Tuesday, Jun 25th

weightlossThe following was submitted by Elizabeth DeRobertis, Registered Dietitian at White Plains Hospital.
Often women come to see me during menopause years, stating that what they used to do in the past to manage their weight does not work anymore – an understandably frustrating situation.

When working on weight management, calories are usually the most important thing. But during menopause there are also many hormonal changes that take place in the body. Often women become more insulin-resistant during this time, which can further complicate the situation, so in addition to looking at calories, I begin to work with women on also managing their carbohydrate intake.

Whenever we eat carbohydrates, our body needs to produce insulin to keep our blood sugar in check. If a woman has a higher carbohydrate intake throughout the day, her insulin level may stay higher – and, as insulin is a fat-storing hormone, it may make it harder to manage weight.

When a woman who comes to see me is feeling “stuck” in this way, often we will change her breakfast routine from a carbohydrate-heavy one to one focused more on protein. This swap can be as simple as shifting from oatmeal to eggs – one basic change that I have seen result in weight loss.

Another modification in the day may be spacing out carbohydrates as to not have too many in one sitting: saving a piece of fruit for an afternoon snack, instead of having it along with lunch, can be a simple modification that can actually help to keep insulin level down, by not having too many carbohydrates in one sitting.WPHAdAugust 23

Keep in mind, though, that what’s healthy is not always helpful for weight loss. If someone drinks a smoothie with multiple pieces of fruit at once, the amount of carbohydrates in one sitting may not be helpful for weight management.
There are other things that also take place during menopause that may make it harder to manage weight, with sleep being one of the most important. If a woman is not getting adequate, quality sleep – the general recommendation is seven to nine hours – it can throw off their hormonal balance.

This is also a time in life when exercise may need to change. Often women spend a lot of time focusing on cardio activity; during menopause, however, it’s a good idea to spend some more time lifting weights, as each year we lose a little bit of lean body mass, which decreases metabolism. Making sure that you’re doing adequate weight training can help to keep your metabolism higher.

Research suggests that non-fat dairy products can help you shed pounds while retaining muscle mass. So pairing weight bearing exercise with an increase in non-fat dairy snack choices, such as 0% greek yogurt and cottage cheese, can help to increase lean body mass, which can have a positive impact on metabolism.

Finding a weight-management regime that is right for you should always be a priority. And while menopause may cause some temporary disorder with what had been your usual routine, a few easy adjustments can keep you on a healthy path during this new stage of life.

For more information on the GPS weight loss program, visit https://gps.mykajabi.com/gps.

DeRobertisElizabeth DeRobertis is a Registered Dietitian with the Scarsdale Medical Group. To make an appointment, call 914-723-8100.

Health Matters: The original version of this article was published in Health Matters, a White Plains Hospital publication.

heartdiseaseCoronary artery disease (CAD), also known as atherosclerosis, is the most common type of heart disease, with the CDC reporting that it killed 375,476 people in 2021. About 5% of those aged 20 and older have CAD – but many may not even be aware of it until serious symptoms occur.

In fact, CAD may take place over decades, as it involves the buildup of plaque. Plaque is made of several substances, including cholesterol. Plaque buildup can start at an early age and is caused by a combination of genetic and lifestyle risk factors. As plaque builds up over time, the arteries become increasingly narrow; the resulting poor blood flow to the heart can result in angina (chest pain) as well as blood clots, further blocking the arteries and possibly leading to a heart attack.

Indeed, many symptoms of CAD, are similar to those of a heart attack: in addition to chest pain, they may experience tightness in the chest during exertion, shortness of breath, fatigue, and lightheadedness. People who experience these symptoms during exertion may feel relief when they stop physical activity, but if it recurs when they begin exerting themselves, it may be time to visit their primary care physician or a cardiologist.WPHAdAugust 23

Causes of CAD include several modifiable factors: high blood pressure, diabetes, smoking, and a lack of exercise can all contribute to developing the disease. In addition, a family history of CAD (primiarly in your parents or siblings) can also be a significant consideration.

Furthermore, men are at a higher risk for developing CAD, although menopause increases a woman’s risk of developing the disease due to the many hormonal changes they experience during and after menopause.

Determining a given patient’s risk for developing (or already having) CAD can involve a number of tests, including a routine blood test, which will reveal if they have low-density lipoprotein (LDL) – commonly called the “bad” cholesterol” –, high-density lipoprotein (HCL) chloesterol (the “good” cholesterol). We also are now checking other markers in the blood like lipoprotein (a) and C-Reactive Protein (CRP), which is an indication of unusual inflammation.

Another test I perform is a coronary calcium score, which is a CT scan that looks at calcification in order to assess your risk of a heart attack over 10 years. There are three levels of results: mild is any number between one and 100; moderate is anywhere from 100 to 300; and severe is any number greater than 300; in fact, a severe score can be several hundred, indicating that action should be taken quickly.

Prevention and Treatment
A good diet can help reduce your risk of coronary artery disease. I recommend eating vegetables, fruits, fish, and legumes. It is also important to get enough exercise; I recommend at least 150 minutes of moderate aerobic activity, or 75 minutes of vigorous aerobic activity, a week. As is always the case, the long-term use of cigarettes or other nicotine products can have serious health risks, including the development or acceleration of CAD.

If a person’s case of CAD is found to be especially concerning, there are several prudent treatment options. These can range from taking medications to undergoing surgery. If you are concerned that you may be at risk for, or already have, CAD, ask your doctor to perform an EKG, bloodwork, and/or a calcium score test.

Dr. Gregory Pontone is a noninvasive cardiologist and the Associate Medical Director of Ambulatory Quality and Physician Services at White Plains Hospital. To make an appointment, call 914-849-4800.
Health Matters

The original version of this article was published in Health Matters, a White Plains Hospital publication.

milk(Submitted by Debra Etelson, Pediatrics at White Plains Hospital.)

Many parents and guardians, especially those with children going to daycare or school for the first time, are understandably concerned about whether the facility, its staff, and its other attendees are taking proper precautions when it comes to food allergens.

The good news is that any reputable, licensed establishment – by law – must do so. But that does not necessarily mean that one’s anxiety can simply be put away.

According to the nonprofit Food Allergy Research and Education (FARE), about 8% of children under the age of 18 have food allergies – equal to one in 13 children, or approximately two in every classroom. Eggs, milk, and peanuts are among the most common causes of food allergies in children, with wheat, soy, and tree nuts also included. Fish and shellfish are also on the list, though of course those are rarely served in schools or daycare centers.

Determining what foods your child may be allergic to can be complicated, but it needn’t be. Obviously if the child WPHAdAugust 23suddenly has trouble breathing, or experiences cramps, swelling, vomiting or diarrhea, a trip to the emergency room is necessary. But before such symptoms occur, a simple blood test or a scratch test performed by an allergist can raise the appropriate red flags.

Research has shown that children may outgrow some of these allergies before they’re five, although allergies to peanuts, tree nuts, fish and shellfish are usually lifelong.

Follow-up tests for someone who does have a food allergy usually take place every one to two years, and pediatricians will review allergies at each visit to track any changes. If the child has outgrown an allergy, there may be whole new edible worlds for them to explore – liberalizing a kid’s diet can be amazing.

Some food sensitivities and/or allergies may not be immediately apparent. Hives or tongue-swelling may occur when eating certain fruits and vegetables, but those reactions rarely progress to something more serious. You may see a reaction to raw carrots or apples, but not cooked ones, as cooking reduces the allergenic proteins and thus lowers the impact they have on the immune system.

When Kids Are in Someone Else’s Care

It may be relatively easy to monitor your child’s food intake at home, but what if they’re off to school or a playdate? Schools require the completion of a food allergy sheet like the one below before the term begins. This, along with a supply of Benadryl and/or an EpiPen, should help ease fears about your child being away for the day. In addition, many schools now prohibit peanuts and some other allergy-producing foods from the premises, eliminating the chances of an airborne infection.

Emergency Action Plan

Similarly, if your child is going to another home where you will not be present, converse with that caregiver and provide the appropriate medications. In all cases, remember that EpiPens are effective for 12 to 18 months, and like any other medication, will likely require a refill/replacement somewhere down the line. Also keep in mind that as your child ages, they begin to seek more independence, generally when they’re 10 or 11. That means they may don’t always carry their EpiPen or medication with them, so take the time to explain the importance of responsibility (and not just in this area of life!).

The FDA’s Pulmonary-Allergy Drug Advisory Committee (PADAC) voted 16-6 in favor for adults, and 17-5 in favor for children (under 18 years of age and weighing 66 or more pounds), acknowledging that available data supported a favorable benefit-risk assessment for neffy in the treatment of severe allergic reaction (Type 1), including anaphylaxis, for adults and children who weigh more than 66 pounds.

DEBRA ETELSON FINAL copyTaking care of a child with a food allergy can be challenging, but being aware of what’s available and discussing the issues frankly with a pediatrician and other caregivers in your kid’s life should take at least a little worry out of the equation.

Dr. Debra Etelson is a board-certified pediatrician at White Plains Physician Services in Somers. To make an appointment, call 914-849-7075.

Health Matters
The original version of this article was published in Health Matters, a White Plains Hospital publication.

pickleballGood news for Pickleball fans. The hard tennis courts at Crossway will be converted to pickleball courts for a pilot program starting on September 18 Through October 31. In order to participate Scarsdale residents must purchase a crossway pickleball pilot permit for a fee of $30. Residents wishing to take advantage of this program opportunity can purchase a permit online here: https://www.scarsdale.com/208/Tennis-Platform-Tennis-Pickleball or at the Department of Parks Recreation and Conservation. Located at 244 Heathcoat Road.

Only Crossway pickleball permit holders will be able to reserve court time and reservations can be made here: https://secure.rec1.com/NY/village-of-scarsdale-ny/catalog

The hours of play for the pickleball pilot program are 9am to dusk daily. Players without permits must show proof of Scarsdale residency, and the fee is $15 per player per hour. Non resident guests may only play on weekends between noon and 4pm and must play with a resident. The non-resident guests fee is $20 per player per hour. All players must check in with the attendant before playing.

Enjoy pickleball this fall and sign up today. Please call the Parks Recreation and Conservation Department with any questions you can reach our staff at 914-722-1160.

bearThis photo of a bear in Heathcote was taken in May, 2020The Westchester County Department of Health has confirmed today that the bear that attacked a 7-year old boy in Bedford as he played in his backyard on Tuesday August 22, 2023 has tested negative for rabies. The child is being treated and the bear was shot by authorities shortly after the attack.

Residents should never approach or have contact with a stray or wild animal. Residents who see a stray or wild animal acting strangely should alert local authorities to avoid possible exposure to rabies. Residents can also help by keeping their trashcan lids securely sealed, removing wild bird feeders, and avoid leaving pet food outdoors.

Health Commissioner Sherlita Amler, MD, said: “If you see an animal that is acting aggressively, stay away from it and contact local police immediately.”

Unusual behavior may be the first sign of rabies in an animal. A rabid animal may become either abnormally aggressive or unusually tame. It may lose fear of people and become excited and irritable, or, conversely appear particularly passive and lethargic. Staggering and frothing at the mouth are sometimes noted.

Any physical contact with a wild or unfamiliar animal should be reported to a health care provider. All animal bites or contacts with animals suspected of having rabies must be reported to the Westchester County Department of Health at (914) 813-5000, 24 hours a day.

Keeping pet rabies vaccinations up to date is also important for protection against rabies. New York State law requires dogs, cats and ferrets to be vaccinated against rabies and receive regular booster shots. For more information, go to www.westchestergov.com/health or call the RABIES INFOLINE at (914) 813-5010.

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