Friday, January 20, 2017

How To Eat Healthy In A Nutshell & How To Change Eating Behaviors!

I believe in evidence based medicine to make recommendations on what's truly considered "healthy." 

I also use the dietary guidelines by the U.S. Department of Agriculture and the Department of Health and Human Services to focus on the specific dietary issues that we face in the USA. Click here to view the new guidelines.

My overall recommendations are in line with these guidelines and include the following:

1) Limit added sugar to <10% of your total daily calories
 This is very important considering how much added sugars we as Americans take in. Added sugars are sugars and syrups that are added to foods or beverages when they are processed or prepared. Decreasing added sugars means we have to start looking at the nutrition labels of all the foods we eat. There's a ton of "secret" or "hidden"added sugars in different items that you would never guess - things from cereal to pasta sauce! Many researchers have suggested that "added sugars" can have independently bad outcomes on health (heart disease, diabetes, obesity) when compared to "natural sugars:" i.e. the sugars in milk, fruit,vegetables, grains, etc. I will blog on this separately soon!

2. Incorporate more healthy eating patterns (how we eat, think, and relate to food)

See below for my take on what this means

Continued recommendations include:

3. The recommended amount of vegetables in the Healthy U.S.-Style Eating Pattern at the 2,000-calorie level is 2½ cup-equivalents of vegetables per day

4. Consume less than 10 percent of calories per day from saturated fats

5. Consume less than 2,300 milligrams (mg) per day of sodium

6. Recommended daily intake of whole grains is to be at least half of total grain consumption, and the limit for refined grains is to be no more than half of total grain consumption.

7. If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.

You might be wondering what "healthy eating patterns" mean exactly?

Think about when you are hungry or have a craving -- you always make a conscious decision (whether right or wrong) of what goes into your mouth. The right decision is made by keeping in mind your caloric intake (or restriction if you are following a restricted diet) & need for nutrients (vitamins, minerals, number of servings to maintain a balanced diet).
A healthy eating pattern would mean choosing the right food which is healthy for you, and avoiding the foods that you know are "bad".
Much of understanding and utilizing "healthy eating patterns" comes from educating yourself on nutrition and what foods are considered "good" or "bad".


I will try to help with some of the very basics!

Our food groups consist of:
- Vegetables
- Fruits
- Grains
- Dairy
- Protein
- Fats

Think of the food pyramid:


In each category there are "good" and "bad" options for you. One way of changing your eating pattern and behavior would mean picking the "good" options, and limiting those which you know are "bad".

The "bad" and "good" foods in each category also depends on your underlying medical issues! I.e. Diabetics have a certain diet where too many carbs are "bad", dialysis patients have a certain diet where too much protein is "bad", etc. So if you have any underlying medical condition you should ask your MD about the best diet for you. 

I will share with you some of the good and the bad foods in each category....

Vegetables:
Good options: All fresh, frozen, canned, and dried options in cooked or raw forms
Bad options:  French fries, potato chips, vegetable chips/straws, tortilla chips, popcorn

Fruits: 
Good options: Whole fruits raw, cooked, canned (be aware of the canned fruits with fruit juice added), frozen, and dried
Bad options: Fruit juice, fruit candies, smoothies bought in bottles, breakfast bars with fruit flavoring or filling, blueberry pie

Grains:
Good options: Whole grains that are not enriched or refined
Bad options: Sugary cereals (most kids cereals are loaded with sugars even though some have grains), bagels, doughnuts, biscuits, bran muffins, oatmeal cookies, beer, whole wheat tortilla chips, crackers

Dairy:
Good options:  Milk or dairy products (yogurt, cheese, etc.) that is made from fat-free or low-fat milk, soymilk, almond milk
Bad options: Ice cream, Indian sweets made from cheese (!), cheesecake, pizza, alfredo sauce

Protein:
Good options: Lean meats like chicken and fish, nuts (cooked or raw), legumes (beans, peas and lentils), tofu, eggs
Bad options: Processed meat (lunch meats), sausage, bratwurst, hot dogs, bacon, fried chicken, breaded fish sticks, breaded chicken cutlets

Fats:
Good options: Choose oils with monounsaturated fats (olive, sesame, canola, peanut, safflower oils) and polyunsaturated fats (soybean, corn, sunflower oils & fatty fish such as salmon, mackerel, herring, trout)
Bad: Solid fats (named so because they are solid at room temperature and high in saturated fats) like butter, stick margarine, shortening, lard, coconut oil, trans fats like margarine, doughnuts, cookies, frozen pizza, most fast food items, pie crusts, etc.


I will blog more on each of these food groups and discuss how Americans are doing with their eating habits and what we can do better!

Please feel free to ask any questions! Email me at DoctorDeenaMD@gmail.com or ask/follow me on Twitter/Instagram @Doctor_Deena

**PLEASE REMEMBER IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR HEALTH AND/OR BEFORE STARTING OR STOPPING ANY TREATMENT OR ACTING UPON INFORMATION CONTAINED ON THE SITE, YOU SHOULD CONTACT YOUR OWN PHYSICIAN OR HEALTH-CARE PROVIDER**







Wednesday, January 11, 2017

Tips to prevent mosquito bites and mosquito born infection, like the ZIKA virus!!



This great question comes from a lovely friend and she asks:

Dear Dr. Deena,

I am planning on traveling to India. How can I protect myself from mosquitoes? 

NB

Don't worry, NB, I got your back. There's nothing I hate more than mosquitoes! Mainly because I have a severe allergy to their bites. 

I consider mosquitoes as one of the deadliest animals because they can carry a host of illnesses - like malaria, yellow fever, dengue, etc. Just look at all the chaos they have caused with the Zika virus. It may be years until pregnant females (or those considering pregnancy) can safely travel to Mexico and the Caribbean again! :(

Here are some tips to prevent mosquito bites (and ultimately diseases transmitted via mosquitoes):

-Use air condition when possible, and keep windows/doors closed when you can

-Make sure that if you do keep windows or doors open -- that there is always a screen in front of the window/door to keep mosquitoes outside

-If you are not able to protect yourself from mosquitoes inside your home, consider sleeping under a mosquito net

-Mosquitoes love stagnant water bc thats where they breed. Avoid areas with stagnant water (swamps, ponds, lakes, marshes, junk yards, etc.)

-Wear long-sleeved shirts and long pants when possible

-Wear socks when possible to cover your feet

-Use insect repellents. I recommend OFF Deep Woods. 
Spray repellent on all exposed areas

-Treat clothing with permethrin or consider purchasing permethrin-treated clothing

-Avoid being outside when its dark, most mosquitoes feed during the night (though every species has different preferences for feeding time)

-Mosquitoes love scent, so avoid wearing fragrance (scented perfume, body lotions, etc.)

-Wear lighter colors (like white) as mosquitoes are attracted to darker colors (like black)

-Sleep under a ceiling fan or close to a fan. The wind generated from the fan makes it difficult for the mosquitoes to fly 

-I use an electric mosquito swatter to protect myself and highly recommend it! It easily gets rid of mosquitoes that might be flying to fast for you to catch 



I would also recommend finding out whether or not you need to take medications for malaria prophylaxis. This will depend on which area you are traveling to in India...though its recommended in majority of the areas.

Hopefully with these keys to prevention you will be able to prevent nasty mosquito bites and infections!

Please feel free to email me at DoctorDeenaMD@gmail.com with further questions, comments. 

Follow me on Instagram & Twitter: @Doctor_Deena 


**PLEASE REMEMBER IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR HEALTH AND/OR BEFORE STARTING OR STOPPING ANY TREATMENT OR ACTING UPON INFORMATION CONTAINED ON THE SITE, YOU SHOULD CONTACT YOUR OWN PHYSICIAN OR HEALTH-CARE PROVIDER**

Tuesday, January 3, 2017

Travel smart and safe. Be aware of where the Zika epidemic lies and avoid these countries if you are pregnant or trying to conceive (both men and women)!


The Zika epidemic has hit many countries. Do you know which ones they are?

I've had 2 friends (who are interested in getting pregnant) book a recent deal to Cuba and Argentina, respectively, last week. They didn't realize that there's tons of great travel deals out there currently because the Zika epidemic has taken over that country. After I spoke with them, they sadly had to cancel the trip! (sorry, ladies :( )
I don't want this to be you, either.

Many of my patients are asking me about where they can or cannot travel, so I wanted to point you all in the right direction.
The CDC is an excellent source of information on the Zika virus:
https://www.cdc.gov/zika

Check out the map below to see where Zika is the most active currently. These are the places you should be avoiding if you are pregnant or trying to get pregnant (both men and women!).

In general, I recommend avoiding the following regions:
-Certain parts of the USA- currently Miami (Florida), Brownsville (Texas) and all of Puerto Rico
-All of  Mexico
-All of  Central America
-All of South America
-All of the Caribbean
-All the Pacific Islands
-Certain parts of Africa-currently Cape Verde
-Certain parts of Asia-currently Singapore









                                                                              
If you do have to travel to these destinations, I would recommend the following:

1) Protecting yourself as best possible against mosquitoes. You can read my post on this here.

2) Practice safe sex, and always use condoms!

3) Get tested for the Zika virus when you return, if you are concerned over being infected


4) The CDC recommends the following if you are interested in pregnancy and have traveled an area with Zika:
-WOMEN should wait at least 8 weeks after symptoms start or last possible exposure before trying to get pregnant
-MEN should wait at least 6 months after symptoms start or last possible exposure before trying to get pregnant (this is because Zika lives longer in semen than in other body fluids)

Safe travels everyone! To continue with this trend on Zika information, tomorrow I will share ways on how you can prevent mosquito bites; thus, exposure to Zika.



**PLEASE REMEMBER IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR HEALTH AND/OR BEFORE STARTING OR STOPPING ANY TREATMENT OR ACTING UPON INFORMATION CONTAINED ON THE SITE, YOU SHOULD CONTACT YOUR OWN PHYSICIAN OR HEALTH-CARE PROVIDER** 




Monday, January 2, 2017

Everything you need to know about the Zika virus and why you still need to worry about ZIKA in 2017!


It's winter and you might be dreaming of lounging on a warm beach with a cocktail in hand....being lulled to sleep by the sound of waves crashing on the sand in the distance. Sounds amazing right?


But before you think about a beach vacation, please don't forget about the Zika virus. I know it's ruined so many of my friend's vacation plans -- honeymoons, babymoons, wedding destinations, etc..... but better safe than sorry!


Let's start with some basics first. 

How does the Zika virus spread?
The Zika virus can been transmitted:
-Through mosquito bites 
-From mother to child during pregnancy or at the time of birth
-Through having sex with a person infected with the Zika virus
-Through blood transfusions (this has only happened in Brazil thus far)

Why should we worry about the Zika virus?
-Zika infection during pregnancy can cause serious birth defects 
-Zika may be associated with a neurologic condition called Guillain-Barré syndrome (GBS), which if undiagnosed can lead to paralysis and/or death

The Zika virus can infect anyone, but as long as you have a good working immune system - your body should be able to protect you against this virus. 



Though the Zika has only been reported in certain parts of the USA thus far (Miami, Florida, Brownsville, Texas and all of Puerto Rico) its a huge public health concern.

I do not agree completely with the recent WHO statement that the ZIKA virus is no longer a Public Health Emergency of International Concern (PHEIC), and I still recommend caution for many important reasons listed below.

Here's why you still need to worry about the Zika virus:

1) The Zika epidemic is young, and we need more time to learn about the long-term health  consequences of the Zika virus
We began to learn of how the Zika virus causes neurologic problems and birth defects in babies in July 2015. That's not too long ago! Not every baby infected by Zika developed medical problems, but its just too early to know if they ever will. Often times its hard to diagnose neurologic or behavioral disorders until a child is olderAt this time - its really hard to know which baby will develop what complication from the Zika virus and when these complications can be be expected to develop.

2) Zika can affect the brain in ways beyond microcephaly
The common complication of the Zika virus in newborns is microcephaly (the development of smaller brains and skulls). What you may not know is that a study published in Radiology suggests that there are many other brain abnormalities that can occur with the Zika virus beyond just microcephaly. Whether or not these other brain abnormalities are significant clinically, is unknown....however, Zika has been shown to affect brain development leading to abnormalities in speech, hearing, behavior, intellect, movement, etc. Again when these abnormalities may arise is still unclear. 


3) There is still no cure for the Zika virus
Currently the only option we have to avoid the Zika virus is prevention. There is NO treatment, NO vaccine, and NO cure at this time...though scientists are working hard at this!


4) You might be infected with the Zika virus and not even know it!
According to the WHO, the MAJORITY of people (80% or more) who become infected with Zika never have symptoms. In those who do, the most common Zika virus symptoms are fever and rash; some may also develop muscle and joint pain, headache, pain behind the eyes, and conjunctivitis (red eyes).

4) We are still not sure about how long the virus actually lives in our body
We know that ONE way Zika can be transmitted is through sex, but what we don't know is how long the virus actually lives in semen and vaginal fluids and/or how long it can be passed to sex partners. Current research shows that the Zika virus remains in semen longer than in other body fluids, including vaginal fluids, urine, and blood. Scientists are still trying to figure out how long Zika can actually live in semen.


Hope this gives you some insight on the Zika virus. Please share with friends and family, especially those who are pregnant and/or trying to conceive!

Tomorrow I will blog on another popular topic-- how you can protect yourself during this Zika epidemic and the places to avoid traveling to!

**PLEASE REMEMBER IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR HEALTH AND/OR BEFORE STARTING OR STOPPING ANY TREATMENT OR ACTING UPON INFORMATION CONTAINED ON THE SITE, YOU SHOULD CONTACT YOUR OWN PHYSICIAN OR HEALTH-CARE PROVIDER**