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Frequently Asked Questions

Anemia
Anorexia Nervosa
Bulimia
Cancer
Celiac Disease
Diabetes
Food
Heart Disease
Heart Health
Obesity
Osteoporosis
Physical Activity
Pregnancy
Stress
Stroke

ANEMIA 

What is anemia? Anemia is a condition in which there is a reduced number of red blood cells or reduced hemoglobin, which is responsible for carrying oxygen in the blood.
What are the types and causes of anemia? Anemia can be due to a deficiency in B12 (also called pernicious anemia), folate (megaloblastic anemia), or iron. Anemia can also be classified as sickle cell anemia or anemia of chronic disease.

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Causes of anemia include inadequate B12, folate or iron. It can also be caused by poor iron utilization of iron by the body, blood loss, lead poisioning, GI bleeds, taking antacids (interferes with iron absorption), or medical conditions such as Celiac or Crohn's disease.
What are the signs of anemia? In cases of mild anemia, there are usually no signs or symptoms. However, in severe cases, you may experience the following symptoms:

  • Blue color to whites of the eyes
  • Brittle nails
  • Decreased appetite (especially in children)
  • Fatigue
  • Headache
  • Irritability
  • Pale skin color
  • Shortness of breath
  • Sore tongue
  • Unusual food cravings (called pica)
  • Weakness

How do I find out if I have anemia? Testing for anemia is done by your healthcare provider. He/she may choose to use one or a combination of the following tests:

  • Fecal occult blood test
  • Hematocrit and hemoglobin (red blood cell measures)
  • Iron binding capacity (TIBC) in the blood
  • RBC indices
  • Serum ferritin
  • Serum iron level

What is the treatment for anemia? If you are suffering from iron-deficiency anemia, your healthcare provider can determine if you need supplements, intravenous iron, or can reach your goals through diet. It is often advised to include more vitamin C (think citrus or citrus juices) when eating iron-rich foods. Foods that are rich in iron include egg yolks, fish, legumes (peas and beans), meats, poultry, raisins, whole grains and fortified cereals.

How do I prevent anemia? Everyone should try to include enough iron in their diet with eggs, meats, poultry, legumes (peas and beans), raisins, whole grains and fortified cereals. If you do not feel you are getting enough iron in your diet, speak with your healthcare provider about possible supplements.

How much iron do I need every day? The amount of iron you need every day depends on your age and gender.

Infants and children

  • Younger than 6 months: 0.27 milligrams per day (mg/day)
  • 7 months to 1 year: 11 mg/day
  • 1 to 3 years: 7 mg/day
  • 4 to 8 years: 10 mg/day

Males

  • 9 to 13 years: 8 mg/day
  • 14 to 18 years: 11 mg/day
  • Age 19 and older: 8 mg/day

Females

  • 9 to 13 years: 8 mg/day
  • 14 to 18 years: 15 mg/day
  • 19 to 50 years: 18 mg/day
  • 51 and older: 8 mg/day

I am a vegetarian. What steps should I take to ensure I get enough iron? Although meat is often thought of as one of the best sources of iron, you can also get your iron from non-animal sources, such as raisins, whole grains, fortified cereals and legumes (peas and beans). It is also important to pair your iron-rich foods with vitamin C (oranges, grapefruits, orange juice, etc.) to help your body better utilize the iron you are consuming.

What happens if my body gets more iron than it needs? It is unlikely that you will consume too much iron from your diet, but some symptoms of too much iron include:

  • Fatigue
  • Anorexia
  • Dizziness
  • Nausea
  • Vomiting
  • Headache
  • Weight loss
  • Shortness of breath
  • Grayish color to the skin

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ANOREXIA


What is anorexia nervosa? Anorexia nervosa, more commonly referred to as anorexia, is an inability to stay at a healthy body weight through extreme dieting, excessive exercise or other weight loss measures.

What causes anorexia nervosa? The exact cause of anorexia nervosa is unknown, but there are likely many factors. Anorexia nervosa generally begins in the adolescent or young adult years and may be caused by such things as: the desire to be perfect, obsession with appearance or weight, having a family member with anorexia nervosa or other addictions, having parents who are concerned with appearance or weight loss, having a negative self image, undergoing a stressful life change, or experiencing a traumatizing event such as rape or abuse.

What are signs of anorexia nervosa? Signs of anorexia nervosa include,

  • intense fear of gaining weight even when he/she is underweight
  • distorted body image
  • missed menstrual cycle for 3 or more months (in women)
  • cutting foods in small pieces instead of eating
  • Obsessively exercising
  • Going to the bathroom immediately following meals
  • Refusing to eat around others
  • Using medications to make them urinate, have bowel movements or decrease appetite
  • Blotchy or yellow skin that is dry and covered with fine hair
  • Dry mouth
  • Extreme sensitivity to cold
  • Loss of bone density

What happens to your body with anorexia nervosa? Complications of anorexia nervosa can be severe and may require hospitalization. Complications may include,

  • Bloating or swelling
  • Bone weakening
  • Electrolyte imbalance (such as low potassium)
  • Irregular heart beat
  • Increased risk of infection
  • Severe dehydration
  • Severe malnutrition
  • Seizures due to fluid loss from excessive diarrhea or vomiting
  • Thyroid gland problems, which can lead to cold intolerance and constipation
  • Tooth erosion and decay

How do you treat anorexia nervosa? Anorexia nervosa is generally treated using a combination of therapies. Treatment should include a team of healthcare professionals, the individual's family and a support group. The first goal in treatment is to help the patient realize that he/she suffers from anorexia nervosa. Next, restoration of weight to reach a healthy weight should be the over-arching goal of treatment. A goal of 1 pound of weight gain per week is usually appropriate. In severe cases of anorexia nervosa, hospitalization is required to restore fluids and electrolytes before weight management can be addressed.

What should I do if I think someone I know has anorexia nervosa? If you suspect that someone you know is suffering from anorexia nervosa, talk to your healthcare provider about signs, symptoms and intervention strategies. Because anorexia nervosa is a very sensitive disease, it is important to handle each case individually.

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BULIMIA

What is bulimia? Bulimia is a condition in which a person has repeated cycles of eating large quantities then purging. Purging can be done through exercise, laxatives, vomiting or other methods.

What causes bulimia? The exact cause of bulimia is unknown. It is likely due to a combination of factors including genetics, psychological, trauma, or cultural factors.

What are signs of bulimia? Signs of bulimia may include,

  • Compulsive exercising
  • Use of laxatives, diet pills, emetics (drugs that induce vomiting), or diuretics (drugs that reduce fluids, also called water pills)
  • Regularly going to the bathroom right after meals
  • Suddenly eating large amounts of food

What happens to your body with bulimia? Frequent binging and purging can cause detrimental damage to your body. Some of the complications of bulimia may include,

  • Constipation
  • Dehydration
  • Dental cavities
  • Electrolyte abnormalities
  • Hemorrhoids
  • Inflammation of the throat
  • Pancreatitis
  • Tears of the esophagus from excessive vomiting

How do you treat bulimia? Bulimia is most often treated by gradually decreasing the need to binge and purge. Individuals suffering from bulimia rarely need to be hospitalized, except in extreme cases. Support groups are often helpful for patients with mild cases of bulimia. However, behavior therapy and nutritional therapy are preferred treatment.

What should I do if I think someone I know has bulimia? If you suspect that someone you know is suffering from bulimia, talk to your healthcare provider about signs, symptoms and intervention strategies. Because bulimia is a very sensitive disease, it is important to handle each case individually.

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CANCER


What is cancer? Cancer is a general term which describes abnormal cell growth in the body. When your cells grow very rapidly, the cancerous cells can "steal" nutrients from healthy cells, leading to serious illness or death.

What types of cancer are there? There are numerous types of cancer that affect all systems in the body. Some of the most common types of cancer are

  • Adrenal Cortical Cancer
  • Anal Cancer
  • Bile Duct Cancer
  • Bladder Cancer
  • Bone Cancer
  • Brain/CNS Tumors
  • Breast Cancer
  • Cervical Cancer
  • Colon/Rectum Cancer
  • Endometrial Cancer
  • Esophagus Cancer
  • Eye Cancer
  • Gallbladder Cancer
  • Hodgkin Disease
  • Kaposi Sarcoma
  • Kidney Cancer
  • Leukemia
  • Liver Cancer
  • Lung Cancer
  • Lymphoma
  • Malignant Mesothelioma
  • Nasal Cavity and Paranasal Sinus Cancer
  • Nasopharyngeal Cancer
  • Neuroblastoma
  • Non-Hodgkin Lymphoma
  • Oral Cavity and Oropharyngeal Cancer
  • Ovarian Cancer
  • Pancreatic Cancer
  • Pituitary Tumors
  • Prostate Cancer
  • Sarcoma
  • Skin Cancer
  • Small Intestine Cancer
  • Stomach Cancer
  • Testicular Cancer
  • Thyroid Cancer
  • Uterine Sarcoma
  • Vaginal Cancer

What are the different stages of cancer? The stage of cancer describes the extent that the cancer has spread and the size of the tumor. Cancer is usually described as stages I-IV, depending on the degree of the cancer.

  • Stage 0 cancer has not invaded surrounding tissues
  • Stage I cancers are localized to one part of the body.
  • Stage II cancers are locally advanced.
  • Stage III cancers are also locally advanced. Whether a cancer is designated as Stage II or Stage III can depend on the specific type of cancer.
  • Stage IV cancers have often metastasized (spread to other organs or throughout the body).

What are the signs of cancer? Cancer can cause almost any sign or symptom. The signs and symptoms will depend on where the cancer is, how big it is, and how much it affects the organs or tissues. If a cancer has spread (metastasized), signs or symptoms may appear in different parts of the body. Furthermore, signs and symptoms of cancer may not appear until later stages. Some general signs of cancer include unexplained weight loss, fever, fatigue, pain or skin changes. Signs of cancer can also be localized in the affected area.

What can I do to prevent cancer? Although there is no surefire way to prevent cancer, there are steps you can take to reduce your risk.

  • Avoid alcohol and tobacco use
  • Staying out of the sun between the hours of 10 a.m. and 4 p.m.
  • Wearing a hat, shirt, and sunglasses when you are in the sun
  • Using sunscreen with a sun protection factor (SPF) of 15 or higher
  • Not using tanning beds or lamps
  • Maintain a healthy diet with lots of fresh fruits and vegetables (5-9 servings per day, whole grains, lean meats and limited process meats
  • Maintain a healthy weight

How is cancer treated? Cancer can be treated with one treatment or a combination of many. The three most common treatments are surgery, radiation and chemotherapy.

Surgery

Surgery is often the first treatment option if the cancer is a tumor that can be removed from the body. Sometimes only part of the cancer can be removed. Radiation or chemotherapy might be used to shrink the cancer before or after surgery.
Chemotherapy

Doctors use chemotherapy or "chemo" drugs to kill cancer cells. Usually, the drugs are given intravenously (IV or into a vein) or taken by mouth. Chemo drugs then travel throughout the body in the bloodstream. They can reach cancer cells that may have metastasized (spread) from the tumor.

Radiation therapy

Radiation therapy is treatment with high energy rays (such as x-rays) to kill or shrink cancer cells. The radiation may come from outside the body, called external radiation, or from radioactive materials placed right into the tumor (internal or implant radiation). Getting external radiation is a lot like getting an x-ray. It is painless, but it can cause side effects.

Other types of cancer treatment

Other kinds of treatment you might hear about include hormone therapy, stem cell or bone marrow transplant, and immunotherapy. Hormone therapy is sometimes used to treat certain kinds of prostate and breast cancers. Immunotherapy is treatment designed to boost the cancer patient's own immune system to help fight the cancer.

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CELIAC

What is celiac disease? Celiac disease is the ability to digest gluten (found in wheat, barley, rye and some oats) due to an autoimmune disease. Gluten damages the part of the small intestines, called villi, leading to malabsorption of nutrients.

What are the symptoms of celiac disease? The symptoms of celiac disease can vary, which makes celiac disease sometimes hard to diagnose. The most common symptoms are gastrointestinal and include

  • Abdominal pain
  • Bloating
  • Bloody or fatty stools
  • Constipation
  • Decreased appetite
  • Diarrhea
  • Gas
  • Increased appetite
  • Nausea

Symptoms can also be unrelated to gastrointestinal tract and include

  • Anemia
  • ADD/ADHD
  • Bone and joint pain
  • Depression
  • Enamel defects on teeth
  • Failure to thrive/delayed growth in children
  • Fatigue
  • Infertility
  • Itchy skin rash
  • Migraine headaches
  • Osteoporosis/osteopenia
  • Sores in the mouth

How is celiac disease diagnosed? Celiac disease is diagnosed using an antibody test called Anti-Tissue Transglutaminase (tTG-IgA). These test measures a person's response to gluten; a person with celiac disease will have higher than normal antibody levels. It is important to continue to eat as you normally would before a tTG-IgA test. Your doctor cannot accurately diagnose you with celiac disease if you have not been consuming gluten.

How is celiac disease treated? The only treatment for celiac disease is a gluten-free diet. There are no medications or surgeries that can treat celiac disease. Following a gluten-free diet can be overwhelming at first, but it is important to be patient and stick with it - a gluten-free diet is a way of life for individuals with celiac disease.

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DIABETES

What is diabetes mellitus? Diabetes mellitus, also known as diabetes, is a disease of carbohydrate metabolism. Causes can be due to insufficient insulin production or decreased insulin sensitivity, resulting in elevated blood glucose levels.

What is pre-diabetes? Pre-diabetes occurs when blood glucose levels are higher than normal but are not high enough to be classified as diabetes. An Impaired Fasting Glucose (IFG) of 100-125 mg/dL after an overnight fast of an Impaired Glucose Tolerance of 140-199 mg/dL following a 2 hour Oral Glucose Tolerance Test (OGTT) can be used to diagnose pre-diabetes.

What are the different types of diabetes? The three most common types of diabetes mellitus are Type 1 diabetes, Type 2 diabetes and gestational diabetes.

Who gets diabetes? Diabetes can be diagnosed at any age, in any race and in any gender. Type 1 diabetes occurs equally in males and females, but is more prevalent in Caucasians. Type 2 diabetes typically occurs in older adults, especially those who are overweight. African Americans, Asian Americans, Native Hawaiians, and Hispanics/Latinos are also at an increased risk for Type 2 diabetes.

What causes diabetes? Diabetes is caused by malfunctioning cells in the pancreas. Type 1 diabetes results from the destruction of beta-cells, which are responsible for insulin production. Multiple genetic factors may lead to beta-cell destruction, many of which are still not completely understood. Type 2 diabetes is due to insulin resistance. The beta-cells still produce insulin, but the tissues do not respond to insulin as they should. Type 2 diabetes has also been linked to genetics, but the risk increases with obesity and physical inactivity.

What are the risk factors for diabetes? Although genetics plays a role in the development of diabetes, there are also factors that increase the risk for Type 2 diabetes. These include older age, obesity, history of gestational diabetes, impaired glucose metabolism, physical inactivity and race/ethnicity such as African-Americans, Hispanic/Latino Americans, American Indians, some Asian Americans and Native Hawaiians.

What are the signs of diabetes? The first signs of Type 1 diabetes often include frequent urination (polyuria), increased thirst (polydipsia) and increased hunger (polyphagia) due to chronic hyperglycemia (high blood glucose). If hyperglycemia persists, ketoacidosis - which is an acid-base imbalance, may result, causing nausea/vomiting, stomach pain, fruity or acetone breath and mental status changes.

How can I take care of myself if I have diabetes? Treatment for diabetes should always focus around avoiding hyperglycemia and maintaining stable blood glucose control. Individuals with Type 1 diabetes depend on insulin in conjunction with nutrition therapy and physical activity. Insulin regimens vary depending on each individual's lifestyle and routine, and should be prescribed accordingly by your healthcare provider. Individuals with Type 2 diabetes may not require insulin, but treatment does include nutrition therapy, physical activity and possible medication. Managing your diet is a vital part of any diabetes management routine. Contact a Registered Dietitian or Diabetes Educator to help you learn about optimal nutrition and carbohydrate counting.

Is there anything I can do to prevent type 2 diabetes? You can reduce your risk of developing type 2 diabetes by maintaining a healthy weight and increasing physical activity. Although type 2 diabetes has strong genetic links, healthful lifestyle changes can decrease your risk and delay the onset of complications.

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FOOD

What is a calorie? A calorie is the amount of energy required to raise the temperature of 1 gram of water by 1 degree Celsius.

What are carbohydrates? Carbohydrates are compounds containing carbon, hydrogen and oxygen. Carbohydrates include sugars, starches and most fibers. Carbohydrates are the main source of energy for the body and are used the quickest.

What is protein? Proteins are made up of amino acids, which provide building blocks for the body. Proteins maintain muscle, bone and connective tissues.

What is a well balanced diet? A well balanced diet is one which includes a variety of foods from many different food groups. In general, a well balance diet should consist of 45-65% carbohydrate, 20-35 % fat and 10-35% protein.

Why do I crave certain foods? First, it is important to distinguish cravings from genuine hunger. Hunger is your body's need for fuel, which is controlled by your stomach and brain. On the other hand, cravings can stem from psychological or physical stimuli. Many times food is associated with certain events (think turkey dinner on Thanksgiving) or emotions (ie - ice cream when you're feeling sad). These cravings are often hard to ignore due to the strong connections with feelings. Your cravings could also be nutrition-based. Although research is inconclusive, your body may actually be able to tell you when it is lacking in a certain nutrient by causing a craving. Similarly, when you are tired, your body tells you to crave foods high in simple carbohydrates to boost energy quickly.

What kind of milk is best - whole milk, reduced fat, skim, soy or almond? Depending on your individual needs, age, lifestyle, etc. the best type of milk will vary. In general, low fat or fat free milk is recommended for individuals over the age of two to reduce saturated fat intake. However, children under two who are no longer consuming formula should drink whole milk to ensure adequate fat and calories. However, if you experience food allergies or intolerances related to milk proteins or lactose, consult with a Registered Dietitian to determine the best alternative for you.

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HEART DISEASE

What is heart disease? Heart disease is a broad term for all diseases affecting the heart. These can include coronary artery disease, cardiovascular disease, heart failure and hypertension (high blood pressure).

What can I do to prevent heart disease? The ABCs of heart disease prevention are Avoiding tobacco, Becoming more physically active and Choosing good nutrition. There are genetic risk factors that you cannot control, but you can maintain a healthy weight, exercise regularly, choose fruits, veggies, lean meats, whole grains and low-fat or fat-free dairy, and reduce your sodium intake.

What does high blood pressure have to do with heart disease? High blood pressure that is left untreated can cause damage to your heart and coronary arteries. These can lead to stroke, kidney damage, loss of vision, erectile dysfunction, memory loss and angina.

How can I lower my blood pressure? High blood pressure has many modifiable factors that can help you lower your blood pressure. Eating a better diet, including reducing sodium, engaging in regular physical activity, maintaining a healthy weight, managing stress, avoiding tobacco, limiting alcohol and complying with medications as prescribed by your doctor.

What does high cholesterol have to do with heart disease? High LDL (or "bad") cholesterol increases your risk for heart disease by forming plaque in your arteries. These arteries are responsible for feeding your heart and your brain, but they become narrow and less flexible as more plaque builds up. If the artery becomes completely blocked, a heart attack or stroke can result.

What do my cholesterol and triglyceride numbers mean?

Total Cholesterol

Less than 200 mg/dL Optimal. Low risk for heart disease
200-239 mg/dL Borderline high
>240 mg/dL High

HDL Cholesterol

<40 mg/dL for men Low. Major risk factor for heart disease
< 50 mg/dL for women Low. Major risk factor for heart disease
>60 mg/dL High. Protective against heart disease

LDL Cholesterol

Less than 100 mg/dL Optimal
100-129 mg/dL Near or above optimal
130-159 mg/dL Borderline high
160-189 mg/dL High
>190 mg/dL Very high

Triglycerides

Less than 150 mg/dL Normal
150-199 mg/dL Borderline high
200-499 mg/dL High
>500 mg/dL Very high

How can I lower my cholesterol? Aside from medications, lifestyle changes can also help you lower your cholesterol. Following a heart healthy diet, engaging in regular physical activity and avoiding tobacco can all improve your cholesterol. Learning the details of a heart healthy diet can help you optimize the nutritional benefits, such as knowing your fats, increasing whole grains, choosing lean proteins and avoiding alcohol.

How do I know if I have heart disease? Only your physician can diagnose you with heart disease. However, following a heart healthy diet and maintaining healthy lifestyle habits can be beneficial for everyone.

What are the signs of a heart attack? Most heart attacks start slowly, and if you use this time to take action, help can reach you quickly. Warning signs of a heart attack include chest discomfort, pain in the arms, jaw, neck back or stomach, shortness of breath, cold sweat, nausea or lightheadedness.

Should I take a daily aspirin to prevent heart attack? You should not begin an aspirin regimen before consulting with your physician. However, your doctor may prescribe you a daily low dose aspirin if you are at high risk for heart disease.

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HEART HEALTH

Why do I need to be concerned about heart healthy eating? Nutrition plays a large role in preventing heart disease. Focusing on a heart healthy diet at any age reduces your risk of high blood pressure, cardiovascular disease, heart attack and stroke.

What foods should I eat to help prevent heart disease and stroke? It is important to eat a balanced diet full of variety.

Aim to eat 5-9 servings of colorful fruits and veggies
6-8 servings of grains (try to make half of your grains whole grains)
3-6 ounces lean meat, chicken, fish or poultry (cooked)
2-3 servings of low-fat or fat-free dairy products
2-3 servings of unsaturated fats (use liquid oils and soft margarines most often)
2-3 servings of nuts, seeds and legumes (nuts, peanut butter, seeds, beans and peas)

And fewer than 5 servings of sweets per week.

How can I tell how much saturated fat, trans fat, and other substances are in the food I eat? The best way to determine what is in the food you're eating is to look at the nutrition facts label. When deciphering fat content, keep these tips in mind for a 2000 calorie diet: keep total fat intake to 56-78 grams per day, less than 16 grams of saturated fat per day and less than 2 g of trans fat per day.

Remember, a product can be labeled zero grams of trans fat if it contains less than 0.5 grams of trans fat per serving, so it is important to look at the list of ingredients for partially hydrogenated oils. It is also important to make sure you are getting enough heart healthy unsaturated fats. Look for products that have the majority of their fat coming from unsaturated fat (monounsaturated and polyunsaturated). A quick look at the %DV (percent Daily Value) can also help you when picking out a product. If a product contains 5% or less of your %DV for total fat or saturated fat, it is considered low. If it contains 20% or more, it is considered high.

I've heard that eating fish is good for my heart. Why is that? Fish is a good source of omega-3 fatty acids. Omega-3s have been shown to decrease arrhythmias (irregular heart beat), lower triglyceride levels, slow the growth of atherosclerotic plaque and lower blood pressure. The American Heart Association recommends eating fish two times per week to enjoy the benefits of omega-3s.

Is drinking alcohol bad for my heart? Drinking alcohol in moderation can actually help you heart. Moderation includes 1-2 drinks per day for men and 1 drink per day for women. One alcoholic beverage consists of 1 (12 ounce) beer, 4 ounces wine, 1.5 ounce 80-proof alcohol or 1 ounce 100-proof alcohol. Alcohol and wine have been shown to increase HDL ("good" cholesterol) and wine provides antioxidants to protect your heart. However, drinking in excess can increase triglycerides, cause high blood pressure, heart failure or stroke and may lead to increased caloric intake.

Besides eating healthy foods, what else can I do to keep my heart healthy? Aside from eating a heart healthy diet, you can also increase your physical activity to keep your heart healthy. The American Heart Association recommends being physically active for 150 minutes per week; a goal of 30 minutes of physical activity five days per week is a reasonable. Physical activity has been shown to provide a plethora of health benefits including improved circulation, improved cholesterol levels, prevents and manages high blood pressure, helps manage stress and promotes a sense of well-being. Exercise can also reduce your risk of coronary heart disease by 30-40 percent in women and reduces the risk of stroke by 27 percent in highly active individuals!

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OBESITY

How do I know if I'm overweight or obese? There are many equations to use to determine if you are overweight or obese, but the most commonly used is BMI (Body Mass Index).To determine your BMI: multiply your weight (in pounds) by 703. Divide this number by your height (in inches) squared.

For example, if you are 5'5" and weight 130 pounds
(130*703) / (652) = 21.6
To evaluate your BMI, use the following chart:

<18.5 underweight
18.5-24.9 normal weight
25-29.9 overweight
30-34.9 obese (class 1)
34-39.9 obese (class 2)
>40 extreme obesity (class 3)

What causes someone to become overweight or obese? The cause of overweight and obesity is simple: consuming more calories than your body expends. Although the cause is simple, your calorie imbalance may be due to lack of exercise, metabolic disorders, eating too many calories or a host of other factors.

What are the health effects of being overweight or obese? Obesity is a serious threat to your health and should be taken very seriously. Being obese can lead to type 2 diabetes, high blood pressure, heart disease, stroke, sleep apnea, sleep disorders, certain cancers (including breast and colon cancer), depression, osteoarthritis and hypoxemia. Hypoxemia occurs when your tissues do not receive enough oxygen, causing you to feel tired throughout the day, and can ultimately lead to heart failure.

What is the best way for me to lose weight? Obesity can be treated using a combination of diet, physical activity and behavior modification. One pound of body weight is equal to 3500 calories. In order to successfully lose 1 pound of body weight each week, individuals should aim to decrease their caloric intake by 500 calories each day. 30-45 minutes of physical activity most days of the week can increase calorie expenditure, which facilitates weight loss. It is important to lose weight slowly and consistently in order to maintain your weight loss and not feel deprived. Behavior modification techniques are necessary to break habits of overeating and resolve any underlying issues with food that may be present.

How can I make healthier food choices? One of the most important things you can do to make healthier food choices is to learn appropriate portion sizes. Learning what your plate should look like is the first step in any healthy lifestyle. You also want to be conscious of what is in the food you're eating by reading the nutrition facts label. Look for foods that are high in fiber, vitamins and minerals to keep you full and give your body the nutrients it needs. Limit foods that are high in total fat, sodium and cholesterol. Although what you eat is important, where and how you eat are also important when trying to lose weight. Eat only at the table to avoid overeating in front of the TV, while driving or while standing in front of the refrigerator. Learn to manage stress to overcome emotional eating and find a support group or friend to help you reach your goals.

How can physical activity help? Physical activity can help you burn more calories and aid in further weight loss. Physical activity is also key in maintaining your weight loss. Aside from weight loss, physical activity can also improve your mood, help with anxiety, increase bone strength, reduce risk of heart attack and stroke and help you manage high blood pressure and cholesterol.

I'm concerned about my children's eating and physical activity levels. How can I help improve their habits? A growing child should never be encouraged to lose weight; instead weight gain should be slowed or stopped while the child grows taller. As a concerned parent, begin by setting a positive example. Your children learn eating and exercise habits at home first, which makes you the best teacher there is! Teach your children how eating healthy and exercising can benefit their health, not just help with weight loss. Try increasing your physical activity as a family and monitoring meals away from home. These are positive ways to incorporate healthier habits without focusing on weight loss. Also, don't use food as a reward OR punishment. Food should be used as fuel, not related to behavior.

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OSTEOPOROSIS

What is osteoporosis? Osteoporosis is the loss of bone density over time.

What increases my chances of developing osteoporosis? Osteoporosis is most common in women over the age of 50. This is mainly due to a drop in estrogen due to menopause, which causes a decrease in bone density. Other causes may include,

  • Lack of physical activity
  • History of an eating disorder
  • Taking corticosteroids medications (prednisone, methylprednisone) for more than 3 months
  • Absence of menstrual periods
  • Excessive alcohol consumption
  • Family history of osteoporosis
  • Low body weight
  • Smoking
  • Low calcium diet

What bones does osteoporosis affect? Osteoporosis affects all bones in the body, but damage to the hips, wrists and spine are most common.

How can I find out if I have weak bones? The best way to determine the strength of your bones is to have your doctor take a scan of your bones using a dual x-ray absorptiometry (DXA) test.

When should I get a bone density test? It is recommended that you get a bone density test if you are over the age of 65, or if you are under age 65 with certain risk factors. Speak with your healthcare provider about risk factors associated with menopause, your height and weight, tobacco and alcohol use, medicines, family history and medical conditions that may increase your risk for osteoporosis.

How can I prevent weak bones? In order to prevent weak bones, make sure your diet is full of calcium-rich foods. Calcium-rich foods include milk, cheese, yogurt, spinach, tofu and white beans. It is also important to get enough vitamin D, which helps your body absorb calcium. Vitamin D is present in salmon, fortified milk and fortified eggs. Because it is difficult to get all of the vitamin D your body needs through food, talk to your healthcare provider about a vitamin D supplement. Increasing physical activity (particularly weight bearing exercise), smoking cessation and decreased or moderate alcohol intake can also help prevent weak bones.

What if dairy foods make me sick or I don't like them? How can I get enough calcium? If you choose not to consume dairy, there are other ways to get enough calcium in your diet. Other calcium-rich sources include canned salmon with bones, sardines, Chinese cabbage, bok choy, kale, collard greens, turnip greens, mustard greens, broccoli and calcium-fortified orange juice. However, if you suspect you have symptoms of lactose (natural sugar found in dairy) intolerance, talk with your healthcare provider.

Do men get osteoporosis? Yes. In the U.S., over two million men have osteoporosis.

How is osteoporosis treated? If you have osteoporosis you will likely need to make lifestyle changes to prevent fractures. You may also need to take medicine approved by your doctor. Work with your healthcare provider to find the best treatment plan for you.

  • Bisphosphonates (bis-fos-fo-nates) - Bisphosphonates are approved for both prevention and treatment of postmenopausal osteoporosis. Drugs in this group also can treat bone loss, and in some cases, can help build bone mass.
  • SERMs - A class of drugs called estrogen agonists/antagonists, commonly referred to as selective estrogen receptor modulators (SERMs) are approved for the prevention and treatment of postmenopausal osteoporosis. They help slow the rate of bone loss.
  • Calcitonin (kal-si-TOE-nin) - Calcitonin is a naturally occurring hormone that can help slow the rate of bone loss.
  • Menopausal Hormone Therapy (MHT) - These drugs, which are used to treat menopausal symptoms, also are used to prevent bone loss. But recent studies suggest that this might not be a good option for many women. The Food and Drug Administration (FDA) has made the following recommendations for taking MHT:
  • Take the lowest possible dose of MHT for the shortest time to meet treatment goals.
  • Talk about using other osteoporosis medications instead.
  • Parathyroid Hormone or Teriparatide (terr-ih-PAR-a-tyd) - Teriparatide is an injectable form of human parathyroid hormone. It helps the body build up new bone faster than the old bone is broken down.

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PHYSICAL ACTIVITY

How can physical activity improve my health? Physical activity hosts a variety of health benefits including, aiding in weight management, stress relief, reduced anxiety, increased bone strength, reduce your risk of heart attack and stroke and can help you manage your blood pressure and cholesterol.

How much physical activity should I do? Aim to be physically active for 30 minutes, 5 days of the week. If you cannot do 30 minutes at one time, break up your physical activity into ten or 15 minute intervals throughout the day.

Does the physical activity I choose matter? The specific activity you choose does not matter, as long as it increases your heart rate.

What are some tips to help me get moving? Try to incorporate more activity throughout your day. Take the stairs instead of the elevator, park your car further away from the door and take walks around the block. If you are just beginning an exercise regimen, be patient and work your way towards your goal. It is also wise to consult your healthcare provider before beginning a new exercise program.

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PREGNANCY

I'm thinking about getting pregnant. How can I take care of myself? Research has shown that good nutrition and a healthy lifestyle can boost your fertility. Overall your diet should consist of a variety of fruits, veggies, whole grains, lean meats and dairy. However, there are a few nutrients you may want to pay closer attention to. 400 micrograms of folate (or folic acid) is recommended for all women of child-bearing age because of its ability to prevent neural tube defects, such as spina bifida. Folate can be obtained naturally through dark green leafy vegetables, citrus fruits, nuts, legumes, whole grains and fortified breads and cereals. 1000 of calcium is recommended if you're trying to conceive. Get three servings of calcium through milk, cottage cheese, yogurt, canned salmon, sardines and cheese. Nutritional supplements should be discussed with your healthcare provider, as most nutrients required during conception can be met through a healthful diet. If you trying to become pregnant, it is important to wean yourself off caffeine, and stop smoking, using recreational drugs and consuming artificial sweeteners.

I'm pregnant. What should I do to take care of my unborn baby and myself? Pregnancy is the perfect time to nourish yourself and your baby. It is important to eat a well balanced diet in order to receive optimal nutrients for you and baby. Contrary to popular belief, you are not really eating for two during pregnancy. In fact, during your first trimester, you don't need any additional calories. However, in your second and third trimesters you only need about 300 additional calories per day. While what you eat during pregnancy is important, what you don't eat is also important. Due to risk of food borne infections and food borne illnesses, pregnant women should not consume raw meat, deli meat, fish containing mercury (shark, swordfish, king mackerel, tile fish, sushi), smoked seafood, fish exposed to pollutants, raw eggs, unpasteurized dairy, soft cheeses, caffeine, alcohol and unwashed fruits and vegetables.

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STRESS

What is stress? Stress is your body's physical response to anything that makes you feel threatened or disrupts your balance in any way. Stress serves as natural protection in demanding situations by allowing to have more energy, focus and concentration by increasing your alertness and physical capabilities.

What are the most common causes of stress? Any situation or pressure that causes stress is known as a stressor. Stressors can be external or internal and are largely individualized depending on each individual's view on a situation. Common external stressors include work, life changes, relationships, financial hardships, children and family. Common internal stressors include pessimism, negative self-talk, unrealistic expectations, perfectionism, lack of assertiveness or an inability to accept change or uncertainty.

What are some common signs of stress? Stress can affect many aspects of your life and it is important to learn how you show signs of stress. Stress can present in cognitive, emotional, physical or behavioral symptoms.

Cognitive Symptoms Emotional Symptoms

  • Memory problems
  • Inability to concentrate
  • Poor judgment
  • Seeing only the negative
  • Anxious or racing thoughts
  • Constant worrying
  • Moodiness
  • Irritability or short temper
  • Agitation, inability to relax
  • Feeling overwhelmed
  • Sense of loneliness and isolation
  • Depression or general unhappiness
  • Physical Symptoms Behavioral Symptoms
  • Aches and pains
  • Diarrhea or constipation
  • Nausea, dizziness
  • Chest pain, rapid heartbeat
  • Loss of sex drive
  • Frequent colds
  • Eating more or less
  • Sleeping too much or too little
  • Isolating yourself from others
  • Procrastinating or neglecting responsibilities
  • Using alcohol, cigarettes, or drugs to relax
  • Nervous habits (e.g. nail biting, pacing)

Can stress affect my health? Although a certain amount of stress helps your reach your goals and overcome challenging situations, chronic or prolonged stress can affect almost every system in your body. Chronic stress has been linked to the following conditions:

  • Increased blood pressure
  • Decreased immune function
  • Increased risk for heart attack and stroke
  • Infertility
  • Anxiety and depression
  • General body pain
  • Heart disease
  • Digestive problems
  • Sleep disorders
  • Obesity
  • Autoimmune disorders
  • Skin conditions, like eczema

Does stress cause ulcers? It was previously believed that stress caused ulcers, but now research shows that ulcers are actually causes by bacteria called Heliobacter pylori (also known as H.pylori). Individuals respond to H. pylori differently, and not all those positive with H.pylori will develop an ulcer.

What is post-traumatic stress disorder (PTSD)? PTSD is an anxiety disorder that stems from a traumatic event that caused threat of injury or death. PTSD can occur immediately after a major event, or can appear months later. Signs of PTSD usually fall into three categories: reliving the event to the extent that it affect daily life, avoiding the event, or experiencing emotional disturbances such as irritability, anger, outbursts or anxiety.

How can I help manage my stress? It may seem like your stress is spiraling out of control, but you can always take control of your thoughts, emotions, environment and reaction to stressors. There are four easy steps to help you manage your stress.

1. Identify stressors - these could be anything from family to unrealistic expectations of yourself
2. Examine how you react to stress - do you become depressed? Angry? Etc?
3. What signs did you show of stress - signs can be cognitive (mental), emotional, physical or behavior
4. Follow the 4 A's of stress management
a. Avoid the stress
b. Alter the stressor
c. Adapt to the stress
d. Accept the stressor

Avoid unnecessary stress

Not all stress is bad, but there are strategies to reduce the amount of stress in your life. Learning to set limits and avoiding individuals or situations that cause you stress can in turn reduce your own stress. Downsizing your to-do list based on what "could" be done and what "must" be done can help you eliminate extra items from your list that cause you added stress.

Alter the situation

If you can't avoid a stressful situation, try to alter it. Often, this involves changing the way you communicate and operate in your daily life. Managing your time and communicating openly and honestly with those around you is the best way to alter a stressful situation. When you express your feelings and assertiveness, you will be more likely to reach a compromise and avoid the stress altogether.

Adapt to the stressor

If you can't change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude. Looking at the big picture can often help you regain perspective - will this situation matter in a month? A year? Is it really worth getting upset over? If the answer is "no", then focus your energy elsewhere.


Accept the things stressor

Some sources of stress are unavoidable. You can't prevent or change stressors such as the death of a loved one, a serious illness, or a national recession.


Other ways to manage stress

  • Healthy ways to relax and recharge
  • Go for a walk.
  • Spend time in nature.
  • Call a good friend.
  • Sweat out tension with a good workout.
  • Write in your journal.
  • Take a long bath.
  • Light scented candles
  • Savor a warm cup of coffee or tea.
  • Play with a pet.
  • Work in your garden.
  • Get a massage.
  • Curl up with a good book.
  • Listen to music.
  • Watch a comedy

 

  • Exercise regularly. Physical activity plays a key role in reducing and preventing the effects of stress. Make time for at least 30 minutes of exercise, three times per week. Nothing beats aerobic exercise for releasing pent-up stress and tension.
  • Eat a healthy diet. Well-nourished bodies are better prepared to cope with stress, so be mindful of what you eat. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day.
  • Reduce caffeine and sugar. The temporary "highs" caffeine and sugar provide often end in with a crash in mood and energy. By reducing the amount of coffee, soft drinks, chocolate, and sugar snacks in your diet, you'll feel more relaxed and you'll sleep better.
  • Avoid alcohol, cigarettes, and drugs. Self-medicating with alcohol or drugs may provide an easy escape from stress, but the relief is only temporary. Don't avoid or mask the issue at hand; deal with problems head on and with a clear mind.
  • Get enough sleep. Adequate sleep fuels your mind, as well as your body. Feeling tired will increase your stress because it may cause you to think irrationally.

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STROKE

What is a stroke? A stroke occurs when a blood vessel that supplies oxygen to the brain is blocked or bursts. The affected part of the brain cannot receive oxygen and therefore is damaged or dies. What is a mini-stroke? Mini-strokes, also known as TIAs (Transient Ischemic Attacks) or warning strokes, occur when a clot forms temporarily in the brain. Although TIAs typically last less than five minutes, they should still be taken very seriously as one-third of individuals who experience a TIA have a stroke within one year. TIAs usually do not cause permanent damage, but if you experience any signs of a stroke, dial 911 immediately.

What are the effects of a stroke? The effects of a stroke are determined by part of the brain affected and the length of time the clot was present. If a stroke occurs in the right side of the brain, there may be left side paralysis, vision problems, quick/inquisitive behavioral style and memory loss. If a stroke occurs on the left side of the brain, right side paralysis, speech and language problems, slow/cautious behavioral style and memory loss may result.

Who is at risk for stroke? There are many factors that determine the risk for a stroke. Individuals who are over the age of 55, have a family history of stroke, are African American, male, or have had a previous stroke, TIA or heart attack are more ask risk. Cardiovascular disease, poor diet, lack of physical activity and cigarette smoking also increase your risk of stroke.

How do I prevent a stroke? To decrease your risk of having a stroke, speak with your healthcare provider about managing any cardiovascular-related issues. Managing high blood pressure, artery disease, atrial fibrillations, sickle cell anemia and high cholesterol can decrease your risk of a stroke. Similarly, following a heart healthy diet, maintaining a healthy weight, engaging in physical activity, and quitting tobacco use can also decrease your risk of a stroke.

How is stroke treated? Treatment for stroke can begin immediately if you make it to the hospital in time. An FDA-approved clot-busting medication called tPA (tissue plasminogen activator) can be used if an individual reaches the hospital within three hours of the onset of stroke symptoms. This drug is administered by a healthcare professional through an IV in the arm to help break up the clot and prevent further damage. However, there are treatments available to help prevent a stroke from occurring. Anticoagulants and antiplatelet agents like aspirin and Warfarin can be used to decrease the formation of clots before they happen. Carotid endarectomies remove any blockage to help prevent a stroke and angioplasties/stents can be placed to reduce fatty acid build up.

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