'Tis the Season for Overeating

For many people, the holiday season is the happiest time of the year. But power shopping, visiting relatives and over-eating can also take its toll on the body. During this time of year, food seems to be everywhere. One explanation for how this got started is that in days of old, meals on a day-to-day basis were fairly simple, some would say even boring. Many people barely had enough food at all, particularly during the long winter season. On special occasions such as religious holidays, marriages and season changes, feasting became a way to celebrate the event and to break the monotony of their meager diets.

Fast forward to today.  Grocery stores offer a veritable cornucopia of foods from all over the world. Exotic fruits and vegetables, fresh seafood in even the most landlocked states, and a variety of ethnic foods are available on even the darkest, coldest days of the year. Restaurants are seemingly located on every corner, with more under construction. While hunger continues to be a problem throughout the world, for most of us in this country, food is no longer a luxury.

During the holidays, our more than adequate food options and supply can sometimes expand to near shameful proportions. The obvious problem with this is that we eat more than is necessary, and often the eating choices are not of the highest nutritional value. Here are some strategies to help you enjoy the foods of the season without overdoing it.

Eating tricks

• Before going to parties or family get-togethers, eat something that will suppress the tendency to overdo it at the table. A piece of fruit, a small carton of yogurt, or some cheese and crackers should do. The worst thing that you can do is to “save up” for a meal. Being famished makes it very difficult to moderate your food consumption.
   
• If you can’t eat before you arrive, start with salad or veggies which will help with your portion control later.
   
• Fill your plate with lower calorie foods initially such as lean meat, vegetables and fruit. Limit butter and high-fat salad dressings and gravies. Once you have taken the edge off of your hunger, you will be less likely to go back for those high-calorie offerings.
   
• Use smaller plates or limit portion size. You may need to politely insist on serving yourself.
   
• Stand away from the food table. The closer you are, the more likely you are to nibble.
   
• Delay dessert. If you wait a while, your craving for sweets should lessen.  

Think before you drink

• Not only can overindulging in “Christmas Cheer” cause a painful morning after, but it racks up the calories as well. Mixed drinks are especially high in calories, with the liquor alone weighing in at more than 100 calories per shot. Note the caloric content of other common alcoholic beverages: 12 oz beer = 150 calories, 12 oz lite beer = 110 calories, 5 oz wine = 90 calories.
   
• Alcohol can also contribute to overeating by making you hungry and impairing your good judgment. Eating before you drink alcohol will help.
   
• Consider toasting the occasion with a lower-calorie non-alcoholic drink or sparkling water.
   
• Try to limit special holiday drinks such as eggnog and mulled cider which are loaded with calories.

Don’t forget to exercise

• If you exercise regularly, stick to your exercise routine as much as possible. It will burn calories and you’ll feel better about yourself, even if you occasionally overeat.
   
• If you are unable to exercise on one day, add some extra time to your workout the next day. If you are pressed for time, remember that it is better to do a shortened version of your workout rather than skipping it entirely.
   
• Integrate exercise into family gatherings.  Take an after-dinner stroll together. When visiting neighbors, walk instead of driving.
   
• Try taking several walks during the work day. Getting your usual amount of exercise in shorter periods of time throughout the day burns just as many calories and is almost equally beneficial to your health as a longer, single workout.
   
• Park in the back of the parking lot and walk to the mall instead of parking as close to the door as you can.
   
• Try to take the stairs instead of elevators or escalators whenever possible.
   
• Don’t let the weather serve as an excuse for not exercising. Rather than giving up on your activity during inclement weather, seek out an alternative location for exercise such as shopping malls or gyms. With proper clothing, walking outdoors can be enjoyable almost any time of the year.

Focusing on friends, family, and the less fortunate can take the emphasis off of food during this time of the year. Moderating your eating practices and continuing to exercise during the holidays will help you to avoid having to address the results of overeating later as a New Year’s resolution.

Growth Plate Injuries

Growth plates are narrow sections at either end of children’s long bones where growth in length occurs.  Examples of bones in the developing skeleton with growth plates include the femur (thigh bone), the humerus (upper arm bone), the ulna and radius of the forearm, and the tibia and fibula in the lower leg.  The growth plate (also known as the physis) is made of cartilage which is weaker than actual bone. This makes them particularly susceptible to injury or fracture.  With closure of growth plate at skeletal maturity, the bone is no longer capable of further lengthening.

How does a growth plate injury occur?  Up to one-third of all fractures in children and adolescents involve a growth plate.  Being the weakest link in the bone-joint-bone chain, an injury that would break a bone or sprain a ligament in an adult would more likely result in a growth plate fracture in a child. Most growth plate injuries are caused by a blow or twist of a limb.  Accidents during recreational activities such as biking, sledding, skiing, or skateboarding are responsible for a large percentage of growth plate fractures. They can also occur from repetitive stress or overuse. For example, a young baseball pitcher with poor throwing mechanics risks the development of a growth plate injury to the shoulder or elbow.
 
How Are Growth Plate Fractures Diagnosed?   Fractures involving bones typically show up well on x-rays.  Cartilage, however, lacks the calcium content of bones and does not show up on x-ray.  Since growth plates are made of cartilage, the diagnosis of growth plate fractures with standard x-ray can be challenging.  Signs or symptoms that would suggest the presence of a growth plate injury include:

• Persistent pain near the end of a long bone (in the area of the growth plate)
   
• A visible deformity, such as angulation or bend in the limb
   
• Swelling, warmth and/or tenderness near a joint

If a growth plate fracture is suspected but the initial x-rays appear normal, several measures can be taken to further investigate the injury. Taking a “comparison view” of the uninvolved limb may demonstrate a difference in the injured vs. uninjured limb.  For example a widened growth plate on the injured side suggests that there is a fracture through the growth plate. If the initial x-rays are negative, doctors may also choose to splint or protect the injured limb and repeat the x-rays in a few weeks.  Since the body’s response to a growth plate fracture is to deposit calcium at the site of the injury, this may be seen on follow-up x-rays.  When an immediate diagnosis is required, special imaging, such as CT scanning or MRI scanning may reveal the presence of a growth plate injury not seen on x-ray.

Are all growth plate injuries the same?  The Salter-Harris classification system defines five basic types of growth plate fractures.  These range from the least severe (Type 1) that affects only the growth plate itself to the more severe types (Types 2 through 4)  that involve both the growth plate and a segment of adjacent bone. The most severe (and least common) growth plate injury is the Type 5 fracture that occurs when the growth plate is compressed or crushed. While the prognosis for eventual normal bone development is good in the less severe growth plate fractures, stunting of eventual bone length is more likely with the more severe types. 

How Are Growth Plate Injuries Treated?   Treatment of growth plate injures depends on several factors such as the Salter-Harris fracture type, the specific bone that was injured, and the age of the individual that was injured.  With less severe injuries that are not out of place (non-displaced), immobilization with a cast or splint may be adequate.  If the bone fragments are out of place, surgery to restore the alignment (reduction) and to maintain that position with the use of screws or plates is often required. Healing can take anywhere from a few weeks to several months, depending on the severity of the injury and whether surgery was necessary.
 
What is the long term outlook for a growth plate injury?  With prompt identification of the injury and appropriate treatment, most growth plate fractures heal without any lasting effects. The most frequent complication of a growth plate fracture is premature arrest of bone growth.  If the growth plate fracture involves an arm or leg, this could result in a significant shortening of the extremity.  With any growth plate injury, follow-up care is important to make sure bones are healing and continuing to grow normally.

Avoiding Type 2 Diabetes

Of the 24 million Americans with diabetes currently, fewer than 10% are Type 1 diabetics. The great majority have Type 2 diabetes, the form that typically develops in adulthood and does not require taking insulin. Type 1 diabetes, previously known as "insulin-dependent" diabetes, is an autoimmune disease in which genetics plays an important role in its development. The development of Type 2 diabetes, on the other hand, is much more related to the effect of certain lifestyle issues, such as what you eat and your physical activity.

Several studies have looked at factors related to the development of Type 2 diabetes.  One study conducted over 16 years, looked for the occurrence of type 2 diabetes in 85,000 female nurses.  During that period of time, 3,300 of the women developed type 2 diabetes.  In 90% of the cases, five factors were found to be responsible for the development of the disease: 1) being overweight, 2) not getting enough exercise, 3) eating an unhealthy diet, 4) smoking cigarettes, and 5) abstaining from drinking alcohol. 

 

A second study followed over 42,000 healthy adult male health professionals for 12 years to assess for the development of type 2 diabetes.  Factors that were associated with the development of type 2 diabetes in this study group were: 1) eating a "western diet" (characterized by higher consumption of red meat, processed meat, French fries, high-fat dairy products, refined grains, and sweets and desserts), 2) obesity, and 3) low physical activity.

 

When the findings from these two studies were combined, some encouraging results regarding the opportunity to prevent the development of type 2 diabetes emerged.  Key points from this analysis were: 

• In subjects whose weight was above the healthy weight range, losing 7 to 10 percent of their current weight cut their chances of developing Type 2 diabetes by 50%.

• Swapping out red meat or processed red meat for a healthier protein source, such as nuts, low-fat dairy, poultry, or fish could lower diabetes risk by up to 35%.

• In someone who rarely eats whole grains, eating two to three servings of whole grains a day reduced the risk of developing Type 2 diabetes by 30%.

• Walking briskly for a half hour every day reduced the risk of developing Type 2 diabetes by 30 %.

The bottom line is that, for the most part, Type 2 diabetes is a preventable disease.   Eating a healthy diet, keeping one’s weight in a healthy range, and getting regular exercise are the most important factors in avoiding this disease.

 

It is estimated that around 57 million adults have a condition known as "pre-diabetes." These people have somewhat elevated blood sugars, but not in the range for the diagnosis of diabetes. In this group of people, addressing lifestyle issues offers the real possibility of avoiding the development of Type 2 diabetes altogether. Likewise, people who are "at risk" (overweight, sedentary, eating an unhealthy diet, etc.), but currently have normal blood sugar values can drastically reduce their risk of developing Type 2 diabetes through attention to lifestyle measures.

 

To see if you are at risk, take the American Diabetes Association's Diabetes Risk Test.  Helpful suggestions for lowering your risk of developing diabetes through diet and exercise are also available through the American Diabetes Association.