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GAM BIT’S HEALTH & WELLNESS > AUGUST 2011 > VOLUME 3 > NUM BER 8
G A M B I T ’ S H E A LT H + W E L L N E S S
exercise YOUROPTIONS
Diversify your routine to help prevent sports injuries
WHERE TO FIND AFFORDABLE
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A HEALTHY TAKE ON
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HOW TO MANAGE
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HEALTH & WELLNESS > bestofneworleans.com > aUGUst 09 > 2011
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Health news in brief
The jUiCe
A protein-packed timbale recipe
experT AdviCe
The new guidelines for diagnosing gestational diabetes
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HEALTH & WELLNESS > bestofneworleans.com > aUGUst 09 > 2011
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Sprain Drain D
TO HELP PREVENT INJURY, DIVERSIFY YOUR WORKOUT ROUTINE, STRETCH, AND KNOW YOUR BODY’S LIMITS.
they suddenly experience discomfort in their shoulders during a serve. “After a while, your body just gets to a certain point where it’s irritated,” McKenzie says. “Most people think physical therapy is for one specific injury that has been sustained during a single event, but a lot of the problems we see come from years of overuse.” Fortunately in these instances, he notes, rest, rehabilitation and slight modification of the activity in question are usually enough to prevent any further damage. The most important thing to do with a recent injury, says Dr. Pamela Petrocy of East Jefferson General Hospital’s Rehabilitation Center (4200 Houma Blvd., Metairie, 456-5119; www.ejgh.org), is to rest it immediately, as continuing with the activity can turn a minor injury into a serious problem requiring surgery. Apply ice consistently over the first 48 hours, wrap it with a compression bandage and elevate the wounded part to keep swelling down. If it doesn’t resolve completely within two weeks, see a doctor. “When we first see a patient with what we assume is a minor injury, we start with an X-ray and an anti-inflammatory (medication), to see what the problem is and to help reduce swelling,” Petrocy says. “Most of the time, it’s something that can be resolved by taking some time off. We often give patients exercises that they can do at home to help restrengthen the muscle.” Injuries that require surgical attention, like a torn ACL or rotator cup, are more painful, expensive to treat, and have a slower recovery rate. All three doctors agree adequate preparedness is the best way to avoid getting seriously hurt. Fortunately there are a number of preemptive measures an athlete can take to ensure his or her body is ready for activity. Stretching, before and afterwards, is paramount. If your health is poor, consult a physician before engaging in any exercise routine. Above all, know your limits. “One of the most important things to remember when performing all kinds of physical activities is
BY C A RRIE M A RK S
PROPER FOOTWEAR
is instrumental in preventing injury to athletes — particularly for runners. Jessica Demello of Varsity Sports (2021 Claiborne St., Mandeville, 985-624-8200; 3450 Magazine St., 899-4144; www.varsityrunning. com) shares her tips for finding the right shoe.
1 2
3
4 5
Have a gait analysis to determine what type of foot you have and what type of shoe you’ll need. Whether you are a distance runner, jogger or walker, a shoe built to withstand intense training is imperative. “A running shoe tends to be lighter weight, more breathable, and provide more cushion and shock absorption,” Demello says. Regularly replace your running shoes. If you run often and prefer a lighter shoe, Demello says, you will likely have to replace your shoes more frequently. The average runner logging 15 to 20 miles per week should get new shoes about every six months. To extend the life of the shoes, rotate between two pairs. Try several different pairs before making a decision: “Brand and style come down to personal preference. Go with something properly fit,” she says.
that you need to ease into them,” O’Brien says. “When you’re starting, go for shorter durations that are less intense. Don’t go out the first day and run six miles.” He also recommends working whenever possible with licensed trainers, since their background makes them more educated about their clients’ physical limits. McKenzie agrees that designing your workout to fit your body’s needs is a good way to avoid damage. “You need to ensure that you’re exercising all of your muscles and joints, not just the ones you can see —
although those are usually the ones people pay most attention to,” he says. Focusing equally on the less visible parts of your physique helps increase your stability, which in turn prevents you from going off-kilter and straining a muscle in the heat of the game. For those who engage in contact or year-round sports (like many high school students), McKenzie stresses the importance of cross-training: switching up gym routines to develop the specific muscle strengths that may not necessarily be used in your sport of choice. For example, instead of training in the off-season by only focusing on his throwing power, a quarterback might switch from resistance training, like weight-lifting, to more balance-focused exercise, like yoga. This way, athletes maintain their fitness level, but avoid overusing or stressing the muscles they use while playing the game. Even non-contact athletes should diversify to their workout routine to prevent injuries caused by overuse. Runners face especially great risks of damage to their knees and hips because of the strong impact of the ground against their feet. “I’ve seen people who are only 40 years old with their knees in terrible shape, because they’ve been running for so long,” McKenzie says. He recommends staggering treadmill time with workouts on elliptical machines, stair climbers and exercise bikes, as these machines work all the leg muscles without causing stress to the bones. There are even options for those who are particularly fragile or who want to avoid the risk of injury. Swimming and water exercises help decrease the amount of stress from impact and provide universal resistance for optimal muscle development. For older athletes who are reluctant to relinquish the thrill of competition, McKenzie recommends biking. “It strengthens your legs and improves your cardiovascular endurance while still limiting the amount of stress on your hips and knees,” he says. Of course, as Petrocy notes, engaging in any strenuous physical activity requires a certain degree of “accepting the risk.” Still, preparedness, selfawareness, and slight modifications of your routine can go miles toward ensuring your body will keep up with your personal fitness goals. For more information on what to do when injured, visit www.moveforwardpt.com.
HEALTH & WELLNESS > bestofneworleans.com > aUGUst 09 > 2011
r. Jacob McKenzie, a physical therapist at the Movement Science Center in Metairie (111 Veterans Memorial Blvd., Metairie, Suite 470, 834-9259), has noticed an increasing awareness in the National Football League (NFL) about just how hard contact sports like football can be on the body. The NFL recognized certain precautionary measures can help reduce the risk of serious damage. “First the players’ helmets were redesigned to provide better protection from impact,” he says. “Then, rules started being enforced concerning how exactly they can hit each other during the game.” But sports injury doesn’t just occur on the multimillion dollar, televised level. Painful damage can befall even the most casual exerciser or weekend competitor. In fact, Dr. Michael O’Brien of the Tulane Institute of Sports Medicine (6823 St. Charles Ave., 864-1476; www.tulaneorthopaedics.com) says the most common types of sports-related ailments he witnesses are sprains and strains, which occur across all types of athletes, regardless of age, activity or experience level. The difference between the two injuries, he says, is the location of the damage: A strain occurs when a tendon or a muscle is overstretched or torn, while a sprain occurs when the ligament surrounding a joint is injured. “Most people can tell when they’ve hurt themselves,” O’Brien says. “They sense right away that something is off.” Warning signs include swelling, bruising (caused by the internal bleeding of the torn muscle) and inability to use the extremity or area normally without pain. Another common ailment McKenzie often notices is painful inflammation caused by overuse of the certain muscle areas. Patients who have played the same sport for years — say, tennis — are often surprised when
HOW ATHLETES CAN AVOID INJURIES AND STAY IN THE GAME.
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YOGA STUDIOS OFFERING DONATION-BASED CLASSES ARE POPPING UP ACROSS NEW ORLEANS.
W
BALANCE YOGA & WELLNESS
Balance Yoga (120 S. Cortez St., 309-9618; www.balanceyogawellness. com), specializing in yoga, pranayama breathing practice and ayurvedic consultations, offers donation-based community yoga a few times a week. Classes are taught by rotating instructors and emphasize alignment, full breath and attentive posing and are appropriate for beginners.
FAIR GRINDS COFFEEHOUSE
Fair Grinds Coffeehouse (3133 Ponce de Leon St., 913-9072; www.fairgrinds. com) hosts free weekend meditation sessions, and fitness offerings at this cozy, brightly-decorated tea and coffee house include low-cost classes like Tai Chi and Mom and Baby Yoga, as well as by-donation yoga with Lauren Dito every Tuesday at 5:30 p.m. Dito, a professional full-time yoga instructor, has taught the class for nearly two years. “I had been feeling dissident teaching classes purely for living wages,” she says. “I wanted to start getting back to the heart of how yoga was originally taught.”
LULULEMON
Yoga and running outfitters lululemon(802 Nashville Ave., 8952895; www.lululemon. com) offers occasional (often monthly) free classes.
SWAN RIVER YOGA
At Swan River Yoga (2130 Magazine St., 2600 Chartres St., 2940 Canal St., 7011 St. Claude Ave., Arabi,
566-4922; www.swanriveryoga.com) the first class is free for local students, and every class at the Community Center is by donation. Swan River also provides a free class at the Lower Garden District, Marigny and/or Mid-City studios once a month, and has several package deals available.
TAPAS YOGA AND MOVEMENT STUDIO
Tapas Yoga (4413 Chastant St., Metairie, 302-9264; www.tapasyoga.net) has partnered with the Leonard C. Thomas HOS Foundation to create a special yoga program for cancer patients and their caregivers. “It relieves stress in an already stressful situation,” says Judy Ogle, executive director of the HOS Foundation. The classes are focused on healing through gentle movement and relaxation, and take place Tuesdays at 11:30 a.m. Tapas also offers a 7-7-7 Special: all new students can try seven Hatha yoga or Pilates classes for $7 within one week.
TEMPLE GYM
Certified yoga and judo instructor Dmitri Khorov teaches a by-donation power and restorative yoga class every weekday morning from 9 a.m. to 9:45 a.m. at Temple Gym (4521 Magazine St., 261-8988; www.thetemplegym.com) for both athletes and yoga students.
WILD LOTUS YOGA
Wild Lotus Yoga (2372 St. Claude Ave., 4842 Perrier St., 899-0047; www. wildlotusyoga.com) recently opened a downtown location in the New Orleans Healing Center that offers a by-donation class once a week. There are free prenatal yoga and meditation classes, and community discount classes for $7 throughout the week.
YOGA TEACHERS SAY DONATION-BASED CLASSES ARE THEIR WAY OF GIVING BACK TO THE COMMUNITY.
HEALTH & WELLNESS > bestofneworleans.com > aUGUst 09 > 2011
hen Haiyan Khan, Keith Porteous and Michele Baker of Swan River Yoga opened New Orleans’ first and only fully donationbased yoga studio in January 2011, they didn’t expect to break even for a full year. With a strong commitment to the concept of seva, or selfless service as an altruistic act, the founders and teachers don’t spend much time checking the donation box. But because of overwhelming community support, or maybe good karma, Swan River Community Center broke even just one month after opening — and has broken even every month since. “We were all amazed,” says Khan, director at the Swan River Community Center. “We’re simply providing a service, and we hope that people can get the benefit of yoga.” Located in Arabi, the studio is a way of giving back to the community. “The cost of yoga is prohibitive for a lot of people, especially if you want to have a sustained practice,” Khan says. He says regulars who have been coming to his classes for years, initially at the St. Bernard Community Center, have advanced in ways that would not have been possible without this affordable program. Though the Swan River Community Center is the only studio to offer exclusively donation-based classes, many local spaces and instructors provide bydonation yoga on a regular basis. Sean Johnson, founder of Wild Lotus Yoga, says yoga has played a special role in New Orleans because of its power to heal and renew. “Mainly we offer donation-based classes because it just feels good to give back to the city we love, and we know it’s helping a lot of other people to feel good,” he says. With by-donation classes happening everywhere from Uptown to Arabi, that good feeling is now within the reach of most New Orleanians.
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By Kandace Power Graves Mobile HealtH Care
The Interim LSU Public Hospital (ILH) and the March of Dimes are providing care for pregnant women, mothers and babies at a mobile neighborhood health center at three rotating locations in Mid-City, Bayou St. John and the Upper 9th Ward. The Mom & Baby Mobile Health Care Center opened July 14 and operates from 9 a.m. to 3:30 p.m. every Monday and Wednesday at Asia Baptist Church (1400 Sere St.), Tuesday and Thursday at First Grace United Methodist Church (3401 Canal St.) and Friday at Desire Street Ministries (3600 Desire Pkwy.). Appointments are encouraged; call 235-1706. The center delivers prenatal care in groups and individually as well as offering services to women of child-bearing age and children up to 2 years old. Services include screenings, immunizations, prenatal and postpartum care and annual gynecological exams. The mobile unit is fully equipped and has private exam space and ultrasound. It’s staffed by a medical assistant, clinical nurse specialist and nurse practitioner midwife under the supervision of a board-certified obstetrician.
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free CliniC
The National Association of Free Clinics (NAFC) and MSNBC’s The Ed Show will present a free health clinic for the uninsured from 11 a.m. to 7 p.m. Aug. 29, at the Ernest N. Morial Convention Center (900 Convention Center Blvd.). It is the third free clinic NAFC has hosted in New Orleans since Hurricane Katrina. The Ed Show will broadcast from the clinic, which MSNBC helped raise money to fund. People do not have to be ill to attend the clinic; it is for people who have not seen a doctor recently and need primary care. The Kaiser Family Foundation has reported Louisiana has the country’s 10th highest rate of uninsured residents who are not elderly. The foundation says more than one in five Louisianans lack health insurance. To schedule an appointment at the clinic, call (877) 2367617 or visit www.regonline.com/2011NOLACARE.
breastfeeDing HelP
Lakeview Regional Medical Center (95 Judge Tanner Blvd., Covington, 985-867-3800) has been certified as a Guided Infant Feeding Techniques (GIFT) facility by the Louisiana Maternal and Child Health Coalition, the Louisiana Perinatal Commission and the Louisiana Office of Public Health’s Maternal and Child Health Program. Twenty-one birthing facilities in Louisiana have received the certification, which is based on a hospitals’ programs to increase breastfeeding among the new mothers it serves. Lakeview’s GIFT participation is part of the state’s effort to increase breastfeeding rates to 81.9 percent over the next 10 years. To schedule a consultation at Lakeview, call (985) 8674362, or register for a class at www.lakeviewregional.com.
oCHsner baPtist enHanCes er
Ochsner Baptist Medical Center’s Emergency Department pledged to keep waits in its full-service ER to no more than 30 minutes. It also is offering newly renovated “seniorfriendly” rooms for older patients.
Ed Schultz, hoSt of MSNBc'S thE Ed Show, will tEaM up with thE NatioNal aSSociatioN of frEE cliNicS (Nafc) for a frEE hEalth cliNic at thE ErNESt N. Morial coNvENtioN cENtEr aug. 29. it'S thE third cliNic of itS kiNd that Nafc haS hEld iN NEw orlEaNS SiNcE hurricaNE katriNa.
Qtrack, a program first implemented at Ochsner’s main campus, guarantees patients will see a doctor within a halfhour of arrival. Ochsner Baptist’s ER also has implemented Senior ED to help senior patients get comfortable quickly, which doctors say makes a big difference in their recovery. ER nurse Julian Springler says about 50 percent of patients admitted after coming to the emergency room are older adults, and Senior ED staff is specially trained in geriatric medicine. Renovations include private ER rooms designed around the needs of older patients to alleviate stress and make the stay safer. Some features include low-skid, low-glare floors to prevent falls, blanket warmers, thicker mattresses, handrails in rooms and adjacent hallways, color schemes designed around how aging eyes see and large nurse call buttons for those with limited dexterity.
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The LSU Health Sciences Center New Orleans (LSUHSC) won a $2.6 million grant for a nurse-managed clinic to serve underserved citizens in eastern New Orleans. The grant from the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) provided the funding for the clinic at Village de Jardin Independent Living Center. The clinic will offer primary care to residents of Village de Jardin and other people in the neighborhood who don’t have access to adequate primary care. LSUHSC faculty will see patients, and as many as 132 nursing students throughout the year will assist at the clinic.
cal professional licensed in their state will offer a diagnosis and any prescriptions needed within 24 hours (guaranteed) at an average cost of about $50. There is no charge for setting up an account at SkinofMine.com or for uploading photos. Treatment rates are set by individual doctors, and they can call in prescriptions to a pharmacy chosen by the patient. The iPhone app is available on iTunes.
minute workout
09
E AT TO LI VE
Top Timbale
TIMBALE TIPS
BY RUSS LANE
HEALTH & WELLNESS > bestofneworleans.com > aUGUst 09 > 2011
F
10
EXCELLENT BRUNCH FODDER, TIMBALES PAIR WELL WITH SALADS.
irst introduced to America courtesy of Julia Child’s corn timbale in Julia Child & Company (1978), timbales (pronounced “timbles” or “tim-ball-lay”) have French roots. Locally, Commander’s Palace’s summer seafood timbale includes blue crab, shrimp and Gulf fish paired with fennel, truffles and golden pepper vinaigrette. Varied forms of timbale have appeared on local menus over the years, but it maintains an air of mystery. The dish’s mystique likely stems from its dual nature: its name refers to a small, quiche-like egg dish, or any food layered and compressed in a small mold. Timbale can be either a dish or a technique, but as chef Allison Gorlin of New Orleans Cake Cafe & Bakery explains, neither are complicated. “Generally, timbales lend themselves to high–end cooking, but they’re really easy,” Gorlin says. Her first experience with the dish was in France, a mushroom-laden triumph. “I think people are more afraid of it because it has a French name, and Rachael Ray and Martha Stewart and all the ladies we know that try to identify with the housewife would not [prepare it].” Timbales serve as interesting, powerful additions to a health food arsenal. Like most egg-based dishes, they are ideal vehicles for repurposing leftover lean protein or roasted vegetables in small portions. Servings of grains or legumes can be pre-portioned into smaller molds, which also creates a striking presentation not often found in home cooking. Traditional timbale molds are available at WilliamsSonoma, but Gorlin says any cylindrical container such as espresso cups or ramekins make suitable substitutes. “It’s the perfect dish while you’re dieting because it’s a small weight — it’s four ounces or less — so you can really have more portion control,” Gorlin says. “You can eat it as an appetizer, or put a salad around it so it’s more of a meal.” Below is a simple timbale that begs for leftover roasted vegetables, using roasted garlic puree and crushed red pepper to sidestep the lack of saturated fat.
ROASTED VEGETABLE TIMBALES RECIPE BY RUSS LANE
SERVES 4
1 MEDIUM ONION OR SHALLOT, FINELY CHOPPED 3/4 CUP LEFTOVER ROASTED VEGETABLES (SUCH AS ASPARAGUS, ZUCCHINI, TOMATO, MUSHROOMS OR ARTICHOKE), FINELY CHOPPED 3 LARGE EGG WHITES 3 LARGE EGGS KETTLE OF HOT WATER 2 TEASPOONS OLIVE OIL 1 TABLESPOON GOAT CHEESE, PLUS EXTRA FOR GARNISH 2 TABLESPOONS ROASTED GARLIC, PUREED 1 TEASPOON FENNEL OR FENNEL SEEDS, TOASTED AND CRUSHED 1 TEASPOON CRUSHED RED PEPPER FLAKES 1/4 CUP 2 PERCENT COTTAGE CHEESE OR SILKEN TOFU (OPTIONAL, FOR CREAMIER CONSISTENCY), PUREED SALT AND WHITE PEPPER, TO TASTE
Special equipment: roasting pan, ramekins, cheesecloth 1. Chop vegetables and separate eggs. Heat water in a kettle and preheat the oven to 350 degrees. 2. In a large mixing bowl, add oil, eggs, egg whites, goat cheese, roasted garlic and cottage cheese or tofu (optional); whisk briefly to combine. 3. Add onion, vegetables, fennel, salt and pepper. 4. Divide the egg mixture among ramekins sprayed with cooking spray. Place ramekins into the roasting pan equal distances apart and put it in the oven.
Inspiration: Look to recipes for
frittatas, souffles, omelets or quiche for flavor combinations and ways
to incorporate vegetables and additional protein.
A word of caution : Roasted vegeta-
bles or those with low moisture points tend to fare well in timbales — watery vegetables do not. Take the extra step of draining chopped or frozen spinach by wrapping it in cheesecloth.
For egg-based timbales: The
amount of egg yolks used in timbale preparation can be reduced by half
or even three-quarters. This affects
the dish’s color more than its flavor; to compensate, use vividly-colored
vegetables or colorful vinaigrettes.
Serving suggestions: Excellent
brunch fodder, timbales pair well
with salads. For a delicate but pro-
tein-packed lunch, pair a roasted vegetable timbale with poached chicken and fruit purees, or serve with heavy roasted vegetables for dinner.
WHAT &
HOW
Add simmering water to the pan until the ramekins are half-submerged. 5. Bake for five minutes, then reduce heat to 325 degrees and cook 20-25 minutes, until the eggs set. 6. Remove ramekins from the roasting pan. Slide a sharp knife along the edge of the ramekins and invert the molds to remove the timbales. Garnish with the remaining goat cheese. Per serving: calories 145 (calories from fat 78), fat 8g (2g saturated fat), cholesterol 163mg, sodium 180mg, carbohydrates 4g (dietary fiber 1g, sugars 2g), protein 12g.
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and whether she will need to take insulin for the remainder of her pregnancy. Gestational diabetes can occur in any woman during pregnancy, but women who are overweight, have given birth to a baby weighing more than nine pounds, have had gestational diabetes in the past, are over age 25 or have a family history of diabetes have a higher risk. Fortunately, gestational diabetes generally resolves itself after childbirth, when pregnancy hormones disappear. Although there is no way to prevent the disease, Wade recommends women planning to become pregnant try reaching their ideal body weight (or close to it) first. However, losing weight during pregnancy is not advisable. Gestational diabetes can usually be managed without adverse effects. Diet changes and exercise are the first line of defense. “We always send patients to a nutritionist who can set them up with a meal plan,” Wade says. “They are typically advised to cut out sweets, limit carbohydrates and eat six small meals a day instead of three big ones.” If blood sugar levels are too high, patients may have to take insulin throughout pregnancy. Although the idea of daily insulin injections may be unsettling, refusing them can be dangerous. Patients should test blood sugar levels regularly. “They should test blood sugar before breakfast, and two hours after the beginning of breakfast, lunch and dinner,” Wade says. One high reading is not necessarily cause for alarm. In that event, Wade advises women to consider what they ate that day. If they find they’ve strayed too far from their meal plan, going back to the recommended diet should help bring blood sugar levels back down. Adding light exercise, like a 20-minute walk after a meal, can also help. All patients with gestational diabetes are advised to stay in close contact with their physicians. “All of the blood sugar levels should be slightly better than the normal limits for a nondiabetic,” Wade says. “Because there is a baby involved, physicians want the gestational mom to be better than normal.”
NEW R ON
s
sugar Babies n January, the American Diabetes Association (ADA) enacted stricter guidelines for diagnosing gestational diabetes. Although the new guidelines are predicted to greatly increase the number of women treated for the disease, doctors hope the changes will reduce the number of early births and diabetes-related complications in mothers and babies. The ADA lowered the normal range for blood sugar levels in pregnant women to under 92 after a fasting test, under 180 after a one-hour glucose tolerance test, and under 153 after a two-hour glucose tolerance test. Previously, these levels had been considered normal. Also, a woman now has only to receive one high-level test result, instead of two, to be diagnosed with gestational diabetes. Rose Wade, program coordinator for East Jefferson General Hospital Diabetes Management Center, explains the reasoning behind the change: “Even at these levels, women were having babies that were too large, which can complicate pregnancy, birth and sometimes compromise the health of the mother and baby. Expanding the guidelines to include more women will hopefully mean more mothers can successfully manage the effects of the disease.” Because of added sugar in the blood, gestational diabetes causes the baby to gain weight too quickly, potentially leading to a variety of problems including early delivery or cesarean, jaundice, respiratory issues, obesity and an increased likelihood of developing type 2 diabetes later in life. Gestational diabetes also puts mothers at risk for type 2 diabetes. Normally, the pancreas produces enough insulin to remove sugar from the blood. However, according to Wade, “pregnancy hormones work in direct opposition to this, causing the liver to release more sugar into the bloodstream and making the body more insulin resistant. As pregnancy progresses and the body prepares for birth, the hormones get stronger, further increasing the amount of sugar being released.” The test, which is usually given during the sixth month of pregnancy, can indicate to what degree the mother will need to change her diet, if at all,
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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
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Ochsner Baptist delivers –
Quality care and exceptiOnal service - 24-hour full-service, fully renovated emergency room - All private inpatient rooms, benefiting you and your family - Expanded Intensive Care Unit - State-of-the-art Imaging Center - Skilled team of physicians and specialists – loyal to Baptist and to our community
Talk to our CEO and learn more about our commitment to the Uptown community. Call 504-897-5998 Accepting most insurance plans including:
ochsner.org/baptist
©2011 Ochsner Health System (ochsner.org) is a non-profit, academic, multi-specialty, healthcare delivery system dedicated to patient care, research and education.
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