Community Health - Dec 2015

1COMMUNITYHEALTHMAGAZINE.COM | DECEMBER 2015

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Treat Yourself Rethink dessert to indulge guilt-free By Paige Fumo Fox

Dieting? Trying to maintain your weight? Dont skip dessert. Dessert isnt the enemy to your waistline. Unrealistic limits are.

Do you want a hot fudge sundae, but only on a weekend? Do you like a little something sweet and can settle for one square of dark chocolate or a baked apple each night? Anna Ardine, clinical nutrition manager at Magee Womens Hospital in Pittsburgh, says to come up with a reasonable limit for the foods you eat. Figure out what will work for you.

Mary Vogliano, a Weight Watchers ambassador and group leader in Pittsburgh, agrees, saying you shouldnt deprive yourself.

The big thing we always talk about at Weight Watchers is there really is no reason to declare a food off-limits, Vogliano says. De-privation is one of the things that make you want to give up.

Follow a few simple tricks and revamp the way you think about dessert to satisfy your sweet tooth without the guilt.

ReTRain youR TasTe buDs Many chocoholics were thrilled to hear there

are good health benefits found in chocolateuntil they listened further to learn those benefits come from dark chocolate, not milk chocolate. But if you work at it, you may eventually find your-self savoring the dark and not craving the milk chocolate, Ardine says. Rather than digging into a piece of dark chocolate like you would a piece of milk chocolate, take smaller bites and eat it slowly so you can savor the flavor and so you dont become overwhelmed with its slight bitterness.

The same works for other healthy treats. Start slow and learn to appreciate the taste, whether its bitter or tart, sweet or savory.

slim Down youR seRvings If youre ordering dessert at a restaurant,

remember one restaurant serving is much more than whats typically recommended for a single person. One of the best ways to control your intake is to order one dessert and split it with someone else. Dont be shy about asking your waiter how many people that slice of bread pud-ding is meant to serve. Knowing that ahead of

HOW MUCH IS ENOUGH? while 100 calories is an easy goal to pick for por-tion control, there isnt necessarily a magic number for desserts. It depends on what else youre eating all day, says Weight Watchers ambassador Mary Vogliano. Consider these calorie and fat counts as you plan how sweets will fit in to your day.

a half-cup serving of ice cream, depending on the flavor and whether it is light, can be 100 to more than 300 calories and 7 or more grams of fat.

a batch of traditional Tollhouse cookies, made by dropping the dough by rounded tablespoons, makes 60 cookies at 110 calories and 7 fat grams of fat each.

Two 3-inch pineapple slices have 50 calories and no fat and are satisfy-ingly sweet.

time can help you plan how you split it up before it hits your table.

If you need a little help watching your serving sizes, try pre-portioned, 100-calorie low-fat treats. You can also portion out snacks yourself using a plastic snack bag.

Fill uP on FibeR When you add fiber-filled foods like fruit to your dessert, it can help you feel more satisfied, Vogliano says.

Top low-fat ice cream or frozen yogurt with some fresh berries. Dip apple slices into chocolate sauce. Or, simply eat some fresh, natural strawber-ries for dessert instead of eating that slice of cake. Eat naturally sweet things, Ardine says.

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simply eat some fresh, natural straw-berries for dessert instead of eating that slice of cake. Eat naturally sweet things, Ardine says.

ingReDienT swaPsSwap out fat- and sugar-filled ingre-dients with healthier options when baking. Fruit pures can fill in for some of the oils in baking, and nonfat Greek yogurt can be substituted for sour cream in many baked goodies.

Use applesauce in place of eggs, oil or butter.

Whole-wheat flour is a good sub-stitute for all-purpose flour. One cup of whole-wheat flour has 408 calo-ries, 13 grams of dietary fiber and 16 grams of protein compared with one cup of all-purpose, which has 455 cal-ories, 3.4 grams of dietary fiber and 13 grams of protein.

KeeP iT occasionalHow often should you have dessert? Treats used to be, well, a treat, Ardine says. If Mom baked pies, she proba-bly wasnt doing it every day, and the size of the pie was probably smaller than what youd find in any restau-rant today.

Desserts were never supposed to be an everyday thing, Ardine says.

Limit desserts to once per week or less, and plan for special occasions where dessert will be abundant. If your friend is celebrating her birth-day next week, and you know youre going to indulge in some cake and ice cream, skip the dessert this week so you can have more guilt-free fun next week.

Desserts were never supposed to be an everyday thing.anna aRDine clinical nutRition manageR

Sweet tooth, ServedBy Tim DuDiK, Community HealtH House CHefJust because youre trying to lose weight or watch what you eat doesnt mean you have to completely eliminate dessert from your diet. A little fresh fruit, natural sugar and fiber-filled ingredients along with a little creativity can take your dessert from straight sugar bomb to a healthy and delicious delight.

cHocolate and espresso glazed frozen yogurt witH bananasCoffee and dessert go hand-in-hand, and when you introduce coffee into your dessert you add a great deal of flavor, which means you can use less sugar and create a healthier dessert.

Serves 4

triple berry trifle witH Honey and flaxseedThe fresh berries in this dish are naturally sweet, and the honey is a healthier option than refined sugar giving this dessert a subtle sweetness. The flaxseed also offers a

different texture with health benefits such as omega-3 fatty acids and fiber.

dark Hot cHocolateServes 2

2 tablespoons cocoa powder2 tablespoons

dark chocolate chips1 teaspoon sugar2 cups milk, almond milk

or soy milkPinch of salt teaspoon vanilla extract

1. Combine all ingredients in a medium size saucepan over low heat.

2. Whisk together until all ingredients are incorporated and chocolate is melted.

3. serve in a mug and top with a shake of cinnamon.

Serves 41 cup blueberries1 cup strawberries, tops removed,

and quartered1 cup raspberries cup honey, divided into thirds

cup flaxseed, divided into thirds2 cups plain Greek yogurt1 cup whipped topping,

such as Cool Whip

fresh mint to garnish

1. Toss strawberries with one-third of the honey and flaxseed. Repeat for raspber-ries and blueberries.

2. In four tall clear glasses, lay strawberries on bottom, then top with a layer of yogurt, then a layer of raspberries, then another layer of yogurt, then a layer of blueberries, then top with whipped topping. Garnish with a sprig of mint.

2 cups vanilla frozen yogurt2 bananas, peeled, cut into thin slices1 cups powdered sugar

cup cocoa powder1 teaspoon instant espresso3 tablespoons brewed coffee

1. To make the glaze, mix together the sugar, cocoa and espresso powder. Whisk in the brewed coffee.

2. Let glaze chill for 20 minutes.

3. serve frozen yogurt topped with the chilled glaze and bananas. you can also serve the glaze warm over the frozen yogurt to create a healthier version of the classic hot fudge sundae.

4 C o m m u n i t y H e a l t H | l u D i n G t o n D a i ly n e W S | F R i D ay, D e C e m b e R 11 , 2 0 151 xx 2014 C o m m u n i t y H e a l t H

As a primary care physician, Dr. Joseph Teel is used to seeing patients who want to get his medical adviceand then double-check it with another doctor.

Dont worry, hes not offended. And theres a good chance your doctor isnt, either.

All of us have been in a situation where it doesnt seem like there is any-thing concerning, and the patient says, I really am concerned, Teel says.

It can tough to decide whether that headache or stomach pain warrants a second opinion. Am I overthinking it? Should I spend the money on a second visit to a specialist? Is my doctor going to be annoyed or think I dont trust him?

There are certainly times when a patient should go with their instinct about their own body, says Teel, who also serves as assistant professor of clini-cal family medicine at the University of Pennsylvania. After all, he says, no one knows better than you when something definitely feels off.

Its also true with pediatric care. Sometimes moms and dads have a sense of whats going on, he says.

MAke it A conversAtionIf you feel like you need a second exam or the help of a specialist, Teel suggests first double-checking your insurance plan. If

you have an HMO, you have to get autho-rization from your primary care provider to get an insurance referral for a special-ist, he says.

But other plans dont require that step, which means you could go straight to a cardiologist or neurologist or other specialist without having to first get the opinion of your primary physician.

If you do see your family doctor first, Teel says most are happy to provide a rec-ommendation for a specialist, even if they first advise you that they dont believe another appointment is necessary.

Approach the topic as a conversation, rather than an accusation.

I wouldnt put it in the context of tell-ing the provider, I think what you did is incorrect, Teel says. You can personal-ize it, putting it on yourself to say, I feel something else is going on and maybe someone else could weigh in.

Do your reseArchThe wealth of health information avail-able online can be a useful part of the

conversation, especially if patients are careful to do research with reputable sources, Teel says. The websites of some of the countrys large medical systemsplaces like the Mayo Clinic and Cleveland Clinicprovide useful systems to inves-tigate your symptoms so you have a good sense of questions you can ask your doc-tor on that first visit.

If you get there and are asking those questions and there are inadequate answers or someone is stepping around the question, that could help you feel empowered (to get a second opinion), he says.

Do whAt feels rightIts important to go with what feels right to you, Teel says. If a patient will feel bet-ter by having another conversation with another doctor, it doesnt make sense for a primary physician to stand in the way.

In the end, this is not our body, our health or our life, he says. Were there to provide guidance.

Listen to Your Gut

You can personalize it, putting it on yourself to say, I feel something else is going on and maybe someone else could weigh in.Dr. Joseph Teel

how to talk to your doctor about getting a second opinion By erin golDen

1 xx 2014 C o m m u n i t y H e a l t H

As a primary care physician, Dr. Joseph Teel is used to seeing patients who want to get his medical adviceand then double-check it with another doctor.

Dont worry, hes not offended. And theres a good chance your doctor isnt, either.

All of us have been in a situation where it doesnt seem like there is any-thing concerning, and the patient says, I really am concerned, Teel says.

It can tough to decide whether that headache or stomach pain warrants a second opinion. Am I overthinking it? Should I spend the money on a second visit to a specialist? Is my doctor going to be annoyed or think I dont trust him?

There are certainly times when a patient should go with their instinct about their own body, says Teel, who also serves as assistant professor of clini-cal family medicine at the University of Pennsylvania. After all, he says, no one knows better than you when something definitely feels off.

Its also true with pediatric care. Sometimes moms and dads have a sense of whats going on, he says.

MAke it A conversAtionIf you feel like you need a second exam or the help of a specialist, Teel suggests first double-checking your insurance plan. If

you have an HMO, you have to get autho-rization from your primary care provider to get an insurance referral for a special-ist, he says.

But other plans dont require that step, which means you could go straight to a cardiologist or neurologist or other specialist without having to first get the opinion of your primary physician.

If you do see your family doctor first, Teel says most are happy to provide a rec-ommendation for a specialist, even if they first advise you that they dont believe another appointment is necessary.

Approach the topic as a conversation, rather than an accusation.

I wouldnt put it in the context of tell-ing the provider, I think what you did is incorrect, Teel says. You can personal-ize it, putting it on yourself to say, I feel something else is going on and maybe someone else could weigh in.

Do your reseArchThe wealth of health information avail-able online can be a useful part of the

conversation, especially if patients are careful to do research with reputable sources, Teel says. The websites of some of the countrys large medical systemsplaces like the Mayo Clinic and Cleveland Clinicprovide useful systems to inves-tigate your symptoms so you have a good sense of questions you can ask your doc-tor on that first visit.

If you get there and are asking those questions and there are inadequate answers or someone is stepping around the question, that could help you feel empowered (to get a second opinion), he says.

Do whAt feels rightIts important to go with what feels right to you, Teel says. If a patient will feel bet-ter by having another conversation with another doctor, it doesnt make sense for a primary physician to stand in the way.

In the end, this is not our body, our health or our life, he says. Were there to provide guidance.

Listen to Your Gut

You can personalize it, putting it on yourself to say, I feel something else is going on and maybe someone else could weigh in.Dr. Joseph Teel

how to talk to your doctor about getting a second opinion By erin golDen


Catch Some ReliefHow to help your furry friend when he comes down with a cold or flu

By erika grotto

your cat breaks into a sneezing fit or you come home to find your dog has puked on the living room floor. This might seem normalperhaps your cats sneeze is just a sneeze and maybe your dog just ate a little too fast. But it could be some-thing more.

Can your four-legged friend catch a cold or suffer from the flu? The answer is yes. And just as with the human dis-eases, there are different strains that can infect your beloved pet, but you can use vaccines to help ward off infection. FiDo anD The Flu There are two strains of canine influenza: H3N8, which has been in the United States for about 15 years, and H3N2, a newer strain.

Symptoms of canine flu are similar to those humans get, includ-ing cough, runny nose and fever, says the U.S. Centers for Disease Control and Prevention. And like humans, most dogs will be fine with a few days of rest and plenty of fluids, says Dr. Colin Parrish, veterinarian and professor of virology at the Cornell College of Veterinary Medicine.

Dog owners should follow their instincts and visit the vet if theyre concerned, but treatment is typically just to relieve symptoms. Most of the time, antibiotics arent called for, Par-rish says.

is iT conTagious? The good news is that dogs and humans dont catch each others illnesses, according to Parrish. Dogs are very resistant to human flu, he says.

An infected dog, however, can pass the flu on to another dog. Sick dogs should lay low until they feel better. Keep them out of social and play areas like doggie daycare, kennels and dog parks.

Symptoms of canine flu are similar to those humans get, including cough, runny nose

and fever.

dig for more Get more information about dog and cat illnesses and how to prevent or treat them at the American

Society for the Prevention of Cruelty to Animals website, aspca.org/pet-care.

Once symptoms start, its possible a dog has already passed the virus along to another dog, so theres little reason to keep two dogs in the same home sepa-rated, Parrish says. As of now, you can only get your dog vaccinated for the H3N8 strain, he says. There is no vaccine for the H3N2 virus.

whaT abouT caTs? Cats are safe from the latest canine influenza strains. They can, how-ever, suffer from upper respiratory infection, some-times called cat flu, according to charity International Cat Care.

URIs typically infect kittens and elderly felines and cats kept in large groups, such as those in breeding facilities, rescue shelters or multi-cat households, says the American Society for the Prevention of Cruelty to Animals. Symptoms include sneez-ing, nasal discharge, loss of appetite, fever, depression and conjunctivitis, a.k.a. pinkeye.

There are vaccines available to pro-tect against the viruses that cause URIs. These vaccines will provide protection against, but not com-pletely eliminate the possibility of, infection, says the ASPCA.

If your vet does diagnose your cat with an upper respiratory infection, he may prescribe medication, isola-tion, rest, and fluid and nutritional support.

Cats can also catch a common cold. Most symptomswhich include runny nose and coughwill go away in about a week, according to Kansas State University.


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You pay for your use with your life. When people make that connection and make the changes they need to, its immensely gratifying to see that progress. DR. DaviD gReenFielD Center for Internet and teChnology addICtIon


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caReFul TReaTmenT Even for geriatricians, caring for older people with multiple health problems can be tricky, the society says.

An 85-year-old is not the same person they were at 45, Hall says.

As people age, their bodies change. They go through metabolic changes, changes in kidney function, and changes in body fat that can affect metabolism, among other things, says Dr. Amy M. Westcott, a geriatrician who works in the pallia-tive care department of the Penn State Milton S. Hershey Medical Center in Hershey, Pa.

In fact, more than half of adults age 65 and older have three or more medical problems, such as heart disease, diabetes, arthritis, Alzheimers disease or high blood pressure, according to the American Geriatrics Society.

Many patients with multiple medical prob-lems are on multiple medications, and changes in peoples bodies as they age also affect the way the medicines affect them. One of a geriatricians key roles is to manage the many medications a person takes.

A lot of time is spent fi guring out, Do they re-

ally need all these medications or are they better off without them? Westcott says.

For example, Hall says, there was one point when the philosophy on high blood pressure was to leave it untreated. But with all the advancements in medications, more people are taking them to lower their blood pressure. But lowering a patients blood pressure can sometimes lead to lightheadedness and even falls, something every older person wants to avoid, Hall says.

Its a fi ne balance between treating high blood pressure and not treating high blood pressure, he says.

Along with high blood pressure, diabetes is among the top medical problems facing older patients. But regulation of blood sugar is a very complicated thing, Hall says. In some patients, its incredibly easy to over-treat.

Older patients might have different liver func-tion or eating habits that could affect treatments, as well. So geriatricians work to ensure the care for one condition isnt actually causing more harm than good, with the ultimate goal of helping people live independently longer.

We will undertreat one chronic illness because

One for the AgesKnow when its time to see a geriatricianby John obRien

eres no magic age when you should start seeing a geriatrician. Some patients are as young as 65, often already with multiple medical conditions. Others are into their 80s before they need specialized care.

as the baby boomer generation ages, the number of Americans age 65 and older is increasing dramatically.

According to U.S. Census fi gures, the nations 65-and-older population grew from 44 million in 2013 to 46 million in 2014. By 2030, that number will explode to more than 75 million, according to census estimates.

And as the population ages, so does the need for geriatri-cians. Geriatri-cians are doctors who specialize in treating older patients. They get training and certifi cation beyond basic family practice.

The fi eld of geriatrics is a relatively new one, says Dr. William J. Hall, a Paul Fine Professor of Medicine at the University of Rochester School of Medicines Center for Healthy Aging.

Its the youngest of specialties, even though we take care of the oldest of patients, Hall says.

treating it will make another illness worse, Hall says.

when The Timing is RighT So when is it time for an aging patient to see a geriatrician?

Theres no age really, Westcott says. What aging is in our society you cannot put a number on.

Some patients are as young as 65, often already with multiple medical conditions. Others are into their 80s before they need specialized care.

Yet there are more patients who are younger and healthier who are opting to see a geriatrician.

They say, Im aging and I want to age well, Westcott says. It might help them feel better and live independently longer.


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Call today to set up your appointment. More information is available. Crawford County Office 501 Norway Street Ste. 1 Grayling, MI 49738 Phone: (989) 348-7800

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Oceana County Office 3986 N Oceana Drive Hart, MI 49420 Phone: (231) 873-2193

Mason County Office 916 Diana Street Ludington, MI 49431 Phone: (231) 845-7381

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Community Health - Dec 2015