Tackling childhood obesity in rural Oregon

To counter the alarming growth in childhood obesity across the country, the Robert Wood Johnson Foundation recently announced $500 million additional dollars to its longstanding campaign to achieve a healthy weight for all children.

These new funds bring the total to an unprecedented $1 billion since 2007 to build a culture of health across communities in the U.S. and ensure that all children have access to healthier foods and opportunities to be physically active.

But because children in rural America suffer from obesity at rates that far exceed their urban peers, solutions that fit rural communities are especially needed because rural communities and families face unique challenges, such as limited health promotion resources.

In rural Union County, Oregon, healthcare professionals, educators, parents, grandparents, youth, and other community members have teamed up with OHSU’s School of Nursing to tackle the problem of obesity in kids and adolescents.

The partnership is part of a study named Students Now Advocating to Create (Healthy Snacking) Zones — SNACZ, a program that prepares youth to become advocates promoting healthy snacking among their peers and in their schools and communities.

An example of the power of this partnership is the success of a recent community educational event, Fuel Your Body to Win. Designed to counteract media messages often associated with sports that encourage high-sugar/high-fat snacks and beverages, this event brought together top athletic trainers from Oregon State University, Eastern Oregon University coaches, and OHSU scientists for a workshop on the importance of healthy eating for optimal sports performance.

During this two-day event, students from middle schools across Union County attended keynote presentations by well-known athletic stars, participated in “myth-buster stations” and break-out sessions with keynote speakers, assessed their nutrition knowledge and habits through interactive exhibits, and signed a Fuel Your Body to Win banner to commit to healthier food choices.

Childhood obesity is a critical and complex public health problem – but it’s a problem that can be solved.

The OHSU School of Nursing and its partners in Union County are leading the way in showing how communities can come together to build a culture of health and ensure that all children – especially those in rural areas of Oregon – can grow up at a healthy weight.

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Nancy Findholt, PhD, RN is an associate professor with the OHSU School of Nursing, La Grande campus and coordinates the Union County SNACZ project.

The magic bullet for heart health?

If you knew there was a “magic bullet” that would reduce your risk of coronary heart disease (CHD) by 92% and lower your risk of other cardiovascular risk factors, including type 2 diabetes, hypertension, and high cholesterol, by 66%, would you take it?

A recent large, prospective study showed what appears to be the key to drastically reducing the risk for heart disease in women aged 27-44, potentially preventing more than 70% of CHD and almost half of type 2 diabetes, hypertension, and high cholesterol diagnoses in this group.

What is this revolutionary new recommendation, you ask? A healthy lifestyle. Specifically, the following six healthy lifestyle habits, which, when followed together, slashed the risk factors and incidence of heart disease in young women:

  • Don’t smoke
  • Get at least 2.5 hours of physical activity every week (that’s only 30 minutes 5 days a week – you can do that!)
  • Eat a healthy diet (try a Mediterranean or DASH plan)
  • Maintain a healthy weight (to calculate your BMI, go here)
  • Watch less than 7 hours of TV per week
  • Drink alcohol in moderation (one drink a day for women, two a day for men)

Not exactly groundbreaking, and maybe not even front-page news, but the message is clear – you hold the power to prevent heart disease. The choices you make every day are what will keep you healthy—we already have the magic bullet!

The not-so-good news is that only about 5% of the 88,940 women monitored in the study followed all six healthy lifestyle habits consistently. But committing to some or even one of these habits proved to be beneficial!

While this study looked at young women, these healthy lifestyle habits work for men and women of all ages. In the spirit of American Heart Month, commit to being part of the small (but growing!) group of people following all six pieces of the heart-healthy puzzle.

Need help getting started? Check out the Million Hearts Initiative for information about preventing heart disease and stroke, heart-healthy recipes, and 28-day meal plans.

What change will you adopt this month to protect your heart?

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Tracy Severson, RD, LD, is the dietitian for the Center for Preventive Cardiology at the Knight Cardiovascular Institute. She specializes in nutrition counseling for cardiovascular health and weight management.

Student perspective: OHSU School of Dentistry

Since 1899, the OHSU School of Dentistry has produced Dentists, Dental Specialists, and Dental Hygienists, as well as participating in research, patient care, outreach and community service throughout the region. This month, we hear from Farielle Houran, who is nearing the end of her four-year D.M.D student journey. 

How did you pick Dentistry?

I grew up in southwest Portland, graduating from Beaverton High School, and then Pacific University with a bachelor of science in biology, and a minor in Spanish.

Through a string of events and excellent mentorship throughout my years at Pacific, it was clear to me that God had put me on the journey to dentistry. I had no dental insurance growing up, so by the time I was in my teens, I had a lot of cavities, a tooth that needed a root canal, and a chipped central incisor. At an early age, I learned what it was like to be embarrassed of your teeth and in dental pain.

Luckily, I had an awesome dentist who took care of my dental problems, and put the idea of dentistry in my mind. After that, I spent time observing a dental hygienist and dentist when I was in high school. I got bored observing the hygienist, but loved the teaching aspect of dentistry, being able to help people smile, and the dental tools looked fun!  I also appreciate that as a dental professional, I am privileged with the opportunity to influence my community in a positive way.

Why did you choose OHSU?

The primary reason I chose OHSU is that it is in Oregon. The last four years have been the hardest years in my life so far, but a highlight is being able to learn dentistry with a group of 75 students, as well as mentored by some outstanding instructors. I love seeing my classmates interact with and treat their patients. I’ve learned so much from them, and that’s one of the many things I’m going to miss about being a student at OHSU after graduation.

What programs have you been involved with as an OHSU student?

I am the chief scheduler for dental students volunteering on four Medical Teams International vans, which the dental school utilizes monthly for care in low-income Portland neighborhoods. About 40 children per month receive oral care, thanks to these vans. We see a number of oral problems in the children who come to the vans. It’s not uncommon to hear dental students rave about the pediatric dental experience they have when volunteering on the vans.

I also created the Reach Out and Read program, which provides books and readers to dental school pediatric patients in the waiting areas. Other organizations I volunteer for include Give Kids a Smile, Sealant Day, and Celebration of Smiles.

Highlights of my four years include being a member and President of the Hispanic Student Dental Association. I was able to organize an annual school wide screening/fluoride application day at Cornelius elementary, a predominately Hispanic speaking k-5 school that I work at during undergrad.

I’ve also discovered the incredible opportunity to offer the skills that we’re taught in dental school in different countries, while being exposed to different cultures! In the last year and half, I’ve served on two dental humanitarian trips, traveling to Barron, Mexico in 2013, and Ecuador in 2014.

What are your plans for the future?

After graduation, I hope to advance further in pediatric dentistry, and ultimately work as an associate in a pediatric dentistry practice with a Spanish- speaking clientele. I love learning, and in dentistry, you’re constantly learning. Placing a child into the mix makes the profession that much more challenging, rewarding, and fun.

People are often surprised when I tell them I’m interested in pediatric dentistry, but I’ve always known that I wanted to work with children. I can’t look at a child and not smile. I love the aspect of preventative care in pediatric dentistry, and being able to start early in educating children about healthy oral habits.

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For more from our students, be sure to visit our Student Speak blog.

6 easy tips for fueling during a run

There is so much that goes into running well. Good form, flexibility, strength, endurance, training, and good shoes. An often neglected aspect of running well is nutrition.

There are two main aspects of fueling on a run: hydration and fueling.

The main goal is to maintain energy levels for actively working muscles. Every runner has a unique “fuel economy” for a given pace, there is no one-size fits all approach for the perfect on-run fueling technique. Here are some key variables when considering fueling during a run:

  1. If your run is less than 30 minutes fueling is not usually needed.
  2. If your run is 30-60 some runners will benefit from fueling in-run.
  3. If you are running more than a hour, you need to fuel.
  4. When choosing a fuel source, it is important that the carbohydrate concentration is not too high – this can cause abdominal discomfort.  Energy drinks use 6-8 percent carbohydrate per serving.
  5. Choose a source that is easy for you to digest (gel, goo, bars, etc.) Everyone is different in terms of what works best.
  6. Consider using small fuel intake several times as opposed to one larger fuel load.

As with any “new” addition to your regime, make sure to take time to incorporate these strategies into your training runs. Use mid-week training runs to practice fueling techniques for your race, and make adjustments to find a fuel recipe that your body responds well to and stick with your best fueling strategy on race day.  Never start a new fueling program on a race day!

Enjoy your run!

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Ryan Petering. M.D. specializes in Sports Medicine and Family Medicine. He also has special interest in Pediatric Care, Primary Care Sports Medicine, Recreational Athletes, and Wilderness Medicine.

 

Congenital Heart Defect Awareness Week

It’s safe to say Kimmie Harding knows her way around OHSU. She’s been treated here for the last 34 years and counting for her Congenital Heart Defect (CHD).

Her passion for advocacy made her the perfect person to enlist to help raise awareness about CHD – and OHSU’s incredible care team – this CHD Awareness Week. Take it away, Kimmie!

What are Congenital Heart Defects?

Congenital Heart Defects are problems with the heart’s structure that are present at birth. These defects range anywhere from leaky valves and holes in the walls of the heart to more severe forms, where blood vessels or heart chambers may be missing, poorly formed and/or in the wrong place. CHDs are the most common birth defect and are also the leading cause of birth defect-associated infant illness and death in the U.S.

How has your heart defect impacted your life?

Living with a critical CHD changes the way you see the world. I’ve heard the words “science hasn’t caught up with you yet” more times than I would have liked. I spent most of my childhood in hospitals (my second home!), limiting my activities and spending a lot of time feeling scared and wondering why I had to go through any of this (truthfully, I sometimes still wonder that). Living with CHD has the potential to drain a person, put a lot of stress on the family and deplete finances. That’s why I believe it’s important to be an advocate, to show the possibilities beyond the defect and to continue to fight for a better life.

How has OHSU been a part of your CHD journey?

OHSU has played an integral part in my heart health journey. CHD patients are in it for the long haul, and I’ve found that OHSU’s team atmosphere has helped through every step of the process. They helped my family when I was younger, and they helped me come to terms with the fact that this will never go away – something that was difficult to accept as a teenager and young adult. Now, as an adult, I find that they’re able to help educate me on how to advocate for my community.

I feel lucky to be a part of a health community that sees value in patient relationships. The Cardiac Cath team quite possibly has some of the funniest people on it; there’s nothing better than laughter before settling in for a cath! I’m grateful that my team works so diligently to seek out procedures and new treatments to keep my heart going so I can continue to live a productive life.

Photo courtesy of Kimmie Harding

Is there anything you wish people knew about CHD?

CHD in adults aren’t always visible on the outside. We have some wicked scars (we call them ‘battle zippers’) and we might walk a little slower or look tired (this happens to everyone though, right?), but those may be the only external indicators. As a result, I feel like the CHD community gets overlooked. Our battle is internal, but it’s still a serious one.

While there is a large community of people living with CHD, it’s not highly publicized or funded. There are more adult survivors like me than ever before due to technological advances, and I believe it’s imperative that CHD starts to gain the attention, funding and research needed to help bring more treatment options to those living with CHD. Even with the limited funding for CHD, I’ve witnessed huge leaps in science just in my lifetime. Can you imagine the amazing possibilities if more resources became available? Wouldn’t it be wonderful to live in a world where a CHD patient never had to hear “We’re waiting for science to catch up with you?”

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Kimmie is sharing her CHD journey on her blog, View from the Recovery Trail. Though she can’t change the existence of heart problems, she hopes to change the way people think about them by educating the public about the CHD community.

Another great resource Kimmie recommends for adults and families dealing with CHD: the Adult Congenital Heart Association (ACHA).

Set SMART Resolutions for 2015

Are you one of the millions of Americans who make New Year’s resolutions, or have you sworn them off since they never seem to stick?

Studies show that 45% of Americans make at least one resolution every year, yet only 8% of these people are actually successful in meeting their goal. By setting a specific goal rather than making a generic resolution, you will be 10 times more likely to achieve your goal in 2015.

How to start? Get SMART! Use the SMART acronym to help set achievable goals:

  • Specific – Rather than deciding to “eat better” this year, figure out what that means to you and decide what elements you would like to change to improve your diet. Are you eating out too often at lunchtime? Your goal could be to begin bringing lunch to work.
  • Measurable – Make sure you’re changing something that is measurable so that you can monitor your progress. If your goal is to bring lunch to work more often, you are able to track how many days you achieve this.
  • Attainable – Don’t set goals that are too difficult; you want to succeed! If you eat out at lunchtime every single day now, deciding to never eat out at a restaurant in 2015 may be out of reach initially. Bringing lunch to work three days a week would be a great start. Set goals that are challenging but still possible.
  • Realistic – Consider the time and resources needed to achieve your goal. Will you pack a lunch the night before so your mornings aren’t too rushed? Will you prepare a meal from scratch or bring a low-fat frozen entrée? Think about what it will take to reach your goal so you’re prepared to succeed.
  • Timely – Set a timeline for reaching your goal. Will you bring lunch to work at least three days a week during January? That’s a very SMART goal! At the end of the month, evaluate your progress and either continue or set a new goal. Think of this as an ongoing journey to good health rather than a one-time event!

As the mother to a toddler and a 6-month-old, I’m a bit preoccupied with sleep these days. My SMART goal is to be in bed by 9pm at least 4 days a week during January. By getting more sleep, I will be more productive at work, make better food choices, and have more energy to exercise.

Here’s to a healthy and well-rested 2015!

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Tracy Severson, RD, LD, is the dietitian for the Center for Preventive Cardiology at the Knight Cardiovascular Institute. She specializes in nutrition counseling for cardiovascular health and weight management.

 

The promise of gene therapy for inherited eye disease

I first learned about inherited blinding disorders as a freshman in college, when I got a summer job with Dr. David Birch, a leading scientist who has been studying retinitis pigmentosa (RP) for many years.

At that time, there were no treatments for genetic conditions like RP, which damage the eye’s light-sensing retina and cause progressive vision loss and blindness. Now, after working in this field for many years, it’s exciting to know we are at the cusp of sight-saving treatments for some of these degenerative diseases of the retina, which often appear at an early age.

What’s also exciting–and what many don’t realize–is that OHSU’s Casey Eye Institute is at the epicenter of many of these groundbreaking investigations, particularly in the promising field of gene therapy.

We are conducting more gene therapy trials than any other research center in the world, and are the first to test this novel approach for such inherited diseases as Usher syndrome and Stargardt disease. Usher syndrome is an especially devastating genetic disorder. Not only are patients born with deafness, they lose eyesight from RP as they grow older.

In the coming year, we also plan to launch the world’s first gene therapy studies for achromatopsia, which causes color blindness, daytime blindness and light sensitivity, and x-linked retinoschisis (XLRS), a disease that affects males and leads to retinal detachment and vision loss.

pennesi performing gene therapy

What has brought us to this point is the result of major technological advances and a robust infrastructure at Casey that enables us to recruit, test and treat study patients using cutting-edge approaches.

At the Oregon Retinal Degeneration Center, we’ve developed sophisticated diagnostic techniques that allow us to objectively measure whether the gene medication is working.

These capabilities are critical to a clinical trial’s success.

The human eye is ideal for testing novel treatments like gene therapy because it is accessible, yet segregated from the rest of the body. Moreover, since only one eye is treated, the fellow untreated eye serves as a valuable control. With gene therapy, our goal is to stabilize vision by replacing the targeted, malfunctioning gene with a single application of a healthy version.

The experimental medication is inserted into the eye by way of a non-active virus where healthy copies of the gene are delivered into eye cells. While it is too early to tell if these experimental treatments are effective, we are seeing beneficial effects from our first gene therapy study – for a rare childhood disorder called Leber congenital amaurosis (LCA). As we move forward, we hope to expand our investigations to include patients with less severe forms of these diseases as well as more common eye conditions, such as age-related macular degeneration.

Gene therapy won’t restore eye cells lost to disease, but if we can treat people in the early stages, we can help them face a future without ever-diminishing eyesight.

Learn more about Casey’s ophthalmic genetics program and clinical trials

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Mark Pennesi, MD, PhD, is assistant professor of ophthalmology at OHSU Casey Eye Institute, where he specializes in ophthalmic genetics. He also is director of Casey’s Visual Function Service and the Ophthalmic Genetics Fellowship Program.

In recognition of his work in the field of inherited retinal disease, he is the recipient of numerous awards, most recently the Foundation Fighting Blindness’s prestigious Enhanced Career Development Award. He is currently exploring the potential of a new class of drugs to up regulate protective growth factors in the retina.

Your health questions answered: Kids and technology use

You ask. OHSU health experts answer. This month, our pediatric and and pituitary specialists are on the hot seat.

Q. When is my child old enough to use an iPad or tablet?

A. In general, consider any child younger than two years old too young. Tablets may prevent infants and toddlers from engaging in the give-and-take of everyday exchanges with family, as well as the “real” world of playing with physical objects that require and develop sensory and motor skills.

iPads do offer some terrific “edu-tainment” apps to help young children learn, especially in spelling, reading, and math. Tablets can also promote self-control. Before you use one for the first time, practice when it’s time to start and stop using it. Make its use dependent upon stopping on time, and let the child earn additional minutes with good behavior.

Finally, lead by example: Children mirror what their parents do, and if you’re always on your phone (“app-sorbed”), your child may follow suit or sigh, cry, or go to other great lengths to get your attention.

Q. I’ve noticed a change in my menstrual cycle and frequent headaches. Could this be a pituitary issue?

A. If you are experiencing absent or infrequent periods and other symptoms, such as frequenct headaches and abnormal weight gain, talk to your doctor. While these symptoms certainly could be due to other causes, they also may be signs of pituitary deficiency or a pituitary tumor that is overproducing a particular hormone.

The good news is that pituitary tumors are rarely cancerous and are typically treated with medication or surgery.

The pituitary is a pea-sized gland located at the base of your brain. It secretes prolactin, a growth hormone, and other hormones that control symptoms such as the thyroid, which regulates almost all metabolic processes; the adrenal cortex, which produces hormones, such as cortisol that regular metabolism and the body’s reaction to stress; and the ovaries.

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Dr. Craigan Usher, M.D., joined the OHSU faculty in 2008 and specializes in psychiatry and pediatrics. 

 

 

 

 

Dr. Maria Fleseriu, M.D., F.A.C.E., is Director of OHSU’s Northwest Pituitary Center and an internationally renowned clinician, researcher and author. She focuses her clinical practice on the diagnosis and treatment of pituitary and adrenal tumors and pituitary dysfunction.

Winter recipes packed with cancer-fighting nutrients

Winter time is full of delicious fruits and vegetables that are flavorful and rich in cancer-fighting nutrients. Every fruit and vegetable contains their own cancer fighting compounds, including fiber.

Aim for 3-5 servings of fruits and vegetables daily to reap the rewards of these low calorie, high nutrient quality foods.

Try out these fall and winter recipes, then check out the American Institute for Cancer Research Test Kitchen for more ideas.

Roasted root vegetables with butternut squash

Ingredients:
4 medium sized sweet potatoes, cubed
2 to 3 turnips (approx. 1lb), peeled and cubed
2 rutabagas (approx. 1lb), peeled and cubed
1 butternut squash (approx. 1lb), peeled and cubed, seeds removed
1 bunch of beets, peeled and chopped
1-2 tablespoons coconut or olive oil
1 tablespoon garlic powder
2 teaspoons sea salt
1 tablespoon onion powder
2 teaspoons paprika
1 tablespoon black pepper

Directions:
1) Preheat oven to 375 degrees.
2) Place the first 4 ingredients in a large mixing bowl.
3) If using coconut oil, melt before adding.
4) Add all other spices, stirring to combine.
5) Add the beets to bowl.
6) Spread mixture on a large baking pan, or two if need more room.
7) Bake for approximately 45-55 minutes, until vegetables are soft and tender to the touch.

Fall Cranberry Smoothie

Serving size: 2 small or 1 large smoothie

Ingredients:
1 cup fresh or frozen cranberries
1 stalk celery, chopped
1 sweet medium apple, peeled and chopped
3 inches of medium sized cucumber, peeled and chopped
1 tablespoon honey or agave syrup
1/4 cup water or several ice cubes 

Directions:
1) Add the first 4 ingredients to the blender.
2) Blend on low and increase to high. Add water or add ice cubes to chill if using fresh cranberries.
3) Add honey and blend until smooth. Add more water if needed.

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Amanda Bryant helps support the nutritional needs of adult patients affected with urological cancers, lymphoma, sarcoma, lung, and GIST during treatment and through survivorship. She primarily sees patients in the outpatient infusion unit and by scheduled appointments.

 

 

 

Know Your Healthy Heart Score

Do you try to follow a healthy lifestyle but wonder how good of a job you’re actually doing?

If you’re not sure where to begin, there’s a great new tool called the Healthy Heart Score from the Harvard School of Public Health that will help estimate your 20-year risk of a heart attack or stroke.

Although cardiovascular disease is largely preventable, it remains the leading cause of death in the world.

This easy quiz looks at your lifestyle choices such as physical activity, smoking, diet, and alcohol, along with age and BMI, and calculates your Healthy Heart Score. Unlike many other health assessment tools, such as this one from OHSU, you don’t need to know your cholesterol levels or blood pressure. Based on your answers, it also provides suggestions for changes you can make to improve your score.

By knowing your Healthy Heart Score, you can take control of your future by making effective changes to protect your heart.

Once you know your score, work on making small but effective choices every day to keep your heart healthy.

  • Small swaps in your diet – such as bringing lunch instead of buying it, or drinking water instead of soda – add up quickly. By paying more attention to your everyday choices, you won’t feel like you’re “on a diet.”
  • If you smoke, make a plan to quit.
  • Make it enjoyable and memorable. Increase your physical activity by taking more steps every day or planning your workouts for the week (schedule them on your calendar like an appointment). Try starting new holiday traditions with your loved ones – go ice skating, play tag football, or bundle up and go on a walk.

Make it enjoyable and memorable. Think about what choices you can make each day to protect your heart. Here’s to a healthy 2015!

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Tracy Severson, RD, LD, is the dietitian for the Center for Preventive Cardiology at the Knight Cardiovascular Institute. She specializes in nutrition counseling for cardiovascular health and weight management.


 

 

 

OHSU Health Fair at Pioneer Square.

Why 96,000 Square Miles?

President Robertson is fond of saying that OHSU has a 96,000 square mile campus, serving Oregonians “from Enterprise to Coos Bay, from Portland to Klamath Falls.”

This blog aims to highlight that breadth. 96,000 Square Miles (96K for short) will focus on the people of OHSU, the Oregonians we serve and the ripple effect of our work in Oregon and beyond.

Read more

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