Be Well

Be Well Bids Farewell

2011-08-14T20:23:00.001-07:00

The time has come for me to acknowledge that I can no longer keep up with this blog and successfully fulfill my obligations to my family, work and myself.

Therefore, I have decided to bid you all farewell and thank you for following this blog for as long as you did. I thoroughly enjoyed writing it and will continue to promote being well in other capacities.

Sorry there is no logo on this last entry as there was a problem uploading images to this blog. A sign or just a coincidence?

Be Well,
Wendi

Organic Gardening...Another Love of Mine

2011-03-08T20:04:00.000-08:00

Spring is around the corner and what better time than now to plan your garden. Living in the Bay Area has its INCREDIBLE benefits when it comes to gardening. You can have a year round garden with a combination of fruit trees and vegetables.

I started my garden early...maybe even too early-February. Be that as it may, I am looking forward to a summer of non-stop crops. I planted broccoli, brussel sprouts, kale, onions, carrots, lettuces, squash and herbs. I am awaiting to plant peppers. And I can't wait for my blueberries, raspberries, and fruit trees to produce juicy organic fruits!

Fruit trees are blossoming now and will soon produce organic, vitamin packed lemons, oranges, apricots, pears, apples, peaches and plums. What a joy to be able to walk outside my back door and pick fruit to eat and share with others.

What is one healthy, vitamin-C filled advantage to having lemon trees?? Lemon water!! I have been drinking water with lemon for years and I am so glad I do. I love it!

Drinking water with lemon juice/slices helps to satisfy hunger and acts as a bile thinner, according to Jackie Warner from her new book This Is Why You're Fat (And How to Get Thin Forever). It is a good book and I do recommend reading it if you need tips on healthy eating and exercise.

Be Well-gardening and drinking lemon water,

Wendi

Dieting and Weight Loss 101

2011-02-16T14:29:00.001-08:00

Losing weight is on a lot of people's minds. How do I lose weight and keep it off? What is the best way to exercise?

Here is my Top 5 List of Ways to Lose Weight and Keep it Off. It is a lifestyle not a diet per say:

1. Eat complex carbohydrates in the form of vegetables, legumes, nuts and grains. Avoid quick breads and carbs. Avoid all the packaged crappy foods like cookies, sugary foods, pretzels, etc. Leafy greens are wonderful! Spinach, kale, broccoli, turnip leaves, etc. Have as much as you want. Lower glycemic index foods are best to keep your blood sugar from spiking and making you feel full faster.

2. Drink water! Pretty much just water....you may have tea and coffee but watch what you put in it. Don't drink juices/alcohol/shakes with lots of calories...they're empty calories with out fiber.

3. Work out daily or 6 days per week and mix it up. Interval training and an every changing weight training and stretching routine is key to stimulating muscle fibers, burning more calories and avoiding plateaus with weight loss. It also helps you avoid burn out. I like to run, cycle, weight train, practice yoga and do P-90X.

4. Eat small, frequent meals to keep your blood sugar stable, or three meals a day with snacks. Eat protein with every meal. I love high protein tofu and greek non-fat yogurt! (Yes, I am a vegetarian). Walnuts are also high on my list.

5. Write down your intake for two weeks and then you will get the feel for what you are eating and then you can just go with it thereafter.

Be Well,

Wendi

Reading the 4 Hour Body

2011-02-01T12:57:00.000-08:00

OK so it is a new year and everyone wants to make some changes in their diet, exercise routine and their physique. What better time than the present at the start of a new year.

Lucky for me, I was introduced to Tim Ferriss' latest book The 4-Hour Body a couple of weeks ago. I LOVED his first book, The Four Hour Work Week so I just had to read his take on diet and exercise. So far, so good. His extreme way of experimenting with his body is remarkable and entertaining. He has the time, resources and guts to take it to the max.

His book simplifies research into five rules to eat by along with plenty of success stories, sample exercise routines and scientific facts to back it all up. I actually follow one of his rules to the tee-I drink water or tea only. Another great tip is the drink a glass or two of ice water upon awakening. This replenishes water from sleeping and boosts your metabolism by making you a little cold on the inside.

In short, it's a good read. www.fourhourbody.com

Be Well,

Wendi

Just Smile!

2011-01-17T12:34:00.000-08:00

Smile! What a difference a smile can make when you start your day. Lucky for me, I wake up to a smiling baby every morning. -No kidding. He really does smile every time he awakens. He is so precious and has a beautiful smile.

Smiling actually triggers increased production of endorphins-happy chemicals in the brain that make you feel great. So when you make a point to laugh, tell jokes and just smile, your mood and your outlook change for the better. What an easy way to improve your day and quality of life!

Smiling also shows your pearly whites so remember to brush, floss and eat healthy foods to prevent tooth decay, gingivitis and and tooth loss. Coffee and dark tea stain your teeth too so you may want to lay off those drinks if your teeth are showing signs of too much cups of Joe.

I recently had my bi-annual dental appointment and it is always a great reminder to floss daily, which I had been neglecting to do. When you get busy, it's easy to forget and neglect your teeth and gums.

Smile!

Be Well,

Wendi

New Year Resolutions: How To CompleteYour Resolutions in 2011

2011-01-03T19:39:00.000-08:00

New Year's almost forces all of us to analyze our past year and plan for the new year ahead. We look at what we did, didn't do and how it all turned out. This gives us a perspective on what a "redo" or a "do better" course of action would entail.

Honestly, I never remember what I resolve to do each new year. So this year, I wrote down 13 goals and I intend to review them each month to see where I am at and where I am going.

2011 is the year of the Rabbit, according to the Chinese Zodiac. If I follow this lunar calendar system, I am to focus on family, home, personal relationships with women and children, and security. Coincidentally, many of my goals surround these realms, which I recently discovered after I made them.

Do you have any new year resolutions? Are you going to follow through with them?

Do you want to lose weight, exercise more, quit smoking, spend more time with family and friends, enlighten yourself with learning a new skill or traveling? You are then one of millions of people whom want the same things this year.

But how do you accomplish your resolutions, for real?

My Answer:

Set small, attainable goals with short term follow-up. Write down your goals and objectives and hold yourself to it! (This is hard to do but you will ACHIEVE your goals if you do write it down and follow through.)

If you are the type who needs rewards for achieving your small objectives, then reward yourself but don't give up! You CAN and WILL achieve everything you truly want to do as long as you hold yourself to it and break it down into small pieces you can achieve over time.

Good luck and Happy 2011!

Be Well,

Wendi

Healthy People 2020 is Published

2010-12-06T13:45:00.001-08:00

The U.S. Dept. of Health and Human Services has published 2020 health goals for Americans.

http://http//www.healthypeople.gov/2020/default.aspx

New subcategories which I find interesting and an essential, positive shift in improving individual and community health standards include Adolescent Health, Early and Middle Childhood, Sleep Health, and Social Determinants of Health.

Why is this important? Too many reasons to list, however, policy makers and money have a lot of pull when it comes to creating, implementing or cutting wellness programs. So funding and policy making at the federal, state, county and city levels are all influenced by these goals, hence you are affected.

And what can you do? You can try and implement a healthy program at the local level or simply work on yourself. The same tricks I have been preaching can actually help improve your health and keep you in line with the HHS 2020 goals...eat healthy foods (I prefer vegetarian), exercise regularly, sleep well, have an emotional outlet, and laugh out loud often!

Check out my debut blog for my five fundamentals of wellness.

Be Well now and in 2020!

-Wendi

Fighting the Flu Before It Gets To You

2010-11-18T14:34:00.000-08:00

Flu season is just around the corner. Are you ready for it? Have you gotten your Flu vaccine yet?

The CDC recommends EVERYONE over the age of 6 months get their flu shot this year.

The current influenza vaccine protects us from H1N1, A H3/N2 and influenza B strains. See the CDC website for all the updates at www.cdc.gov/flu/freeresources/print.htm

There are several things you may do to stay well this flu season, besides get the flu vaccine:

1. Eat healthy foods-fruits, vegetables and whole grains

2. Exercise

3. Rest well

4. Avoid people coughing and with a fever

Wishing you a healthy flu season and a Happy Thanksgiving!

Be Well,

Wendi

Gardening as a Mood Lifter

2010-11-04T10:40:00.000-07:00

Often your mood is neglected when discussing your health. But I have news for you- mood is a significant part of your health and well-being. How you feel and your mood is an indicator for possible mental health and mood disorders.

As a mom to a two month old, I am getting very little sleep and it IS affecting my mood. Now, I am trying to focus on the quality time I have while up at night feeding my baby rather than the utter and complete lack of sleep. This shift in my viewpoint has helped lift my spirits.

But the best two things I do to boost my mood each day are:

1. exercise

2. get outside

I have been planting bulbs for spring this week and what a joy it has been to get out into the garden and feel the warm sun on my face. Working in the garden is one of my therapeutic activities-it keeps my mind off all the "things I have to do" and lets me just relax.

So get outdoors to exercise or just relax doing something as simple as planting bulbs.

Be Well,

Wendi

Cooking Light

2010-10-16T09:30:00.001-07:00

Cooking healthy, yet tasty and flavorful, meals is actually quite easy with just a few simple pantry staples. My cupboards always have extra virgin olive oil, balsamic vinegar, canola oil, dried herbs- basil, rosemary, oregano, dill and thyme, seeds such as sunflower or pumpkin and curry sauce.

Lately, I have been using my wok to saute veggies and tofu with a variety of sauces, herbs and vinegars to keep my taste buds and incessant appetite satisfied-now that I am breast feeding. Saute veggies with water and vinegar with a touch of oil in the wok to keep your meals light. And to save time meals later in the week I make enough food to freeze for at least two more meals.

Just an aside, my slow cooker has been my time and energy savior lately-it makes healthy, light soups, vegetable dishes and lasagna.

Happy light cooking and Be Well, as always.

Wendi

Social Wellness...I am working on it

2010-10-08T11:48:00.000-07:00

Social wellness is really about spending quality time with others-the essence of being human. Creating memories with people is what life is all about; an essential fundamental to being well.

As a mother to a newborn, I am eager to venture back out into the world after a month of finding a new rhythm in the house. Lucky for us, we live in a wonderful place with plenty to do. I have been taking advantage of all the great fall weather and doing day trips around the Bay with the kids. This helps my mood stay up, gets me outside, as well as helps me socialize with family and friends. My weekly goal at this stage is to get out and do something new each week.

The Oakland Zoo, Half Moon Bay pumpkin farms, a local Harvest Festival, Fleet Week in San Francisco topped our list this week. I love the look on Elsa's face when she discovers something new-what joy it brings to me.

I am trying to get back to blogging twice a month. So I hope to have another entry in two weeks.

Until then, get out outside to socialize and Be Well in this beautiful autumn weather.

Wendi

Dylan is Born

2010-09-13T09:37:00.000-07:00

I recenlty gave birth to my son Dylan Ray. He is doing excellent and is such a blessing to our family. I am just getting adjusted to the necessary sleep deprivation and balancing that with rest and exercise.

I feel great in general and have been able to get back on my spin bike four days after Dylan came home. I fit in exercise when the kids are napping and rest in the afternoon when Dylan naps. This is a true test of motivation to stay in shape while being flexible and understanding to the new demands of my family. I work in stretching, relaxing baths and reading when possible.

My advice for moms with a new born and toddler?

Ask for help, count to ten whenever necessary, deep breathe and hold on tight for a roller coaster ride of a lifetime (short lived, however)!

Be Well,

Wendi

Yoga and Pregnancy

2010-08-16T07:40:00.000-07:00

I have arrived at my last three weeks of my pregnancy. I must say, it has been another relatively easy 37 weeks, physically, and I hope it continues. Of course, I have my moments, but all in all, this baby has treated me well.

I still exercise daily and do my yoga practice, although not nearly as often as I planned at the beginning of my second pregnancy. A recent article entitled, Yoga's Benefits Outweigh Risks for Pregnant Women, the American Academy of Orthopaedic Surgeons states that yoga's benefits of building strength and flexibility while low impact are worth a try. Of course, you want to confirm with your OB however.

Exercising in general keeps my stress level to a minimum, my mood up and my mobility magnificent. But it is especially important as a mom-to-be. My spin bike has been a life saver as far as fitting ina workout and not driving to and from the gym.

People close to me know this has been the most stressful year of my life. Exercising, eating well, taking baths, gardening and reading have made it a lot easier for me.

To all you moms-to-be, exercise well, eat well, and be well.

-Wendi

Healthy Gardens, Healthy You

2010-07-30T09:51:00.000-07:00

Holistic health includes a healthy relationship with your natural environment. One of my new goals is create a mentally and physically therapeutic, sustainable garden to not only nourish my body but also to create a place for relaxation, meditation and fun-n-games with the kids. I am so blessed and grateful for this opportunity; it is so exciting to work with a blank canvas and a piece of land full of possibilities.

Vegetable, fruit and herb gardens are necessities to me. Growing and nurturing my own produce is how I want to spend some of my free time. So I will be planting a year-round vegetable garden this fall. But, I also need some relaxation time, so I am also creating a Japanese garden with benches and a pond to sit, meditate, read and be still in.

We mustn't forget herbs to flavor our food and for aromatherapy. My hillside slope will feature a year-round herb garden mixed-in with perennials to pick fresh herbs. And of course, my garden must include fruit trees and berries. Blueberries, strawberries, raspberries, and blackberries are just a few of the berries I want to share with Elsa and the baby on the way.

Wish me luck as I turn my over-grown and unattractive yard into a natural paradise!

Be Well in your environment.

-Wendi

The Great Escape

2010-07-13T11:45:00.000-07:00

How we may temporarily escape the often stressful, crazy, and busy lives we lead is innumerable. I've been working on new ways to help relieve my stress as I am getting closer to my due date-which is just 8 short weeks away!

Five Tips to De-Stress Be Well Style this Summer:

1. Sit in a chair at the water's edge and let it soothe your feet and soul

2. Pick fresh summer flowers to brighten your room and your day

3. Borrow a summer-time novel from your local library and escape through reading

4. Take a hike-I like to walk through wooded trails and along the beach

5. Blow bubbles and watch them float away

Be Well,

Wendi

Relaxation...a Part of Holistic Health

2010-06-18T12:19:00.000-07:00

Relaxation. A theme for me and gifts that I plan to give this year.

This is an area of health I need to improve on. It seems as though my days are full of "to do" lists, which are necessary to some extent, but having a plan to relax needs to be on that list too.

So I am resolving to set aside time to relax and rejuvenate myself each week. I am taking more baths on the weekends and have restarted my yoga videos. So I am off right now to meditate and do some yoga.

Here are some five suggestions to help you relax too:

1. Aromatherapy

2. Stretching/yoga

3. Warm, fragrance baths-ex. lavender, mint, rosemary

4. Meditation and/or visualization exercises

5. Gardening

Be Well,

Wendi

Sun Safety and Sunscreen 101

2010-06-06T09:40:00.000-07:00

Last year I posted a blog entry on sunscreen and skin care in the sun. With summer approaching, it is time to revisit this topic.

We all know how important it is to protect your skin from short and long term sun damage. Age spots, wrinkles and moles and cancerous lesions are all due to the damaging ultraviolet sun rays.

How can we protect ourselves? 5 Tips for You:

1. Wear sunscreen every day, despite getting direct sun exposure such as when it is cloudy

2. Use sunglasses with UVA and UVB protection

3. Wear a wide brimmed hat to keep the sun off

4. Avoid direct sunlight between 10am and 2pm

Here is an excerpt from my previous blog about sunscreen and skin safety. Be well this summer!

-Wendi

Two types of UV radiation are UVA and UVB; UVB causes sunburns and UVA causes skin integrity to wear down over time.1 (UVA penetrates the skin deeper than UVB).2 But either type may cause skin cancer, basal cell carcinoma or squamous cell carcinoma. Lentigos are sun-induced lesions (flat brown spots) on the skin. They show up on our hands, arms, legs, face with age and also long-term sun exposure. They may also get darker with age and continued sun exposure. Additionally, over exposure to sun may cause first or second degree burns! Ouch!

When it comes to choosing a sunscreen, it may become overwhelming. Basically there are types; organic sunscreens are absorbed by the skin whereby the chemicals filter UV light (sunscreen) and inorganic sun blocks which are not absorbed by the skin-they block UV absorption altogether. Athelios SX is an organic sunscreen and zinc oxide is an example of inorganic sun block that protect skin from both UVA and UVB.

Here are Be Well's Tips for Skin Protection Under the Sun:

1. Choose a sunscreen with BOTH UVA and UVB protection.

2. Choose a sunscreen with SPF of 30 or higher. Sun Protection Factor, SPF, is the scale for determining UV protection in sunscreens. Apply to all sun exposed skin when outside longer than fifteen minutes-Sun or cloud cover-it doesn't matter. And babies over six months old also need a hat and sunscreen as well.

3. Avoid direct sunlight at its peak between 10 am and 4 pm.

4. See a dermatologist for any suspicious lesions/moles on your skin.

5. Cover yourself with SPF clothing when out in the sun for over two hours. My husband uses long-sleeved, dark colored UPF (ultraviolet protection factor) index clothing when golfing or at the beach.

6. Reapply sunscreen! Reapplication of sunscreen is necessary to maintain protection especially after being in the water, exercising or sweating.

7. Don't forget your lips and your head! They need sun protection too with lip balm sunscreen and a hat.

8. Wear sunglasses with UVA and UVB protection.

9. Don't go to tanning beds or under sun lamps. (An exception to this rule would be, for example, light therapy or for eczema treatment as ordered by your health care provider)

10. Apply sunscreen a half hour before going out into the sun so it may be absorbed.

References:1 http://www.skincancer.org/sunscreens-explained.html2http://www.skincarephysicians.com/skincancernet/selecting_sunscreen.htmlResources:http://www.aad.org/http://www.aad.org/public/sun/smart.html http://www.aad.org/public/sun/seal/products.html http://www.anthelios.com/anthelios-uvraydamage.html http://www.neutrogena.com/econsumer/ntg/productscategory.browse?segment=women&catId=3 http://www.cancer.gov/cancertopics/types/skin

Swimming is The Fun Summer Workout

2010-05-27T12:32:00.000-07:00

What better way to get in shape, or stay in shape, this summer than swimming? Swimming works practically every muscle in your body, improves your cardiovascular fitness, strengthens muscles, improves joint mobility/flexibility, and just feels fabulous! This type of workout is a low impact, full-body resistance and cardio workout in one.

I simply love swimming laps in the warm summer sun (lathered in sunscreen, of course). Lakes, oceans, bays, and community pools all are open to you to swim the stress away this summer. Take advantage of it!

As a pregnant woman, swimming is great for me to keep in shape and reduce my risk of injury from high impact running, for example. I won't be running again until this fall. Even using a kick board can give you an excellent cardio and resistance training workout.

So put on the sunscreen and head out to the beach or pool for a great workout!

Be Well,

Wendi

Five Extra Pounds Off by Summer

2010-05-16T13:13:00.000-07:00

Summer is just around the corner and many of you are wondering how to lose those extra 5 pounds still hanging on from winter. Well, there are a few tips I have to help you do just that. Losing 1-2 pounds per week is considered "safe weight loss" for those that are over-weight or obese.

And with summer just 5 weeks away, a 5 pound weight loss goal is definitely within reach.

Five Tips to Lose Five Extra Pounds:

1. Drink water and only water. No alcohol, coffee with cream, juice or smoothies; these drinks are low to no nutritional value and are extra, no good calories.

2. Avoid extra sugar. So that means no cookies, ice cream, frozen yogurt, cake, pie. These snacks are easy to indulge in but add the extra fat layer you are trying to get rid of.

3. Make lunch or breakfast your largest meal of the day. That is so you will get the majority of calories in before 4 pm.

4. Eat off of small plates and do not refill your plate. In other words, portion control is key to success. Don't eat more than an appropriate serving. (2-3 oz of meat, fish, poultry; 1/2 cup to 1 cup of cooked vegetables; 1/2 cup of cooked rice; 2 Tbsp. peanut butter; 1 slice of bread is one serving; 1 cup of nonfat milk, 1 cup of yogurt or cottage cheese)

5. Exercise! You can lose weight by diet alone, but it is much better for your health and long-term success to workout regularly. So hit the pavement and walk your weight down.

Be Well,

Wendi Lelke-Wallway, MSN, FNP

Welcome Back Homemade Meals

2010-05-03T12:57:00.000-07:00

Meal budgeting and prioritizing expenses are a reality for many families during this economic recession. Our current economy may actually help return the concept of a nightly, home-made "family meal".

Dining out less means eating-in more, or does it? Countless families I meet have such hectic schedules that parents and children eat all at different times and often, in the car, late at night or on the run.

According to a recent essay, "Our Big Problem", by Theodore Dalrymple published in the May 1-2, 2010 edition of The Wall Street Journal, 36% of kids in Britain do not eat a meal at home with family (http://online.wsj.com/article/SB10001424052748704423504575212281013855148.html?KEYWORDS=Theodore+Dalrymple). This statistic was surprising to me and is hardly conducive to promoting healthy eating habits and family communication.

How can we reconnect and approach the concept of a healthy, family meal despite both parents working, kids' extra-curricular activities, sports programs and fitting in our own workouts?

Choose at least three days a week for a sit-down, family dinner; just a half-hour for a meal and conversation. Making meal time a priority is the only way to establish this commitment.

I love eating at home and making nutrient rich, vegetarian meals. Granted, I wish I had more time to prepare meals, as I get home from work around 5:40 pm. Left-overs from weekend dinners last for several nights, which makes it easier on me. But, it's super fast and simple to boil fresh vegetables and cook beans on the stove. It is even faster to saute` veggies with tofu and to broil chicken or fish in the oven with fresh herbs. Brown rice cooks quickly in a rice cooker too-20 minutes is all it takes for me. What about salads? Less than five minutes and you can make a fiber rich, green salad.

Eating well together is all about planning and prioritizing. My advice is to simply plan your meals ahead and make it a priority to eat together-friends and family matter most to me.

I admit to only eating out a handful of times a year. I would rather make my own meals at home. Home cooking creates a warm atmosphere in the house as well. And eating-in cuts our costs down quite a bit.

Enjoy your next home-cooked meal a little more than before.

Be Well,

Wendi Lelke-Wallway, MSN, FNP

Resources:

Food Network star cook and author, Rachel Ray has some healthy meals you can make in thirty minutes or less.

http://www.foodnetwork.com/30-minute-meals/index.html

http://www.rachaelray.com/

http://www.foodnetwork.com/quick-and-easy/index.html

Sleeping Well?

2010-04-23T15:21:00.000-07:00

Trouble sleeping is a common complaint in primary care. "I can't fall asleep", "I wake up all the time" and "I feel so tired during the day" are some descriptions of sleep disturbances.
Sleep disturbances are often a symptom of physical or psychological problem, rather than an isolated issue.

Having trouble falling asleep, waking up frequently, or an inability to fall back asleep are in fact, problematic. We need quality sleep in order to function optimally. Our body needs rest to rejuvenate and regenerate.

How much sleep do you need?

That is a difficult question to answer; it depends on the person. There are some general recommendations published by the National Sleep Foundation.1

Toddlers need 12-14 hours of sleep a day.1

School-aged kids need about 10-11 hours, teenagers need around 9 hours and adults, 7-9 hours of sleep each night. 1

Snoring, waking up short of breath, daytime sleepiness, gasping, shortness of breath, insomnia or witnessed apenic episodes (lack of breathing) are symptoms to seek medical help.

Insufficient sleep may lead to higher blood pressure, weight gain, irritability, depression, moodiness, inability to focus, decreased job performance/academic performance and athletic performance, to name a few.

So, if you are having problems sleeping, go see your health care provider.

But here are some tips to help you get a good night's sleep:

Avoid alcohol and caffeine
Avoid any stimulating activities before bed such as Internet surfing, working or talking on the phone/computer
Avoid eating right before bed
Take a warm bath to help calm you down for sleep
Try an herbal warm tea to relax you such as lemon or chamomile tea
Meditate before bedtime
Keep the television off and out of the bedroom
Workout before dinner, not after
Relax before bedtime

Be Well,

Wendi Lelke-Wallway, MSN, FNP
Resources:

1 http://www.sleepfoundation.org/article/how-sleep-works/how-much-sleep-do-we-really-need

Weight Training 101

2010-04-13T13:13:00.000-07:00

Incorporating of weight training, AKA resistance training or strength training, in a comprehensive fitness plan is essential. Benefits of weight training, in general, out weigh any risks for most people.

I have been weight training regularly since age 18 (I am 35 now, pregnant, and a full-time working mom to a toddler, so no excuses for not having enough time!) It feels great (more so afterward) to move some weight around. Even your own body weight is good enough to get an excellent workout; it's true, you don't need a gym to weight train. Good ol' fashioned push-ups, pull-ups, dips, arm curls/extension exercises with bands or dumb bells are just as good. Lunges, wall squats, and squats are easy to do at home using your own body weight rather than at a gym.

If you already have a membership collecting dust, go ahead and use it this week. There are even group weight classes at most gyms if you are a group class junkee.

Be Well's Pros to Weight Training:

Builds muscle mass
Improves bone density-reducing risk of osteoporosis and osteopenia

Enhances metabolism-you burn more calories at rest/doing nothing! Helps lose weight for most people over time.

Improved physique-that is, you look better, leaner, more in shape

Reduces risk of injury due to weak muscles and joints
You feel better after a good workout!

I exercise each body part on weights once a week. So I have a split which I change constantly so I don't get bored or develop overuse syndrome.

Always seek advice from your health care provider before staring a new exercise program. Here is a recent article from The New York Times on weight training.
http://www.nytimes.com/2010/04/06/health/06real.html?ref=health

Be Well,

Wendi

Games....More Than Just Fun?

2010-04-07T13:18:00.000-07:00

Mind games...a combination of fun and training for your brain which will benefit you years from now. A recent article,"How to outsmart Alzheimer's" by A. Marcus, published in The Wall Street Journal re-emphasized four of my fundamentals of wellness to stave off Alzheimer's Disease (AD)-mindful health, social wellness, nutrition and physical activity.

Cognitive Fitness and Innovative Therapies program created last year at Neuroscience Research Institute at the University of California, Santa Barbara enrolls participants in their 50's and older who are more at risk for developing AD (blood relative with AD, for example) to help delay onset or prevent AD.

Activities or games such as card games, memory games, board games, and socially interactive games including the Wii system are all part of the program. Even a low fat, low cholesterol diet are recommended in preventing this disease.

According to the article, "People who exercised more and followed the Mediterranean diet more closely had a 35% to 44% lower risk compared with those who didn't follow these regimens."

The bottom line...Playing games, learning new languages, painting, drawing, eating well, exercising and socializing are essential factors in reducing risk of AD.

Read On, Play On and Have Fun!

Be Well,

Wendi

References: http://online.wsj.com/article/SB10001424052748703416204575145921517534304.html?KEYWORDS=memory+games

Spring Season Allures Allergies

2010-03-24T20:16:00.000-07:00

Along with beautiful blossoms, singing birds and sunny days, spring brings wind swept pollen, grasses, weeds, and allergy symptoms-weepy eyes, itchy eyes, nose and throat, sneezing and runny noses. Later signs of allergies include nasal congestion, sore throat, puffy eyes, cough and clogged ears.

What can you do to reduce your allergy symptoms this season?

The best action you can take is simply to avoid the allergen as much as possible. Wearing a scarf and sunglasses may help reduce your exposure to allergens while outdoors. Avoid long-term exposure to the elements, especially on hot, dry, windy days. Washing your linens in hot water may help reduce allergen exposure and mediate your symptoms.

Monitor the pollen count on the morning news or through an online weather report such as weather.com. Try not to mow your lawn; have someone else do it. Wear a mask if you must be outdoors doing yard work. An indoor allergy filter may be worth your money but clean your air ducts first. Also, allergy resistant bedding is a good idea if you have really bad allergies.

Over-the-counter non-sedating antihistamines such as Loratadine (Claritin) and Cetirizine (Zyrtec) are helpful for controlling allergy symptoms. You may prevent your allergy symptoms by taking an antihistamine before your symptoms start. Saline nasal sprays and decongestants (for people without high blood pressure) are other over-the-counter therapies which may help allergy symptoms. Prescription medications are available for symptoms not controlled using over-the-counter medications. Always ask your health care provider before starting any medications. Enjoy an allergy free spring!

Be Well,

Wendi

Probiotics..what are they and what do they do?

2010-03-20T10:01:00.000-07:00

Probiotics have been around for years; recently, patients have asked me if they should take probiotics. This is a difficult question to answer in some cases. I thought it would be best to just address the most common questions I am asked about probiotics using credible resources from journals.

1. What are probiotics?

A: Microscopic organisms in supplemental form that behave like our own friendly microbes found naturally in our gut.1 According to the World Health Organization, probiotcs are "live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host." 1, 2 Lactobacillus and Bifidobacterium are the most common types of bacterial probiotics over the counter.

2. Why do people use probiotcs? -To "help" balance there natural flora and off set side effects of antibiotic use such as gas, bloating, loose stool. -To help with childhood eczema. To treat diarrhea and urinary tract infections.2

Some people take it for IBS-irritable bowel syndrome too and to help treat acute Clostridium dificile-an infection of GI tract that has an overgrowth of this bacteria that naturally lives in the colon.

3. What is the difference between live active cultures, as in yogurt, and probiotics?

"Live cultures are microbes associated with foods, often as food fermentation agents.
Many of these have not been directly tested for health benefits. Probiotics are live
microbes that have been shown to have a health effect." 2

4. Are probiotics medications?No. They are dietary supplements."Currently, probiotics are best regarded as dietary adjuncts to ease certain symptoms, shorten illnesses,
and provide an edge to staying healthy."3

They may be prescribed by health care providers in certain circumstances, but they are not drugs approved by the FDA.

I hope this helps clear up some questions you may have about probiotics. There is a lot of information on the web but you should always consult with your health care provider.

Be Well,

Wendi Lelke-Wallway, MSN, FNP

Resources

1. National Center for Complementary and Alternative Medicine. Get the Facts: An introduction to probiotics. Retrieved March 20, 2010 from http://nccam.nih.gov/health/probiotics/D345.pdf

2. DOUGLAS, L. and SANDERS, M. (2008). Probiotics and Prebiotics in Dietetics Practice.
J Am Diet Assoc. pp. 510-521.

3. SANDERS, M.(2008). Clinical Use of Probiotics: What Physicians Need to Know. American Family Physician. 78: 1026.

A Happy and Healthy Home....

2010-03-12T11:04:00.000-08:00

Have you ever heard of the expression, "A happy and healthy home"?

What makes your home happy and healthy?

My five fundamentals of wellness encompass part of what makes a happy and healthy home: nutrition, occupational/social wellness, mindful health, physical and spiritual health. The other parts are what you need and desire in your life/home. -The possibilities are literally endless.

But just imagine what that looks like for you. What would you change, if anything? What are you lacking in regards to health and happiness? If you can answer, "nothing", wonderful!

If you can't, what is it that you don't have and want, for your health and happiness?

What would it take for you to receive it?

Dream big, and big things will happen. Dream small, and small things will happen. There is no right or wrong answer to these questions I am posing.

But I choose to dream big and I will keep you informed of the changes I will make as they come to my health and happiness.

Be Well,

Wendi Lelke-Wallway, RN, MSN, FNP

Add Some Spring into Your Step

2010-03-05T08:34:00.000-08:00

Join the masses and lace up your sneakers for some spring time jogging, walking, running, or hiking. Spring is the best season to get into outdoor shape now that the snow is melting and the winter rains are through. It is easy and fun. No expensive equipment required...just a desire to move and enjoy the weather with a friend.

There are plenty of "Fun Runs" all across the country this time of year to help motivate you to step it up. I am planning on joining an organized run the last weekend in March at the Oakland Running Festival. http://www.oaklandmarathon.com/Home_Page.htm Check out your local listings.

Be Well and Run/Walk On!

-Wendi

Simple sugars...the new fat?

2010-02-25T12:19:00.000-08:00

What do I mean by sugars are the new fat?

I mean that any excess sugar, which is in the form of carbohydrates, is stored as fat in your body. So, if you eat extra fruit, bread, candy, juice, white rice, etc. it ALL gets converted to fatty acids and stored as adipose tissue, or fat cells.

When I hear patients say, "I eat a lot of healthy foods, fruit, carrots, pasta, rice...", I know they are likely taking in too many sugars in general. This type of diet also makes you crash two hours after a meal.

Modifying sugar intake is a sure way to lower your calorie consumption and your weight.

Mark my words..."Hold the sugar, please" will by the next craze.

Be Well,

Wendi Lelke-Wallway, MSN, FNP

Heart Healthy Tips on Valentine's Day

2010-02-14T13:43:00.000-08:00

There are plenty of ways to keep your heart healthy as we age. This Valentine's Day, let me give you five tips to keep your heart well.

1. Engage in aerobic exercise daily, or 5 times per week. We need to keep our vascular system clean and freeof gunk and grime. Exercising regularly has a profount effect on keeping our arteries clear. Working out has too many heart benefits to list so just get moving.

2. Eat a low cholesterol diet to avoid plaque build up in your arteries over time. A diet rich in vegetables and whole grains will keep your heart well.

3. Reduce your stress! This is the one BIG factor to heart health we seem to ignore because we can't feel the effects it has on our heart. Stress can and does kill.

4. Don't add the salt. We have plenty of salt in our diet therefore we generally don't need to add more, unless your health care provider recommends it, of course.

5. Omega-3 fatty acids are heart healthy because they have anti-inflammatory properties, cholesterol lowering properties and clot reduction properties. Walnuts, canola oil, flax seed, salmon and soy beans are excellent sources of omega-3's.

Happy Valentine's Day!

Be Well,

Wendi

Extra Effort Pays Off in the Long Run

2010-01-08T11:33:00.001-08:00

How hard do you really have to workout to reap the most benefits?

For cardiovascular health, it's best to actually work out harder than we think, according to exercise researcher Dr. Paul Williams.1 His research, although controversial, show that if we exercise more at a higher intensity than currently recommended we will lower our risk of stroke, diabetes and heart attacks by over 50% than if we followed the current guidelines.1 Running or jogging 30 miles a week verses walking less than 20 miles per week is the difference Dr. Williams is talking about.

Looking for more reasons to up the anti?

The 2008 Physical Activity Guidelines for Americans [The Guidelines] published by U.S. Department of Health and Human Services details exactly how much and how hard you should exercise to reap health benefits. But you will notice that The Guidelines suggest more intensity and frequency to lower risk of heart disease and premature death, even more than with moderate exercise.3

This is an exert from the Physical Activity Guidelines for Americans published on the web by U.S. Department of Health and Human Services explaining how hard to workout.3 http://health.gov/paguidelines/guidelines/chapter4.aspx

"For additional and more extensive health benefits, adults should increase their aerobic physical activity to 300 minutes (5 hours) a week of moderate-intensity, or 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity activity. Additional health benefits are gained by engaging in physical activity beyond this amount."

What are some examples of intense exercise?

These are The Guidelines examples: http://health.gov/paguidelines/guidelines/chapter4.aspx

"Racewalking, jogging, or running
Swimming laps
Tennis (singles)
Aerobic dancing
Bicycling 10 miles per hour or faster
Jumping rope
Heavy gardening (continuous digging or hoeing, with heart rate increases)
Hiking uphill or with a heavy backpack"

How about lowering your risk of breast cancer by 20-30%.2 Exercise can do that too. Basically exercise lowers your risk of cancer, obesity, diabetes, heart disease, depression, stroke and dementia.

Need any more reasons to start on a new exercise routine? - I don't. I'm off to get my running shoes!

Be Well America!

Wendi

References:

1 Helliker, K. "...And why more may even be better". The Wall Street Journal. January 5, 2010.

2 Lando, L. "The hidden benefits of exercise". The Wall Street Journal. January 5, 2010.

3 U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. Retrieved January 8, 2010 from http://health.gov/paguidelines/default.aspx.

New Year's Resolutions..To Do or Not to Do?

2009-12-29T15:57:00.000-08:00

New Year's resolution time is now upon us. I'll save you all the trouble and heart ache when I say, according to research, New Year's resolutions simply don't work. I recently read an article in The Wall Street Journal by Jonah Lehrer called "Blame it on the Brain" (Dec. 26-27, 2009) which summarized studies on will power and breaking bad habits.1 When you are stressed, worried or have too much going on in your brain, it's harder to change your undesirable habits.1 The prefrontal cortex can't handle all the pressure to say "No, don't eat those cookies" when you have a lot going on upstairs.1

Personally, I don't make New Year's resolutions anymore; I can't keep track them and it doesn't work for me anyway. Rather, I make daily, weekly, and monthly goals where I can easily track my progress and make changes quickly. I make specific objectives to meet each goal with definite time frames. This works!

Make 2010 a great year starts with you setting positive goals with specific time lines to achieve them.

Happy New Year!

Cheers and Be Well,

Wendi

References:

1 Lehrer, J. (2009). Blame it on the brain. The Wall Street Journal, Dec. 26-27th ed.

Happy Holidays and Merry Christmas

2009-12-19T20:19:00.000-08:00

Another year is almost about over and Christmas is just around the corner....less than a week away! Where does the time go?

My patients are saying that they just can't get everything they want to get done, done in time for the holidays. Some are stressed out and others are just flying high, excited about getting time off to spend with family and friends.

The holiday season brings us a range of emotions: joy, sadness, guilt, and excitement. It is natural to have emotional ups and downs this time of year. We tend to put a lot of external pressure on ourselves to do it all when it doesn't all need to be done.

Let's not lose sight of the true meaning of this time of year. Give love, laughter and your heart to people you know and those whom you don't know but need it most.

Merry Christmas!

Be Well,

Wendi

Tis the Season

2009-12-06T17:41:00.001-08:00

'Tis the season for reflecting on the year gone by, planning for the year ahead and giving thanks to all that is wonderful in our lives. This is my state of mind each December.

Reflection: Joy and laughter have filled my day, each day, since Elsa was born December 17, 2008. I am so grateful and feel truly blessed to have Elsa in our lives. I am more mentally and physically healthier and happier than I have ever been in my life.

What are your reflections?

Planning ahead: I plan to help more individuals and families live a healthy lifestyle. I plan to spend even more time with Elsa and teaching her about the world around us. I plan to hike and swim more than I did this year. And I plan to write more in 2010 using different outlets.

What are your plans?

Thank you: I always begin and end my day giving thanks to God for all the blessings in my life. I also give thanks for all the hardships that make me a stronger person, better mother, and enhance my list of obstacles to overcome. And I really am thankful-for my family, my health, my home, my job and friends.

What are you most thankful for?

I pose these three questions to enhance your spiritual and mental health areas of holistic health and wellness. Being holistically well is about balancing you and your life.

Be Well,

Wendi Lelke-Wallway, RN, MSN, FNP

Healthier Holiday Dessert Options

2009-11-29T15:39:00.000-08:00

Our annual rich and filling Thanksgiving meal and post-meals are finally over. Now it's time to get back on track to your "normal" eating and exercise routine, right?
It's hard to do with all the upcoming holiday parties, I know. But now is more important than ever to eat well and exercise regularly in order to avoid those holiday hips from creeping up.
I'm not saying never have a piece of pie or a bite of ginger bread cookies. I am saying if you are going to eat a sweet snack, do it early in the day and account for it in your total calorie intake for the day. Plan well to eat well. It's that simple.

Here are some healthy holiday treats to substitute the rich, high-calorie desserts.
1. Have one sugar or ginger cookie instead of a slice of pie.
2. Try 1 scoop of low fat, low sugar frozen yogurt with one fresh strawberry on top instead of whole fat ice cream with chocolate sauce.
3. Drink herbal tea with soy milk instead of hot chocolate with whipped cream.
4. Enjoy a small cup of fresh pineapple or orange rather than cherry or apple pie.
5. Indulge in a small sampler plate of two 1" size square desserts instead of the entire slice of cake, pie or tiramisu.

Be Well this holiday season.
-Wendi Lelke-Wallway, MSN, FNP

My Thanksgiving Prayer

2009-11-22T15:53:00.000-08:00

This is our first Thanksgiving with Elsa. We are so thankful for her and all the love and joy she has brought into our home. Elsa is such an angel and inspires Justin and me to be better parents each passing day.

This Thanksgiving is about giving thanks for Elsa, our home, our health, our family, our jobs and the all the wonderful opportunities we are given each day.

We know there is plenty of sorrow, loss, destruction, despair and depression in our country, our city and our world. But we choose to focus on the good in our lives. Accentuating the positive brings more good to us. I tried living the other way and it is not worth it.

Thank you for all the love, prosperity and health we have.

What do you want to give thanks for this year?

Be Well,

-Wendi

The Perfect Snack-Almonds

2009-11-14T18:21:00.000-08:00

We all find ourselves driving long distances or running errands when all of a sudden our stomach starts growling and you know you have to fulfill your hunger with something healthy and quick. What shall you eat?
May I suggest almonds? They are the perfect pocket-sized snack to pack where ever you go. They don't melt like cheese or become bruised like fruit and they don't require refrigeration.

There are plenty of health benefits of almonds. One ounce serving five times a week has shown reduction in LDL cholesterol, for example. They are rich in fiber, protein, healthy monounsaturated fats, calcium as well as vitamin E.

One serving of almonds: 1/4 cup or about 23 almonds
Calories: 160
Unsaturated fatty acids: 13 gm
Protein: 6 gm
Calcium: 75 mg
Fiber: 3.5 gm
Now, be sure to only have a serving, which is about a handful.
Check out this website on almonds and consider packing them in your purse for emergencies!
http://www.almondboard.com/HealthProfessionals/Pages/Default.aspx
Be Well,
Wendi Lelke-Wallway, MSN, FNP

Aromatherapy...The Great Escape!

2009-11-08T09:35:00.000-08:00

Picture from oregonlavenderfestival.com

Women often ask how to help them relax,"de-stress", and help soothe tight muscles. Well, aromatherapy has been around for thousands of years as a therapeutic method for relieving pain and soothing stressed minds. Aromatherapy is the therapeutic use of fragrances whether is is used directly on the skin or inhaled through vapors in a bath or oil sitting nearby. The scents generally trigger the limbic system of the brain as well as the parasympathetic nervous system through smell and touch to help relax you.1 According to the National Cancer Institute, "Aromatherapy products do not need approval by the Food and Drug Administration because no specific claims are made for the treatment of cancer or other diseases."(http://www.cancer.gov/cancertopics/pdq/cam/aromatherapy/Patient/page2)
Essential oils are used in aromatherapy which are extracted from flowers, plants and wood resins.4

Research has shown that aromatherapy may help relieve anxiety and that rosemary oil may enhance alertness and lower anxiety.2,3 Some scents used in aromatherapy are the following: lavender, rosemary, grapefruit, lemon, mint, jasmine, and eucalyptus. Aromatherapy has also been used to help women relieve stress/anxiety during labor.

I often used lavender oil in a bath to relax after a long day or week. I also have lavender filled neck warmers to use while reading. So nice! There are plenty of books available on the subject.

Enjoy your next great escape with an aromatherapy bath.

Be Well,

Wendi

Resources:

http://nccam.nih.gov/health/lavender/D366.pdf

http://nccam.nih.gov/

References:

1. Steflitsch W - Journal of Men''s Health - March 2008; 5(1); 74-85

2. Diego MA, Jones NA, Field T, et al: Aromatherapy positively affects mood, EEG patterns of alertness and math computations. Int J Neurosci 1998; 96:217-224.

3. Dunn C, Sleep J, Collett D: Sensing an improvement: An experimental study to evaluate the use of aromatherapy, massage, and periods of rest in an intensive care unit. J Adv Nurs 1995; 21:34-40.

4. Amado A - Dermatol Clin - 01-APR-2006; 24(2): 259-69, vii

"I don't have time to..."

2009-11-01T07:08:00.000-08:00

Almost daily women say to me that they "don't have time to exercise", "I don't have time to prepare meals", "I don't have time for myself", "I don't have time to" ...fill in the blank. I agree that time is our most precious asset and it is limited to 24 hours per day. However, EVERYONE has the same amount of time each day, we just use it differently.

Time is a non-recyclable, nonrefundable, most precious asset, I know. We cannot get it back once it is lost. So how to we make the most of it?

It is once again about prioritizing and managing your asset.

How do I make time for myself?

Well, make time for yourself whether that is getting up 30 minutes earlier or rearranging your lunch break to do something for you, or going to bed 30 minutes later (if you can) one day a week. Whatever it takes, you can and will, find the time for you to workout for a half an hour, or meditate for 15 minutes, or read a favorite book for 15 minutes before going to bed. Ask for help if you need it in order to squeeze in a workout, if you have children for example.

Did you know what you can get done while standing in line somewhere waiting to checkout at the store?

We all stand in line for something almost daily; use this to your advantage. You could read several pages of that novel you have been wanting to finish, for example. I work on my "to do" lists a lot of times and play games with Elsa. I can get quality time with her while still doing my emergency store trips.

I understand completely about this time issue. I leave the house by 7:40 am and get home around 5:40 pm Monday through Thursday. I miss Elsa dearly, but I work to provide her ALL the BEST that I can! So when I am not working or driving to work, I am with her. That being said, I try and get my workouts done when she is sleeping and my grocery/COSTCO trips on my lunch break so I can spend as much quality time as possible with her and my family.

As far as meals go, I try and prepare healthy meals ahead of time so I can reheat dinners when I get home at night. And I always make my lunches for the week on Sunday so I can bring them to work on Monday. This is such a time saver!

So if you are running yourself into the ground and not exercising or eating well because you don't have time, please take a good, hard look at your situation and try to make small changes for your health.

Here's to time for you!

Be Well,

Wendi Lelke-Wallway, MSN, FNP

Healthy Holiday Time Tips

2009-10-23T16:45:00.000-07:00

The holidays are just around the corner, believe it or not. Thanksgiving is a month away with Christmas and Hanukkah a few weeks later, followed by New Year's. So how can we stay fit and fabulous during the holidays despite all those parties, pies and sweets?

Well, there are several tips I have for you to avoid overindulging and increasing your waistline during the months ahead.

Top Five Tips to Keep You Fit and Fabulous over the Holidays:

1. Exercise regularly even if you "don't feel like it"-keeping up with your workouts is crucial to maintaining your weight and mood.

2. Eat when you are hungry and drink water instead of sugary drinks or cocktails. Don't eat just because there is food out on display; eating off a small plate may also curb your intake. Avoid skipping meals-it messes with your hunger signals and metabolism.

3. Fill up on vegetables or salad first before you take in the higher calorie foods. And dressings on the side will assure you less unwanted calories.

4. Share dessert! Try a half a piece of pie instead of the whole piece. You still get to enjoy the treat, but not all the calories.

5. Stay away from any chips-n-dip or too many appetizers as it adds to your waistline once January rolls around.

Be Well,

Wendi

Weathering the Winter Blues

2009-10-18T20:09:00.001-07:00

Along with the change of season often times comes a change of mood. The shorter, colder days may have an affect on some people's mood. With seasonal affective disorder (S.A.D) affecting many Americans, this blog entry is intended to answer common questions on S.A.D.

I interviewed Dr. Brenda Byrne, expert on S.A.D., via Email a month ago with the intention of writing an article on the "winter blues". Well, I never heard back from the editors so I thought I would give my dedicated followers some of my interview Q & A's.

Background on Dr. Byrne:

Dr. Byrne is a licensed psychologist and expert on S.A.D. She is on staff at Margolis Berman Byrne Health Psychology Associates in Center City, Philadelphia and consults for Jefferson’s Light Research Program, where she is Director of the Seasonal Affective Disorder Program. Dr. Byrne was previously (1982-90) on staff at the Jefferson Sleep Disorders Center.

She co-authored an article entitled "Seasonal Affective Disorder and Light Therapy" with Dr. George C. Brainard published in the journal Sleep Medicine Clinics volume 3, 2008.

Pasted below are some of my Email interview questions and Dr. Byrne's responses.

Wendi: What is the "winter blues" and is it a true medical or psychological condition?
Dr. Byrne:" "Winter blues" is a generic term for seasonal shifts in fall-winter (compared to spring-summer) toward lower energy, depressed mood, social withdrawal, fatigue, tendency to sleep more, and increased appetite for carbohydrates. It is a common psychophysiological experience that in its more severe forms can be termed "Seasonal Affective Disorder" or SAD.

Wendi: What are common symptoms of "the winter blues"?
Dr. Byrne: "Winter blues" is a broad term that could include SAD as well as less severe changes in the same direction. Typical SAD symptoms include sadness and depression, social withdrawal, reduced energy and motivation, increased appetite for carbohydrates, fatigue and a tendency to sleep longer."

Wendi: Why do you suspect women experience the winter blues and SAD more than men?
Dr. Byrne: "Very likely this is a matter of hormones, since SAD women outnumber SAD men during childbearing years, but in older ages the female-male prevalence is more similar."

Wendi: Since SAD is a type of major depression, according to the DSM IV, there is no cure for it, only treatment, correct?
Dr. Byrne: "The diagnosis of SAD, strictly speaking, includes either major depression or bipolar disorder. Though it is managed and treated rather than "cured," some people seem to just get over it at some point, or move to a different climate and no longer are bothered by it, or have changes in life circumstances that help them feel better."

I hope this clears up any questions you may have had on S.A.D.

Enjoy the October colors while they last!

Be Well,

Wendi Lelke-Wallway, MSN, FNP

Fiber-Fact, not Fiction

2009-10-08T12:50:00.000-07:00

It's time to talk about fiber-the stuff in plants that gives it structure and keeps your gut clean.

Many patients I talk to don't know what fiber really is, the difference between soluble and insoluble fiber and why fiber is an important component to a healthy diet. With this entry, I hope to clear up the murky waters with facts about fiber.

Fibers are mostly polysaccharides (there are exceptions) that do not break down to be used as energy. Rather, fiber gives food its structure and acts as a binding compound, depending on the type of fiber. There are insoluble fibers, soluble fibers, gums and fibers that bacteria digest in your colon called fermentable fiber. (I am keeping it simple here but there are actually other types of fibers too.)

Fiber has many health benefits such as increasing waste product transit time in your gut, treating constipation and hemorrhoids, lowering cholesterol and helping control blood glucose levels in diabetics.

There are different ways to categorize fibers. For the purpose of this blog, I am separating them into insoluble and soluble fiber. Insoluble fiber, such as cellulose and hemicellulose, does not dissolve in water; it is the roughage that keeps your gut clean and gives plants their structure. They aid in keeping you regular and ridding your body of waste (literally).1 This is the type of fiber that prevents constipation and increases transit time through your gut (because it holds onto water) which is believed to be connected to a lower risk of colon cancer.1,2

Insoluble fibers are mostly in whole grains and vegetables. (ex. whole-wheat flour, bran, whole grains, vegetables) As a general rule, the darker the grains, the more fiber and the healthier it is for you. Some examples are dark rye, pumernickel, barley, and brown rice.

Soluble fiber, such as gums and pectin, dissolve in water to become soggy or visous (thick "liquidy")compounds.1 Soluble fiber is known to reduce your risk of heart disease and diabetes, and lowers cholesterol too. These fibers bind with cholesterol to help elminate it from your body in stool. According to Jillian Michaels, author of Master Your Metabolism, "soluble fiber traps carbohydrates to slow their digestion, blunts the rise of glucose after meals, and keeps insulin levels low." Oats, fruits, vegtables, beans/legumes, barley, and flax are rich in soluble fiber. Over-the-counter soluble fiber supplements include Psyllium (Metamucil) and Guar gum (Benefiber).

Fruits and vegetables have a combination of both soluble and insoluble fibers but fall into each category based on the main type of fiber present. For example, the skin of the apple has insoluble fiber and the flesh has soluble fiber-it is mostly composed of soluble fiber so I will put it into the soluble fiber category.

Have you noticed that foods high in fiber are good for you? They are rich in nutrients, antioxidants and are low in fat and cholesterol. You didn't see any potatoe chips, ice cream or dark chocolate listed above, did you? There is a reason for that. A healthy, varied and balanced diet has enough fiber for you to generally not worry about getting enough. And a high fiber diet lowers your risk of certain cancers such as colon and breast cancer.4

What are the daily intake recommendations?3

(the amounts below total fiber which is dietary fiber plus functional fiber)

Women 19-30 yrs, 25 grams

Women >31 yrs, 21 grams

Men 14-50 yrs, 38 grams

Men >50 yrs, 30 grams

There is always truth to the saying "too much of a good thing isn't good". So more than 50-60 grams of fiber per day will actually negatively affect vitamin absorption.1 Eating a lot of fiber may make you more gassy too. Drinking water helps reduce gas as well as increasing your fiber intake slowly.

The bottom line about fiber facts...eating a varied healthy, diet rich in whole grains, fruits, legumes and vegetables will guarantee you nutrient dense diet with plenty of fiber. My Pyramid http://www.mypyramid.gov/has wonderful, detailed information on how to eat a well-balanced, healthy diet for your age, gender and activity level. It has all the details you want including sample menus.

I absolutely love the mypyramidtracker too. This is a free online tool by the USDA designed for you to track your calories, activity levels and weight/BMI. http://www.mypyramidtracker.gov/ Check it out today!

Be Well,

Wendi Lelke-Wallway, MSN, FNP

References
1 Duyff, R. (2006). Complete Food and Nutrition Guide. American Dietetic Association. Hoboken, NJ: John Wiley & Sons, Inc.

2 Whitney, E. & Rolfes, S. (2005). Understanding Nutrition (10th ed.). Belmont, CA: Thomson Wadsworth.

3 Dietary Reference Intakes (DRI) (2005) National Academies Press. The National Academies of Sciences.
4 Nutrients - How Fiber Helps Protect Against Cancer. The Cancer Project. Retrieved October 9, 2009 from http://www.cancerproject.org/protective_foods/fiber.php

New Experiences Broaden Your Horizons

2009-10-01T13:31:00.000-07:00

All right, I'm sure you have been told a long, long time ago "to broaden your horizons". What does that mean, really?

To me, it means seeking and trying new experiences whether it's traveling, taking a class, or running a new route. It means breaking the mold and getting out of your comfort zone.

How is this good for you, you may be wondering?

It expands your world view, sometimes, and enhances your awareness as well has stimulates your brain. I think it is important to disrupt your normal routine and try something novel such as hiking a new mountain, eating out at a new restaurant, attempting a new sport, or even something as simple as reading a different genre of books than you usually do.

What have you tried lately?

Each birthday, I reflect upon the previous year and dream about the year ahead. I turned 35 on Monday so you can just imagine the array of thoughts I have had and still do. Did I accomplish what I thought I would have by this time? Did I make the right choices? Etc., etc. Luckily for me, this only lasted a couple of minutes.The bottom line (to me) is this...I really don't have yesterday anymore, it has already past. And I certainly don't have tomorrow either. I have the present and what a gift that is. I make the right choices now because that is all there is anyway. Now. I have touched on this in previous blogs. I guess it is a common theme lately in the lives of many of my patients, and myself.

Now, what are you going to do today? What new experiences do you want to try?
My latest new experience was indoor skydiving for my birthday.

What a thrill!
Check out the picture below. Here is the website too: http://www.iflysfbay.com/

Be Well,

Wendi Lelke-Wallway, MSN, FNP

The Flu and You

2009-09-23T13:48:00.000-07:00

Flu season is just around the corner and I am answering patients' questions on the seasonal flu and H1N1 virus every day. I believe in getting vaccinated and practicing prevention strategies to lower my risk.
I wash my hands often, eat fresh vegetables/fruits/whole grains, exercise regularly, sleep well, lower my stress through stretching and meditation as well as get vaccinated.

There are great tips on the CDC's website for avoiding the flu too.

I thought it would prudent to give you hyperlinks to the best sites for the latest on the seasonal flu and H1N1 virus.
Click on the hyperlinks below for details.

http://www.cdc.gov/

Q and A on the flu:
http://www.cdc.gov/h1n1flu/qa.htm

CDC Press Briefing Transcripts September 18, 2009:
http://www.cdc.gov/media/transcripts/2009/t090918.htm

H1N1 Vaccine info:
http://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm

NIH Press release on the H1N1 vaccine for children:
http://www.nih.gov/news/health/sep2009/niaid-21.htm

Vitamin A-Common Questions and Answers

2009-09-18T20:48:00.000-07:00

I have addressed your questions about vitamin B12 and vitamin D in prior blog entries. Now it's time to touch on vitamin A.
What does vitamin A do for us? What foods are high in vitamin A? How much vitamin A do I need each day? These are just some of the frequent questions I am asked and will address in this week's blog.

First of all, what is a vitamin?
According to Taber's Cyclopedic Medical Dictionary, a vitamin is "an accessory but vital nutrient that serves as a coenzyme or cofactor in an essential metabolic process."

Basically, a vitamin is a micronutrient essential for biochemical reactions in order to live. We cannot make vitamins; we get them from the food we eat or supplements we take.

What is vitamin A?
Vitamin A is an organic fat-soluble compound of high molecular-weight.1 Retinoid is the general term for all forms of vitamin A-retinol, retinal, and retinoic acid.4

What does vitamin A do for us?
It is essential for immune function, cell growth/differentiation, eye function/vision (retina specifically), and wound healing.1,2,4.

What foods are rich in vitamin A?
The active forms of vitamin A (retinoids) are found in animal products such as dairy foods-eggs, milk, cheese, liver, cod and fish oil and fortified foods.3 Provitamin A carotenoids (beta-carotenoids, alpha-carotenoids, and beta-cryptoxanthin) are pigments in fruits and vegetables that are precursors to vitamin A; they are converted to active forms of vitamin A in the body.2 Darkly pigmented fruits and vegetables are rich in carotenoids such as carrots, sweet potatoes, pumpkin, winter squash, papaya, cantaloupe, collards, turnips, spinach, kale, and apricots.2, 3,5

What is your favorite food rich in vitamin A? (Actually, no one really asked me this, but I thought I'd let you know anyway) I love cantaloupe, sweet potatoes, spinach and squash. Elsa's favorites are sweet potatoes, carrots, and squash.

How much vitamin A is recommended?
The Recommended Dietary Allowance (RDA) is 900 mcg (3,000 IU) per day for men 19 years and older, and 700 mcg (2,333 IU) for women 19 yrs and older.2,5 There are no current recommendations for beta-carotene intake.

What are some early signs of vitamin A deficiency?
Night blindness is often the first sign of vitamin A deficiency.1,2 Deficiency causes dry conjunctiva (xerosis) and dry corneas, Bitot's spots (foamy gray or white patches on the conjunctiva), and damages the retina (xerophthalmia).1, 2 Hyperkeratosis is a late sign of deficiency; this is the overproduction of keratin in skin which creates a rough skin texture.1,2 Another sign is poor immune function-frequent UTI's, respiratory infections, inner ear infections and GI or vaginal infections are more common due to impaired growth and development of epithelial cells.2,4

Click the hyperlinks below for pictures of how vitamin A deficiency may present.
Xerosis:
http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Clinical%20Images/xerosis-J.jpg
http://www.joshuakaye.com/images/xerosis.jpg
Corneal xerosis:http://www.unu.edu/unupress/food2/uin02e/uin02e01.jpg
Bitot's spots: http://motherchildnutrition.org/early-malnutrition-detection/images/bitots-spots.jpg
Xerophthalmia:http://www.anmf.net/programs/projects/2007projects/07bpk002/07bpk002b.JPG
http://www.dsm.com/en_US/images/dnpus/di_vita4.jpg
http://eyepathologist.com/images/KL18256.jpg

What are common causes of vitamin A deficiencies?
Deficiency most often occurs in poorer countries with high rates of malnourishment.1, 2 Fat malabsorption conditions (ex. Crohn's diseas, celiac disease and pancreatic problems), excessive use of mineral oil laxatives (especially in the elderly), chronic diarrhea, excessive alcohol consumption, and zinc deficiency are additional causes.1, 2

Can you get too much vitamin A in your diet?
Yes. Toxicity of vitamin A occurs when consuming over 25,000-50,000 IU a day for 90 days or more.1,3 Some symptoms include dry skin, vomiting, decreased appetite, abnormal bone growth (hyperostosis), nerve and liver damage.5 Eating too much beta-carotene from food has not been proven to cause toxic levels of vitamin A, rather it makes your skin turn yellow-orange which is harmless.1,4 Ingesting vitamin A directly or taking supplements of beta-carotene cause toxic levels.4 Acute hypervitaminosis A causes nausea, vomiting, abdominal pain, headache, fatigue, and swelling and inflammation of the optic nerve.1,2

How do you treat hypervitaminosis A?
Modify dietary intake of vitamin A.

What is the relationship between vitamin A and cancer? There is a relationship between lower cancer rates and a diet rich in vitamin A and beta-carotene.2 Supplementing with beta-carotene supplements does not reduce cancer risk and the Institute of Medicine does not recommend taking beta-carotene supplements in the general American population.2

Vitamin A deficiency is the leading cause of preventable blindness in children living in poor countries around the world. See the links below for commentaries and global efforts to reduce vitamin A deficiency across the globe.

Op Ed piece in The New York Times:
http://www.nytimes.com/2009/05/14/opinion/14kristof.html?_r=2&scp=1&sq=kristof%20vitamin%20a%20&st=cse
World Health Organization:
http://www.who.int/child_adolescent_health/news/events/2008/04_12/en/
UNICEF:
http://www.unicef.org/media/media_49989.html

Be Well,
Wendi Lelke-Wallway, MSN, NP-C

References: 1 Tierney, L., McPhee, S., and Papadakis, M. (2006). Current Medical Diagnosis & Treatment. San Francisco:Lange Medical Books/McGraw-Hill.
2 Office of Dietary Supplements. (2009). Vitamin A and Carotenoids. Dietary Supplement Fact Sheet. Retrieved September 13, 2009 from http://ods.od.nih.gov/factsheets/VitaminA_pf.asp
3 Vitamin A. MedlinePlus. Retrieved September 13, 2009 from http://www.nlm.nih.gov/medlineplus/print/ency/article/002400.htm
4 Whitney, E. and Rolfes, S. (2005). Understanding Nutrition (10th ed.). United States: Thomson Wadsworth.
5 Duyff, R.L. (2006). American Dietetic Association Complete Food and Nutrition Guide. 3rd Ed. Hoboken, NJ: John Wiley & Sons, Inc.

Five Fun Family Activities for the Fall

2009-09-07T06:50:00.001-07:00

Fall is just around the corner-can you believe it? Leaves will soon begin changing color as the scent of dry leaves fills the air. Cozy sweaters, hats, and wool socks will soon become your fall weather essentials.

Staying connected and spending time with your family is also essential for mental, emotional and physical health. Getting outdoors and staying active are two other basics to wellness.

-Looking for some new ideas on how to spend your weekends this fall season...try some of these five fun family activities that will be sure to bring you smiles, laughter and warm memories.(Click on the hyperlinks for some inspiring photos)

1. Apple picking-visit your local organic orchard and pick your own ripe apples. This way, you're outside enjoying the weather and fruits of labor with others who love nature too. Come October, you can pick your own pumpkins too.

http://bancroft.library.ca.gov/diglib/images/shades/kern_county_frazier/web_images/kc580.jpg
2. Go on a hay ride. When were you too old for a hay ride? -Never!

http://cache.boston.com/bonzai-fba/Globe_Photo/2006/09/11/hayride__1158008263_7208-1.jpg

3. Hot air balloon ride-what a unique way to view the fall foliage. Take a hot air balloon ride and get a bird's eye view of the beautiful scenery. Sight-seeing planes or helicopter rides are other options. Now that's something for the memory books. http://d17123.u21.servmatix.com/images/hotair1%5B1%5D.jpg

http://www.shawneemt.com/images/s_hotairballoonride.jpg

4. Hike in the crisp, clean air. Hiking is a wonderful way to get some exercise and to learn more about your local flora/fauna. Guided tours are available at most state parks on the weekends if you prefer. Pack a lunch and take along a guidebook on local plants/trees to discover what's in your back yard.
http://i.pbase.com/g6/28/745328/2/73771731.d3YkTBm4.jpg

5. Cycling-taking a bike ride with others is a great way to spend a few hours, or even a day. You always see more than driving in a car and experience fresh, cool breezes and fall scents as you ride through town after town. Pack plenty of water and snacks.

http://backroadsandbeachesohio.com/uploaded_images/fall.riders-777319.jpg

Be Well,

Wendi Lelke-Wallway, MSN, NP-C

Facts About Flatus

2009-08-27T15:29:00.000-07:00

"Oh, excuse me please," you mutter as you turn a shade of red while stepping off the elevator on your way back from your lunch break.

Flatus, AKA gas or flatulence, is a natural process but sometimes it may be embarrassing to release your steam unexpectedly. I often hear women complain, "I just feel more gassy and I am tooting more lately. I don't know why."
"What did you eat yesterday?", I ask.

"For breakfast I had an omelet with peppers, broccoli, onions and cheese and a cup of coffee. For lunch I usually have a huge salad full of vegetables. And for dinner, I generally eat something spicy like Cajun chicken with vegetables and a glass of milk or a beer. I have a piece of chocolate for dessert sometimes too." Hmmm........

Today I am addressing the "The Facts About Flatus" in hopes of clearing up any myths and answering those burning questions you may have about passing gas. Not too glamorous, but it we all do it and don't talk about it.

Flatus or flatulence is the medical term for gas and there are two main origins for gas-swallowing air (usually causes nitrogen gas) or the production of byproducts due to bacterial fermentation of carbohydrates (hydrogen gas, carbon dioxide, and methane gas).1 But gas may also be due to malabsorption, IBS, food intolerances (commonly dairy or gluten) or medications including antibiotics and laxatives.2 Passing gas up to 10-20 times is normal, according to the MayoClinic.com.2

What are the most common dietary causes of gas?
As mentioned previously, fermentation of carbohydrates cause gas. Fructose and lactose, carbohydrates from fruits and dairy respectively, in addition to other complex carbs and fiber all create gas. Some may not know this, but fructose is also found in soda, fruit juice and candy.1 Foods high in complex starches and fiber (such as cruciferous veggies-broccoli/cauliflower/brussel sprouts), in addition to beans/legumes produce a lot of gas.

Surprising to some, chocolate, coffee, eggplant, onions, carbonated drinks (including beer) and garlic are big culprits of foul-smelling gas. Dairy may also cause you to toot more-milk, eggs, ice cream, and cheese are included.

So many women I know claim to have a daily chocolate and coffee fix. They are amazed to find out from me that these two foods are known to cause really bad gas. Keeping a food diary may help determine which foods are causing gas.

What about swallowing air? Swallowing air contributes to gas too. Avoid chewing gum, eating candy and using straws to help reduce gas. And if you need another great reason to quit smoking, it may help reduce gas from all that inhaling. Eating fast may increase air intake as well, so slow down when you eat. When someone has too much gas it is hard to determine and it is best to consult a medical professional.

What's my personal experience?
I eliminated chocolate from my diet (and I don't drink coffee ever) while breast feeding because Elsa could not get restful sleep due to the gas from digesting chocolate in my breast milk. What a relief once I changed my diet and Elsa was able to rest after breast feeding without crying and burping as much.

Hard boiled eggs do me in too..."sulfur smells are not attractive," my husband reminds me.
As a vegetarian, I expect more gas if I am eating raw fruit and vegetables. I know which vegetables will make it worse for me such as raw cucumbers, broccoli and carrots. So if I am eating out and don't want to pass gas too much afterward, I watch which vegetables I eat.

Foods that Contribute to Gas (Deen and Hark, 2007)3:
-Broccoli, brussel sprouts, beans
-Cauliflower, cucumbers, cabbage
-Peppers, onions, garlic, radishes, turnips
-Apples, avocado, melon, raw fruits in general
-Dairy, spicy foods, carbonated drinks, fatty/fried food
As a vegetarian, I eat all the vegetables listed above and I expect to pass gas after meals with these foods.

Now for some comic relief.....

Have a great weekend and send me your comments/suggestions.

Be Well,

Wendi Lelke-Wallway, MSN, FNP

References:
1 Tierney, L., McPhee, S., and Papadakis, M. (2006). Current Medical Diagnosis & Treatment. 45th Edition. McGraw-Hill Professional.
2 MayoClinic.com Gas and gas pains. Retrieved August, 28, 2009 from http://www.mayoclinic.com/health/gas-and-gas-pains/DS00080/METHOD=print

3 Deen, D. & Hark,L. (2007). The Complete Guide to Nutrition in Primary Care. Malden, MA: Blackwell Publishing.

Good Ol' Fashioned Exercise and a Healthy Diet ...

2009-08-12T20:46:00.000-07:00

Good old fashioned exercise and a healthy diet still hold true as the major factors to long-term health. Another recently published study highlights the impact that YOUR LIFESTYLE has on your health.
The study entitled "Healthy Living is the Best Revenge" in Archives of Internal Medicine states that lifestyle factors such as regular exercise and a healthy diet help you stave off chronic disease.

No, duh. I thought it was common sense that exercise and a healthy diet help prevent acute and chronic disease? I was glad I read the study, though, as I learned which lifestyle factors have the most influence on chronic disease.

The study examined four lifestyle factors and their influence on the incidence the four most common causes of mortality or morbidity- Type 2 diabetes, heart attack, stroke and cancer in 23,153 German participants (ages 35-65 yrs) over ~ 7 years. The specific four lifestyle factors were:
1. smoking status
2. BMI (body mass index=(weight in kg/height in m^2)) less than 30
3. healthy diet of low meat intake, lots of vegetables/fruits and whole grains
4. exercising 3.5 or more hours a week

The study showed that all the healthy lifestyle factors significantly reduced risk for any of the four chronic conditions studied. However, maintaining a BMI<30 was the biggest factor in reducing risk of chronic disease, and was especially protective against diabetes. Never smoking was the next significant factor on health.

Exercise was more protective against diabetes and heart attack than cancer. And a healthy diet protected participants from diabetes, stroke and cancer to about the same degree.

O.K., so what's the bottom line Wendi?
The bottom line is...."The participants with all 4 healthy lifestyle factors had a reduced risk of major chronic diseases of almost 80% compared with those with none. These results applied equally to men and women."

WOW! -Now that is a great reason alone to never smoke, exercise regularly, eat healthy foods and maintain a healthy weight. I plan on using this study as a motivational tool for patients that are obese and smoke. Please read the study for yourself.

So, do what you have always known to be well....eat right, exercise, don't smoke and maintain a healthy weight.

I'm off line for a two week vacation now. Off to Cape Cod to visit Elsa's grandparents.

-Be back by Sept 1st. So take care, be well and send me any topic suggestions.
Next time I plan on writing about gas-the embarassing bloating and tooting that is very common, just never talked about.

Be Well,

-Wendi Lelke-Wallway, MSN, NP-C
Reference:

Ford, E., Bergman, M., Kroger, J., et al. (2009). Healthy living is the best revenge. Archives of Internal Medicine, 169, pp. 1355-1362. Retrieved August 13, 2009 from http://archinte.ama-assn.org/cgi/content/full/169/15/1355?home

Mind Games for Mindful Health

2009-08-06T08:28:00.000-07:00

Intellectual stimulation is vital to enhance and create new neural pathways (“brain circuits”) which affect memory, thought processing and intellect. Creative activities that interest and stimulate us are essential for keeping our minds sharp as we age. Such “brainy” activities include learning a new hobby, reading books, writing, painting, drawing, playing card games or solving puzzles.
Keeping your mind sharp takes work. Physical exercise and mental activities designed to challenge your memory skills, hand-eye coordination, body-mind connection in general are important components to staying mentally sharp as we age.

Try some of these 10 memory and mental games/activities to keep you on your game (as well as eat well and exercise regularly).

1. Learn a new skill such as painting, drawing, woodworking, pottery, jewelry making or sewing to enhance your hand-eye coordination and stimulate your mind.

2. Avoid alcohol and eat plenty of vegetables, whole grains and healthy proteins keep your body and mind healthy as we age.

3. Use word associations to remember items, such as on a grocery list-BEANS-bread, eggs, apples, napkins, soap.

4. Do puzzles such as crossword puzzles, number games, and Scrabble on a regular basis. This not only expands your vocabulary but also speeds up your thought processing time.

5. Write it down-writing down your ideas or your "things to do" list allows you to visualize the words you are trying to remember which will enhance memory skills later.

6. Visualize the face of people/places/things you are thinking of to trigger your memory if you can't remember the name.

7. Sleep well. Sleep helps consolidate memory into long-term memory. Eight hours of sleep a night is a descent amount of sleep to help your brain function at its best.

8. When meeting new people, say the person's name out loud to help you remember it.

9. Read books/magazines/newspapers and write often.

10. Learn a new language-quite a challenge for some people, but it really helps your brain stay well.

Be Well,
Wendi

Summer Skin Care

2009-07-30T12:13:00.001-07:00

My husband recently had his biannual dermatology appointment/mole check. He is covered in moles resembling a giraffe (hee-hee) due to long term sun exposure and a gene pool of fair-skinned European decent. Anyway, since it is the season for sunny days and UV exposure, I thought I would touch on how to keep your skin safe under the sun. A reminder on sun skin care this summer can't hurt.

I have been using Neutrogena sunscreen SPF 55 on my face every day for years. It is the first thing I put on my face each morning after washing with Cetaphil facial soap. On days where I put on makeup, my powder foundation has an additional SPF of 30. I am hoping it keeps my "crows feet" away for a while.
It is so important to protect your skin from ultraviolet rays; ultraviolet radiation damages your skin over time increasing your risk of skin cancer, wrinkles, sun burn and saggy skin- premature aging of the skin.
Two types of UV radiation are UVA and UVB; UVB causes sunburns and UVA causes skin integrity to wear down over time.1 (UVA penetrates the skin deeper than UVB).2 But either type may cause skin cancer, basal cell carcinoma or squamous cell carcinoma. Lentigos are sun-induced lesions (flat brown spots) on the skin. They show up on our hands, arms, legs, face with age and also long-term sun exposure. They may also get darker with age and continued sun exposure. Additionally, over exposure to sun may cause first or second degree burns! Ouch!

When it comes to choosing a sunscreen, it may become overwhelming. Basically there are types; organic sunscreens are absorbed by the skin whereby the chemicals filter UV light (sunscreen) and inorganic sun blocks which are not absorbed by the skin-they block UV absorption altogether. Athelios SX is an organic sunscreen and zinc oxide is an example of inorganic sun block that protect skin from both UVA and UVB.

Here are Be Well's Tips for Skin Protection Under the Sun:
1. Choose a sunscreen with BOTH UVA and UVB protection.

2. Choose a sunscreen with SPF of 30 or higher. Sun Protection Factor, SPF, is the scale for determining UV protection in sunscreens. Apply to all sun exposed skin when outside longer than fifteen minutes-Sun or cloud cover-it doesn't matter. And babies over six months old also need a hat and sunscreen as well.

3. Avoid direct sunlight at its peak between 10 am and 4 pm.

4. See a dermatologist for any suspicious lesions/moles on your skin.

5. Cover yourself with SPF clothing when out in the sun for over two hours. My husband uses long-sleeved, dark colored UPF (ultraviolet protection factor) index clothing when golfing or at the beach.

6. Reapply sunscreen! Reapplication of sunscreen is necessary to maintain protection especially after being in the water, exercising or sweating.

7. Don't forget your lips and your head! They need sun protection too with lip balm sunscreen and a hat.

8. Wear sunglasses with UVA and UVB protection.

9. Don't go to tanning beds or under sun lamps. (An exception to this rule would be, for example, light therapy or for eczema treatment as ordered by your health care provider)

10. Apply sunscreen a half hour before going out into the sun so it may be absorbed.

Be Well in the Summer Sun!

References:
1 http://www.skincancer.org/sunscreens-explained.html
2http://www.skincarephysicians.com/skincancernet/selecting_sunscreen.html
Resources:
http://www.aad.org/
http://www.aad.org/public/sun/smart.html http://www.aad.org/public/sun/seal/products.html
http://www.anthelios.com/anthelios-uvraydamage.html
http://www.neutrogena.com/econsumer/ntg/productscategory.browse?segment=women&catId=3
http://www.cancer.gov/cancertopics/types/skin

Healthy Summer Snacking

2009-07-23T12:35:00.000-07:00

Who doesn't love summer? Warm, long days at the lake, beach, golf course, tennis court, park or your favorite spot fill your weekends relax and having fun. You're busy and on the go all day long and you want healthy, light snacks to pack to keep your battery charged.

I created a top ten list of the best, healthy, lacto-ovo vegetarian summer snacks to fill you up and maintain your energy. They are light, portable, and tasty.

If you have any snack ideas, please make a comment below.

Be Well's Top 10 Healthy Summer Snacks to Pack

1. Raw almonds, walnuts, peanuts, soy nuts-a handful of almonds is packed full of unsaturated fatty acids and protein with only about 170 calories. You may even add raisins, dried cranberries or dried blueberries or dark chocolate chips for a boost of antioxidants!

2. Raw vegetables-carrots, peppers, cucumber slices have pretty good longevity out side of the fridge. This is a light snack with a crunch!

3. Hard boiled eggs-the whites in particular, full of protein and no fat (7-10 grams of protein per egg white)

4. Raw fruit-fresh peach, nectarine, or plum is a healthy snack with about 65 kcal per medium sized fruit; They taste great and are full of vitamins and antioxidants too!

5. Clif Bar-these are a well-balanced portable snack with organic ingredients in many different flavors to suit your tastes. And they stay well in the sun with out melting.

6. Yogurt-freeze a cup size of yogurt and bring it with you...by the time you are ready to eat it, it will be smooth and ready to eat.

7. Cheese sticks (low fat)/cottage cheese/tofu sausage-this snack is good as long as it's not in the direct sun for a while. -Full of protein to keep you satisfied.

8. Whole grain bread with peanut butter (or your favorite nut spread)- this has plenty of protein, carbs and fat to recharge you and tide you over 'til dinner. (My favorite is California sprouted bread with organic peanut butter from Costco)

9. Low fat crackers-I like Trader Joe's Organic Wheat and Flax seed crackers and Kashi's TLC Original or Sesame Seed crackers

10. Left overs- never under estimate the satisfaction of having left over dinner as a snack or meal the next day. So easy to just pack it in Tupperware container and go.

Hope your summer is going well.

Be Well

-Wendi Lelke-Wallway, MSN, NP-C

Making a Difference...An Entry on Mindful and Spiritual Health

2009-07-08T09:09:00.001-07:00

Making a Difference....
This entry focuses on my fundamentals of mindful and spiritual health.

We all make a difference in other people's lives by the relationships we foster, the work we do and through a variety of endeavors from volunteering to writing an editorial in the local newspaper.

Some people desire to have a great impact on the masses and others prefer to positively influence a few. Whatever you decide, you can and do make a difference.

How are you making a difference in your community? Your community may be your family, your neighborhood, your work environment, your county, or your state.

Investing time and energy in activities that have a positive impact on others and/or the environment is what I mean by "making a difference." When I feel I am making a difference, my spirits and mood are lifted. I am motivated to do more for that person or community and enhance my own emotional and spiritual development.

I strive to make a positive difference in the health and wellness of others on a daily basis through my work, my time with family and writing. I remember one wise nurse told me several years ago, "Now remember, you can only help one patient at one time." He meant, you may have four patients but rest assured, you can't be in four different rooms at the same time. Make a difference one patient, one encounter at a time.

-Be Well.
Wendi

Making Time for Your Health

2009-07-08T08:59:00.000-07:00

I often hear my patients say that they "just don't have time to workout" or "I don't have time to cook healthy meals". Another comment I hear is, "I am too busy to exercise."

We ALL have the same amount of time- the same 24 hours each day, 7 days a week. Making time to exercise and eat well is a matter of priorities. I understand the difficulties associated with balancing work, exercise, family and private time. It is challenging, no doubt about it. However, your health is a crucial foundation to an active, prosperous life and it greatly impacts your ability to enjoy life with friends and family. Eating right and working out are pivotal to maintaining health and wellness.

According to the U.S. Dept. of Health and Human Services, Dietary Guidelines for Americans, the general adult U.S. population should, "engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week."

Patients often ask me for help on how to improve their eating and exercise habits. Here are some tips to help you make time in a busy schedule for healthy meals and a regular workout routine:

1. Prepare extra servings of vegetables and grains such as rice or barely on the weekends and freeze the leftovers for dinners during the week. If you do eat poultry, it freezes well too.

2. For you working people, make a weeks worth of lunches on Sunday for the week and bring them all to work on Monday. This time saving strategy has made my life so much easier! I don't have to think about packing a lunch each day because it's already done, only once.

3. Buy only fresh produce (or frozen vegetables- the next best option) and whole grains to make your meals. -The less processed, the better it is for you. This way you are guaranteed to consume healthy food. And don't buy the high calorie chips and desserts you really want to avoid.

4. Set your alarm clock for thirty minutes earlier three times a week for an early morning workout-whether that is simply jumping rope to your favorite iTunes, going for a quick walk/jog or popping in your favorite yoga DVD. Any extra movement counts. Just make sure you enjoy it so you keep it up.

5. Go for a walk at lunch time to get some fresh air and exercise if you can't go before or after work; mix it up with some jogging spurts or stair/hill work.

6. Plan ahead as to when you are going to exercise and stick to it. Make it a priority and an appointment for yourself. I've had clients arrange workout "dates" with friends so they are held accountable. It's easier to show up when you are planning on meeting someone.

7. Join an adult sports league of your choice such as softball, baseball, cycling club, running club or soccer. Team sports is a fun way to reduce stress as well as work out. As a team member, you will be more likely to show up so you don't let down your teammates.

8. Hire a personal chef. I have several busy patients that have selected this option. The chefs buy fresh, organic produce from local farmer's markets and make the meals in your own home- enough for an entire week. Surprisingly, it may actually be cost effective compared to the time you may be investing toward shopping and cooking for yourself.

Here are some excellent websites for more details about healthy eating and exercise:
http://www.mypyramid.gov/

http://www.health.gov/dietaryguidelines/dga2005/document/
http://win.niddk.nih.gov/publications/just_enough.htm

What other suggestions can you think of?

-Off to San Diego for the weekend to visit grandma, cousins, aunt and uncle.

Be Well.

-Wendi

Mantras for Mindful Health

2009-07-02T13:22:00.001-07:00

It's been a while since I addressed mindful health. See my debut blog for more of what I mean by mindful health.

Emotional and mental health are a part of being well holistically. Creating and revising your own mantra may help improve your mood as well as reduce stress when combined with meditation and other practices such as yoga or stretching.

What is a mantra, you may be wondering? Here are two quoted definitions of mantra:

"A commonly repeated word or phrase."1

"a word or sound which is believed to possess a special spiritual power:A personal mantra is sometimes repeated as an aid to meditation or prayer. a word or phrase which is often repeated and which sometimes expresses a belief" 2 Cambridge Advanced Learner's Dictionary

One of my most memorable stories regarding a mantra was when I was in my final days of graduating with my Master of Science in nursing-Family Nurse Practitioner degree. Smiling, one of my colleagues handed me a small piece of paper with a mantra written on it especially for me...it read something along the lines of..."I am a wonderful health care provider." She winked at me as I read it and I thanked her dearly with a smile. Both of us knew that positive reinforcement was key to our new journey as nurse practitioners. I carried that piece of paper in my purse for over a year just to keep me focused on my goal.

Now, I have several mantras which I say out loud on a daily basis; at least once in the morning and once in the evening, sometimes more often. I may vary the phrase a bit depending on what is going on in my life. Mantras help me stay focused on all the good in life and where I intend to be in the future. It helps with me visualize positive events to literally create an amazing, healthy future. Does this sound too far fetched? It really works, but you have to believe that it does.

Vocalizing your mantra while meditating, doing yoga, praying or visualizing what you desire helps you move toward that goal. One piece of advice is to keep it simple.

One of my mantras is the following: "I am a healthy, successful mother, wife, nurse practitioner and health writer."

What is your mantra? If you feel like sharing your mantra(s), leave a comment for us.

Happy 4th of July everyone!

Enjoy your holiday weekend and Be Well.

-Wendi

References:
1 mantra. (n.d.). The American Heritage® Dictionary of the English Language, Fourth Edition. Retrieved July 02, 2009, from Dictionary.com website: http://dictionary.reference.com/browse/mantra

2 Cambridge Advanced Learner's Dictionary retrieved July 2, 2009 from http://dictionary.cambridge.org/define_b.asp?key=48702&dict=CALD

Coenzyme Q10-Making it Simple

2009-06-25T12:05:00.000-07:00

More supplement news for you this week...this time on Coenzyme Q10, (AKA ubidecarenonel, ubiquinone, vitamin Q10, CoQ10) as Americans are taking more supplements than ever before. This entry is intended to answer the most common questions people ask me about Coenzyme Q10 and is based on my research. It is by no means comprehensive.

FYI: The NIH created The National Center for Complementary and Alternative Medicine (NCCAM) in 1998 to meet ever growing needs of researching and evaluating complementary and alternative medicine. Click here to find out more: http://nccam.nih.gov/ This is a great site to find out more about supplements and non-traditional approaches to medical conditions.

What is Coenzyme Q10?
Let's break it down the word: Co-partner, Enzyme-protein

It is a fat-soluble vitamin-like compound naturally made in our bodies that "partners" with enzymes (proteins) to create chemical reactions in the body.2 Coenzyme Q10 acts as an antioxidant and is important in energy production (ATP production specifically). It is also a supplement; CoQ10 is not regulated by the FDA because it's a supplement.1

What has research shown regarding deficiency of Coenzyme Q10?
It has been implied or found to be deficient, in some studies, in some patients with heart failure, hypertension, cancer, diabetes and Parkinson's disease.3 This is controversial, however and we don't know why it occurs. Studies have not been conclusive on whether or not coenzyme Q10 deficiency causes or contributes to disease states.4

What does the research say about its role in high blood pressure and cardiovascular disease?
Coenzyme Q10 may protect against the artherogenesis process by acting as an antioxidant against LDL cholesterol.3 The American College of Cardiology does not recommend coenzyme Q10 supplements for prevention or treatment of cardiovascular disease, however.4

A meta-analysis of 12 studies showed that CoQ10 may lower blood pressure in patients with hypertension by about 16 mmHg (systolic/upper number in blood pressure readings), however, it is not recommended in the guidelines (The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) due to lack of evidence in randomized double blinded clinical studies.4,5,8

Does CoQ10 supplements help with muscle aches due to statins?
Not according to one small double-blinded, controlled study (the only fairly decent study I found).6 But according to another small study that was not randomized clinical trial, coQ10 did seem to help alleviate myalgia in patients taking statins.3

But, research has shown that statins may lower CoQ10 levels.7

One small study, not a double-blinded, placebo controlled study, showed that supplementation did restore CoQ10 levels in patients on statins.6 But this doesn't mean that the patients are necessarily better off taking coQ10, nor at lowered risk for muscle aches associated with statin drugs.

What is its role in cancer?
According to the National Cancer Institute, there has not been a double-blind, randomized clinical trial using coenzyme Q10 for treatment of cancer that has been published to date.
http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/HealthProfessional/page2
-And cancer should not be treated with coenzyme Q10.9

What forms of CoQ10 are there available?
It is sold as a supplement over the counter and comes in capsule or soft gel forms in various doses from 10mg to 300 mg each.2 It is taken orally and excreted by the liver.2 It is not regulated by the FDA; it is marketed by the DSHEA of 1994 (Dietary Supplement and Health Education Act)

What is the bottom line about coenzyme Q10?
There has not been any large double blinded placebo controlled studies to prove coQ10 lowers cancer risk, improves immunity in HIV patients, helps with neurological disorders, prevents migraine headaches, or prevents or improves cardiovascular disease. 2,9,10,11

So what? The jury is still out.

Enjoy your weekend! My sister, Elsa and I are going hiking at Point Reyes National Park.

Until next week, Be Well.

-Wendi
References:
1 National Cancer Institute. Coenzyme Q10 overview. Retrieved June 25, 2009 from http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/HealthProfessional/page2

2 Co-Enzyme Q10. Retrieved June 22, 2009 from http://druginfo.goldstandard.com/direct/getmono.asp?caller=esmdcF&option=1&cpnum=2

3 Frishman, W., Beravol, P. & Carosella, C. (2009). Alternative and complementary medicine for preventing and treating cardiovascular disease. Disease-a-Month, 55: pp. 121-192

4 Coenzyme Q10. Wikipedia. Retrieved June 23, 2009 from http://en.wikipedia.org/wiki/Coenzyme_Q10
5 Wexler, R. and Aukerman, G. (2006). Nonpharmacologic strategies for managing hypertension. American Family Physician, 73, pp.1953-1956.
6 Young, J., Florkowski, C., Molyneux, S., McEwan, R., Frampton, C., George, P. & Scott, R. (2007). Effect of coeznzyme Q10 supplementation on Simvastatin-induced myalgia. The American Journal of Cardiology, 100, pp.1400-1403
7 Deen, D. & Hark, L. (2007). The Complete Guide to Nutrition in Primary Care. Blackwell Publishing: Malden, MA.

8 Sidani, M. & Ziegler, C. (2008). Preventing heart disease: Who needs to be concerned and what to do. Primary Care: Clinics in Office Practice, 35, pp. 589-607.

9 http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/HealthProfessional/page2

10 Coenzyme Q10. MedlinePlus. Retrieved June 23, 2009 from http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-coenzymeq10.html

11 Duyff, R.L. (2006). American Dietetic Association Complete Food and Nutrition Guide. 3rd Ed. Hoboken, NJ: John Wiley & Sons, Inc.

Summer Staycations

2009-06-18T12:22:00.000-07:00

Two big reasons to celebrate this Sunday-Father's Day and the first day of summer.
The year is just flying on by! -Thanks to all you dads out there!

Summer vacations are now officially underway. A lot of people I know are staying closer to home to vacation this summer as a money saving strategy. Last year the term "staycation" was widely used and I think this concept has stuck with the current economic climate. In order to help me plan some trips, I sent away for a free California vacation guide from the California Travel and Tourism Commission; it has opened my eyes up to an array of amazing escapes I didn't even know existed.

http://tourism.visitcalifornia.com/B2B/default.aspx

I am planning several local California trips this summer which helps me appreciate home even more knowing all the exciting possible adventures in our own backyard. -We are headed to Lake Tahoe area to do some hiking and swimming, the San Diego area for some beach-time R and R, camping along the central coast of California, canoeing along the rivers of the Sonoma Coast and much more hiking and biking in the San Francisco Bay Area.

So what Wendi, you may ask? Well, if you want to discover some free, amazing local excursions, check out your local Chamber of Commerce website or your state tourism department for some free guides and ideas of how to spend your summer days at home. I bet you will learn something new about home or uncover a treasure in your own backyard. Appreciating your home and staying active in your community will improve and enhance your mental health as well as your physical health.

Here are some links to state tourism departments of some of my readers (in no particular order):
http://tourism.visitcalifornia.com/B2B/default.aspx
http://www.mass-vacation.com/
http://www.ctvisit.com/
http://www.iloveny.com/home.aspx
http://www.visitnh.gov/
http://www.visitidaho.org/
http://www.exploregeorgia.org/
http://www.traveloregon.com/
http://www.experiencewa.com/

Enjoy your staycation this summer and tell me all about it!
Next time I plan to write about Co-Q Enzyme, unless you have a special request.

Happy Father's Day and Happy Summer 2009!
Be Well.
-Wendi

Staying in "The Now"

2009-06-12T11:02:00.000-07:00

What do I mean by staying the the now and why should we care about it?

Being in the now is being present mentally and emotionally to the current moment. It is about embracing what is, now, and not focusing on what may be or what was.

I think it is important to take a time out daily to meditate and be present to what is going on around you at the moment....take it all in. It is important to visualize yourself involved in joyous, loving, positive events because this exercise changes your outlook/mood which you bring back into the now when you are done visualizing or meditating. Positive visualization and meditation exercises will really help change your life for the better.

When we let our minds drift or take off uncontrollably into some distant, hypothetical, negative circumstance it can and will seriously affect our mood and life now. I am not saying, don't plan for the future; I am saying that dwelling on and thinking of what possible dismal situations or circumstances may arise will negatively affect your life today. Because if you do this, persistently, it will come to pass. -At least I can say it did for me. So I decided long ago to simply change my thought patterns and change my life.

This week I have heard several people say, "This growing old thing is for the birds."
"Really? Well, we all are in the same boat on growing older, but I don't think it has to be as bad as you think," I responded.
If you think growing old is so bad and causing you unwanted aches and pains, guess what....growing old WILL create real physical pain. But, if you say to yourself, "I feel great today and will make the most of it" along with really treating yourself well by eating healthy foods, exercising, socializing with positive people, and continually stimulating your mind, life will be more wonderful as you grow old.

I feel better today at 34 than I did at 24 because I choose to treat myself well physically, emotionally, mentally, socially and spiritually. It is possible to be more well with each passing day as long as you set your mind that way.

Alright, I will get off of my soap box now.

Be Well Now.
-Wendi

What About Acai Berry?

2009-06-05T11:47:00.000-07:00

A lot of people here in the Bay Area take herbal and vitamin supplements. I'm guessing about 9 out of 10 of my patients are taking some form of supplement whether it be vitamin D, a multivitamin, a prenatal vitamin, St. John's Wort, Estroven, or Monavie for example.

I have had several people ask me about acai berry lately, the "powerful new antioxidant" supplement on the market. It triggered some research on my end and here are the facts I found through my research.

Acai palm trees grow in South America and Central America in wetland environments such as swamps.1 The tree produces a round, small dark purple berry that is claimed to taste like raspberry and grows to be about 2 centimeters in diameter.1,2 Acai berries are edible and have a moderate antioxidant content, but less than strawberries, which act against inflammation in the body.2 The berry is processed and sold as a juice, tablet supplement, fruit, and powder.2

It seems to me that this berry is being claimed to help with a lot of ailments from more energy to weight loss, however the research I found does not support these claims.

In one study 12 people consumed acai pulp and acai juice in the amount of 7 ml/kg body weight of the subject and had antioxidant levels (called anthocyanins which are also pigments and make the acai berry purple) measured about two hours later.3 The antioxidant levels were about double the amount in acai patients than those who had the control, which was apple sauce.3, 5 But blueberries and grapes for example, also have anthocyanins and were not included in the study.3, 5

Another study showed that acai antioxidants may act as antioxidants at low doses and get inside human cells without chemically changing.4

But I did not find any research suggesting it is a super-food or an amazing fruit that will help you lose weight, slow aging or boost immunity as some advertisements claim. Eating a balanced, healthy diet rich in vegetables,whole grains and fruits is still recommended as the best way to stay healthy and well.

Until next week...be well.
Wendi
References:
1 http://acaiberrycompany.com/extra_info_pages_hidden.php?pages_id=4

2 Acai Palm. Wikipedia retrieved June 1, 2009 from http://en.wikipedia.org/wiki/Acai_berry

3 Mertens-Talcott, S. (2008). Pharmacokinetics of anthocyanins and antioxidant effects after the consumption of anthocyanin-rich acai juice and pulp. Journal of Agricultural and Food Chemistry, 56, pp. 7796-7802.

4 Schauss, A. (2006). Antioxidant capacity and other bioactivities of the freeze-dried Amazonian palm berry, Euterpe oleraceaemart. Journal of Agricultural and Food Chemistry, 54, pp.8604-8610.

5 Acai Berries and Acai Berry Juice-What are the health benefits? Retrieved June 1, 2009 from http://www.webmd.com/diet/acai-berries-and-acai-berry-juice-what-are-the-benefits

Vitamin B12

2009-05-26T12:27:00.001-07:00

Vitamin B12 (cobalamin) deficiency is common and worth discussing as I am finding deficiencies common in people over 50 years old, people on long-term medications for gastric reflux, and vegetarians. As a vegetarian myself, I take vitamin B12 supplements daily....50 mcg to be exact. I decided to make this entry a question and answer style. Hope it's simple enough.

What is vitamin B12?
Vitamin B12 (AKA cobalamin) is a water soluble vitamin critical for nerve cell function, making myelin and neurons, red blood cell production, metabolizing fat and carbohydrates and even making DNA.1 It is readily available in protein food sources such as dairy, shellfish, fish, poultry, meat and fortified cereals.

Vegetarians, especially vegans, are more at risk for vitamin B12 deficiency due to lack of dietary intake. Elderly and pregnant women are more at risk for deficiency due to less absorption with age and an extra demand for vitamin B12 during pregnancy. However, malabsorption, not low intake, of vitamin B12 is the number one cause of vitamin B12 deficiencies.6

How do we get vitamin B12?
Hydrochloric acid mixes with protein in food to release vitamin B12. Vitamin B12 combines with intrinsic factor (a protein) in the stomach and is absorbed in the small intestine (the terminal ileum specifically).2 Once in the blood, it is transported in plasma and stored in the liver.

If you can't make intrinsic factor, you develop a type of anemia called pernicious anemia. Also, individuals who use medications that decrease stomach acid production over a long period of time may not absorb vitamin B12 well leading to a deficiency.3 Examples of medications include proton pump inhibitors (ex. omeprazole), antacids or H2 receptor blockers (ex. ranitidine). Bacterial infections caused by H. pylori, pancreatic insufficiency, and Chron's disease are other potential causes of deficiencies.5 Surgical removal of the stomach (gastrectomy) and/or small intestine will prevent absorption of vitamin B12 as well.5 Since the liver stores lots of vitamin B12, it may take a few years to develop a deficiency in individuals without the above conditions or surgeries.5

What are symptoms of low vitamin B12?
Symptoms of low vitamin B12 include tingling of feet or hands, megaloblastic anemia, fatigue, pallor of hands, nail beds and face, nerve damage, muscle aches, moodiness and inflamed tongue/mouth.3,4 Late symptoms are memory loss and hip or spine fractures.6

How do I know if I am deficient?
A simple blood test will determine your vitamin B12 level. 5
Normal range is > 240 pg/mL
Deficient is <170 pg/mL
Borderline is 170-240 pg/mL

What is the recommended daily allowance of vitamin B12?4
2.4 micrograms/day for adults 14 yrs and over
2.6 micrograms/day for pregnant women
2.8 micrograms/day for lactating women

What food sources are high in vitamin B12?4
salmon 3.0 mcg per 3 oz.
yogurt 1.5 mcg per cup
milk 1.3 mcg per cup
egg 0.7 mcg per egg

What is the treatment for deficient vitamin B12?

It depends on the cause and your health care provider; generally people are replaced with monthly vitamin B12 intramuscular injections (1,000 mcg/dose) or oral supplements, most often for life.

Enjoy your weekend and please let me know how this blog is helping you or influencing your life. I appreciate it!

Be Well,

Wendi

References:

1 Dietary Supplement Fact Sheet. Office of Dietary Supplements. NIH Clinical Center. Retrieved May 25, 2009 from http://ods.od.nih.gov/factsheets/VitaminB12_pf.asp

2 Vitamin B12. Medline Plus. Retrieved May 25, 2009 from http://www.nlm.nih.gov/medlineplus/print/druginfo/natural/patient-vitaminb12.html

3 Deen, D. & Hark, L. (2007). The Complete Guide to Nutrition in Primary Care. Blackwell Publishing: Malden, MA.

4 Duyff, R.L. (2006). American Dietetic Association Complete Food and Nutrition Guide, 3rd Edition. John Wiley & Sons, Inc. Hoboken, NJ.

5 Tierney, L., Mc Phee, S., & Papadakis,M. (2006). Current Medical Diagnosis and Treatment. 45th Edition. Lange Medical Books/McGraw-Hill: San Francisco.

6 Margo, K. & Mahon, K. (2008). Vitamin B12 Deficiency. The 5-Minute Clinical Consult. Lippincott Williams and Wilkins.

Just Smile

2009-05-22T13:55:00.000-07:00

Smiling. It's the easiest way to make yourself feel better. Since Elsa was born, I have smiled big smiles each day. She greats me every morning with a big, bright smile as I peer into her crib to pick her up.

Smiling releases endorphins which literally give you energy and happy emotions. It's the quickest way to positively change your mood and get your day off to a great start.

Make it a point to smile to every person you see tomorrow...whether they are in the grocery store, at the gas pump or walking by your house. Just smile and see what it does for them, as well as yourself. Smiling at others actually makes them feel good too; it may have a profound influence on their day. Smiling is contagious.

If everyone smiled more we would all be a happier society, all else remaining constant. Imagine that for a minute. Everything in your life would be no different, and you would feel 100% better. Is that really possible? Yes.

People that are happier, live healthier, longer lives. Happiness comes from within you; your mind and emotions affect your physical health and well-being.

Some people may say, "that's pretty idealistic and unrealistic to think that smiling can really make a difference in your health." But it's true. If you feel you can't smile because you are struggling, then watch a comedy or read the comics and laugh because you are humored. I assure you that you will feel great afterward.

Smile for your health!

Be Well.
-Wendi

P.S. I will be writing about vitamin B 12 next week.

Top 10 Secrets to Being Well

2009-05-15T09:54:00.000-07:00

I constantly get asked by my patients, "How do you stay healthy when you are around so many sick people?" There are several reasons why I generally do not get ill and stay healthy all year long. I decided to post my top 10 ways to Be Well this week. Some of it seems obvious, but not everyone follows these tried and true secrets to being well.

Happy Friday everyone and enjoy your weekend!

Top 10 Secrets to Being Well:

1. Think positive, healthy thoughts. The more positive your mindset is, the healthier your body is and becomes over time.

2. Eat fresh vegetables, whole grains and fruits. I am a vegetarian and honestly believe that is part of my success to being healthy and well.

3. Exercise regularly. Sounds obvious, I know. But I can't tell you how many people do not work out regularly. I am talking five days a week, not once or twice. If you had a choice, I think cardiovascular exercise and stretching are the best for long-term health. Stretching reduces risks of injuries.

4. Wash your hands frequently. I wash my hands before and after each patient visit as well as before and after eating, going to the gym, etc. You can wash your hands too much, and I had a problem with dermatitis while working in the hospital due to the harsh antibacterial soaps. If you don't have soap, use water and friction for the time it takes you to sing "Happy Birthday" Song twice.

5. Don't smoke, nor expose yourself to air pollutants, too much sun and toxic chemicals. Always where gloves when using cleaning detergents and washing the bathroom, etc. Wear sunscreen everyday.

6. Drink water throughout the day. Avoid caffeine and alcohol.

7. Relax and meditate. Take time out for treating yourself to quiet time to calm your body and mind. This will lower your stress level and help you stave off infection and mental stress.

8. Engage yourself with others and create a social life that you can rely on in times of need.

9. Pray every day.

10.Get restful sleep every night. Sleep is extremely important to health and wellness. Check out my April 16, 2009 entry entitled "If I Only Had a Good Night's Sleep" for more details on sleeping well.

Mother's Day

2009-05-08T18:04:00.001-07:00

I finally understand what it really means to be a parent. It cannot really explain it all but part of my definition is undying and unconditional love for their children. It means choosing my child first, before anything or anyone else.

Since I recently became a mom, I have even more love and respect for my own mother. All the love, time and energy she put into raising her three daughters amazes me now. The word mother has a deeper, personal meaning to me which I just could not conceive of before December 17, 2008. I would do anything for my daughter Elsa; I would sacrifice, or choose, what ever was necessary for her to live a healthy and happy life.

My experience with Elsa is just wonderful. She is such an amazing, wonderful person and I love each and every moment with her. What a joy and privilegeto be her mom.

Happy Mother's Day to all you moms out there! Enjoy your weekend with family and celebrate moms around the world.
Be Well.
Wendi

Gratitude

2009-05-01T07:01:00.000-07:00

Thankfulness. What does it mean to me?

I am grateful for ALL the many blessings I have. I am so thankful for my lovely daughter and husband. I am grateful for my health and my sharp mind. I am thankful for my cozy home and beautiful garden in my back yard. I am grateful for my job and supportive work environment. I am thankful for so much in life.

Sometimes I get into the groove of a busy work-home life that I forget just how wonderful my life really is. It is an amazing journey.

The great and the "not-so-good" events are all part of living a fulfilling life. If we didn't have the lows, we wouldn't appreciate the highs in life. I just think that we need to stop, take a good look at our lives from the outside through a new lens at times, especially when we think we are failing or life is failing us. Our situations are never really as bad as it seems to us in times of deep sorrow and stress.

The more I am grateful, the more blessings seem to come into my life as well.

And now for my declaration; I am committing to take time each day to give thanks to God and to meditate on it and my desires each day.

What are you thankful for?

Be Well.
Wendi

Top 10 Stress Busters

2009-04-23T13:23:00.000-07:00

Daily stress is a persistent problem for many people. As adolescents, we learn how to cope with stress and life's challenges; but sometimes stress builds up overtime contributing to both mental and physical problems such as anxiety and fatigue. Too much stress may lead to illness, both acute and chronic.
There is not a day that goes by where I don't hear someone's story of stress and anxiety. I talked about stress earlier in this blog, but this entry is dedicated to a simple list of my Top 10 Stress Busters to help relieve some built up stress.

Top 10 Stress Busters:
1. Exercise- physical activity increases endorphins, the feel-good chemicals released from the brain (which literally make you feel better). Ever noticed how much better you feel after a great hike or bike ride? It is from increased levels of serum beta-endorphin. Cardiovascular exercise, yoga, tai chi, dancing, lifting weights may all improve your mood and lower stress.

2. Call a friend-talking to friends/family really helps you get some of that stress off your shoulders.

3. Read a book- or go see a movie-getting lost in a novel or watching a movie is a great escape from all your worries. You find yourself lost in a story and soon forget about what you were worrying about.

4. A hot bath with aromatherapy- warm water is so soothing and relaxing. I can't tell you how good I feel after a warm, cozy bath with calming scents.

5. Massage-you can spend the money or just ask someone you know for a nice shoulder/back rub.

6. Play with your pet-animals are a great release for both the animal and you. Volunteer at a shelter for an afternoon if you don't have a pet, or even if you do. Time and energy redirected toward helping animals is a wonderful way to make you feel good, while doing good.

7. Reprioritize your time- take on the tasks that you are dreading and just get it done. If taking care of business will lower your stress level, then just take the time to do whatever it is you are avoiding.

8. Listen to soothing music-music therapy is another outlet for stress.

9. Take a long weekend away-getting out of town and into a relaxing one will help you clear your mind to approach problems through a new lens.

10. Deep breathing exercises/meditation- take 15-20 minutes a day to deep breathe and envision success, positive outcomes, and your ideal reality. This exercise really works.

Be Well.

If Only I Had a Good Night's Sleep...

2009-04-16T20:56:00.000-07:00

I can't tell you how many people I see in the office complaining of problems with sleep each week. Most often patients complain of waking up at night frequently or difficulty falling asleep. Their minds are racing thinking or worrying about problems, or they are just not getting restful sleep for a variety of reasons such as menopausal symptoms, urinary frequency or back pain.

As a new mom, I understand the importance of a good night's sleep. It has been over 8 months since I slept more than five hours straight. I used to wake up to use the bathroom when I was pregnant, now I am waking up to feed Elsa. My memory has suffered somewhat where I have to write everything down on my "list of things to do", otherwise it may just slip my mind. Lucky for me, I know this stage of parenthood is only temporary (and all new parents have experienced it).

But some people really have serious sleeping problems where their work, home life and health is severely impacted by lack of sleep. Such problems include sleep apnea, GERD, chronic pain and anxiety. Quality sleep is essential for a mental health, physical health and a well-balanced life.

I have pasted the sleep section of my book in progress below (in italics). I hope you enjoy reading it and it may help you get a good night's sleep.

Other online sleep resources:
The National Sleep Foundation http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2417141/k.27D9/Home_of_the_Sleep_in_America_Poll.htm The American Academy of Sleep Medicine

http://www.aasmnet.org/PatientsPublic.aspx
The American Sleep Apnea Association
http://www.sleepapnea.org/

Sleeping Well
The incredible benefits of sleep are so underrated. We need daily quality sleep to think and concentrate, and even more sleep to work and exercise effectively. Intuitively, we know we can’t function and live well without quality sleep.
Sleep is essential mental and physical rest for a healthy immune system, optimal thinking and body function as well as a positive, stable mood. Sleep is the time for your body and conscious mind to completely and thoroughly relax. Scientists do not completely understand the true purpose of sleep although there are theories such as promoting memory and energy conservation.3 Studies have proven that rapid eye movement (REM) sleep improves thinking, learning, mood, memory, body temperature regulation, exercise performance, as well as psycho-motor skills.4,5,6,7 Sleep deprivation puts us at risk for a multitude of problems: decreased alertness and energy, impaired cognition, decreased response or reaction time, poor immunity, increased appetite, high blood pressure, increased risk of Type 2 diabetes, increased inflammatory mediators in the blood, such as C-reactive protein and cytokines IL-6 , which contribute to arterial disease, and a higher risk of obesity are just a few consequences of lack of sleep. 8,9,10 Thus, sleep is a crucial cog in the wheel of wellness. Without adequate quality sleep we cannot live and be well.
The National Sleep Foundation recommends adults sleep at least 8 hours per night and teenagers sleep 9 hours.11 Approximately 66% of Americans are getting far less than that.9 In the 2006 Sleep in America poll, 45 % of adolescents reported inadequate sleep during the school week.12 In the 2007 Sleep in America Poll, about 67% of women surveyed had some sleeping problem a few times per week in the last month.13 Additionally, research studies have shown a significant reduction in the number of hours Americans sleep over the past 40 years.10
Why aren’t we getting enough sleep? Could we be a little anxious, ill, over stimulated at bedtime or stressed out? We may be excessively busy with work, school, and children, or live with a high level of stress/anxiety that stimulates our sympathetic nervous system too much. Lifestyles like these inevitably affect the quality and quantity of sleep.
According to Cole (2005) other factors that influence sleep quality are smoking, excess caffeine or alcohol use, exercising late in the day, uncomfortable room temperatures and bothersome light or noise.14 But there may also be pathological reasons for not sleeping well such as chronic pain, hyper or hypothyroidism, depression, anxiety disorders, sleep apnea or snoring.8
To top it off, there are several different types of sleep disorders such as jet lag, acute and chronic insomnia, obstructive sleep apnea and irregular sleep-wake syndromes. Possible causes of sleep disorders may include behavioral and environmental factors, medications, and medical or mental illnesses. In order to improve your quality of sleep, and your life, recognize the value of a good night’s sleep and seek medical attention if you have trouble sleeping.15 If you find yourself tired during the day, taking naps often, or wake up short of breath during the night, please see your health care practitioner for further evaluation.

Sleep hygiene
In order to have a good night’s sleep, some of us have to change our habits. Dr. David Neubauer (2005), for instance, recommends maintaining comfortable bedroom temperatures, using a “noise” machine to drown out other noises (such as a fan), and to wake up and go to bed at the same time each day to establish a regular sleep/wake cycle.16
Regular daily exercise
Regular meals without late night eating or drinking
Avoid excessive alcohol, nicotine, and caffeine use, especially several hours before going to sleep
Sleep in a dark, quiet room with a comfortable bed
Try relaxation exercises such as a warm bath, massage, and stretching before going to bed to quiet your mind
Do not read in bed…. keep your bed for sleeping and intimacy only
Wear comfortable clothing

References
1 American Heart Association. (2006). Diet and lifestyle recommendations revision 2006: A scientific statement from the American Heart Association Nutrition Committee. Circulation, 114, 82-96.
2 Franklin, B.A. (Ed.). (2000). ACSM’s guidelines for exercise testing and prescription. 6th Ed. New York: Lippincott Williams & Wilkins.
3 Ting, L. & Malhotra, A. (2005). Disorders of sleep: An overview. Primary Care Clinics in Office Practice, 32, 305-318.
4 Born, J. & Wagner, U. (2007). Sleep, hormones, and memory. Sleep Medicine Clinics, 2, 209-224.
5 Ellenbogen, J.M. (2005). Cognitive benefits of sleep and their loss due to sleep deprivation. Neurology, 64, E25-E27.
6 Malik, S.W. & Kaplan, J. (2005). Sleep deprivation. Primary Care Clinics in Office Practice, 32, 475-490.
7 Markov, D. & Goldman, M. (2006). Normal sleep and circadian rhythms: Neurobiologic mechanisms underlying sleep and wakefulness. Psychiatric Clinics of North America, 29, 811-853.
8 Basta, M., Chrousos, G.P., Vela-Bueno, A., & Vgontzas, A.N. (2007). Chronic insomnia and the stress system. Sleep Medicine Clinics, 2, 279-291.
9 Caples, S.M. & Somers, V.K. (2006). Sleep, blood pressure regulation, and hypertension. Sleep Medicine Clinics, 2,77-86.
10 Knutson, K.L. (2007). Impact of sleep and sleep loss on glucose homeostasis and appetite regulation. Sleep Medicine Clinics, 2, 187-197.
11 National Sleep Foundation (2007). How does sleep work? Retrieved December 16, 2007 from http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2420541/
12 National Sleep Foundation (2006). 2006 Sleep in America Poll. Retrieved December 26, 2007 from http://www.sleepfoundation.org/atf/cf/%7BF6BF2668-A1B4-4FE8-8D1A-A5D39340D9CB%7D/2006_summary_of_findings.pdf
13 National Sleep Foundation (2007). 2007 Sleep in America Poll. Retrieved December 26, 2007 from http://www.sleepfoundation.org/atf/cf/%7BF6BF2668-A1B4-4FE8-8D1A-A5D39340D9CB%7D/Summary_Of_Findings%20-%20FINAL.pdf
14 Cole, R.J. (2005). Nonpharmacologic techniques for promoting sleep. Clinics in Sports Medicine, 24, 343-353.
15 Åkerstedt, T. (2006). Sleepiness and circadian rhythm sleep disorders. Sleep Medicine Clinics, 1, 17-30.
16 Neubauer, D.N. (2005). Insomnia. Primary Care: Clinics in Office Practice, 32, 375-388.

Oh, My Aching Back

2009-04-10T13:47:00.000-07:00

This week I am writing about back injury prevention, since it has come up frequently at work this week. Musculoskeletal injuries are common; every week I treat someone complaining of low back pain or muscle strains or some sort. This past week I saw at least three patients with low back pain as their chief complaint. This blog entry will address how to help prevent these common injuries.

We all experience low back pain at some point in life. It is common to lift something heavy and feel the sudden pull or sharp pain in your low back. I lifted my daughter two weeks (she's only 9 lbs.) and ended up straining my low back. Here are some tips to help prevent low back injuries and reduce your risk of ending up in the NP's office.

Proper lifting techniques and a strong core may help prevent injuring your back.
Strengthening you core muscles (abdominals and back muscles) is essential for long-term injury prevention.
Maintaining a healthy weight where your BMI is between 19-24 is also important in injuiry prevention since being overweight or obese increase your risk of injuries in general.
Stretching your back and large muscles before and after exercise also helps reduce muscle strains. Some examples of stretches are hamstring stretches, cat-cow stretches and pelvic tilts. See the hyperlink for details. http://www.nismat.org/orthocor/programs/lowback/backex.html
Avoid high heels in general. It is bad for your feet, ankles, legs, hips and back.
Stand up straight! Good posture is extremely important for preventing injuries and height loss over time. Be sure to sit with your knees at a 90 degree angle and both feet flat on the floor while working at a desk. While driving, you need your low back supported. A low back support pillow is a good idea if your car seat is lacking lumbar support.
Dont' lift heavy objects alone. Ask for help.
Lift with your legs, not your back. Keep your knees bent and feet shoulder width apart before you bend to lift. See the hyperlink for more details. http://www.webmd.com/back-pain/lifting-properly-to-prevent-back-injury#tn9294
Lie with a pillow under your knees to take the weigth off your low back
Avoid sleeping on your stomach
Try yoga, tai chi or a regular whole body stretching routine twice a week to keep your increase your flexibility
Reduce your stress level. Sometimes we store our stress in our back and have aches without any injury

According to my sister, Johanna Lelke, DC, the best exercises to stregthen your core is a series of movements call "quadruped track". Start on your hands and knees raising one arm in front of you in line with your shoulders, then alternate. Next lift your legs alternating. Finally, lift one leg with opposite arm (one at a time). Dr. Lelke states that proprioceptive training and core stabilizing exercises are key to back injury prevention.

We only have one back for our entire life, so treat it with care. Always consult with your health care provider regarding any back pain. Here is some more information on how to prevent back injuries from webmd.com.
http://www.webmd.com/back-pain/tc/low-back-pain-prevention

Be Well and Happy Easter.
-Wendi

Vitamin D and You

2009-04-04T11:40:00.000-07:00

Vitamin D has been in the news lately and patients have been asking about supplements so I decided to comment on this topic today. This blog entry will address the importance of vitamin D, research on vitamin D deficiency, cancer link as well as the latest recommendations on supplementation.

Vitamin D is the general term given to a group of fat-soluble organic micronutrients which vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol) are the major types.1 Vitamin D3 is made in the skin through sunlight exposure and is also available from foods while vitamin D2 is made by plants and fungi.1, 2

What does vitamin D do for us?
-Deposits calcium and phosphorus in bones, cartilage and teeth
-Maintains blood levels of calcium and phosphorus
-Regulates absorption of calcium and phosphorus from the GI tract
-Helps in immune function
-Aids in cell growth regulation

Deficiency and Insufficiency of Vitamin D:
Vitamin D deficiency is quite common in the United States and believed to be due to lack of exposure to sunlight and poor intake.2,4,7,8,9 Ten to fifteen minutes of sun exposure (UVB rays) on the arms, face and hands 2-3 times per week is supposed to be enough for our bodies to make enough vitamin D, but research shows deficiencies in children and adults despite sun exposure.3,4,7

Deficiency of vitamin D (and calcium) may lead to rickets in infants and children and softened bones in adults called osteomalacia. Later in life, it may contribute to osteoporosis (loss of bone mass). Signs of rickets include bowed legs, curved spine, muscle weakness, cranial deformities, delayed closure of skull bones, low blood calcium, and delayed growth.

Once vitamin D2 and D3 is absorbed in the small intestine, they are converted to hormone forms of vitamin D. The active form is vitamin D 1,25-dihydroxyvitamin (calcitriol), while the inactive form is 25-hydroxyvitamin D (calcidiol).2

Blood levels of 25-hydroxyvitamin D are used to determine deficiencies. Vitamin D 25-hydroxy levels represent current dietary and skin production levels (about the past two to three weeks).2,3 Unfortunately there are no universal parameters to determine vitamin D deficiency and values may vary on which laboratory you are using.2, 3 Deficient levels are generally <20 ng/L, while insufficient levels are between 20-30 ng/L and sufficient vitamin D is above 30 ngl/L (75 nmol/L).2 Levels over 150 ng/mL are considered toxic.9 I regularly check vitamin D levels in menopausal women and older adults and recommend supplementation based upon lab results.3

What are vitamin D supplement recommendations and food sources?
The National Academy of Sciences recommends 5 micrograms (200 IU)/day of vitamin D for ages 9-50 yrs, 10 micrograms (400 IU)/day for ages 51-70 yrs and 15 micrograms (600 IU)/day for over 70 yrs. The Tolerable Upper Intake Level is 2,000 IU/day.5,6
It is not easy to achieve toxic vitamin D levels. Supplementing vitamin D in high doses such as 10,000 IU/day over a long period of time will cause toxicity, not 2,000 IU per day.9

Recently, The American Academy of Pediatrics changed its recommendations for infants to supplement breast fed infants 400 IU/day of vitamin D due to an increase in prevalence of rickets.10

What is the connection of vitamin D to chronic conditions and cancer?
Research shows a link between vitamin D deficiency and increased risk of colon cancer, periodontal disease, breast cancer, prostate cancer, ovarian cancer, autoimmune disorders such as rheumatoid arthritis, diabetes mellitus, obesity, and cardiovascular disease.7,8,9 One study found that vitamin D deficiency doubled the risk of colon cancer in the study participants.9 Although no causal relationship has been found in hypovitaminosis D and cancer. Research has shown benefits in calcium and vitamin D supplements in reducing blood pressure, colon cancer risk, reduced risk of diabetes, and improved mood.1,8,9,11

What are food sources are rich in vitamin D?
Fortified cereals
Fish oil- 1Tbsp has 1350 IU
Egg yolk- 260 IU
Milk- 100 IU/cup
Salmon
Codfish
Cheddar cheese
Fortified orange juice- 50 IU/cup
Fortified yogurt
Fortified soymilk

Vitamin D is essential for a healthy body and mind. I take vitamin D supplements in the amount of 1,400 IU per day. Eating a well-balanced diet rich in vitamin D is important for long-term bone health and may even help reduce risks of cancer.

Be Well.
Wendi

References
1 Deen, D. & Hark, L. (2007). The Complete Guide to Nutrition in Primary Care. Malden, Massachusetts: Blackwell Publishing Ltd.
2 Wolpowitz, D. & Gilchrest, B. (2006). The vitamin D questions: How much do you need and how should you get it? The Journal of American Academy of Dermatology, 54, 301-317.
3 Rao, S., Singh, M., Parkar, M. & Sugumaran, R. (2008). Health maintenance for postmenopausal women. American Academy of Family Physicians, 78, 584-591.
4 Binkley, N., Novotny, R., Krueger, D., Kawahara, T., Daida, Y., Lensmeyer, G., Hollis, B. & Drezner, M. (2007). Low vitamin D status despite abundant sun exposure. The Journal of Clinical Endocrinology & Metabolism, 92, 2130-2135.
5 National Academy of Sciences (2005). Dietary reference intakes: Macronutrients. Retrieved November 18, 2007 from http://www.iom.edu/Object.File/Master/7/300/Webtablemacro.pdf
6 Duyff, R.L. (2006). American Dietetic Association Complete Food and Nutrition Guide. 3rd Ed. Hoboken, NJ: John Wiley & Sons, Inc.
7 Kim, D., Sabour, S., Sagar, U., Adams, S. & Whellan, D. (2008). Prevalence of hypovitaminosis D in cardiovascular disease (from the National Health and Nutrition Examination Survey 2001 to 2004). American Journal of Cardiology, 102, 1540-1544.
8 Lee, C. & Majka, S. (2006). Is calcium and vitamin D supplementation overrated? Journal of the American Dietetic Association, 106, 1032-1034.
9 Garland, C., Garland, F., Gorham, E., Lipkin,M., Newmark, H., Mohr, S. & Holick, M. (2006). The role of vitamin D in cancer prevention. American Journal of Public Health, 96, 252-261.
10 American Academy of Pediatrics. (2008) New Guidelines Double the Amount of Recommend Vitamin D. Retrieved April 4, 2009 from http://www.aap.org/pressroom/nce/nce08vitamind.htm
11 WebMD Health News. Vitamin D May Ease Depression. Retrieved April 4, 2009 from http://www.webmd.com/depression/news/20040803/vitamin-d-ease-depression

Occupational Wellness-Does It Really Exist?

2009-03-27T08:49:00.001-07:00

Layoffs, pay cuts, depression, anxiety and stress have been major themes with my patients this week so I thought I would touch on my fundamental of holistic health called "occupational wellness" this week. I will address what I have been through regarding previous jobs/careers and what I mean by occupational wellness.

It's scary now with so many layoffs and foreclosures in the Bay Area. I can't even count how many of my patients have lost their jobs and are scared about their future, finances and their family.

If I may offer one piece of advice to anyone going through a job loss or any crisis for that matter; a positive attitude has a significant influence in getting through any challenge. It's not the only factor, of course, but attitude impacts how you perceive everything in your life. My point? Try and focus on the positive things in your life now, be grateful for what you have today, while working toward your financial and occupational goals.

In a perfect world, we would all do the work we loved for excellent pay. But that is not the reality for many. I am fortunate to be able to say that I have a job I love as well as a great boss. But I could not have said this more than two years ago. -I spent 18 years doing things I never imagined I would to pay my way. Let me share my job history with you to let you know that you are not alone.

I have had a myriad of positions over past twenty years....so many I can't even count them. I started working at age 12 babysitting and never looked back. I've done everything from dish washing to tutoring, from waiting tables to teaching outdoor education, from working as a barista to environmental consulting. I lost jobs and had to find less than glorious positions to get by. But I was lucky then because I didn't have a mortgage or a baby. Now, it's another story.

I also earned three college degrees before I finally got it right. I started out in engineering and ended up with three degrees: soil science, kinesiology and nursing. My master's degree in nursing as a Family Nurse Practitioner got me to where I can say "I love my job." But it took years in school and thousands of dollars for me to get it. -All I can do is laugh and smile when I reflect on my path to self discovery. It was a long journey and I never stop learning through it all.

I am going to paste a section of my book in progress below (in italics) to explain what I mean by occupational wellness. It is an idealistic view in these challenging times but I still believe you can have an occupation you love and make it work for you (no pun intended!).

The occupation we choose greatly affects our health in all five areas. The combination of social and occupational environments dictate what and when we eat, sleep, who we interact with, attitudes, belief systems...basically, everything in daily life. This fundamental of wellness will either enhance or detract from our sense of self-worth, self-confidence and ultimately, health and happiness.

For younger people, the occupation may be student and for retired individuals it may be volunteer work, hobbies or travel. An occupation does not have to be a paid job. However, your occupation should be something you enjoy. It is the “work” people do that influences values, self-worth, self-confidence and most importantly, health. Social and occupational wellness complete the circle of wellness and is usually omitted in other programs and philosophies.

Some good books that may help you with you perceptions on your life are the following:

The Power of Positive Thinking by Norman Vincent Peale
The Tough-Minded Optimist by Norman Vincent Peale
Prayer Works by Robert Collier
The Wisdom of Florence Scovel Shinn by Florence Scovel Shinn

One good thing about difficult times is that is can only get better.
Expect the best each day and it will come.

Be Well,
Wendi

Stay tuned for information on vitamin D in my next blog.

Spring into Action

2009-03-20T18:17:00.001-07:00

It’s the first day of spring! One of my favorite seasons-the flowers are blooming and it's a great time to meet new people and engage in outdoor sports and social activities with the winter blues finally behind us.

I’m planting my herb garden this weekend. Basil, mint, and chives are my top choices. There’s nothing like picking fresh herbs from your own garden to add some flavor to homemade meals.

I am fortunate to live in a climate with a year-round growing season. Did you know you can burn 200-300 calories an hour while gardening? There’s nothing like working the soil with your hands.

But if you don’t have an outdoor garden or if you live in a colder environment, try creating a potted herb garden in your kitchen window. You can watch them grow as you wash you dishes. You may also look into gardening at a community garden where share a plot planting vegetables and flowers with others in your neighborhood. -It is so therapeutic to be outside working with nature and neighbors alike.

Check out this link on community gardening:
http://www.oaklandnet.com/parks/programs/communitygardening.asp

I also think spring is the best time to take up new sports such as tennis, swimming, cycling or golf. I just bought my first tennis racket and have been out on the court a couple of times this week. –Tennis gives me a great workout and allows me to spend time with my husband while the baby sleeps nearby in the stroller. (You can burn 300-600 calories an hour playing tennis too.) Learning new motor skills stimulates your brain's memory cells and is great for longevity.

Spring into action this week and do something you have never done before…join a club, strike up a conversation with a stranger in line with you, try a new sport. Smile and be well.

-Wendi

Reducing Stress in These Tough Times

2009-03-14T12:56:00.000-07:00

Many people are experiencing increased levels of stress and anxiety related to job losses, foreclosures, bank bail outs and other financial difficulties. Although we can not change the economic climate overnight, we can change what we focus our attention on and try to relieve some built up stress. How you may wonder? -Through a variety of mental, social and physical exercises.

First, try waking up with the thought that today is going to be a great day. Believing you will have a positive day starts you off in that direction mentally and will more likely follow through to reality.

Exercise regularly to increase your endorphins and reduce stress. I can’t tell you how important exercise is to a healthy body and mind. You will feel better afterward. Go for a walk when you feeling angry, sad or irritable. It will have a positive effect on your mental state. Pair up with a friend to talk to on your walks.

Try relaxation exercises when you feel your body responding to your negative thoughts or feelings. Close your eyes, deep breathe and count to 100; you will slowly feel your body relax and your emotions become more controlled as you breathe out the stress and in fresh air. Going outdoors to do this exercise may be more relaxing.

Aromatherapy is another method to help relax you after a long day. Scents such as lavender, vanilla and mint in your bath, body lotions or candles may have a calming effect on your emotions. Choose the scents that you feel make you calm and at ease.

Stretching also releases cumulated stress in your body. Lie on the floor and try some upper and lower body stretches to physically relieve tension in your muscles and tendons. Deep breathe throughout your stretches. Taking a hot shower before hand also helps soothe tight muscles.

Call a friend/family member for support. Connecting with supportive, positive family and friends surely reduces anxiety and stress.

Read a book, do a cross word puzzle or play your favorite card game. Focusing on games or reading will take your mind off your worries and stimulate your brain. Group board games or playing cards is a healthy social outlet as well.

Consulting with your health care provider is important, especially if your stress and anxiety are interfering with your life. There are many treatment options available.

Don’t worry your life away. Seek help if you feel you need it.
Be Well.
Wendi

Top 10 Ways to Lose Weight

2009-03-05T15:11:00.000-08:00

I returned to work this week from maternity leave, and the number one question asked by women during their yearly physicals was, “How do I lose weight?”. It is time to let you all know my top 10 tried and true tips to losing weight.

1. Eat Less! Consume about 500-750 less calories per day and this will add up to 1-1.5 pounds of weight loss per week.
2. Exercise! Regular exercise is key to burning more calories and speeding up your metabolism. Start slow and build up to 40-45 minutes of cardiovascular exercise 5 days per week.
3. Log EVERYTHING you eat. Write it all down. You will soon be surprised when you discover the amount of food and total calories you were taking in by the end of the day.
4. Eat three meals a day with snacks, or 5-6 small meals throughout the day. Fresh raw vegetables are a light, healthy snack to have when you are hungry. Just avoid the heavy dips.
5. Eliminate alcohol from your diet. Alcohol is excess calories, and extra calories means excess weight. So whenever you want to lose weight, always avoid alcohol and drink water instead. Water is the best fluid for your body.
6. Eat protein with every meal. Protein increase satiety, rather than fat or carbohydrates. Eat your breads, rice, pasta dishes before 4 pm, and focus on vegetables and protein, such as tofu, egg whites and fish for dinner.
7. Eat breakfast! Breakfast jump starts your metabolism and increases your energy level. Those that skip breakfast actually weigh more on average than those whom eat breakfast daily.
8. Interval training increases your metabolism by burning more calories during and after exercise. Try doing sprints for 30-60 seconds throughout your cardio workouts to burn more calories and increase your metabolism when you are not working out.
9. Eat when you are hungry, not if you are bored, stressed, tired or angry. Create a healthy plan to follow when you are upset or stressed so you don’t eat. Try reading a book, meditating, doing yoga or calling a friend. Go for a walk if you are stressed out and wanting to snack to feel better. The idea is to have an outlet other than food.
10. Use a small plate for your meals so you don’t fill the entire large plate with food. This trick trains you to eat less with each meal. But it only works if you avoid second helpings and all your sauces and dressings are on the side.

Social Wellness Succinctly

2009-02-24T15:56:00.000-08:00

Surrounding yourself with optimistic, supportive and encouraging people is fundamental for positive personal growth and development as well as emotional and mental health. We all need people to be well and healthy. However, you have a choice of who you socialize with, develop close relationships with and how/whom you spend your time and energy.
It is so important to feel respected, happy and calm when you are around co-workers, friends and family. If you don’t feel good spending time with someone, don’t do it. I’m not saying you need to be bouncing off the walls with excitement, but I am saying that your time valuable, so don’t waste it on people that bring you down with negative energy. Be true to yourself about who you feel is worth your time.
Studies have proven that healthy human relationships affect mental and physical health.1 Socializing, whether it be volunteering in the community, going to church or synagogue, attending a weekly card-playing group, shopping with your friends, or participating in group sport/exercise activities such as biking, hiking or jogging, improves your mood and physical health. Spending time with happy, positive people in general, makes you happy too.2 A recent study published in the British Medical Journal discussed in the February 10, 2009 issue of the San Francisco Chronicle states, “that knowing someone who is happy makes you 15.3 percent more likely to be happy yourself.”2 According to this study, happiness is, in a way, contagious.
Dr. Ryan Howell’s research showed that life experience brings happiness rather than material things because of the social aspect.3 Think back to the best vacation you ever had. Are you thinking of the people you shared it with, or the clothes and watch you wore? Hopefully, the former.
Some unsolicited friendly advice….call or write a letter (not Email) a friend or family member whom you haven’t spoken to in some time. Make plans with them to meet again soon. It will make both of your days better.

References
1 Herzog, A., Ofstedal, M., & Wheeler, L. (2002). Social engagement and its relationship to health. Clinics in Geriatric Medicine, 18, 593-609.
2 Morago, G. Spirits say in survey, but you can improve your mood. San Francisco Chronicle, February 10, 2009.
3 Roan, S. Experiences prove better boost. San Francisco Chronicle, February 10, 2009.

The Skinny on Omega-3 Fatty Acids

2009-02-22T13:17:00.000-08:00

By Wendi Lelke-Wallway, MSN, FNP

What is the buzz all about with omega 3 fatty acids? Have we discovered something radically new about these fats? How do omega-3’s affect our health? This Be Well blog entry reveals the truth about omega-3’s and much more about fat in our diet.
Triglycerides (AKA fats, fatty acids) are one of the three macronutrients; carbohydrates and proteins are the other two. Triglyceride is chemically a glycerol with three fatty acids attached. Fats play significant roles in our body. Fat protects the body from injury, transports vitamins A, D, E, and K, through the blood stream, provides energy, a whooping 9 kcal/gram, insulates the body to maintain heat, helps to satisfy hunger, and maintains cell structure and function as member of phospholipids in cell membranes.
Types of Fats
There are several different kinds of fats: trans fats, saturated fats, monounsaturated fats and polyunsaturated fats. Not all fats are the same-they are found in different food sources and act differently in the body. Saturated fats and trans-fats are the least healthy because they may increase cholesterol and triglycerides levels in our bloodstream, which ultimately increases risk of heart disease.1 These fats are in mainly animal sources such as poultry, dairy, meat however they are also found in coconut and palm oils. Trans-fats may even lower HDL (“good”) cholesterol which increases risk for inflammation and heart disease.1,2,3,4 Trans fats are mostly found in processed foods such as crackers, cookies, fried foods and pastries, but they are also in beef, butter and pork.
Polyunsaturated fats and monounsaturated fats are the healthiest fats because they lower cholesterol and clotting factors in the blood, as well as act as antioxidants.18 Higher amounts of monounsaturated fats (“good fat”) are found in canola oil, olive oil, flaxseed oil, avocado and nuts such as peanuts, almonds and macadamia. These fats have the added benefit of lowering LDL cholesterol and triglycerides in the blood. Monounsaturated fats are also in dairy products, meat and other animal sources. Monounsaturated oils provide phytochemicals-non-nutrient chemicals that act as antioxidants and reduce inflammatory reactions in the body. Monounsaturated and polyunsaturated fats, compared to trans and saturated fats, are the healthiest fats for you.
Omega Fatty Acids
Our bodies can make all but 2 types of essential fatty acids, linolenic acid (omega-3 fatty acid) and linoleic acid (omega-6 fatty acid). These polyunsaturated fats are incorporated into the phospholipid layer of cell membranes and actually compete with each other for cell sites.5
There are three main kinds of omega-3 fatty acids: (a) α-linolenic (ALA), (b) eicosapentaenoic acid (EPA), and (c) docosahexaenoic acid (DHA).5 Omega-3’s make up the cell membranes of the retina, brain and myocardium and are especially important for developing fetuses. EPA and DHA are found in fish such as salmon, mackerel, trout and tuna, while ALA is in plant sources such as flaxseed, canola oil, walnuts and soybeans. Our bodies naturally convert ALA to EPA and DHA for use in the body. Although, it is unknown how much EPA and DHA is made through the conversion of ALA.
Eicosanoids are chemicals made from EPA and arachidonic acid, common type of omega-6.6 Generally, eicosanoids made from omega-3’s are anti-inflammatory in nature, and those from omega-6 are proinflammatory.7 Arachidonic acid, stimulates inflammatory mediators in the body when activated.
Omega-3’s are “anti-inflammatory” in action because compete with arachidonic acid for the enzymes that make inflammatory mediators. Eiconsanoids made from omega-3’s inhibit clot formation in the blood stream, help prevent cardiac arrhythmias, lower blood pressure and reduce production of markers for inflammation.6,7 Therefore a diet rich in omega-3’s, EPA and DHA, is “cardioprotective” and lowers your risk for cardiovascular disease. 5,7,8 In fact, 1 gram per day of fish oil supplements are recommended for some patients with cardiovascular disease.7 A diet rich in omega-3’s may also lower serum triglyceride levels, therefore, fish oil supplements are sometimes recommended by qualified health care providers for patients with high serum triglycerides in the doses of 2-4 gm/day.7 Studies show that omega-6 FA’s have the potential to lower LDL-cholesterol, but they may also lower HDL. It is believed that the optimal dietary ratio of omega-6 to omega-3 is 4:1.9
Dietary sources of omega fatty acids
When it comes to choosing foods full of healthy mono and polyunsaturated fats, select nuts, soy products, seeds, olive oil or nut oils and limit intake of processed foods, cholesterol and saturated fats.10 Vegetarian sources of omega-6 acids include sunflower, soybean, corn and safflower oils, seeds and nuts (Table 1). Omega-3 packed vegetarian foods include flaxseed, soybean/tofu, canola oil, walnuts and algae (spirulina and Crypthecodinium cohnii).1,5,11 Walnuts and flax seed have the most ALA per gram compared to soy and canola oil.12 For example, one tablespoon of ground flaxseed provides 3.8 grams of ALA and one ounce of walnuts provides 2.6 grams ALA compared to just .6 grams in 1 tablespoon of canola oil.9 A great breakfast packed full of omega fatty acids and antioxidants is oatmeal and soymilk topped with flaxseed, blueberries and walnuts.

Intake recommendations:
There are several recommendations by nutritional organizations regarding daily intakes of fats. According to the 2005 Dietary Guidelines, approximately 20-35% of our daily calories should come from fat, with less than 7% from saturated fats.12,13 Vegetarians should consume omega-3 FA’s totaling 1-2% of total calories per day.14 The International Society for the Study of Fatty Acids and Lipids recommends 500 mg per day of omega-3’s.5 The American Heart Association (AHA), American Dietetic Association (ADA) and Dieticians of Canada recommend eating two servings of fish per week which equates to approximately 500 mg of EPA and DHA per day.8,15 The Vegetarian Society recommends about 4 grams/day of ALA (1.5% of total calories), which they claim is enough ALA for the body to make EPA and DHA.9 Supplementing with 1 gram/day of EPA and DHA is recommended by the ADA if your diet is deficient in omega-3’s. Algal supplements rich in EPA and DHA are available over-the-counter for vegetarians to be sure they are getting enough omega-3’s.
Fats are an essential part of our diets. They are necessary for energy, cell membrane structure and function, vitamin transportation and countless chemical reactions in the body. Omega-3 fats are essential fats so they must be obtained from food. Eating the majority of fats from monounsaturated and polyunsaturated fats will lower risks of high cholesterol, inflammatory markers and heart disease. Following a nutrient rich, balanced lacto-ovo vegetarian diet will give you plenty of energy, fiber, protein and nutrients.

References
1 Duyff, R.L. (2006). American Dietetic Association Complete Food and Nutrition Guide. 3rd Ed. Hoboken, NJ: John Wiley & Sons, Inc.
2 Kromhout, D. (2001). Diet and cardiovascular diseases. The Journal of Nutrition, Health, & Aging, 5, 144-149.
3 Murray, S. & Flegel, K. (2005). Chewing the fat on trans fats. Canadian Medical Association Journal, 173, 1158-1159.
4 Stone, N.J. & Kushner, R. (2003). Effects of dietary modification to reduce vascular risks and treatment of obesity. Cardiology Clinics, 21, 415-433.
5 Surette, M. E. (2008). The science behind dietary omega-3 fatty acids. Canadian Medical Association Journal, 178, 177-180.
6 Whitney, E. and Rolfes, S.R. (2005). Understanding Nutrition. (10th Edition) Thomson Wadworth. Belmont, CA.
7 DeFilippis, A.P. & Sperlin, L.S. (2006). Understanding omega-3’s. American Heart Journal, 151, 564-570.
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Be Well debut

2009-02-19T12:50:00.003-08:00

Be Well is my philosophy of holistic health and wellness which I discovered after years of education, healthcare experience, research and my personal journey.
My five fundamentals to Be Well include:

nutrition-vegetarian style
balancing activity and rest
mindful health-mental and emotional well being
social and occupational wellness
spiritual well-being

A balance of these areas is what being well is to me. I will be blogging about topics that fall under any of these five fundamentals.

I am working my hardest now to stay in balance as I am a new mom. My daughter, Elsa, is the greatest and I am enjoying every moment of newly found motherhood. She keeps me in "the now" like I have never been before. I thank God for her every day.

Now regarding my vegetarian lifestyle-I have been a vegetarian since 1992 and never been more healthy since I made the switch. I follow a lacto-ovo diet for a variety of reasons. Mainly, I despise the thought of eating meat or poultry...the conditions of raising animals for slaughter...no thanks. Not to forget all the processing and added hormones wasted water and natural resources for raising animals to eat just doesn't make sense to me. So for me, a vegetarian diet works.

A great cookbook I found is The Tropical Vegan Kitchen by Donna Klein. Excellent recipes from around the tropics for healthy meals.