SPOON Foundation

I learned about SPOON Foundation a few months ago from a friend living and working in Kazakhstan. Having lived and worked in Kazakhstan, I once considered the situation for orphans there hopeless. Yes, people were adopting children, but I had always said I would never consider adopting from a former Soviet country. Orphans from former Soviet countries are notorious for having developmental delays, both cognitive and physical, due to severe nutritional deficiencies as infants and toddlers. These children lack key nutrients for "normal" brain development. Many of these deficiencies can easily be solved by a multi-vitamin.

Here's where SPOON Foundation comes in. They are blazing a trail in this part of the world by piloting a simple nutrition program in a handful of baby houses in Kazakhstan. This program includes daily vitamins for orphans. Why didn't anyone think of this before? Such a simple solution to an important problem. Watch this video to learn more or visit their website www.spoonfoundation.org

Air National Guard Wingman Project

Speaking of being "fit-to-fight"...

Air National Guard Wingman Project

Better childhood nutrition needed, retired military officials say – The Chart - CNN.com Blogs

Better childhood nutrition needed, retired military officials say – The Chart - CNN.com Blogs

Is it just me or does anyone else find it interesting that the military is backing this? An interesting turn of events in the passage of this bill. Will congress be more convinced to pass with a military reason? Rather than wanting healthier kids to decrease medical spending and disability later in life, we want healthier kids so we have more adults "fit to fight"?

Managing Diabetes with a Vegan Diet

This may be old news to some folks, but according to one study, a vegan diet may be effective in managing type 2 diabetes. Why am I now just discovering this? See the report from CBS News for yourself here.

What is "vegan"? A vegan diet means eating no animal products. Period. No meat, no eggs, no dairy. I'm giving eating vegan a try myself. Read about my adventures with eating vegan on my other blog: Hearts, Hands, Pots and Pans.

Hidden Health Costs of Transportation

Interesting new report from the American Public Health Association.
View the full report here.

Get Out(side)!

How many of us had mothers who would tell us to go outside after being too rambunctious in the house? If you consequently played outside a lot, you might be a healthier adult because of your mother’s orders. Some people claim more outside time increases creativity in children, but there are some concrete health benefits of getting outside:

1. Childhood obesity is on the rise – according to the CDC, for children ages 6-11 the prevalence of obesity has nearly tripled between 1980 and 2006. It’s a simple calories in-calories out equation. And the sedentary lifestyles of kids spending after school and weekend time watching TV and playing video games is half of that equation. It’s no secret that a child burns more calories playing “War” outside than playing “War” on a video game. And you know what? A child is more likely to spend time outside if it’s modeled for him by a parent. Just like a child is more likely to be sedentary if it’s modeled by a parent. So get outside and play TOGETHER!

2. According to a study in the Archives of Ophthalmology since the 1970’s, we’ve seen a 66% increase in the prevalence of Myopia (near sightedness). (See article in post from Monday, January 11^th) The cause? Partly genetics, but researchers at Ohio State University have found it may be partly due to low levels of outdoor activity. Don’t want to spend money on glasses and contacts until your child is 18? Get them outside!

3. An article published in Pediatrics in 2004 reported the more TV-time a child experienced between the ages of 1 and 3, the more likely they were to develop attention problems (e.g. ADD, ADHD) by the age of 7. Granted, kids are naturally hyperactive beings, but attention problems can significantly affect your child’s performance in school. Make an effort to turn your young child’s energy into productivity.

I acknowledge it’s not realistic for children in some locations to play outside every day, year-round (I grew up in Minnesota, I know firsthand). But knowing that increased outside time can lower a child’s risk of obesity, myopia, and attention disorders ought to motivate parents to encourage getting outside as much as possible.

While increased outside time can lower the risk of certain health issues, it can increase the risk of another: sunburn (and consequently skin cancer). Please be mindful that increased outside time means increased sun exposure, so please act accordingly (e.g. sunscreen, hats, sunglasses).

The Buzz on Nearsightedness (Myopia)

Something for parents to consider: spending time outdoors may help decrease a child's risk of developing myopia. Check out the story from NPR

Re: Fat Acceptance

This post is in response to the article I posted last week from CNN.

I found this article to be particularly interesting primarily because I could identify with the story of the woman's overweight daughter. But I would also like to insert my opinion on the matter.

I've always been "well-built" and stocky. I've always liked to describe myself as a bowling ball: small, but hurts when you drop it on your toe.

I was a little on the chunky side for most of my life and always struggled with my self-esteem. As I began to accept that being chubby was my fate, I became more and more complacent with diet and exercise.

However, when I began to truly LOVE myself to the core, that's when I began to care more and more about my health and fitness.

I think there is a fine line between accepting yourself and loving yourself. When you love yourself, you genuinely care for your body's well-being and take steps to improving the way you treat your body. Sometimes the result is weight-loss, sometimes not.

This is why there is such a challenge for health care professionals (public health professionals included!). Too many people are in acceptance mode, which I feel results in behavioral complacency. In health behaviorist speak (and according to the Transtheoretical Model), we would call these folks the "pre-contemplaters" (reference: Prochaska and DiClemente's Stages of Change Model). We want those pre-contemplaters, especially those with heinous health behaviors, move into contemplation, preparation, and action modes. How can we do this when we're now telling people it's okay to be fat?

I think everyone can make changes and improvements to health behaviors. I also think there are positive and negative ways to go about making changes, for example, there are positive and negative motivations for making changes. Negative motivation: to look like a super model; Positive motivation: to feel good physically, mentally, and spiritually. I think that by achieving self-love, our internal compasses will direct us all toward positive health behavior change.

Fat Acceptance

Check out this article from CNN Health: Is the fat acceptance movement bad for our health?

Pip, Pip, Cheerio!

I will be out of the country for a research meeting in Cambridge, United Kingdom until October 11th. I'm sure I'll have a lot to share about peer support and diabetes self-management when I return. If you'd like to learn more about this topic in the meantime, visit www.peersforprogress.org

It Got Me!

Just a heads up that even the most well-informed and prepared people succumb to illness, and I am one of them.
After months of touting how easy it is to prevent yourself from the flu (basic hand-washing and sanitary precautions, people!), I unfortunately found out that it is much easier to catch the flu.
I don't know how or when or where, but all I know is that it got me! And it got me good!
So be warned, but don't panic. You will not die from the "swine flu."
I called my primary care doctor to ask whether or not I ought to come in and they told me it's really up to the person. If you think you WILL die from the flu, please go see your doctor. If you're confident in your abilities to care for it on your own (i.e. drinking fluids, getting rest, taking Tylenol to control fever), then you're probably A-okay.
One tip my doctor's office gave me I found to be particularly helpful is keep track of your daily/hourly body temperature fluctuations with a thermometer. If you don't have a thermometer, go buy one from your local pharmacist. Persistent fever is a key indicator of whether or not you need to see a doctor.

More to come as I'm "on the mend"...

Sun Protection Satire

I just posted an article from the New Yorker, which is a hilarious must-read!

Sometimes as a public health professional, you have to take a step back and laugh at yourself. One characteristic that makes a good health educator: a good sense of humor. No amount of schooling will teach you that, people!

I invite you to refer to my "serious" post about sun protection from September 2nd.

Shouts & Murmurs: A Guide To Summer Sun Protection: newyorker.com

Shouts & Murmurs: A Guide To Summer Sun Protection: newyorker.com

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Elmo Says, "Swine Flu is BAD!"

I've been a fan of Sesame Street since the beginning. And by "the beginning," I mean my beginning, not Sesame Street's.

Thousands of children have learned the alphabet, counting, lessons on sharing, friendship, and diversity from colorful puppets. And now, Sesame Street characters are getting in on the Public Health action by helping the Department of Health and Human Services with a flu prevention and hygiene campaign directed at small children. And I must say, I am a fan.

Check out the CNN article!

Watch the new Elmo (and Gordon) flu videos! (I'm a sucker for Elmo's cuteness)

Back to School!

Can you hear the school bells ring? Well here in North Carolina, public schools are back in session. More inconveniently, college students have returned to the multitude of universities and colleges in this area. Since I work at one of these universities, I am already missing the days of quiet and empty hallways in my building.

For many college freshmen, they not only face the challenge of college-level calculus, lecture halls, and dealing with a roommate, but also face the feared “FRESHMAN FIFTEEN.” I’m pretty sure I was a victim of the freshman 15 (I never weighed myself freshman year so I don’t really know), though by the end of college I came out under par.

So why is gaining weight so common among college students?

· Dining Halls: Buffet-style eating is never good for anyone

· Liquid Calories: Between sugared sodas, energy drinks, and frou-frou coffee drinks to stay awake to study and increased alcohol consumption – all of these pack a lot of caloric punch

· Inconsistent and Inadequate Sleep: late nights on weekends, early morning bio, sleeping until noon – many college students make the mistake of sleeping whenever and wherever they can (I used to take naps in the big chairs in the student center), usually not amounting to 5-8 hours every night.

· Late Night Binge Eating: Pizza. The forever friend of late night study groups.

· Food Kept in the Dorm Room: Easy Mac. Need I say more?

· Swapping Fitness for Physics: Quiz time! What’s more important to a college student – studying, sleeping, eating, socializing, or working out? Sorry “working out,” you’ve been voted off the island.

Needless to say it’s a combination of factors that leads to weight-gain, the primary culprit being poor eating behaviors. But awareness and preparation can aid college students in the battle with the scale. Here’s how:

· Most Dining Halls now post calorie information for each dish. So go ahead and count your calories.

· Use a plate format. Okay so this method may have been designed for people with diabetes, but it also helps the average person eat a balance diet. Check it out!

· If you must drink soda, opt for diet sodas. Most coffee shops now offer sugar free and low-fat versions of their frou-frou drinks, too.

· I realize college students are going to drink regardless of anti-drinking campaigns, but try to stick to 0-4 drinks per day. Not only does this keep away from what is considered “binge drinking”, but you’ll limit your calories from alcohol too.

· Set a bedtime for yourself (especially on school nights) and strive for 8 hours of sleep per day. Easier said than done, I know.

· If you’re participating in a late night study group or pulling an all-nighter, chew sugar-free gum. Studies have shown this actually can help! If you do get the munchies, buy the single serving or 100 calorie bags of chips or cookies.

· Keep healthy snacks in your dorm room like baby carrot sticks, whole grain granola bars, nuts, and dried fruit.

· Most gyms at universities and colleges are free or low-cost to students, so take advantage of it!

· Not fond of weights or machines? Check out the fitness class schedule or join an intramural sports team.

· Walk or bike instead of taking the bus.

· Get credit for physical fitness by taking a class. Many universities offer classes for credit like running, tennis, and even ballroom dancing.

No Problem, Mon!

I just got back from a vacation to Jamaica – go ahead, be jealous.

While there, I learned that Jamaica was recently rated the 3^rd happiest nation in the world by the New Economics Foundation. I wondered about the source of the Jamaican happiness and what benefit happiness has for their country. Of course, being an American and a Health Educator I think in terms of economics and health status. But are those things really related to happiness?

Side Note: You may be asking yourself why I care about happiness as a health educator. The simple answer: mental health is part of public health!

The famous rapper, Notorious B.I.G. once penned a song called “Mo Money Mo Problems” (More money, more problems). And in fact, the same “happiness report” from New Economics Foundation found that the richer, more developed countries (e.g. USA and UK) tended to have lower scores on the Happy Planet Index. So perhaps there’s a negative relationship between money and happiness such that as money increases, happiness decreases?

Or perhaps this report is completely bogus since happiness is culturally defined? How do you control for cultures in which optimism and happy-go-luckiness are cultural norms?

On the health side of things, how do you treat diseases in a country where the motto is “No Problem!”? Is ignorance truly bliss?

On the flip side, the American health care system has created a culture of practicality and bleak outlooks, leading us to think about only about death and not about life.

Perhaps we should adapt an attitude of a “Jamerican,” somewhere between carefree and stark practicality. Perhaps if we take care of our mental health first, everything else will fall into place.

HIV: The Elephant in the Room

Human Immunodeficiency Virus, aka HIV, is the virus that causes AIDS (Acquired Immunodeficiency Syndrome). HIV/AIDS lives up to its namesake – causing a deficiency (aka lack or absence) of the immune system. This means the body is unable to fight off infections, from strep throat to cancer.

As of 2007, there were 33 million people living with HIV/AIDS in the world. In the United States along, it’s estimated that there are 1.2 million adults and children living with HIV/AIDS (World Health Organization, 2008 http://www.who.int). About 80% of people living with HIV/AIDS in the US contracted the virus through high-risk sexual contact (e.g. unprotected sex), around 13% through injection drug use (e.g. needle/paraphernalia sharing), and the remainder through a combination of both or other means (CDC, 2006 http://www.cdc.gov).

I wanted to comment on two recent HIV-related news stories, one I posted last week. The United States House of Representatives voted to lift the ban on using taxpayer dollars to fund needle exchange programs. Needle exchange programs work to prevent the spread of HIV by allowing IV drug users to exchange used needles for clean ones. However, there are many opponents to such programs because they believe that by allowing drug users to exchange their needles that we are encouraging them to continue using drugs. I wonder if these are the same people who believe we shouldn’t hand out condoms in schools because it will promote pre-marital sex. My argument is we (and by “we” I mean people who support comprehensive HIV/AIDS prevention) are not promoting copious drug use, we’re promoting SAFE drug use. Similarly, we’re not telling teenagers “Here’s a condom, now go have lots of sex,” we’re teaching them to have SAFE sex. HIV/AIDS is a global problem that requires multi-point and multi-method intervention. Why not “nip it in the bud” at the points of transmission in addition to antiretroviral therapy (medicinal treatment for HIV/AIDS) after diagnosis. Additionally, thousands upon thousands of people around the world are living with HIV but don’t know they have it. Antiretroviral therapy is only good if a person is diagnosed. We need to take measures to prevent transmission of HIV, particularly HIV that is unknown.

In other HIV news, researchers have identified a new strain of HIV that is derived from gorillas. Check out the article here. What are the implications of this? HIV is ever-changing. Microbiologically, we need to be aware of the different variants that may emerge in the next few years. Anthropologically, the face of HIV/AIDS has changed and will continue to change. It is not longer a virus that affects vagrants, druggies, prostitutes, and homosexual men. It affects EVERYONE.

House lifts ban on federal funding for needle exchange programs - The Boston Globe

House lifts ban on federal funding for needle exchange programs - The Boston Globe

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Social Media: A Health Educator's Friend or Foe?

I am truly overwhelmed by the social media frenzy and the advances in new technology. More so, there’s the whole subset of “vocabulary” that needs to be learned to effectively stay in the loop. Sometimes I want to throw my hands in the air and give up on trying to stay in touch with it all, but then I realize by being culturally relevant, I become a better health educator.

Now the question is: are social media like Facebook, Twitter, blogging, and texting my friends or foes? I think if social media can be harnessed and used appropriately it can be a very effective health education tool. However, like your mother always told you “Everything in moderation.” I think if overused or used improperly, we could have a global disaster on our hands. Okay, maybe that’s an exaggeration. But the results wouldn’t be good.

Example 1: The CDC on Twitter

The Centers for Disease Control and Prevention have multiple sub-centers/departments on Twitter, tweeting updates to their followers. This is a pretty effective way of keeping the general public (at least those on Twitter) updated to any breaking public health news like a new publication or report or “Hooray! It’s International Eat-Your-Veggies Day!” But probably the section that may have the most purpose with Twitter is the Disaster Preparedness section of the CDC. Twitter is potentially a good channel for communicating information (albeit, brief) on preparing yourself for, well, disaster. One situation where this may have back-fired, however, is with the swine flu. Tweeters panic and make assumptions since there’s no way to get the whole story due to the 140 character limits. Plus, there’s no room for a post-script “Don’t Panic.”

Example 2: Online Forums

Gobs and gobs of research have shown that social support in its various forms is an effective way of managing chronic disease. If you Google Scholar or do a PubMed search of “Social Support and Disease" you’re bound to be overwhelmed with the search results. Online support groups, such as those for type 2 diabetes or breast cancer, have had great impact on mental and physical well-being of their participants. You might even know someone who participates in one and can attest to how much they love their online support system. Some benefits of online support groups are:

1. Common interest. Not feeling alone in your suffering is a good thing.

2. Anonymity. Participants don’t feel judged by people who already know them and have preset opinions.

Some health issue support groups, however, aren’t destined for greatness. Studies have found that support groups of teenagers suffering from anorexia or bulimia are counterproductive because the teens share their “methods” for staying thin. I give an “A” for effort, though.

Example 3: Texting Health Messages

I hate texting. I’m so glad I’m not a middle or high school teacher because I’d probably hate it more. I think we’ll have an emerging pandemic of “texter’s thumb” on our hands (no pun intended) in the next few years. And I think it teaches teenagers bad grammar and inappropriate use of the acronym. However, realizing we live among the “text generation,” I think it can be an important avenue for health messages. I’m currently working on a project that works with multiple sites doing diabetes self-management studies. One of our studies is using text messaging as a means of reminding participants of upcoming doctor appointments, medication reminders, healthy eating tips, and the list goes on and on. I’m very interested to see the results of this study. Several studies have already been done (mostly international) that have found text messaging (or SMS) to have a positive impact on certain behavior changes. However, several studies have also been deemed “inconclusive,” so more research needs to be done in this area.

Okay, so I haven’t covered all forms of social media. I tried to be objective, but let’s face it, I’m a fan of you, social media. Let’s be friends.

Fireworks, Food, and the Fourth of July!

The Fourth of July is right around the corner and there are a lot of things that can go wrong when you’re camping, picnicking, or family reunioning. Not to rain on anyone’s Fourth of July parade, but there are some things everyone should be wary of in the midst of the festivities. I’ve seen a lot of crazy Independence Day celebrations and seen a lot of things go wrong. Here are some mistakes people make on the Fourth of July:

1. Drinking too much. Many adults raise a glass in celebration of our nation’s independence, and unfortunately, many adults will binge drink. Binge drinking means drinking more than 5 alcoholic beverages in one sitting for men and more than 4 alcoholic beverages in one sitting for women. According to the CDC, excessive alcohol use is the 3^rd leading lifestyle-related cause of death.

Like drinking and driving, drinking and fireworks DO NOT MIX. If you’re drinking feel free to go to a professional fireworks show, but don’t try to set them off yourself. Please.

2. Carelessly using fireworks. 60% of injuries related to fireworks occur on or around the 4^th of July (Green & Joholske, 2006). In the months of June and July, firecrackers, sparklers, and rockets account for most injuries seen in emergency departments, and sparklers are associated with half of the injuries seen in children under 5 (Green & Joholske, 2006). And the best way to prevent firework-related injuries? Leave them to the professionals!

3. Eating contaminated or spoiled food. Be wary of food that’s been sitting out in the sun too long, especially if it’s a mayonnaise-based salad, dairy product, or meat product. Even if a food has been washed and cooked thoroughly, bacteria flourish at room (and warmer) temperature. If you can, try to keep leftovers cool or throw them away.

Also, even if you love your burgers rare, ground beef is a common culprit for food-related illness. Make sure the internal temperature of your hamburgers is a balmy 160 degrees Fahrenheit to keep yourself safe from bacteria.

Obviously these aren’t the only things that can go wrong on the 4^th. I urge you to be safe and wary as you “eat, drink, and be merry!”