after tobaccoIt is the time of year when many of us make resolutions to better ourselves. I always have a hard time making a New Year’s resolution because within a short time I have failed, and then, I need to think of yet another resolution! Eventually, I reach the point where it becomes ridiculous because I have made and broken so many resolutions that I run out of ideas!

It’s difficult to tackle resolutions at any time of year, even when there are sound reasons to do so. Change can be difficult. Start by educating yourself about the risks and benefits of making these changes. You also have to be careful that you do not replace one bad habit with another one. For example, the dangers of smoking are well documented, but the risks associated with e-cigarettes are still unknown. Yet some people who are trying to quit smoking are turning to e-cigarettes. There are also a number of people that have never smoked that are now “vaping” (using an e-cigarette). E-cigarettes or electronic cigarettes are battery-operated devices that often look like regular tobacco cigarettes. The way they commonly work is that an atomizer or heating element heats a liquid often containing nicotine and various flavorings. Flavoring options include tobacco and menthol flavor, and flavorings that might appeal to younger users like bubblegum, cherry and apple. The heated liquid converts into a vapor or mist that the user inhales. The vapor cloud resembles smoke, but does not have an odor, so it is harder to know later if someone has been vaping.

Recent studies suggest that e-cigarettes do not help people reduce or quit smoking. E-cigarettes do not contain carbon monoxide or tar, which are two of the harmful chemicals in traditional cigarettes, but the Federal Drug Administration does not regulate e-cigarettes for recreational use, so what’s in them can vary. The FDA is currently looking into extending its authority to include alternatives to tobacco products, which would allow them to use regulatory rules to impose age restrictions and review claims made that e-cigarettes reduce tobacco-related disease and death.

tobacco smokingI applaud you if one of your resolutions this year is to quit smoking. I encourage you to educate yourself on the many resources available to help you. I recommend that you read the American Heart Association’s policy statement on the use of e-cigarettes. You may still find that e-cigarettes are a viable option for you or you can find a quit-method that may work for you here. If you live or work in the Howard County there are free Smoking Cessation & Tobacco Treatment Programs. Visit the library for resources on smoking and health-related issues.

This is a great time of year to reflect on major issues you would like to change in your life. You do not have to tackle everything at once. In fact, if you successfully tackle the little things it may give you confidence to tackle more major issues.

For me, I may try going to bed earlier one night a week, drinking a glass of water in the morning, taking a walk before lunch or dinner, exchanging a piece of fruit for candy as an afternoon pick me up, or using the stairs at work instead of the elevator to my resolution list. These small changes are more doable, and even I might just succeed this year in keeping a New Year’s resolution. Wish me luck! If some of you still need inspiration here are some resolutions that are popular each year with information on how to successfully achieve these resolutions.

Happy New Year!

Nancy Targett is an Instructor & Research Specialist at the Miller Branch. She lives in Columbia and is the proud mom of three boys and a girl and a Siamese cat.

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sneezing father and daughter

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The flu season started earlier than usual this year, and most states are reporting continued and widespread outbreaks. Here are some commonly asked questions answered by a Johns Hopkins infectious disease specialist.

Q. Is it true that the flu season is turning out to be more severe than expected this year?
A. The flu season started off earlier and stronger than in several previous years, and the Centers for Disease Control and Prevention (CDC) says state-by-state reports of flu cases, hospitalizations and deaths are elevated. But it is still too early to tell if there will be more flu cases than is typical in the United States this flu season, which runs from October until May. That said, influenza is widespread in most states, so everyone should take precautions to avoid getting the flu.

Q. If people become sick with flu symptoms, should they go to an emergency room?
A. The flu can make you feel pretty lousy, but the best thing to do is first consult your personal doctor or health care provider. If you don’t have one, visit a community health clinic. Your personal health care provider is best able to determine, based on your symptoms, age and medical history, whether you need specialized care in an emergency department or hospital setting. Emergency departments are primarily set up to address urgent and critical medical issues.

Q. The flu vaccine available this year isn’t very effective. Why?
A.
Flu vaccines are developed in advance to protect against several strains of flu virus that epidemiologists who track worldwide flu virus outbreaks do their best to predict. Unfortunately, the strain infecting most people this season — known as H3N2 — mutated, something viruses often do. As a result, the vaccine available this season isn’t as effective as hoped in protecting against the H3N2 strain.

Q. Does that mean the vaccine is useless? Should people still get it?
A. The vaccine still has significant value. Definitely ask your doctor or health care provider for a flu shot, because even this late in the season, it may still offer some protection or moderate the flu if you get it. The CDC recommends that everyone 6 months or older get a flu shot every year because it is an effective way of boosting the immune system to fight circulating strains of flu virus. In addition, by protecting yourself, you may also help protect others who could be exposed if you don’t get a flu shot and come down with the flu.

Q. Other than a flu shot, what other steps can we take to keep from getting the flu?
A.Yes. Wash hands often or use alcohol-based hand gel, especially after shaking others’ hands or being around someone who has cold or flulike symptoms, such as high fever, cough and fatigue.

Q. Should people who have the flu take Tamiflu?
A.
Antiviral drugs like Tamiflu are best and typically prescribed for those most at risk for serious flu complications, including the young, elderly, or those with other serious health conditions or compromised immune systems. Antivirals are only available by prescription and can’t be purchased over the counter. No one should take an antiviral unless a doctor specifically prescribes it. Most otherwise-healthy people can beat the flu by staying home and resting in bed, taking medicines to reduce fever and drinking plenty of water or other clear liquids to stay hydrated.

Q. What can health care workers do to keep themselves and patients healthy in flu season?
A. First and foremost, health care workers who have direct patient contact should get the flu vaccination. They also should practice good hand hygiene with frequent hand-washing or the application of sanitizing hand gel. Health care workers who feel sick with cold and flu symptoms should stay home and rest to avoid exposing patients to a flu or cold virus.

Lisa Maragakis, M.D., is an infectious disease expert and director of the Department of Hospital Epidemiology and Infection Control at The Johns Hopkins Hospital.

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diet soda canRecent studies have shown that intake of artificial sweeteners may contribute to glucose intolerance. Those of us who enjoy diet drinks and cut calories by selecting foods with sugar substitutes may decide that the trade-off is not the healthy choice. We may want to think twice before satisfying cravings for Diet Coke and go for an unsweetened iced tea instead.

Glucose intolerance is a serious health risk because it can lead to diabetes as well as metabolic syndrome. Diabetes is characterized by the body’s inability to produce insulin to process sugar intake. Insulin is a hormone produced in the pancreas that is needed by the body to regulate glucose levels. Metabolic syndrome is a set of biochemical changes that increases one’s risk for heart disease and diabetes. The physiologic changes in metabolic syndrome include glucose intolerance, abnormal lipid levels, insulin resistance and obesity.

The human intestines are filled with microscopic living organisms, the so-called “gut flora.” A normal intestinal environment is home to these organisms, most of which are bacteria. A study published in the 9/18/2014 issue of Nature described findings that intake of artificial sweeteners changes the composition and function of this flora. The researchers fed mice three of the most commonly-used sugar alternatives: aspartame (Equal), saccharin (Sweet’N Low) and sucralose (Splenda). The mice drinking the artificially-sweetened water had altered intestinal bacteria and marked glucose intolerance. Antibiotics administered to kill this bacteria resulted in resolution of the glucose intolerance.

Additional research was carried out on a limited number of human subjects. Nondiabetic subjects who reported artificial sweetener use were more likely to develop glucose intolerance over time than were those who stated they did not use artificial sweeteners. These participants also were more likely to show changes in gut flora. The researchers gave seven human subjects high levels of saccharin over six days, and four of thee subjects then had abnormal sugar levels. The scientists theorize that the altered combination of bacteria causes a change in glucose metabolism, blocking the sugar levels from declining as quickly as they should.

Although the study’s authors point out that the percentages supporting their findings are statistically significant, they note that more studies are needed. Over the past several years, evidence has accumulated that intake of artificial sweeteners increases sugar cravings. Some studies have even shown that those who use artificial sweeteners are more likely to be overweight. Now with the possibility that these additives can have serious health effects such as diabetes, the support for decreased ingestion of artificial sweeteners grows. The research findings indicate that it might be time to cut back on total intake, perhaps drinking one fewer can of diet soda per day and selecting a snack of nuts or blueberries rather than sugar-free cookies. Limited consumption of products with artificial sweeteners could be important to limiting the associated health risks. Similar to other medical recommendations regarding nutrition and fitness, the guidance at this point is moderation.

Cherise Tasker is an Instructor & Research Specialist at the Central Branch and has a background in health information. Most evenings, Cherise can be found reading a book, attending a book club meeting, or coordinating a book group.

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grapefruit & pills

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You are diligent about taking your medication each day. But did you ever think that the bologna sandwich, grapefruit or glass of milk you have with it could be making your medicine less effective, or even dangerous? Read on for five facts you need to know about food and drug interactions.

      1.  Beware of grapefruit. This popular breakfast fruit interacts with a variety of medications, including blood pressure meds, statins, and HIV and organ transplant medications, says Charlie Twilley, Pharm.D., a pharmacist at Johns Hopkins Bayview Medical Center. The culprits are furanocoumarins, compounds found in grapefruit that block the enzymes in the intestines responsible for breaking down these drugs. This can make the drugs more potent, and raise the level of drug in your bloodstream. If you are a big grapefruit fan, talk to your doctor or pharmacist to find out whether it is safe to eat with the medications you take.
      2. Dairy diminishes an antibiotic’s infection-fighting powers. Twilley warns that the calcium in milk, yogurt, cheese, ice cream and antacids can interact with tetracycline and the tetracycline group of antibiotics used to treat a number of bacterial infections. To make sure you are getting the full benefit of your antibiotic, take it one hour before, or two hours after, you eat anything containing calcium.
      3. Leafy greens cancel warfarin effects. The vitamin K in spinach, collards, kale and broccoli can lessen the effectiveness of warfarin, a blood thinner used to prevent blood clots and stroke. The darker green the vegetable is, the more vitamin K it has. “You don’t want to eliminate leafy greens from your diet, because they do have many health benefits,” says Twilley. The key is to be consistent with the amount you eat. If you plan to drastically change the amount of these veggies in your diet, talk to your doctor or pharmacist first.
      4. Beer, red wine and chocolate are dangerous to mix with some antidepressants. These popular indulgences may be a nice way to relax in the evening, but they contain tyramine, a naturally occurring amino acid that can cause an unsafe spike in blood pressure when mixed with MAO inhibitors. Tyramine also is found in processed meat, avocados and some cheeses. “This is a significant, dangerous interaction,” says Twilley. If you take MAO inhibitors for depression, talk to your doctor or pharmacist before eating anything with tyramine. Alternative therapy may be considered.
      5. Think before you crush medication in applesauce. Many people who have trouble swallowing pills like to crush them and mix them with applesauce or pudding. Always ask your doctor or pharmacist before you crush or take apart medication. “This method can dump too much of the drug into your system at once, or change the way the drug works,” says Twilley.

Also keep in mind that some medications are affected by whether or not you eat with them. Before you start any new drug, talk to your doctor or pharmacist about whether it is affected by food. “They can help you come up with a schedule that’s good for the drug and convenient for you,” says Twilley. Even over-the-counter medications and supplements can have food interactions.

For additional reliable information about common food and drug interactions, you can search for this topic in the Johns Hopkins online Health Library.

Sara Baker, Public Affairs and Marketing Coordinator, Johns Hopkins Bayview Medical Center

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Childhood headaches or frequent constipation? They can sometimes be symptoms of poor nutrition choices. Here’s five tips to get your child’s diet on track.

Adults in children’s lives play a large role in a child’s nutrition and developing eating habits. “Kids are going to model what their parents do. If their parents are eating a lot of fast food and drinking a lot of soda, their kids are going to develop those habits,” said Michael Lasser, M.D., a pediatrician on staff at Howard County General Hospital. “It is really important families sit down and eat together. Not only to see how the child’s day was, but if parents are eating healthy food, that is what the kids are going to eat.” Check out the below slideshow for more tips to help your children make wise food and drink choices.

 

  • The Water Connection: Children need to drink more water. "Kids do not drink enough water throughout the day and will come home from school with headaches because they didn't have breakfast or drink enough water and are dehydrated," said Dr. Lasser. [© Yarkovoy | Dreamstime.com]

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fattening food; nutrition tips

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Did you know vitamin-enhanced water can have as much sugar as 7 chocolate sandwich cookies? Think about your drink and other nutrition guidelines for your 2015 diet.

Here we go again! New Year’s Eve is tomorrow night, and after an evening  (and a season) of overindulging in so many ways, most of us will end the night with a farewell toast to Auld Lang Syne and a pledge to give up at least some of our vices in the new year. Many will be food-related – losing weight, giving up sugar and eating a healthier diet.

But what exactly does that mean? With so many choices and so much information about food and nutrition, it can be difficult—even for adults—to make good decisions when it comes to eating the right foods. These choices are important, because a healthy diet and lifestyle are the best weapons to fight diseases such as heart disease, stroke, diabetes and certain types of cancer.

The American Heart Association recommends a diet including lean meats and skinless poultry; fish at least twice a week; selecting fat-free, one percent fat or low-fat dairy products and cutting back on added sugars.

Choosing a healthy lifestyle that includes eating the right foods and getting plenty of exercise goes a long way in keeping the body healthy. Make sure half of your plate is vegetables or salad, and eat your fruit or vegetable first to help fill you up so you will eat less of other things.

Think about your drink
Everything has gotten big. Serving sizes that were once 8 ounces are now 20 ounces and sometimes even larger. When you couple the increasing size with the amount of sugar in many beverages, you have a recipe for weight gain. This is especially true when it comes to energy drinks.

Many beverages that may appear to have health benefits have added sugar that is not healthy. Scientific evidence supports the association between consumption of sugar-sweetened beverages and an increased risk of obesity, which can contribute to the development of diabetes, heart disease and cancer. Drinks that are labeled vitamin-enhanced water can have the same amount of sugar as seven chocolate sandwich cookies! To burn off the calories in a fancy 16 ounce coffee drink, you will need to strength train for 30 minutes. Also, calories consumed in a liquid form don’t tell our body to turn off hunger. So we need to be careful about using beverages to satisfy cravings.

Eat the rainbow
It is important to include colorful fruits and vegetables in your meals. Brightly-colored fruits and vegetables indicate that they are high in antioxidants. The deeper and darker the color of the vegetable or fruit, the better it is for you. When thinking about your daily diet, choose at least four servings of colorful vegetables and three servings of colorful fruits. Though there are supplemental pills available you may think would be easier, they do not supply the same benefits derived from food.

Read the labels for these key words
I understand that most of us are not going to soak our own beans and make our own breads, but if you buy pre-packaged food, you really need to read the labels. If one of the first three ingredients is sugar, salt or partially hydrogenated oil, put it back on the shelf. Processed food contains added salt, sugar and fat, and you lose fiber. On a food ingredients label, there are many words that can indicate added sugar that doesn’t occur naturally, including: high fructose corn syrup, agave, fruit juice concentrate – often added in yogurt, dextrose, honey, molasses and brown rice syrup just to name a few. Excess sugar causes inflammation inside our blood vessels even more so than saturated fats. Research is leading us to really take a look at the role excess sugar has on our cardiovascular system.

Let’s start the new year with a resolution we can actually stick to. Think about what you eat and drink and try to make it healthier!

Howard County General Hospital’s Teresa Love, MS, RD, CDE, has been a registered dietitian for more than 30 years and a certified diabetes educator since 2009. She enjoys helping patients manage their diabetes. In her spare time she is an avid tennis player.

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