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By Dr. Madelyn Fernstrom College credit for walking? That’s what the University of Georgia offers as one of its fitness classes for students. Whether this is a good sign or bad sign for our nation’s fitness is debatable.  Most of us are very familiar with the public health message about the multiple benefits of walking. A daily 20- to 30-minute walk supports cardiovascular health, weight control, and stress management. But how many of us actually follow that advice? The results might surprise you. Nearly 40% of Americans report that they “do not exercise.” This percentage has remained stable for many years. National recommendations for daily physical activity are actually quite modest: a minimum of 150 minutes of moderate activity per week. This translates to about a half hour of brisk walking five days a week. Some recent evidence using more sophisticated activity sensors (instead of self-report information) suggests that only around 4% of adults meet that goal. Why is it such a c...

By Dr. Madelyn Fernstrom With the holiday season adding extra activities to our already busy lives, we all sometimes feel we’re running low on energy. And this lack of energy can become a barrier to enjoyment. Below are three of my favorite strategies for boosting holiday energy in a healthy way.  I hope they’ll also work for you! Structure Your Eating.   Make sure to pre-plan your eating day; avoid skipping meals. No time for lunch? Try a protein bar or shake along with fruit if you’re on the run. Carry a small bag of nuts and/or dried fruit with you for a quick emergency energy boost, especially in the late afternoon. When you avoid getting “over-hungry” it’s much easier to resist the holiday treats on every desk and in office break rooms!  Don’t Skimp on Sleep. While it might be tempting to cut back on your sleep to lengthen your active day, fight that urge. Aim for at least seven hours nightly during this busy season. When you’re rested, you’ll be much more efficient ...

By Dr. Madelyn Fernstrom There’s a lot of debate about whether high-calorie “junk” foods should be taxed to help stem the obesity epidemic in our country. Maybe we can gain some insights from the recent policy change in Denmark. About a year ago, Danish lawmakers instituted a fat tax — a surcharge of foods high in artery-clogging saturated fat. The Danish tax ministry has now repealed that decision, citing a negative effect on both businesses and consumer buying power. So what went wrong? Perhaps one problem was taxing a whole category of nutrients (fat) rather than specific foods. The bigger problem seems to be that consumers just bought these foods elsewhere. They went to neighboring countries where prices were lower to buy their favorite butters and ice creams. Most of us are familiar with the “soda tax” issue in our country. Most recently, a bill that would have imposed taxes on sugary drinks was defeated in California.  The Danish legislature has now cancelled plans for a tax ...

By Dr. Madelyn Fernstrom Grapefruits are one of nature’s perfect fruits – low in sugar, rich in fiber, and a great source of vitamin C. But this fruit also contains a compound that can interfere with the activity of some prescription medications. A new study published this week in the Canadian Medical Association Journal reveals that the number of these drugs has significantly increased over the past few years. Researchers estimate that there are 43 drugs (26 having been introduced to the market in the past 4 years) that have been shown to cause serious harm in susceptible individuals when mixed with grapefruit. There are three major categories of drugs that can have serious negative effects when combined with grapefruit: - Cholesterol lowering statins - Some heart drugs, like beta-blockers - Some antibiotics While food and drug interactions are printed on every label and stated on package inserts, many people do not take these warnings seriously.  The best step is to talk wit...

By Dr. Madelyn Fernstrom PepsiCo has just launched a new soda in Japan, claiming to burn fat and support weight loss. It’s called “Pepsi Special” and the “special weight loss ingredient” is the addition of dextrin to the standard Pepsi formula. Dextrin is a non-digestible fiber, used in baked goods and other food products. Scientific studies have documented that fiber can help bind small amounts of dietary fat, and this metabolic observation is the sole “science” upon which this claim is based. Americans have a love-hate relationship with soda, and soda consumers are always happy to hear of some redeeming health benefit that helps justify consumption. This is not the first time soda has made a weight loss claim. In the U.S., you might be familiar with a soda named “Celcius” containing 200 mg of caffeine (the amount in a large mug of coffee) claiming to burn fat and raise metabolism. And Coca Cola’s Fuze Slenderize energy drink, containing a special blend of minerals, promises to help ...

By Dr. Madelyn Fernstrom You might be surprised to hear that the day after Thanksgiving can be a big barrier for many people when it comes to sticking with a healthy lifestyle over the holidays. This is the day most people make the decision to indulge smartly and adjust their eating and activity patterns to adapt to the culinary treats of the season, or disconnect from mindful eating until January and “worry about it later.” The first step in this decision starts with what I call “eater’s remorse” – feeling bad about your overindulgences of the previous day. It’s easy to get stuck in the mindset that you’ve gotten off track, and there’s no hope for your diet, so why not just keep eating until New Year’s Day.  Today is the day to adjust your thinking for weight control success. No more guilt!  Thanksgiving is just one day of eating, even if you’ve eaten way more than you intended. Don’t feel guilty about your past eating. Learn from your eating behavior, to see how you c...

By Dr. Madelyn Fernstrom Today I’d like to share some interesting facts about turkey in honor of the day most often associated with eating this bird – Thanksgiving! Here’s a list of my favorites: Nearly 95% of Americans eat turkey on Thanksgiving. That translates to 45 million birds! Turkey has more protein, ounce per ounce, than chicken or beef. White meat and dark meat turkey have almost the same number of calories per serving. Dark meat has four calories more per ounce, or 24 calories in a six-ounce serving A 15-pound turkey has 70% white meat and 30% dark meat. Eating turkey does not put you to sleep. While the old wives’ tale about the sleep-promoting effects of tryptophan-containing turkey remains active, it’s not true. The metabolic explanation is that the large caloric load consumed with the Thanksgiving meal drives more energy to the digestive tract, often causing drowsiness. Benjamin Franklin originally proposed the turkey as the official bird of the United States, instead ...

By Dr. Madelyn Fernstrom If you’ve lost and gained the same 20 (or 30, 40, 50+ pounds) for years and believe that you’ve “wrecked” your metabolism and can’t maintain successful long term weight loss, there’s very good news for you! A recent article in the scientific journal Metabolism followed more than 400 women for one year. About 40% of the participants classified themselves as “weight cyclers,” defined as losing (and regaining) at least 10 to 20 pounds at least three times. Participants were assigned to one of four treatment groups: (1) reduced calorie diet only; (2) reduced calorie diet plus exercise plan; (3) exercise plan alone; (4) no intervention, served as the comparison group.  Now here’s the good news! There was no significant difference for the total amount of weight lost between women who were yo-yo dieters and those who weren’t. That’s a reassuring message for the millions of women (and men) who feel their efforts are sabotaged by their past weight cycling history....

By Dr. Madelyn Fernstrom You might have seen advertisements or read magazine articles and health books touting the health benefits of coconut oil. We’re often led to believe that there is a new health secret to using this oil – that adding it to your diet is definitely a good choice. But what’s the truth about coconut oil?  Coconut oil is a vegetable fat - it comes from a coconut after all. But unlike most vegetable fats, coconut oil has a lot of saturated (artery clogging) fat. The saturated fat in coconut oil is no different from any other saturated fat and it raises the “bad” LDL cholesterol (think “L” for Lousy). But coconut oil is different from other saturated fats because it also raises the “good” HDL cholesterol (think “H” for healthy). It’s not really clear what impact coconut oil has on overall heart health because studies show that it raises both good and bad cholesterol. So is it healthy? I’d stick with the other vegetable oils like soybean, canola, or olive that do n...

By Dr. Madelyn Fernstrom When it comes to food, when we hear the word “salt,” most of us automatically think about sodium. The emphasis on lowering sodium intake to promote heart health is important and well documented.  But there’s another important salt in the dietary picture: potassium. Getting the right balance of sodium and potassium is another key component for heart health. According to a recent study published in the American Journal of Clinical Nutrition , 90% of a group of of 12,500 people consumed more than 2,300 mg of sodium daily, the upper limit from the American Heart Association (AHA). While sodium intake was up, potassium intake was down. This group consumed only about half of the AHA recommendation of 4,700 mg/day per day. How does this finding translate into what you should eat? Because nearly three quarters of daily sodium intake comes from the consumption of processed foods (food contained in boxes, cans, and bags), cutting back on these items can drastically...

By Dr. Madelyn Fernstrom Three cheers to the American Academy of Dermatology for designating November as “National Healthy Skin Month.” This makes a lot of sense since November brings the arrival of colder, drier air as the winter months approach. Their main goal is to raise awareness of healthy skin care throughout the year, as well as provide some specific tips for protecting your skin all winter long.  Keeping your skin hydrated and protected isn’t just important to reducing the visible signs of aging, it’s also a preventive measure for avoiding long-term skin damage. Follow these five easy steps for a healthy skin year-round! - Wear sunscreen. You know by now that I’m a big advocate of year-round sun screen. Cloudy and cold conditions do not block the rays of the sun, although the heat is less intense in winter. Remember to coat the skin on your hands (unless you’re wearing gloves) and your lips to avoid chapping. - Use milder soaps and scrub lightly. Washing the skin removes n...

By Dr. Madelyn Fernstrom For those of you who skimp on sleep because of “too much to do,” this weekend is meant for you. It’s the end of daylight savings time, and we turn our clocks back one hour at 2 a.m. Sunday morning. It’s time to “fall back” and gain an extra hour! While you might be tempted to pack more activity into this extra hour, how about using that time for an extra hour of sleep? Many people tell me they can’t make the time to sleep 7-8 hours every night. With our busy lives, sleep is often at the bottom of the “to do” list. Lack of adequate sleep is increasingly becoming a risk factor for our long term health. Chronic lack of sleep is associated with weight gain, hormonal shifts, mood changes, and lack of work productivity. One extra hour won’t make up for weeks and months of inadequate sleep, but it’s a start. It’s a big step for increasing personal mindfulness of your own sleep schedule. Pleasant dreams!

By Dr. Madelyn Fernstrom With Halloween on the horizon, I thought it would be fun to provide a little “candy trivia.” If you choose to indulge, stick with the “fun size” servings at around 100 calories, and you get to eat the whole thing! Here are some of my favorite candy facts.  1. Nearly half of the 200 million pounds of candy sold in America is at Halloween.  Most of the other half is sold at Easter and Valentine’s Day. 2. The top selling candy in America is candy corn.  But we don’t know how much we eat, and how much we use for crafts and decorations.  3. Candy does not cause weight gain and often supports weight loss.  The Swiss are among the biggest consumers of chocolate (about 2 pounds per month per person) in the world, yet they have an overweight/obesity rate of around 7%! In the United States, about 35% of the population is overweight or obese. Allowing yourself a small amount of chocolate or candy can be an indication of good control over food, not ...

By Dr. Madelyn Fernstrom Power outages often accompany big storms. While Hurricane Sandy might not knock out your electricity this time, it’s good to know the basics of food safety related to your refrigerator and freezer. If you don’t already have a refrigerator thermometer, run – don’t walk – to get one at any store selling kitchen gadgets (including most supermarkets). This is a key step to following my four-hour/40 degree food safety rule.  All food in your refrigerator is safe to eat after a power outage, if the temperature remains below 40 degrees . An ideal range for food safety is 36–38 degrees. At 40 degrees or higher, bacteria start to multiply quickly and can easily cause food-borne illness.  If you have a thermometer , your food might be good for much longer than four hours (that’s with the door closed!). If you don’t have a thermometer , stick with the four-hour rule and toss most foods from your refrigerator. Don’t use the taste or smell test to determine food ...

By Dr. Madelyn Fernstrom If you’re like millions of people in our region and across the country, the typical answer to that question is, “in the medicine cabinet in my bathroom.” And who doesn’t love extra storage space in their bathroom?  But if you’re keeping your prescription or over-the-counter medications there, you’ll want to change the location! The bathroom turns out to be the worst place to store medications because there are constant changes in room temperature and humidity caused by hot showers and baths. Too warm or moist of an environment over time can reduce the potency of your medicines.  Keep your medications in a cool, dry place. For daily prescription medications, be sure to keep them where you are likely to see them. “I forgot,” is one of the biggest reasons people give for being non-compliant with prescription medicines. Keep your daily medications and dietary supplements (like vitamins and minerals) at your bedside or on the kitchen table – both serve as i...

By Dr. Madelyn Fernstrom The debate on whether the serving size of a soda should be regulated by the government is continuing to heat up. I’ve been writing about this controversial ban on selling soda with a limit of 16 ounces because this is a prime example of how food regulatory policies could be used help stem the obesity epidemic. The question remains: is this an effective strategy? It’s important to follow these new developments, as these decisions will likely impact implementation of policies like these in our region, and throughout the country. In response to the NYC Health Department’s ban on selling sodas larger than 16 ounces in places like movie theaters and restaurants, a lawsuit aimed at overturning this ban was filed by a consortium that includes the American Beverage Association, the National Restaurant Association, the soda workers union, and movie theatre owners. The argument is that such a ban would hurt small businesses and burden consumers, and it could even affect ...

By Dr. Madelyn Fernstrom If healthy eating is a daily challenge, this post is definitely for you! You know by now that I’m a huge champion of eating in moderation, and my motto is “no bad foods, just bad portions.”  When it comes to healthy eating, the biggest challenge we all face is not what to do, but how to do it. That’s where UPMC Health Plan’s Dining Smart program comes in. Our team took several years to develop the Dining Smart program to come up with some real world — not perfect world — guidelines that support healthier eating. Small daily improvement in food choice is the best way to sustain long-term change.   Dining Smart food choices and guidelines are available at all UPMC sites, and we’re expanding our program to support healthy eating throughout the region. One example is a dinner this weekend in honor of the One Young World event in Pittsburgh. The dinner celebrates healthy eating. Spearheaded by Chef Jamie Oliver, this event is intended to raise awareness ...

By Dr. Madelyn Fernstrom October is National Breast Cancer Awareness Month. While there are no specific instructions for breast cancer prevention , there are many things you can do to reduce your risk . Here are six lifestyle steps that research shows contribute to reducing breast cancer risk.  Manage Your Weight. Overweight and obesity increase the occurrence of breast cancer, especially after menopause (when breast cancer occurs most often). Healthy eating and physical activity likely contribute most to risk reduction by promoting weight loss. Limit Your Alcohol Intake. As alcohol intake rises, so does breast cancer risk. If you do consume alcohol, limit intake to one drink daily from all sources (a 12-ounce beer, 5 ounces of wine, or 1.5 ounces spirits).   Breastfeed. The longer you breastfeed, the greater the protective effect. Breastfeeding for one year appears to provide the greatest effect. Avoid Hormone Replacement Therapy. Using hormone replacement therapy for men...

By Dr. Madelyn Fernstrom Caffeine is one of the most widely consumed compounds in the world. Nature’s original stimulant, caffeine is found in coffee beans, tea leaves, and cola nuts. Because caffeine boosts mental focus and alertness, it was an important survival tool in caveman days, when our ancestors had to run away from  predators and search for food. But nowadays, when it comes to caffeine consumption, a little goes a long way. The LESS you consume, the better it works when you need a boost. Too much caffeine makes your body resistant to the positive effects and can result in health negatives, including rapid heart beat, stomach upset, and jitteriness. When it comes to caffeine, less is definitely more. Most adults should limit caffeine intake to about 300 mg daily. That’s about two mugs of coffee or five cups of tea. An added  “turbo shot” from a coffee house adds another 100 mg or so.  Caffeine is well known to help athletic performance, so a large cup of coffee b...

By Dr. Madelyn Fernstrom When did the idea become acceptable that the personal weight issues of other people are somehow everybody’s business? Many people feel entitled to comment and judge others about whom they know nothing. They are who I call “weight bullies.” Weight bullies are occurring with increasing frequency, and I believe they are a big step in the wrong direction!  Here is a case in point: an overweight television anchor in Wisconsin received an email from a viewer commenting on her obesity. The remarks included (1) surprise that her physical condition had not improved over the years, (2) that she should present and promote a healthy lifestyle, and (3) that she was a poor role model, especially to girls. While many overweight and obese people are judged – both intentionally and accidentally – the usual response is silence and hurt feelings. Many patients have told me they feel obesity is the last “acceptable” area for open criticism and that they are not only hurt by c...