Category: Disease

Host a Healthy Holiday

In recent years, attention has been shifting away from medication-only treatment plans to incorporating special diets into comprehensive disease management strategies, for example rather than just giving a patient a pill to lower cholesterol and high blood pressure, a doctor will prescribe a diet low in sodium and fats (saturated and trans) as well as refer the patient to a dietitian. Consequently, many Americans are following, or at least should be following, a “special” diet. From a health professional perspective, it is encouraging to see efforts to reduce medication, which often have numerous side-effects, and increase healthier long-term lifestyle changes.

However, all the holiday parties, feasts, and edible gifts can be a real threat to staying committed to healthful diets and lifestyle habits. A lot of pressure is placed on the individual to resist temptation, exercise moderation, or swap unhealthy options for healthier choices. Yet little attention is focused on the host or hostess for providing less healthy options.

If you are planning a holiday meal, I encourage you to be cognizant of your friends’ and family’s health and lifestyle choices. Just because you make “the best creamy mashed potatoes” every year, doesn’t mean you can’t find an equally delicious substitute or alternative. It’s only logical; if a dish is available, it has a chance of being consumed, but if it’s not available, it can’t be eaten.

tableLuckily, there are a wide variety of recipe websites dedicated to special diets, such as,, I would suggest trying out the recipes prior to the “big” feast, as light cooking or cooking with substitute ingredients is not always the same and may take a practice run or two. Try not to think of creating a healthier meal as an inconvenience or break in tradition, but rather a fun, worth-while challenge and opportunity to show loved ones you care about their health. After all, we want to celebrate many more holiday seasons with all our friends and family.

Please post links to your favorite healthful recipes or websites for others below.

Good luck and happy holidays!

Heavy foodborne illness burden for children, WHO’s first global estimates find

The World Health Organization (WHO) announced its first ever global foodborne disease estimates, which show that about 1 out of 10 individuals become sick each year due to tainted food and 420,000 die as a result. Other major findings include: kids younger than 5 are at particularly high risk, with 125,000 children dying from foodborne diseases every year; the WHO’s African and South-East Asia regions had the highest burden of foodborne diseases, with the highest incidence and highest death rates.

It is especially notable that almost one third of all deaths from foodborne diseases are in children under the age of 5 years, despite the fact that they make up only 9% of the global population.

Foodborne diseases’ short-term symptoms include nausea, vomiting and diarrhoea (commonly referred to as food poisoning), but there are also longer-term illnesses that can caused by foodborne diseases, such as cancer, kidney or liver failure, brain and neural disorders. Such diseases are often more threatening for children, pregnant women, and those who with a weakened immune system. Children who survive some of the more serious foodborne diseases may suffer from delayed physical and mental development, impacting their quality of life permanently.

The WHO hopes this report will shed light on better understanding which foodborne pathogens are causing the biggest problems in which parts of the world can generate targeted action by the public, governments, and the food industry.

Mental health Mondays: signs of Alzheimer’s

Nurse_in_geriatryLast week, in honor of National Alzheimer’s Disease Awareness Month and Family Caregivers Month, I mentioned some strategies that could help a family member with a dementia be integrated into holiday festivities. But what if the family member has memory loss but hasn’t been diagnosed with a dementia? What are the signs of Alzheimer’s, and how do they differ from those of an ordinarily aging mind?

The Alzheimer’s Association website (a terrific resource) suggests that your level of worry should partly be determined by the person’s degree of incapacity. For instance, missing a monthly credit card or other bill payment could happen to anyone. A persistent inability to manage a budget, on the other hand, could be a warning of a developing dementia.

Forgetting words for specific things happens all the time. Difficulty having a conversation might be a warning. Losing things periodically? Totally normal. Misplacing things and being unable to retrace steps to find them? Could be trouble. At our house we have a joke: it’s OK to lose the car keys, but you’re in trouble if you don’t know what the car keys are for. There’s some truth in that.

The holidays are a time to see family you haven’t seen in a while, and we notice aging more when we don’t see it every day. If you think you have a relative who’s becoming impaired, don’t panic. But, check out the Alzheimer’s Association website, and then you might want to check with your relative’s doctor. Be aware that one in three American seniors dies with Alzheimer’s or another dementia, and many people with dementia don’t know that they have it. The earlier you come to grips with it, the better you can plan for it. And the better you plan, the better things will be for you, your relative and his or her caregivers.

National Diabetes Month – What is Pre-diabetes?

Continuing the Diabetes theme I began last week in honor of National Diabetes Month, this week will focus on the “elephant in the room”: pre-diabetes.

I mentioned that 86 million people in America are considered “pre-diabetic,” putting them at high risk of developing diabetes with high blood sugar levels. Diabetes results when either your body doesn’t make enough insulin (type 1) to handle the glucose in your blood, or your body has become less “sensitive” to the insulin that is being produced (type 2). Either way, high levels of sugar in your blood can be a dangerous situation. In fact, diabetes can lead to serious conditions such as heart attacks, stroke, blindness, kidney failure, and loss of toes or feet.

Levels indicating pre-diabetes include:

  • Hemoglobin A1c (HgA1c) of 5.7-6.4%
  • Fasting blood glucose (sugar) of 100-125 mg/dL
  • Oral Glucose Tolerance Test (OGTT) 2-hour blood glucose of 140-199 mg/dL

Other factors that increase the risk of developing type 2 diabetes include age (45 years or older), overweight status, family history of type 2 diabetes, physical inactivity, and gestational diabetes (when you have diabetes during pregnancy).

Fortunately, you can work to change your pre-diabetic status and lower your risk of developing diabetes by losing weight (if you are overweight) and exercising moderately (such as brisk walking) 30 minutes a day, fiver days a week. One great way to incorporate this exercise is to walk for 10 minutes after every meal (it also helps your body react to the insulin to decrease blood sugar after you eat).

If you’re worried about developing diabetes, take the CDC’s online quiz to assess your risk!


Photo source: Pan American Health Organization, World Diabetes Day via

What is Movember?

My boyfriend has always been a fan of No-Shave-November, mainly because of his love for his scruffy beard all year-long. But this year, he told me he was doing something different. He was shaving his beard on November 1st to instead grow out a mustache all month long. While at first I cringed at the thought of him sporting a dying 1970s trend, once I learned more about the organization behind this attempt at a mustache comeback, I became more supportive.

Movember, the month formerly known as November, marks a month where men and women join together to bring men’s health issues, a topic often neglected, into the spotlight. Men, called “Mo-Bros” sign up and grow and groom a mustache for 30 days. The organization has also made efforts to get women (called “Mo-Sistas”) involved, so they can also raise money and awareness to support the men in their life (without growing the mustache). 

You may be wondering, how does a mustache help with men’s health issues? Well, the idea behind the Movember Foundation is that a mustache is nature’s billboard. The founders discovered that the mustache is a powerful way to start conversations and decided to use that idea to get men more comfortable talking about their health. What most people don’t realize is that the state of men’s health is in a crisis, and on average, men die six years earlier than women. Some of the main causes of death in men (suicide, prostate cancer, and testicular cancer) are a result of the stereotypical forms of masculinity that prevent men from seeking help or getting preventative care.

Since the foundation of the project in 2003, the organization has grown from just 30 “Mo-Bros”, to 5 million “Mo-Bros” and “Mo-Sistas” worldwide. They also have raised $649 million and have funded over 832 men’s health projects since 2003.

So no, mustaches are not making a comeback (thank god), but they are making a significant contribution to men living happier, healthier, longer lives. For more information about the foundation, or to sign up for your own Movember (it’s not too late!) visit

UNC Student’s Global Experience

By Hillary Murphy, UNC-CH MPH:Health Behavior candidate 2016

Summer of 2015 I found myself unexpectedly working in sub-Saharan Africa on a pilot intervention involving breastfeeding practices among mothers with HIV.

File:Malawi in Africa.svgJust to help you, the reader, understand how out of my element this was, here is a little background on me. My public health experience up to this point involved local food movements, health disparities in rural North Carolina, and, for a few months, community engagement and education in permaculture practices in Java, Indonesia.  Despite my obvious lack of experience, I was lucky enough to be offered a practicum position, and less than a month later, I began working in Malawi, a small country in southern Africa.

Currently in Malawi, 13% of pregnant women are HIV positive. Without intervention, 5-20% of their children will become infected from HIV exposure though breastmilk, suggesting that prevention of mother-to-child transmission is of critical importance.

During my time in Malawi our goal was to tailor and pilot test an Infant and Young Child Feeding (IYFC) promotion intervention among HIV+ Malawian women in community-based village savings and loan associations (VSLAs). We tailored training materials and IYFC learning sessions on 1) breastfeeding, and 2) complementary feeding for use with Malawian trainers and VSLA volunteers, and pilot tested these materials to further refine them for use in Malawi.

Although this practicum certainly helped build my skills in program implementation and tailoring, and gave me a deep love for sub-Saharan Africa, it most importantly was a reminder to be open to unexpected experiences. There is no way to know what your true passions in life are unless you welcome opportunities that are out of your element.

Photo source: Wikimedia

Mole Monitoring Made Easy

Moles – most of us have them but few of us probably think much about them. Most of the time that’s not a problem, since the majority of moles are simply harmless clusters of pigment cells called melanocytes. These are the same cells that are spread throughout our skin, creating its natural color. But sometimes, moles can change or develop into the cancerous cells that cause melanoma, the deadliest form of skin cancer. So how do you know if your mole is a problem?

A new app called Mole Mapper has been released that allows users to photograph their moles in order to monitor their size, shape, and color, and to track any changes over time. This tool can help you to detect early warning signs of melanoma and gives you valuable information to share with your physician if you suspect that there’s a problem.
If you’d rather go old school with your mole monitoring, you can also use the following ABCDEs to detect warning signs that indicate you should have your mole checked by a medical professional:

Asymmetry. One half of the mole does not match the other half.
Border. The border or edges of the mole are ragged, blurred, or irregular.
Color. The color of the mole is not the same throughout or has shades of tan, brown, black, blue, white, or red.
Diameter. The diameter of a mole is larger than the eraser of a pencil.
Evolution. The mole is changing in size, shape, or color.

Whatever strategy you choose, I encourage you to take an active role in your health and monitor those moles!


Today is National Healthy Eating Day

New Years Day is not the only day you can commit to a healthier lifestyle – why not start today? Today marks the American Heart Association’s 7th annual National Healthy Eating Day, a day where millions of people throughout the United States come together and make a pledge to take steps toward living a healthier life. A healthy diet and lifestyle are vital in the fight against cardiovascular disease, the global leading cause of death accounting for 17.3 million deaths per year.

For many people, the idea of starting a healthy lifestyle can be both daunting and overwhelming, but the truth is, it’s a lot easier than you think. However, it’s important to keep in mind that lifestyle changes don’t happen overnight, so remember to just take it one day at a time. Here are some simple changes you can make each day to begin your commitment to a healthier life:

Day One: Opt for a fruit and vegetable filled lunch today. Fruits and vegetables are high in nutrients, minerals and vitamins and low in calories. Today for lunch, have a hearty vegetable filled salad with a piece of fruit, or fill your sandwich with vegetables and opt for raw veggie sticks instead of chips.

Day Two: Make the whole-grain swap. Many whole grains are good or excellent sources of dietary fiber and can lower risk of heart disease, stroke, obesity and type 2 diabetes. For breakfast, choose a whole grain english muffin or whole grain cereal over refined grains like corn cereal and white toast. For lunch or dinner, try swapping out white rice for brown rice or quinoa.

Day Three: Cut down on sugar. Sugar is filled with empty calories that can lead to weight gain and high blood sugar levels. Today, swap out your soda or juice for a sugar-free beverage like flavored seltzer, green tea, or just water!

Day Four: Cut down on red meat. Generally, red meats have more cholesterol and saturated fats (big contributors of heart disease) than other proteins like chicken, fish and beans. While it’s still OK to have red meat, it’s important to limit the amount. For dinner tonight, try one of my favorite heart-healthy chicken and bean dishes here.

Day Five: Get moving. While healthy eating and nutrition is an important part of living a heart-healthy life, being physically active is also an important part of preventing both heart disease and stroke. Today, take thirty minutes out of your day and go for a jog, or a bike ride, or take workout class at your local gym. If you don’t think you can make 30 minutes, start small and work your way up.

For more resources and information about National Healthy Eating Day, register for your free toolkit here.

Risk of Breast Cancer Rising Among Black Women

It used to be a safe assumption that African American women had a relatively low risk getting of breast cancer, but a recent study published on behalf of the American Cancer Society (ACA) has found that black women now have an equal risk of developing the disease as white women.

Previously, the disease was most common among white women, but as rates among black women increase, researchers are seeing the rates for white and black women become more balanced. Since 2008, the risk of occurrence among African American women has increased 0.4 percent each year, translating into roughly 124 black women per 100,000 being diagnosed (the rate for white women still remains slightly higher, around 128 per 100,000). Incidence increased slightly for Asian and Pacific Islander women (88 per 100,000), while the rate for Hispanic women remained the same 91 per 100,000).

In terms of mortality, black women continue to be the most at-risk group, with nearly 32 per 100,000 women dying from the disease (compared to 22 per 100,000 white women). One significant reason for this is likely due to the fact that African American women tend to receive a later diagnosis, and thus, the cancer is more likely to have spread to other areas of the body. Another occurrence being looked at is the amount black women being diagnosed with estrogen-positive breast cancer. Researchers believe this could be due to an increase in obesity rates among black women, since more fat increases estrogen, a known risk factor for certain forms of breast cancer. According to ACA, in 2012, 58 percent of black women are obese, compared to only 33 percent of white women.

Another interesting fact resulting from the study’s results was that rates of breast cancer among black women tended to be higher in the South – Alabama, Kentucky, Louisiana, Mississippi, and Tennessee (rates were higher in Missouri and Oklahoma as well).

Of course, all women, regardless of race, should be aware of common risk factors for breast cancer, and should be proactive in maintaining a healthy weight, getting enough physical activity, and limiting their alcohol intake. One of the single most important acts a woman can take at decreasing her chances of developing the disease is by getting mammograms on a regular basis, to ensure treatment begins at the earliest stage possible.

Breast Cancer: A Look at How Far We’ve Come

As National Breast Cancer Awareness month comes to an end, it’s important to reflect on how far we’ve come. Breast cancer mortality has fallen by more than a third since its peak in the 1980s, and can be attributed to the vast improvements made in regards to breast cancer screening, treatment, and prevention over the last 20 years. Here is a quick look at some of the most effective advancements so far:

Screening- Early detection of breast cancer by mammography has a variety of benefits, including a greater range of treatment options. A combined effort of both the increase of programs designed to improve access to breast cancer screening and improvements with early detection testing techniques (mammograms, clinical breast exams, genetic testing and magnetic resonance imaging) has allowed for over 90 percent of breast cancers to be diagnosed at an early stage.

Treatment- When treatment for breast cancer first began, radical mastectomies were one of the only options, regardless of the stage of the disease. Now, many women have the option to receive much less evasive surgery, such as lumpectomies, with no loss in effectiveness for treatment. Refined chemotherapy regimens and improved radiation techniques have also allowed for women to safely undergo less extensive surgery and has overall improved the quality of life for patients.

Prevention- Recent clinical trials have shown that the drugs such as tamoxifen and raloxifene can significantly reduce the risk of breast cancer in women known to be at increased risk. [1] Preventative surgeries have also developed and been proven effective in reducing cancer risk.

National Breast Cancer Awareness month may be at its end, but it is still important to be aware of the risks and screening options available year-round. For more information visit:


[1] Nelson HD, Smith ME, Griffin JC, Fu R. (2013). Use of medications to reduce risk for primary breast cancer: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 158(8):604-14