health beat, june 2013

BeatMMAAGGAAZZIINNEE

JUNE 2013 A PUBLICATION OF THE RICHMOND REGISTER

Health

DEALING

WITH THE

TERRIBLE

TEMPER

TANTRUMS

DR. RUTHERFORD:

How manysteps areenough?

Rabiesstill common

in the wildAs long as rabies is circulating among

wildlife populations, our best protectionagainst this fatal disease is to keep dogs

and other pets vaccinated annually.

TIME TOMAKE

MY FAT

FEELING THEBURN WITH BURNS:

Cry

2 Richmond Register HEALTH BEAT JUNE 2013

IndependentLiving

625-1400

AssistedLiving

625-1400

Personal/Nursing Care

626-5200www.standrewsplace.orgConveniently Located off

Tates Creek Ave.,Near Downtown Richmond

A Continuum of Care...

In a Community That Cares

By Lindsey TannerAP Medical Writer

CHICAGO — As the guitarist strumsand softly sings a lullaby in Spanish, tinyAugustin Morales stops squirming in hishospital crib and closes his eyes.

This is therapy in a newborn intensivecare unit, and research suggests thatmusic may help those born way too soonadapt to life outside the womb.

Some tiny preemies are too small andfragile to be held and comforted by humantouch, and many are often fussy and showother signs of stress. Other common com-plications include immature lungs, eyedisease, problems with sucking, and sleep-ing and alertness difficulties.

Recent studies and anecdotal reportssuggest the vibrations and soothingrhythms of music, especially performedlive in the hospital, might benefit pre-emies and other sick babies.

Many insurers won’t pay for musictherapy because of doubts that it results inany lasting medical improvement. Somedoctors say the music works best at reliev-ing babies’ stress and helping parentsbond with infants too sick to go home.

But amid beeping monitors, IV poles

and plastic breathing tubes in infants’rooms at Chicago’s Ann & Robert H.Lurie Children’s Hospital, music thera-pist Elizabeth Klinger provides a sooth-ing contrast that even the tiniest babies

Tiny preemies geta boost from live

music therapy

AP PHOTO/M. SPENCER GREEN

Music therapist Elizabeth Klinger, left, quietly plays guitar and sings for Henry Buchert and his motherStacy Bjorkman, in the Pediatric Intensive Care unit at Ann & Robert H. Lurie Children’s Hospital inChicago. Research suggests that music may help those born way too soon adapt to life outside thewomb. Recent studies and anecdotal reports suggest the vibrations and soothing rhythms of music,especially performed live in the hospital, might benefit preemies and other sick babies.

Turn to MUSIC THERAPY, page 7

JUNE 2013 HEALTH BEAT Richmond Register 3

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READ CHRISTIE GREEN’S COLUMN ON PAGES 8-9

GROWING UP: Dealing with the terrible temper tantrums . . . . . . . . . . . . . . . . . . . . . . .page 4

FEELING THE BURN WITH BURNS: Time to make my fat cry . . . . . . . . . . . . . . . . . . . . . . .page 5

THE BREAKING POINT: Defeating bullies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .page 6

DR. JACK RUTHERFORD: How many steps are enough? . . . . . . . . . . . . . . . . . . . . . . . . .page 10

RECIPE FOR A HEALTHY LIFE: A lighter take on barbecued chicken . . . . . . . . . . . . . . . . .page 11

MENTAL MORSELS: Defining your terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .page 12

MEDICAL MINUTE: Best workouts for good health . . . . . . . . . . . . . . . . . . . . . . . . . . . . .page 13

CHIROPRACTIC CORNER: Try chiropractic for help with migraines . . . . . . . . . . . . . . . . .page 14

WASHINGTON (AP) — A surprising new report ques-tions public health efforts to get Americans to sharplycut back on salt, saying it’s not clear whether eatingsuper-low levels is worth the struggle.

Make no mistake: Most Americans eat way toomuch salt, not just from salt shakers but because ofsodium hidden inside processed foods and restaurantmeals. The report stresses that, overall, the nationneeds to ease back on the sodium for better hearthealth.

But there’s no good evidence that eating very lowlevels — below the 2,300 milligrams a day that thegovernment recommends for most people — offersbenefits even though national guidelines urge thatcertain high-risk patients do just that, the Institute ofMedicine concluded.

Also, there are some hints, albeit from studies withserious flaws, that eating the lowest levels might actu-ally harm certain people — those who are beingaggressively treated for serious heart failure, thereport added.

The prestigious group, which advises the govern-

ment about health, urged more and better research tosettle the best target range.

“We’re not saying we shouldn’t be lowering exces-sive salt intake,” said Dr. Brian Strom of the Universityof Pennsylvania, who led the IOM committee. Butbelow 2,300 mg a day, “there is simply a lack of datathat shows it is beneficial.”

The average American consumes more than 3,400mg of sodium a day, equivalent to 1 1/2 teaspoons.Current U.S. dietary guidelines say most people shouldlimit that to 2,300 mg a day, while certain people —those older than 50, African-Americans, and peoplewith high blood pressure, diabetes or chronic kidneydisease — should aim for just 1,500 mg.

The report sparked an immediate outcry fromhealth organizations that have long battled to lowerthe nation’s salt consumption.

The American Heart Association said it stood by itsown recommendations, stricter than the govern-ment’s, that everyone eat no more than 1,500 mg of

Study questions how sharply U.S. should cut the salt

Turn to SALT, page 15

Rabiesstill common in the wildAs long as rabies is circulatingamong wildlife populations,our best protection is tokeep dogs and other petsvaccinated annually.

The mother could tell itwas about to begin. She

had just told her 2-year-oldthat she could not have acookie. The 2-year-old’s facewas beginning to turn red.She was starting to open hermouth where a howling,high-pitched screech cameout with the words, “I wantit!” The girl proceeded tocontinue screaming and

stomping her feet. The mother is beginning

to wonder if these frequenttemper tantrums are normaland if so, will they ever goaway?

Temper tantrums arenever easy to deal with, espe-cially when it is your darlinglittle one that is throwing thetantrum. The good news isthat temper tantrums in

young children is a normalpart of development and willtypically go away in time.

Temper tantrums are asign that toddlers are becom-ing more independent andthey want the world to knowit. However, they only havelimited ways of displayingtheir wants and needs. Thisusually consists of basicwords like “no” and behav-ioral outbursts.

Temper tantrums tend tostart around 18 months ofage, worsen between the agesof 2 to 3 years old, and thenlessen by the age of 4. By theage of 4, most children havesufficient language skills sothat they are better able tocommunicate their wantsand needs through wordsversus actions.

While it is comforting toknow that temper tantrumswill eventually fade, thereare still a couple of years inwhich parents need to dealwith them. When a tantrumdoes occur, it is important tostay calm and see how thetantrum progresses as theyare often short-lived.

Ignoring minor displays ofanger such as crying,screaming, and kicking canalso shorten the duration ofthe tantrums. Other timesdistraction like changing thechild’s location can prevent atantrum.

However there are somebehaviors that are not okayand should not be ignored.This includes hitting or kick-ing people, throwing thingsthat might hurt others, or

screaming or yelling for longperiods of time. If any ofthese behaviors occur, takethe child away from the prob-lem and say firmly, “No hit-ting” or “No yelling” toensure the child knows thebehaviors are not okay.

Of course prevention canbe the most satisfyingapproach to tempertantrums. One technique isto encourage the child to usewords to tell how he is feel-ing. Another technique is toset reasonable limits and notexpect the child to be perfect.A third technique is to keep adaily routine as much as pos-sible so the child knows whatto expect.

Finally, give the childchoices such as askingwhether they want to eattheir goldfish or drink theirjuice. It is harder for thechild to get upset when theyhave some choices.

There are some childrenwho continue to tantrum reg-ularly past 4 years old. If thetantrums are severe or hap-pen too often, it could be asign of early emotional prob-lems. If this is the case, con-sult with a pediatrician orchild psychologist about theissue.

Dan Florell, Ph.D., is an assis-tant professor at EasternKentucky University and has aprivate practice, MindPsi(www.mindpsi.net). PraveenaSalins, M.D., is a pediatricianat Madison PediatricAssociates (www.madis-onpeds.com).


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DAN FLORELL, PH.D. AND

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G R O W I N G U P

TERRIBLETEMPERTANTRUMS

Dealingwith the

If every time I wrote thiscolumn I talked about

how great I was doing withmy weight-loss efforts, youwould know I was lying toyou.

I almost didn’t want tostart this column because Iknew if I hit a snag, I wouldfeel crappy about reporting itto the people who are hold-ing me accountable.

Although I want to behappy for other people whomake and achieve weight-loss goals, I find myself shut-ting them out, mostlybecause I’m jealous that I’mnot getting the same results.

None of this is Neil’s fault.He’s constantly encouraging.He kicks my butt duringworkouts to maximize mycalorie burn. And mostimportantly, he never givesup on me.

I’ve not given up on myself,by no means, but I’m current-ly searching for ways torecommit myself to this jour-ney in light of a work/homeschedule that has becomeincreasingly crushing.

Let me tell on myself.Here’s what I do: I don’t eatbreakfast. I work all day andgrab some food when I can(most of the time it’s a not-so-healthy choice). When Iget home, I’m starved and amusually inclined to eat what-ever is easiest to consume. Igo to sleep late, wake upearly, and repeat.

Neil always says if you getyour eating right, the restwill fall in line. I know that’strue because I’ve kept up thesame intensity during work-outs, but have strayed (far)

from my calorie goals (eithertoo much or too little). I haveto remember it’s not alwaysabout eating less, but eatingright.

During January, the firstmonth of my weight-lossjourney, I lost more than 10inches and almost 10 pounds.But once I stopped keepingan eye on calories and eatingthe right foods at the righttimes, I stopped losing.

I was asked to include inmy column a numbersupdate on pounds and incheslost, but I don’t have one. I’venot lost anymore weight. ButI still have hope.

When I lost 70 poundsbefore my pregnancy, Ithought I would NEVER seethose pounds again. I swore Iwould never gain them back.I couldn’t even fathom it. ButI know of others who havegotten closer to their weight-loss goals than I, but sudden-ly found themselves rightback where they started.

For example, Neil said onetime he lost more than 100pounds. But he got injuredsomehow, gained every bit ofit back and then some. It’s afamiliar story for anyonewho has tried to lose weight.

I don’t know the answersright now. To some, losingweight seems as simple ascalorie-watching and exercis-ing, but it’s the most difficultthing to actually do.

Being discouraged aboutthe progress of my weightloss has stopped me fromcontinuing before – but notthis time.

Quoting redneck extraor-dinaire Joe Dirt: “You gotta

keep on keepin’ on.” Regardless of my slow

progress, I’m getting in regu-lar workouts, I’m buildingfat-burning muscles, and I’melevating my heart-rate dur-ing cardio exercise.

I look at Neil, who just cel-ebrated his three-yearanniversary since he startedthe journey to lose 400

pounds, and I know I don’thave nearly as far to go. I canbe at the weight I want to bewithin a year if I could justget this right. I have to getthis right.

In a recent Facebook sta-tus update, Neil wrote it was“time to make my fat cry.”

I agree Neil; that’s whattime it is.


FEELING THE BURN WITH BURNS

TIME TO MAKE

MY FATCRYSTAL WYLIE

FEELING THE BURNWITH BURNS

Editor’s note:The Register featuredRichmond native Neil

Burns three times over thecourse of his incredibleweight-loss journey. In2010, Burns was a 680-pound backhoe operatorwho began to lose weight“the old-fashioned way”

through healthy eating andexercise. Today, Burns is

a personal trainer atFirst Step Fitness andis helping others maketheir own incredibleweight-loss stories.

Cry

Have you or your childever had to deal with

bullies? When most peoplethink of bullies they think ofthe old school-yard, but thatisn’t always the case.

Bullies come from allwalks of life. They come indifferent shapes, sizes and allethnic backgrounds. In theend, for the most part, bulliesare who they are because oflow self-esteem. Maybe theywere treated that way andbelieve that everyone mustgo through it. Or their livesare so bad and uneventfulthat they feel the need toshare it with you.

A person has two optionswhen it comes to bullies.Either stand up for yourselfor back down and continueto take the punishment.

Now standing up meansmany things, and only oneaspect is physical. It also hap-pens to be the last option.You’ve probably heard thesaying, “The worst thingabout war is war itself.” So itis with physical altercationsbecause there are so manyuncontrollable variables thatcan go wrong during a fight.While they may be necessaryfrom time to time, more oftenthan not they can easily beavoided with a little brains.

There are a few basic pre-pare strategies to defeat abully nonviolently. One is tosimply walk away. This isusually very easy to do and ittakes some guts or moxie todo.

Now when you walk away,keep your head up and walkaway no matter what thebully or bullies say. Above all,don’t mouth back or say ordo anything that would raisetensions. Be humble andwalk slowly and confidently.

This is usually the best

approach.It’s safe,easy todo,and haslittle to nodrawbacks. Plus while walk-ing away you could tell ateacher or supervisor aboutwhat happened. Parents,teachers and coaches canteach this technique and oth-ers quickly and safely.

A second tactic is to makea joke out of a taunt andmake light of it or agree withthe bully.

For example, let’s say abully makes fun of yourneon-orange with blue, pinkand purple stripe shirt. Aneasy response would be toagree with the bully that theshirt is ugly and that you’rewearing it as a bet. Anothereasy one is to blame it onyour mom or wife for pickingout such a bad selection.

If you notice these don’trequire a lot of thought, andit quickly calms down the sit-uation., especially if the bullyhas lots of friends aroundand feels he or she has tolook good in front of theirbuddies.

Usually this tactic worksvery well. Just be sure tolook the bully in the eyewhen you say it and stand upstraight with good postureand speak in a confident,nonaggressive voice.

More on this next time ...

Master Will Schneider is theCEO of Elite Martial Arts &Fitness, Martial Arts Global,and the Elite Martial ArtsChallenge. He is a 1996 WorldMartial Arts Hall of FameInductee and a popular speak-er on self-defense, leadershipskills and child protectionskills. He can be reached [email protected].


MASTER WILLSCHNEIDER

DEFEATING

BULLIES

T H E B R E A K I N G P O I N T

seem to notice“What music therapy can

uniquely provide is that pas-sive listening experience thatjust encourages relaxation forthe patient, encourages partic-ipation by the family,” Klingersaid after a recent session inAugustin’s hospital room.

The baby’s parents, LucyMorales and AlejandroMoran, stood at the crib andwhispered lovingly to theirson as Klinger played tradi-tional lullabies, singing inSpanish and English.

“The music relaxes him, itmakes him feel more calm”and helps him sleep better too,Lucy Morales said.“Sometimes it makes us cry.”

Some families request rockmusic or other high-temposongs, but Klinger alwaysslows the beat to make it easi-er on tender ears.

“A lot of times familiesbecome afraid of interactingwith their children becausethey are so sick and so frail,and music provides themsomething that they can stilldo,” Klinger said, who worksfull time as a music therapistbut her services are providedfor free.

Music therapists say liveperformances in hospitals arebetter than recorded musicbecause patients can feel themusic vibrations and alsobenefit from seeing the musi-cians.

More than two dozen U.S.hospitals offer music therapyin their newborn intensivecare units and its popularity isgrowing, said Joanne Loewy, amusic therapist who directs amusic and medicine programat Beth Israel Medical Centerin New York.

Preemies’ music therapywas even featured on a recentepisode of the hit TV show“American Idol,” when showfinalist Kree Harrisonwatched a therapist working

with a tiny baby at Children’sHospital Los Angeles.

“Music is such a huge partof our lives and to do some-thing like this, make it a sortof healing process, is a coolthing,” Harrison said on theApril 25 episode.

Dr. Natalia Henner, a new-born specialist at Lurie hospi-tal, said studies in nursingjournals show music therapyfor preemies “does help withpromoting growth. Andthere’s some good literature ...saying that the time to dis-charge is a little bit shorter inbabies who’ve been exposedto more music therapy.”

She said it “definitely facili-tates bonding” between par-ents of preemies and otherbabies too sick to go home.

Loewy led a study pub-lished last month in the jour-nal Pediatrics, involving 11U.S. hospitals. Therapists inthe study played special smalldrums to mimic womb soundsand timed the rhythm tomatch the infants’ heartbeats.The music appeared to slowthe infants’ heartbeats, calmtheir breathing, and improvesucking and sleeping, Loewysaid.

Soozie Cotter-Schaufele, amusic therapist at AdvocateChildren’s Hospital-ParkRidge near Chicago, sayssoothing rhythmic sounds ofmusic can mimic wombsounds and provide a comfort-ing environment for preemies.

She sings and plays a smallharp or guitar, and says thesounds help calm tiny babieswhile they’re undergoingpainful medical procedures.

Cotter-Schaufele said sherecently heard from a womanwhose daughter was born pre-maturely at her hospital six

years ago. She had played the1960s folk song “Today” forthe infant.

The mother reported herdaughter “’still loves thatsong,” She said ‘She didn’tlearn that song from me, shelearned it from you,’” Cotter-Schaufele said.


MUSICTHERAPYContinued from page 2

Music therapistElizabethKlinger, right,quietly playsguitar andsings forAugustin as hismother, LucyMorales, sitsnext to him inthe newbornintensive careunit at Ann &Robert H. LurieChildren’sHospital inChicago.

AP PHOTO


Rabies is such an uncommon dis-ease in our society today that wemay only think of it when our vet-erinarian reminds us to get ourpets’ annual vaccinations. However,on closer inspection one finds thatthis disease is not as uncommon asit appears.

Rabies has beenwith us a long time

The name rabies comes from theLatin revere, which means to rageor rave. The Greeks gave the humanform of rabies the name hydropho-bia. This means “fear of water,”

which is a symp-tom shown by

rabies vic-tims.

With animal bites being the mostcommon form of transmission, andwith maddening symptoms endingin death, the disease has held ourattention for millennia.

Its incidence has been document-ed throughout history, with recordsas far back as the Babyloniansdescribing symptoms and deathsfrom rabies more than 4,000 yearsago.

Rabies occurs in outbreaks, andthe number of cases in a region willrise and fall over time. During theMiddle Ages, officials in cities some-times ordered mass slaughter ofstray dogs to try to stop rabiesoutbreaks.

The majority of rabiescases happen in wildlife,such as raccoons, foxes,

skunks and bats. However, mostcases in humans are from being bit-ten by a domestic animal. Dogs arethe most common transmitter ofrabies to humans because they arethe most common link to infectedwildlife.

Rabies is more common in devel-oping countries that lack caninevaccination programs than in indus-trialized countries. The WorldHealth Organization Reports thatglobally, approximately 35,000 to50,000 individuals die of rabieseach year.

Rabies is fatal if not treatedBEFORE symptoms show

Rabies is a viral disease thataffects the central nervous sys-tem. It can take a long time forrabies symptoms to appear, butthe course is quick and fatalonce symptoms develop.

Early symptoms include anx-iety, confusion or agitation. Asthe disease progresses, victimsexperience delirium, hallucina-tions, abnormal behavior andinsomnia. Paralysis typicallyoccurs, and death comes fromcardiac arrest as the victims’

systems shut down.To date, less than 10 docu-

mented cases of human survivalhave been reported. After develop-

ing symptoms, victims typically liveonly 10 days or less.

For thousands of years, no hopeexisted for someone bitten by arabid animal. Then Louis Pasteurand Emile Roux created a vaccine

RabiesCHRISTIE

GREEN, MPH

MCHD PUBLIC

INFORMATION

OFFICER

M A D I S O N C O U N T Y H E A L T H D E P A R T M E N T

still common in the wildAs long as rabies is circulating among wildlife populations, ourbest protection is to keep dogs and other pets vaccinated annually.


June 8th10 a.m.- 2 p.m.Madison County Health

Department*216 Boggs Lane, Richmond

Sponsors: SkipworthVeterinary Clinic; Town &Country Veterinary Clinic

June 22nd 12 -2 p.m.ByPass Animal Clinic1401 Lexington Rd,

RichmondSponsor: ByPass Animal

Clinic

July 13th10 a.m.- 2 p.m.Madison County Health

Department*216 Boggs Lane, Richmond

Sponsors: Central MadisonVeterinary Clinic; Barnes MillAnimal Hospital

August 3rd12-2 p.m.Advanced Animal Care201 Pauline Dr., BereaSponsor: Advanced Animal

Care

Cost: $5 per vaccination.Clinics will be held

regardless ofweatherconditions.

Each year MCHD, in partnership with several local veterinarians, provides rabies vaccination clinics

Prevent rabies -have your dogs, cats, and ferrets properly vaccinated

for humans that successfullyprevented a case of rabies in1885. Scientists now use a PEP(postexposure prophylaxis)treatment made up ofimmune globulin and a seriesof rabies vaccines to preventthe disease.

However, the PEP treatmentis only effective if given quick-ly, before symptoms begin.

Rabies is trickyIn the United States, public

health departments beganoffering rabies vaccinationclinics for domestic pets in the1940s. Thanks to success atgetting a good portion of thedog population vaccinated,rabies incidence has changeddramatically over the last 80years. Before 1960, the majori-ty of rabies cases were indomestic animals. Now mostdocumented cases are in wildanimals.

Currently, there are lessthan 10 deaths per yearbecause of rabies in the U.S.The few fatalities that do occurare in people who failed to getimmediate medical attentionafter a bite, usually becausethey were not aware that theyhad been exposed to rabies.

We can’t rest on our laurelswith rabies, however. It is stillcommon in the wild, andparts of the world wherecanine vaccinations are notwidespread still see severaldeaths from rabies each year.As long as rabies is circulatingamong wildlife populations,our best protection is to keepdogs and other pets vaccinat-ed annually.

We shouldn’t forget ourcompanions, either. Rabies isalso deadly for our pets.Vaccinating them annuallyhelps keep them protected,too.

Madison County Health Department 2013 Rabies Clinic Schedule

* Clinics held at the MadisonCounty Health Department will

be located in the shelter at theback of the property at

216 Boggs Lane, Richmond.

Rabies can be kept in checkThe fatal madness of rabies captures

our attention. Once a person or animalshows symptoms, death is nearly certain.

This is why Kentucky law requiresthat all dog bites be reported to theEnvironmental Services programs atlocal health departments. Once they getnotice of a bite, the environmentalistswork with the dog owner to identifywhether the bite victim might be at riskof rabies. If there is risk for rabies, thebite victim needs to get the PEP treat-ment quickly.

Even though we had ZERO confirmedcases of rabies in Madison County in2012, it remains a priority that we vacci-nate our domestic pets. Because rabiesis still common in the wild, it is an ongo-ing public health concern.

That’s why the health departmentand local veterinarians partner to offerconvenient, low-cost rabies vaccinationclinics for pet owners. Each summer,they work together to host clinics atvarious dates and locations. The vetsdonate their time, and the vaccine isgiven for only $5 per pet.

Physical activity guidelines for the promotion ofbetter health and fitness are typically written

in terms of frequency, intensity and durationparameters, essentially trying to answer thequestion of “how much is enough?”

However, with the increasing popularity ofpedometers and accelerometers, simple step-count guidelines are needed to provide a rea-sonable approximation of daily physical activ-ity.

So how do step counts translate to themore commonly used FIT guidelines?

The answer needs to be provided in thecontext of one’s age.

For purposes of this discussion, the FITguidelines will be described in terms of dailyminutes of moderate-to-vigorous physicalactivity (MVPA). The steps per day guidelinesare shown in Figure 1.

Children are recommended to accrue atleast 60 minutes of MVPA per day.

This equates to 13,000 to 15,000 steps perday in primary/elementary school boys and11,000 to 12,000 steps/day in girls.

For adolescents (both boys and girls),10,000 to 11,700 steps/day is associated with60 minutes of MVPA.

In adults, estimates range between 7,000and 11,000 steps per day, to obtain minimalamounts of MVPA.

Given that 100 steps per minute representsa reasonable floor value indicative of moder-ate intensity walking, a 30 minute brisk walkwould then generate 3,000 steps of MVPA.

It is important to recognize that a 30-minute walk comprises less than 50 percentof the total number of daily steps recom-mended for good health. Much of the remain-der can be achieved through occupationalactivities, walking to and from vehicles,chores and other activities.

Nevertheless, one should realize that eventhe minimum step value normally will not bereached through obligatory activities and thatat least a 30-minute workout above andbeyond daily activity is needed to providehealth benefits.

Some activities, like swimming and bicy-cling, are healthy physical activities that donot lend themselves to tracking with pedome-ters.


DR. JACKRUTHERFORD

D R . J A C K O N H E A L T H & F I T N E S S

How manysteps are enough?

Ste

ps

/da

y

Turn to HOW MANY, page 15

By Sara MoultonAssociated Press

Barbecue chicken is one ofmy favorite summertimedishes. I like every part of it —the tomato-based sauce (thespicier the better), the crispyskin, even the bones.

And taste aside, it's alsorelatively healthy, at least ascompared to such sundry firstcousins as grilled and/orsmoked ribs, brisket or pulledpork. It's chicken, after all,and it wears that lean proteinhalo. Unfortunately, when it'sprepared with its skin andbones, and slathered with asugary sauce, barbecuechicken is very nearly ascaloric as its brethren. Knowwhy chicken skin is so deli-cious? It's high in fat.

So I set myself the task ofcoming up with a recipe for aleaner version of barbecuechicken that somehow stillboasted the most lovableaspects of the classic version— a mouth-watering sauceand an element of crunch.

I started by enlisting theusual lean poultry suspect,the boneless, skinless chickenbreast. Chicken breasts comein all different sizes andthicknesses. Generally, if it'slabeled "cutlet," it's fairly thin.If it's labeled "chicken breast,"it's rather thick. But there's arange of thickness withinthese categories, too. I triedboth and opted for the latterbecause the thicker breastswere simply harder to over-cook.

The breasts also are cov-ered for two-thirds of thecooking time, which helpskeep them moist, furtherensuring perfectly cookedbarbecue.

By the way, the internaltemperature of the cookedbreasts should be 165 F. Andbe sure when you take thetemperature to insert thethermometer sideways intothe center, and not straightdown from the top. That way

you'll get a more accuratereading. Also, don't forget tolet the chicken rest for a fewminutes after you pull it outof the oven. It's another way tomaximize the juiciness.

EASY BAKED BARBECUECHICKEN BREASTS

This barbecue sauce can beas flavorful as you like. Forthe adobo sauce and garlic,start with the lower amounts,then taste and adjust to yourpreference.

Start to finish: 40 minutes(10 minutes active)

Servings: 41/2 cup ketchup1 to 2 tablespoons adobo

sauce (from a can of chipotlesin adobo)

2 teaspoons packed darkbrown sugar, or to taste

2 tablespoons cider vine-gar

2 tablespoons Dijon mus-tard

1 to 2 cloves garlic, mincedKosher salt and ground

black pepper, to taste1 pound boneless skinless

chicken breasts without thefilet (a total of 2 to 3 breasts,each about 3/4- to 1-inchthick)

1 tablespoon extra-virginolive oil

1/2 cup panko bread-crumbs

2 teaspoons chopped freshthyme

Heat the oven to 350 F.In a small bowl combine

the ketchup, adobo sauce,brown sugar, vinegar, mus-tard and garlic. Season withsalt and pepper.

Line a shallow baking dishwith foil, leaving enoughexcess to generously over-hang the sides. Spread half ofthe sauce on the foil in anarea just the size of the chick-en breasts. Arrange thebreasts on top of the sauceand spoon the remainingsauce over them. Bring theedges of the foil up and overthe chicken and fold it to

enclose them. Bake thebreasts on the middle shelf ofthe oven for 20 minutes.

Meanwhile, in a small skil-let over medium, heat the oil.Add the breadcrumbs, thyme,a pinch of salt and some pep-per. Saute until light golden, 2to 3 minutes. Set aside.

After the chicken hasbaked for 20 minutes, openup the foil and spoon anysauce that has fallen off thechicken back on top of it.Sprinkle the crumb mixtureevenly over the chicken.Continue baking, uncovered,until the chicken is justcooked through, another 8 to10 minutes. Let stand for 5minutes.

Carefully slice the chicken,then divide between 4 servingplates, spooning any sauceand crumbs that have fallenoff over the chicken slices.

Nutrition information perserving: 240 calories; 45 calo-ries from fat (19 percent oftotal calories); 5 g fat (1 g sat-urated; 0 g trans fats); 65 mgcholesterol; 20 g carbohy-drate; 0 g fiber; 9 g sugar; 28g protein; 750 mg sodium.


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A lighter, foolproof take on barbecued chickenR E C I P E F O R A H E A L T H Y L I F E

AP PHOTO

Since 1949, the professionof psychology has most

often trained its practitionersunder what came to be calledthe “Boulder Model.”

This philosophy, first for-malized in Bolder, Co., estab-lishes a scientist-practitionerexpectation of aspiring grad-uates into the profession.That is, those who seek toapply psychological knowl-edge to help others musthave a firm background inthe principles of scientific

theory and research. Therationale is that the profes-sion needs to protect the pub-lic from quackery or other-wise unproven treatments.

The reality, of course, is

that most of us REALLYdreaded the experimentaland research methods class-es when we were in school. Iwell remember the long lec-tures over dense materialabout Bell Curves, probabili-ties, null hypotheses andthen the mind-bending studyof the squiggly-lookingGreek characters used todenote complex statistics thatseemed designed for an ageof Spartans in spaceships.

We really just hoped tosqueak through those cours-es, so we could keep our eyeson the “real” training incounseling, hypnosis andabnormal psychology.

Years later, however, I havedeveloped a whole newappreciation for the utility ofthe scientific perspective,whether in clinical work orjust in conversations withpeople. It amazes me howuseful it can be, and yet howalien it can still seem to thegeneral public.

Consider one little illustra-tion: the operational defini-tion. Without going into toomuch detail, an OD is basi-cally a measurement forsomething. For example, youmight measure how tiredyou are by counting the num-ber of minutes you wereawake past your bedtime lastnight. Why is an OD useful?Let’s take a closer look andsee.

Often in intimate relation-ships or friendships, commu-nication has broken downbecause neither side is defin-ing their terms. Instead, theyare reacting. Finger-pointing,accusations and expressionsof hurt.

We see only our own feel-ings, and not what the otherperson is actually doing thatbothers us so much. Here iswhere we observe peoplecalling each other “jerk” or“inconsiderate” or in theworst circumstances, “evil.”

But how helpful are suchadjectives? Once you’vecalled someone a name, whatoptions have you left themexcept to bristle and responddefensively? The role ofcounseling is often to gethurting people in a relation-ship to define their termsrather than emoting aboutthem.

What is the problem withthe other person’s behavior?What behavior would youlike to see them decrease orincrease? If the other person

is a “jerk,” is it because theywon’t wipe their feet whenthe weather is wet? Becausethey forget birthdays? Chewwith their mouth open?

You see, once you havemeasurable behavior, youcan negotiate from a positionof neutrality and objectivity,rather than hurt, aggressive-ness or defensiveness.

It gets better. When youfocus on behavior, you canmake a constructive plan forhow to increase or decreaseit. Think about sensible eat-ing plans, for example, wherethe operational definition forphysical attractiveness orself-esteem is usually inpounds or waistline inches.You know if your plan is suc-cessful by changes in thescale or the tape measure.

Now, learning how tothink in terms of operationaldefinitions can be challeng-ing. How, for example, do youmeasure feelings like jeal-ousy? Low self-esteem?Positive thinking?

With the help of a coun-selor, however, each one ofthese terms can indeed bedefined in behavior. Even thejourney of a thousand milesis measured in footsteps,right?

Thomas W. Thornberry, M.A.,is a mental health professionalwho has worked extensivelywith those suffering lifestylestress and communicationissues. His interest is in lan-guage and the power of wordsto create change. Thomas wel-comes your feedback: [email protected].


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THOMASTHORNBERRY

Defining your termsM E N T A L M O R S E L S

Aworkout a day will notnecessarily keep the

doctor away, but it is proba-bly the best thing you can dofor your health.

What are the best work-outs for good health? Thereis no clear answer that isright for everybody; it alldepends on your physicaland mental makeup andwhat you enjoy doing. Someexercises are better than oth-ers for certain health condi-tions, though.

HEART HEALTHWhen Kenneth Cooper,

M.D., MPH, used the term“aerobic” in the late 1960s,he was referring to vigorousexercise that gets the heartbeating at a training rate–60to 90 percent of capacity.

These workouts are pri-marily running, biking,swimming and aerobicdance. There is no questionthat they are effective atstrengthening the heart,improving the health ofblood vessels and controllingcholesterol, blood pressureand weight.

Because of their intensity,however, they also increasethe risk of soft tissueinjuries, particularly whenthe athlete has biomechani-cal issues or tries to pushtraining a bit too rapidly.

Walking is less hazardous,but leisurely strolling–whilehealthy–does not qualify asaerobic exercise and does notbuild increased cardiovascu-lar fitness. It does, however,improve circulation and helpcontrol weight. Brisk walk-ing is aerobic; for most indi-

viduals, this means a pace ofabout 4.0 mph or faster.

HEALTHY JOINTSThe best exercises for your

joints are those that improvethe strength and flexibility ofyour muscles.

Contrary to what you mayhave heard, running does notcause arthritis. It can, howev-er, damage your joints if youalready have arthritis.

For persons with stiff,aching joints, warm waterexercise is often recommend-ed, along with supervisedstretching and strengtheningroutines. Yoga and tai chi aregood options.

POWERFUL MUSCLESare not just for showing off atthe beach; they are necessaryto maintain a good metabo-lism, keep joints workingproperly and to prevent fallsand fractures.

Virtually any exercise ben-efits the muscles, butstrength and endurance arebest obtained from resistancetraining. The basic principleis to overload the muscles,lifting to the point of fatiguethrough progressivelyincreasing weights or repeti-tions.

Generally, endurance isbuilt through lower weightsand more repetitions;strength, through higherweight and fewer repetitions.Power involves speed andexplosiveness as well.

The professional athleteultimately requirespower–whether swinging abat or running the 100 meterdash. And it’s now believed

that some degree of power isalso important for everydayactivities–from starting alawn mower to preventing afall.

STRONG BONES areimportant at any stage of life.During youth, it’s importantto lay down bone density as areserve for later in life whenloss of bone density puts sen-iors at risk of falls and frac-tures.

Runners and walkers tendto develop strong bones; but

even highly competitiveswimmers and cyclists havelower-than-expected density,according to studies. That ledto the theory that bones ben-efit from weight-bearingexercise.

Recently, researchers havebegun to re-think that theory.Exercise that’s too prolongedor too intense may be detri-mental to bone health, lead-ing to excessive calcium lossthrough sweat. What’s most


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Best workoutsfor good healthSome exercises are better than others for certain health conditions

Turn to WORKOUTS, page 15

Migraine headaches aresevere headaches that

can incapacitate the personhaving it.

There are many types ofmigraines. We will discusssome of the types ofmigraines and treatments.

Signs and symptoms of amigraine:

• Severe or moderate painwith more than half of thesufferers feeling the pain onone side of the head.

• Pain is described asthrobbing or wavelike painand the pain increases withactivity.

• Nausea with or withoutvomiting may occur as wellas loss of appetite.

• Very sensitive to light andor noise.

Most of these migrainesrun a course within threedays. The frequency ofmigraines depends on theindividual.

Heredity seems to play alarge part in migraine suffer-ers. I believe, at last guess,about 80 percent of sufferershad some family tie. Studiesrange from a 50/50 percentoccurrence in men to womenup to three times as manywomen as men.

Two categories ofmigraines are commonmigraine and classicmigraine. The basic differ-ence between these is anaura. Classic migraines havea neurological precursor thatmay show in the form of star-like or flashing light in yourvisual field, hazy vision orlines, or temporary visionloss. This primarily occurs 10to 30 minutes prior to theonset of the migraine.

Both types of migrainescan be as frequent as daily or

as infrequent as once everyfew years. The pain of amigraine is classified byintense throbbing or pound-ing pain that starts on oneside of the head and can set-tle to both sides and often set-tles behind one or both eyes.

An episode can last forminutes or days; the intensityis usually constant and easeswith being as motionless aspossible in a dark, quietroom.

Symptoms prior to a com-mon migraine are fatigue,mood swings and vaguethinking or memory lapses.Nausea, vomiting withabdominal pain and/or waterretention may also occur.

Migraines can be triggeredby food such as cheese,chocolate, nuts, some fruits,dairy products, grain thatinclude gluten, processedfoods, MSG or shellfish.

Certain odors like perfumeand smoke can certainly trig-ger a migraine.

Migraines may also be ini-tiated by increased stress lev-els, hormonal changes, lackof sleep, prescription drugs,alcohol and caffeine.

In my practice I see abouttwice as many women formigraines and seem toreduce or stop the migrainesin about 75 percent to 80 per-cent of my patients who suf-fer from them.

Upper thoracic and cervi-cal adjustments seem to bethe most effective areas fortreatment. However there areseveral areas in the lowerback that can also causemigraines.

Many of my patients whosuffer from migraines have aprecursor sign their migraineis about to start, symptoms

such as visual problems,aura, etc. as discussed previ-ously. If my patient can comein for an adjustment duringthe early stages, many timesthe migraine can be avoided.

If adjustment occurs dur-ing the migraine, then theduration is reduced.

Usually with theseheadaches taking an aspirinis like hunting an elephantwith a pea shooter, and it isn’tgoing to touch it. Some med-ications, however, do seem tohelp. But some medicationscan cause migraines so if youhave recently changed pre-scriptions and started havingmigraines tell your doctor.

Try chiropractic first. Themost conservative approachshould be tried. Relaxationand elimination of environ-mental, emotional and physi-cal stress should be attempt-ed.

Keep a diary to track foods,stressors, frequency andduration of migraines. Thiscould prove to be invaluablein stopping the migraines.

One of my patients camein with torticollis (neck inspasm on one side), so I

adjusted for that and inciden-tally reduced the number ofmigraines experienced asreported during the 30-dayre-exam. The patient hadn’thad a migraine in 30 days,after suffering with two tothree per month.

I asked why the patienthadn’t written that down onthe history form and was told,“I didn’t think you guys (chi-ropractors) could do anythingabout that.”

Well, as I say, we returnthe body to as close to normalas possible allowing thebody’s inner intelligence toheal the body.

Get to a chiropractor andsee what they can do for you.Keep the diary to assist inassessing the trigger of themigraines. Include time ofday, how long, intensity andwhat you did for relief. Checkwith your family for othersthat suffer from migraines.Communicate with your chi-ropractor to help him or herto give you the best care pos-sible.


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beneficial, it’s believed, arelarge forces released in a rel-atively big burst, as in hop-ping or skipping rope. If youalready have weak bones, ofcourse, jumping is not rec-ommended as it could resultin a fracture. And, if you areover age 60, a safer and morepractical workout may bebrisk walking–the faster thepace, the better.

MENTAL HEALTHTo relieve or prevent

stress, anxiety and depres-sion, research indicates thatexercise is often as effectiveas medications. And it’sfaster–all you have to do isstep on the treadmill or hitthe pavement and your ther-apy starts to work.

Physical activity releasestension, of course, and it alsoincreases the production ofneurochemicals that lead to afeeling of well-being. Thebest exercises are continuousand rhythmic such as walk-ing, swimming, dancing andcycling. Yoga and tai chi havea mind/body element that isspecifically intended for heal-ing.

Whatever your healthneeds, the best workout foryou is one that you mostenjoy doing; otherwise, youwon’t keep at it, day after day,year after year.

WORKOUTSContinued from page 13

Likewise, a number of sports may be cate-gorized as vigorous activities that are not easi-ly translated into MVPA by pedometers.

These activities should of course beacknowledged and count towards one’s dailyMVPA total. However, the largest segment ofthe population does not regularly engage in anysport or exercise apart from walking. Thesestep count ranges then are in line with publichealth’s guidelines for time spent in MVPA.

Older adults and special populations (livingwith disability and/or chronic illness that maylimit mobility) may also benefit from a moreactive lifestyle that involves higher levels ofMVPA.

Step-counting devices such as pedometersoffer a chance to monitor daily ambulatoryactivity. However, a translation of publichealth guidelines in terms of steps/day is cur-rently unknown.

Some research data suggest that healthyolder adults average between 2,000 and 9,000steps/day and special populations average1,200 to 8,800 steps/day. Using the adultcadence of 100 steps/minute to demark the

lower value of the range of moderate intensity,multiplying it by 30 minutes gives a guidingvalue of 3,000 steps.

This cadence may be unattainable in frailor diseased populations. However, if publichealth guidelines are to be strictly translated,these steps should be taken above and beyondactivities of normal daily living. They can beaccumulated in smaller bouts (e.g. 10 min-utes) of moderate intensity and should add upto at least 30 minutes a day.

In studies involving direct measurement ofMVPA and background activities, the evidencesuggests that 30 minutes of brisk walking, inaddition to habitual daily activities in healthyolder adults, is equivalent to 7,000 to 10,000steps/day.

By now it is clear to you that current publichealth guidelines for physical activity call for30 minutes or more of moderate intensityactivity be performed on most, preferably all,days of the week.

More recent guidelines recommend at least150 minutes/week of moderate intensity, 75minutes/week in vigorous intensity physicalactivity, or a combination of both.

If you have taken to wearing a pedometeror accelerometer during the day, now you cansee how your daily step counts compare toage-related guidelines.

HOW MANYContinued from page 10

sodium a day. Studies make clear thateating less sodium helps lower bloodpressure, and lower blood pressure inturn leads to less heart disease, saidheart association spokesman Dr. ElliottAntman, a cardiologist at Boston’sBrigham and Women’s Hospital.

“We’re sticking where we have themost solid evidence,” Antman said.

What to study is key to the debate:

The IOM committee was asked to exam-ine whether eating less salt directlyaffects longer-term outcomes such asheart attacks and death.That’s harder toprove, especially since the panelstressed many of the studies it reviewedhad quality problems. Among thoseproblems, Antman said, was includingsome patients too sick for diet to mat-ter.

Debating how little salt is too little isa moot point, added nutritionist BonnieLiebman of the Center for Science in thePublic Interest.

“The average American is still in the

red zone, the danger zone,” she said.The salt industry, in contrast, has

long opposed the push for sharp sodiumreductions and welcomed the report.

“There is no scientific justification forpopulation-wide sodium reduction tosuch low levels, and the recognition bythe IOM experts that such low levelsmay cause harm may help steeroverzealous organizations away fromreckless recommendations,” saidMorton Satin of the Salt Institute.

Some salt is necessary for goodhealth, although it’s not clear exactlyhow much.

SALTContinued from page 3

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