- General Page Tier 3BlogWho doesn’t love a turkey sandwich with freshly baked bread for lunch? Or who would ever say no to cheesy lasagna for dinner? Besides tasting good, what both of these foods have in common is gluten. Gluten is a protein found in grains, wheat, barley and rye. Foods like bread, baked goods, crackers, pasta and cereals contain gluten. This protein gives dough its elasticity and acts like a glue, which gives foods like bread its chewy, soft texture we all love. The term “gluten-free” has evolved from diet trend to big business. To put it into perspective, market trends suggest that gluten-free products could be worth as much as $7.5 billion by 2020. Some surveys have found over 25 percent of people stating that they are looking to cut gluten out of their diet for health reasons. READ MORE: Why does nutrition advice change? However, there is a nutritional downside to going gluten-free. If you unnecessarily cut out gluten, you may be risking nutrient deficiencies. Gluten-free products are lower in fiber and contain white rice flour or various starches. They also have more fat and sugar to make them bind together and taste better. And even if junk food is labeled as gluten-free, it’s still junk food, so keep this in mind if weight loss or eating a healthier diet is your goal. When diets and trends hit the mainstream, it creates an atmosphere ripe for myths and misinterpretation. The good news is that if you decide to go gluten-free, you have more options. Once you have made the decision to go gluten-free due to a gluten intolerance or celiac disease (an inflammatory response), consider the following: If the product doesn’t have a gluten-free label, carefully read the ingredient list and allergen warning. Check the allergen warning found underneath the ingredient list for wheat. If the warning lists wheat, then it is not safe for consumption. Barley and rye are not included in allergen labeling, but if found in the ingredient list, the product is still not safe for consumption. Only consume a product containing oats if it is labeled gluten-free. Oat products must be labeled gluten-free to be safe. Most commercial oats are contaminated with gluten from cross contact with wheat, barley or rye during harvesting and processing. Consider avoiding ingredients that contain gluten. Some common ones include malt, brewer’s yeast, wheat, barley, rye and wheat starch. Know which ingredients you can still consume. Some common gluten-free ingredients you do not need to avoid include caramel color, maltodextrin, glucose syrup and distilled vinegar. Read the manufacturer’s warning if the product is not labeled gluten-free. Avoid grain-based products (rice, corn and other cereal grains) that are labeled “may contain” or “made on shared equipment” with wheat/gluten. Prevent cross contact with gluten-containing foods while cooking and prepping food. The smallest amount of gluten, even one-eighth of a teaspoon, can cause intestinal damage in people with celiac disease. Individuals who do not have celiac disease may be able to tolerate gluten in these small amounts without allergic reactions. You should always sanitize cutting boards, toasters, strainers and knives to avoid contamination. Other considerations to keep in mind is assuring medications or supplements do not have gluten additives. Distilled alcohol, wine, gluten-free beer and ciders are safe for consumption. Try to stay away from all malted products, such as hard lemonade, mixed drinks and beer. Take some time to read labels and understand which ingredients you can or cannot consume if you’re trying to follow a gluten-free lifestyle. Start by becoming familiar with the most common foods with gluten and do some research on alternatives. Don’t forget that planning and preparation are important when trying to maintain a gluten-free lifestyle. But when in doubt, go without. Happy eating! Authors Ann Caldwell and Maureen Shackelford are nutritionists and registered dietitians at Anne Arundel Medical Center. To reach them, call 443-481-5555. Originally published Sept. 2, 2019. Last updated Aug. 31, 2020.0
- General Page Tier 3BlogNothing says fall quite like pumpkins and pumpkin-flavored foods. Pumpkin bread, pumpkin coffee, pumpkin smoothies — the list goes on! Not only do pumpkin foods taste good, they are full of vitamins and minerals. They’re a rich source of beta-carotene, an antioxidant that gives orange vegetables their color. Your body converts beta-carotene to vitamin A once you eat it. The vegetable also contain a lot of vitamin C, vitamin E, riboflavin, potassium and other nutrients. Here’s how this fall favorite can boost your health. Some health benefits of pumpkin Cancer prevention: The National Cancer Institute says antioxidants including beta-carotene may play a role in preventing cancer. The substances in pumpkin seeds have also been linked to lower levels of stomach, breast, lung, prostate and colon cancers, says the National Foundation for Cancer Research. Eyesight: Vitamin A helps with good vision, especially in the dark. Tougher immune system: Vitamin A may help your body fight infections and viruses, while vitamin C could help you recover from colds faster. Heart health: Pumpkin seeds contain chemicals that may reduce “bad” cholesterol and decrease your risk of heart disease, the National Institute of Health says. Weight loss: Pumpkin has less than 50 calories per cup, and most pumpkin recipes contain far less than a cup. It’s also a good source of fiber, which can help you stay full longer. Mood booster: Pumpkins contain the amino acid tryptophan, which helps form serotonin. Serotonin regulates mood, sleep and your appetite. Watch out for added sugar Despite the gourd’s health benefits, not everything pumpkin-flavored is healthy! Take a look at Starbucks’ popular pumpkin spice latte: A 16-oz. grande, with 2 percent milk and whipped cream, has 380 calories, 14 grams of fat and 50 grams of sugar. In fact, many items labeled “pumpkin spice” don’t actually contain any pumpkin. It’s a mixture of spices, including cinnamon, nutmeg, ginger and clove, or allspice, which taste like pumpkin pie. A typical slice of pumpkin pie, by the way, contains 323 calories and has 13 grams of fat and 25 grams of sugar. If you’re still craving a pumpkin spice latte, here is a healthier option: Pumpkin Spice Latte 1/ 2 cup unsweetened vanilla almond milk 3 tablespoons pumpkin puree 1 teaspoon pumpkin pie spice 1/ 2 teaspoon vanilla 1 teaspoon sugar 8 ounces brewed coffee Sprinkle with cinnamon and enjoy! Each latte contains 55 calories, 1.5 grams protein, 8 grams carbohydrate, 2 grams fat and 136 percent of your daily vitamin A needs. And if you’re in the mood for dessert, these cranberry pumpkin muffins are only 200 calories each. Cranberry pumpkin muffins Ingredients 2 cups flour 1/ 2 cup sugar 3 teaspoons baking powder 1 /2 teaspoons salt 1 /2 teaspoons cinnamon 3 /4 teaspoons allspice 1/ 3 cup vegetable oil 2 large eggs 3/ 4 cup canned pumpkin 2 cups fresh or frozen chopped cranberries Instructions Preheat oven to 400 degrees. Sift together dry ingredients (flour through allspice) and set aside. Beat oil, eggs, and pumpkin together until well blended. Add the wet ingredients (pumpkin mixture) to the dry ingredients all at once. Stir until moistened. Fold in chopped cranberries. Spoon into paper-lined muffin cups. Bake at 400 degrees for 20 to 25 minutes. Makes 12 servings Each muffin contains about 200 calories, 7 grams total fat, 1 grams saturated fat, 35 milligrams cholesterol, 230 milligrams sodium, 32 grams carbohydrates, and 3 grams protein. Toasted pumpkin seeds also make a healthy fall snack. First, rinse seeds well to wash away pumpkin pulp. Spray nonstick cooking spray on a baking sheet, then spread seeds. Or place seeds on the sheet, then add a bit of olive oil. Bake for 30 minutes at 325 degrees Fahrenheit, stirring occasionally. Bake until seeds are toasted lightly. Authors By Ann Caldwell and Maureen Shackelford, nutritionists and registered dietitians at Anne Arundel Medical Center. To reach them call 443-481-5555. Originally published Sept. 22, 2017. Last updated Aug. 25, 2020.0
- Men's Health, Women's HealthGeneral Page Tier 3BlogThe holidays are here and so are all the get-togethers, parties and delicious meals. If you suffer from heartburn, then you know indulging in holiday fatty foods and alcohol can be a trigger, even if you take over-the-counter medications for temporary relief. However, if you notice that you are experiencing indigestion-like symptoms more than twice a week, you might have something more serious. Heartburn is the most common symptom of gastroesophageal reflux disease, or GERD. GERD is a digestive disorder that affects up to one in five U.S. adults. It happens when the muscle in the esophagus called the lower esophageal sphincter (LES) opens or relaxes too often or for too long. This causes stomach contents to back up into the food pipe, causing heartburn and acid indigestion. Other symptoms of GERD include shortness of breath, difficulty swallowing, chest pain, chronic cough, sore throat, hoarseness and bad breath. Although there isn’t a specific cure for the disease, you can make some lifestyle and diet changes to help you manage your symptoms: Maintain a healthy weight. The risk and severity of GERD tend to intensify for those who have higher body weights. Losing a few pounds could make you feel better. Avoid tight-fitting clothing. Tight clothes could exert pressure on the stomach, causing stomach acid to move up towards the esophagus and resulting in acid reflux. Try wearing looser clothes that don’t compress the stomach area. Avoid trigger foods and drinks. These include fatty or fried foods, tomato sauce, alcohol, chocolate, garlic, onion and caffeine. Eat smaller meals and slow down. Smaller meals can help you reduce pressure in your stomach while eating slowly can help you identify when you’re full more quickly. By slowing down, you’re also less likely to irritate your esophagus. Wait at least three hours after eating before lying down or going to bed. Staying up a few hours before going to bed will reduce your risk of reflux. Elevate the head of your bed. This will reduce the contact of the lining of the food tube with acidic contents and help you get a good night’s sleep. Quit smoking. Do not smoke or chew tobacco. Choose water over soda. Carbonation bubbles can expand in the stomach, causing increased pressure that contributes to reflux. Avoid creamed or cheesy foods and soups. All high-fat foods can cause reflux, so skipping the dairy items can help. If untreated, GERD can lead to more serious health problems over time, including esophageal cancer. It’s important that you talk to your primary care doctor about your symptoms and find a solution that works best for you. There is not yet a cure for the disease but with lifestyle modifications and/or medications, you can manage your symptoms to improve your quality of life. If lifestyle changes and medication don’t help manage your GERD symptoms, your doctor may refer you to a surgeon. Surgery may also be a reasonable alternative to a lifetime of drugs and discomfort. Author Adrian Park, MD, is chair of Anne Arundel Medical Center’s Department of Surgery and an internationally recognized specialist in minimally invasive surgery. To schedule an appointment with him, call 443-481-6699. Originally published Nov. 26, 2018. Last updated Nov. 14, 2019.0
- Community, Infectious DiseaseGeneral Page Tier 3BlogCharlotte Wallace makes her way inside Morris H. Blum Senior Apartments. She knocks three times on one of the wooden doors. ‘I’m a nurse with Anne Arundel Medical Center,’ she identifies herself. The lock slowly turns. Before Wallace knows it, a hand quickly grabs the bag she’s holding and then disappears with the sound of the door shutting. ‘Thank you,’ they shout from inside. She smiles, grabs another bag and repeats the process. She does this with more than 150 tenants in that building alone. “Some of the seniors we visit are scared and close the door immediately,” she said. “Others give us Halloween candy in exchange as a thank you and some are just excited to see new faces.” Wallace explained a few of the residents are not as in tune with the news or updates. As a result, they’re confused as to why Wallace and her team are there. “We answer their questions and give them as much education as we can,” she added. Wallace is a community health nurse at Anne Arundel Medical Center (AAMC). Her main role is to bridge the hospital and the community. When news about coronavirus (COVID-19) broke, she knew she had a lot of work to do. She started by contacting community partners to look at ways to slow down the spread of the virus. This meant looking at the ‘wrong trends,’ misconceptions and ways to close the gap. To do this, she launched the COVID-19 Community Outreach program. The primary goal of the program is to decrease the spread and hospitalization of COVID-19 patients. This is achieved through increased education and improved access to support and health services. “We quickly discovered there was a gap in some of our housing units,” Wallace explained. This was primarily the case where subsidized seniors, disabled adults and homeless shelter residents lived. Wallace had already built relationships of trust and understood the systemic problems in the community. As a result, her approach included passing out educational fliers and kits to meet basic needs. On April 14, she started to knock on doors to personally distribute the kits. To date, she has visited 18 different locations around Anne Arundel County – conducting visits in 14 of those locations by herself. Just a couple of weeks later, another team at Doctors Community Hospital (DCH) did the same in Prince George’s County. This team covered 10 additional locations. “We used the same program in Prince George’s County,” said Leslie Strimel, director of Case Management, Social Work and Transition for Care at DCH. “We sent out a nurse practitioner to the communities that the county identified as being in need of this program.” Just like in Anne Arundel County, Strimel said low-income seniors in residential facilities formed these communities. Each COVID-19 Community Outreach kit has two cloth masks per resident, two laundry detergent pods and a bar of soap per apartment, along with educational resources. The printed resources are Centers for Disease Control and Prevention (CDC) guidelines simplified by Wallace to help residents understand how to best protect themselves. Each kit also includes fliers that explain how to wear a mask, how to protect yourself and others, how to wash your clothes during the pandemic and much more. In Prince George’s County, the educational material includes the 211 number, which is also a crisis number for behavioral health. According to Wallace, the identified gaps already existed. However, the outbreak made these and the need to close them more obvious. “Some people told me that they just wash their clothes in hot water and don’t use any soap,” she said. “With the pandemic, a lot of our most vulnerable residents are taking a bigger burden. ‘Just doing telehealth’ is not possible without a phone or an email address. Some of these residents don’t even have a landline.” Wallace goes out at least twice every week and visits several sites to distribute kits. Additionally, she gives out kits with instructions. These are specifically for management at the sites and include best practices to protect their residents. Wallace also uses visits as an opportunity to conduct screenings. These include screenings for mental health and nutrition. According to her, many seniors she visits are scared, isolated, already limited and depressed. “We came across a senior who was very depressed,” she said. “I went through a basic screening and I gave the person the crisis response number in case they needed to reach someone. I was giving out that number at least once per building, which is common.” To date, the program’s teams conducted over 2,900 visits in Anne Arundel County and over 2,250 visits in Prince George’s County. And while it is hard to measure the true impact of the outreach, Wallace is confident the team is helping many during this difficult time. “One day, a team entered a floor to find a gentleman, with rotted nubs for teeth, standing in the hallway,” she said, adding that he started to cry. “He said he thought we missed him with our ‘masks and laundry soap’ after his sister, who lives in the same building, called him to tell him that the nurses came by her apartment.” After a short screening, they noted that he had major food insecurities and connected him to the Senior Nutrition Program. Another resident received her kit and couldn’t stop hugging it. “She was so excited to receive two laundry detergent pods,” Wallace said. Similarly, Ursula Friton, manager of Transitional Care at DCH, said residents in Prince George’s County have been very welcoming of the program. According to her, it’s been very new but a great experience both for the DCH team and the seniors. “There was a big need for this program in our county,” she said, explaining that the program is on its third week. “Seniors are happy to see us and very grateful to get their kits.” The outreach teams in both counties plan to continue working with managers at the various facilities. They plan to support the most vulnerable communities, even after the pandemic subsides. Wallace and Strimel are working with both counties and the Maryland Health Department to reach other communities that are in need of resources and information.0
- Cancer CareGeneral Page Tier 3BlogWhen cancer begins inside the mouth, throat or nose, it is considered a head and neck cancer. According to the National Cancer Institute (NCI), head and neck cancers account for nearly 4 percent of all cancers in the United States. That may sound low, but more than 70,000 new cases are diagnosed in the U.S. annually. Our experts review the symptoms associated with this disease. The signs of head and neck cancer include: Lumps and sores that do not heal Persistent sore throat Difficulty swallowing Harshness/change in voice Red or white patches in the mouth Trouble breathing or speaking If you experience these changes, talk to your primary care doctor. These could be symptoms of cancer in the oral cavity, throat, voice box, sinuses or salivary glands. Depending on your symptoms, age and medical history, your provider can recommend a diagnostic test for you. Options including imaging, biopsies and speech and swallowing tests. If you are diagnosed with a head and neck cancer, treatment may include: Surgery Radiation Chemotherapy There is potential to use these treatments alone or combined, depending on the subtype and extent of cancer. Treatment requires expert team work among multiple doctors, such as ear-nose-throat (ENT) doctors, surgeons, radiation oncologists and dentists. These providers work together to create a treatment plan. Risk factors for head and neck cancer include heavy tobacco use, heavy alcohol intake and human papilloma virus (HPV). In fact, according to the Head and Neck Cancer Alliance, at least 75 percent of head and neck cancers are caused by alcohol and tobacco use. To reduce your risk of this disease, our experts recommend: Avoiding alcohol – it is best to not drink alcohol. If you choose to drink, drink moderately, limiting intake to no more than two drinks per day for men and one drink per day for women (definition per the Centers for Disease Control). Avoiding tobacco – it is never too late to quit smoking. Call Luminis Health at 443-481-5388 for free resources to help you quit. Vaccination for HPV – most providers routinely recommend it for preteens ages 11-12. For adults up to 45 years, have a thorough discussion with your provider. If you or a loved one has been diagnosed with a head and neck cancer, our cancer team is here to help. Read about our cancer care services to learn more. Authors Antony Koroulakis, MD is a radiation oncologist with experience treating a wide range of cancers.0
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