Health Resolutions

Welcome to my site! I’m excited to begin posting information and tips to help my patients become healthier and happier. This site is coupled with my newsletter and will give more detailed information about the subjects I address in the newsletter as well as answers to the monthly crossword puzzle. You can write comments, make suggestions and ask questions. I’m looking forward to connecting with you in this new and unique way…….Now lets get started on a healthier you!

Food Safety

cookingforwebsite

FDA Recommends Four Steps to Food Safety

1. CLEAN: Wash hands and surfaces often

Bacteria can be spread throughout the kitchen and get onto hands, cutting boards, utensils, counter tops and food.  To ensure that your hands and surfaces are clean, be sure to:

  • Wash your hands with warm water and soap for at least 20 seconds before and after handling food and after using the bathroom, changing diapers and handling pets.
  • Wash your cutting boards, dishes, utensils and counter tops with hot soapy water after preparing each food item and before you go on to the next food.
  • Consider using paper wash them often in towels to clean up kitchen surfaces. If you use cloth towels the hot cycle of your washing machine.
  • Rinse fresh fruits and vegetables under running tap water, including those with skins and rinds that are not eaten.
  • Rub firm-skin fruits and vegetables under running tap water or scrub with a clean vegetable brush while rinsing with running tap water.
  • With canned goods, remember to clean lids before opening

2. SEPARATE: Separate raw meats from other foods

Cross-contamination can occur when bacteria are spread from one food product to another. This is especially common when handling raw meat, poultry, seafood and eggs. The key is to keep these foods—and their juices—away from ready-to-eat foods. To prevent cross-contamination, remember to:

  • Separate raw meat, poultry, seafood and eggs from other foods in your grocery-shopping cart, grocery bags and in your refrigerator.  Bag your raw meats in the store at the meat counter
  • Use one cutting board for fresh produce and a separate one for raw meat, poultry and seafood.
  • Never place cooked food on a plate that previously held raw meat, poultry, seafood or eggs.
  • Don’t reuse marinades used on raw foods unless you bring them to a boil first. 

3. COOK: Cook to the right temperatures


Food is safely cooked when it reaches a high enough internal temperature to kill the harmful bacteria that cause illness. To ensure that your foods are cooked safely, always:

  • Use a food thermometer to measure the internal temperature of cooked foods. Check the internal temperature in several places to make sure that the meat, poultry, seafood, eggs or dishes containing eggs are cooked to safe minimum internal temperatures.
  • Cook ground meat or ground poultry until it reaches a safe internal temperature. Color is not a reliable indicator of doneness.
  • Cook eggs until the yolk and white are firm. Only use recipes in which eggs are cooked or heated thoroughly
  • When cooking in a microwave oven, cover food, stir, and rotate for even cooking. If there is no turntable, rotate the dish by hand once or twice during cooking.
  • Always allow standing time, which completes the cooking, before checking the internal temperature with a food thermometer. Food is done when it reaches the safe minimum internal temperature.
  • Bring sauces, soups and gravy to a boil when reheating.

 

4. CHILL: Refrigerate foods promptly


Refrigerate foods quickly because cold temperatures slow the growth of harmful bacteria. Do not over-stuff the refrigerator. Cold air must circulate to help keep food safe. Keeping a constant refrigerator temperature of 40ºF or below is one of the most effective ways to reduce the risk of food-borne illness. Use an appliance thermometer to be sure the temperature is consistently 40ºF or below and the freezer temperature is 0ºF or below. To chill foods properly:

  • Refrigerate or freeze meat, poultry, eggs, seafood and other perishables within 2 hours of cooking or purchasing. Refrigerate within 1 hour if the temperature outside is above 90ºF
  • Never thaw food at room temperature, such as on the counter top. Food must be kept at a safe temperature during thawing. There are three safe ways to defrost food: in the refrigerator, in cold water, and in the microwave. Food thawed in cold water or in the microwave should be cooked immediately.
    • Always marinate food in the refrigerator.
    • Divide large amounts of leftovers into shallow containers for quicker  cooling in the refrigerator.
    • Use or discard refrigerated food on a regular basis.

Food Safety

FDA Recommends Four Steps to Food Safety

1. CLEAN: Wash hands and surfaces often

Bacteria can be spread throughout the kitchen and get onto hands, cutting boards, utensils, counter tops and food.  To ensure that your hands and surfaces are clean, be sure to:

  • Wash your hands with warm water and soap for at least 20 seconds before and after handling food and after using the bathroom, changing diapers and handling pets.
  • Wash your cutting boards, dishes, utensils and counter tops with hot soapy water after preparing each food item and before you go on to the next food.
  • Consider using paper wash them often in towels to clean up kitchen surfaces. If you use cloth towels the hot cycle of your washing machine.
  • Rinse fresh fruits and vegetables under running tap water, including those with skins and rinds that are not eaten.
  • Rub firm-skin fruits and vegetables under running tap water or scrub with a clean vegetable brush while rinsing with running tap water.
  • With canned goods, remember to clean lids before opening

2. SEPARATE: Separate raw meats from other foods

Cross-contamination can occur when bacteria are spread from one food product to another. This is especially common when handling raw meat, poultry, seafood and eggs. The key is to keep these foods—and their juices—away from ready-to-eat foods. To prevent cross-contamination, remember to:

  • Separate raw meat, poultry, seafood and eggs from other foods in your grocery-shopping cart, grocery bags and in your refrigerator.  Bag your raw meats in the store at the meat counter
  • Use one cutting board for fresh produce and a separate one for raw meat, poultry and seafood.
  • Never place cooked food on a plate that previously held raw meat, poultry, seafood or eggs.
  • Don’t reuse marinades used on raw foods unless you bring them to a boil first. 

3. COOK: Cook to the right temperatures


Food is safely cooked when it reaches a high enough internal temperature to kill the harmful bacteria that cause illness. To ensure that your foods are cooked safely, always:

  • Use a food thermometer to measure the internal temperature of cooked foods. Check the internal temperature in several places to make sure that the meat, poultry, seafood, eggs or dishes containing eggs are cooked to safe minimum internal temperatures.
  • Cook ground meat or ground poultry until it reaches a safe internal temperature. Color is not a reliable indicator of doneness.
  • Cook eggs until the yolk and white are firm. Only use recipes in which eggs are cooked or heated thoroughly
  • When cooking in a microwave oven, cover food, stir, and rotate for even cooking. If there is no turntable, rotate the dish by hand once or twice during cooking.
  • Always allow standing time, which completes the cooking, before checking the internal temperature with a food thermometer. Food is done when it reaches the safe minimum internal temperature.
  • Bring sauces, soups and gravy to a boil when reheating.

 

4. CHILL: Refrigerate foods promptly


Refrigerate foods quickly because cold temperatures slow the growth of harmful bacteria. Do not over-stuff the refrigerator. Cold air must circulate to help keep food safe. Keeping a constant refrigerator temperature of 40ºF or below is one of the most effective ways to reduce the risk of food-borne illness. Use an appliance thermometer to be sure the temperature is consistently 40ºF or below and the freezer temperature is 0ºF or below. To chill foods properly:

  • Refrigerate or freeze meat, poultry, eggs, seafood and other perishables within 2 hours of cooking or purchasing. Refrigerate within 1 hour if the temperature outside is above 90ºF
  • Never thaw food at room temperature, such as on the counter top. Food must be kept at a safe temperature during thawing. There are three safe ways to defrost food: in the refrigerator, in cold water, and in the microwave. Food thawed in cold water or in the microwave should be cooked immediately.
    • Always marinate food in the refrigerator.
    • Divide large amounts of leftovers into shallow containers for quicker  cooling in the refrigerator.
    • Use or discard refrigerated food on a regular basis

    •  

Diabetes and Hypertension

Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mmHg) and recorded as two numbers—systolic pressure (when the heart beats – the higher number) over diastolic pressure (when the heart relaxes between beats –the lower number).

Blood pressure rises and falls during the day depending upon your level of activity.  When it stays elevated over time, then it’s called high blood pressure. High blood pressure is dangerous because it makes the heart work very hard, and the high force of the blood flow can hurt the blood vessels that supply the heart, kidneys, brain, and eyes. High blood pressure often has no warning signs or symptoms. Once it occurs, it usually lasts a lifetime. If uncontrolled, it can lead to heart and kidney disease, stroke, blindness, even death.

High blood pressure can be controlled if you take these steps:

■ Maintain a healthy weight

■ Engage in moderate physical active on most days of the week

■ Follow a healthy eating plan, which includes foods lower in sodium

■ Do not smoke; if you drink, only drink in moderation

■ Take prescribed blood pressure medication daily

Blood pressure can be unhealthy even if it stays only slightly above the normal level of less than 120/80 mmHg. The more blood pressure rises above normal, the greater the health risk.

Studies show that blood pressures were reduced with an eating plan that is low in saturated fat, cholesterol, and total fat and higher in fruits, vegetables, and fat-free or low-fat milk and milk products. This eating plan—known as the DASH eating plan—also includes whole grain products, fish, poultry, and nuts. It has less lean red meat, sweets, added sugars, and sugar-containing beverages compared to the typical American diet. It is rich in potassium, magnesium, and calcium, as well as protein and fiber.

The DASH eating plan follows heart healthy guidelines to limit saturated fat and cholesterol. It focuses on increasing intake of foods rich in nutrients that are expected to lower blood pressure, mainly minerals (like potassium, calcium, and magnesium), protein, and fiber.

dash

Grains – 6-8 servings – A serving =1 slice bread or 1 oz dry cereal or 1/2 cup cooked rice, pasta, or cereal

Vegetables – 4-5 servings – A serving =1 cup raw leafy vegetable or 1/2 cup cut-up raw or cooked vegetable or 1/2 cup vegetable juice

Fruits – 4-5 servings – A serving = 1 medium fruit or  1/4 cup dried fruit or  1/2 cup fresh, frozen, or canned fruit or 1/2 cup fruit juice

 Fat-free or low-fat milk and milk products – 2-3 servings – A serving = 1 cup milk or yogurt or 11/2 oz cheese

 Lean meats, poultry, and fish – 6 oz or less of poultry, fish, or lean meat

 Nuts, seeds, and legumes- 4-5 servings per week – A serving = 1/3 cup or 11/2 oz nuts or 2 Tbsp peanut butter or 2 Tbsp or 1/2 oz seeds or 1/2 cup cooked legumes (dry beans and peas)

 Fats and oils2-3 servings –– A serving = 1 tsp soft margarine or 1 tsp vegetable oil or 1 Tbsp mayonnaise  or 2 Tbsp salad dressing

 Sweets and added sugars –-5 or less serving per week – 1 Tbsp sugar or 1 Tbsp jelly or jam or 1/2 cup sorbet, gelatin or1 cup lemonade

*Whole grains are recommended for most grain servings as a good source of fiber and nutrients.

**Eating plan shown is based on 2,000 calories a day.

 The DASH eating plan can be adopted to promote weight loss. It is rich in lower-calorie foods, such as fruits and vegetables. You can make it lower in calories by replacing higher calorie foods such as sweets with more fruits and vegetables—and that also will make it easier for you to reach your DASH goals. Here are some examples:

Increase fruits—

● Eat a medium apple instead of four shortbread cookies. You’ll save 80 calories.

●Eat 1/4 cup of dried apricots instead of a 2-ounce bag of pork rinds. You’ll save 230 calories.

 Increase vegetables—

●Have a hamburger that’s 3 ounces of meat instead of 6 ounces. Add a 1/2-cup serving of carrots and a 1/2-cup serving of spinach. You’ll save more than 200 calories.

 ●Instead of 5 ounces of chicken, have a stir fry with 2 ounces of chicken and 1 1/2 cups of raw vegetables.

●Use a small amount of vegetable oil to stir fry. You’ll save 50 calories.

 Increase fat-free or low-fat milk products—

●Have a 1/2-cup serving of low-fat frozen yogurt instead of a 1/2-cup serving of full-fat ice cream. You’ll save about 70 calories

 Calorie-saving tips:

●Use fat-free or low-fat condiments.

●Use half as much vegetable oil, soft or liquid margarine, mayonnaise, salad dressing, or choose available low-fat or fat-free versions.

●Eat smaller portions—cut back gradually.

●Choose fat-free or low-fat milk and milk products.

●Check the food labels to compare fat content in packaged foods—items marked fat-free or low-fat are not always lower in calories than their regular versions.

●Limit foods with lots of added sugar, such as pies, flavored yogurts, candy bars, ice cream, sherbet, regular soft drinks, and fruit drinks.

●Eat fruits canned in their own juice or in water.

●Add fruit to plain fat-free or low-fat yogurt.

●Snack on fruit, vegetable sticks, unbuttered and unsalted popcorn,or rice cakes.

●Drink water or club soda—zest it up with a wedge of lemon or lime.

Thirty minutes of moderate-intensity physical activity each day can help.

●If your blood pressure is moderately elevated, 30 minutes of brisk walking on most days a week may be enough to keep you off medication.

●If you take medication for high blood pressure, 30 minutes of moderate physical activity can make your medication work more effectively and make you feel better.

●If you don’t have high blood pressure, being physically active can help keep it that way. If you have normal blood pressure—but are not active—your chances of developing high blood pressure increase, especially as you get older or if you become overweight or obese or develop diabetes.

Getting started: Your physical activity program can be as simple as a 15-minute walk around the block each morning and evening. Gradually build up your program and set new goals to stay motivated. The important thing is to find something you enjoy, and do it safely. And remember—trying too hard at first can lead to injury and cause you to give up. If you have a chronic health problem or a family history of heart disease at an early age, be sure to talk with your doctor before launching a new physical activity program.

1. Set a schedule and try to keep it.

2. Get a friend or family member to join you. Motivate each other to keep it up.

3. Cross-train. Alternate between different activities so you don’t strain one part of your body day after day.

4. Set goals.

5. Reward yourself. At the end of each month that you stay on your exercise program, reward yourself with something non-food related—new clothes, a compact disc, a new book—something that will help keep you committed.

 

Vaccines across the lifespan – more information

Flu vaccine:  Influenza (“flu”) is a contagious disease that spreads around the United States every winter, usually between October and May.  Flu is caused by the influenza virus, and can be spread by coughing, sneezing, and close contact. Anyone can get flu, but the risk of getting flu is highest among children. Symptoms come on suddenly and may last several days. They can include:

• fever/chills

• sore throat

• muscle aches

• fatigue

• cough

• headache

• runny or stuffy nose

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Flu can make some people much sicker than others. These people include young children, people 65 and older, pregnant women, and people with certain health conditions—such as heart, lung or kidney disease, or a weakened immune system. Flu vaccine is especially important for these people.  Flu vaccine will be available soon at the Family Health Center.  It can also be obtained from many pharmacies and some drive-by flu injection sites.

Flu viruses are constantly changing. That’s why each year’s flu vaccine is made to protect from viruses that are most likely to cause the flu that year. While flu vaccine cannot prevent all cases of flu, it is our best defense against the disease. Inactivated flu vaccine (the kind that you get by injection) protects against 3 or 4 different influenza viruses and takes 2 weeks before it will provide you with protection – but that protection lasts several months to a year.

Td vs Tdap: TD is the vaccine for tetanus and diptheria.  It is recommended for all adults every 10 years, or if you sustain a high-risk injury your doctor will give you a dose if it is > 5 years since your last tetanus shot.  Tdap is a vaccine for tetanus, diptheria and pertussis (whooping cough).  Most everyone has had the Tdap as a child, but until recently it was thought that immunity to pertussis was lifelong.  We now know differently.  Immunity to pertussis fades and revaccination is very important, especially for those over age 50 years – the age of most grandparents.   During 2012, more than 48,000 cases of whooping cough were reported across the United States, including 20 deaths. All adults are recommended to get a dose of Tdap vaccine, which protects against whooping cough. It does not matter how long ago your last Td vaccine was – it’s ok to have the Tdap at any time.  Serious illness and death is most common among infants, so it is especially important that pregnant women, parents, family members (especially grandparents) , and anyone else in contact with young infants is up to date with their pertussis vaccination.

Whooping cough is very contagious and most severe for babies. People with whooping cough usually

spread the disease by coughing or sneezing while in close contact with others, who then breathe in the bacteria that cause the disease. Many babies who get whooping cough are infected by family or friends who might not even know they have the disease and who, although vaccinated years ago, now are no longer immune.

About half of babies younger than 1 year of age who get the disease need treatment in the hospital. About 1 in 4 hospitalized babies with whooping cough get pneumonia (lung infection), and about 2 in 3 babies will have trouble breathing. Whooping cough can be deadly for 1 or 2 in 100 babies who are hospitalized.  Because the disease can make babies so sick, and they can catch it from anyone around them, they need protection. These are the three important ways you can help provide that protection:

  • All pregnant women should be vaccinated in their third trimester
  • Vaccinated family members and caregivers are the only people who should be allowed to come in contact with very young babies
  • Babies should get all recommended doses of his whooping cough vaccine

I have attached the recommended vaccine charts from the CDC for children, teens and adults.  You can also visit the CDC site at http://www.cdc.gov/vaccines/adults/index.html.  This site has much information about all the vaccines recommended as well as about other vaccines recommended for travelers outside the United States.