We all know that too much sugar is not good for us. Added sugars, or sugars and caloric sweeteners that are added to foods and beverages when they are processed or prepared, contribute to excess caloric intake and provide little to no nutritional value. Consequently, sugar can lead to serious health concerns, such as poor oral health, obesity, heart disease and Type 2 Diabetes.

In an effort to limit sugar intake, many of us may steer clear of cakes, cookies, candy and other foods with obvious added sugars, but we often overlook the amount of sugar present in our favorite beverages. Non-diet sodas, sweet tea, flavored coffee beverages, fruit drinks, energy drinks and sports drinks are all full of added sugars.

Dietary Guidelines
The 2010 Dietary Guidelines for Americans recommends an upper limit of 10 percent of our total daily calories from sugar. Meanwhile, the World Health Organization is currently working on a proposal that recommends this number be lowered to five percent, similar to current recommendations of the American Heart Association. This would mean an intake of 25 grams of sugar per day would meet the limit, based on a 2,000 calorie diet. To put this in perspective, one 12 oz. can of soda contains, on average, 40 grams of sugar; 15 grams above the recommendation.  So what should we do?

Choose Water
The best advice is to make water your drink of choice. If water is not your favorite beverage, make it more interesting by adding freshly squeezed lemon or orange, or make your own fruit-infused water by adding slices of strawberries, watermelon, lemons or lime in your glass or bottle. Even water infused with cucumber can be delicious and refreshing.  When you desire something with a little more zip, add a splash of 100 percent fruit juice to sparkling water.

Other favorable beverage options include decaffeinated unsweetened tea or coffee. Nonfat or low-fat milk can also be healthy in moderation as it contains important nutrients such as calcium, vitamin D and potassium. And when it comes to fruit juice, remember that it is always better to eat the whole fruit because it offers the same nutrients in addition to fiber.

Read the Labels
Additionally, be sure to read the Nutrition Facts label on your beverages carefully and be mindful of serving sizes.  Often, the serving size is less than the portion served, which would double or even triple your sugar and caloric intake if you drank the entire can, bottle or cup. 

Is it time to rethink your drink?

Talitha Ellsworth, MPH, RD, LDN, is a nutritionist with WakeMed Corporate & Community Health.

Brand name or generic?  This is the subject of a recent study conducted by The University of Chicago Booth School of Business.  The study shows overwhelmingly informed consumers in their specific fields purchase the generic items, saving a significant amount of money.  Chefs bought generic baking soda over name brand.  Pharmacists purchased store brand headache remedies over the name brand.

The reasoning is simple.  Chefs, pharmacists and doctors both know there is no reason to spend more to get the same active ingredient.

Lynn Eschenbacher, a pharmacist and manager on Raleigh Campus, explains the logic behind purchasing generic medications.

“Health care is highly regulated and all drugs in the U.S. must be approved by the U.S. Food & Drug Administration, including generic medications. For a generic medicine, the FDA reviews the product and deems it to be AB rated, which means the generic is equivalent to its brand-name counterpart.  The FDA requires generics to have the same active ingredients, although the products might have different secondary ingredients.  Basically, the generic is the same drug and will deliver the same result without paying for advertising the brand name product.”

Now that just makes cents!

Read the study

Last week at the Raleigh Campus Farmers’ Market, the Jo Co Golden Girls performed. If you missed last week’s performance, you can see part of it below. I think you’ll agree the Jo Co Girls are very talented.

7-22-14 Farmers Market Singers R1 from WakeMed Health & Hospitals on Vimeo.

The Jo Co Golden Girls are all seniors and have won gold medals for performing arts in the Johnston County Senior Games two years in a row as well as a silver medal in the NC Senior Games 2013. They are set to compete again this year in the state competition.

The group includes WakeMed, multi-talented acute care nurse Nancy White (far right). In addition to Nancy, the group comprises Mary Braswell, who is retired from the Johnston County school system, Judy Wiggs, a retired PE teacher, Barbetta Hester, who is retired from Hester Properties, and Suzanne Coates, a media specialist at Smithfield Middle School. The group performs a variety of music from 1940’s to current hits.

Aronia Berries

Every so often, a new “super food” hits the market, and people flock to it with the hopes of finding the secret to perfect health.  A long list of foods have been touted as having “superpowers,” including Acai berries, Goji berries, pomegranate juice, coconut oil, coconut water, kale and chia seeds, just to name a few.

The latest super food getting lots of attention is the Aronia berry. According to research published last year in the Journal of Agriculture and Food Chemistry, this small purple berry has one of the highest antioxidant values ever recorded when compared to any other fruit. In fact, the level of antioxidants in this berry is so high that it is too astringent to be eaten raw. Aronia berries are also high in dietary fiber, iron and vitamin C. These berries boast higher levels of quinic acid than cranberries which make them more effective in treating urinary tract infections.

Also known as the chokeberry, this fruit is indigenous to North America and has been cultivated in Russia and Eastern Europe since the last century. Farmers in the United States and Canada are now joining the race. Various companies across the country are jumping on the bandwagon to cultivate and profit from the sales of the fruit and its products such as juices, wines and baked goods. The Midwest Aronia Association’s website also offers a recipe page: http://midwestaronia.org/recipes/

So should we all start eating Aronia berries? Soon we will get questions about serving sizes and the amount of berries we need to eat daily. There is no doubt that foods have healing powers. Some foods are called “super foods” because they indeed have extra nutrients that help prevent and treat chronic diseases such as diabetes, heart disease and cancer. Hippocrates was right when he said, “Let thy food be thy medicine and thy medicine be thy food’.  Adding the right foods to your diet, especially super foods that are rich in antioxidants, can increase your immunity, and help your body fight against disease.

However, the answer is not found in any one magical food. Also, a large dose of one food is not going to give you an extra advantage. More is not always better. There are a number of vital nutrients present in all natural foods. Each food group contains many important vitamins, minerals, antioxidants and phytochemicals. If you want to get the maximum benefit from your diet, focus on variety. Eat all the different foods from each food group, especially colorful fruits and vegetables, whole grains, beans and legumes, and nuts and seeds. Expand your palate. Make sure you “eat a rainbow,” and sure, throw in a few Aronia berries in there!

Parul Kharod, MS, RD, LDN, is a clinical dietitian with WakeMed. With questions for the dietitians, e-mail askadietitian@wakemed.org. For individual nutrition counseling, call WakeMed Cary Hospital Outpatient Nutrition Services at 919-350-2358.

So you have a cut.  What do you do now?

The first sight of blood likely sends you running to the medicine cabinet to grab the hydrogen peroxide or rubbing alcohol, Neosporin®, and a Band-Aid®.  These products may actually do more harm than good and can result in slower healing, more tissue damage and potentially a bigger scar.

Summer outdoor activities bring greater opportunities for cuts and scrapes.

Cleaning the Wound
Medical professionals are now recommending against using hydrogen peroxide or rubbing alcohol to clean open wounds.  Instead, wash the area with warm soap and water and pat dry with a clean towel.  Try to avoid further traumatizing the wound.

Antibiotic Cream
Using an antibiotic cream will keep the wound from drying out, which may promote healing and kill some harmful bacteria in the wound, helping to prevent infection.  When selecting an antibiotic cream, choose Polysporin® over Neosporin.  Neosporin includes an ingredient that is an allergen for about 20 percent of the population.  An allergic reaction can slow wound healing and cause inflammation of the wound site.  For clean wounds, such as those that result from surgery, Vaseline is often the best choice.

Covering the Wound
Covering the wound with a Band-Aid is a good idea until the bleeding stops or if you are doing something that may reintroduce dirt or germs into the wound.  Otherwise, going Band-Aid free can promote faster healing.

1. Wash the impacted area with warm soap and water to remove dirt
2. Pat the area dry with a clean towel
3. Apply antibiotic cream – Polysporin preferably
4. Cover with a bandage until the bleeding and oozing stops, then leave open when there is little chance of dirt getting in the wound.

What NOT TO DO When Treating a Cut:

1. Do not use hydrogen peroxide or rubbing alcohol
2. Do not rub the wound aggressively
3. Do not choose Neosporin to keep the wound moist

Dr. Michael Soboeiro is an internal medicine physician with WakeMed Physician Practices – Garner Primary Care.  He is currently accepting new patients.

In the summer 2014 issue of WakeMed’s Families First magazine, Michele Casey, MD, executive medical director for Primary Care and Urgent Care at WakeMed Physician Practices and Fellow of the Academy of Wilderness Medicine, shared tips to prevent health problems and what to do when you encounter some of the more common pesky problems that come up frequently in the summer. Here’s what she had to say about the pesky little tick.

Some ticks carry pathogens that cause disease in humans. It’s tough to know if a tick you find poses a problem. Even experts have difficulty identifying a specific tick species within a group. “The most important thing about ticks is knowing how to properly remove them and when you need to come in to be seen,” said Dr. Casey. “We started seeing tick bites this spring.”

If you find a tick, don’t panic. If it is loosely attached or is flat, it has probably only been on someone for a short amount of time. After removing the tick (see removal tips on page 7), Dr. Casey recommends monitoring the site and watching for symptoms for approximately 1-2 weeks. If nothing appears or symptoms do not develop, there is probably nothing to worry about.

“Remember, a small amount of redness without rash can be a body’s initial, normal inflammatory response to the tick bite,” said Dr. Casey. “However, if you develop a rash, significant redness or the area looks worse over time, get it assessed by a doctor.”

Other symptoms of concern include headache, joint aches, muscle aches and fatigue. If any of these occur and are new, get checked by a doctor. A trip to the emergency room is only necessary if symptoms progress rapidly, which is rare.

“If you do need to see the doctor and are able to bring in the tick at the time of your visit, it might be helpful for identifying the type,” said Dr. Casey. “However, keep in mind that the tick won’t necessarily be identifiable nor analyzed for specific diseases.”

Tips for Tick Removal
Avoid trying removal techniques that involve matches, nail polish remover, gasoline, etc. “Burns and other risks outweigh the benefits for most of these methods,” said Dr. Casey. They might even irritate the tick more, which could cause them to regurgitate pathogens into the wound.”

• DO use fine-tipped tweezers.
• DO wear gloves if available.
• DON’T use your fingers.
• DO grab the tick at the part that is stuck in your skin.
• DON’T grab the tick around its bloated belly.
• DO gently pull the tick straight out until it lets go of your skin.
• DON’T twist and turn the tick.
• DON’T crush it because you are expelling its pathogens.
• DO consider putting the tick in a jar or sealed bag and place it in a freezer for possible identification later.

Note: Try to remove the entire tick. If most of it is removed, you generally do not need to have it checked unless other symptoms develop.

“It is normal to see a small crater or indention in the skin after tick removal,” said Dr. Casey. “Clean the area with basic soap and water. You can use peroxide initially to clean the area and add antibiotic ointment. If the area itches a lot, use a topical or oral Benadryl® (diphenhydramine). Make sure the dosage is appropriate for children.”

Learn more
CDC.gov – Ticks – Removing a Tick

Summer is the season for fresh, delicious produce. From traditional fruits and vegetables, like corn-on-the-cob and watermelon, to the not-so-common ones, such as the tomatillo and the passion fruit, everything seems to be ripe and abundant. To help you figure out what you can do with all of these seasonal goodies, here are some healthy summer recipes from WakeMed chef Jennifer Leamons. Enjoy! 

Passion Fruit Salsa
(For fish, chicken or pork)
Yield: 20 servings

Ingredients

• 5 tomatillos
• 2 ripe passion fruits
• 1 large ripe tomato 
• ½ a green pepper
• ½ a small onion
• ½ a jalapeño
• 2 tbsp. olive oil
• ¼  cup cilantro
• ½ a lime
• ¼ tsp. ground cumin
• Salt & pepper to taste

Method of Preparation:
1. Wash all vegetables, toss in olive oil and roast in oven on 400 degrees for 10 mins.
2. While hot, transfer vegetables from pan to food processor and pulse five times.
3. Add cilantro and pulse until you reach consistency you like (chunky vs. smooth).
4. Season with salt & pepper and top your favorite protein or taco .

Grilled Spicy Corn on Cob
Yield: 8 servings

Ingredients

• 8 ears corn-on-the-cob
• 2 sticks of butter, softened
• 1 lime, juiced
• 1 tbsp. chipotle powder
• 1 tsp. onion powder
• 1 tsp garlic powder
• Salt and pepper to taste
• 1 tbsp. ground cumin
• 1 cup mayonaise
• ½ cup grated Cotija cheese or Parmesan cheese
• 8 tsp. hot sauce (Cholula is good!)
• Lime wedges

Method of Preparation:
1. Combine well in a bowl: butter, lime juice, chipotle, onion and garlic powder, salt & pepper and cumin.
2. Corn: Peel back husk but don’t take off cob; remove all silk.
3. Using a pastry brush, brush the butter mixture all over the corn. Pull the husk back up over the kernels again.
4. Wrap each corn cob in aluminum foil individually and place on a hot grill, turning over after 5 minutes. Cook on other side for 5 minutes.
5. Peel back the husk and grill kernels directly on grill grates for a minute or until you reach a nice char.
6. Remove from heat and slather with mayo. Sprinkle cheese generously all over mayo; top with hot sauce and lime juice, if desired.

Watermelon & Basil Salad
Yield: 1 Salad

Ingredients

• 1 cup pea shoots
• ¾ cup watermelon, cubed
• 1 oz feta cheese
• 5 grape tomatoes, halved
• 5 large basil leaves, torn 
• 3 mint leaves, torn
• 2 scallions, tops only, thin sliced
• ¼ of a yellow pepper, medium dice
• 2 radishes, thin sliced
• 1 tbsp. balsamic vinegar
• 3 tbsp. olive oil
• ¼ tsp. Dijon mustard
• ¼ tsp. honey

Method of Preparation:
1. Wash all vegetables and cut as suggested above. Toss pea shoots, basil and mint together, and put on plate.
2. Scatter watermelon cubes, grape tomatoes, yellow peppers and radishes in appealing presentation.
3. Sprinkle feta cheese and scallions on top.
4. In a bowl, combine balsamic vinegar, Dijon and honey, whisk together. Slowly drizzle in oil until vinaigrette forms.
5. Lightly drizzle over entire salad and enjoy!

In the summer 2014 issue of WakeMed’s Heart to Heart magazine, four women shared stories about supporting a loved one through heart attack recovery, surviving heart disease and managing high blood pressure. Here’s a peek at the stories and advice they shared and click for the full article.  

Supporting Role 

Jennifer and Chris Petty

Jennifer Petty’s husband Chris suffered a heart attack after complaining about indigestion for a few days, then experiencing excruciating pain. After receiveing stents in one artery, Chris returned home, and Petty realized what he needed most was reassurance and support. Chris also participated in WakeMed’s Cardiac Rehab program, which offered supervised exercise sessions, educational lectures and cooking classes. 

“Many patients find peace of mind in learning all they can about their condition as well as healthy habits. That’s where patient education and cardiac rehab come into play,” said Dr. Islam Othman, a cardiologist with WakeMed Physician Practices – Raleigh Cardiology. 

“[Cardiac Rehab] was empowering for Chris,” said Petty, who also changed her family’s diet to organic and significantly reduced the amount of fats, sugar and processed foods they were eating. She offered some additional advice to the family members of loved ones who experience a heart attack. 

“Let them talk and really listen to what they’re saying,” said Petty. “…Work to keep the balance, knowing that family and health should come first. It is [also] important to ask questions about your loved one’s clinical well-being. … Knowledge about the process can reduce stress for the patient as well as the caregiver. Finally, encourage your loved one to fully embrace the Cardiac Rehab program from beginning to end.” 

Advice from Survivors 

Bev Stanion

Bev Stanion and Gerry Campbell-Days each experienced a heart attack and offered advice to other women about the importance of caring for yourself. 

“Talk about your risk factors with your primary care physician. And if you don’t feel well, don’t try to rationalize it or brush off your symptoms,” said Stanion. “Women are in tune with their bodies, so it’s up to us to be proactive and take our health seriously. We owe it to ourselves and to the people who love us.” 

Since experiencing a heart attack and a second heart catheterization, Campbell-Days said it is better to adopt healthy behavious sooner rather than later. A 30-year smoker who quit in 2000, Campbell-Days knows that smoking contributed to her poor heart health. 

Gerry Campbell-Days

“I encourage women to never start smoking, and if you do, quit now. Trust me when I say that the choice you make, good or bad, will eventually catch up with you.” 

Campbell-Days also participates in the WakeMed Cardiac Rehab program, which is available at WakeMed Cary Hospital Outpatient Rehabilitation at the Kraft Family YMCA (919-350-1875) and Healthworks on the WakeMed Raleigh Campus (919-350-8602).    

Fighting the ‘Silent Killer’ 

Felecia Williams

Felecia Williams was diagnosed with hypertension (high blood pressure of 140/90 or higher) at age 29. Complications of hypertension include heart failure, renal disease, stroke and coronary artery disease. At first, Williams was frustrated and depressed, and she felt helpless over her condition. She also experienced a rollercoaster of medication side effects and a change in physician care providers, which was unsettling. 

But through it all, Williams has remained proactive about her health by finding the right physician partners to help her manage her condition and making lifestyle changes. Specifically, the DASH diet has worked well for Williams and her family. DASH, or Dietary Approaches to Stop Hypertension, is proven to help reduce high blood pressure. It includes whole grains, lots of fruits and vegetables, low-fat milk; lean meats, poultry and fish, and a decrease in fats, oils, sweets and added sugars. Between 2,300 and 1,500 mg of sodium are recommended daily. 

Dr. Sahar Amery, a cardiologist with WakeMed Physician Practices – Raleigh Cardiology, highly reccomends the DASH diet and also advises to get your blood pressure checked regularly, get regular exercise, reduce stress and quit smoking. 

Said Williams, “The inside of the body is much more important than the outside. … Health can be taken for granted until is it jeopardized. It’s a better scenario to be proactive than reactive.”

Kids learn more about sugar at Healthy Communities Day 2014.

On Thursday, July 10, WakeMed was proud to partner with the YMCA of the Triangle and Saint Augustine’s University in Raleigh to host Healthy Communities Day for the sixth year in a row. Annually, this event aims to help build a healthier community by giving free medical screenings to children who participate in Camp High Hopes, a fully subsidized YMCA day camp. The camp is made up of 800 children, kindergarten through tenth grade.

This year, WakeMed, Eye Care Associates, Wake Human Services and the Wake County Healthy Smiles program offered the children comprehensive physicals, which included a body mass index check, dental and eye screenings, a blood pressure screening and a scoliosis check.

Children at the event are also educated about living a healthy lifestyle, including advice on nutrition and physical activity. A fun-filled afternoon of fitness activities always rounds out the day.

Learn more about Healthy Communities Day here.

Hand, Foot & Mouth Disease (HFMD) is more prominent in the summer and fall, which is why many cases are popping up in Wake County right now. HFMD is a common childhood illness but can also be found in adults. The disease is wrought with uncomfortable symptoms and has no medicinal treatment; however several types of supportive therapy are recommended. Dr. Joanne Fruth of WakeMed Physician Practices – Accent Urgent Care in Cary shares more about this illness.

Signs & Symptoms
HFMD is a virus that typically begins with a mild sore throat and high fever, 101 to 103 degrees. One to two days later, sores will appear in the mouth as well as blisters on the hands and/or feet, and sometimes on the buttocks as well. Blisters can also appear around the mouth or on the arms and legs. Symptoms last for about one week. When the sores and blisters disappear, a person is no longer contagious. Dehydration can also be a concern for infants who find it difficult to drink breast milk or formula with painful sores in the mouth.

Transmission
Because it is a coxsackievirus, HFMD is transmitted via saliva or droplets created by coughing and sneezing. It is also transmitted via the stool, which makes it common within daycare centers due to diaper changes.

The blisters that come from HFMD are also teeming with virus. They are not contagious through skin-to-skin contact, but liquid from within the blisters are infectious via the mouth, nose and eyes.

Supportive Treatment
While there is no medicinal treatment for HFMD, supportive treatment is recommended, such as:

• Tylenol® and Motrin® (never give a child aspirin for a viral illness)
• Cool foods such as pudding and Jell-O®.  Sometimes cold foods like popsicles can irritate the sores in the mouth.
• Gum-numbing gels for infants
• Adults can even swish with Maalox® or Mylanta®.

When to See the Doctor

• If you wish to receive a definitive diagnosis
• If your child is exhibiting signs of lethargy and seems unengaged or is not interacting as he or she usually does (i.e. not smiling back at you)
• If you have concerns that your child is dehydrated.  This can be detected when there is a decrease in oral intake of fluids, dry mouth, sunken eyes and lethargy.  Additionally, if a baby has less than three wet diapers per day, he or she very likely could be dehydrated and may require IV fluids.
• If you have other concerns that need medical attention, never hesitate to see your doctor.

Prevention
Hand washing with warm, soapy water is always key to prevention of illness. Scrub hands together while singing “Happy Birthday” twice for effective cleaning. Additionally, avoid as much contact as possible with other children or adults who are sick with the virus, and keep sick children out of daycare or school.

While HFMD can be extremely uncomfortable, people experience different degrees of symptoms. Some can have very mild symptoms, some more extreme. Unfortunately, you can get HFMD more than once since there is more than one virus that causes it.  However, you won’t get sick with the same strain twice. Hang in there – it should be gone in a week.

Located in Raleigh and Cary, WakeMed Physician Practices – Accent Urgent Care sees adults and children of all ages and is open seven days a week. Learn more here.