodium

Chicken Club Sandwich

610 calories, 31 g fat, 1,460 mg sodium

2 Junior Cheeseburgers

720 calories, 32 g fat, 1,720 mg sodium

Medium French Fries

420 calories, 20 g fat, 430 mg sodium

Smart options but…

Ultimate Chicken Grill Sandwich w/Side Salad w/Red fat Ranch & Med Iced Tea

540 calories, 22 g fat, 1,780 mg sodium

Small Chili & 5 piece Crispy Chicken Nuggets

450 calories, 21 g fat, 1,300 mg sodium

Single w/ Everything

430 calories, 20 g fat, 900 mg sodium

Sour Cream & Chives Potato

320 calories, 4 g fat, 55 mg sodium

http://investmentwatchblog.com/restaurant-recovery-fizzles-76-percent-of-people-are-cautious-about-spending-and-they-are-eating-out-less-often/

 

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHealthWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 13 grandchildren.    

 

Shin Splints: What are they really?

shin-splints-1

By Stephen Karam PT, DPT,

In the lexicon of medicine, “shin splints” is yet another phrase that has a specific and real definition.  The real name for this condition is called Medial Tibial Stress Syndrome (MTSS).  That sounds much worse and more ominous than “shin splints.”  MTSS generally presents as pain just along or right behind the shin bone (tibia).  It is pain caused by inflammation or disruption of tissue that connects the the muscles of her lower leg to the tibia.  Fortunately, MTSS is very curable and rarely requires a medical procedure other than a visit to your Physician or Physical Therapist to diagnoses it properly.  It is a common injury that is seen frequently in runners and athletes that have to play on hard surfaces or those who have to start/stop frequently.

MTSS can develop into more serious conditions such as a stress reaction/fracture or compartment syndrome.  It is also very important to rule out these 2 conditions before MTSS is ruled in.  Signs of something worse like compartment syndrome may include redness, hotness, significant swelling or feeling of pressure building in your lower leg.  Signs of a stress reaction may include pain at rest, pain for a long period of time and increased pain in a weight bearing or standing position.

Risk Factors of “shin splints” may include:

  • Tight/stiff muscles of the legs and gastrocs
  • Worn down or old running shoes
  • Runners who over pronate or who have flat feet
  • Runners who are beginning a new running program
  • Individuals participating in high impact, high intensity sports/workouts

Tips to manage or prevent shin splints:

  • Wear appropriate shoes or arch support for your foot shape and mechanics
  • Warm up before activity and stretch afterwards
  • Ice or cold treatment to shins when painful
  • Participate in less impact activities like swimming, biking, elliptical
  • Listen to your body when it is in pain

Most health insurance plans now allow patients to seek physical therapy treatment directly without a physician referral.

Image from: www.erinchapmanfitness.com

Clinic Director Stephen Karam PT, DPT, earned his doctorate in physical therapy from the University of Kentucky after completing a bachelor’s degree in exercise science. He is a member of the American Physical Therapy Association (APTA). He specializes in manual therapy with a strong emphasis in orthopedics and sports medicine. In his spare time, he enjoys tennis, working out, music and football.

 

Dealing with the Picky Eater – The Battle Between Parents and Children

picky girl

By Barbara Day, M.S., R.D., C.N.

Winning the war on what the child should eat or not eat is a continuing issue in every family in every generation.  Strategies such as, “You’ll sit here until you finish every bite on your plate” and “What do you want to eat – whatever you want, darling,” have not proven effective in ensuring that children eat healthier.

These strategies may help you survive the battle.

  1. Avoid the power struggle.  Don’t say, “Do it, because I’m the parent.”  The child needs to understand the why behind the rules, which may help lay the groundwork for lifelong, sound food choices.
  2. Let children participate in the meal preparation.
  3. Children under five are selective eaters.  That’s a fact.
  4. Introduce new foods slowly. Studies have shown children need to be exposed to a new food 10 to 15 times before they will accept it. Limit exposure to one or two new foods a week. When introducing a new food, serve it alongside familiar foods your child likes.
  5. Never use food as a reward.  Rather than using food as a reward, use something physical and fun – such as a trip to the park or a game of catch or basketball.
  6. Beware of over-snacking.  Knowing how many calories your child needs to eat and keeping track of those calories periodically can help ensure they are getting enough calories, but not too many. (See “How Many Calories Should Your Child Eat Each Day?”)
  7. Don’t label foods as “good” or “bad.”  Tie certain foods with things the child might care about , such as, lean protein helps build muscles and bones, whole grains energize sports performance, and antioxidants in fruits and vegetables help keep skin radiant and hair shiny and healthy.
  8. Be a good role model.  If you don’t eat fruits and vegetables, how can you expect the children to do so?  Your mealtime attitudes have a strong influence on your child’s eating behavior.
  9. Keep healthy foods available and accessible.  Your child can only choose foods that you purchase and bring into your home. Keep a low shelf in the refrigerator stocked with cut-up fresh fruit and other healthy food choices.
  10. Be more creative in your food design and preparation.If a child won’t drink milk, add it to oatmeal, pudding or mashed potatoes.  If a child won’t eat vegetables, serve fresh vegetables with low-fat dressing or puree the vegetables and add them to main dishes or side dishes. Don’t give up.
  11. Give your children small portions.  Children don’t need to eat the same portion sizes as adults.  Too much food can be overwhelming; they can always take seconds.
  12. Make sure the food looks and tastes good.
  13. Some children have food jags.  They will only eat certain foods.  Fortunately, children can thrive on a boring diet.
  14. If your child definitely won’t eat vegetables then boost their vitamin and mineral intake by serving more nutrient-dense fruits such as cantaloupes, berries, red or purple grapes, raisins, kiwi and oranges.
  15. If your child won’t eat meatyou can also puree the meat and add it to sauces.  You can also add gravy to meat, serve it with ketchup or mix it into mashed potatoes. A healthy diet doesn’t have to include meat but needs to include enough dairy products, beans and legumes or soy-based products, which can provide adequate amounts of protein, iron and B vitamins.

Image from: www.babble.com

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHEALTHWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 13 grandchildren.     

Nutrition 101 for Seniors

seniors shopping healthy

By Barbara Day, M.S., R.D., C.N.

Macronutrients

The fact is less active seniors need less calories or they may end up gaining weight as they age. Even though less calories are needed as we age, you need just as many nutrients. Therefore, choosing nutrient dense foods over calorie dense foods are warranted. For example, choosing skim milk over whole milk; choosing reduced fat cheese over full fat cheese; baking, grilling, or broiling meats rather than frying with lots of fat. Seniors should choose small portions of foods high in fat, sugar and sodium. Using spices to help flavor foods may be helpful since smell and taste are affected as we age. Protein needs don’t change as we age but some seniors tend to eat less meat. Choosing foods that are higher in dietary fiber will help prevent constipation. Beans are high in dietary fiber but also contain protein and lots of nutrients such as folate, manganese, potassium, iron, copper and magnesium. But when you eat more dietary fiber, you need to make sure you drink enough fluids as well. Adequate fluid intake for seniors is essential! The number one problem that typically sends seniors to the emergency room is dehydration. Water, juice, milk, coffee and tea contain fluids. In addition, high fluid foods like melons, berries, and grapes offer dietary fiber and also lots of nutrients.

Micronutrients

As we age, it is important that we eat more calcium to help prevent osteoporosis.  Including 2 to 4 servings of dairy products like vitamin D enriched milk, yogurt or cheese each day. If you can’t tolerate these foods, check with your doctor about appropriate nutritional supplements. Make sure these supplements contain a source of Vitamin D as well. Other nutrients that are important as we age are: iron, vitamin C, and zinc.  Iron and zinc are found in meats, eggs and seafood. Vitamin C rich foods include: citrus fruits, green and red peppers, broccoli, tomatoes, strawberries and potatoes.

Problems Facing Seniors

Eating alone can affect the amount and type of food you eat.  Loss of teeth or improper fitting dentures may affect your eating style as well. Affordable food is also an issue if you are on a fixed income. Drug therapy can also affect your taste & your appetite. Depression can either decrease your food intake or increase your intake. Gas and heartburn become an issue as we get older. Overeating, avoiding fatty foods, alcohol & carbonated beverages may help to relieve heartburn problems. In addition, eating slowly, chewing food thoroughly, & eating smaller more frequent meals may help.

Senior Nutritional Tip Sheet

  • Eat breakfast every day.
  • Drink plenty of water or water based fluids & high fluid foods.
  • Select high fiber foods like whole grain breads & cereals, beans, & brightly colored fruits and vegetables.
  • If poor appetite is a problem, eating smaller more frequent mini-meals may be helpful.

 

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHealthWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 13 grandchildren.    

Dehydration, Confusion & Increased Heart Rate: What Do These Symptoms Have In Common?

sick medicare patient

By Barbara Day, M.S., R.D., C.N.

I participated in a webinar sponsored by the Coca Cola Company. Ron Maughan, PhD, discussed Hydration, Health and Performance. He presented some very interesting data regarding chronic dehydration (hypohydration) in the elderly and how it affects their health status*. Dr. Maughan reported chronic dehydration in the elderly may be associated with a decline in physical function and also a decline in their cognitive status. Apparently, dehydration can be due to a reduced thirst sensation which occurs as people get older.

In addition, some drugs that seniors routinely take may also suppress their thirst.  These drug classes include: SSRI’s, ACE Inhibitors and also anti-Parkinson drugs. Selective serotonin reuptake inhibitors or serotonin-specific reuptake inhibitor (SSRIs) are a class of compounds typically used as antidepressants in the treatment of depressionanxiety disorders, and some personality disorders. They are also typically effective and used in treating some cases of insomnia. Many seniors routinely take anti-depressants.

Signs & Symptoms of Dehydration

Unfortunately, some of the signs and symptoms of dehydration can be identical to senile dementia symptoms, age dementia symptoms and Alzheimer’s symptoms. Correcting dehydration can allow the senior to return to a full and normal life. But, not correcting the dehydration may actually ensure the hospitalization of the senior.

The most common signs and symptoms of dehydration include persistent fatigue, lethargy, muscle weakness or cramps, headaches, dizziness, nausea, forgetfulness, confusion, deep rapid breathing, or an increased heart rate. Dehydration is a very serious condition, more than most people realize. Since seniors often have a reduced sense of thirst, dehydration is one of the most frequent causes of hospitalization after age 65.

Other less common signs and symptoms of dehydration can include:

  • Excessive loss of fluid through vomiting, urinating, stools or sweating
  • Poor intake of fluids, “can’t keep anything down”
  • Sunken eyes
  • Dry or sticky mucous membranes in the mouth
  • Skin that lacks its normal elasticity and sags back into position slowly when pinched up into a fold
  • Decreased or absent urine output
  • Decreased tears

After reviewing these symptoms, if you or your family member has any of

these symptoms, maybe dehydration is the cause of the confusion rather than a diagnosis of dementia or Alzheimer’s.

 

Dehydration Can Cause Death

According to Dr. Maughan, about 50% of elderly hospitalized with dehydration died within a year of admission. In fact, readmission rates are high due to repeated dehydration. Hospitalization of elderly with a diagnosis of dehydration is a serious and costly medical problem but preventable.

Prevention of Dehydration in Seniors

Prevention is key to helping seniors remain healthy and also will help drive down costs. Although most people get about 20% of their fluid intake from food, most seniors get about half their fluid intake from solid foods such as fruits and vegetables because seniors have a reduced sense of thirst.  In addition to a reduced sense of thirst seniors also have a reduced appetite.  Reduced thirst and reduced appetite may also be due to their medications. Proper hydration may be a challenge but one strategy that will help keep seniors healthy, alert, active and out of the hospital.

Institutionalized seniors may need between 1,700 milliliters or 56 ounces and 2,000 milliliters or 67 ounces of daily fluid**. The Institute of Medicine advises men to consume about 13 cups of fluids per day and women should consume about 9 cups per day.

Another way to determine hydration is the color of one’s urine. Urine color for the first void of the day is typically yellow but as the day goes on urine color should be pale (slightly yellow) to colorless. If not, more fluids need to be ingested.

Here’s a Urine Color Chart that you might find useful, http://www.rte.ie/tv/useitorloseit/hydration.pdf.  Check out Table 1. Water Content of Fruits & Vegetables.

Table 1. Water Content of Fruits & Vegetables

Food                                                % of Water

Apples (raw)
Applesauce (canned, sweetened)
Apricots (raw)
Apricots (canned)
Asparagus (cooked)
84%
80%
86%
78%
91%
Avocados (raw)
Bananas (raw)
Bell Peppers (raw)
Blackberries (raw)
Blueberries (raw)%
73%
74%
92%
86%
85%
Broccoli (cooked)
Broccoli (flower clusters, raw)
Cabbage (raw)
Cantaloupe (raw)
Carrots (raw)
91%
91%
92%
90%
88%
Cauliflower (raw)
Cauliflower (cooked)
Celery (raw)
Cherries (raw)
Corn (1 ear, cooked)
92%
93%
95%
81%
70%
Cucumbers (raw)
Grapefruit (pink or red, raw)
Grapes (raw)
Honeydew Melon (raw)
Kiwi fruit (raw)
96%
91%
81%
90%
83%
Lettuce (raw)
Mangoes (raw)
Nectarines (raw)
Olives (ripe, canned)
Oranges (raw)
96%
82%
86%
80%
87%
Peaches (raw)
Peaches (canned)
Pears (raw)
Pears (canned)
Plums (raw)
88%
79%
84%
80%
85%
Potato (baked)
Raspberries (raw)
Strawberries (raw)
Tangerines (raw)
Tomatoes (raw)
Watermelons (raw)
75%
87%
92%
88%
94%
92%

 

 

 

*Warren et al (1994). The burden and outcomes associated with dehydration among US elderly. 1991. Am J Public Health 84, 1265 – 1269.

**Chidester JC et al (1997). Fluid Intake in the institutionalized elderly. JADA, 97, 23-28.

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHealthWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 12 grandchildren.    

 

 

Cheesy Quinoa Black Bean Sweet Potato Casserole

sweet potato black bean quinoa recipe

By Barbara Day, M.S., R.D., C.N.

Quinoa (pronounced KEEN-wah) is considered a whole grain but it is really a seed. Quinoa is high in protein and dietary fiber. It contains more high quality protein than any other grain. Quinoa is considered a complete protein because it contains all the 9 essential amino acids. It does not contain any gluten.  Quinoa is a perfect food for vegetarians, vegans and people who are lactose intolerance. Quinoa can be served hot or cold. It can be served as a side dish, in soups, as a pilaf or as a breakfast cereal.  One cup of cooked quinoa has 222 calories, 8 grams of protein, 4 grams of fat, 32 grams of carbohydrate and 5 grams of dietary fiber.  Quinoa is a good source of magnesium, iron, selenium, calcium, folate and vitamin E.  I typically use quinoa in the place of rice or couscous. It takes about 10 – 15 minutes to cook. I typically cook a batch and store in the refrigerator.  It can be stored up to 4 days. I use it in soups and as a base for stir fry vegetables.

Nutritional Information Per Serving: 443 calories, 25 grams protein, 7 grams of fat,  61 grams of CHO, 19 grams dietary fiber, 1868 mg sodium.

Preparation Time: 15 minutes  Cook Time: 30 minutes

Serves:  4

 

Ingredients

  • 1 cup cooked quinoa*
  • 2 15-ounce cans black beans, drained and rinsed
  • 2 large sweet potatoes, shredded**
  • 1 cup reduced fat shredded cheddar cheese
  • 1 tbsp ground cumin
  • 1 tsp chili powder
  • Salt & pepper to taste
  • 2 eggs or 4 egg whites
  • 2 cups of medium salsa
  • 2 tsp fresh cilantro, chopped as garnish

Instructions

Cook quinoa according to the package. Preheat oven to 350 degrees.  Prepare a 9” X 9” casserole dish with nonstick cooking spray.  In a large bowl, mix cooked quinoa, black beans, sweet potatoes, ½ cup cheese, chili powder, cumin & salt and pepper to taste.  In a small bowl, mix together the eggs and the salsa.  Pour the salsa mixture over the vegetables and beans.  Then pour the mixture into the prepared casserole dish. Sprinkle the rest of the cheese over top & bake uncovered for 30 minutes. Garnish with cilantro.

 

Shopping List

  • quinoa
  • 2 15-ounce cans black beans
  • 2 large sweet potatoes
  • ground cumin
  • chili powder
  • eggs
  • medium salsa
  • fresh cilantro

*You can substitute whole wheat couscous.

**You can substitute fire roasted red pepper and garlic instead of the sweet potatoes.

Image from: Jerry Miller.

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHealthWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 12 grandchildren.     

The Use of Prophylactic Bracing In Sports

sport_braces1

By Stephen Karam PT, DPT

Unfortunately, knee and ankle injuries have a high incidence rate in both football and basketball.  Physicians, trainers and athletes have tried and are willing to try just about anything to prevent one of these injuries from occurring.

If you have been watching college or professional football over the past 10-15 years, it would be hard not to notice large, bulky knee braces on the entire offensive line.  These large, bulky braces come with a large, bulky price as well and are “supposed” to prevent serious knee injuries from occurring allowing these players to stay on the field.  Some of these injuries include meniscus, MCL, ACL and damage to the articular cartilage of the knee.

So do these expensive, large braces prevent these devastating injuries from occurring? 

In a 2010 issue of the Journal of Sports Health, Salata et al conducted a systematic review of 6 articles that studied the use of knee braces in football and injury prevention.  The systematic review suggests that there may be limited protection of the MCL and that there is no evidence that wearing these prophylactic knee braces prevent injuries to the ACL and meniscus.  One of the articles in this systematic review suggests that wearing these braces may even increase the risk of injury to knees, ankles and feet.  At this time there is not enough significant medical evidence that suggests wearing these knee braces prevents serious injuries from occurring in football. Due to the “ounce of prevention is worth a pound of cure” theory, college and professional budgets allow for any and all measures of prevention to be taken whether or not it has a high value of efficacy.

On a positive note there is significant medical evidence that supports that use of ankle braces in prevention of ankle sprains in basketball.  A 2011 study by the American College of Sports Medicine looked at nearly 1500 male and female basketball players from 46 high schools.  The incidence of ankle injury in the braced group was .47 per 1000 exposures and 1.41 per 1000 exposures in the control group.  Demonstrating a significant difference in those athletes wearing braces and those athletes who were not wearing the provided brace.  The study did note that there was not a significant difference in severity of injuries between the braced and controlled groups.  In contrast to the knee braces these lace up ankle braces are affordable and probably should be considered as a method to prevent ankle injuries.

Please consult your Physical Therapist or Athletic Trainer before purchasing or fitting for one of these prophylactic braces as wearing the wrong size may increase your risk for injury.

Image from: www.trinityhhc.com/sportSupportBraces.php

KORT Chevy Chase Clinic Director Stephen Karam PT, DPT, earned his doctorate in physical therapy from the University of Kentucky after completing a bachelor’s degree in exercise science. He is a member of the American Physical Therapy Association (APTA). He specializes in manual therapy with a strong emphasis in orthopedics and sports medicine. In his spare time, he enjoys tennis, working out, music and football. For more information go to: www.kort.com

How Sure Are You About Your Surefootedness This Winter?

snow_walk

By Matt Hall, PT, DPT, OCS.

How sure are you about your surefootedness this winter? As we approach the heart of winter in Kentucky, this is the opportune time to seriously ponder this question.  Your response may portend idyllic enjoyment of the outdoors, or could reveal your heightened risk for injury.  In attempting to answer this question it may first be helpful to consider a wide spectrum of influences.  Here are just a few:

Shoes– Due to the increased risk of slipping, it is advisable to utilize aids that provide added traction.  While spray-on resins can provide rubbery grip to the soles of any shoe, for those tackling more serious terrain or who require maximum traction, screw in metal cleats can be manually attached using a specialized tool.  A more likely option for most  might be crampons like YakTrax, or Sandys that can be easily secured to and removed from the soles most styles of shoes before stepping out into inclement weather.  Additionally, these devices spare the floor from damage.

Canes or walking sticks– Whether you routinely use one or not,  a cane or walking stick can provide added support and enhanced stability when walking on slick or uneven terrain.  However, before you venture forth into the elements one very important modification should be made.  The rubber tip should be replaced by one that has small spikes that does not slip when planted.  The tip may need to be switched again to rubber for indoor use or may be retractable.  Check with the vendor before purchasing.

Eyewear– This one can be easily “overlooked”, no pun intended, because the risk usually occurs when returning to the warmth of a shelter.  Often the sudden temperature change causes glasses to fog up for a few moments and this could lead to a trip or fall.  Another risk is the self- tinting feature that can likewise render the wearer’s vision momentarily impaired when coming from sunlight into an indoor lighting environment.  One solution is simply pausing upon entry until the glasses stabilize; another is to leave a spare pair near the entry way that can be swapped.

Clear walk ways– Sidewalks and porches should be cleared of snow as soon as possible.  Walking on freshly fallen sow only serve to compact it making it more difficult to remove latter, and hastening its transformation to ice.  However, as we Kentuckian’s are all too acquainted, snow is usually not the issue but rather it seems that ice is our nemesis.   One effective solution is to spread deicer upon walkways.  Keep a container near doorways for convenient use when needed.  Sand and cat litter can be substituted but they will not melt the ice and can be a bit messy.

Finally, I’d like to leave you with a few additional suggestions to keep you safer this winter.

  1. Walk like a penguin, exit your automobile like a cat burglar, and if you find yourself falling, do so like a gymnast.
  2. Keep a wide stance and walk “flat footed”.  Imitating a penguin greatly increases your stability on slick surfaces.
  3. When exiting a car, do not jump out!  Think cat burglar.  Gingerly step out and down while holding onto the handle, seat and door until your footing is assured.
  4. And lastly while the physicality of a gymnast is well beyond the capabilities of most, their approach to tumbling does effectively illustrate my point.   Gymnasts use their hands to “soften” their landing.  Therefore, if you are carrying objects attempt to throw them out of the way don’t try to hold onto them.  It is paramount, in the event of a fall, to protect your head and you can only do this if your hands are free.  Furthermore, don’t attempt to twist away from or stiffen as one falls.  Instead, roll with the fall as this can reduce the potential for injury.

While there can never be a 100% guarantee that winter falls can be prevented, following some or all of the aforementioned suggestions can only serve to improve your overall safety.  Godspeed.

Image from: www.catalystsforhealth.com/watch-your-step-parenting

Matt Hall PT, DPT, OCS is a graduate of Transylvania University and the University of Kentucky. A board certified specialist (OCS), he is a member of both the Kentucky and the American Physical Therapy Associations. He has been a practicing physical therapist since 1995 and has experience in both inpatient and outpatient facilities. Matt’s areas of professional interest include general orthopedics, industrial/workplace preventative and rehab services, and foot orthotics to correct mechanical gait deviations. For more information about injury prevention and treatment, check  out  www.kort.com.