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31/Mar/2015

An estimated 1 in every 12 adults are living with alcohol abuse or dependence.

Alcohol Abuse is an often and seemingly socially acceptable behavior that affects millions of people in the United States. In fact, according to the CDC, 88000 deaths per year are linked to excessive alcohol use.

WHAT is alcohol abuse?

Alcohol Abuse or alcoholism is a chronic disease recognized by the following 4 symptoms:

Cravings (the urge to drink)
Loss of Control (Not being able to stop once drinking has begun)
Tolerance (The need to drink greater amounts of alcohol for the desired psychological effect.)
Physical Dependence (Withdrawal symptoms after stopping drinking: nausea, sweating, shakiness, anxiety).

But everyone drinks alcohol! Why should I be worried?

Other than the emotional and financial impact alcohol abuse can have on your life, it also ravages your body; excessive alcohol use affects ALL of you organ systems!

The most commonly known outcomes of alcohol abuse are:

Liver diseases – hepatitis, cirrhosis
Gastrointestinal complaints – gastritis, pancreatitis
Neurological impairment – dementia, neuropathy
Cardiovascular problems – hypertension, heart attacks
Unintentional Injuries – motor vehicle accidents, drowning, falls
Alcohol abuse can even lead to the development of diabetes!

What can I do?

Although there is treatment for alcohol abuse, there currently is no ultimate cure. Preventing the development of this condition is the best course of action for anyone. In order to play it safe, the U.S. Department of Health recommends that women do not imbibe more than one drink per day.

If you feel that you may have a problem with alcohol or are uncertain, discussion is the first step. Schedule an appointment to talk to your doctor as soon as you are able. Your physician can help determine whether your habits need correction and, if necessary can help you find an optimal treatment program which can include counseling and/or medications.

If you are not ready to talk to a doctor, please explore the following resources:

www.ncadd.org – National Council on Alcoholism and Drug Dependence

www.niaaa.nih.gov – National Institute on Alcohol Abuse and Alcoholism

www.recovery.org – Connecting people and their families with the information and resources to help them recover from substance abuse and behavioral disorders.

Don’t allow your life and health to be washed away – talk to your Primary Care Provider today!

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25/Mar/2015

With the Broad Street Run coming up, it’s important to properly fuel your body. Everything you eat and drink leading up to the run has a direct impact on performance. In order to help you better prepare, our dietitian, Theresa Shank, RD LDN has outlined the best advice to strengthen your body for this year’s race.

Hydration: Because of the high level of exercise your body is about to endure, hydration is key to regulating body temperature throughout the race. Not only is body temperature a concern, but also without proper hydration your body may experience muscle cramping, which can make for a very unpleasant Broad Street Run.

Pre-exercise: Drink at least 16 ounces of water or sports drink an hour or two before the race.

During: Drink 5-12 ounces of water or sports drink every 15-20 minutes during your run.

*Don’t drink TOO much. If you start to hear “sloshing” in your stomach or nauseous then wait at least 15 minutes before drinking more.

Post exercise: Drink 16-30 ounces of water or sports drink.

*Because you are running 10 miles, a sports drink with 5-8% of carbohydrate (Look at Daily Value Percentage) is appropriate for achieving proper hydration and replenishing of glycogen stores.

Pre-Exercise Nutritional Goals: It is important to prepare your body with adequate nutrition in the hours leading up to your 10 mile run. Two-three hours before the race, eat a full meal with at least 50 grams of carbohydrate.

Example: A bagel with a tablespoon of peanut butter

Pre-Exercise Fuel (30 minutes – one hour before): 30 grams of Carbohydrate

You want to eat a snack in at least an hour before the race that contains carbohydrates, protein, and a little bit of fat to power through your run.

Examples:

6 ounces of Greek yogurt w/10 almonds and ½ cup fresh/frozen berries
2 slices of whole wheat bread with 1 Tbsp. of peanut butter and 2 tsp. of fruit preserves
1 hard-boiled egg, a slice of whole wheat toast and a small piece of fruit
1 English muffin with ½ banana and 1 Tbsp. of almond butter
8-ounce smoothie with 1-cup plain Greek yogurt, ½ banana, 1 Tbsp. peanut butter, ½ cup orange juice or low-fat milk, and ½ Cup ice. (blend together)

Post Exercise Fuel:

After the race, your body is continuing to burn calories. You must ensure proper nutrition after the event to replenish your body with the energy it lost. Focus on eating a small snack with a 4:1 carbs to protein ration within the first 15 minutes after your run. Choose a snack low in fat and fiber to insure proper digestion. Later, within two hours after your run eat a balanced meal.

Post Workout Snack Examples:

1 Cup of oatmeal with ½ cup frozen berries or ½ banana
8 ounces Greek yogurt with 1 piece of fruit
1 slice of whole wheat bread with 2 slices of turkey and 1 slice of low-fat cheese
Sweet potato with lean protein
8 ounces low-fat/non-fat chocolate milk

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24/Mar/2015

Spring is on its way! Along with budding trees and flowers comes pollen — a common trigger for allergies. Limiting the frequency and duration of your exposure to pollen can prevent or decrease symptoms and reduce your need for medications. For those who suffer from spring allergies here are a few tips to make the season more enjoyable.

Limit outdoor activities when pollen counts are the highest, between 5am and 10am.
Pay attention to pollen reports, available with the daily weather report and online, and stay indoors when counts are high. Dry, windy days are more likely to have large amounts of pollen in the air than damp, rainy days when most pollen is washed to the ground.
Keep windows and doors closed to keep pollen from drifting into your house. Likewise, keep your car windows rolled up and sunroof closed when you drive and adjust your ventilation system to re-circulate inter-compartment air instead of drawing air from outside.
Pollen can accumulate on your clothes and hair while you are outdoors. Remove your shoes at the door and change out of clothes you’ve worn outside. Shower to rinse pollen from your skin and hair. Your pet’s fur presents a similar problem. Though it is certainly not practical to bathe your dog every night, try to keep pets off of the furniture and out of your bed so that you will limit your exposure.
Wash bedding often and always machine dry. Pollen may collect on laundry if it is hung outside.
Rinse out your nasal passages once you are inside for the day or before you go to bed. If you can’t get the hang of a neti pot, pick up a reusable nasal irrigation kit available at most pharmacies.

Maria Mazzotti, D.O.

02/Mar/2015

As spring comes along, some of us are starting to think about our summer vacation plans. If you are one of those people who is considering traveling to an area that requires updating your vaccines or getting vaccines that are not required growing up in the United States, it is never too early to get started with your Travel Visit.

There are a few things to keep in mind before traveling:

Schedule your travel appointment as soon as possible. We recommend 4-6 weeks in advance.
Have a list of your medical problems, medications, allergies and your doctors name and phone numbers.
If you have artificial devices in your body.
Insurance companies may or may not pay for the travel visit, vaccines and medications.
Some vaccines require more than one shot.
We do not carry the Yellow Fever Vaccine. You are able to do a travel visit with one of our doctors and then they will give you a Rx to get the vaccine injected at a local pharmacy.
Check with your insurance company if you require more medication for extended vacations.

How to prepare for your travel visit:

Have your travel itinerary with you at the time of your visit.
Have a copy of your previous vaccines.

Scheduling a travel visit will help to ensure that you make the best out of your trip!

Theresa Shank, Registered Dietitian

26/Feb/2015

With Memorial Day right around the corner, we asked Theresa Shank, our registered dietitian what she recommends clients to have in their kitchens to help them lose unwanted winter pounds. Here is what she had to say:

There are many items that are important to have in a healthy kitchen while trying to lose weight, but I won’t bore you with that and just keep it simple by recommending my “must haves.”

Fresh Fruit: Don’t over fruit. Even though fruit is loaded with nutrients and antioxidants, its natural sugar content can be troubling for weight loss. I recommend limiting fruit intake to 1- two servings per day. My favorite picks are apples, grapefruit, blueberries, strawberries, cantaloupe and pears.

Fresh seasonal vegetables or frozen vegetables: the more vegetables you eat the leaner you will be, so aim for at least 5 servings a day. * One vegetable serving counts as a ½ cup cooked or 1 cup raw.

Chia or Hemp Seeds: These seeds are good sources of Omega 3’s and fiber. Try adding to salads, oatmeal or smoothies. * Omega 3 fatty acids aid in decreasing cholesterol, depression, joint pain, diabetes and improve the health of your skin and hair.

Greek Yogurt: Fage and Siggi’s are my favorite brands. I always recommend Greek yogurt because it is higher in protein, making it more satiating than other yogurts. Siggi’s is the only flavored yogurt that I recommend because of its low sugar content in comparison to other flavored yogurts. For example, Siggi’s vanilla flavored yogurt contains just 9 grams of sugar, that’s only 2 more grams of sugar than Fage’s plain Greek yogurt. Can’t beat that!

Grains: Incorporate grains into your meals to help keep you feeling full longer. Grains provide nutrients such as B vitamins, folic acid, fiber and protein. I recommend limiting grains to 1-2 servings (think the size of your fist) per day. My go to grains are quinoa, black or wild rice and oats (make sure they are hand rolled, never instant)

Sprouted Bread: Sprouted grain bread vs. store bought whole wheat bread has higher nutrients such as niacin, B6, folate and protein. Some sprouted grain breads are also noted to contain less carbohydrate than the average slice of whole wheat bread because some of the carbohydrate content is lost in the sprouting process; making it an all-around better choice.

Lean Proteins: Organic poultry, eggs, and wild caught fish are a must in my kitchen. If you are a vegetarian, I caution you to leave the overly processed “meat substitutes” alone! Instead, try tofu, seitan or tempeh, which lend themselves well to various vegetarian dishes such as homemade burgers, stir-fry’s or veggie chili. The possibilities are endless! * I encourage clients to consume fish at least 3-4 times per week during weight loss efforts.

Olive oil and nut butters: Don’t let the myth that nut butters and oils make you fat, stop you from incorporating these essentials into your diet. Instead, limit you intake of added fat to 1 tbsp. per meal to insure your body the healthy fat it needs while preventing the excess intake that causes weight gain. If you are feeling adventurous try substituting coconut oil, cashew oil or grape seed oil the next time your dish calls for olive oil.

Audrey Hasse, Registered Dietitian

26/Jan/2015

The days are cold, the skies are gray, and the motivation to eat healthy and exercise is harder and harder to find. Staying on track during the winter months is always a challenge, but one that you can conquer if you create a healthy plan and stick to it. Here are some tips for healthy eating and exercise to help you stay on track during the seemingly endless winter season.

Healthy Eating

Think Ahead: Before starting another hectic week, take a few minutes to plan ahead for the meals and snacks you are going to eat that week. Create a shopping list, and hit the grocery store to stock up on everything you will need.
Cook Ahead: Now that you have all of the healthy ingredients, make as much food as you can while you have some extra time to ease the stress of weeknight cooking.
Get Creative: Find new recipes, try new dishes, and turn the same old veggies and protein into something new and exiting.
Find a Friend: If you feel your motivation waning, recruit a friend to join in the challenge of staying healthy. Motivate one another and find the fun of healthy living once again.
Purge Your Kitchen: Before we know it, unhealthy food has crept back into our pantries. Take a few minutes to purge your kitchen of all the junk, and start again with a clean slate of only healthy options.
Here’s a hearty and healthy chili recipe to help inspire some creative cooking.

Butternut Squash Chipotle Chili with Avocado

Modified from Cookie and Kate

INGREDIENTS

1 medium red onion, chopped
2 red bell peppers, chopped
1 small butternut squash (1½ pounds or less), peeled and chopped
4 garlic cloves, pressed or minced
2 tablespoons olive oil
ground sea salt
1 tablespoon chili powder
1 teaspoon ground cumin
½+ Tbsp chopped chipotle pepper in adobo* (start with ½ tablespoon and add more to taste)
1 bay leaf
¼ teaspoon ground cinnamon
14-ounce can diced tomatoes, including the liquid**
4 cups cooked black beans or 2 cans, rinsed and drained
14-ounce can (about 2 cups) vegetable broth
2 Avocados

INSTRUCTIONS

In a 4 to 6 quart Dutch oven or stockpot, sauté the chopped vegetables (onion, bell pepper, butternut squash, garlic) in one to two tablespoons of olive oil on medium-high heat. You’ll need to stir the ingredients every few minutes so they can cook evenly.
Once the onions start turning translucent, turn the heat down to medium-low. Add all of the spices and canned ingredients, and stir. Cover for about one hour, stirring occasionally. Taste test for spice level and add more chipotle if desired.
By the time your chili is done, the butternut squash should be nice and tender and the liquid should have reduced a bit, producing the hearty chili consistency.
Serve the chili in individual bowls with plenty of diced avocado. You can add a little sprinkle of red pepper flakes and cilantro to garnish (optional).

Exercise

Try Something New: Find a new class to try, jump on a new machine at the gym, or maybe hop in the pool to help spice up your workouts. Just when you are getting bored with your current routine, find something new to get you motivated once again
Ditch The Excuses: Don’t let the never-ending list of excuses get in your way. Ignore that little voice in your head that is always making up reasons not to workout.
Make Workout Appointments: Set aside specific time every day in your schedule, literally block it out on your calendar, for exercise, making it a priority each and every day.
Find a Friend: When you know your friend is waiting for you at the gym, you are more likely to get there. Find a friend to hold you accountable and try new workouts together.
Set An Event Goal: Sign up for a race a few months away, (The Broad Street Run, for example) and use that as motivation to get training. When you have a goal in the future and a reason to workout every day, you are more likely to stay on track.

Here’s a workout you can do right in your living room. You don’t even have to leave your house!

Warm up

25 jumping jacks
Go up and down your stairs

Repeat 4 times

Workout: 10 reps of each exercise as many times as you can in 30 minutes

Squats
Pushups
Lunges
Tricep dips on your coffee table or couch
Sit ups
Lateral lunges

Jillan Rowbotham, D.O.

02/Jan/2015

2015 has made an arrival and now is the time to consider making some resolutions. These goals will help you focus on a healthier you in the new year.

1. Be informed about what you are consuming

If you are not in the habit of reading food labels I highly recommend it. Many people underestimate calorie, fat, and sodium content and overestimate portion size. Even with reading individual labels it can be hard to keep track of your total consumption throughout the day. Keeping a food diary can make this easier and there are many websites and apps that make it less time consuming and more informative. Livestrong.com and Sparkpeople.com are two popular sites that also have phone apps.

2. Start moving

You don’t have to join a gym or start running marathons to be healthy. Take a class, do an exercise video at home, or walk on your lunch break. As a general goal you should aim for at least 30 minutes of physical activity every day but this can be broken up into three 10-minute sessions if you don’t have 30 minutes in a row available. Weight training is an important part fitness and weight loss plans. Meeting with a personal trainer can help you learn what weights and exercises will best help you meet your goals.

3. Eliminate tobacco

If you don’t smoke, don’t start. “Social smoking” still counts as smoking; consider making this the last year you light up when having a drink. Even those occasional cigarettes add up over time. If you are not ready to quit right now at least pause to consider it – is there a goal time, even if it is far in the future, you would like to be quit by (ie your wedding or a child’s graduation)? What would change in your life if you were no longer smoking? Just thinking about quitting can bring you closer to being ready. If you are ready to quit and would like some help please come in and see us. Even if you aren’t able to stay quit you are still better off than if you didn’t try.

4. Increase your water intake

Most of us don’t drink enough water. The Institute of Medicine determined that adequate daily intake for a woman is 2.2 liters, which is just a little more than the classic “eight 8-ounce glasses” or 64 ounces. You need more when you are exercising, sick, pregnant or breastfeeding, or in a warmer climate. Staying well hydrated helps your skin and other important organs and can fight off fatigue and hunger. Count up the amount of non-caffeinated fluid you are drinking in a day – how close to 64 ounces are you?

5. Get enough sleep

Most adults need seven to eight hours of sleep, six is generally not enough. Getting a good night’s rest can help you function better in every aspect of your waking life. Cutting out some screen time or having the kids help more around the house can help get you into bed earlier. Make this the year you seek help if you suffer from chronic insomnia or anxiety that prevents you from getting sleep.

6. Moderate caffeine intake

A moderate amount of caffeine is 200 to 300 milligrams (mg) or about two to four 8-ounce cups of brewed coffee a day. Don’t forget to count caffeine in tea (black, green, or iced tea), soda, and hot chocolate. Because caffeine can interfere with your sleep cycle even if you do not have problems falling asleep, I recommend finishing your last caffeinated beverage at least eight hours before you go to bed.

7. Moderate alcohol intake

If you drink alcohol, do so in moderation. Moderate intake for a woman is one drink a day. One drink is considered 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor.

8. Manage stress

Stress symptoms can affect your body, thoughts, feelings, and behavior. Stress can cause many physical symptoms including headaches, digestive issues, chest pain, memory problems, and eczema, to name a few. Stress that is left unchecked can contribute to health problems such as high blood pressure, heart disease, obesity, and diabetes. Managing your stress is an important part of any healthy lifestyle. Regular exercise, particularly yoga and tai chi, getting enough sleep, practicing relaxation techniques, and maintaining a good social support system can help reduce stress. Many people benefit from professional counseling to find stress management strategies that work for them.

9. Stay up to date with routine screening tests

Depending on your age and other risk factors this may include PAP smears, mammograms, colonoscopies, cholesterol screening, etc. Not sure if you are due for anything? An annual physical provides a good opportunity to review current screening recommendations and get up to date.

10. Be an active participant in your health

Learn what you can about any health conditions you have and stay informed about what conditions run in your family. Know what prescriptions, over-the-counter medicines, and supplements you are taking and what they are for. Keep track of the dates of your most recent screening tests and any abnormal results. We are always happy to provide a copy of your labs to you and to go over anything you may have questions on – just ask!

Theresa Shank, Registered Dietitian

02/Jan/2015

Start this New Year off right by purchasing kitchen tools that support healthy cooking and eating. Our registered dietitian, Theresa Shank, has shared her favorite kitchen must have for 2015 to keep your motivation for healthy eating strong and your belly full of wholesome nutrition!

The Spiralizer

This simple kitchen tool is the latest gadget taking healthy kitchens by storm! The spiralizer can turn vegetables such as zucchini, carrots, sweet potatoes, or squash into spaghetti “noodles”.

Whether you are a vegetable lover, a low carb monitor, paleo fanatic, or have gluten intolerance, you’ll want to purchase this tool for your healthy kitchen!

The spiralizer can be found at most kitchenware stores such as William and Sonoma or on websites such as Amazon.

Try one of my favorite recipes using a spiralizer from SkinnyTaste.com

http://www.skinnytaste.com/2014/04/zucchini-noodles-zoodles-with-lemon.html

Theresa Shank, Registered Dietitian

25/Nov/2014

Halloween candy, Thanksgiving feasts and holiday parties; the last couple of months until the end of the year can test the limits of even the most disciplined weight watcher. Registered dietitian, Theresa Shank, has provided us with simple tips to avoid weight gain during the holiday.

Stay Mindful
Try to remember that the holiday season is about more than just food. Next time you go to a holiday party, take time to admire the decorations. If there is entertainment, be sure to enjoy it. Focus on visiting with friends and family whom you haven’t seen in a long time. That said, be honest and acknowledge that it would be unrealistic not to indulge in some holiday treats. The key is to do it mindfully, and in moderation.

Do Not Show Up Hungry
Indulge with a purpose. Do not show up to the party starving. Some people will skip breakfast and lunch because they want to save calories for their holiday feast. This is a big mistake because most people are then ravenous and end up eating more than they typically would. I encourage clients to eat something small as opposed to skipping an entire meal. Try having a yogurt with fruit and nuts for breakfast and a protein shake blended with fruits and veggies, this way you can get in your fruit and vegetables before carbohydrate and sweet overload.

Plan Your Plate
Set boundaries. Do not go on autopilot the moment the food is on the table; instead survey your options before piling up your plate. Once you observe your options, choose two options from the less healthy dishes and for the rest of your meal stick to healthier options, such as lean meat, complex carbohydrates and vegetables. To ensure that there is a healthy option available, offer to bring one yourself such as a salad with root vegetables or a side such as quinoa or roasted sweet potatoes.

Alcohol
The holidays are a time for cheering and making toasts. I am not suggesting that you do not drink but I do encourage clients to limit themselves to two drinks per gathering. Two drinks average anywhere from 200- 250 calories, which is the amount I suggest for snacks. Once you hit 3-4 drinks you are hovering close to 500 calories, which doesn’t account for the calories that are coming from your food indulgence. Be smart and drink less. Alcohol causes hangovers, which may cause you to skip the gym the next day. It’s a horrible cycle that can be avoided with control.

Maria Mazzotti, D.O., Board Certified Physician

25/Nov/2014

I often tell patients to wait for the first cold week of the fall/winter season to stop their allergy medications. And while that works for a lot of people, I am forgetting that the holidays can also be a source of allergy flares. This is due to exposure to mold, dust mites, seasonal greenery/decorations live and artificial and foods .

During the holiday season the weather gets colder so we tend to keep the door sand windows shut more than in the other seasons, so the usual indoor allergens (pet dander, mold and dust mites may be higher). Another reason is that during this time of the year pets tend be indoors more increasing our exposure. Also we are bringing in live plants/trees that may have mold spores and mildew which thrive in the damp evergreens. The sap on the aromatic evergreen trees can also be source of skin irritation. When opting for the artificial decorations, keep in mind that these are also often stored in dusty/moldy basements which can be a problem for those reasons. The sometimes potent Potpourri aromas can also be a problem for asthma patients. Also keep in mind that those beautiful Poinsettia’s are in the rubber family and can cause problems for us who have latex allergies. When warming up by the wood burning fireplaces don’t forget that they can be sources of a lot of ash and smoke which may cause problems for you and your guests. And we often overlook the effects of stress which can also trigger asthma symptoms for some of us.

One other big group that causes problems this time of the year is food allergies. Often times, we do not want to disappoint friends and relatives by not trying the home made foods, but before doing so, do not forget to ask if the ingredients include something you are intolerant or allergic to. These can include milk, eggs, peanuts, tree nuts, fish, shell fish, soy and wheat. These 8 groups account for 90% of food allergies.

There are things we can do to reduce our exposure so we can still enjoy the holiday season without a trip to the doctor or ER. When handling any live trees you may want to throw on Latex free gloves so you do not come in contact with the sap from the evergreen trees. You may also want to water the trees down with your garden hose or blast them with the leaf blower before bringing them in. When handling the artificial decorations, make sure you dust them off and maybe wear a mask when doing so.

If all else fails, thankfully there are medications that can help. Antihistamines like,Benadryl, Zyrtec, Claritin and Allegra often are enough. Hydrocortisone creams can help with skin irritations also. Patients who have asthma should make sure their Albuterol inhalers are still good. Also, if you have food allergies make sure your Epipen is not expired. Sometimes, though, if you have tried a thing or two you may still need help from your doctor or need to see an allergist, so do not feel like you need to treat on your own.

Newer Posts

Older Posts

What You Need to Know About Alcohol Abuse

An estimated 1 in every 12 adults are living with alcohol abuse or dependence.

How to Fuel Your Body for the Broad Street Run

How to Manage Springtime Allergies

Ensure Safe Travels

What’s in a Registered Dietitians Kitchen?

Staying Motivated Through The Winter Months

2015 Wellness Goals

Theresa’s Healthy Kitchen ‘Must Have’ 2015

Tips To Avoid Weight Gain This Holiday

Holiday Allergens

A Note from RWWC

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