Growing Pains

Growing Pains in Children: Causes, Symptoms, and Treatment

Are achy legs keeping your child awake at night? They may have growing pains.

Growing pains are cramping, achy muscle pains that some preschoolers and preteens feel in both legs. The pain usually occurs in the late afternoon or evenings. But it may cause your child to wake up in the middle of the night.

Growing pains usually start in early childhood, around age 3 or 4. They tend to strike again in kids aged 8-12.

Causes of Growing Pains

Despite the name “growing pains,” there is no firm evidence that growing pains are linked to growth spurts.

Instead, growing pains may simply be muscle aches due to intense childhood activities that can wear your child’s muscles out. These activities include running, jumping, and climbing. Growing pains seem to be more common after a kid has a particularly full day of sports.

Symptoms of Growing Pains

Growing pains are different for everyone. Some kids have a lot of pain, others do not. Most kids do not have pain every day.

Growing pains can come and go. They may be experienced for months or even years. Most kids outgrow growing pains within a few years.

The pain is usually felt in the late afternoon and evening, right before dinner time, and at bedtime. The leg pains may hurt so much that they may wake your child from sleep.

If your child seems perfectly fine in the morning, don’t be quick to think they were faking. Growing pains disappear in the morning. They usually do not interfere with the child’s ability to play sports or be active.

In general, growing pains are felt in both legs, especially in the front of the thighs, back of legs (calves), or behind the knees.

Studies suggest that children who have growing pains may be more sensitive to pain. Children who have growing pains are also more likely to have headaches and abdominal pain.

How Are Growing Pains Diagnosed?

A doctor can usually diagnose growing pains by examining your child and asking questions about their medical history and symptoms. It is important to rule out any other possible causes of the pain before making the diagnosis of growing pains. This is why it is important to see the doctor if you think your child has growing pains or any limb pain.

If your child has growing pains, the doctor will not see anything abnormal during the physical exam. Blood work and X-rays are usually not needed in this case.

How Are Growing Pains Treated?

Treatment of growing pains depends on how much pain your child has. The following things may ease discomfort and help your child feel better:

  • Massaging the legs.
  • Stretching the leg muscles. This may be difficult for younger kids.
  • Placing a warm cloth or heating pad on the sore leg. Be careful not to burn the skin and do not use during sleep.

If the pain does not get better, ask your health care provider if it’s OK to give your child an over-the-counter pain medicine, such as acetaminophen or ibuprofen. Ask about the appropriate dose for your child. Never give aspirin to a child. Aspirin use in children has been linked to a life-threatening disease called Reye’s syndrome.

When Should I Call the Doctor?

When deciding whether to call the doctor, it’s important to remember that growing pains are almost always felt in both legs. Pain that is only in one leg may be a sign of a more serious condition. Call your health care provider if this happens.

It’s also important to remember that growing pains affect muscles, not joints. And they do not cause limping or fever.

Call your child’s doctor or nurse if leg pain occurs with the following symptoms. They aren’t symptoms of growing pains, but your doctor will need to examine your child and run tests:

  • injury, such as a fall
  • fever
  • loss of appetite
  • limping or difficulty walking
  • pain in one leg
  • rash
  • red, warm, painful, swollen joints
  • tiredness
  • weakness
  • weight loss

And of course, call your doctor if you have any other concerns.

Kids’ School Lunches: Tips, Meal Ideas, and More


Look What I Got!

Remember being a kid and finding something delicious in your lunch box? Or did you take one look and swap with someone else? Now that you’re a parent, you’re on deck to pack something your child will love. It’s simpler, and takes less time, than you might think.

Cool for School

Freezing is a go-to technique. Fill muffin cups with yogurt and/or pureed fruit (no sugar added) and freeze overnight. This is a good way to make child-sized portions of meatloaf and quiche, too. As they thaw, these treats will help keep the other stuff in your kid’s lunch box cool at school. Many items — meat, fish, eggs, beans, cheese, milk, rice, pasta, mayo, and butter — need to be chilled.

Read more…

Fish Oil Pills: ‘No Net Benefit’ for Depression Prevention?

fish oil capsules

– Fish oil supplements do not help prevent depression or boost mood, new research suggests.

The VITAL-DEP study included more than 18,000 participants. Among adults 50 or older, none of whom were clinically depressed, long-term use of marine omega-3 fatty acid (omega-3) supplements did not reduce risk for depression or symptoms of depression — or make a difference in the quality of mood.

In fact, there was a small increase found in risk for depression or depressive symptoms with omega-3 supplements.

“While a small increase in risk of depression was inside the statistical margin of significance, there was no harmful or beneficial effect of omega-3 on the overall course of mood during the roughly 5 to 7 years of follow-up,” lead author Olivia I. Okereke, MD, of Massachusetts General Hospital and Harvard Medical School, says.

The findings were published online this week in the Journal of the American Medical Association.

Assessing General Population Risk

For many years, experts have recommended omega-3 supplements for depression in some high-risk patients, Okereke says, but there are no established guidelines for its use.

The study enrolled 18,353 older adults (average age, 67.5 years; 49% women). Of these, 16,657 were at risk for incident depression, defined as having no previous history of depression; and 1,696 were at risk for recurrent depression, defined as having a history of depression but not having undergone treatment for depression within the past 2 years.

Roughly half the participants were randomly assigned to receive omega-3 fatty acids and the other half to a placebo for an average of 5.3 years.

Vitamin D Flops in Moderate-Severe COVID


A close up of a blister pack of vitamin D capsules

Among patients with moderate to severe COVID-19, there was no difference in length of hospital stay in those given a single 200,000-IU dose of vitamin D3 versus those given placebo in a randomized trial in Brazil.

Median length of hospital stay was about 7 days for both groups, with no significant differences in secondary outcomes including in-hospital mortality, admission to ICU, or need for mechanical ventilation, reported Rosa Pereira, MD, PhD, of Universidade de Sao Paulo, and colleagues in an online edition of JAMA.

An accompanying editorial by David Leaf, MD, of Brigham and Women’s Hospital in Boston, and Adit Ginde, MD, MPH, of University of Colorado School of Medicine in Aurora, noted that prior research showed that lower levels of vitamin D were independently associated with worse outcomes in patients with acute illness, but also that vitamin D supplementation as a treatment had no impact on clinical outcomes.

Leaf and Ginde said that COVID-19 has generated renewed interest in vitamin D, adding that this study was “the largest published randomized, double-blind, placebo-controlled trial of vitamin D3 administration among hospitalized patients with COVID-19 to date.”

While the findings taken in isolation “may appear ambiguous” and show no evidence of benefit for moderately to severely ill patients, they said, perhaps the door should not be closed altogether.

“It is important to remain open-minded to emerging results from rigorously conducted studies of vitamin D (despite smaller sample sizes and important limitations of some studies),” they wrote, adding that the study did not address outpatients with mild COVID-19 or the use of vitamin D as prophylaxis against the disease.

Pereira and colleagues examined data from hospitalized patients with moderate to severe COVID-19 at two sites in Sao Paulo from June to August 2020, with the final follow-up in October. Participants were eligible if they were adults who tested positive for SARS-CoV-2 via PCR or had a CT scan finding “compatible with the disease,” as well as “diagnosis of flu syndrome with criteria for hospitalization.” Primary outcome was length of hospital stay, defined as date of randomization to hospital discharge.

Overall, 240 patients were randomized: 120 to a single oral dose of 200,000 IU of vitamin D and 120 to placebo. Of these, 237 were included in the primary analysis. Participants’ mean age was 56, about 44% were women, and mean baseline 25-hydroxyvitamin D level was 20.9. They were given the intervention after a mean of 10.3 days from symptom onset.

The adjusted hazard ratio for hospital discharge was 0.99 (95% CI 0.71-1.37, P=0.94). There were also non-significant differences between the intervention and placebo groups in secondary outcomes, including in-hospital mortality (7.6% vs 5.1%, respectively, P=0.43), admission to the ICU (16.0% vs 21.2%, P=0.30), and need for mechanical ventilation (7.6% vs 14.4%, P=0.09).

In the intervention group, 86.7% achieved 25-hydroxyvitamin D sufficiency versus 10.9% of the placebo group, meaning “the present null findings cannot be attributed to the failure of increasing serum 25-hydroxyvitamin D levels.”

Researchers noted no adverse events, except a single episode of vomiting linked to the intervention. They also noted no significant differences between groups in any health-related laboratory markers following the intervention.

Limitations to the data included that a minimal clinically important difference in hospital length of stay among COVID-19 patients has yet to be determined, as well as the small and heterogeneous sample size, with different patients with co-existing diseases on different medication regimens.

Leaf and Ginde noted that 30 studies on vitamin D interventions in COVID-19 are currently listed on, globally and across the disease spectrum. However, they suggested that many of these studies may be “underpowered or will not achieve target enrollment,” based on experience during the pandemic.

Omicron in the U.S.: What to Know

What to know about the omicron variant

The Omicron coronavirus variant has been found in dozens of states across the country since it was first identified in South Africa in November, and many may be wondering: Will it upstage Delta and cause a winter surge? Is it still safe to gather with others for the holidays? How is this variant affecting children?

Experts addressed those and other questions in a webinar hosted by New York University last week, acknowledging that it will take some time to find out all the crucial facts about Omicron.

But in the meantime, here’s what’s known — and not — about Omicron in the fast-changing COVID landscape.

How widespread is Omicron now?

As of Dec. 15, Omicron transmission had been reported in 80 nations, according to Michael H. Merson, MD, a visiting professor of global health at the New York University School of Global Public Health. In the 35 states with Omicron cases, the numbers vary. Right now, New York and New Jersey are detecting the Omicron variant at about four times the overall rate in the country, he said. But whether or not the variant will remain in ”pockets” is currently unknown, he said.

How can people enjoy the holidays safely?

When it comes to deciding about gatherings and travel, “trust your instincts,” Elodie Ghedin, PhD, chief of the systems genomics section at the National Institute of Allergy and Infectious Diseases and affiliate faculty member at NYU, said.

As an example of safe holiday gatherings, the experts cited President Joe Biden’s appearance last Tuesday at a party of 400, which was held on a hotel rooftop due to COVID concerns.

“It’s very important to spend the holidays with family and friends,” Merson said. “But do so wisely. That’s my advice about travel.”

That means getting vaccinated and boosted when eligible, making use of rapid testing when called for, masking, handwashing, avoiding crowded indoor spaces, and keeping your distance from others.

Knowing your risk level and that of family and friends when making plans for the holidays is also important, Merson said.

Is Omicron greatly affecting children?

Experts are waiting on data to find out.

“The jury is still out on how virulent Omicron will be for kids,” said Celine R. Gounder, MD, a member of President Biden’s COVID-19 task force and a clinical assistant professor of medicine and infectious diseases at NYU Grossman School of Medicine. “We don’t know.”

The best thing parents can do right now is to vaccinate their children ages 5 years and up who are eligible, she said.

Do monoclonal antibody drugs work well against Omicron?

No, Ghedin said.

“Most of the monoclonal antibodies do not seem to work very well against Omicron,” she said.

What’s known about how infectious Omicron is?

“It appears to be the most infectious variant to date,” said Gounder.

“Relative to Delta, Omicron appears to be 2-3 times more infectious.”

Put another way, she said, you are likely to infect 2 to 3 times more people than if infected with other variants.

People should not count on their natural immunity from a prior COVID infection to protect them from the Omicron variant, Gounder said.

It also does seem that the Omicron variant might be less virulent than other variants, she said. (Virulence refers to how severe a disease an infected person can get.)

If Omicron is less virulent, isn’t that good news?

Yes and no, Gounder said.

“Even if it’s a mild disease, you can still have lots of deaths. Let’s say COVID has a case fatality rate of 1% and you have 100 people who get infected — and one death,” she said.

Then say Omicron’s rate is .25%, but if you have 400 cases, since it is more infectious, that’s still one death.

“We really have to be very careful when we say less deadly and less severe [when talking about Omicron]. On a population level, Omicron could be just as deadly as Delta even if it causes mild disease, if more are infected,” she said.

If a COVID test is positive, will the results specify whether it’s the Delta or the Omicron variant?

“Unfortunately, you will not be able to get that information from a PCR test done in the community,” Ghedin said. “If you are doing it through a research entity, they might provide that information, but I highly doubt it.”

With more people vaccinated now than in the past, can we consider COVID endemic, not a pandemic, now?

No, Gounder said.

“We are nowhere near endemic [status],” she said. “We are still very much pandemic. Saying it is endemic now is like saying, ‘Let’s do nothing.'”

Currently the U.S. is at a level of about 60% of the population vaccinated, she said.

“We really need to be getting to 85, 90 percent” before transitioning into endemic status.

In tropical countries, the flu is endemic, Ghedin said, ”and it’s there year-round. We are not there with SARS-CoV-2.”

Can a dangerous microbe offer a new way to silence pain?

Can a Dangerous Microbe Offer a New Way to Silence Pain? - Neuroscience News

Anthrax has a scary reputation. Widely known to cause serious lung infections in humans and unsightly, albeit painless, skin lesions in livestock and people, the anthrax bacterium has even been used as a weapon of terror.

Now the findings of a new study suggest the dreaded microbe also has unexpected beneficial potential — one of its toxins can silence multiple types of pain in animals.

The research reveals that this specific anthrax toxin works to alter signaling in pain-sensing neurons and, when delivered in a targeted manner into neurons of the central and peripheral nervous system, can offer relief to animals in distress.

The work, led by investigators at Harvard Medical School in collaboration with industry scientists and researchers from other institutions, is published Dec. 20 in Nature Neuroscience.

Furthermore, the team combined parts of the anthrax toxin with different types of molecular cargo and delivered it into pain-sensing neurons. The technique can be used to design novel precision-targeted pain treatments that act on pain receptors but without the widespread systemic effects of current pain-relief drugs, such as opioids.

“This molecular platform of using a bacterial toxin to deliver substances into neurons and modulate their function represents a new way to target pain-mediating neurons,” said study senior investigator Isaac Chiu, associate professor of immunology in the Blavatnik Institute at Harvard Medical School.

The need to expand the current therapeutic arsenal for pain management remains acute, the researchers said. Opioids remain the most effective pain medication, but they have dangerous side effects — most notably their ability to rewire the brain’s reward system, which makes them highly addictive, and their propensity to suppress breathing, which can be fatal.

“There’s still a great clinical need for developing non-opioid pain therapies that are not addictive but that are effective in silencing pain,” said study first author Nicole Yang, HMS research fellow in immunology in the Chiu Lab. “Our experiments show that one strategy, at least experimentally, could be to specifically target pain neurons using this bacterial toxin.”

The researchers caution, however, that for now, this approach remains purely experimental and still needs to be tested and further fine-tuned in more animal studies and, eventually, in humans.

Primed to connect

Researchers in the Chiu lab have long been interested in the interplay between microbes and the nervous and immune systems. Past work led by Chiu has demonstrated that other disease-causing bacteria can also interact with neurons and alter their signaling to amplify pain. Yet only a handful of studies so far have looked at whether certain microbes could minimize or block pain. This is what Chiu and Yang set out to do.

For the current study, they started out by trying to determine how pain-sensing neurons may be different from other neurons in the human body. To do so, they first turned to gene-expression data. One of the things that caught their attention: Pain fibers had receptors for anthrax toxins, whereas other types of neurons did not. In other words, the pain fibers were structurally primed to interact with the anthrax bacterium. They wondered why.

The newly published research sheds light on that very question.

The findings demonstrate that pain silencing occurs when sensory neurons of dorsal root ganglia, nerves that relay pain signals to the spinal cord, connect with two specific proteins made by the anthrax bacterium itself. Experiments revealed that this occurs when one of the bacterial proteins, protective antigen (PA), binds to the nerve cell receptors it forms a pore that serves as a gateway for two others bacterial proteins, edema factor (EF) and lethal factor (LF), to be ferried into the nerve cell. The research further demonstrated PA and EF together, collectively known as edema toxin, alter the signaling inside nerve cells — in effect silencing pain.

Using the quirks of microbial evolution for new therapies

In a series of experiments, the researchers found that the anthrax toxin altered signaling in human nerve cells in dishes, and it also did so in living animals.

Injecting the toxin into the lower spines of mice produced potent pain-blocking effects, preventing the animals from sensing high-temperature and mechanical stimulations. Importantly, the animals’ other vital signs such as heart rate, body temperature, and motor coordination were not affected — an observation that underscored that this technique was highly selective and precise in targeting pain fibers and blocking pain without widespread systemic effects.

Furthermore, injecting mice with the anthrax toxin alleviated symptoms of two other types of pain: pain caused by inflammation and pain caused by nerve cell damage, often seen in the aftermath of traumatic injury and certain viral infections such as herpes zoster, or shingles, or as a complication of diabetes and cancer treatment.

Additionally, the researchers observed that as the pain diminished, the treated nerve cells remained physiologically intact — a finding that indicates the pain-blocking effects were not due to injury of the nerve cells but rather stemmed from the altered signaling inside them.

In a final step, the team designed a carrier vehicle from anthrax proteins and used it to deliver other pain-blocking substances into nerve cells. One of these substances was botulinum toxin, yet another potentially lethal bacterium known for its ability to alter nerve signaling. That approach, too, blocked pain in mice. The experiments demonstrate this could be a novel delivery system for targeting pain.

“We took parts of the anthrax toxin and fused them to the protein cargo that we wanted it to deliver,” Yang said. “In the future, one could think of different kinds of proteins to deliver targeted treatments.”

The scientists caution that as the work progresses, the safety of the toxin treatment must be monitored carefully, especially given that the anthrax protein has been implicated in disrupting the integrity of the blood-brain barrier during infection.

The new findings raise another interesting question: Evolutionarily speaking, why would a microbe silence pain?

Chiu thinks that one explanation — a highly speculative one, he added — may be that microbes have developed ways to interact with their host in order to facilitate their own spread and survival. In the case of anthrax, that adaptive mechanism may be through altered signaling that blocks the host’s ability to sense pain and therefore the microbe’s presence. This hypothesis could help explain why the black skin lesions that the anthrax bacterium sometimes forms are notably painless, Chiu added.

The new findings also point to novel avenues for drug development beyond the traditional small-molecule therapies that are currently being designed across labs.

“Bringing a bacterial therapeutic to treat pain raises the question ‘Can we mine the natural world and the microbial world for analgesics?'” Chiu said. “Doing so can increase the range and diversity of the types of substances we look to in search for solutions.”

Coinvestigators included Jörg Isensee, Dylan Neel, Andreza Quadros, Han-Xiong Bear Zhang, Justas Lauzadis, Sai Man Liu, Stephanie Shiers, Andreea Belu, Shilpa Palan, Sandra Marlin, Jacquie Maignel, Angela Kennedy- Curran, Victoria Tong, Mahtab Moayeri, Pascal Röderer, Anja Nitzsche, Mike Lu, Bradley Pentelute, Oliver Brüstle, Vineeta Tripathi, Keith Foster, Theodore Price, John Collier, Stephen Leppla, Michelino Puopolo, Bruce Bean, Thiago Cunha, and Tim Hucho.

This study was funded by the Burroughs Wellcome Fund; Chan-Zuckerberg Initiative; Ipsen Pharmaceuticals; National Institutes of Health (DP2AT009499, R01AI130019, R01NS036855, NIA 5T32AG000222 fellowship, NIH NIGMS T32GM007753 fellowship), and NIH NINDS (NS111929); National Institute of Allergy and Infectious Diseases Intramural Program; European Regional Development Fund (NeuRoWeg, EFRE?0800407 and EFRE?0800408); Innovative Medicines Initiative 2 Joint Undertaking (116072-NGN-PET); and São Paulo Research Foundation (2013/08216-2 Center for Research in Inflammatory Diseases); Deutsche Forschungsgemeinschaft (271522021 and 413120531), EFRE-0800384, and LeitmarktAgentur.NRW (LS-1-1-020d).

Shop Smart for Groceries for Diabetes


Shop Smart for Groceries for Diabetes – Keep Your Inner Army Strong

The grocery store looks different when you have type 2 diabetes. Aisles of menu ideas and possibilities become well-lit lanes of decisions and pitfalls. Instead of, “What’s for dinner?” you wonder, “What will this do to my blood sugar?”

“Before my diagnosis, I went to the store and bought everything on my list and anything that caught my fancy,” says Linda Leitaker, a retired elected city clerk in Lake Almanor, CA. “What I thought I knew about nutrition was woefully inadequate. I had to read, research, and repeat.”

But if you manage your food, it’s a powerful way to control your type 2 diabetes. You don’t need to follow a special diet. Just eat the way it’s recommended for most people. Studies show that healthy, balanced meals are one of the best ways to control your blood sugar and manage your diabetes.

Picture Your Plate

There’s no magic list of foods you can and can’t eat with diabetes.   

“You can really eat anything,” says Shamera Robinson, MPH, a registered dietitian and associate director of nutrition for the American Diabetes Association. “Your favorite foods can be part of an individualized eating plan. The best way to go about eating is by finding a balance of nutrients that work for you.”

One way to do that is with the Diabetes Plate Method. Imagine a 9-inch plate split evenly in two. Fill one side with non-starchy vegetables like asparagus, Brussels sprouts, broccoli, cauliflower, greens, squash, or tomatoes.

Split the other half into quarters horizontally. Fill one quarter with carbs, like brown rice, tortillas, beans, fruit, milk, or yogurt. Fill the last quarter with protein, such as eggs, tofu, and lean meats like chicken and fish.

“Carbs will always digest the fastest, then protein, then fat. When you eat all three together, you feel full and don’t crave as much between meals,” Says Lori Zanini, an author, nutritionist, and dietitian in Los Angeles.

Make a Meal Plan

One secret to Leitaker’s success is that she keeps her eating simple. She sticks to one or two choices for breakfast. Lunch is always a salad with chicken. For dinner, she has a protein, salad, and vegetables.

Leitaker rarely makes dessert. When she does indulge, it’s often berries or other fruit that’s in season.

You can plot out a week’s worth of meals before you hit the grocery store. You can do that on your own, or use a meal-planning template like the one on the American Diabetes Association’s Diabetes Food Hub.

Use a Shopping List

Once you know what you want to eat, make a list of ingredients. Check your pantry to make sure you don’t already have them.

There’s no right or wrong way to make a grocery run. You can group the items you need by department, such as produce, meat, and frozen foods. Or you can write your list in the order that your favorite store is laid out to avoid retracing your steps.

It’s natural to focus on breakfast, lunch, and dinner, but don’t forget the snacks.

“A snack can really be anything,” Robinson says. She suggests a handful of unsalted roasted nuts or seeds; hummus and vegetables; berries; baby carrots with guacamole; and a hard-boiled egg.

The key to eating with diabetes is not to give into impulse buys.

“If I see something new at the store, I usually go home and research it first to see if it’s a good fit for me,” says Leitaker, who dropped her A1c below 6 and lost more than 50 pounds by eating carefully and walking. 

Leitaker often adapts recipes so that she and her family enjoy the same protein, like fish or beef, but eat different side dishes.

Shop the Edges of the Store First

The best places to spend your time and money at the market are the fresh produce and refrigerated sections. Shop with caution in the center aisles, where many highly processed and packaged foods are stocked.

“A snack can really be anything,” Robinson says. She suggests a handful of unsalted roasted nuts or seeds; hummus and vegetables; berries; baby carrots with guacamole; and a hard-boiled egg.

The key to eating with diabetes is not to give into impulse buys.

“If I see something new at the store, I usually go home and research it first to see if it’s a good fit for me,” says Leitaker, who dropped her A1c below 6 and lost more than 50 pounds by eating carefully and walking. 

Leitaker often adapts recipes so that she and her family enjoy the same protein, like fish or beef, but eat different side dishes.

Shop the Edges of the Store First

The best places to spend your time and money at the market are the fresh produce and refrigerated sections. Shop with caution in the center aisles, where many highly processed and packaged foods are stocked.

Load your cart with:

Vegetables. Fresh, in-season vegetables are always best. Frozen and canned are great choices as long as the vegetable is the only ingredient. Non-starchy vegetables and leafy greens like spinach, Brussels sprouts, and broccoli are better than starchy veggies like green peas, corn, potatoes, and winter squash.

Pro tip: Drain and rinse your canned vegetables. This lowers the sodium content by almost half.

Fruit. Look for fresh, frozen, or canned fruit in their own juice. Avoid those with syrup, which is sugar. Dried fruit and 100% fruit juice are options, too. But watch your portions since fruits are high in carbs and naturally sweet.

Whole grains. Make sure the first ingredient is a whole grain.

Meat, poultry, and fish. Buy according to your serving size, and focus on lean meats and cuts.

Drinks. Water is best.

Desserts. It’s better to plan a dessert than make an impulse buy at the store. Know your portion sizes, stick to them, and enjoy.

Read Every Label

“I always tell people not to look at the front of the package,” Zanini says. “That’s where the marketing happens. Flip it over and look at the food label first.”

Check the serving size, and then read down for the total carbohydrates. That’s a key number when you have diabetes because carbs raise your blood sugar level more quickly than protein or fats. Something sugar-free can still have lots of carbs.

Make It a Habit

Reading labels and making healthy choices at the market will become second nature. Your first few trips to the store may take longer. Plan for the extra time, and eat first so you won’t be making purchases on an empty stomach.

Need some support? Ask your doctor to recommend a registered dietitian nutritionist (RDN) with experience in type 2 diabetes. They can guide you on what foods to eat based on your tastes, budget, and health goals.

7 Facts About Tea That May Surprise You


hot tea

Judging from our local coffee shop’s drive-thru line, which snakes out onto the street and up the block every morning, coffee dominates the morning caffeine scramble for a lot of people. But tea actually outshines coffee worldwide. Here are some other facts that may surprise you:

It’s the most widely consumed drink in the world. After water, tea is the most popular drink for people around the globe. China, Turkey, and the U.K. have some of the biggest tea drinking populations. On a given day, half of all Americans drink it — though the vast majority is consumed as iced tea.


Truth About Tea

It doesn’t take all the tea in China to reap its health benefits–about three cups a day will do you.ABOUT

It’s a heart-healthy drink. One popular tea brand got approval from the FDA to display a health claim on plain black and green tea that states, “Can Help Support Heart Health.” Tea contains natural plant compounds that are known to be heart-healthy, and studies have found tea drinkers to have lower rates of heart disease.

It’s basically calorie-free. Like coffee, plain tea contains just a couple of calories per cup and no sugar. But what’s added can change that. A medium sweet tea and a large iced matcha latte from fast food restaurants both pack about 7 teaspoons of sugar. (The American Heart Association recommends no more than 6-9 teaspoons for the whole day).

It all comes from the same plant. Varieties may look and taste different, but all real tea originates from the Camellia sinensis plant. The varieties — black, white, oolong, and green — are made by processing the plant differently. For example, black tea comes from leaves that are exposed to the air longer (called oxidation) than green tea. Herbal teas, on the other hand, don’t come from that plant. Instead, they’re infusions of different plants.

It’s just as hydrating as water. You may have heard that beverages that contain caffeine somehow don’t “count” when it comes to hydration. But that’s actually not the case. Tea is more than 99 percent water, so tea’s hydrating qualities offset any diuretic effects.

It contains the same healthy compounds as broccoli. Flavonoids are natural plant compounds that have potential health benefits, and foods like grapes, berries, and broccoli all contain them. Tea is an especially rich source. According to a USDA database, 1 cup of black tea has 170 milligrams of flavonoids, while 1 cup of broccoli has about 3 milligrams.

It’s sometimes topped with cream cheese. Bubble tea is still enjoying popularity. (Is it bad for you? Read about it here.) But look out for the latest fad that’s brewing: cheese tea, which is topped with a frothy, foamy mixture of milk, cream cheese, and whipped cream and a sprinkle of sea salt. (It doesn’t exactly compete with plain tea as a healthy drink, but it might make a unique dessert!)


Best Energizing Yoga PosesHow It Works

Workout fads come and go, but virtually no other exercise program is as enduring as yoga. It’s been around for more than 5,000 years.

Yoga does more than burn calories and tone muscles. It’s a total mind-body workout that combines strengthening and stretching poses with deep breathing and meditation or relaxation.

There are more than 100 different forms of yoga. Some are fast-paced and intense. Others are gentle and relaxing.

Examples of different yoga forms include:

  •  Hatha. The form most often associated with yoga, it combines a series of basic movements with breathing.
  •  Vinyasa. A series of poses that flow smoothly into one another.
  •  Power. A faster, higher-intensity practice that builds muscle.
  •  Ashtanga. A series of poses, combined with a special breathing technique.
  •  Bikram. Also known as “hot yoga,” it’s a series of 26 challenging poses performed in a room heated to a high temperature.
  •  Iyengar. A type of yoga that uses props like blocks, straps, and chairs to help you move your body into the proper alignment.

Intensity Level: Varies with Type

The intensity of your yoga workout depends on which form of yoga you choose. Techniques like hatha and iyengar yoga are gentle and slow. Bikram and power yoga are faster and more challenging.

Areas It Targets

Core: Yes. There are yoga poses to target just about every core muscle. Want to tighten those love handles? Then prop yourself up on one arm and do a side plank. To really burn out the middle of your abs, you can do a boat pose, in which you balance on your “sit bones” (the bony prominences at the base of your pelvic bones) and hold your legs up in the air.

Arms: Yes. With yoga, you don’t build arm strength with free weights or machines, but with the weight of your own body. Some poses, like the plank, spread your weight equally between your arms and legs. Others, like the crane and crow poses, challenge your arms even more by making them support your full body weight.

Legs: Yes. Yoga poses work all sides of the legs, including your quadriceps, hips, and thighs.

Glutes: Yes. Yoga squats, bridges, and warrior poses involve deep knee bends, which give you a more sculpted rear.

Back: Yes. Moves like downward-facing dog, child’s pose, and cat/cow give your back muscles a good stretch. It’s no wonder that research finds yoga may be good for relieving a sore back.


Flexibility: Yes. Yoga poses stretch your muscles and increase your range of motion. With regular practice, they’ll improve your flexibility.

Aerobic: No. Yoga isn’t considered aerobic exercise, but the more athletic varieties, like power yoga, will make you sweat. And even though yoga is not aerobic, some research finds it can be just as good as aerobic exercise for improving health.

Strength: Yes. It takes a lot of strength to hold your body in a balanced pose. Regular practice will strengthen the muscles of your arms, back, legs, and core.

Sport: No. Yoga is not competitive. Focus on your own practice and don’t compare yourself to other people in your class.

Low-Impact: Yes. Although yoga will give you a full-body workout, it won’t put any impact on your joints.

What Else Should I Know?

Cost. Varies. If you already know your way around a yoga mat, you can practice for free at home. Videos and classes will cost you various amounts of money.

Good for beginners? Yes. People of all ages and fitness levels can do the most basic yoga poses and stretches.

Outdoors. Yes. You can do yoga anywhere, indoors or out.

At home. Yes. All you need is enough space for your yoga mat.

Equipment required? No. You don’t need any equipment because you’ll rely on your own body weight for resistance. But you’ll probably want to use a yoga mat to keep you from sliding around in standing poses, and to cushion you while in seated and lying positions. Other, optional equipment includes a yoga ball for balance, a yoga block or two, and straps to help you reach for your feet or link your hands behind your back.

What Family Doctor Melinda Ratini MD Says:

There are many types of yoga, from the peaceful hatha to the high-intensity power yoga. All types take your workout to a level of mind-body connection. It can help you relax and focus while gaining flexibility and strength. Yoga can also boost your mood.

Even though there are many instructional books and DVDs on yoga, it is well worth it to invest in some classes with a good instructor who can show you how to do the postures.

Chances are, there’s a type of yoga that suits your needs and fitness level. It’s a great choice if you want a holistic approach to mind and body strength.

Yoga is not for you if you like a fast-moving, competitive workout. Be open-minded, since there are physical and mental benefits you can gain by adding some yoga into your fitness plan, even if it isn’t your main workout.

Is It Good for Me If I Have a Health Condition?

Yoga is a great activity for you if you have diabetes, high blood pressure, high cholesterol, or heart disease. It gives you strength, flexibility, and mind-body awareness. You’ll also need to do something aerobic (like walking, biking, or swimming) if you’re not doing a fast-moving type of yoga.

If you have high blood pressure, diabetes, or heart problems, ask your doctor what you can do. You may need to avoid certain postures, like those in which you’re upside down or that demand more balance than you have right now. A very gentle program of yoga, coupled with a light aerobic activity like walking or swimming, may be the best way to start.

Do you have arthritis? Yoga can help you stay flexible and strong without putting added stress on your joints. You get the added benefit of a mind-body approach that can help you relax and energize.

If you’re pregnant, yoga can help keep you relaxed, strong, and in shape. If you’re new to yoga or have any health or pregnancy related problems, talk to your doctor before you give it a try. Look for an instructor who’s experienced in teaching prenatal yoga.

You’ll need to make some adjustments as your baby and belly grow and your center of gravity shifts. After your first trimester, don’t do any poses that have you lying on your back. And don’t try to stretch any further than you did before pregnancy. Your pregnancy hormones will loosen up your joints and make you more likely to get injured.

While you’re pregnant, avoid postures that put pressure on your belly or low back. Don’t do “hot” yoga, where the room temperature is very high.

When and How Should I Stretch My Leg Muscles?




photo of leg stretch

If you’ve ever gotten to a baseball game well before it started, you may have seen the players doing all sorts of leg stretches in the outfield. But you don’t have to be an athlete to stretch your leg muscles, or benefit from doing so. The benefits are many, and include:

  • Overall improved fitness
  • Enhanced ability to be more skillful at a particular sport
  • Increased relaxation
  • Reduced risk of injury
  • Reduced soreness
  • Increased flexibility

Types of Stretching

But before you start a routine, it’s helpful to know that there are several types of stretches, or flexibility exercises, like:

Static stretching. This is the most common. It’s done by extending the muscle as far as you comfortably can and holding the stretch for up to 30 seconds. There are two types of static stretches:

  •  Active: You pull, or push, on the muscle to increase the intensity of the stretch.
  •  Passive: Someone else applies force to the muscle, or you use something like a towel or elastic band to increase the intensity.

Dynamic stretching. This involves moving continuously to imitate a portion of the sport or exercise that you perform. For example, if you’re a runner, you could take slow strides in which you raise your knees to your chest and pump your arms slowly.

Ballistic stretching. This type uses repeated bouncing movements, like dropping down into a crouch and then springing straight up into the air by pushing off on the balls of your feet repeatedly. This helps stretch your calf muscles. These normally switch between low speed and high speed. Doctors recommend you do static stretching before moving to ballistic stretches.

Active isolated stretching. You do this for only 2 seconds at a time, but for several repetitions. At each interval, you should try to increase the degree of stretching by just a little bit.

Myofascial release. This is often done with the assistance of a hard foam roller. For example, you can sit on one so that the underside of your thigh, or your hamstring, is resting on the foam roller. Then you slowly roll back and forth over the roller, which helps relieve tension and improves flexibility in the muscle. While rolling you should cover 2 to 6 inches of your leg, for 30 to 60 seconds. If you’ve never used a foam roller before, have a trainer show you the right way to do it. There are also different yoga poses that can do the same thing for you..

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