Live Well Ohio: December 2015

News + Notes
From the Ohio Department of Health

While falls can be dangerous for anyone, they are particularly harmful to older adults. Falls and fall-related injuries can seriously affect your quality of life and potentially even lead to death. The good news is falls are not a normal part of the aging process and can be prevented by taking the proper precautions. The following are some simple steps to help prevent falls this winter.

Bundle up, but make sure you can see in all directions and move easily and freely. Wear sturdy shoes or boots, and make sure they have good tread. Wear sunglasses during snowy winter days to help reduce the glare on surfaces.

Slow down and pay attention to how and where you’re walking.

Keep sidewalks and stairs outside your home clean of ice and snow, and keep clutter out of walkways inside.

Carry a small bag of salt, sand or kitty litter in your coat for traction on icy paths. Be sure to replace worn rubber tips on canes, walkers and crutches.

Carry a cellphone and designate someone to call for help if you need it. Let loved ones know when you are leaving the house and when you will be back. Call them when you return.

Do some light stretching before you venture out. Also, drink plenty of water to prevent dehydration, which affects balance. Stay active to maintain strength.

Attend a balance and exercise program designed to help build balance, strength and flexibility.

Review your medications with your healthcare provider to ensure that none of your medications’ side effects increase your risk of falling.

Get your vision and hearing checked every 12 months.

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Flu Prevention
It’s one of the worst parts of winter: The fever, cough, sore throat, runny nose and body aches that are the telltale signs of flu.
Here’s why you should get the vaccine.

Who Should Get Vaccinated: Health officials recommend everyone 6 months and older get a flu vaccine every winter. Young children and older adults, as well as those with certain health conditions, are more susceptible to flu. The upcoming season’s flu vaccine will protect against the influenza viruses that research indicates will be most common during the season. This includes an influenza A (H1N1) virus, an influenza A (H3N2) virus, and one or two influenza B viruses, depending on the flu vaccine.

Flu Versus a Cold: The flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness and dry cough are more common and intense. Colds are milder and cause a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections or hospitalizations.

Potential Complications: Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetes.

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Menu Options 

There’s no way you’re going to stick to your usual eating routine this time of year, but you can make choices that’ll help keep your weight in check.  

Holiday meals are pleasurable affairs, with familiar dishes crowding the table and our loved ones at our side. But they’re also rough on the waistline. The average American consumes 4,500 calories and 229 grams of fat during a typical holiday get-together, according to the Calorie Control Council, an association that represents makers and suppliers of low- and reduced-calorie foods and beverages.

“Eating is social, it is pleasurable, and we need to let ourselves enjoy that,” says Selena Baker, nutrition counselor with Ohio University’s WellWorks wellness program in Athens. “When we get into that mindless eating, and we keep grazing or we eat until we are uncomfortably full, then it becomes a problem.”

Here are some pointers for navigating the holiday table this year, as well as ideas for preparing healthful versions of perennial favorites.  — Kara Kissell

SIDE DISHES

Avoid This: Jane Graffin, clinical nutrition manager at Wood County Hospital in Bowling Green, advises staying away from casseroles or dishes that have heavy creams, sauces and butters. “Those are some main culprits that cause a lot of the calories,” she says. She also suggests foregoing the roll or the extra piece of bread, which can run anywhere from 80 to 120 calories. “Have that be one of the things that you limit other than limiting some of your favorite holiday traditional foods.”

Try This Instead: Helen Lange, clinical dietitian with Berger Health System in Circleville, suggests going with either sweet or white mashed potatoes and sticking to one scoop. “Keep your portions small, less than the size of your fist total,” she says. The cook can make meaningful choices, too. “Make a savory sweet potato recipe [instead of candied yams],” suggests Lange. “Use evaporated milk and light sour cream to make your mashed potatoes creamy.”
For those who simply can’t skip the stuffing this time of year, Lange suggests a portion no larger than a deck of cards. “If you are the cook, add extra celery, onion, and even additional vegetables to your stuffing and less bread and butter.”
Graffin suggests trading the green bean casserole for sauteed or steamed vegetables, or make a less-creamy preparation. “When I do [green beans], as a fat I use a couple tablespoons of olive oil along with some almonds,” she says. Almonds offer the same crunch as fried onion strips while also containing heart-healthy monounsaturated fats.

GRAVY

Avoid This: There’s no way around it, traditional gravy is as delicious as it is bad for you. “Your sauces and gravy, and items like that, can pack a lot of calories depending on how you prepare them,” cautions Baker.

Try This Instead: “Choose heart-healthy fats that are anti-inflammatory like avocado oil, olive oil, canola oil and grape seed oil [when preparing dishes,]” suggests Baker.

She makes vegetarian gravy during the holidays, using garbanzo bean flour and equal parts Smart Balance margarine substitute and olive oil for the base. She then adds garlic powder, soy sauce and vegetable broth and lets the mixture thicken up. “It is an absolutely delicious gravy,” Baker says.
 
If you simply can’t give up the gravy, Lange suggests refrigerating and then skimming the fat before serving. Or, you could stick with turkey’s other sidekick: cranberry sauce. “It is going to have a lot less fat,” Graffin says, but adds that you should limit yourself to just a couple tablespoons because of the sugar content.

MAIN DISHES

Avoid This: It would be foolhardy of us to suggest you skip the holiday table’s culinary centerpiece: a roasted bird. But easy choices about how you consume it can instantly cut calories.

Try This Instead: “Choose white meat over dark meat,” says Lange. “Also, choose pieces without skin or remove the skin before eating.” This switch alone can save almost 50 calories and two grams of saturated fat per four ounces of turkey meat.

DESSERTS

Avoid This: Don’t overindulge when it comes to dessert. “We are biologically wired to seek out sweet flavors,” says Baker. “What we have to think about with desserts is really being mindful about what dishes do we really want to have?”

Try This Instead: “Choose pumpkin or apple pie over pecan,” suggests Lange. “Make your pumpkin pie crustless to make it healthier, [and] use less sugar in your fruit pies.”

For hosts, Baker suggests cutting the pie into smaller pieces and serving it alongside fresh fruit. “That is a lot more satisfying than an empty plate with one little piece of pie in the middle,” she says. “[And the] fruit is actually getting some good nutrition in there.”

Graffin’s healthful tweak to her grandmother’s fruit salad brings down the family favorite’s sugar and fat content. “I use vanilla sugar-free pudding for it so we’re not adding a lot of sugar,” she explains. “And it doesn’t have any fat in it.”

Graffin makes her pudding using pineapple juice, and although all of the fruits and juices carry a high number of calories, they are beneficial. “There are a lot of natural sugars in there, but there are vitamins and minerals in there, too.”

DRINKS

Avoid This: “Eggnog and alcoholic beverages … punches and sodas all have added sugars and can be high calorie sources,” says Baker.

Try This Instead: Baker suggests a hot mulled cider, which delivers comforting seasonal flavors but doesn’t have sugar added. “Or, get a nice Christmas blend [tea] or an herbal tea,” she says, “something to settle your stomach after dinner that has a nice flavor but doesn’t have any caffeine or calories.”

Another of Baker’s go-to beverages is La Croix sparkling water, which packs an appealing sweetness but is sugar, sodium and calorie-free. “Kids will enjoy them, too, because they have enough flavor that it is like a sparkling juice,” she says.

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Seasonal Strategy
If you need a game plan for your holiday meals, these tips will keep guilt from creeping onto your plate.

Keep It Fresh: Salads are nutrient-packed and low-calorie, but they lose their healthy benefits when they end up swimming in dressing. “Putting your dressing on the side … and doing the fork dip is really [effective],” says Ohio University nutrition counselor Selena Baker.

Balance Your Meal: are the thing that really get us into trouble,” says Jane Graffin, clinical nutrition manager at Wood County Hospital. Berger Health System clinical dietitian Helen Lange gets specific with a helpful visual: “Your plate should be half vegetables and fruits, one quarter protein and one quarter starches, such as potatoes and stuffing.”

Be Social: “Focus on your conversation, focus on the family, rather than the act of eating,” suggests Graffin. “If you do that and eat slowly, the brain kicks in and says, ‘You’re full.’ ” Graffin explains that it takes the brain anywhere between 15 to 20 minutes to recognize that the stomach has taken in enough food.

Forgive Yourself: From time to time, you end up overindulging despite your best intentions. Baker says it’s important to be ok with it. “It’s realizing that, if I ate too much today, I am going to take a walk after dinner and tomorrow is a new day,” she explains. “Give yourself that permission to slip up once in a while, as long as it’s not the trend.”

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Toy Talk 

Three experts share their ideas for enriching and educational toys, whether you’re buying for toddlers or preteens.

Toys are on the mind of every child, so naturally it’s the gift most people turn to when shopping. Although store shelves are lined with colorful and musical games and figurines, some toys are better than others when it comes to stimulating young minds.

“It is important to find toys that foster interaction with others,” says Carolyn Ievers-Landis, licensed clinical psychologist at University Hospitals Rainbow Babies & Children’s Hospital. “Children don’t need a huge amount of toys. It can actually be very anxiety provoking, overwhelming and overstimulating for young children if your bedroom is so filled with stuff you don’t even know where to start or what to play with.”

We asked Ievers-Landis and two other child specialists for advice on choosing gifts that will enrich kids.  — KK

Infants
“We really look for toys that are comfort items and provide self-regulation skills — the ability to calm themselves down and to figure out the world through their senses,” says Julie Snider, child life specialist at Nationwide Children’s Hospital.

She points to teething necklaces: colorful pieces of jewelry made from silicone or amber that are worn by the mom but pacify the baby. Also on Snider’s list is the popular Sophie the Giraffe, a charming teething toy that also squeaks.

“Things like rattles or toys that they hold ... or attach to their hands help them master body awareness and motor control,” adds Beverly Hubbard Smolyansky, staff psychologist at Cincinnati Children’s Hospital Medical Center.

Toddlers
“If you think developmentally about what a toddler is doing, they are getting better motor skills,” says Smolyansky, adding that she loves the multipurpose sensory tables that allow children to play with sand or water. “It is stacking and dumping, filling and dumping, knocking things over. That is their goal. That is their job right now.”

And, as any parent who has raised one knows, toddlers are on the move, and there are toys suited to encourage that.

“To give toddlers a workout, buy them a crawling tunnel,” says Snider. “It’s hard to take them outside in the cold winter months in Ohio. But a fun crawling tunnel, where they figure their way inside and out, [will get them using] their large muscles to move.”

Preschoolers
“With preschoolers, you really want to focus on building their imagination and utilizing their make-believe play,” says Snider. “They are figuring out the difference between reality and fantasy, so the more imagination opportunities that they have, the better.”

She says make-believe animals such as Fur Real Pets are popular with little ones. The animals make noises and move, requiring kids to evaluate the differences between the pet and real-life ones. “It’s really good for their development to figure out what is real and what is fantasy,” Snider says.

Ievers-Landis adds that another way to encourage a preschooler’s imagination is through an experience, be it a visit to an excursion railroad’s Thomas the Tank Engine weekend or a trip to a teahouse for a real-life tea party.

Preteens
For preteens, it’s important to focus on the development of social skills. In a world filled with iPads, kids are not always making those connections.

“Building sets are really huge, and I would recommend doing that with a friend or doing that with parents,” Snider says. Roominates are building sets in pastel colors that are meant to appeal to girls. They ask the user to serve as an architect or an engineer as they follow the directions and think critically to build a Ferris wheel or rooms of a home. “It’s a really great way to connect,” Snider adds.

Ievers-Landis also suggests gifts such as sleds, snowshoes, cross-country skis or even just warm coats, which will encourage kids to get outside during the cold-weather months, especially if the family does so together.

“You can say, ‘Yeah, it’s winter, but we as a family go sledding or we go out skiing or we go out in our snowshoes tromping around,’ ” she adds.

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Guidance & Growth
A statewide initiative helps soon-to-be and new moms and dads navigate the world of raising little ones. Shaniya and Charles Barnes’ family is one of more than 9,000 across Ohio currently benefiting from the program.

Shaniya Barnes was still getting a grasp on motherhood when she found out that she was expecting her second child. Her first son, Charles Jr., was just 4 months old when an ultrasound confirmed that she and her husband, Charles Sr., were having another boy.

Although Barnes had support from friends and family, her husband worked full time, meaning the daytime responsibility for the boys rested on her shoulders. Barnes worried about getting it right.

“I wanted to [find] all of the resources that I could to get them on the same page — to make sure that one or the other wasn’t left without,” she says.

A friend told Barnes about a program that had helped her find a new crib and new clothes for her baby. While Barnes wasn’t in need of any clothing, she thought it would be worth giving the hotline a call to find out how the program might be beneficial to her young family.

“When I called,” Barnes says, “I found out that there was much more to offer.”

Help Me Grow is a statewide program run by the Ohio Department of Health. In all 88 counties, the 20-year program reaches out to first-time moms and families with young children to establish practices for healthy births and productive starts to a child’s life.

Of the 9,044 families currently helped by the program, half are prenatal moms and half are moms who have one — and sometimes two — children under the age of 3. It is geared specifically toward helping children get a strong start in school and making sure that they are developmentally ready for this step. The program is open to any family who qualifies, but 85 percent of those in the program are first-time moms who need a little extra support.

“When I first started the program, I wasn’t sure how it was going to work, but once I started … it eased all of that fear and worry that I had,” says Barnes.

Help Me Grow assigns each family a primary service provider who makes in-house visits and teaches parents how to become good educators for their children. An extension called Early Intervention assists families whose children have a medical diagnosis or a developmental delay, such as struggling with speech or not walking by the expected age.

“We monitor and assess the family as a whole,” says Bianca Brookins, a Cuyahoga County Help Me Grow primary service provider. She benefited from the program herself when her first son was 2 years old. Brookins now works with 33 families, including the Barneses.

While Barnes and Brookins talk over questions, resources and future milestones during home visits, the boys work through an activity tailored to their current developmental achievements.

“We do activities with the children to make sure that they are meeting their developmental milestones,” Brookins says. “We do screenings and assessments, and … if there is an area that they are struggling in, that is what we will work on.”

That may include coloring, reading books, matching and memory games, and activities that enhance motor skills, social interactions and communication. The parent is involved in each activity and the moments become educational opportunities for both parent and child.

“I will tell [Shaniya] what the activity is about and what area it is helping her child in,” says Brookins. “I encourage the mothers to be involved in the activity because attachment is very important. [These] activities are a good way for parents and their kids to bond.”

But there is also the bonding that happens between the two mothers over the course of their time together. Because Brookins has gone through the same things herself, Barnes says she feels less alone in navigating the inspiring-but-often-hectic territory of being a parent to young children. The two share coping strategies, they collaborate on solutions, they sympathize with each other and connect over finding a sense of humor in the journey of parenting.

“What I have learned is that I need to be patient,” Barnes says of the skill she has worked on the most. “I have two boys, and they are just busy all the time.”

While most of the visits take place in the home — a comfortable space for parents and their children — Help Me Grow of Cuyahoga County also organizes a monthly meet-and-greet at its agency, the Friendly Inn Settlement House. Activities, food and refreshments make for a nice outing for new moms who often find themselves cooped up at home.

“We get our parents together who are in the program, we invite them to the agency ... and they get to mingle with one another. They all have children, so they have that in common.”

Events, such as summer trips to the zoo, are planned as well. All of it aims to foster the growth of young minds and make connections for new parents.

These days, Brookins visits once a month to help advise Barnes on how to engage her children in play and education and also assist with early childhood milestones, such as potty training.

“It has been a goal since we first met,” says Barnes. “[Brookins] has helped me along the way because she also has two sons … at first I wasn’t working, but I am working now, so I am trying to get [my oldest] on a schedule.”

As for Charles Jr. and Isaiah, Barnes says they are thriving as her family prepares to enter its second year in the program. “I have noticed that they are more sociable now,” she says.

“They are speaking in complete sentences. … They are verbally telling me the things that they want — like if they want milk, if they want juice, if they want to eat. They have the verbal skills, the communication skills, their social skills. They have really grown.”  — KK