NEJM Perspective Piece Examines Realignment Of Inpatient Medicare Reimbursement Rate

Dental Health :: AAPD suggests ways to prevent risk for children’s tooth decay

Proper preventive care, fluoridation use and a balanced diet are key to the oral and overall health of every child. The American Academy of Pediatric Dentistry (AAPD) continues to emphasize that the way to decrease children’s tooth decay is by visiting a dentist early on. The AAPD recommends that each child should have a dental home by his/her first birthday.

The results from the recent Centers for Disease Control and Prevention (CDC) report show that young children do not receive the proper oral care they need to promote optimal oral health. Tooth decay declined in every other age group, except for children aged 2 to 5 years which increased from 24 percent to 28 percent between 1988-1994 and 1999-2004. Tooth decay is the single-most common chronic childhood disease, yet 90 percent of all tooth decay is preventable.

The AAPD recommends that parents adopt the following practices to help prevent tooth decay in young children:

Year-one dental visit

– Dental visits should begin around six months but no later than one year, or with the appearance of a child’s first tooth. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily, learn to speak clearly and smile with confidence.

Fluoride use

– Young children require fluoride to help developing teeth grow strong, and it helps prevent tooth decay in older children when used on a regular basis. Children who primarily drink bottled water may not be getting the fluoride they need. If your child routinely drinks bottled water, make sure to choose a product that contains fluoride. Talk to your pediatric dentists about your child’s fluoride needs.

Healthy eating habits

– Parents should ensure their children are eating a balanced diet, and limit frequency of snacking which can increase a child’s risk of developing cavities. In order to prevent cavities, parents should limit the child’s number of snacks and the amount of time each child snacks throughout the day.

“Proper preventive care, fluoridation use and a balanced diet are key to the oral and overall health of every child,” said Dr. Phil H. Hunke, D.D.S., M.S.D, president of the AAPD. “When kids are exposed to sugar for extended periods, they are at a higher risk of tooth decay. If left untreated, this puts these young children at increased risk for pain and infection, which can lead to missed school, lost sleep and loss of appetite.”

ShareThis

DASH Diet :: NutriGenie DASH Diet for Windows

The DASH diet is based on findings from the “Dietary Approaches to Stop Hypertension” a National Heart, Lung, and Blood Institute-supported study that found that elevated blood pressure levels can be reduced with an eating plan low in total fat, saturated fat, and cholesterol, and rich in fruits, vegetables, and lowfat dairy products.

Magnesium, potassium, calcium as well as protein and fiber are important components of the DASH diet.

The DASH diet eating pattern has been shown to substantially lower blood pressure without weight loss or reduced sodium intake. More recently, another landmark study, DASH-Sodium, has shown that a combination of the DASH diet and sodium reduction can lower blood pressure even more. This combination benefits those with and without high blood pressure.

NutriGenie DASH Diet software is one of our latest and most comprehensive nutrition software with many of NutriGenie unique technologies and analyses, such as star rating of overall diet quality.
Our ratings take into account the latest guidelines issued in September 2002 by the Institute of Medicine, the medical division of the National Academies. The latest guidelines establish for the first time a range of recommended amounts (Dietary Reference Intakes or DRIs) for macronutrients proteins, fats and carbohydrates and also include advice on how much dietary fiber and how little cholesterol or saturated fat people should strive for to maintain good health.

Features -

Has star ratings and descriptive analysis of diet

Incorporates the September 2002 guidelines issued by the Institute of Medicine, the medical division of the National Academies.

Can automatically generate nutritious and balanced daily menus based on calorie level.

Has weight control planner, cholesterol profiler, blood pressure log, body mass index calculator

Exellent food database management utilities and graphic analyses of diet.

ShareThis

Breast Cancer :: Vegetables, fruits, low fat diet not necessary for breast cancer survivors

Eating a diet very high in vegetables, fruit and fiber and low in fat did not reduce breast cancer recurrence or death in early stage breast cancer survivors, according to a new study.

Researchers from the Rebecca and John Moores Cancer Center at the University of California, San Diego found that this intensive diet provided no additional benefit to following the generally recommended dietary guidelines.

The study is published in the July 18 issue of the Journal of the American Medical Association.

The results are from the multi-center Women?s Healthy Eating and Living (WHEL) Study, based at UC San Diego, the largest randomized clinical trial to assess the influence of diet on additional breast cancer events. Participating institutions included the University of California, Davis; Stanford University; Kaiser Permanente in Oakland and Portland; University of Arizona at Tucson, and the University of Texas M.D. Anderson Cancer Center in Houston.

?This is a definitive study,? said principal investigator John Pierce, Ph.D., director of the University?s Cancer Prevention and Control Program. “The WHEL Study provides strong evidence that, for the typical woman diagnosed with early stage breast cancer, there is no additional health benefit over 7 years from dramatically increasing the diet’s amount of nutrient-rich plant-based foods, compared to following the recommended healthy diet.”

The study followed 3,088 breast cancer survivors, aged 18 to 70, for between 6 and 11 years. Participants were randomly assigned to one of two diet groups. The comparison group followed the guidelines promoted by the U.S. Department of Agriculture (USDA). The intensive intervention group was asked to follow a daily dietary pattern that included 5 vegetable servings, 16 ounces of vegetable juice, 3 fruit servings, 30 grams of fiber, and 15-20% from fat.

At the start of the study, both groups consumed similar amounts of vegetables and fruits (7 servings a day on average), fiber, and calories from fat. Telephone counseling helped women assigned to the intensive dietary group to change their diets substantially: at the end of the first year of observation, women in the intervention group had increased their average vegetable and fruit intake by 5 servings per day (to an average of 12 servings per day). They also increased their fiber intake substantially and decreased fat intake

These large changes in self-reported dietary pattern were validated by large changes in plasma carotenoid concentrations. By the fourth year of the trial, relative to the comparison group, the intensive dietary group was still consuming more vegetable servings (+65%), more fruit servings (+25%), more fiber (+30%), and less fat (-13%). The difference in diets between the two groups was maintained throughout the trial.

?The dietary changes achieved and maintained by the women in the intervention group resulted in some of the biggest differences in dietary pattern ever reported in a large randomized clinical trial,? said Vicky Newman, M.S., R.D., Director of Nutrition Services for the Cancer Prevention Program at the Moores UCSD Cancer Center. ?It provides further evidence of the effectiveness of telephone counseling in helping people to change behaviors.?

After a median of 7 years of follow-up, the study observed no difference in recurrence or survival between groups: about 17% of women in both diet groups developed a breast cancer recurrence or new breast cancer, and 10 % of women in both groups died.

?These results do not mean that women should stop paying attention to what they eat,? said study investigator Bette Caan, Dr.P.H., senior epidemiologist at the Kaiser Permanente Division of Research in Oakland, California. ?In addition to exercising regularly, eating a diet that has plenty of fruits and vegetables and is moderate in fat is still one of the best ways we know to maintain health.?

?We want to keep in mind that this study relates only to breast cancer survivors,? said co-investigator Cheryl Rock, Ph.D., R.D., of the Moores UCSD Cancer Prevention and Control Program. ?We recognize that several other very well-designed, controlled studies have shown clearly that eating more than five fruits and vegetables a day can make major differences in disease risk, such as in lowering blood pressure and reducing risk of stroke and heart disease.?

The study results refer to the typical woman on the study. The research team emphasizes that there may be subgroups that benefited from the intensive dietary pattern and further research will investigate this. The 7 year follow-up time is also short for young and middle aged women diagnosed with breast cancer. It is possible that there will be longer term benefits particularly from reduction in heart disease risk with this intensive dietary pattern.

ShareThis

Ayurveda :: Eating for Balance - Ayurvedic Guidelines for Good Digestion

In ayurveda, diet and digestion are accorded equal importance in maintaining good health. Just as choosing improper foods for your constitution can lead to imbalances, following improper routines and habits can wreak havoc on your digestion, turning even carefully chosen and prepared foods into ama or toxins in your system rather than ojas, the biochemical essence that supports all aspects of life, health, bliss and longevity.

Here are some universally applicable principles of eating that ayurvedic healers recommend to keep your digestion working efficiently:

1. Eat three meals a day. Fasting and skipping meals are not recommended in ayurveda because they throw the digestion rhythm off. A light breakfast, a substantial lunch and a light dinner allow you to keep in tune with the ebb and flow of the digestive fire, which builds up during the morning, peaks around noon and then ebbs again in the evening.

As soon as you get up, drink a cup of hot water to which a tablespoon of lemon juice has been added. This will help elimination, get the digestive juices flowing, and cleanse out the digestive tract. Caffeinated beverages are not recommended in ayurveda.

A light breakfast is essential to kick-start the digestion and provide energy necessary to get through the activity of the day. If you wait until lunch to eat a proper meal, chances are you?ll be tempted to wade into that packet of potato chips or get a doughnut some time during the morning. Have a stewed apple or pear, and then follow 30 minutes later with some warm cereal or a whole-wheat flatbread spread with a little honey or almond butter. Warm cooked foods are preferred as breakfast items over cold cereal, cold milk and cold juice, all of which are harder on the waking digestive fire.

For a mid-morning snack, choose fresh fruit?an apple for Kapha, a sweet pear for Pitta and a mango or some strawberries for Vata. Fruit is best eaten in the morning, and on its own.

The ideal ayurvedic lunch includes two or three kinds of vegetables, one of which should be a leafy green; a lentil or bean dish or a paneer dish; a whole grain; a chutney or relish; a small helping of a warm salad or soup; and lassi, a beverage made by blending together fresh yogurt and water. All of the dishes should be cooked with dosha-appropriate spices, and using a dosha-appropriate healthy fat?ghee for Vata and Pitta and olive oil for Kapha are good choices. This may seem like a huge meal, but portions can be kept small to moderate?the variety is crucial for wholesome, balanced nutrition.

If you need a mid-afternoon snack, eat a small helping of soaked nuts (almonds should be blanched) if you are trying to balance Vata, or some sunflower or pumpkin seeds if you are trying to balance Pitta or Kapha. Popcorn in moderation without salt or butter is also fine for Kapha, and soaked blanched almonds for Pitta.

For dinner eat a small, light meal?a one-dish vegetable/grain casserole or a vegetable/lentil soup with a whole-wheat flatbread, for example.

Drink lots of pure water through the day, but limit your water or beverage intake at meals. Do not drink iced, carbonated or caffeinated beverages and avoid alcohol and milk with meals.

At bedtime, drink a cup of warm milk spiced with nutmeg for Vata, cardamom for Pitta and ginger for Kapha.

Fresh foods are easier to digest, so cook only what you think you will eat at a meal. To enhance the appetite, have a slice of fresh ginger root spiked with some rock salt and fresh lemon juice about an hour before a meal. Chew fennel seeds after a meal to enhance digestion and freshen the breath naturally. Taking rasayanas such as Amalaki and Triphala after a meal also boosts digestion and assimilation and helps the system flush out ama regularly.

2. Eat at around the same times each day Like your sleep/wake cycle, your digestion will also benefit from a regular routine. Pre-program meal times into your day so that you have the time to take care of sustaining yourself. Water and food are next only to air for survival. When sustenance is that vital for good health, why would you have mealtimes play second-fiddle to work or social engagements?

When your digestion is ?trained? to kick in at those set times through regular practice, it functions efficiently to build more ojas from the foods you eat. Ojas is the most refined product of the digestive process?the biochemical essence that sustains life and health. Nutrients from the foods you eat are absorbed and assimilated to the maximum extent by your body, and wastes are flushed out effectively, leaving little room for ama–digestive toxins?to build up in the body and act as a breeding-ground for imbalances and disorders.

3. Avoid incompatible food combinations Ayurvedic texts outline some food combinations that overtax the digestion and lead to increased ama build-up. Milk and cream, for example, should not be combined with salty or sour tastes. Melons should not be eaten with heavy foods like cheese, deep-fried foods or the heavier grains. Fruit, in general, should be eaten on its own because it is very quickly digested. Meat or fish should not be taken together with milk. Honey should never be heated or cooked.

In general, if you follow the meal guidelines and food suggestions given above, you will avoid most incompatible food combinations. One general rule to follow is to not eat foods with different digestion times at one sitting.

4. Prepare your meals with care and love Everything is connected. For the food to eat to become ojas, you have to prepare it with attention, a positive attitude, caring and love. Many traditions hold the acts of cooking and eating sacred. In the Vedic tradition, the chef bathes and offers thanks to agni?fire?before beginning the task of preparing the first meal of the day for the family. Do not prepare meals (or eat) when you are upset or stressed, because your liver and digestion are adversely affected by negative emotions and will not digest that meal efficiently.

Eat in the area or room designated for eating in your home or place of work, not in front of the television or at your workstation. Diffuse a pleasant aroma blend in your dining area about an hour before you will begin eating?lemon, coriander, sweet orange and mint are good choices to whet the appetite and get the digestive juices flowing. Dress up your dining table with fresh flowers or a pretty tablecloth. Make sure everything you need for your meal is at hand before you sit to eat so you do not have to get up or be distracted from your meal once you start eating.

5. Practice mindful eating Ours is, sadly, an on-the-run, 24/7, get-everything-done-yesterday world. Extending multi-tasking to eating is one often-seen habit that probably causes many health problems that could be avoided if one only took the time to accord the meal the attention it deserves. The time that is perceived as ?lost? by doing nothing but eating can more than likely be made up in increased energy and productivity the relished, well-digested meal returns to you. Eating in silence, with all your senses focused on the aromas, flavors, colors and textures on your plate is best, with muted, pleasantly relaxing conversation or soft music in the background a second-best option. Arguments, highly stimulating discussions and disciplining children are activities not suited to mealtimes.

Other mindful eating habits to follow:

? Do not work or speak on the telephone when you eat. Do not read or watch television. ? Offer thanks or sit in silence a minute before you begin eating. ? Do not gulp down your food; savor each mouthful and chew well before you swallow. A few sips of warm water during the meal will help digestion, but do not drink too much of any beverage. ? At any meal, do not eat until you are very full. The ideal ayurvedic portion is what you could hold in your two cupped hands joined together. Leaving some room in the stomach when you are done enhances digestion. ? After you are done eating, sit quietly for a few minutes; do not immediately rush off to do the next chore of the day.

Note: This material is educational in nature and is not intended to replace standard medical care or advice. If you have a medical concern, please consult your physician.

Shreelata Suresh is a yoga instructor who lives in the Bay Area. She writes for various publications on yoga, ayurveda and Indian culture. For more articles on ayurveda and premier ayurvedic products, please visit http://www.ayurbalance.com.

ShareThis

Atkins Diet :: Nature of the diet

The Atkins represents a radical departure from prevailing theories. He claimed there are two main unrecognised factors about Western eating habits, arguing firstly that the main cause of obesity is eating refined carbohydrates particularly sugar, flour, and high-fructose corn syrups; and secondly that saturated fat is overrated as a nutritional problem, only trans fats from sources such as hydrogenated oils need to be avoided. Consequently, Dr. Atkins rejects the advice of the food pyramid, instead telling us the tremendous increase in refined carbohydrates is responsible for the rise in metabolic disorders of the 20th century, and the focus on the detrimental effects of dietary fat has actually contributed to the obesity problem by increasing the proportion of insulin inducing foods in the diet.

Dr. Atkins argued that many eating disorders are the result of hyperinsulinism, or excessive secretion of insulin which comes through eating too many carbohydrates. According to Dr. Atkins, this causes food cravings and unstable blood sugar levels, which can cause mood swings, depression, and sleeping problems. He claimed that his diet stabilizes insulin and blood sugar levels, eliminating cravings and often reducing appetite.

While most of the emphasis in Atkins is on the diet, nutritional supplements and exercise are considered equally important elements.

Atkins involves restriction of the intake of carbohydrates in order to switch the body’s metabolism from burning glucose to burning fat (chiefly stored fat). This process (called lipolysis) begins when the body enters the state of ketosis as a consequence of running out of carbohydrates to burn. Although Dr. Atkins claimed that ketosis helped the body burn fat more easily, nutritionists are quick to point out that the body will burn stored fat for energy whenever the calories taken in are less than those burned.

Atkins restricts “net carbs”, or carbs that have an effect on blood sugar. Net carbohydrates can be calculated from a food source by subtracting sugar alcohols and fiber (which are shown to have a negligible effect on blood sugar levels) from total carbohydrates. Sugar alcohols need to be treated with caution, while they may be slower to convert to glucose they can be a significant source of glycemic load and can stall weight loss.

Preferred foods in all categories are whole, unprocessed foods with a low glycemic load.

ShareThis