Phytochemicals Can Help Keep You Healthy

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

It’s no secret, you are what you eat.  Phytochemicals which come from plants provide the plant color, aroma but more importantly provides protection from infection and predator cells which can cause cancer, heart disease, stroke, diabetes and aging. Phytochemicals work effectively with vitamins and minerals to help fight disease in a concerted effort.  Check out the table below to see what foods and herbs contain phytochemicals and how they are beneficial in keeping us health.

Table 1. Phytochemicals Found in Food & Herbs*

Phytochemical Family Plant Sources Possible Actions & Benefits
Allium Compounds Allicin


Allyl sulfides

Chives, garlic, leeks, onions, scallions, shallots -Slow or stop the growth of tumors.

Foods in the allum family probably protect against stomach cancer.

Garlic probably decreases the risk of developing colorectal cancer.

Laboratory studies suggest that allium compounds might also protect against leukemia and cancers of the prostate, bladder, skin and lung.

Hint: Cutting or crushing garlic at least 10 minutes before cooking makes more cancers fighters available.







Red, orange, yellow and some dark green

Fruits: apricots, cantaloupe, citrus fruits, nectarines, papayas, peaches, watermelon.

Vegetables: Bok choy, broccoli, carrots, corn, green (collards, kale, lettuce, spinach), pumpkin, red peppers, sweet potatoes, tomatoes and tomato products, winter squash

-Acts as an antioxidant.

-Inhibit cancer cell growth.

-Improve immune response.

Foods containing carotenoids probably protect against cancers of the mouth, pharynx and larynx.

Carotenoids in dark leafy vegetables might inhibit the growth of cancers of the skin, lung, stomach and some types of breast cancer cells.

Lycopene in tomatoes and tomato products may reduce the risk of prostate cancer.

Flavonoids (a group of Polyphenols)Anthocyanidins (cyanide, delphinidin, malvidin, pelargonidin, peonidin)

Flavan-3-ols (catechin, eicatechin, epicatechin gallate, epigallocatechin, epigallocatechin gallate, theaflavins)

Flavanones (hesperetin & naringenin)

Flavones (apigenin & luteolin)

Flavanols (kaempferol, myricetin)

Flavonoids (quercetin)

Isoflavones (see separate category below)

Fruits: Apples, berries, cherries, citrus fruits, cranberries, currants, grapes, pears, plums

Vegetables: Beets, bell peppers, broccoli, celery, chard, eggplant, kale, lettuce, onions, red cabbage, radishes

Beans: Black beans, kidney beans, pinto beans

Herbs: Parsley, rosemary, thyme

Other: Cocoa powder, dark chocolate, coffee, tea

-Act as an antioxidant.

-Increase the enzymes that protect the body from cancer-causing compounds.

-Stimulate self-destruction of abnormal cells.

-Inhibit inflammation that supports cancer groups.

-Inhibit tumor growth.

-Boost immune function .

Some flavonoids may help prevent colon cancer.

In laboratory studies, the phytochemicals in apples reduced the growth of lung cancer cells.

IndolesIndole-3-carbinol Cruciferous vegetables: broccoli, Brussels sprouts, cabbage, cauliflower, horseradish, mustard greens, turnips, watercress -Act as a antioxidant.

-Increase the activity of enzymes that protect the body from cancer-causing compounds.

– Helps repair damaged DNA.

-Block the activity of hormones that influence the development of some cancer (breast & cervical).

-cause cancer cells to die.

Laboratory studies suggest that cruciferous vegetables protect against cancers of breast, endometrium, lung, colon & cervix.



InositolPhytic acid (also called inositol hexaphosphate or IP6) Whole grains: Bran from corn, oats, rice, rye, and wheat


Legumes: Soybeans and dried beans

-Act as an antioxidant.

-Slow growth of tumors.

-Cause cancer cells to die.

Laboratory studies suggest that phytic acid may prevent tumors from forming in the colon, lung, prostate & skin.

Isoflavones (a category of Flavonoids)Daidzien



Soy: Soybeans & soy products (such as edamame, soymilk, tofu) -Acts as antioxidant

-decrease production of some hormones

-inhibit growth of tumors

IsothiocyanatesAllyl isothiocyanate






Cruciferous Vegetables: Arugula, broccoli, bok choy, Brussels sprouts, cabbage (red & green), cauliflower, collard greens, horseradish, kale, mustard greens, radishes, rutabaga, turnips, watercress


-Act as antioxidants.

-Block tumor growth.

-Cause cancer cells to die.

-Inhibit inflammation that supports cancer growth.

-Increase the activity of enzymes that protect the body from cancer-causing compounds.

Laboratory studies & some small population studies suggest that cruciferous vegetables protect against cancers of the bladder, breast, endometrium, esophagus, lung, colon, liver, prostate, & cervix.

Isothiocyanates form when glucosinolates in cruciferous vegetables are broken down by an enzyme released when the vegetable is chewed or chopped.

Polyphenols (other than Flavonoids & Terpenes)Coumarin



Phenolic Acids (cafferic acid, ferulic acid, ellagic acid, gallic acid)

Stilbenes (pterostilbene, resvertrol)

Tannins (such as ellagic acid)

Fruits: Apples, blackberries, black raspberries, blueberries, cherries, red grapes, pears, pomegranates, strawberries

Other: Chestnut, peanuts, lentils, pecans, turmeric, walnuts

-Act as a antioxidant.

-Inhibit inflammation that supports cancer growth.

-Prevent cancer formation.

-Cause abnormal cells to die before they can become cancerous.

Cell culture & animal studies suggest pterostibene could help prevent colon, lung, skim stomach, pancreatic & breast cancers by inhibiting growth & stimulating destruction of abnormal cells.

In laboratory & animal studies, resverstarol has inhibited the formation or slowed the growth of cancers of liver, prostate, stomach & breast.

Resveratrol has caused the death of leukemia & colon cancer cells.

In lab studies, ellagic acid has inhibited the development of cancers of the colon, esophagus, liver, lung & skin.

In the lab, curcumin has reduced the formation & growth of breast, colon, & stomach cancer cells.

Protease Inhibitors Legumes: Beans, lentils, peas, soybeans & whole soy products (such as edamame, soymilk, tofu) -Inhibit cancer cell growth.-Prevent tumors from releasing compounds that can destroy nearby healthy cells.




Vegetables: Asparagus, beets, Brussels sprouts,



Seeds: Flax, pumpkin, sesame & sunflower seeds

Most Vegetable Oils: corn, olive, safflower & sesame oils

Whole Grains

-Cause the death of cancer cells.

-Lessen the inflammation that supports cancer growth.

Terpenes (a group of Polyphenols)Carnosol



Perillyl Alcohol

Fruits: Apples, cherries, citrus fruits, pears, prunes

Herbs: Bay leaves, dill, oregano, parsley, rosemary, sage, thyme

Other Foods: Pumpkin seeds

-Act as antioxidant.

-Slow cancer cell growth.

-Boost immune function.

-Inhibit inflammation that supports cancer growth.

Laboratory studies suggest carnosol may decrease cells’ sensitivity to reproductive hormones that promote prostate cancer.


*From the American Institute for Cancer Research handout: Facts on Preventing: The Cancer Fighters in Your Food.

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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,, 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, Barbara writes nutrition and health columns for 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.    


Healthy Back. Healthy Life.

By Julie L. Lyles, DC

One of the least understood but most important parts of the human body is the spine.  The spine is the lattice work and foundation for every other soft tissue and organ.  The spine is composed of 26 moveable segments.  Hear that?  Moveable! Each joint is angled in a certain way to provide optimal motion and optimal protection.  When loaded correctly and free of fixation, there is nothing more brilliant!   So, why such confusion?  Why such a lack of respect?  Why so little education on the value and importance of healthy joint mobility and postural balance?  Maybe it’s a lack of understanding of the complex simplicity of the spine and its care.

When a child is born, she has 2 curves in her spine:  the mid-back and the sacrum.  As the child starts to get nosey, she lifts her head while on her belly and starts to develop the curve in her neck.  The forces that the back part of her neck feels is what triggers her body to pour calcium in the right places until the age of 25.  (Wolff’s Law” of Physics states that bone models and remodels in response to the mechanical stresses it experiences so as to produce a minimal-weight structure that is ‘adapted’ to its applied stresses.”)

Later on, she gets a little more nosey and goes to all fours, dropping her belly with her head lifted up, developing the curve in her low back.  And, off she goes…through a stage of crawling, building necessary brain and body strength, and mechanical and neurological synchronization.  Then, only when she and her spine are ready, she will start to pull up, with ideally, a properly curved spine that has been fortified by normal instinctive motions and body positions.

When the curves in the spine are not properly formed, as is becoming the norm due to a decrease in “belly-time,” walking too soon without first crawling, more sedentary lifestyles and of course, technology posture, the body reacts profoundly!  Look at the body this way, the back or posterior, is the foundational structure, whereas, the front or the anterior, is where all of the organs and pipes are that supply the body with nutrition and eliminate waste.  If you place the weight of your head, shoulders, and hips in the back and heels, you are correctly putting stress in the purposefully larger, denser bones intended to carry such weight and leaving the front to “flow.”  If you place the weight of the head, shoulders, and pelvis in the front, you are blocking flow of nerve supply, blood supply, and lymphatic supply and compressing all of your vital organs, ultimately leading to dysfunction and disease.

What are common symptoms of joint fixation and postural distortion?  Headaches, neck and back pain, numbness, tingling, and weakness in the upper and lower extremities.  Big deal?  Motrin or Tylenol can help you live with those symptoms, right?  Well, every seven years when the body remodels bone and every year when your organs try to replace their tissues, you are allowing dysfunction and disease to continue…until, of course, you get the symptoms that you can no longer cover up and no longer live with.  What are some conditions that are on the rise, linked to postural distortion and joint fixation: hypertension, migraine headaches, ADD/ADHD, sinusitis/allergies/asthma, reflux and GERD, osteopenia/osteoporosis, infertility, and constipation to name a few.  All of these conditions typically lead to a less active you.  The decreased motion in your body further accelerates the deterioration of the joints and the organs through fixation and stagnation.

What can you do?  Look at yourself and your family and notice if the center of your ear is close to the back of your neck and in line with your shoulders?  Are your shoulders lined up with your hips?  Are your hips lined up with your heels?  Do you have any of the aforementioned conditions and use a lot of over the counter medications? Do you have trouble turning your head or bending it forward, backward, or sideways?  Do you avoid bending over or leaning back? Have you become less active and accepted “feeling bad” as your norm?  Or, has disease set in?

Seek out a health care professional whose specialty is the structure and function of the human form, one whose skills, through manual correction, proper education, and physical retraining can help restore your body to the strong balanced flowing structure capable of brilliant healing powers: The Doctor of Chiropractic.

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Dr. Julie Lyles, DC is a doctor of chiropractic who practices chiropractic care and also owns GetWell Solutions which is focused on Nutrition Counseling, Well Coaching, and Corporate Wellness Programs. For more information, contact Dr. Lyle directly at  




Inguinal Hernias: What are they and how are they repaired?

Inguinal Hernias: What are they and how are they repaired?

By Steven F. Samuel, MD, general surgeon

A hernia occurs when the lining that separated the intestine from the skin weakens and a hole forms.  Hernias can be congenital, meaning individuals can be born with them.  They can also occur from increases in weight, straining and other activities causing the lining to become stretched.

A hernia can occur anywhere in the abdomen, but many occur in the groin. This type is called inguinal hernia. Some studies report as much as 80 percent of hernias are inguinal. This type of hernia is also more common in men than women.

A great number of my patients with an inguinal hernia say they were doing an activity and experienced pain in their groin.  Upon investigation, they noticed a bulge.  You may push on the bulge and it will go away, but return again with activity.

Other signs and symptoms of an inguinal hernia include:

  • A bulge in the area of the pubic bone
  • A burning or aching sensation at the bulge
  • Pain or discomfort in your groin, particularly when bending over, coughing or lifting
  • A heavy or dragging sensation in your groin
  • Weakness or pressure in your groin
  • Pain and swelling around the testicles

Anytime you notice an abnormal bulge in your abdomen or groin, you should see a physician for evaluation and treatment.

Hernias of all kinds, including inguinal, can be repaired through an elective, outpatient surgical procedure.  According to the National Institutes of Health data, roughly 600,000 surgical procedures are performed annually to repair inguinal hernias.

Inguinal hernias have a three to five percent chance of recurrence. They can be repaired multiple times. However, subsequent repairs can be more complicated. Surgical mesh is often used to strengthen tissue during hernia repair and help prevent recurrence of the hernia.

When diagnosed with a hernia of any kind, it is best to have it repaired quickly.  Without repair, organs and tissue from the abdomen can come through the hole and become strangled, cutting off the blood supply to those areas. This is called a strangulated hernia, which can be life threatening. Once that occurs, an emergency surgery will be needed, followed by a prolonged hospital stay.  At times, the strangulated organ may need to be resected, meaning a portion may be damaged and require removal, which can result in long term affects.

There are a limited number of cases where surgical repair may not be the preferred course of treatment. For example, patients of advanced age, or who have diabetes or hypertension may not be well enough to undergo surgery.  If an individual is too ill to undergo surgery, treatment usually involves monitoring of the hernia. In these cases, we would regularly monitor and watch closely for signs of a strangulated hernia.

If you think you have a hernia of any kind, seek medical attention. A simple procedure can repair the hernia and help you to avoid serious complications.

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Steven F. Samuel, MD, is a general surgeon with Jewish Physician Group which is  part of KentuckyOne Health.  For more information, go to



Feel Better—The Answer is in Your Food


By Sandra Meyerowitz, MPH, RDN, LD, CLT

Do you suffer from symptoms like headaches, joint pain, anxiety, diarrhea, or reflux? And have you spent endless hours searching for answers that will alleviate your discomfort? The answers you are looking for are not always easily found and you may feel like this continuous search for relief will never end. You are not alone in your pursuit of feeling better. After visiting with numerous doctors without success, there may be one treatment option still undiscovered by you.

Melanie was in this position. She came to Nutrition Works after spending years looking for answers to her health problems. She suspected the food she was eating was making her sick, but no one had been able to verify that hunch and they sent her on her way. Every time she went to a doctor, she was told that everything was fine, but she knew that things were not fine. She had too many sick days accrued and spent too much time in pain for everything to be fine.

Melanie followed Nutrition Works’ LEAP program for food sensitivities and within six weeks she had reduced her symptoms drastically. Her symptom survey score (a tool that is used to measure symptoms all over the body) was 136 before she began the program and 27 after 6 weeks. She has generously allowed her story to be published here to share a treatment option that could provide others with relief also. In her own words, here is Melanie’s story.

Health wise, I was considered very healthy by any doctor I would visit.  I felt awful though and knew something was wrong but couldn’t figure out what.  I would complain to my doctor of all sorts of symptoms and I had all sorts of tests run… all showing I had nothing wrong.  I would miss work and social events often, because I literally couldn’t get out of bed.  Whatever was going on in my body was ruining my life.  So, I was referred to Nutrition Works by my physical therapist to have my food sensitivities checked.  No doctor ever told me about this option.

I was having many different symptoms, some were severe enough to keep me in bed all day and some were just constantly lingering.  I had migraines just about once or twice a week.  I felt like I had the flu everyday… body aches, no energy, sore to the touch, cranky, bladder frequency and urgency, diarrhea, gas and bloating, burning ears, yeast infections (that were resistant to Diflucan).  I felt like I had been run over by a truck and had no energy to exercise.  A nap was an absolute must every day.  I also had dizziness, lightheadedness, shaking, and nausea.

I had many different tests run by different doctors… blood work, endoscopy, colonoscopy, bladder installations.  Every doctor said the same thing as far as me having no deficiencies or odd results.  I was looked at like a hypochondriac.  I felt very alone and depressed about my health and the fact that I didn’t know what was wrong with me or if it would ever go away.  So basically I had no treatment or relief of my symptoms prior to the LEAP program.

Figuring out what foods I can eat has changed my life.  I am no longer a prisoner of my “sick” body.  I feel like I can do anything and not be held back.  My symptoms disappeared in about a week. I feel very fortunate to have found the LEAP program.

There were many surprising foods and chemicals that came back as reactive on the test.  I felt that a lot of these foods were “healthy” and I was eating lots of them.  I had no idea that certain foods converted into chemicals that my body could not handle.  Media and even a lot of the health and diet books I read would encourage copious amounts of these “healthy” foods.  While they may be healthy to some people, they are poison to my body.  I had to learn that everybody is different and what works for some may not work for others.  We are not one size fits all when it comes to a healthy diet.

I would recommend the LEAP program to everyone with general aches, pains, allergies, and digestive problems that most people just put up with.  It can also be a godsend to anyone who feels like something is wrong, but all of their tests are negative and their doctor finds nothing.  I tell anyone that asks what I have done and they are surprised that food can have such an effect on the body.

Food sensitivities are difficult to pinpoint because obvious symptoms may not show up for 72 hours. With the passage of time, it is very difficult to identify which foods or chemicals may have caused the problems. Working with an experienced registered dietitian who is a food sensitivity specialist eliminates the mystery so a custom made diet can be created. By following this special diet, symptoms can be greatly reduced and in many cases completely wiped out. Melanie is a good example of how following a personalized diet can allow someone to get their life back. Have you discovered this option yet? The dietary management of food sensitivities may provide you with the relief you’ve been looking for.

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Sandra Meyerowitz, MPH, RDN, LD, CLT is the owner of Nutrition Works, a health promotion company specializing in food sensitivities, weight loss, and sports nutrition. She offers individual consultations, specialized programs and team and corporate seminars. She can be reached at or 502-339-9202. Visit to learn more about Nutrition Works and to subscribe to her complimentary nutrition and fitness e-newsletter.

Losing Weight: Dieting, Food & Exercise

By Nancy Clark MS RD CSSD

As an athlete, you are unlikely obese, but you may have concerns about your weight or have relatives who struggle with their weight. To address the complexities of how to deal with undesired body fat, the Weight Management Group of the Academy of Nutrition & Dietetics held a conference (Indianapolis, April 2013). Here are some highlights.

Dieting and weight

•  An estimated 35% of all US adults are not only overfat but also pre-diabetic, including 50% of adults over 65 years. Relatives who have watched a loved one needlessly die from diabetes see first-hand the need to prevent themselves from going down the same road. There are clear benefits from eating wisely and exercising regularly! Losing just 5% of body weight can reduce health risks attributed to diabetes.

•  Most dieters want to lose weight quickly. The problem is that plan tends to backfire. You can lose weight fast or lose weight forever—but not lose weight fast and forever.

• Most dieters regain about two-thirds of their weight loss within a year and all of it within 3 to 5 years. Tips to maintain weight loss include: exercise regularly, eat fewer fatty foods, watch less TV, have strong social support, and sleep more than 5 hours a day.

• Chewing gum can help lean people consume fewer calories, but that is not the case for obese gum-chewers. (Perhaps the act of chewing increases their desire to eat?)

•  To stay on track, successful dieters should plan ahead by predicting everything that could possibly go wrong with their eating plan and develop strategies to deal with the unexpected. For example, if the waiter serves the salad soaked with dressing (not on the side, as requested), the dieter knows he can send it back, not eat it, or eat less of it.

• If you “blow your diet,” please don’t hate yourself. Just regret you over-ate and learn from the experience. You learned to overeat for a reason. (For example, overindulging in birthday cake may have been your “last chance” to eat cake before your diet started again the next meal.) The better plan can be to enjoy a reasonable slice of cake for several days. You’ll feel less need to overindulge when you know you can have more cake the next day (just fit it into your calorie budget).

• Other success-promoting dietary habits include using portion-controlled foods and keeping food and weight records. High-tech diet aids include: tracking steps by wearing a pedometer (goal: 10,000 steps a day), and wearing an armband or other body-activity monitor that detects changes in activity over time. Some popular high-tech tools include New Lifestyles-1000 pedometer, FitBit Zip, and Nike Fuel Band.  (Note: Accuracy of the high-tech tool is less important than day-to-day reproduce-ability.)

• Websites or apps like,,, and can also be helpful. In the near future, you’ll be able to take a photo of your meal and an app will then calculate the calories. This info will be very helpful when eating in restaurant with super-sized meals.

Food and weight

•  An estimated 80% of weight loss happens by eating fewer calories; 20% relates to exercise. You need to change your diet to lose weight and change your exercise to keep weight off.

• Overweight people tend to eat by time cues. Noon is lunchtime, regardless if the clock is significantly wrong!

• Adults may eat more of a food if it is deemed healthy. That is, subjects ate more oatmeal cookies when they were described as high fiber, high protein as compared to high sugar, high butter. And yes, even healthy high fiber and high protein calories count!

• In contrast, adolescents (who are heavily influenced by their peers) tend to eat less of a food labeled healthy.  For teens, eating carrots is just not as acceptable as eating chips.

• People who eat a high protein diet (25% of calories) tend to eat fewer calories per day. A protein-rich breakfast with 25 to 35 g protein helps manage appetite for the rest of the day.

• The decline in hearty breakfasts mirrors the rise in obesity. Try eating an 800-calorie protein-rich breakfast and see what that does to your appetite for the rest of the day!  You’ll undoubtedly notice you feel less need to “reward” yourself with evening treats.

• A 100-calorie portion of natural whole almonds actually has only 80 available calories due to digestibility. The same likely holds true for other high fiber, high fat “hard” foods, such as other kinds of nuts. People who frequently eat nuts are actually leaner than folks who avoid nuts;; hence, you need not fear them as being “fattening” (in moderation, of course, as with all foods).

Exercise and weight

• Weight loss is about quality of life; exercise is about health. However, exercise strongly predicts who will be able to maintain their lost weight. While the reason for this is unknown, some researchers wonder if purposeful exercise allows the reduced obese person to eat more calories? (You know—the more you exercise, the more you can eat.) Or perhaps exercise is a marker of discipline and dedication to maintain a healthier eating style and lifestyle?

• Lifting weights is a good entry point for unfit people who want to start exercising. First they get strong, and then they can add on the walking, jogging, and aerobic activities.

• Lifting weights reduces the loss of muscle that occurs with diet-only reducing plans and creates the same health benefits of slimming the waist-line and improving blood glucose levels (hence reducing the risk of diabetes).

• Because weight loss without exercise contributes to loss of muscles and bone-density, some health professionals advise against weight loss for older people. Instead they recommend that people over 60 years focus on adding on exercise rather than subtracting food. You are never too old to lift weights!

• An effective exercise program includes 110 minutes per week of moderate to vigorous physical activity and two times a week of lifting weights for about 20 minutes.

• Men who maintain a stable weight tend to be active about 70 minutes a day. In comparison, obese men are less active and likely to be frail. Do obese people become frail—or do frail people become obese?

The bottom line: Keep active, enjoy whole foods that are minimally processed, live lean, and be well!

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Nancy Clark MS RD CSSD (Board Certified Specialist in Sports Dietetics) counsels both fitness exercisers and competitive athletes in her private practice in the Boston-area (617-795-1875). Her Sports Nutrition Guidebook, Food Guide for Marathoners and Cyclist’s Food Guide all offer additional weight management information. The books are available via See also



Spinach Salmon Cakes

Spinach Salmon Cakes

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


I grew up eating canned salmon because we couldn’t afford fresh salmon. So you might say canned salmon is one of my comfort foods. Canned salmon is high in omega 3 fatty acids and always is wild salmon not farmed salmon.  If you mash the bones, you can get some extra calcium. Adding the spinach helps to increase the nutrient content as well and adds some dietary fiber. Canned salmon doesn’t contain more sodium, however.

Nutritional Information Per Serving:  336 calories,  28 grams protein, 14 grams of fat,  27 grams of CHO,  3 grams dietary fiber,  971 mg sodium.

Preparation Time: 10 minutes  Cook Time: 10 minutes 

Serves:  4


  • 1 can (14 ¾ oz) salmon or 1 lb skinless salmon filet
  • ½ cup diced red onion
  • 1 egg, beaten
  • 2 tbsp lemon juice
  • 10 oz frozen chopped spinach, thawed
  • 2 tbsp Dijon mustard
  • ½ cup corn meal or whole wheat bread crumbs
  • 1 tbsp oil


In a large bowl, drain salmon, remove skin.  Mash salmon bones & mix.  Add onion, lemon juice, spinach, sour cream, mustard, egg, and bread crumbs to mashed salmon.   Form into 3-inch cakes that are about ½-inch thick.  In a large non-stick pan, heat oil over medium heat. Cook salmon until lightly browned.

Yogurt-Dill Dressing

Can use this dressing on your salmon or other fish as well.

  • 6 oz fat free plain Greek yogurt
  • 1 cup fresh dill sprigs
  • 1 tbsp lemon juice
  • 1 tbsp Dijon mustard
  • 1 small shallot
  • ¼ tsp salt


Put all the ingredients in a food processor or blender. Blend until smooth.  Serve over the Salmon Cakes.

Shopping List

  • 1 can (14 ¾ oz) salmon or 1 lb skinless salmon filet
  • red onion
  • 1 egg
  • lemon juice
  • 10 oz frozen chopped spinach
  • Dijon mustard
  • corn meal or whole wheat bread crumbs
  • oil
  • 6 oz fat free plain Greek yogurt
  • fresh dill sprigs
  • 1 small shallot

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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,, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s website which is an on-line health & wellness magazine, Barbara writes nutrition and health columns for 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.    


Chicken Crunch Waldorf Salad

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


This is one of my favorite recipe combinations that I refer to as my comfort food. But I made a few changes. I like to use sweet apples like Gala or Red delicious but you could also use Granny Smith apples. Plus I added grapes because I like grapes, too. I use red grapes because they have more nutrients than green grapes.

Nutritional Information Per Serving:  320 calories, 24 grams protein,  14 grams of fat,  26  grams of CHO,  3 grams of fiber,  219 mg sodium.

Preparation Time: 10 minutes 

Serves:  4


  • 2 cups coarsely chopped cooked chicken breast
  • 1 cup coarsely chopped apples (sweet or tart)
  • ½ cup sliced celery
  • 1/3 cup light Miracle Whip or Mayonnaise
  • ¼ cup walnut pieces
  • 2 tbsp raisins
  • 1 cup grapes



Put all the ingredients in a bowl. Mix well. Place in refrigerator and let chill for 1 hour. Serve plain or on a bed of lettuce.


Shopping List

  • cooked chicken breast
  • apples
  • celery
  • light Miracle Whip or Mayonnaise
  • walnut pieces
  • raisins
  • grapes

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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,, 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, Barbara writes nutrition and health columns for 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.    



Urinary leakage: taking your life back!

By Ganesh S. Rao, M.D.

It’s embarrassing and usually happens at the worst times. Technically we call it female incontinence, but simply put it is the accidental release of urine. If you are a woman with this condition, you are not alone. 10 to 30% of adult women are affected, and at least 50% of elderly women have female incontinence. It causes women to avoid an active lifestyle, shy away from social situations, and constantly search for the nearest bathroom. Some women are even uncomfortable talking to their doctor about the condition.

Uncontrolled release of urine can occur when you laugh, sneeze, cough or exercise. Or, you may have a sudden need to run to the bathroom, but don’t make it in time. Sometimes incontinence is caused by a urinary tract infection, medications, or even constipation.

There are several types or classifications of incontinence; stress, urge, mixed and overflow.

Stress incontinence is urine loss during physical activity that increases abdominal pressure; like coughing, laughing, and sneezing. This is the most common type of incontinence in women. You may leak a small to medium amount of urine.

Urge incontinence is urine loss with the urgent need to void, accompanied by involuntary bladder contractions (also called overactive bladder). With this condition you may leak a larger amount of urine that can soak your clothes or even run down your leg.

Mixed incontinence is a combination of stress and urge incontinence. The most troubling type of incontinence is overflow, or the constant dribbling of urine where the bladder never completely empties.

Bladder control problems can be caused by weak muscles in the lower urinary tract, or problems or damage either in the urinary tract or in the nerves that control urination. Stress incontinence can be caused by several factors like childbirth, weight gain or other conditions that stretch the pelvic floor muscles. When these muscles cannot support the bladder properly, the bladder drops down and pushes against the vagina. Since the muscles that close off the urethra cannot be tightened, urine may leak because of the extra pressure on the bladder when you experience some physical activities. Urge incontinence is a bit more mysterious – and is caused by an overactive bladder that expels urine out of the bladder uncontrollably. It may be caused by irritation of the bladder, stress, or even some medical conditions not associated with the urinary system.

There are several surgical and non-surgical treatments for both stress and urge incontinence. One of the most promising procedures for the treatment of stress urinary incontinence (SUI) is referred to as ‘sling’ procedures.

One such product is the TVT Sling, where the doctor inserts a strip of PROLENE polypropylene mesh tape in a 30-minute, minimally invasive treatment performed in an outpatient setting. The tape-like strip of mesh is woven through the pelvic tissue and positioned underneath the urethra, creating a supportive sling. When pressure is exerted, the tape provides the support needed to allow the urethra to maintain its seal. It is a procedure that can be performed under local anesthesia while the patient is awake. The results can even be tested and the tape adjusted for maximum effectiveness during the procedure, improving success rates.

The sling is also advantageous since patients may be able to go home a few hours after the procedure, with a two to three week recovery period, experiencing very little interference with daily activities. The treatment has been performed on over one million women worldwide, and a recent study showed that even seven years after treatment, 81% of women treated remained dry, with an additional 16% experienced significant improvement. Since all medical procedures present risk, patients are encouraged to ask their doctor about rare, but potential complications associated with sling treatment.

Whatever type of incontinence you suspect you may have, consult your physician for advice and testing to determine the best path of treatment. With today’s treatment options, there is no reason to endure this embarrassing, uncomfortable condition. Take your life back!

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Dr. Ganesh S. Rao, M.D., F.A.C.S, received his bachelor of medicine and surgery at Mysore Medical College, University of Mysore, India. He was a research associate in the Division of Urologic Surgery at Washington University School of Medicine in St. Louis, Missouri, from 1996 to 2001. Between 1997 and 2000, he completed his internship in surgery and his residency in urologic surgery. He is certified by the Educational Commission for Foreign Medical Graduates and is a member of the Indian Physicians Association of Kentucky. Dr. Rao is certified by the American Board of Urology and is a Fellow of the American College of Surgeons. He joined Metropolitan Urology in 2001.




America’s Big Health Problem: OBESITY

By Carlos Rivas, MS, CSCS 

            The obesity epidemic is a big contributor to the skyrocketing healthcare costs in the United States.  The most recent estimates indicate that more than 66% of adults are classified as overweight, 32% as obese, and 5% extremely obese.  What is more frightening is that childhood obesity seems to be rising at alarming speed as well. Childhood obesity rates have more than tripled since 1980 and it seems that it will continue to climb along with the adult rate.  Overweight and obesity are linked to numerous chronic diseases, including cardiovascular disease, diabetes, many forms of cancer, and numerous musculoskeletal problems.  It is estimated that the direct and indirect costs of obesity are in excess of $117 billion.  Obesity is also the leading cause of Type 2 diabetes, a disease that is totally preventable.  In fact, 57 million Americans have what we call prediabetes, a disease defined as having a blood pressure higher than 130/80; triglyceride levels greater than 150; fasting blood glucose levels greater than 100; and a waist line greater than 35 inches for women and greater than 40 inches for men. 

Adult obesity rates have increased in 23 states and did not decrease in any state in the past year.  Sixteen states experienced an increase for the second year in a row, and eleven states had an increase for the third consecutive year. The percentage of obese or overweight children in the United States is above 30% in 30 states.  As you can clearly see, the only way we as a country are going to be able to compete with the rest of the world is by changing our health behaviors.

            The management of our body weight is dependent on energy balance, which is affected by energy intake and energy expenditure.  In other words, for a person who is overweight or obese to reduce body weight, energy expenditure must exceed energy intake.  A weight loss of 5% to 10% provides significant health benefits, and these benefits are more likely to be sustained through better eating habits and participation in habitual physical activity. 

            The Proformance Professional Personal Trainers and Wellness Coaches follow the FITT principles as stated by scientific evidence to work best for those who are overweight or obese. 

Frequency: 5 days per week

Intensity: Initial exercise training intensity should be moderate (40%-60% Heart Rate Reserve).  Eventual progression to 50%-70% of Heart Rate Reserve resulting in further health benefits.

Time: Performance of 10-minute segments of continuous exercise 3 times per day.  Eventual progression of 30-45 minutes of continuous exercise activity per day.

Type:  The primary mode should be aerobic physical activities that involve large muscle groups.  As part of a well-balanced program, resistance-training exercises need to be included.  Resistance exercise will enhance your muscular strength and physical function.

Bottom Line:  You must know why you are deciding to eat better, drink more water, and exercise more!  You must have a compelling reason why you have decided to make major improvements in your lifestyle.  My major reason for following a healthy lifestyle has always been to avoid taking unnecessary medications.  I want to have the energy needed to help as many people as I possibly can.  Having dis-ease does not make it easy for me to accomplish my goals, so I choose to avoid disease by following a simple lifestyle management program I call “5 of 5”.

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Carlos Rivas, MS, CSCS, ACSM-CPT is the Director of Fitness and Wellness Operations for Proformance Fitness, located at 2041 River Road, Louisville, KY, 40206. He is also the founder of FitCorp, a Highly Individualized Worksite Wellness Company.  Carlos has a Master’s degree in Exercise Physiology and has over 20,000 hours of Professional Personal Training and Wellness Coaching experience. Carlos can be reached by phone at 502-741-9428 or by email:

Preventing Gardening Injuries

By Amanda Edsell, OTR/L, CHT   

Many Americans give up their love of gardening every year due to persistent pain and stiffness in their hands, hips, knees, and back. According to the Arthritis Foundation, over 46 million men, women, and children have doctor-diagnosed arthritis (osteoarthritis, rheumatoid, or juvenile).

Practical Pain Free Gardening Tips

  • Break up large tasks into several timed sessions.
  • Work at a steady pace; take intermittent rest periods during the course of the day to avoid over-fatigue and over-stress of joints.
  • Stretch upper and lower limbs before going to work.
  • Take frequent breaks, and use the strongest and largest joints and muscles available for each job.
  • Use proper body mechanics to lift objects so that the legs are being used to lift rather than the arms and back. Keep the weight of the object close in to the center of your body.
  • Use ergonomic equipment such as long-handled spades, bulb planters, and weeding forks to avoid back strain, extreme postures of the knees and hips, and extended reach of the shoulders.
  • Avoid loose-fitting, bulky gloves as they can actually increase the workload on your hands as they attempt to hold onto and maneuver tools/items.
  • Spring-loaded pruners, loppers or any tools that increase leverage while cutting will decrease the amount of force exerted through the hands and upper extremities.
  • When kneeling is preferred or necessary, individual strap-on knee pads or padded mats can reduce mechanical stress on the resting surface of your lower extremities.
  • Consider raised flower beds or flower boxes for easier access or utilize a wagon or stool for prolonged sitting.
  • Stack the most commonly used tools in a cart, wagon, or other gardener’s helper that does double duty as a seat for planting and weeding.
  • Consider low-maintenance plants such as daylilies, hydrangeas, hostas, boxwood or yew shrubs, and groundcover (i.e. English ivy) when planning new landscaping.

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Amanda L. Edsell OTR/L, CHT graduated from Spalding University in 2002 with a Bachelor’s degree in Occupational Therapy. In 2008, she became a Certified Hand Therapist (CHT). Amanda is certified to perform augmented soft tissue mobilization (ASTYM), Functional Capacity Evaluations (FCEs), and is trained in the application of kinesiotaping as well. She joined our KORT team in 2004.