Tag Archives: Q&A

Limiting Sugars in Your Diet

A Q&A with Dr. Pio Poblete of MPCP’s Columbia office

Q: How much sugar do people typically consume?

A: On average, Americans get about 16% of their daily calories from added sugars, according to the Food & Drug Administration.

While many foods naturally contain sugar, a lot more sugar is added to processed foods. For example, a 12-ounce can of cola contains seven teaspoons of sugar, although you might not see that word on the label. Other names for added sugars include high-fructose corn syrup, fruit juice concentrate, molasses, honey, and sucrose.

Even foods that you wouldn’t think of as sweet have added sugar, often in the form of high-fructose corn syrup. High-fructose corn syrup is a preservative, giving packaged foods a longer shelf life, and it plays a role in color and texture.

Q: 16% added sugars sounds like a lot. Are we eating too much?

A: Faced with mounting evidence about sugar’s harms, the 2015 Dietary Guidelines Advisory Committee has recommended that people limit added sugars to a maximum of 10% of their total daily calories.

Q: If I want to reduce my sugar consumption from 16% to 10%, how much sugar is that?

A: On a 2,000-calorie-a-day diet, that equals 12 teaspoons of sugar.

Q: Is added sugar a health concern?

A: Added sugars probably have a greater impact on high blood pressure (hypertension) than does sodium, and fructose in particular may increase cardiovascular (heart and blood vessel) risk. There’s evidence that added sugars, especially sugar-sweetened drinks, raise the risks of excess weight and obesity, as well as type 2 diabetes. And, of course, sugar is a major contributor to tooth decay.

Q: How can I reduce added sugar in my diet?

  1. Use these simple tips to consume less:
  • Drink water or other calorie-free drinks instead of sugary, non-diet sodas or sports drinks. That goes for blended coffee drinks, too.
  • When you drink fruit juice, make sure it’s 100 percent fruit juice — not juice drinks that have added sugar.
  • Choose breakfast cereals carefully. Although healthy breakfast cereals can contain added sugar to make them more appealing to children, skip the non-nutritious, sugary and frosted cereals.
  • Instead of adding sugar to cereal or oatmeal, add fresh fruit (try bananas, cherries or strawberries) or dried fruit (raisins, cranberries or apricots).
  • Opt for reduced-sugar varieties of syrups, jams, jellies and preserves. Use other condiments sparingly. Salad dressings and ketchup have added sugar.
  • Choose fresh fruit for dessert instead of cakes, cookies, pies, ice cream and other sweets.
  • Buy canned fruit packed in water or juice, not syrup.
  • When baking cookies, brownies or cakes, cut the sugar called for in your recipe by one-third to one-half. Often you won’t notice the difference.
  • Instead of adding sugar in recipes, use extracts such as almond, vanilla, orange or lemon.
  • Enhance foods with spices instead of sugar. Try ginger, allspice, cinnamon or nutmeg.
  • Substitute unsweetened applesauce for sugar in recipes (use equal amounts).

For a list of common foods and the amount of sugar they contain, see this article in Medical News Today.

Pio Poblete, M.D.Dr. Pio Poblete is an MPCP partner and practices in our Columbia office. He is certified by the American Board of Internal Medicine.

Heartburn, Acid reflux…How do I get relief?

A Q&A with Loraine Dailey, M.D.

Q: I’ve heard acid reflux can be serious. Is that true?

A: If you’ve been taking antacids and refraining from eating lots of different foods, but you still have acid reflux- or “heartburn”- you may have what doctors term GERD. GERD stands for GastroEsophageal Reflux Disease. And yes, while the symptoms are annoying, GERD can also be serious and cause long-term damage if left untreated.

Q: What causes GERD?

A: At the entrance to your stomach is a valve called the lower esophageal sphincter (LES.) Normally, the LES closes as soon as food passes through it. If it doesn’t close all the way, acid in your stomach can move up into the esophagus, irritating the lining. Symptoms can include burning chest pain/heartburn, a sour taste in the mouth, nausea and other pain. If you have symptoms more than twice a week, you should talk with your doctor. We know that untreated GERD can cause damage, such as esophageal bleeding and increase a person’s risk of esophageal cancer. Plus, newer treatments and lifestyle changes can make you feel better fairly quickly.

Q: What are the latest treatments?

A: If the GERD is not serious, the first course of treatment should focus on lifestyle changes. Patients should avoid or reduce foods that trigger symptoms or weaken the LES—common culprits include chocolate, fried or fatty foods, coffee, alcohol and peppermint. Other changes include losing weight, not snacking several hours before bedtime, quitting smoking and evaluating any medications that could make GERD worse. Some people benefit from raising the head of their bed by six inches or sleeping on a wedge to prevent acid from moving up into the esophagus.

For some, treatment may also require medication. We have an effective class of medications called proton pump inhibitors. They are sometimes combined with over the counter medications, such as antacids or foaming agents to coat the stomach. Other drugs, such as H2 blockers, help some people. If medications don’t work, there are surgical options but they are being used much less today. Talk with your doctor if you have persistent heartburn or think you have GERD. Together, you can come up with an effective treatment plan.

Loraine Dailey, M.D.
Dr. Dailey is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. She received her medical degree from the University of Virginia School of Medicine in 1976 and completed her residency program in Family Practice at University of Maryland Medical Center in 1979. Dr. Dailey is also a Fellow of the American Academy of Family Physicians.

Stroke Warnings – Remember F.A.S.T.

A Q&A with Dr. James Chaconas

doctorQ: What exactly is a stroke?

A: A stroke occurs when a blood clot blocks an artery, or a blood vessel breaks, interrupting the flow of oxygen-rich blood to an area of the brain. The result is that brain cells begin to die and brain damage can occur. Minutes count when someone’s having a stroke.

Q: Are there specific warning signs?

A: The key warning signs of a stroke are sudden onset of symptoms- usually numbness or weakness of the face, arm or leg, especially on one side of the body. The person can also have trouble speaking, seem confused or have trouble seeing in one or both eyes. Another common symptom is dizziness or a sudden severe headache with no known cause. If you personally sense these symptoms, or see them in someone you are with, call 9-1-1 immediately. Some women also report symptoms of sudden hiccups, nausea or shortness of breath.
The National Stroke Association has come up with the acronym F.A.S.T. to help people remember the signs of stroke:
F= Face drooping. Does one side of the face droop? Ask the person to smile and see if it looks uneven.
A= Arm weakness. Is one arm weak/numb? Ask them to raise both arms and see if one drifts downward.
S= Speech difficulty. Are they slurring words or hard to understand? Ask them to repeat a simple sentence.
T= Time to call 9-1-1.ll know when the first symptoms appeared.

Q: Why is time so critical?

A: The most effective stroke treatments must be applied within the first three hours of symptoms. We have anti-platelet medications and certain procedures that can help get blood flow returned to the brain before there is permanent damage. That 3 hour window is critical, so make sure you share the signs of stroke with your family. You may help save a life.

Concussions & Head Injury

Q: What prompted you to get certified by the CDC in diagnosis & treatment of concussions?

A: I was initially interested as a result of my children’s participation on travel lacrosse teams. I also wanted to expand my knowledge to include head injury assessment in my practice. I see this as key information that needs to be more widely understood by individuals of all ages. The CDC points out that head injuries occur in falls and accidents in young children and older adults, so it pertains to more than sports-related head trauma.

Q: What exactly is a Mild Traumatic Brain Injury (MTBI) or concussion?

A: It’s a complex process affecting the brain caused by a blow or jolt to the head that disrupts the brain’s function. It results in a constellation of physical, cognitive, emotional and/or sleep-related symptoms and may or may not involve a loss of consciousness. MTBI symptoms may appear mild, but can lead to significant, life-long impairment. Symptoms can last from several minutes, to days, weeks, months or longer in some cases.

Q: If I’m a parent of a young athlete, how can I help protect my child before a head trauma occurs?

A: To reduce the risk of concussion or traumatic brain injury, individuals should always wear a seat belt when riding in a motor vehicle, wear a properly fitted helmet when biking, skiing, etc., or when playing any contact sport. Athletes should also get a baseline screening every year before the start of the sports season. A set of simple cognitive tests will allow your health care provider to assess changes that may occur with any subsequent head trauma. Also, parents should check with schools or county sports programs to make sure there is a process in place for handling concussions.

Q: What should I know about the recovery process if a loved one is diagnosed with a concussion?

A: It’s important to limit physical and mental activity after a concussion (generally at least one week) until being reevaluated and cleared to return to normal activities by a health care provider.

Julie Henne-Reese, CRNPJulie Henne-Reese, is a Certified Registered Nurse Practitioner at our Queenstown office, who has been with Maryland Primary Care Physicians since 2001. She received her Bachelor of Science in Nursing and her Master of Science in Nursing degrees from the University of Maryland School of Nursing. Ms. Henne-Reese is board certified by the American Nurses Credentialing Center in Family Practice, and has recently received her CDC certification in diagnosis and testing of MTBI (concussions).