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Plate v/s Pyramid

The U.S. Department of Agriculture recently introduced the plate-shaped icon, replacing the pyramid.  Which is better?  The answer is they are both great simplistic guides from the government to help you make healthy food choices.  But, it is important to note that a visual graphic is just a start.

Consumers who are interested in eating healthy and making healthy choices must do some additional research and get more information; this was as true with the pyramid as it is with the plate.

The nice thing about the plate is that it is a visual representation of what each meal should look like.  As with all simplified guidelines, there are a few possible pitfalls, including no mention of physical activity, lack of detail about how to select the healthiest foods and lack of information on portion sizes. This is where the getting additional information becomes important.

Physical Activity

Remember that to maintain a healthy weight you must consider the concept of energy balance. Put simply, to lose weight, you must eat fewer calories than you burn or burn more that you eat.  The previous version of the pyramid did emphasize the need for physical activity, an issue which the plate guide does not address. 

Selecting the Healthiest Foods

Although, the new plate does emphasize eating more fruits and vegetables, there is no information about which vegetables and fruits are the best. To some, that may be translated as I should load up on fried okra and peaches canned in syrup or starchy vegetables like corn, peas, and potatoes that are three times higher in calories than green beans or broccoli.

It is also great to recommend eating more fruits and vegetables, but a clarification that this means focusing on adding fresh or frozen vegetables that are not fried or enhanced with butter, cheese or high calorie sauces would be even better.  

Additionally, it is important to consume a variety of colors of fruits and vegetables and to choose fresh fruits over canned or dried most often.  With this further explanation, it will be clear that fruit gummies are not considered a serving of fruit. 

 Portion Size

Portion size can be a downfall too. It is important to base your eating guidelines on a regular sized dinner plate. Believe it or not there is significant variation in plate sizes.  Follow these guidelines for choosing certain higher calorie foods:

1 fruit serving = tennis ball

1.5 oz. cheese = 4 stacked dice

3 oz. meat = deck of cards or computer mouse

2 Tbsp. peanut butter = a ping pong ball

1/2 cup ice cream = 1 scoop

1 oz. bread = CD case   

1 cup cereal = a fist  

3 oz. fish = a checkbook

1 cup of rice, pasta or potatoes = baseball 

The most important thing to remember is that plate or pyramid is just a general nutrition guide that is easy to visualize and understand. If you are really trying to eat healthier, lose weight or have special nutrition needs, you will need more information to be successful.  In these cases, you may want to consider meeting with a registered dietitian for more specific advice.

Julie Paul is a registered dietitian with WakeMed ENERGIZE!, a program to help kids and teens who either have type 2 diabetes or who are at risk of developing type 2 diabetes learn to make healthy lifestyle changes.  Learn more by clicking here.


E.coli: A Worry in the U.S. Too?

E.coli is nothing new, but today it is causing attention-grabbing headlines around the world. 

The reason: officials are reporting that 1,600 people have been sickened and 18 killed in Europe due to an outbreak of a new strain of E.coli. 

E.coli is primarily found in beef due to the presence of the organism in cow’s gastrointestinal system.  Some of the strains of E.coli are harmless, while others produce toxins that can cause severe gastrointestinal illness, and in some cases death.  Humans and other animals also carry certain strains of E.coli that do not produce these harmful toxins.

With the increasing use of natural fertilizers, including cow manure, harmful E.coli is now more frequently showing up in fruits and vegetables.  In fact, the source of this most recent outbreak is suspected to be fruits and salad vegetables.  And since women tend to have greener diets and consume more fruits and vegetables,  women currently represent 67 percent of those affected by the recent E.coli outbreak. Cases have also been reported in school-aged children.

E.coli is no joke. You can’t see it, but it can make you and your loved ones exceptionally ill. This recent outbreak is not cause for alarm in the United States because no cases have been reported, but it is always important to take steps to protect yourself from E.coli.  The best defense against E.coli is to wash your food thoroughly before eating it; this includes bagged, “ready-to-eat” lettuce, spinach, and other pre-cut vegetables.  Do not eat unwashed fruits and vegetables, and when possible cook foods, including meat, thoroughly.

An infection with toxin-producing E.coli is not like a regular gastrointestinal illness.  It is more intense, and it is important that you seek medical care and not self-medicate because some antibiotics and products like Imodium® may actually cause the E.coli-emitted toxins to damage your kidneys.  Visit WebMD to learn more about e.coli. 

Dominique Godfrey-Johnson, MPH, CPH is a public health epidemiologist with WakeMed Infection Prevention and Control.


It’s Hot Outside – It’s Even Hotter in the Car

If the outside temperature is 101 degrees, then inside a car the temperature can reach a scorching 140 degrees.  Exposure to this high temperature for any length of time can cause serious, irreversible brain injuries, multi-organ failure and even fatalities.

It may be hard to believe, but according to Safe Kids USA, almost 50 children died because they were left in a hot car last year.  Unfortunately, our community is not immune.  Each year our Children’s Emergency Department sees children who have been severely impacted by being left left in a hot car.

So NEVER leave a child alone in a car – even for a minute. And, make a promise to yourself that if you are a bus driver, van driver or the parent dropping his/her child off at camp or daycare, that you will do second-take before walking away from your car.  Here are a few tips from Safe Kids USA to help protect children from an easily preventable disaster.

  • Dial 911 immediately if you see an unattended child in a car.  EMS professionals are trained to determine if a child is in trouble.
  • Never leave a child unattended in a vehicle, even with the window slightly open.

Believe it or not, routines and distractions have caused people to mistakenly leave children behind in cars.

  • Place a cell phone, PDA, purse, briefcase, gym bag or whatever is to be carried from the car on the floor in front of a child in a backseat.  This triggers adults to see children when they open the rear door and reach for their belongings.
  • Set your cell phone or Blackberry reminder to be sure you dropped your child off at day care.
  • Set your computer calendar program, such as Outlook, to ask, “Did you drop off at daycare today?”
  • Have a plan that if your child is late for daycare that you will be called within a few minutes.  Be especially careful if you change your routine for dropping off little kids at day care.

Prevent trunk entrapment.

  • Teach children not to play in any vehicle
  • Lock all vehicle doors and trunk after everyone has exited the vehicle – especially at home.  Keep keys out of children’s reach. Cars are not playgrounds or babysitters.
  • Check vehicles and trunks FIRST if a child goes missing.

WakeMed Children’s is dedicated to providing answers to common questions parents have about children’s health and wellbeing.   Learn more by subscribing to WakeMed’s Families First newsletter.  Have a specific question you would like answered?  Post a comment or email us directly.


Enjoy Movies By Moonlight and Support WakeMed Children’s

Support WakeMed Children’s and have fun evenings under the stars watching movies at Cary’s Koka Booth Amphitheater this summer. 

2011 Movies by Moonlight Schedule
May 26th – The Social Network (PG-13)
June 2nd – The Proposal (PG-13)
June 9th – Eat, Pray, Love (PG-13)
June 16th – Despicable Me (PG-13)
June 30th – Father of the Bride (1950)(NR)
July 7th – Red (PG-13)
July 21st – Twilight: Eclipse (PG-13)
July 22nd – Sound of Music Sing-a-Long (NR) (Special event pricing for this show)
August 4th – Up (PG)
August 18th – Outsourced
September 1st – Rebel Without a Cause (NR)
September 8th – True Grit (2010) (PG-13)

Movie night admission is just $3 for adults and kids 12 and under are free. Picnic baskets are allowed so bring your dinner, blanket and lawn chair to enjoy the stars of the big screen under the stars of the celestial kind! Gates open at 7pm on movie nights and the flms start at dusk.

A portion of movie night proceeds benefit the Just For Kids Kampaign.  The Just For Kids Kampaign is a $20 million WakeMed Foundation fundraising effort to expand pediatric services.  So far, JFKK has fully funded the first Children’s Hospital in Wake County, and now funds are being raised to expand the Level IV Neonatal Intensive Care Nursery

And, a new fun twist this year, turn your movies by moonlight outing into a bike-in cinema night! Ride your bike to Booth Amphitheatre using one of Cary’s many greenways and receive a complimentary ticket to the movie! If you bike to the movie and receive a free ticket, donations to the JFKK are greatly appreciated.


WakeMed Offers Safe Sitter Classes This Summer

Know a teen ages 11-13 who is interested in babysitting?  Then, a Safe Sitter® class is for them.

This summer WakeMed Health & Hospitals is offering Safe Sitter classes to prepare adolescents to become competent babysitters by teaching important tips for how to recognize and handle emergency situations. The two day classes will teach future babysitters how handle various crises in the home, such as CPR for a choking child or infant and what to do in case of a fire or intrusion.

Upcoming classes include the following:

WakeMed Raleigh Campus
June 20 & 21
July 13 & 14
Aug. 16 & 17
Click here to register for the Raleigh Campus Safe Sitter classes.

WakeMed Cary Hospital
June 29-30
July 21-22
August 1-2
Click here to register for the Cary Hospital Safe Sitter classes.


Hurricane Preparedness Week

Hurricane Preparedness Week is this week, because believe it or not, hurricane season starts June 1st.  While we recently experienced the severe tornadoes, it has been several years since our state has been impacted by a major hurricane.  It is important that we remember North Carolina is at risk of being impacted by hurricanes, and a little advance preparation can go a long way.  Numerous hurricane preparedness resources from the National Hurricane Center can be found by clicking here


Of course, as always, we need to stay prepared for tornadoes.  Learn more about what to do before, during, and after a tornado by following these links:

  • How to Prepare for a Tornado – Learn about preparing a disaster supply kit, creating a plan, and knowing the signs of an approaching tornado (dark, greenish sky; large hail; low-lying and rotating cloud; and a loud roar, like a freight train).
  • What to Do During a Tornado – Depending on whether you are in a building, outdoors, or in a vehicle when a tornado strikes, find out what to do.
  • What to Do After a Tornado – Get tips on what to do in a potentially unsafe area following a tornado and learn about federal assistance.

Barb Bisset is the executive director of the WakeMed Emergency Services Institute.


Why WakeMed Offered to Purchase Rex Healthcare

On May 11, WakeMed offered to purchase Rex Healthcare from the University of North Carolina. We made this offer to purchase in the best interest of the community, the patients we serve and the state.

A combined WakeMed/Rex system has the potential to enhance continuity of care, keep resources local, keep patients closer to home, better address complex issues like mental health, and save money by eliminating unnecessary duplication of services.

For 50 years, WakeMed has proudly provided the vast majority of charity care in Wake County. In fact, according to data compiled by the North Carolina Division of Medical Assistance (DMA), WakeMed is one of the leading providers of uncompensated care for the un- and underinsured in the state, and we do it with no taxpayer support. Rex Healthcare, a state-owned hospital, does not provide its fair share of charity care to our community or the state. WakeMed is also increasingly concerned that a government-subsidized, unlevel competitive landscape will cripple WakeMed’s ability to deliver on its mission of caring for all, regardless of the ability to pay.

We know there are many questions about the proposed purchase, so we have set up a separate blog specifically to help keep the public and the legislature up to date. For more information and timely updates on WakeMed’s offer purchase to Rex, please visit


Getting Ready for Bariatric Surgery

Bariatric surgery is not magic.  It takes a lot of commitment and work to make the surgery a success.  I decided to start making some healthy changes in advance of the surgery, so I am in the best shape possible.

I have not only joined the gym – something I told myself I would never do again – but I made commitment to go.  I have been going to the gym 3 to 4 times per week since January.  Previously, I would go for a while and then stop.

I also had a meeting with a dietitian.  She confirmed that I have a pretty healthy diet, but I have started adding additional protein and really watching the number of carbs per serving.  In general, bariatric surgery patients need to get 60 to 80 grams of protein a day and only eat things that have 20 grams of carbohydrates or less and less than 10 grams of sugar per serving.  Sometimes this can be a challenge.

I have had the benefit really reading labels to help my daughter maintain compliance after her surgery on December 29.  She is spectacular at following the recommendations and guidelines.  It is my hope that I can be as disciplined as she has been following surgery.

Debra Dupree is a 30-year tenured nurse on WakeMed Raleigh Campus.  Debra’s daughter had bariatric surgery on December 29, 2010, and because of her daughter’s success, she is scheduled to have bariatric surgery on May 20, 2011. Read previous blog in this series here.

Dr. Brandon Roy, surgeon with Wake Specialty Physicians, has information sessions scheduled May 23, June 9 and June 28.  Click here to learn more.


Nurse, Mother, Self; Perspective on Bariatric Surgery

On December 29, 2010 our family changed for the better.  That was the day my daughter had bariatric surgery. 

At just 24 years old, I was greatly concerned about her future health.  We have a family history of high blood pressure, diabetes, and colon cancer, all of which obesity is an added risk factor. 

After some internet research about bariatric surgery, we attended an information session with Dr. Brandon Roy.  We walked away understanding that bariatric surgery is not an easy way out, and it is not a quick fix to a serious issue.  Bariatric surgery is a serious decision that requires significant lifestyle change. 

I was concerned that because of my daughter’s past weight loss efforts, that she would not be able to maintain the level of commitment necessary to make the surgery a success and stay healthy. 

Additionally, as a nurse for more than 25 years in the operating room, I was more than aware that surgery is serious. As a surgical nurse, I also had the benefit to see different surgeon’s techniques and skills.

After weighing risk and benefit, it definitely appeared that the benefits of bariatric surgery for my daughter could outweigh the risk.  She went in for surgery on December 29, has followed all of the doctor’s advice to the letter, and has lost 47 pounds to date.  But the weight loss is not the only change.  In addition to losing 47 pounds, she has a new joy and excitement about losing weight and taking care of herself – Changes a mother is always thrilled to see in their child.

Now that my daughter was doing so well, I started thinking about bariatric surgery for myself.  I have struggled with weight all my life and have lost weight, gained weight and lost the weight again.  I decided bariatric surgery, and specifically the adjustable gastric band surgery, is something that I would like to do for myself.

On May 20, I will have bariatric surgery, and our family will change once again. Of course, I have questions for myself same as I had for my daughter.  Will I be able to do everything right?  Will I have complications? Will I be successful?

As a mother of a bariatric surgery patient and an operating room nurse, I believe I bring a unique perspective to the decision-making process.  The first place many people look, as I did, for information about bariatric surgery is online.  This is why I decided to do a series of blog posts chronicling my decision-making process, modifications prior to surgery, follow-up after surgery, and a report several months after surgery.  It is my hope that these posts will help others make the difficult decision about bariatric surgery.

Debra Dupree is a 30-year tenured nurse on WakeMed Raleigh Campus.  Debra’s daughter had bariatric surgery on December 29, 2010, and because of her daughter’s success, she is schedule to have bariatric surgery on May 20, 2011.

Dr. Brandon Roy, surgeon with Wake Specialty Physicians, has information sessions scheduled May 23, June 9 and June 28.  Click here to learn more.


WakeMed Employees Celebrate 50th Anniversary

WakeMed Raleigh Campus employees, celebrated on Friday, May 13 in a great parking deck party complete with hot dogs, hamburgers and the electric slide.

WakeMed North Healthplex employees celebrated with a cook-out and games galore.