Beware the Innocent Flip Flop

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Whether you are heading to the beach, taking a dip in the pool, or taking a stroll to get ice cream, flip flops are a popular shoe choice for slip on and go! 

However, having the wrong flip flop can not only put a damper on summer, but can be a health hazard for those who do not pick the right ones to wear, according to Gigi Weiss, MSPT, RVNAhealth’s Director of Rehabilitation Services. 

Flip flops are breezy and cool, so what makes them so dangerous? 

Explains Weiss, “Their appealing characteristics – lightweight, minimally structured, easy to slip in and out of – often lead to debilitating conditions, including back pain, knee pain, plantar fasciitis and Achilles tendonitis.” 

Your aching back 

For starters, says Weiss, many flip flops have thin soles and minimal arch support. “This can wreak havoc on your kinetic chain – the muscles, connective tissues, joints, bones and nerves that work together – and cause back or knee pain.” 

Heel and lower-leg pain 

Another threat unique to flip flops is that tiny thong that separates your big toe from the rest of its partners. While this design allows your feet plenty of room to breathe, it also means that the tendons in your toes need to work constantly to grip the bottom of your footwear. 

This, says Weiss, often leads to plantar fasciitis – a painful condition resulting from inflammation of the fibrous tissue along the bottom of your foot that connects your heel bone to your toes. 

Traveling a bit farther up the leg, another area where you might experience discomfort is in the Achilles tendon. This largest tendon in your body connects your calf to your heel bone, notes Weiss. “Flip flops that lack support and structure cause the Achilles tendon to strain in unnatural ways, particularly if you have low arches or flat feet.” 

What to do? 

Patients who visit RVNAhealth’s Rehabilitation and Wellness Center with the conditions described above are generally prescribed a routine that includes biomechanical stretches to address the underlying symptoms, says Weiss. But, she adds, prevention is the best medicine. “If you must wear flip flops, purchase a pair with good orthotic support. And try to avoid wearing flip flops exclusively.” 

For more information, contact RVNAhealth’s Rehabilitation and Wellness Center at 203.438.7862 or rehabcenter@rvnahealth.org. 

A Healthier Take on Summer BBQ

RVNAhealth nutrition programs

Q:  We love hosting summer cookouts. How can we make our favorite barbecue foods healthier?

A:  To put a fresh and healthy spin on your cookouts, skip the hot dogs, hamburgers, cole slaw and potato salad for lighter options that are trending now. Another reason to lighten up? Without all those mayonnaise-based dressings, your food will stay safer outside on a hot day. Here are some ideas to keep you both healthy and safe:

Lighten Up and Foil Fat with a “Foil Pack”

Opting for grilling favorites that are lower in saturated fat than burgers and hot dogs is the way to start. Go for grilled chicken breasts or lean chicken sausage and a healthier salad on the side. One of my favorite prep methods is the foil pack. Wrap individual portions of meat and veggies in foil and toss on the grill.  A cool no-cook salad with zucchini noodles – also known as zoodles – adds a modern touch. Recipes below.

Healthy Hydration

While you’re at it, lighten up your drinks. Hydration is particularly important in the summer, but alcohol and sugary drinks aren’t thirst quenching and can even cause dehydration. If plain water isn’t your thing, try infusing your water or seltzer with flavor. Add fresh fruits like citrus, berries, and pineapple. Even better, use frozen fruit to both chill and infuse your drink. When you’re finished, the fruit will be defrosted, and you can eat it as a snack!

Safety First

To keep summer buffet foods safe, serve hot foods immediately and keep cool foods chilled (put a salad bowl over ice, for example). Cover food and clean and remove the serving utensils when not in use. As an extra measure, keep hand sanitizer handy so folks can clean up before digging in.

These simple swaps and precautions will keep you and your barbecue healthy and safe all summer. Enjoy!

Try these recipes at your next cookout!

Chicken, Tomato, Corn Packs

For each serving, cut a 12” piece of foil and place a boneless, skinless chicken breast, ½ cup grape tomatoes cut in half, ¼ cup corn kernels, and minced garlic to taste. Drizzle with 1 tablespoon of avocado oil or canola oil, salt and pepper. Seal all sides of the foil and grill on high until the internal temperature is 170 degrees (approx. 20-25 minutes).

Caprese Zoodles

Toss 1 package of zoodles (found in the produce section of most grocery stores) with 2 tablespoons olive oil, salt and pepper. Let marinate for 15 minutes. Add 2 cups of cherry tomatoes cut in half, 1 cup of mozzarella balls, 1/4 cup of torn basil leaves, and 1 teaspoon dried oregano. Drizzle with 2 tablespoons of balsamic vinegar.

Meg Whitbeck, MS, RD, is available for private consultations. For more information, contact RVNA at 203-438-5555.

Deep Dive Into … Water

RVNAhealth nutrition programs, fairfield county, ct

We know! We need to drink more water. Every single day without fail and a single cup won’t do. Correct?

Correct. For those of us who hydrate regularly, we know our bodies catch on. The more water we drink, the more we like it, the better we feel, the more we want it. When we’re low, we notice.

But for those of us who struggle with the immensity of the daily requirements and often simply ‘forget,’ the key questions are: how much do we really need and how can we meet our daily requirements and have a little fun while we’re at it? Are all types of water created equal? And do other beverages contribute to our daily allowance?

Here with advice is RVNA’s nutrition team, Meg Whitbeck, MS, RDN, and her newest colleague, Ava Safir, JD, MS, RDN.

How Much?

How much water do we need each day? Half your body weight in ounces per day, increasing to ¾ or even 1x your body weight if you exercise. You can hydrate with any clear beverage that is unsweetened (real or artificial sweetener), decaffeinated, and alcohol-free. Decaf herbal tea, mineral water, seltzer with a splash of fruit juice… it all counts. If you have a health condition that impacts your need for water – always follow the recommendations that your physician provides.

Are all waters created equal?

Mineral water is typically from a natural, spring-fed source. Water that is from a natural source/spring will have minerals in it from the rock/ground surrounding the area. So, if a spring flows through a limestone rock, it will have higher levels of calcium than water that flows over granite. You can also find sodium, potassium, iron, calcium, magnesium, selenium and many other minerals dissolved into mineral water. That’s the good news. Pollutants also find their way into mineral water too, so you need to proceed with caution.  Know the source of your water, check the bottling dates, and choose glass bottles!
We recommend no more than 10 oz. per day.

Purified water, meanwhile, is treated and filtered to remove any possible contaminants. Distilled water – a form of purified water — is boiled, and the steam is collected and bottled. Distilled water has no minerals in it. Sounds harmless, right?  So why don’t we all drink distilled water all the time? Well, due to the lack of minerals, distilled water doesn’t contain any of the electrolytes, which are minerals, and we need electrolytes for proper hydration and fluid balance in our body. Without electrolytes, we would perish! Who wants that?
We do not recommend drinking distilled water unless it is used to prepare infant formula. 

What about alkaline water?  Well, alkaline water is water that has minerals dissolved into it that raise the pH to a more alkaline level. These minerals are more of those “good-for-you electrolytes” that we just talked about. However, if you water is acidic or too alkaline (aka ‘hard water’), that could be a tad problematic for your teeth, stomach and appliances!
We recommend alkaline water with a known pH of 7.1 – 9.5. 

And seltzer? There is a huge seltzer trend these days. Fizzy and appealing on a hot summer day and the flavors add a little glamour to the whole situation.

Seltzer is carbonated water, usually with natural flavorings added. Ava Safir, MS, RDN, says this: “Seltzer is a great alternative to sugary drinks and sodas when you have a taste for a bubbly treat with flavor. Just be careful to limit your intake to 8-12oz daily since carbonated beverages can increase symptoms of GERD and negatively impact your bone and tooth health.”
To repeat, we recommend no more than 8-12 oz per day.

What about bottled waters – so sleek and attractive?  We are conditioned to think that bottled water is somehow healthier, but .. behold ..  it is not! Bottled waters are expensive and harmful to the environment. Plus, drinking water that has been sitting in plastic for several weeks (or even months) is not ideal. We understand that there’s a time and a place and sometimes bottled water is the only option, but don’t be fooled into thinking there’s an additional health benefit.
We recommend on an as required/needed basis. 

And last but not least, do you want to know what the best water for you is?  The old standby. Tap water.  Cheap, safe, accessible, contains local minerals, environmentally friendly.  It’s hard to beat. If you have a well, be sure to test your water yearly
Our recommendation: turn on your faucets and enjoy in superfluity.

The upshot: Drink mostly tap water. Enjoy carbonated, mineral, and bottled water sporadically.

Eating for Brain Health

RVNAhealth nutrition programs

June 2018: Eating for Brain Health

My family has a history of Alzheimer’s Disease. I’ve read about different diets that can help reduce the risk. What are they and do they work?

A healthy diet is certainly a good place to start in the prevention of many conditions, and brain health is no exception. While there’s no single diet that is proven to reduce the risk of Alzheimer’s, there is promising information about dietary approaches that may help brain function in indirect ways.

What’s key is reducing the risk of other conditions that can contribute to a decline in cognitive function. Cardiac disease and high blood pressure are both linked to a deterioration in blood vessels, including blood vessels in the brain, which increases the risk of Alzheimer’s and vascular dementia. Eating to protect your heart and lower your blood pressure can have the added benefit of lessening risk factors associated with cognitive decline. Diets that reduce cholesterol and inflammation can also contribute to a reduced risk for Alzheimer’s, again because they can reduce your risk for heart disease.

There are three eating styles that show promise in protecting heart health and reducing blood pressure, and therefore may improve brain health, as well. They are the Mediterranean Diet, the DASH Diet, and the Mind Diet. These diets all have some elements in common and it’s smart to consider incorporating these into your diet:

Up This

  • Foods high in monounsaturated and omega-3 fatty acids, such as olives, ground flaxseed, cold water fish and nuts
  • Fruits and vegetables, particularly green, leafy vegetables
  • Whole grains and beans (legumes)
  • Lean meat and occasional low-fat dairy foods

Reduce That

  • Sugar – including honey, syrup, agave and other “natural” forms of sugar
  • Artificial sweeteners – including Stevia, Splenda, Sweet ’N Low, Equal and sugar alcohols
  • Processed carbohydrates, such as those made with white flour
  • High-fat dairy products
  • High-fat and processed meats, such as deli meats and bacon
  • Alcohol

Although there’s no sure-fire way to completely prevent or reverse Alzheimer’s, improving your overall health through diet is certainly food for thought.

If you want to discuss dietary approaches to prevent and manage specific diseases, feel free to contact me for a private consultation at 203-438-5555

Anne Cofone, RN, MSN, LCSW, Joins RVNA as Hospice Clinical Supervisor

RVNAhealth senior care, elder care, fairfield county, ct
Anne Cofone, RN, MSN, LCSW
Anne Cofone, RN, MSN, LCSW

RVNA is pleased to announce that Anne Cofone, RN, MSN, LCSW, has joined our Hospice team as Hospice Clinical Supervisor.  In this role, Cofone is responsible for day-to-day operational oversight and management of the Hospice staff.  She brings significant clinical and social work skills to the position.

A Registered Nurse (RN), and Licensed Clinical Social Worker (LCSW), Cofone holds a Master of  Science degree in Nursing, Social Work and Community Psychology.  She is also currently in the dissertation phase for her PhD in Social Work at Adelphi University.  Cofone has worked in the healthcare field for most of her long career, applying her diverse experience to acute hospital settings, community and home health, academia, and psychiatry.  In the past couple of years, Cofone has discovered her love of working in the hospice and palliative care field.  “It is a place where all of my clinical and human skills are utilized.”

As the Hospice Clinical Supervisor, Cofone will work closely with Hospice staff and families.  Her responsibilities will include clinical oversight, patient advocacy and satisfaction, regulatory compliance, and ongoing education and evaluation of Hospice staff. .

“What I really like about RVNA are the kind, welcoming people and atmosphere.  I love working in the palliative and end-of-life hospice field and I look forward to continuing to grow professionally and personally through my experiences here at RVNA.”

Cofone currently resides in Norwalk and is the proud great-aunt of an adorable 16-month old nephew.  No stranger to Ridgefield, Cofone attended high school at the (long-ago closed) Notre Dame Academy on West Mountain Road.  “Notre Dame provided me with a solid foundation in independent thinking, never taking things at surface value, and challenging myself to always do a little more.  This frame of reference has guided me both professionally and personally throughout my life.”

Cofone started at RVNA on Monday, June 17th.

The Salad Days of Summer

RVNAhealth nutrition programs, fairfield county, ct

In the summertime, we like to keep it fresh and simple.  This year, we’re kicking off the season with salad. Easy to make, easy to eat, and delicious to boot, salads are fast, inexpensive, and versatile.

“Salads can get a bad rap,” says Meg Whitbeck, MS RDN, RVNA’s registered dietitian and nutrition educator.  “People perceive them as “diet food,” or some kind of ‘penance,’ or just a bowlful of lettuce.  But they are so much more!”   Whitbeck’s evidence: Citrus Kale Salad and Tomato & Rye Panzanella, recipes she discovered to keep our salad days fun and flavorful.

As these recipes prove, your salad can be vegetable-based and enjoyed as a side dish or snack; or you can make it a complete meal with the addition of a protein, like beans, fish, nuts, seeds, or lean meat.  Or, you can skip the lettuce altogether, like the Panzanella, and build the salad with toasted bread as the base.  A sandwich in disguise!

When preparing these salads, remember these salad prep basics:  Always wash your hands, cutting boards, and your produce before constructing your masterpiece. When adding meat or fish, prep your salad first, and then prepare and cook your meat and fish. This reduces the risk of contaminating your fresh salad with bacteria from uncooked protein.

Bon appetit!

Recipes — A Tale of Two Salads – Final

Seasonal Allergies and Nutrition

RVNAhealth seasonal allergies

Is there a link between seasonal allergies and diet?

I get this question all the time. And the short answer is YES!  There is a relationship between a person’s diet/nutrition and their seasonal allergies and the connection can best be understood with an explanation of “Oral Allergy Syndrome.”

Also known as “pollen-food syndrome,” Oral Allergy Syndrome is when a person exhibits an allergic reaction in response to certain food items, typically foods that are high in pollen and allergens, such as tree nuts, raw vegetables, and raw fruits. Different foods cause trouble for different people, and typically relate to their specific seasonal allergies.  But first, it’s important to note the difference between Oral Allergy Syndrome and more traditional food allergies to be sure you’re seeking the right help if you respond allergically to certain foods. Let’s start by breaking it down….

Oral Allergy What?

Those who suffer from seasonal allergies due to tree pollen, grass pollen, or ragweed can also experience a type of allergic reaction when eating foods that contain those allergens, as well.  Reactions can range from mild itching and tingling of the lips and tongue to extreme itching of the lips, tongue, cheeks and throat. This kind of reaction is called Oral Allergy Syndrome. It is common in older children, teens, and young adults, and is most frequently found in people who have grass pollen, birch, and ragweed allergies.

What to Watch Out For

Allergic to ragweed? You may find yourself reacting to bananas, melon, or zucchini.  Sensitive to grass pollen? Dates, oranges, potatoes, or peanuts could cause trouble.  Is tree pollen your nemesis? The list of potential trouble makers is long, and includes apples, strawberries, cherries, beans, carrots, almonds, sunflower seeds, and more. The good news is that people who suffer from Oral Allergy Syndrome may be able to eat foods that typically trigger an allergic reaction if they’re cooked. Cooking alters the proteins that cause the reactions, so the immune system no longer triggers a response. Check with your doctor before trying this approach.

Food Allergies – Nothing to Sneeze At

It’s important to make the distinction between a reaction caused by the presence of pollen in certain foods, and a full-blown food allergy, which can be much more serious. There are eight major food allergens – fish, shellfish, milk, eggs, tree nuts, peanuts, wheat, and soy. In allergic individuals, these foods cause symptoms ranging from mild itching of the skin that comes in contact with the allergen, stomach upset, diarrhea, vomiting, swelling of the lips, tongue and throat, and hives to anaphylaxis, a potentially life-threatening reaction.

While those with Oral Allergy Syndrome can sometimes eat bothersome foods by cooking them, this is NOT the case for those with a traditional food allergy. If you are having any concerns with reactions to food, it is always best to see your doctor or allergist to confirm whether or not there is a true allergy present.

As a dietitian, I work with many clients who have food allergies and intolerances. We work together to examine symptoms and see what foods work best for them. I’m also able to give clients alternatives to the foods that they really miss and help create menus to be sure they’re getting the proper nutrition for their needs.

If you suspect you have a food allergy or intolerance, it’s critical to get tested by a professional, as opposed to trying to solve the problem yourself. Once you have your results, you can work with both your doctor and a dietitian to stay safe and find foods that you enjoy.

It’s allergy season.  Be careful out there!

If you need help getting started on your nutritional journey, feel free to contact me for a private consultation at 203-438-5555.

Arthritis and the Anti-Inflammatory Diet

RVNAhealth Arthritis in Hands, elder care programs

I know nutrition can help with conditions like heart disease and diabetes, but what about arthritis. Will changing my diet help my condition?

I’m sorry to hear about your arthritis but am happy to report that there are definitely things you can do nutritionally to protect against the development of the condition or lessen the severity of symptoms. Simply put, arthritis is inflammation in the joints that worsens over time. Several types of arthritis together affect millions of Americans and limit their daily activities. So, what’s the nutritional approach to help with the inflammation of arthritis? An anti-inflammatory diet. Here are key elements to keep in mind.

Out with the Bad — Foods that Promote Inflammation
Higher intake of meat and alcohol contributes to increased inflammation in the body. Lower consumption of vitamin C in fruits and vegetables, whether in combination with high meat and alcohol intake or not, also contributes.

In with the Good – Foods that Help
Evidence suggests that increasing consumption of vitamin C, vitamin D found in fatty fish, omega 3s found in ground flaxseeds and flaxseed oil, and nutraceuticals such as glucosamine and chondroitin may help with arthritic symptoms. Phytochemicals found in a wide variety of foods such as fennel, garlic, basil, rosemary, pomegranate, turmeric, red pepper, cloves, anise, and ginger can also fight inflammation.

Lighten Up
For osteoarthritis in particular, weight loss is effective because excess weight strains the joints. As little as a 5% reduction in weight from a sensible diet— in an overweight person — can bring an 18% gain in overall functioning. While it’s not recommended that people at a healthy weight attempt to lose weight, everyone benefits from vitamins A, C, D, E and omega-3s.

Translating it to the Kitchen Table
The anti-inflammatory diet isn’t new. In essence, it’s similar to the Mediterranean diet, which has myriad health benefits beyond reduction of inflammation. The recommendations from the Academy of Nutrition and Dietetics include:

  • Fish: 3-4 oz. fatty fish (cold water fish like salmon, tuna, scallops, sardines, herring) twice a week. If you’re not a fish fan, try taking 600-1,000 mg of fish oil daily. Omega-3s found in these foods and supplements can help with pain, swelling, stiffness, and tenderness.
  • Nuts: 1 ounce per day to provides benefit from vitamins B6 and Omega-3s. Choose walnuts, almonds, pistachios, or pine nuts.
  • Fruits and vegetables: Nine or more 1-cup servings per day helps due to the antioxidants and phytochemicals they offer. Quick tip — the brighter the color, the higher the antioxidants, so choose broccoli, spinach, kale, blueberries, cherries.
  • Beans: 1 cup at least twice per week. Beans contain fiber and phytonutrients that can help lower a key marker of inflammation in the blood, and are filled with protein which helps with muscle health. Best choices include red kidney beans, pinto beans, and small red beans.
  • Whole grains: 6 oz. of grains per day (at LEAST 3 oz. should be whole grains). A serving boils down to a cup of cooked brown rice or one slice whole grain bread. Much like beans, the fiber here is key.
  • A word about night shade vegetables: Some people report more pain when consuming tomatoes, eggplants, potatoes, and red bell peppers, sometimes referred to as nightshade vegetables. If they cause discomfort for you, avoid them. Otherwise, feel free to eat them as they contain antioxidants, vitamins, and minerals!

By following an anti-inflammatory diet, you can keep inflammation and arthritic symptoms at bay. As always, it’s important to talk to your doctor or healthcare team about supplementation and what’s the best fit for you.

Meg Whitbeck, MS, RD, counsels patients in disease management through nutrition. For more information or to schedule a private consultation, contact RVNA at 203-438-5555