Tummy rumbling?

A noisy stomach: Normal or unhealthy? Published March 31, 2015     

    Our bodies make noise all the time. We snore, burp and pass gas, and sometimes our joints crack. But are our internal soundtracks normal or unhealthy? 

We got this email from a viewer:  Dear Dr. Manny, My stomach makes the loudest and strangest gurgling noises all the time- even when I'm not hungry! Should I be worried and visit a doctor, or is there a simple way to prevent it? Thanks, Becky 

A noisy abdomen does not necessarily mean you are hungry. The digestive system causes stomach sounds, known as Borborygmi, when air or fluid is moving around the small and large intestines. During a process called peristalsis, stomach muscles and the small intestine contract and move contents forward in the gastrointestinal tract. "These sounds occur both when the stomach is full and when it is empty. .  .  About two hours after your stomach empties, there is signaling from the brain for the digestive muscles and peristalsis to begin again. These contractions and vibrations of an empty stomach may make you hungry, and the growling may be louder in this case because your stomach and intestines are empty so the noise created is not muffled. 

People who swallow a lot of air, usually caused from eating too fast or talking while eating, may experience more rumblings than others. Another common cause for a chattering stomach is poor digestion. Fructose and artificial sweeteners, which are often found in sugarless gum and diet sodas, contain sugar alcohols that can be difficult for intestines to absorb. People with a lactose intolerance or celiac disease are also more likely to have increased intestinal noise. Although these noisy gurgling sounds can be uncomfortable or even embarrassing, they are generally a sign that your intestines are working well. 

However, stomach noises can also signal a bigger problem. "Although stomach gurgling can be completely normal and part of healthy digestion, if accompanied by symptoms, this should be looked into a little bit closer,” Dr.  Khodadadian said. "For example, excessive gurgling together with cramping, abdominal pain and possibly nausea and vomiting may be a sign of an obstruction in the bowels. Khodadadian added that growling could be a symptom of a food intolerance or small intestinal bacterial overgrowth. "In this scenario, the growling can be associated with gas, flatulence and distention of the abdomen," he said. To help reduce the natural gurgling of your stomach, Khodadadian suggests two simple tips: 

1. Avoid excessive carbonated drinks because they can cause buildup of gas in the intestines. 

2. Take a walk after meals to aid in digestion and keep your bowels moving along. If your stomach noises are accompanied by symptoms, Khodadadian advises speaking with your doctor. 

Apple a day.....

Apple a day might keep the pharmacist away Published March 30, 2015     

  An apple a day might not keep the doctor away, but it might help keep the pharmacist at bay, a new study suggests. "Everybody thinks of the apple as a healthy food, and it is, but after adjusting for other variables we didn't find a difference in doctor visits between apple eaters and non-apple eaters," said Matthew Davis of the University of Michigan School of Nursing in Ann Arbor, who led the study.  Davis and colleagues set out to tackle a light-hearted question: is a proverb about apples that dates back to at least the 1800s really true? 

To find the answer, they compared apple eaters to abstainers, using data from 8,399 U.S. adults who completed questionnaires between 2007 and 2010 as part of the National Health and Nutrition Examination Survey (NHANES). Just 753 participants, or 9 percent, ate at least one small apple day. People who only consumed apples in the form of juice, applesauce or pie were considered non-apple eaters for the purposes of the study, Davis said. Apple eaters in the study had higher educational attainment, were more likely to be from a racial or ethnic minority, and were less likely to smoke. 

And at first blush, apple eaters seemed more likely to keep the doctor away, with fewer self-reported visits to health care providers. But the difference wasn't statistically significant after adjusting for socioeconomic factors and other health characteristics. The apple eaters did appear to be significantly more likely to avoid prescription medications. Curiously, the link was slightly stronger for people who consumed small- or medium-sized apples than it was with large apples. 

An estimated 19.3 million U.S. adults consume the equivalent of about 26.9 million small apples daily, weighing about 8.8 million pounds, the researchers calculated. Based on the cost per pound of one popular variety of apple, Red Delicious, and the typical amount U.S. adults spend on prescriptions, the researchers say it's possible that convincing the 207.2 million abstainers to eat an apple a day might result in a net savings of as much $19.2 billion. Limitations of the study include its reliance on self-reports of apple consumption, doctor visits and prescriptions. And the research only explores a link between eating apples and possible uses of health services, not a causal relationship. 

"While it does have some scientific basis, checking out whether an apple a day keeps the doctor away isn't your typical scientific hypothesis to test," said Dr. Rita Redberg, editor-in-chief of JAMA Internal Medicine, the journal that published the study. It's possible that people who eat apples have healthier habits than people who don't but there are indeed some health benefits associated with apples, Dr. Michael Roizen, chief wellness officer at the Cleveland Clinic in Ohio, said in an email interview. "Apples are an excellent source of fiber and are low in calories, which means they will satisfy your hunger and keep you fuller for a longer period of time," said Roizen, who wasn't involved in the study. "The best way to get the nutritional benefits of apples is by consuming one medium-sized apple per day. 

There are more than 7,500 varieties of apples around the world with varying levels of polyphenols, healthy plant chemicals that account for the color, flavor, anti-oxidant activity and other health benefits, said Samantha Heller, a nutritionist at NYU Langone Medical Center, in an email interview. Apples have been linked to a reduced risk several forms of cancer, cardiovascular disease and asthma, said Heller, who wasn't involved in the study. In addition, they may have beneficial effects for Alzheimer's disease, diabetes, weight management and bone health. But they're no cure-all. "Eating an apple a day is unlikely to undo the ill effects of the typical 'Western diet' that is high in red and processed meat, junk food and fast food and low in plant foods," Heller said. 

Hearing loss

Hearing loss: Could your headphones be to blame? Published March 29, 2015       

  Most music lovers know that turning on some tunes can help put you in a better mood. In fact, research has shown how it can help relieve stress, reduce pain and improve your overall health. A study also found that listening to classical music enhances mood, sharpens memory and enhances learning. But as beneficial as melodies are, most people-- especially teens, are listening to music at extreme levels and could be putting themselves at risk of hearing damage. 

We got this email from a viewer: Dear Dr. Manny, I'm constantly reading how kids are damaging their hearing from listening to music too loud-my son is always listening to music on his headphones on an ear-splitting level, could this really cause hearing loss? Thanks, Jenny 

According to the World Health Organization (WHO), 50 percent of young adults are exposed to potentially unsafe levels from their personal audio devices. The organization also warns that volumes above 85 decibels for eight hours or 100 decibels for 15 minutes are unsafe. As a reference, the sound of loud city traffic is around 80 decibels. 

"The maximum output of an MP3 player such as an iPod can get up to 115 decibels which can cause permanent hearing damage in as little as 8 to 15 minutes," Dr. Sreekant Cherukuri , founder of MDHearingAid and an Otolaryngologist in Chicago told FoxNews.com. Cherukuri said there are two ways to help protect yourself from permanent, noise-induced hearing loss. "Stay away from in-the-ear headphones, which sit much closer to the ear drum and get much louder. And use the 60/ 60 rule-- no more than 60 percent of maximum volume for 60 minutes at a time and then take a break. Ears that get a rest are less likely to get damaged.

Good first aid tips

7 Dangerous First Aid Mistakes 

BY THE PHYSICIANS OF THE DOCTORS  

 Treating an injury promptly and properly can have a huge effect on recovery. But we still see many patients handling common wounds the wrong way-due partly to old wives' tales that won't die and partly to new science around emergency care. We asked our colleagues-some of the nation's top emergency-care providers-to debunk common misperceptions. 

1. Not Treating a Burn Long Enough 

Forget butter or ice-the best way to soothe burned skin is to run it under cool water. But a few seconds or minutes isn't enough; you need to do it for at least ten to 20 minutes, says Jeffrey Pellegrino, PhD, of the American Red Cross. "The heat from a burn travels deep into your skin, where it can continue to destroy tissue even if you've cooled the surface," he says. "You need the cold to soak in to prevent further damage. 

2. Tilting Your Head Back During a Nosebleed 

This can cause the blood to drain into the back of your throat, which can make you gag or cough, potentially obstructing breathing. Instead, apply direct pressure by pinching your nose, but keep your head in a neutral position with your chin parallel to the ground. Sit and stay relaxed. 

3. Putting Heat on a Sprain or Fracture 

"Always apply cold initially," says William Gluckman, DO, spokesman for the Urgent Care Association of America. Ice helps decrease swelling, whereas heat boosts blood flow, which can make swelling worse. Save heat for issues like back spasms. 

4. Trying to Remove Debris from an Injured Eye 

Fishing around for the irritant can worsen the wound and even lead to permanent damage. Instead, protect the eye-secure a paper 'cup' over it with tape so nothing else can get in-and seek immediate care. The only exception is if you get a chemical in your eye; in that case, flush it out with water for about 15 minutes.

 5. Removing Gauze from a Bleeding Wound 

If the pad soaks through, don't pick it up and replace it-just add a fresh piece of gauze on top, says Chris Cebollero, chief of EMS for Christian Hospital in St. Louis. Clotting factors in the blood surface to help stop the bleeding; picking up the old gauze can remove them and make the wound start bleeding all over again. If that happens, apply pressure to the cut until the bleeding stops, then rinse the wound out (to prevent infection), apply an antibiotic ointment (if not allergic), and rewrap with a bandage. 

6. Not Seeking Care After a Car Accident 

If you have severe car damage, get checked out at the hospital, even if you feel fine. "Your adrenaline-fueled, fight-or-flight response can mask pain initially," says Cebollero. "It can be ten minutes or two hours after the accident before you feel something. Responders at the scene can't necessarily rule out brain bleeds or broken bones. 

7. Making It Hard For the EMT to Find You 

Say you're stung by a bee in your backyard and are having a serious allergic reaction. First have someone call 911. Then head to the driveway. Choking in a restaurant? Don't run to the bathroom. "People die in bathrooms from choking because they don't want to disturb other diners. They collapse, and nobody knows why," says Pellegrino. Stay where people can help you. 

Diabetes and falls

With diabetic nerve damage, walking can pose fall risk Published March 26, 2015    

   Diabetics with nerve damage are more likely to have an uneven stride and struggle to maintain their balance even when walking on flat ground, a small study finds. So-called peripheral neuropathy, or diabetic nerve damage, can lead to numbness and pain in the feet, legs and hands. It is the most common complication of diabetes, and though it has long been linked to an increased risk of falls, less is known about how specific body movements contribute to balance problems during daily activities such as walking or climbing stairs. 

  "By investigating the activities during which falls are more likely to occur, we can look to identify specific detriments of the underlying balance mechanisms, allowing a more targeted and educated approach to preventing falls within this population in the future," lead author Steven Brown, of Manchester Metropolitan University in the UK, said in an email interview. About one in nine adults has diabetes, and the disease will be the seventh leading cause of death by 2030, according to the World Health Organization. Most of these people have type 2 diabetes, which is linked to obesity and advanced age and happens when the body can't properly use or make enough of the hormone insulin to convert blood sugar into energy. Roughly 70 percent of diabetics have some form of neuropathy, according to the National Institutes of Health. 

While the risk increases the longer people live with diabetes, nerve damage may be limited by keeping blood sugar as close to normal as possible. To understand how nerve damage impacts gait and balance, Brown and colleagues analyzed the body mechanics of 22 diabetics with neuropathy while walking on flat ground and going up and down stairs. They compared the results to 39 diabetics without neuropathy and a control group of 28 people without diabetes. The researchers did a gait analysis using a 10-camera motion capture system to collect data as participants moved on stairs and on flat ground. Everybody wore similar shoes, to ensure that footwear didn't influence results. The diabetics with nerve pain moved at significantly slower speeds than the other study participants. 

On stairs, front-to-back sway as well as side-to-side sway, which increase with poor balance, was significantly higher for the diabetics with neuropathy than for the people without diabetes. And front-to-back sway was also significantly greater for diabetics with nerve pain when they walked on level ground. Standing still with open eyes, the diabetics with neuropathy had more front-to-back and side-to-side sway than the other study participants, and more than the control group when the test was repeated with eyes closed. The diabetics with nerve pain also tended to stand with their feet spread further apart, a stance probably adopted to compensate for balance issues that can, in fact, increase the risk of falls.  

There are some steps diabetics can take to stay on their feet even when they suffer from nerve pain, said Dr. James Richardson, a researcher at the University of Michigan Health System. To decrease the chances of falling, diabetics need to have good vision or good control of ankle movements, strong hips, good reflexes, and avoid distractions while moving, said Richardson, who wasn't involved in the study. Regular eye exams and good light can help with vision problems, and lightly touching a railing or wall can help with balance when it's hard to see, Richardson noted. And some exercises may be able to strengthen muscles around the hips. 

At the end of the day, though, concentration is key. "It doesn't matter if the muscles are strong if they are strong three seconds after you lose your balance," he said. "You only have about half a second before you hit the ground. 

Allergy season

How to survive allergy season By Dr. David B. Samadi Published March 25, 2015    

     Allergies are a condition in which the immune system reacts abnormally to a foreign substance - such as pollen, mold or pet dander. When our bodies come into contact with allergens, our immune system's antibodies work to identify what is causing those pesky symptoms like watery, itchy eyes; sneezing, sniffling, wheezing and rashes. Allergens can enter our bodies in a few different ways, however, but the most common way is by inhalation into the nose and lungs. Allergens are often inhaled via airborne pollens of certain trees, grasses, weeds, house dust - including dust mite particles - mold spores, or cat and dog dander.   

While they may be uncomfortable, these antigens are not actually harmful, but the body's immune system thinks they are. Therefore, allergies are actually a result of the immune system's mistaken response to a harmless substance. With spring just around the corner, allergens will soon be more prevalent given the warmer weather, causing the airborne allergen levels to rise. In turn, if you have allergies, your symptoms will soon be flaring up. 

So how can you best prepare yourself for the upcoming allergy season? Here are some tips: Start taking allergy medications as soon as possible. They often work best when started before the symptoms begin. Some over-the-counter antihistamines that may be helpful include: Allegra Benadryl Claritin Zyrtec (certirizine) Over-the-counter medications that have a "D" tacked on the end, like Allegra-D, Claritin-D, and Zyrtec-D, are a combination of antihistamine and decongestant to relieve both allergies and congestion.

 If you're not into taking medication, there are other things you can try: Stay indoors during peak pollen hours. (Know what the pollen count is.) Close windows, turn the air conditioning on to help decrease allergy symptoms. Protect your eyes. Wear a hat that blocks your face or wear sunglasses to prevent pollen and molds from getting into your eyes. Avoid hair products - they attract pollen. Shower daily to wash any pollen, mold or animal dander out of your hair and off of your skin. Wash clothing and bedding frequently to prevent allergens from sticking around.

 For those with severe allergies, shots given by a doctor around once a month and prescription sublingual tablets also exist as more lasting alternatives. The aim of these is to improve a patient's tolerance of allergy triggers - thus relieving the symptoms allergies cause.            

My favorite topic--chocolate

YUM!

440-pound chocolate peanut butter 'cup' breaks Guinness World Record Published March 24, 2015 

 Calling all Reese's lovers. The Candy Factory -a Los Angeles based confectionery-claims it has broken the Guinness World Record for the largest chocolate peanut butter 'cup'.  It took the shop owners three hours to pour the melted chocolate and spread the creamy peanut butter by hand, reports CBS. Instead of using a traditional baker's mold, the candy makers used a kiddie pool to contain this giant confection. Weighing in at just over 441 pounds, this peanut butter 'cup' beats the current Guinness World record holder by over 200 pounds . Though Guinness officials have yet to verify the title, The Candy Factory owners are confident in their creation. After the Guinness team can take official 'cup' measurements, pieces of the larger-than-life candy will be sold in one pound pieces with all proceeds going toward a charity. 

Long awaited SPRING BREAK

Hi everyone,
I have survived until the long awaited spring break! So much to do and only one short week. First, we have been invited to participate in a Diabetes Awarness Walk on Saturday, May 2 with the Hot Springs Village Lions. If you would like a fun day and some fresh air, please call Krystal and get on the list. If we can get a group, Earl will drive us over. We will leave the Center at 7 that morning....

Second, Dr. Boehm will be available this week. If you have burning health questions, let us know.

Have a great week.  Check back often to see what we have going.....surprises coming.......

Until tomorrow,
Dr. Janet

Wow! New Apple TV

Apple plans to unveil a new version of its set-top box -- with long-awaited features -- at its Worldwide Developers Conference, according to a report. by Don Reisinger 

 March 20, 2015 11:08 AM PDT 

The Apple TV might look a little different (and have more features) this year. The Apple TV set-top streaming box will get an update later this year that could finally bring some long-awaited features to the device. Apple will unveil a new Apple TV box at its Worldwide Developers Conference ( WWDC ) later this year, Buzzfeed is reporting , citing people who claim to have knowledge of the company's plans. The Apple TV announcement will come in tandem with the unveiling of a software development kit that will allow developers to bring apps to the set-top box, according to the report. 

Apple TV currently has apps, but those are automatically added to the device. The update would deliver an App Store to the Apple TV, similar to the App Store on iOS devices like the iPhone and the iPad . The Apple TV box has been on a strange odyssey since its debut in 2007. The original device was designed to bring iTunes content to a customer's television and was followed by subsequent versions that stripped away the need for onboard storage and focused solely on streaming content to the television.

 An updated Apple TV device hasn't appeared since 2012. The Apple TV box currently offers access to iTunes content, as well as a host of apps, ranging from YouTube to HBO Go. Owners can also rent and buy movies and television shows from the device. The Apple TV device will also play host to HBO's upcoming streaming-only service, called HBO Now, starting next month. It'll initially be the only TV streaming device to support HBO Now, beating out competitors Roku and Google's Chromecast. 

Years ago, Apple co-founder Steve Jobs famously called the Apple TV a "hobby" and gave little indication that the product would feature prominently in the company's product roadmap. Indeed, over the last several years, some analysts have said that Apple has treated Apple TV as little more than an afterthought. The tide, though, appears to be turning. At its special event earlier this month announcing more details on Apple Watch, Apple said it has reduced the price on the Apple TV to $69 from its previous $99 price tag. Apple also touted that it has sold 25 million Apple TV units since the product's inception in 2007. 

Just a week later, a report surfaced in The Wall Street Journal claiming Apple is working with television networks to launch a service later this year that would let users stream programming from a range of providers, including ABC, CBS and Fox. The service would be available on Apple's iOS devices and the Apple TV . (Disclosure: CBS is the parent company of CNET.) The Buzzfeed report claims Apple is looking to sweeten the pot a bit. The new Apple TV box would come with a new design and more storage than the current device's 8GB to allow for the storage of apps. The Apple TV device could also include a Siri voice control feature and support for Apple's home automation platform HomeKit, the report says. So far, pricing and other key details, like improvements to the device's operating system, are unknown.

 Apple has yet to announce an official date for WWDC 2015. It typically hosts the show, which caters to developers who create software for Apple's iOS mobile operating system and OS X operating system for laptop and desktop computers, in early June. Apple hosts a keynote address to kick off the event, which would likely be where the company announces an updated Apple TV. Apple declined to comment. 

Stress

Does stress make us forgetful?

 Published March 17, 2015     

      Stress can be memory's best friend. But when you forget where you put the car keys, stress can also make you feel stupid. One expert, Rajita Sinha, a professor of psychiatry and neurobiology at Yale University, sorts through the effects of stress on memory, and its troubling relationship to dementia. 

The Basics 

  People use the term "stress" loosely. Dr. Sinha defines it as the process by which we react to stimuli that are threatening, challenging or overwhelming. "It is a complex system of cortisol, adrenaline, peptides and other hormones and chemicals that help us respond, adapt and bring our bodies back to a stress-free baseline," says Dr. Sinha, who is director of the Yale Stress Center. Stress works on a spectrum, the psychiatrist says. At one end is controllable stress, where if you take the correct action you can regain control. "Imagine you notice the fridge is almost empty, but if you hurry you can get to the store before a forecast snowstorm hits," she says. At the other end is uncontrollable stress. Losing your home or ending a significant relationship would fit in this category, she says. The two types often overlap. 

Leaving its Mark 

The brain grasps an uncontrollable threat very quickly and can retrieve relevant information immediately when presented with the same acute stress again, Dr. Sinha says. When you are out alone on a street at night, your stress response might help keep you alert the next time you are alone and feel in danger. "That experience sharpens the mind and encodes an impression," she says. 

Aging

Scientists' new goal: Growing old without disease 

Published March 17, 2015   

       some of the top researchers on aging in the country are trying to get an unusual clinical trial up and running. They want to test a pill that could prevent or delay some of the most debilitating diseases of old age, including Alzheimer's and cardiovascular disease. The focus of the project isn't to prolong life, although that could occur, but to make the last years or decades of people's lives more fulfilling by postponing the onset of many chronic diseases until closer to death.   

The project aims to tap into the growing body of research targeting aging, which has revealed a half dozen or more drugs that appear to delay the aging process in laboratory experiments on animals and observational studies of people. Some of the drugs also have been found to reduce the incidence of chronic diseases associated with old age. "Aging is the major risk factor for all these diseases-heart disease, cancer, diabetes and Alzheimer's," said Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine in New York City who is leading the proposed study. "If you want to make a real impact you have to modulate the risk of aging and by that the risk for all those diseases of aging. 

Dr. Barzilai expects to enroll more than 1,000 elderly participants in the randomized, controlled clinical trial to be conducted at multiple research centers and take five to seven years. The project is in the preliminary stages and permanent funding hasn't yet been secured. Funding for the planning phase is coming from the American Federation for Aging Research, a nonprofit organization of which Dr. Barzilai is deputy scientific director.

Back pain

Intense strength training may help fend off age-related disability 

Published March 16, 2015        

   When he hit 50, Tim Carrigan's lower back started hurting so badly he could barely walk. The injury, which dated to a childhood accident, had caused only occasional pain until Mr. Carrigan lost muscle tone with age. The pain dogged him for several years, but last year the Quincy, Mass., insurance-company treasurer started strength training twice a week on a circuit of a dozen machines. 

 Not only did his back improve, "I feel better. I feel stronger. I sleep better," says Mr. Carrigan, now 54. He adds that his stronger back has held up while shoveling during Boston's historic snowstorms. While old-school wisdom held that older adults were too frail to pump iron, a growing body of research is showing that strength training helps stave off age-related disability, preserve bone mass in women and even boost brainpower. "It's way more dangerous to not be active as an older adult," says Miriam Nelson, professor of nutrition at Tufts University's Friedman School of Nutrition Science and Policy in Boston.  

Dr. Boehm

if you would like to visit with dr. Boehm this week, please call Krystal.  I have a very busy week so please call if we can help.
Until tomorrow,
Dr. Janet

Event update!

What a great time with good friends! It was a rainy day but the auditorium was filled with smiles and laughter as we enjoyed another successful Healthy Habits. Dr. Boehm came by to help kick off our next project. If you have burning medical question, call Krystal. She will relay your number to Dr. Boehm and he will contact you personally. What a great service!   I think I may call it "A Doctor in my Pocket!"

Let us know how your world is turning....
Until tomorrow,
Dr. Janet

More coffee info

How much coffee should you really be drinking? 

By Cynthia Sass, MPH, RD 

Published March 12, 2015     

  I love coffee, and I've written about it a lot over the past few years, from why it's actually good for both mental and physical health, to reasons to drink java before a workout. So I wasn't surprised when, for the first time in history, the Dietary Guidelines Advisory Committee gave coffee a thumbs up. But many of the headlines pertaining to the report didn't tell the whole story, leaving a lot of people wondering how much is really OK. To determine your daily dose, here are five factors to consider.  

 Everyone's different 

The Dietary Guidelines Advisory Committee looked at whether coffee poses any health risks, a topic they have previously been silent on. They concluded that strong evidence shows moderate coffee consumption (3 to 5 eight-ounce 'cup's per day, or up to 400 milligram/day caffeine) isn't tied to any long-term dangers for healthy people. Now, the word "healthy" is key , and this is a general statement, not a directive. In other words, the committee isn't saying that everyone should drink 3 to 5 'cup's a day.  Even if it may offer some benefits, it's important to listen to your body. Some people can drink a strong 'cup' of coffee and feel fantastic. Others may drink half a 'cup' and feel jittery and be left with an upset stomach. There's a lot of individual variation when it comes to how coffee makes you feel. So, don't take this as a green light to down a pot a day. Consider what feels best for you. (And if the answer is none, there's no reason to start drinking java.) 

Your current health matters 

The committee considered healthy individuals. If you already have heart disease or other chronic conditions, you may still need to curb your coffee consumption. For example, I sometimes recommend coffee to my healthy athlete clients, but others who suffer from gastroesophageal reflux disease (GERD) or other digestive disorders feel much better when they eliminate it, as do those who have anxiety disorders. And while coffee hasn't been shown to cause high blood pressure across the board, it may aggravate the condition. Bottom line: if you have any acute or ongoing medical conditions or your blood work values have been out of the normal range, talk to your doctor or personal dietitian/nutritionist about what's best for you.  

Be mindful of your sleep 

One thing we know for certain is that caffeine interferes with sleep for most people, and catching enough zzz's is critical for mental and physical well being, as well as for weight control. A good rule of thumb is to nix all caffeine at least six hours before bed. So if you're tempted to pour another 'cup' when you're in an afternoon slump, find other ways to perk up, like going for a quick walk, or drinking a cold glass of water. 

 Your genetics play a role 

Due to a genetic variation which affects a particular enzyme, some people break down caffeine at a very slow rate. It's fairly common and, for these people, even a moderate daily coffee intake can increase the risk of heart disease and high blood pressure. Access to this genetic test was extremely limited until recently, but if you're interested, a University of Toronto-affiliated company called Nutrigenomix now offers it, and you can order it through a registered dietitian. 

Consider what else is in your 'cup' 

While I've written about coffee's potential benefits, I still often recommend limiting it to just one 'cup' in the morning. That's because many people aren't able to drink it without doctoring it up with some kind of milk and sweetener, and those extras can add up to surplus calories that feed fat cells. For example, 150 calories (roughly the amount in a skinny vanilla latte) doesn't sound like much, but downing an extra 150 calories above and beyond what your body needs to support your ideal weight each day can leave you 10 to 15 pounds heavier. Not to mention that extra 'cup's of Joe tend to crowd out water, the ultimate beverage for optimal health. Balance is always the goal. 

Saturday Reminder

Good morning all,
This is Thursday! If you are planning to attend on Saturday, please let Krystal know. Mr. Earl is working on his pick up list....
Have a great day!
Until tomorrow,
Dr. Janet

Bacon lesson

How to cook perfectly crispy bacon 

Published March 09, 2015   

 This world is crazy for bacon, and not just eating it-opinions on the best way to cook perfect, crispy bacon run deep in the blood of pork eaters everywhere. That's why the Epicurious Test Kitchen just spent a week cooking pounds and pounds of the stuff, in an attempt to cut through the bacon noise and crown a winning method. It was one salty, porky week. This is what we learned.   

 Cast  iron skillets mean crispy bacon.   Start your bacon in a cold skillet. Trust us. When we tossed cold bacon into a hot skillet, it started to brown and crisp before the fat really started rendering out. That leaves you with two choices: Keep sizzling your bacon until the fat's cooked through but the bacon burns, or take it off the heat and deal with fatty, flabby bacon. On the other hand, when we added it to a cold pan and then turned on the heat to medium, the fat had plenty of time to melt away, leaving us with crunchier (and less greasy) slices. A cast-iron skillet cooks bacon faster. 

For our first stovetop cooking test, we pitted a 12-inch cast iron skillet against a 12-inch stainless-steel skillet. When we started with cold bacon in a cold skillet and cooked over medium heat, the taste and texture were the same for the bacon from each skillet: nice and crunchy, with a lovely smoky depth of flavor, and some deeper browned and charred spots. But while the stainless-steel skillet took 11 minutes, the cast-iron skillet took only 8.  

Who can resist a slice (or two)? Add water to the skillet if you want to crumble the bacon. We'd heard from the folks over at America's Test Kitchen that adding a bit of cold water to your cold skillet with your bacon yields better, crispier, bacon. So we gave it a go. It took a bit longer, but sure enough, all the water evaporated and then the bacon started crisping as it normally would. The result was thinner and crisper than the bacon cooked in the skillet without water: it shattered easily, and was very nice and crunchy. It wasn't as salty, and we actually missed the thicker crunch of traditional bacon, but this strategy would be perfect if you wanted to use the bacon as a crumbled topping for, say,  salad   -    

Saturday, March 14

Everyone,
We are trying to catch up from the snow, please help us out and pass the word about the event on Saturday. We will meet 10-12 at the Center. Call Krystal if you plan to come or need a ride.
Dr. Janet

Saturday, March 14

We have a fun filled Saturday's planned at the Center. If you plan to join us, please call Krystal.

Reframing retirement

A Sage Approach to Aging. Jann Freed..

 I am on a mission to retire the word retirement. We are not retiring from but moving to. The question is, what are we moving to?   Three years ago, I left a 30-year career as a college professor of business management in search of a new path. I was elated at the possibility of starting my own business, which would allow me to practice what I had preached and with no 45-minute commute. But I also felt a nagging insecurity about starting over as a baby boomer in a young person's world. What did Jann Freed not Professor Freed have to offer? 

Fortunately my career mentor, Elmer Burack, Ph.D., a professor and author of various books on career guidance, had predicted baby boomers would struggle with the aging process. He had sent me the book From Age-ing to Sage-ing: A Revolutionary Approach to Growing Older by Zalman Schachter-Shalomi and Ronald S. Miller (Warner Books; 1997). Reading this book convinced me I wanted to focus on transitioning and aging. Schachter-Shalomi founded Sage-ing International, an organization with the mission of "helping elders reclaim their role as leaders, sharing wisdom and spirit essential to creating a better world for current and future generations. I became a Certified Sage-ing Leader in hopes of helping aging people live the second half of their lives in the most fulfilling way. Here are challenges my clients experience and advice I share. 

Challenge: In general, our society does not like to discuss aging, but would rather emphasize antiaging. While many other cultures embrace the wisdom of their elders, in the United States we tend to push older people out in favor of the young. Women in our youth-centric society can feel especially invisible. 

Advice: Seek out positive role models who are "sage-ing" rather than just aging and borrow traits you like from them. When we are in the presence of positive people who are making the most of life and sharing what they know, age seems less relevant. Traits I admired about Dr. Burack included his pushing me while also lifting me up. He gave constructive feedback and support, and he believed in my abilities, which in turn boosted my confidence. 

Challenge: Americans are in uncharted territory living and working longer while staying healthier than past generations. This has created a new and unscripted life phase between ages 55 and 75. Many baby boomers are feeling lost, not knowing how to navigate this phase of life. 

Advice: This is the time, especially after becoming an empty nester for many, to hit the "reset button" to determine what to do next. Marc Freedman, author of The Big Shift: Navigating the New Stage Beyond Midlife (PublicAffairs; 2011), argues for "the creation of a new stage between the end of the middle years and the beginning of retirement and old age, an encore stage of life characterized by purpose, contribution, and commitment, particularly to the well-being of future generations. As you move to rather than retire from, consider what you are moving to. Most of my clients focus retirement planning on financial planning instead of life planning how they want to spend their time, money, and energy after their main career. I encourage making intentional decisions about living life with purpose and meaning. A good starting place is to reflect on your life experiences through journaling or memoir writing, which helps you move forward more clearly. 

Challenge: Middle-age confusion or searching is known as midlife crisis, which can be a very stressful time. The characteristics of this condition have remained the same over the decades: longing to stay young, dramatic life changes, makeovers in appearance, trading a spouse for a newer model, feeling stuck in work, and often unexplainable life decisions. According to the Pew Research Center and Centers for Disease Control and Prevention, the numbers for divorce, depression, suicide, and substance abuse are increasing faster for people 50-plus than for other age groups. While there are no clear-cut causes for these trends, research by the MetLife Mature Market Institute concluded that meaning trumps money and significance trumps success. 

Advice: Embrace your mortality and accept it, then leave a legacy. The embracing of death instead of fearing it enables us to live more fully. Also, as you think through your life and what is meaningful to you, consider what you can give back. Ways of leaving a legacy can be tangible (money or stuff) or intangible (storytelling or a written ethical will). The intangible are ways of passing on your beliefs, values, life's lessons, and wisdom with the people who matter most in your life. . 

Event cancellation

Sorry Hot Springs Village,
Due to the inclement weather we have to postpone today's event. Hopefully spring is on the horizon and we can get back on track!
until tomorrow,
Dr. Janet

Great dental article

Foods and drinks that will ruin your smile 

By Fabiana Santana 

Published March 05, 2015         

  Brushing your teeth is just one step towards a healthy smile. The second step is watching what you eat, and that goes far beyond just limiting candy. Yes, even the healthy foods can wreak havoc on teeth. According to the American Dental Association, your mouth is the body's initial point of contact with the nutrients you consume. What you put in your mouth not only impacts your health, but also your teeth, gums and, ultimately, your smile. Sometimes, your teeth are the first place to show signs of malnutrition.  

Dr. Ben Lamielle of Hilliard Modern Dental in Columbus, Ohio, explains that sugar is widely known to be a cause of your tooth decay, but acidic foods can be just as detrimental. "Most people know that sugar is not good for their oral health. What many people may not be as aware of are the effects that acidic foods play on their teeth," warns Lamielle. "Citrus fruits, tomatoes, soda (regular and diet), sports/energy drinks, alcohol, and many, many other foods and beverages that we regularly consume are acidic. Acid is directly corrosive to teeth. Additionally, when the pH of our mouths is low, certain bacteria that cause damage flourish. 

Another pathway for acid damage comes into play with people who suffer from acid reflux-type disorders. Digestive acids are incredibly corrosive, so eating foods that trigger reflux can lead to remarkable damage. Some other things to consider when snacking are the forms of food: whether they are liquid, solid, sticky, or slow to dissolve makes a difference in the way they affect your teeth. 

The bacteria in your mouth feeds off of sugars and carbohydrates, so the more sugar and acid you consume, the higher your risk of tooth decay. While vitamin C is important for healthy gums, overdoing it with lemon and oranges can actually cause the enamel on your teeth to wear away. Aside from the corrosive damage food does to teeth, there are also foods that cause cosmetic damage. 

"Beverages or foods that stain (red wine, coffee, cola, tomato-based pasta sauce, etc.) will negatively impact the appearance of your smile," says Lamielle. That's because, believe it or not, teeth aren't solid. "[Teeth] are actually porous. These pores, not to mention any cracks your teeth may have, collect stains and lead to changes in color and shade. 

To combat the negative effects that food can have on teeth, Dr. Lamielle suggests brushing at least twice a day, getting professional dental cleanings, and flossing. "Flossing is the key to good gum health. You can have beautiful teeth, but, without a healthy foundation, those teeth won't be in your mouth for long. 

In addition to proper dental care, try limiting the following foods to help you maintain a beautiful and healthy smile.

 1.  Balsamic Vinegar 

Balsamic vinegar is a double whammy offender to your smile. Not only is it acidic, so that it can erode enamel, it also stains. If you do enjoy this healthy dressing, make sure it's on a salad with a lot of lettuce. Lettuce has a natural ability to help teeth defend against corrosion with a protective film. 

2. Berries 

 Berries may be good for your health, but blueberries, raspberries, cherries, and other berries can leave some serious stains on your teeth. Be sure to rinse your mouth out with water after eating, and brush if you can.

 3.  Citrus 

Despite the health benefits of lemon water and oranges, too much citrus can damage your teeth. Acidic foods can erode enamel, leaving teeth susceptible to decay over time.

 4.  Coffee  

Sure, coffee is a great way to jump-start your day, but did you know that coffee and tea dry out your mouth and stain your teeth? Also, any added sugar can lead to decay. 

5.  Dried Fruit 

 Sticky foods like dried fruit stay on teeth longer, leading to decay and the weakening of the enamel. If you must indulge, brush and floss, or at least rinse, right after eating.