Health & Wellness May 2011

HW +

BE STRONGER. LIVE LONGER.

GAM BIT’S HEALTH & WELLNESS > MAY 2011 > VOLUME 2 > NUM BER 5

G A M B I T ’ S H E A LT H + W E L L N E S S

IN THE

HOOP HULA HOOPING IS A FUN, FULL-BODY WORKOUT.

SLEEP DISORDER CAUSES AND TREATMENTS

5

ALLERGY OR COLD? HOW TO TELL THE DIFFERENCE

10

ADVANCES IN BREAST AUGMENTATION

11

Mark your calendars for these upcoming events.

All are free for Healthy Lifestyles members unless otherwise noted.

For details, registration and a complete listing of community offerings and membership benefits, visit us online at www.ejgh.org/healthylifestyles or call HealthFinder at 504-456-5000.

5/7

Fitness Outing A bike ride on the levee for Healthy Lifestyles members with Olympic hopeful, Alice Ford of Healthy Lifestyles. Meet at 9am at the Pontchartrain Center boat launch.

HealtH & Wellness > bestofneworleans.com > maY 03 > 2011

5/11

02

Breast Care Seminar Learn what every woman should know about maximizing women’s breast health and breast cancer prevention.

Join Radiologist Mary Beth Lobrano, OB/GYN Stephen Champlin and Sports & Lifestyles Nutritionist Julie Fortenberry for this fun and informative event.

Rembrandt All You Can Art A members only social event. Have fun, get acquainted, enjoy wine & snacks and paint!

6pm at Rembrandt All You Can Art, 5200 Veterans Memorial Blvd. $25.

5/18

Healthy Lifestyles Book Club A book club for Healthy Lifestyles members.

Discounts on all Barnes and Noble products.

5:30–6:30pm at Barnes and Noble, 3721 Veterans Blvd.

6/1

Whole Foods Grocery Tour Maintaining a Healthy Weight Make healthier choices, understand food labels and shop for good health. 5:30–6:30pm at Whole Foods, 3420 Veterans Blvd.

6/16

Girl’s Night Out Fighting Temptations and Staying Fit OB/GYN Kathleen Sullivan and boxing trainer Axel Murillo present ways to maximize your health while minimizing your dress size. Great health, fitness and nutrition information offered along with food, wine and fun. 7pm in the EJGH Conference Center. Free for Healthy Lifestyles members, $10 for non-members.

6/21

Physician Seminar Beating the Heat Roland Waguespack, MD, and EJGH Nutritionist Rebecca Lee discuss ways to safely overcome summertime heat. 7pm in the EJGH Conference Center. Free for Healthy Lifestyles members, $10 for non-members.

Stephen Champlin, MD

Mary Beth Lobrano, MD

Julie Fortenberry

OB/GYN

Radiologist

Nutritionist

Tuesday, May 24, 7pm East Jefferson General Hospital Conference Center Free to Healthy Lifestyles members, $10 for non-members.

Call HealthFinder at 504-456-5000 to register.

East Jefferson General Hospital www.ejgh.org/healthylifestyles East Jefferson General Hospital is a publicly-owned, not-for-profit community hospital.

This hospital service district hospital, formed in 1965, receives no tax support from Jefferson Parish.

The hospital is accredited by the Joint Commission on Accreditation of Healthcare Organizations.

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Snooze THERE ARE MANY REASONS PEOPLE DON’T SLEEP WELL — BUT THERE ARE ALSO MANY TREATMENT OPTIONS.

BY K ATIE WALENTER

PRACTICING GOOD SLEEP HYGIENE The best approach to treating sleep disorders that don’t have a medical cause is to make lifestyle changes. Because most Americans live with electricity and are not hard-working farmers who rise at dawn and prepare for sleep when the sun goes down, many no longer follow natural circadian rhythms. Too little exercise, too much alcohol and caffeine, and late-night snacking while watching TV or surfing the Internet are other behavioral factors that contribute

to poor quality sleep.

“Sleep hygiene is very important for good sleep quality, especially for individuals with insomnia,” Thammasitboon says. “I always recommend my patients go to bed and wake up at the same time every day, avoid long naps (or take only 15- to 20-minute naps if necessary), avoid caffeine after lunch and (consume) no alcohol for five to six hours before bedtime.”

Thammasitboon also emphasizes the importance of regular exercise, a healthy diet and an appropriate weight. Chocolate and certain vitamins and pain medications are often sources of hidden caffeine.

Keep the bedroom environment temperate, not too hot and not too cold, the darker the better, and remove TVs and computers.

PRESCRIPTIONS AND OVER-THE-COUNTER MEDICATIONS The array of over-the-counter (OTC) sleep medications includes products ranging from $3 to $30. The most common are pills containing antihistamines, such as Unisom, which cause sleepiness as a side effect but should not be used in the long term. “OTC sleep aids contain diphenhydramine, which usually makes people drowsy,” says Dr. Stuart Busby, medical director of the Ochsner Sleep Center. “Unfortunately, the effectiveness can wear off over time.”

Because melatonin levels decrease as people age, melatonin supplements are an option for treating occasional sleeplessness. “Melatonin is a sleep hormone that is normally secreted from our brain to induce sleep,” Thammasitboon says. “These supplements can be used safely in certain sleep disorders,

(but) may not work very well for individuals with chronic insomnia.” However, Busby points out that melatonin supplements only work for certain circadian cycle disturbances. The supplements are ineffective if they are not administered properly and for the correct reason.

Many doctors prescribe sleep medication for patients experiencing bouts of extreme stress or sleep disruption from noise or travel. Regular use of these medications is not recommended because they have potentially harmful side effects and can be addictive.

“If possible, avoid taking a sleep aid every night,” Busby says. “Give yourself a break or ‘holiday’ on days when sleep is less critical, e.g. weekend time off. This may help prevent dependence. It is also important to try to take steps to get to the root of your sleep problem.”

NATURAL REMEDIES Natural remedies include noncaffeinated herbal teas with chamomile, lemon balm, passionflower or hops, and other herbal products, such as valerian. “I do not oppose the use of natural remedies as long as you know the definite ingredient in a particular product,” Thammasitboon says. “However, the patient should consult his or her physician if there’s any question at all, especially if the patient has multiple medical problems and is on several medications.”

People often can’t fall asleep because their minds are racing. “Stress reduction is key,” Busby says. “Finding healthy ways to discharge stress deserves your attention.” Besides herbal teas and natural supplements, breathing techniques, certain yoga postures, journaling and meditation aid relaxation.

“A regular, active yoga practice can help release …

HealtH & Wellness > bestofneworleans.com > maY 03 > 2011

A

t one point or another, many people will have trouble sleeping. Whether it’s insomnia, snoring, restless legs or a potentially life-threatening problem like sleep apnea, any sleep disorder interferes with the ability to function and thrive. When people can’t sleep, their work suffers, their moods suffer and loved ones suffer.

“Behavioral factors and poor sleep hygiene are the most common causes of insomnia and sleep problems,” says Dr. Supat Thammasitboon, medical director for the Tulane Comprehensive Sleep Medicine Center. “Unrealistic beliefs or myths about sleep … can deteriorate sleep quality. Some patients set a very high expectation of sleep by saying, ‘I have to sleep nine hours to perform well at work.’ There is no magic number. … We should not force ourselves to fall asleep when the brain is not ready, since it may lead to more use of sleeping aids or sedatives.”

In short, people worry when they can’t sleep and sometimes take medication without figuring out why they can’t sleep in the first place. The good news is this can change by addressing the root causes of poor quality sleep.

PAGE 7

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tension in the body and mind so you become more skillful at managing stressful situations,” says certified Anusara yoga instructor Laura Flora.

“Before bed, doing a few calming poses such as gentle hip openers, forward bends, twists and a simple inversion of lying down with your legs propped up against the wall helps settle the body and quiet the mind. …

(F)ocus on lengthening your exhales … to bring yourself to a deeper state of quiet.”

When Good Sleep hyGiene iS not enouGh Not all sleep disorders can be cured by lifestyle modification alone, Thammasitboon says. “Some people have the opportunity to sleep, but sleep poorly due to sleep disorders or medical conditions,” he says.

Some of these medical conditions, such as frequent urination or coughing and shortness of breath from asthma or chronic bronchitis, can be treated with medication. Depression and anxiety disorders are other common causes of insomnia. More serious health conditions such as heart disease, diabetes, high blood pressure and obesity are often related to sleep disorders such as sleep apnea, which results in loud snoring, choking or gasping during sleep, throat dryness or headaches in the morning, Thammasitboon says.

If you have medical conditions and are having trouble sleeping, it is time to see a doctor for solutions. In some cases, your physician may refer you to a sleep clinic to diagnose a disorder. “It is important to take steps to get to the root of your sleep problem,” Busby says.

Contact the Tulane Comprehensive Sleep Medicine Center (1415 Tulane Ave., 988-1657; www. tulane.edu/ som/departments/medicine/pulmdis/sleep-center.cfm) or the Ochsner Sleep Center ( 1514 Jefferson Hwy., 8424910; www.ochsner.org/services/sleep_disorders) for help with sleep problems, or visit www.sleepcenters.org to locate a sleep clinic.

bottom: herbal teas of chamomile, lemon balm, passionflower or hops can help you relax for a better night’s sleep.

11 Natural Ways to Get A Good Night’s Sleep • Acupuncture: A series of acupuncture treatments over several weeks can increase evening melatonin production in some people and enhance sleep.

• Schedule: Maintain a regular sleep schedule, going to bed and getting up at the same time each day, even on weekends and during vacation.

• Aromatherapy: Fill an essential oil diffuser with lavender, ylang ylang, jasmine or chamomile, or put a few drops of an essential oil in a hot evening bath taken two hours prior to bedtime.

• Sunlight: Spend time outdoors every day in bright sunlight. Keep track of whether morning or afternoon sun works better for you, and don’t forget to wear sunscreen to protect your skin.

• Carbohydrates: Eating carbs (without sugar) such as whole-wheat crackers before bed can help you get to sleep.

• Exercise: Exercise can alleviate muscle tension and stress and promote deep sleep, but don’t exercise too close to your bedtime as it can increase adrenalin levels and keep you awake.

• Magnesium: It’s a natural sedative, so seek out foods high in magnesium.

• Make your bedroom sleep-friendly with a comfortable bed and pillow. Keep it dark, quiet and cool.

• Visualization: Lie in bed and imagine a relaxing scene’s sights, smells, sounds — the more senses you use the more effective it will be.

• White noise: You can buy devices that play white noise to block out other sounds that may distract you while you are falling asleep or awaken you later.

• Yoga: A Harvard study found the deep breathing, meditation and stretching of yoga, performed daily for eight weeks, improves both the time it takes to fall asleep and the total time you will stay asleep.

HEALTH & WELLNESS > BESTOFNEWORLEANS.COM > MAY 03 > 2011

top: a few drops of lavender essential oil in a bath before bed can help you fall asleep.

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be stronger. live longer.

hula hoopers burn calorIes, tone core Muscles and have fun.

g a m b i t ’ s h e a lt h + w e l l n e s s

by MarguerIte lucas

Instructors JulIe MerrItt, Morgan tsu-raun and KIMberly lobert (left to rIght) call hula hoopIng “exercIse In dIsguIse.”

sold at toy stores are responsible for much frustration in beginners.

“If you don’t have the right size hoop, you’re not going to get where you want to be,” Merritt says. “We tell people, ‘It wasn’t you. It was the hoop.’”

With each attempt, I managed to hoop longer. Although the hoop ended up around my ankles every time, Merritt, Lobert and Tsu-Raun said I’d soon be hooping in my sleep.

Place the hoop around your waist, touching the small of your back. Stand with one foot forward, keep knees slightly bent and tilt the pelvis forward just a little.

Give the hoop a strong push in the direction (right or left) that feels most natural.

Immediately push forward from your center while shifting your weight forward and back, repeatedly. Stay upright and keep your arms out of the way. If the hoop starts to drop, try pushing faster to recover it.

Helpful Tips: • When beginning, hoop for five to 10 minutes until you build stamina.

• Wear clothing made of natural fibers and avoid bending at the waist or lifting your arms straight up, as this will cause your hoop to fall.

• Keep movements small and controlled to prevent losing control of the hoop or having it hit your face.

• Bruising on the abdomen can occur when using a weighted hoop.

HealtH & Wellness > bestofneworleans.com > maY 03 > 2011

W

hen I arrived at City Park to meet with Kimberly Lobert, owner and founder of Nola Hooping (www.nolahooping.com), and instructors Julie Merritt and Morgan Tsu-Raun, I dreaded the hula hoop. As a child, I could never keep the hoop in motion longer than 10 seconds, so I reacted with skepticism when they told me “anyone can hoop.”

The instructors explained the basics of hooping: one foot forward, knees bent, arms at the sides and small, controlled back and forward pelvis movements. On my first try, I dropped the hoop.

“When it falls down, we just tell people they’re adding a lunge to the workout,” Lobert says.

Hula hooping can burn as many as 100 calories in 10 minutes, strengthen core muscles and increase balance and stamina, Nola Hooping instructors say. Hooping also stimulates lymph nodes located in the belly, which results in increased circulation, a strengthened immune system and elimination of metabolic waste, Merritt says.

“The massaging quality of hooping stimulates the release of serotonin into the bloodstream,” she says. “It’s like taking a happy pill.”

Open since last July, Nola Hooping offers 21 classes a week at nine locations in the New Orleans area. Offerings include a hooping fitness class where participants learn basic and intermediate moves, “hoopilates” (a hybrid of hooping and Pilates), and cardio hoops (a cardiovascular workout using hoops). While each class covers basic instruction for beginners, instructors also incorporate more advanced moves, such as arm twirling and dance routines, to keep classes exciting and ensure a full-body workout.

At first glance the hoops might seem too large, but instructors say a smaller circumference makes hooping more difficult. The small plastic hoops

Instructor Morgan tsu-raun deMonstrates basIc hoopIng

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When the body is exposed to an allergen, the immune system responds a number of ways. Everybody’s response is different. Most people get a runny nose due to irritation of the mucosa (the lining of the nose). The nose responds (by making) mucus to get rid of that irritation. Sometimes the lining of the nose, the sinuses and throat swell as a response to the irritant. Frequently when that swelling occurs, normal drainage of the (fluid in) nasal passages, sinuses and sometimes the ears can’t take place. When that fluid sits there long enough it can get infected.

Can allergy symptoms lead to a sinus infection?

How can this be prevented?

Yes, they can. To prevent that, do what you can for decongestion. A lot of over-the-counter medicines work reasonably well for decongestion. If you take a specific brand for awhile, it tends to lose its effectiveness, and you have to switch brands. Another option is to irrigate the sinuses. There are many over-the-counter setups such as plastic squeeze bottles or the neti pot, which literally rinses out your sinuses. I’ve seen people use the neti pot to get rid of the irritation, extra mucus and to some extent the swelling. This works well for most people.

How can a patient tell the difference between allergies and a cold?

Sometimes you can’t, because the symptoms are frequently the same. A cold, which is caused by

a virus, starts off more as a sore throat with a sense of swelling higher up in your nose, while allergies are usually sneezing, runny nose and watery eyes.

Decongestants can relieve symptoms

of both. Children are more susceptible to allergies, because they have smaller passages which are likelier to become obstructed and swollen. However, it is possible to develop allergies during any stage of life.

What symptoms should prompt someone to seek a doctor?

Fever, a change in color or texture of nasal mucus, or a cough that (produces) green mucus. In the morning, nasal mucus is usually yellow because it has been collecting overnight. If the color clears up during the day, it’s most likely allergies. If it stays yellow or gets darker or thicker, then you worry about an infection.

What are the most common allergens in the greater New Orleans area?

Ragweed is one of the worst. A lot of the pines, oaks and flowering trees have significant pollen. One

way to get an idea of the amount of pollen in the air is by looking at a car in the morning — if it’s covered with yellow dust, that’s pollen.

What are the best ways to treat allergies?

Staying hydrated, using overthe-counter medicines and rinsing your nasal passages helps a lot. If you have household allergies, cleaning your house and surroundings will help remove allergens relating to cats, dogs and dust. You can place a HEPA (high-efficiency particulate air) filter in the room you spend the most time in, like the bedroom, to help clear the air of allergens. If your allergies involve wheezing or respiratory difficulty, or if you have associated infections frequently and you’re losing time from school or work, that’s a definite indication to consider allergy shots. It’s a matter of how badly your allergies interfere with your life.

C

s ale down

F r o m w w l -T V ’s w e i g hT lo s s w e d n e s days

wiTh meg Farris

From The proFessionals oF easT j e F F e r s o n g e n e r a l h o s p i Ta l

Fat Chance?

Doctors are DiviDeD on using boDy fat for breast implants.

F

formities caused by her breast implants.

Her implants were recently removed, and fat from her thighs was transferred to her breasts.

“Twenty years ago, I had breast implants because I am so out of proportion,” she says. “I regret that I ever (got) implants. Over the last 20 years I’ve had four surgeries (to correct the hardening and deformities).”

After the fat transfer, her breasts kept their volume without hardening. While before and after pictures show good results for this patient and others like her, doctors who have used fat grafts for cancer patients and breast reconstruction are waiting and watching the studies before using the procedure for enlargement alone. Women who lose a lot of weight after the procedure lose breast volume because transplanted fat from the thighs or abdomen still reacts the same way to diet and exercise — by shrinking. For now, doctors say fat transfer is not a good option for a woman who wants to go from an A cup to a C or D cup.

“I don’t think we’re ready as a plastic surgery community to say fat injections for cosmetic or elective breast enhancement are the way to go,” says Dr. John Lindsey, chief of plastic and reconstructive surgery at East Jefferson General Hospital. “There are just too many issues that have not been worked out.”

For now, the procedure is becoming more acceptable for certain patients.

Doctors have more information about cancer risk, the procedure’s effect on mammograms and the best candidates for the procedure, and their experience and techniques for harvesting fat and transferring it are crucial to the procedure’s success.

“For many years, we have been trying to figure out how to get fat to last in the breast, to augment breasts without implants, using (a patient’s) own fat,” says Dr. William Coleman, a dermatological surgeon in Metairie. “It is conceivable that this may be a very viable procedure for the future.”

“I would say keep your eyes open,” Khoobehi says. “Have an open mind.”

Look for Meg Farris’ Medical Watch reports, including “Weight Loss Wednesday” and “Wrinkle Free Friday” stories, weeknights on WWL-TV Channel 4 and anytime on wwltv.com.

Diet affects weight loss more than exercise, one nutritionist says. take off pounDs sensibly with a fooD Diary anD nutrition plan. by amber ballow

T

he key to weight loss has more to do with what and how much you eat, not the intensity and frequency of workouts. According to Rebecca Lee, a registered dietitian and licensed nutritionist at East Jefferson General Hospital, losing weight and keeping it off comes 80 percent from diet and 20 percent from physical activity.

“Building a healthy, personally structured nutrition plan is one of best things you can do for yourself,” says Lee, who has dealt with many clients who felt frustrated because they weren’t losing weight despite vigorous workouts. Not every diet works for every person. A well-balanced diet is the key to a healthy, inshape body.

To set up a personal nutrition plan, first calculate your body’s basal metabolic rate (BMR). This is the rate at which your body burns calories and is determined by the individual’s height, weight, age, sex and activity level. Mayo Clinic provides an online calorie calculator at www. mayoclinic.com/health/caloriecalculator/NU00598.

A nutrition plan may consist of an intake of around 1,800 calories, depending on the person’s physical attributes and weight loss goals. A diet plan should include appropriate amounts of carbohydrates, protein, fat and calories. Dieters record the caloric content of every meal.

At the end of the day, the total number of calories should match appropriate daily calorie intakes.

“Along with a nutrition plan, a food list is necessary,” says Lee, who refers to a food list that divides foods into categories like meats, starches, condiments and fruits, and includes nutritional information. “The food list makes it simple to look up anything

you may think about eating and decide what the proper portion is in order to comply with your nutrition plan.”

Following a food plan worked for Lee’s client Charles “Chuck” Kelly III, who since last August has lost 40 pounds and reduced his blood sugar from diabetic to normal levels. “Most people aren’t educated about eating — I wasn’t,” Kelly says. Lee taught Kelly about nutrition and helped him set weight loss goals. Kelly also recorded everything he ate for three months. “Keeping a food diary is one of the most important things you can do when dieting,” Lee says.

Kelly’s new diet consisted of a daily 1,800-calorie intake divided into three small meals and three small snacks. Kelly followed his nutrition plan and looked up all foods in the food list before preparing his meals and snacks. He relied on lean protein snacks like low-fat cheese, egg whites, nuts, avocados and lean deli meats to stave off hunger.

Kelly says one of the most important things he learned was how to lose the weight and keep it off. “Another key in my weight loss — as with anyone — is losing it slowly. I could lose 30 pounds in 30 days, but you’ll never keep it off doing it that way. I learned that is not healthy.”

According to Lee, losing one or two pounds a week is usually the healthiest rate. Although people gravitate toward fad diets, any weight loss that ensues from these methods is likely to be temporary. By exercising daily and eating healthily, most people lose weight successfully. “It all depends on your body and what is right for you,” Lee says.

HealtH & Wellness > bestofneworleans.com > maY 03 > 2011

at grafts, or transferring fat from one part of the body to another, have been performed for years to plump up sunken faces and lips, hands thinned by sun exposure, or flat buttocks.

However, transferring fat to the breasts rather than using implants has created controversy among doctors. Can women safely have liposuction performed on their lower bodies and use unwanted fat to make breasts fuller without implants?

Are there any unknown side effects, and how would this procedure affect women’s breast cancer risks?

Over the last few years, LSU Health Sciences Center plastic surgeon Dr. Kamran Khoobehi performed and studied the procedure on nearly 200 patients. All women in the study had a mammogram before surgery to make sure they didn’t have undiagnosed cancers.

Khoobehi recently brought surgeons from around the world to New Orleans to discuss his results.

“The biggest group that was reported was from France,” Khoobehi says.

“They have (done) more than 1,000 fat grafts in the breasts and haven’t reported any increased risk of breast cancer in that group.”

Doctors also were concerned about the calcification pattern of fat grafts causing spots on a mammogram that resemble cancer, requiring a woman to undergo a needle biopsy. Radiologists at the conference said any breast procedure or surgery, like a reduction, causes changes on a mammogram, but a radiologist trained to recognize the difference should have no problems.

“The question is whether radiologists have great difficulty in assessing whether those changes are related to the surgery or to breast cancer development,” says Dr. Eva Rubin, a diagnostic radiologist who came to the conference from Montgomery, Ala. “For the most part, it’s not a problem. There’s always going to be a case where you have some questions and you end up doing a needle biopsy, but that’s not a disaster.”

“The calcification pattern (of fat grafts) is totally different than breast cancer calcification,” Khoobehi says.

The fat graft procedure is good for patients experiencing loss of breast volume after pregnancy or implant problems, for those who want to fill a wide space between implants to create cleavage, or to cover rippling or depressions in implants.

One such patient, a 62-year-old woman who chose not to reveal her identity, experienced scarring, hardening and de-

meal plans

11

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s ale down

F r o m w w l -T V ’s w e i g hT lo s s w e d n e s days

wiTh meg Farris

From The proFessionals oF easT j e F F e r s o n g e n e r a l h o s p i Ta l

Fat Chance?

Doctors are DiviDeD on using boDy fat for breast implants.

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Her implants were recently removed, and fat from her thighs was transferred to her breasts.

“Twenty years ago, I had breast implants because I am so out of proportion,” she says. “I regret that I ever (got) implants. Over the last 20 years I’ve had four surgeries (to correct the hardening and deformities).”

After the fat transfer, her breasts kept their volume without hardening. While before and after pictures show good results for this patient and others like her, doctors who have used fat grafts for cancer patients and breast reconstruction are waiting and watching the studies before using the procedure for enlargement alone. Women who lose a lot of weight after the procedure lose breast volume because transplanted fat from the thighs or abdomen still reacts the same way to diet and exercise — by shrinking. For now, doctors say fat transfer is not a good option for a woman who wants to go from an A cup to a C or D cup.

“I don’t think we’re ready as a plastic surgery community to say fat injections for cosmetic or elective breast enhancement are the way to go,” says Dr. John Lindsey, chief of plastic and reconstructive surgery at East Jefferson General Hospital. “There are just too many issues that have not been worked out.”

For now, the procedure is becoming more acceptable for certain patients.

Doctors have more information about cancer risk, the procedure’s effect on mammograms and the best candidates for the procedure, and their experience and techniques for harvesting fat and transferring it are crucial to the procedure’s success.

“For many years, we have been trying to figure out how to get fat to last in the breast, to augment breasts without implants, using (a patient’s) own fat,” says Dr. William Coleman, a dermatological surgeon in Metairie. “It is conceivable that this may be a very viable procedure for the future.”

“I would say keep your eyes open,” Khoobehi says. “Have an open mind.”

Look for Meg Farris’ Medical Watch reports, including “Weight Loss Wednesday” and “Wrinkle Free Friday” stories, weeknights on WWL-TV Channel 4 and anytime on wwltv.com.

Diet affects weight loss more than exercise, one nutritionist says. take off pounDs sensibly with a fooD Diary anD nutrition plan. by amber ballow

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he key to weight loss has more to do with what and how much you eat, not the intensity and frequency of workouts. According to Rebecca Lee, a registered dietitian and licensed nutritionist at East Jefferson General Hospital, losing weight and keeping it off comes 80 percent from diet and 20 percent from physical activity.

“Building a healthy, personally structured nutrition plan is one of best things you can do for yourself,” says Lee, who has dealt with many clients who felt frustrated because they weren’t losing weight despite vigorous workouts. Not every diet works for every person. A well-balanced diet is the key to a healthy, inshape body.

To set up a personal nutrition plan, first calculate your body’s basal metabolic rate (BMR). This is the rate at which your body burns calories and is determined by the individual’s height, weight, age, sex and activity level. Mayo Clinic provides an online calorie calculator at www. mayoclinic.com/health/caloriecalculator/NU00598.

A nutrition plan may consist of an intake of around 1,800 calories, depending on the person’s physical attributes and weight loss goals. A diet plan should include appropriate amounts of carbohydrates, protein, fat and calories. Dieters record the caloric content of every meal.

At the end of the day, the total number of calories should match appropriate daily calorie intakes.

“Along with a nutrition plan, a food list is necessary,” says Lee, who refers to a food list that divides foods into categories like meats, starches, condiments and fruits, and includes nutritional information. “The food list makes it simple to look up anything

you may think about eating and decide what the proper portion is in order to comply with your nutrition plan.”

Following a food plan worked for Lee’s client Charles “Chuck” Kelly III, who since last August has lost 40 pounds and reduced his blood sugar from diabetic to normal levels. “Most people aren’t educated about eating — I wasn’t,” Kelly says. Lee taught Kelly about nutrition and helped him set weight loss goals. Kelly also recorded everything he ate for three months. “Keeping a food diary is one of the most important things you can do when dieting,” Lee says.

Kelly’s new diet consisted of a daily 1,800-calorie intake divided into three small meals and three small snacks. Kelly followed his nutrition plan and looked up all foods in the food list before preparing his meals and snacks. He relied on lean protein snacks like low-fat cheese, egg whites, nuts, avocados and lean deli meats to stave off hunger.

Kelly says one of the most important things he learned was how to lose the weight and keep it off. “Another key in my weight loss — as with anyone — is losing it slowly. I could lose 30 pounds in 30 days, but you’ll never keep it off doing it that way. I learned that is not healthy.”

According to Lee, losing one or two pounds a week is usually the healthiest rate. Although people gravitate toward fad diets, any weight loss that ensues from these methods is likely to be temporary. By exercising daily and eating healthily, most people lose weight successfully. “It all depends on your body and what is right for you,” Lee says.

HealtH & Wellness > bestofneworleans.com > maY 03 > 2011

at grafts, or transferring fat from one part of the body to another, have been performed for years to plump up sunken faces and lips, hands thinned by sun exposure, or flat buttocks.

However, transferring fat to the breasts rather than using implants has created controversy among doctors. Can women safely have liposuction performed on their lower bodies and use unwanted fat to make breasts fuller without implants?

Are there any unknown side effects, and how would this procedure affect women’s breast cancer risks?

Over the last few years, LSU Health Sciences Center plastic surgeon Dr. Kamran Khoobehi performed and studied the procedure on nearly 200 patients. All women in the study had a mammogram before surgery to make sure they didn’t have undiagnosed cancers.

Khoobehi recently brought surgeons from around the world to New Orleans to discuss his results.

“The biggest group that was reported was from France,” Khoobehi says. “They have (done) more than 1,000 fat grafts in the breasts and haven’t reported any increased risk of breast cancer in that group.”

Doctors also were concerned about the calcification pattern of fat grafts causing spots on a mammogram that resemble cancer, requiring a woman to undergo a needle biopsy. Radiologists at the conference said any breast procedure or surgery, like a reduction, causes changes on a mammogram, but a radiologist trained to recognize the difference should have no problems.

“The question is whether radiologists have great difficulty in assessing whether those changes are related to the surgery or to breast cancer development,” says Dr. Eva Rubin, a diagnostic radiologist who came to the conference from Montgomery, Ala. “For the most part, it’s not a problem. There’s always going to be a case where you have some questions and you end up doing a needle biopsy, but that’s not a disaster.”

“The calcification pattern (of fat grafts) is totally different than breast cancer calcification,” Khoobehi says.

The fat graft procedure is good for patients experiencing loss of breast volume after pregnancy or implant problems, for those who want to fill a wide space between implants to create cleavage, or to cover rippling or depressions in implants.

One such patient, a 62-year-old woman who chose not to reveal her identity, experienced scarring, hardening and deformities caused by her breast implants.

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