Northeast Ohio hospitals restricting visitors to curb spread of swine flu

By Kaye Spector Health and Medical Reporter, The Plain Dealer If you have flu symptoms or are younger than age 18, you won't be welcome as a visitor at a growing number of hospitals across Northeast Ohio. Hospitals are limiting who can walk through the door in an effort to stem the spread of H1N1, or swine flu. The Cleveland Clinic became the latest hospital on Monday to announce temporary restrictions: No one age 18 or younger or anyone with flu or flu-like symptoms should visit patients at its main campus in University Circle or its nine hospitals throughout the region. It is the first time the Clinic has imposed such restrictions, said Dr. Ian Glass, senior vice president, medical operations/regional quality. The limits were necessary because H1N1 accounts for the vast majority of flu cases in the community, and so far, its vaccine has been in limited supply, Glass said. H1N1 is particularly prevalent among young people, he said, prompting the age-related guidelines. "This is one of the easiest things we can do in terms of preventing disease," Glass said. Southwest General Health Center announced similar visitor restrictions Monday. Last week, the Akron-area hospitals, including Akron Children's Hospital, Akron General Medical Center and Medina General, put similar restrictions in place, as did Parma Community General Hospital. They joined University Hospitals Case Medical Center, which last spring began asking visitors of all ages with flulike symptoms to stay home and recently began restricting all children from certain high-risk floors. "We have not yet instituted any additional restrictions because we know it would be a hardship to families," UH spokesman George Stamatis said in an e-mail. UH may implement limits later if the situation warrants, he said. Officials at the hospitals with the new rules said that decisions about visits will be handled on a case-by-case basis for patients who are critically or terminally ill. "We talked about this and felt very strongly that there are always going to be mitigating circumstances," Glass said. "A heavy dose of common sense goes a long way toward helping the solution." Hospital personnel won't be accosting violators and sending them home. But they may ask visitors to don masks or not enter a room, said James Gosky, Akron General spokesman. "By and large, people understand and are very courteous," Gosky said. MetroHealth Medical Center has not instituted any new restrictions, but signs are posted throughout the hospital asking visitors with respiratory symptoms -- cough, sore throat, or runny nose -- to wear a mask.

Omega-3 fatty acids, fiber make chia seeds a healthy diet addition

By Kaye Spector
Health and Medical Reporter, The Plain Dealer

Most Americans of a certain age associate chia seeds with kitschy, sprout-covered terra-cotta figures.

But many well-known healthy-eating advocates -- including the Cleveland Clinic's Dr. Michael Roizen and Dr. Andrew Weil of the University of Arizona -- are saying it's a good idea to include the tiny black seed in your diet. Chia seeds are a good source of fiber and calcium, and -- important for vegetarians -- they contain omega-3 fatty acids, essential fats your body does not make but needs to function properly.

If you eat one seven-teaspoon serving of chia seeds every day, you can get a good deal -- 11 grams -- of the U.S. Department of Agriculture's recommended daily allowance of fiber. Compare that to a bowl of oatmeal, which has about 3 grams of fiber, or a slice of whole-wheat bread, which has about 5.

Adult women need 25 grams of fiber daily, while adult men need 38, the USDA says. Most people eat less than 10, says dietitian Tammy Randall. Sprinkling chia seeds on salads or yogurt could be a good choice for those struggling to meet the USDA fiber recommendations.

Jim Perko, executive chef for the Cleveland Clinic's Wellness Institute, uses chia seeds in the recipes he develops for students in his healthy-cooking classes.

Chia seeds soak up to five times their weight and volume in liquid, so Perko blends them into low-fat recipes, such as muffins and meatballs, in much the same way Mom used bread crumbs to make her meatloaf moist.

Perko also adds chia to thicken dressings, which -- because it clings more tenaciously -- lessens the amount of fat in coleslaws and salads. He'll also use chia rather than meat to add body and viscosity to his vegetarian chili.

"Chia not only thickens, but adds moisture. While it's doing all of that, it's adding omega-3 and healthy things," Perko said. "It's got outstanding culinary capabilities."

Chia can be a bit pricey, however. Heinen's sells chia seeds, packaged in a 1-pound plastic container, for about $11.

The local grocery chain began selling chia this year. Chris Foltz, Heinen's director of operations, says Heinen's sells about 20 pounds of chia per store per month.

More and more chia-based products are coming on the market, Soltz said. He recently evaluated a strawberry kiwi dressing and marinade that featured chia as an ingredient.

Chia seeds can also be found at the West Side Market, Nature's Bin and Whole Foods Market.

Patients flooding local ERs in fear they have swine flu

By Kaye Spector
Health and Medical Reporter, The Plain Dealer

Unnecessary fear over swine flu is clogging up area emergency rooms.

Three of Cleveland’s major hospitals - MetroHealth Medical
Center, University Hospitals Case Medical Center and the Cleveland
Clinic - said Tuesday they are seeing unprecedented numbers of people
coming into their ERs with flu symptoms.

The vast majority of these visits are unwarranted because the
cases are mild and don’t require emergency medical attention. After
being seen by a doctor, most patients are being told to go back home,
rest, drink fluids, take Tylenol and avoid contact with others.

The emergency room at MetroHealth has seen a record number of
people with flulike symptoms in recent days - from about 36 people a day
last week to 60 a day this week, said Dr. Charles Emerman, chairman of
the emergency medical department.

MetroHealth doctors say the spike is prompted by unwarranted
fear surrounding H1N1 flu, also called swine flu.

“I think people are really worried about this more than they
need to be,” said Dr. Jennifer Hanrahan, chairwoman of the
hospital’s infectious control committee. “Most people are going
to have a real mild illness. The best thing for these people to do is to
stay home.”

MetroHealth doctors made a public appeal Tuesday for flu
patients to come to the emergency department only if they have serious
symptoms. They stressed that for most people, the swine flu will be no
more dangerous than seasonal flu.

Patients with flu symptoms coming to the Clinic’s ER nearly
tripled over what the staff usually sees, from about 12 to about 30,
said Dr. Thomas Tallman. Most of the cases there too were mild, he said.

Rainbow Babies & Children’s Hospital, which is part of UH, is
seeing an overall increase in ER patients, from about 100 a day to 150 a
day; about half of those numbers are young flu patients.

The number of flu patients coming to Case Medical Center’s
emergency department also jumped in recent days, from the usual 30 a day
to nearly 50 a day. But UH says it is actually seeing more cases of
adults with severe flu symptoms and attributes it to underlying medical
conditions.

In recent days, several of the hospitals have created separate
areas within the ERs for people with flu symptoms to prevent spread of
the virus.

 MetroHealth had a roofed tent set up inside the ER, but took it
down after one day of operation after learning from Cleveland fire
officials that it violated the city fire code by blocking the water
sprinklers on the ceiling. Until the hospital comes up with another plan
to separate flu patients, staff members are handing out masks to people
with flu symptoms in the waiting room.

The Clinic created a separate room that patients enter directly
from the ER entrance. Tallman said he is working on plans to enlarge the
area because the number of patients is expected to increase.

In recent days, Rainbow also created a separate waiting room for its young
patients without flu symptoms. UH and Rainbow also are handing out
surgical masks to ER patients with flu symptoms.

New AHA guidelines for daily sugar levels aim to keep you and your heart healthy

By Kaye Spector
Health and Medical Reporter, The Plain Dealer

Americans are eating an average of just under a half cup of added sugar a day -- that's 22 teaspoons of the white stuff.

We're not talking about the naturally occurring sugar found in fruits or dairy products but rather the sweeteners and syrups added to foods during processing, preparation or at the dining table. Think soda and sweet tea. Processed foods such as instant oatmeal or breakfast cereal. Condiments including jam or maple syrup.

At a time when we're eating more sugar than ever, the American Heart Association recently said that lowering the amount we consume is essential to achieving and maintaining healthy weight, decreasing cardiovascular disease risk and meeting essential nutrient needs. The association published new guidelines this month.

For example, if you're an average adult woman eating around 1,800 calories a day, the association recommends no more than five teaspoons of added sugar a day. If you're an average adult man eating about 2,200 calories a day, the association advises a limit of nine teaspoons. The recommendations vary based on age and activity level.

"These are good benchmarks," says Brenda Walsh, a registered dietitian at University Hospitals. "Where we're at is way beyond what we should be."

What's wrong with making your life a little sweeter?

First of all, sugar has no nutritional value other than providing calories, and it displaces the more nutritious foods and beverages that we all should be consuming instead, Walsh says.

Second, high intake of added sugars can directly damage your health, says Dr. Leslie Cho, an interventional cardiologist with the Cleveland Clinic. The most significant way -- by creating obesity.

Obesity causes numerous chronic health conditions, including hypertension, diabetes and high cholesterol, which lead to heart attack and stroke, Cho says.

"Sugar is calories. An increase in calories is an increase in weight," she says. "It's really important to maintain a good body weight."

All things being equal, eating 50 more calories a day than you expend -- a mere three teaspoons of sugar -- could result in up to a five-pound weight gain over a year, according to the heart association.

High sugar intake also is associated with increased triglyceride levels, a known risk factor for coronary heart disease.

Higher consumption of high-sugar beverages and foods also is associated with evidence of increased inflammation and oxidative stress, a term for damage to cells, tissues and organs caused by free radicals and other pro-oxidant molecules.

But Americans can't seem to get enough of the sweet stuff.

Americans' intake of added sugars increased from an average of about 16 teaspoons a day in 1977 to about 21 teaspoons by 1994, one study estimates.

That amount has remained high -- and has increased to 22 teaspoons a day among those 20 years and older -- estimates The National Cancer Institute, which looked at data from the 2001 to 2004 National Health and Nutrition Examination Survey.

The biggest culprits are soft drinks and other sugar-sweetened beverages, which are the No. 1 source of added sugars in the American diet, the heart association says. Per-person daily consumption of soft drinks increased 70 percent between 1970 and 2000, from 7.8 ounces to 13.2.

It's probably no coincidence that the usual drink size used to be 8 ounces. Now it's routinely 12 ounces and up -- including beverages like the 64-ounce Double Gulp fountain drink, Walsh says.

Most of Walsh's patients are trying to get their weight or diabetes under control. She says they usually are surprised to hear that a 12-ounce can of soda can contain up to 10 teaspoons of sugar. Many of them drink three sodas every day.

Others drink a gallon of juice every day. While juices contain natural sugars, rather than added sugar, they are high in calories, Walsh says. And "we don't feel full from them."

Better beverage choices are milk -- which provides nutrition -- or water, she says.

Artificial sweeteners do help some of Walsh's patients cut down their sugar intake.

"I'm fine with people using artificial sweeteners if it helps them achieve their goals," she says.

Walsh tells her patients to try fruit when craving a sweet: They get the sugar taste they crave, with the added benefits of nutrition, fiber and satiety.

Consumers may have a tough time avoiding added sugars in processed food. U.S. food labels provide information on total sugars per serving but do not distinguish between sugars that are naturally present in foods and sugars added to enhance taste or texture.

For example, flavored yogurt has about 10 grams of natural sugar and, usually, another 10 to 20 grams of added sugar, depending on the flavor.

Added sugars do, however, show up in the ingredient list. Walsh urges her patients to read them religiously and avoid foods where sugar is listed among the first five or so ingredients. (Manufacturers must list ingredients in order according to greatest weight by volume.)

The best way to avoid added sugar is to cut down on eating processed food, Walsh says. "The more processed a food is, the more sugar they need to add."

Also consider the whole product, not just a package claim such as "low-fat" or "no trans fat" when choosing processed foods. Another undesirable ingredient -- such as sugar -- might be amped up to improve taste.

Yes, that cracker might be made from whole grain, but if the second ingredient is sugar, you might want to pass, says Walsh.

When choosing food, Walsh says, step back and really consider what you're getting: Is it an invented product that is far, far away from its origin in nature? If so, that deep-fried snack made from extruded cornmeal and dusted with cheese-flavored powder might not be the best choice.

"My rule is, 'If Grandma doesn't recognize it, don't eat it,' " Walsh says.

Cho's guidelines for her patients: Be a "mindful eater" of the 200 or so food choices they make every day.

"You have to be responsible for whatever goes into your body," she says.

Cleveland Clinic summit names Top 10 medical innovations predicted for 2010

Jay Alberts, a biomedical engineer at the Cleveland Clinic, noticed his bicycling partners with Parkinson's had no symptoms after pedaling faster than they usually did on a tandem bike. Albert's subsequent research bore out his hunch, and the Clinic will recognize his work as one of the Top 10 medical innovations for 2010. (Plain Dealer photo by Chuck Crow).

 

By Kaye Spector
Health and Medical Reporter, The Plain Dealer 

 Sometimes innovation arrives on a bicycle.

That's how it came to biomedical engineer Jay Alberts, whose research into treating Parkinson's Disease symptoms is being recognized today by the Cleveland Clinic as one of the Top 10 medical innovations for 2010.

Alberts' research and the rest of the breakthrough devices and therapies will be announced at 11 a.m. at the Clinic's 2009 Medical Innovation Summit, which concludes this afternoon.

Alberts is a serious cyclist whose inspiration for treating Parkinson's came while participating in two, seven-day, 400-some-mile bike rides in Iowa to raise money for the disease, a neurological disorder that results in resting tremors, slowness of movement and limb rigidity.

In 2003, Alberts noticed that after the day's ride ended, his tandem partner, who has Parkinson's, stopped trembling enough to write clearly. After a 50-mile leg of the 2006 ride with a different partner, Alberts observed that the partner's symptoms were virtually gone.

When Alberts returned to Ohio, he decided to find out why. In a randomized, controlled study released about six months ago, he discovered that Parkinson's patients who rode with a trainer pedaling at 80 to 90 rpms -- a level beyond what they would choose on their own -- for an hour, three times a week showed 35 percent improvement in motor function.

Alberts' pedaling regimen lessens symptoms up to four weeks. He theorizes that the intervention might change brain function. The cycling also is empowering for patients, allowing them to actively manage their disease.

Alberts is now into a second study with Clinic collaborators Drs. Michael Phillips and Mark Lowe, and the initial results look promising.

All from a bike ride.

"To me, it's about always being aware of what's potentially out there," Alberts said. "It illustrates that as a scientist, we don't just find answers in the lab."