Social Media Makes Teen Girls Unhappy

There is a lot of controversy now about children’s access to electronic devices and, particularly, social media.  Many parents are understandably concerned about the effect social media may have on their kids.

Those of us adults who use Facebook, Twitter, Instagram and other social media know that people often choose to show only the happy, pretty, upbeat side of our lives.  Who wants to post about the fight you just had with your spouse, about the fact that you don’t like your daughter’s boyfriend, or the fear of losing your job that’s keeping you up at night?

Those whose only real exposure to others is through electronic media may not realize how inaccurate and misleading others’ social media profiles may be.

I know as a mom I worry that my teen is confining so much of his communication with peers to texting that he is not practicing valuable communication skills.  Gone are the days of teen girls spending hours holed up in their room chatting with friends on the phone.  Now they trade texts which are completely devoid of the tiny clues of tone of voice, facial expression, and uncomfortable pauses that can help interpret and layer meaning on spoken words.

Not to mention that it’s hard to create deep, long-lasting emotional relationships when all you can see is what another person purposely chooses to show.  It’s when things AREN’T pretty that you learn what someone is really like.  And tough times and real struggles build deep connections with others.

There was a study from the UK published recently that brought new focus to these pitfalls.  Researchers conducted a huge survey (almost 10,000 teens) which examined how much time the teens spent chatting on social media.  They also asked questions designed to evaluate the teens’ emotional and behavioral status and created a “happiness score.”

The researchers found that girls used social media more often than boys, although both genders’ use rose with age.  Also, use of social media in girls, particularly at a younger age, was associated with lower “happiness scores.  In boys it didn’t seem to have much if any effect.

Those of us who are parents of teens need to be careful to monitor our children’s use of social media.  Their happiness and well-being can be seriously impacted by spending too much time online, especially our daughters.

QUESTION: Do you have teens who use social media?  Do you notice it affecting their mood and well-being?

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What Parents Need To Know About E-Cigarettes

You see them everywhere.  Adults walking in no-smoking zones exhaling huge clouds of white with ball-point-pen-shaped devices in their hands.  My patients often tell me they’re switching to e-cigarettes when I remind them that they need to quit smoking.

Are e-cigarettes safer than regular cigarettes?  Do they help smokers quit?  What impact are they having on our teenagers?

As parents, we need to understand the appeal of e-cigarettes to our teenagers and what the health risks are.

E-cigarettes are electronic devices that provide a vapor that contains carrier chemicals, nicotine and flavorings.  They don’t contain tobacco and therefore don’t expose the user to the carcinogens and other harmful additives in traditional cigarettes.  They are seen as a safer alternative to traditional cigarettes.

But are they really safer?

According to the American Lung Association, the chemicals in e-cigarettes are largely untested.  Because they are usually marketed without drug claims, companies don’t have to disclose or test their ingredients for safety.  One chemical, called diacetyl, is associated with a lung condition called popcorn lung.

Nicotine itself is NOT safe.  It doesn’t matter whether a user gets nicotine from patches, gums, lozenges, e-cigs or traditional cigarettes, it is harmful to the brain and to the circulatory system.  Nicotine is harmful to developing fetuses and therefore pregnant women should NOT smoke or use e-cigarettes.

Newer research shows that the brains of young people continue developing far longer than was previously thought.  (This is not a surprise to those of us raising teens, right?)   Use of nicotine is associated with problems of working memory and attention in adolescents.

Do e-cigarettes help smokers quit?

Credit ComplianceSigns.com

No, they don’t.  Evidence is pretty clear that using e-cigs actually REDUCES the likelihood of quitting smoking.

There was a survey done in North Carolina of middle- and high-school students about the use of cigarettes and e-cigarettes.  It found that use of e-cigs increased 4-fold between 2011 and 2013.  Those who used both cigarettes and e-cigarettes were actually LESS likely to quit (and less likely to try to quit) than those who smoked cigarettes alone.  Teens who use e-cigs are more likely to start smoking traditional cigarettes as well.

An study published in the American Journal of Preventive Medicine last month reported that those who use e-cigs are about half as likely to quit smoking cigarettes as those who don’t.  Using e-cigs keeps people from quitting smoking!

There has never been any evidence that e-cigarettes help smokers quit.  They cannot be marketed as a smoking cessation aid, but that doesn’t stop people from believing they will help.

As parents raising teenagers it is important we talk to our kids about e-cigs.  They will hear that e-cigs are safe, that they are just a fun, tasty way to get a little nicotine buzz.  E-cigs are heavily marketed to the adolescent age group.

The truth is that they are addictive, dangerous drugs that should be considered a gateway to traditional cigarettes.  They hurt teenagers’ ability to learn and process new information.  They are harmful to the lungs and circulatory system just as traditional cigarettes are.

When we’re talking to our kids about smoking, alcohol, drugs and sex, we can’t forget to cover the dangers of e-cigarettes because marketing messages and their friends certainly won’t give them the whole story.

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Tips For Getting Kids To Eat Veggies

If you’re a parent, this is all too familiar.  The eye rolls.  The gagging sounds.  The battles of wills where your child is still sitting at the table at bedtime glaring at the miniscule dab of sweet potato on their plate.

I know it.  The struggle is real.  (If your kid cheerfully eats salad and green beans and beets, keep it to yourself right now.)  Today I’m really motivated to write about kids and diet.  I found an interesting article with tips for getting kids to eat veggies.

Conventional mom wisdom suggests that kids like bland foods, right?  Chicken nuggets, corn, naked hamburgers, macaroni and cheese?  These are old stand-bys at the kids’ table and on children’s menus at restaurants.

What if this mom wisdom is actually wrong?  What if kids, like adults, are more likely to enjoy food that actually has some taste?

There was a small research paper published that got 100 teenagers in rural Pennsylvania to taste-test plain vegetables compared to vegetables seasoned with different spices.  The teenagers reported that they preferred the seasoned veggies over the plain ones.

This study has some limitations.  For instance the kids chose whether to participate, so more adventurous kids might have been more likely to do the tasting.  Also, it was funded in part by McCormick (the spice company).

But the beauty of this study is that it makes you think.  As a parent, do we change how we cook when we have kids?  (The resounding answer is YES.)  I hear it all the time – parents who want and desperately need to lose weight are resistant to doing what it takes to improve their diet.  They have to cook for their whole family, so they feel limited in their ability to add variety and be adventurous in different ways of cooking their foods.

What if this is based on a flawed premise that kids are little dictators and won’t EVER be willing to try new foods or established foods cooked in a different way?  What if, especially if it’s started early, kids actually will enjoy the foods that YOU enjoy?

There is an interesting book that sheds some light on getting kids to eat veggies.  It’s called “French Kids Eat Everything” by Karen Le Billon, and suggests that part of the blame for the childhood and adult obesity epidemic is due to bad parenting on our part.

French kids eat what their parents eat.  No children’s menus, no separate meals, no catering to childhood food jags.  They don’t snack between meals, in general.  I highly recommend this book for anyone dealing with a picky eater.

After all, getting kids to eat veggies is only a small part of the overall parenting job of helping our kids develop a healthy and adventurous relationship with food.  Food nourishes our bodies and keeps them healthy.  But food is also a pleasure, a feast of sights, sounds, smells, tastes and textures.

If you’re looking for a shortcut with cramming veggies into your diet, Shaklee JUST introduced Organic Greens Booster.  This new product provides one serving of green vegetables per scoop.  I had my first green smoothie this morning in honor of St. Patrick’s Day and it was tasty made with vanilla Life Shake mix 🙂

Organic Greens Booster from Shaklee

Organic Greens Booster can be added to smoothies, soups, muffins and other foods to get extra nutrition support.  Click this link to see more information!

Getting kids to eat veggies is tough, but these three things can help.  Vary the tastes and don’t be afraid to add spices and seasonings.  Start young by offering your kids the foods that you like, and be aware that cooking separate “kid meals” for them can backfire.  Add ninja veggies to fruit smoothies, soups and other kid-friendly foods with products like Shaklee’s new Organic Greens Booster.

QUESTION: Do your kids like veggies?  How do you get your kids to eat them?

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Food Addiction

Do you struggle with your weight?  Are you obese?  Have you tried again and again to lose weight, and had short-term success but then slip back into old patterns?  Have you lost weight only to find yourself gaining the weight back with interest?

As a physician who enjoys helping people lose weight, I am almost as frustrated as my patients when things aren’t going well.  One thing that makes weight loss particularly difficult is food addiction.

Food addiction is just starting to be recognized as a major underlying factor in overweight and obesity.  Just like alcoholism and drug addiction, there are changes in the brain in some overweight and obese people that make it difficult or impossible for them to lose weight without help.

Researchers at Yale developed a questionnaire, published in 2009, to assess food addiction.  This questionnaire, the Yale Food Addiction Scale, is a 25-question tool that helps dig into symptoms and behaviors of food addiction.

What is addiction?  Psychiatrists and psychologists recognize addiction as a persistent pattern of abnormal behavior that results in significant distress in the patient.  Abnormalities include

  • Tolerance (needing more of the substance in question to get the same effect)
  • Cravings and withdrawal symptoms when not using
  • Consuming larger amounts than intended
  • Unsuccessful attempts to cut down in spite of wanting to cut down or abstain
  • A lot of time spent using or recovering from use
  • Continued use or overuse in spite of known consequences
  • Giving up important activities in order to use

You may already recognize some of these markers in yourself.  I certainly do.  For instance, I have a really bad sweet tooth.  I sometimes find myself eating more sugar than I know is good for me.  If I stop eating sugar, I will have sugar cravings, headaches and body aches.  Sugar is addictive and I know I have withdrawal symptoms if I overuse it for awhile then stop.

The same group that developed the Yale Food Addiction Scale published an article looking at almost 200,000 people, and found that about 25% of people who were overweight or obese met the criteria for food addiction.  Food addiction was more common in women, those over 35 years of age and those with clinically disordered eating, like binge eating, anorexia and bulimia.

Addiction is a complicated topic and I could write for days about it.  A VERY over-simplified explanation of addiction is that the reward centers of the brain have low levels of dopamine, the pleasure hormone.  Using the drug of choice (opiates, food, sex, sugar, etc) raises dopamine levels in these areas.  Also, these substances interact with the endogenous opioid (endorphin) systems, giving a morphine-like “high.”

Taken together, the presence of the “high” with use and low dopamine levels without use make it very difficult to resist the urge to overeat and very difficult to stop overeating once started.

Do some foods trigger food addiction more than others?  Well sure, nobody really binges on green beans and broccoli, right?  So called “highly palatable” foods are much more likely to trigger overeating.  The food industry knows this, and adds saturated fat, salt and sugar to processed foods to create this super-tasty addiction trigger.  Chips, cookies, candy, soda, cheeseburgers, French fries, white bread and ice cream are examples of foods likely to trigger an addiction response and binge eating behavior.

My personal belief is that weight loss is much harder than dealing with alcoholism, smoking, even heroin addiction.  You can’t just not eat, right?  However, when you understand what foods and situations trigger addiction, you can avoid them like an alcoholic avoids beer and stays out of bars.

What about people who are motivated to kick their food addiction for good?  What is available to help them?  There are twelve-step programs for food addicts, similar to Alcoholics Anonymous.  One such program is Food Addicts In Recovery Anonymous.  (I have no experience with this program, I just know it exists.)  And like alcoholism and opiate addiction, medications can help.

There is a medication called Contrave which has been shown to promote weight loss.  When you understand food addiction, it’s easy to see how Contrave would be helpful.  Contrave is a combination of bupropion, which raises dopamine levels, and naltrexone, which blocks the endorphin response.

Bupropion, an antidepressant, is well known to help people quit smoking and is the only antidepressant that promotes weight loss.  Raising dopamine levels decreases the need to eat, or smoke, or do other things to raise these levels in the brain.  Naltrexone blocks the “high” from drinking alcohol, using opiates like heroin, or binge eating.

While Contrave is very expensive and only rarely covered by insurance, both bupropion and naltrexone are available in generics and are inexpensive to purchase if not covered.  GoodRx.com can give you an idea what prices would be like near you.

If you believe you may be a food addict, please print and fill out the Yale Food Addiction Scale and take it to your doctor.  You can also print out the scoring instructions, it’s a little tricky to score.  This will help your doctor help you.

Like many similar problems, a combination of medication and counseling is going to be the most effective way to deal with food addiction.  If you are overweight or obese and feel out of control with respect to your eating, don’t give up!  See your doctor and ask for help.  If he or she isn’t comfortable diagnosing and treating food addiction ask for a referral to a bariatric center near you.

Like alcoholism and opiate addiction, food addiction can impact every part of your life.  It can alienate you from friends and family, and can even take your life.  Proper treatment starts with recognizing the problem and asking for help.

QUESTION: Do you or someone you love have a food addiction?  Will you do something differently based on the information in this post?

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Managing Urge Incontinence

Have you seen that cute commercial with the little red “bladder” character who pesters the woman until she takes it to the bathroom?  Imagine that little guy just grew horns and a bad attitude.  It doesn’t pester.  It gives one warning and then unless she finds a bathroom RIGHT NOW it makes an embarrassing mess all over.

That’s urge incontinence.

Frequent urination.  Strong urges which quickly morph to an irresistible urge to void. Accidents.  Getting up at night frequently to pee.

Can you imagine if this was you?  Wouldn’t you be hesitant to leave the house?  I would.  It would be hard to go to the grocery store or do any other shopping, go to church, or function at work, let alone travel anywhere.

It’s hard to turn on the TV anymore without seeing ads for adult briefs and constipation products.  The large number of such ads would make it easy to assume this is a “normal” part of aging.  But it’s not.  Urge incontinence is NOT normal.  And it is definitely treatable.

My friend and colleague Dr. Holly Wyneski is a urologist in practice in Richfield, Ohio.  She specializes in female pelvic and bladder problems.  I reached out to her to get a little information about management of urge incontinence.   Please check out her website at www.hollykaywyneskimd.com 🙂

When dealing with urge incontinence, Dr. Wyneski’s advice is to start with behavioral change.  First, take a close look at diet (including fluid intake) and avoid foods and beverages that irritate the bladder.  Dr. Wyneski’s website has a list you can download here.  Examples include alcohol, caffeine, carbonated beverages and spicy and acidic foods.  Next, do your best to get enough sleep, and be aware of your stress level.  In addition to helping with stress and sleep, a number of my patients have found that magnesium supplementation helps calm the bladder.

In addition, your weight also influences how well your bladder works.  (Go figure, right?  Your weight affects everything ELSE in your body so why not your bladder!)  If you are overweight or obese, losing as little as 5-10% of your body weight can go a long way towards getting your bladder working better.

If the above measures don’t correct your bladder problem, bladder training is a very important behavioral treatment.  This starts with listening to your body.  Dr. Wyneski advises that you should empty your bladder every 2-3 hours.  It is also not considered abnormal to get up one time at night for every decade over age 70.  If you’re drinking enough fluids you will need to go at least that frequently.

Are you holding your bladder for 5-6 hours?  (HELLO all my nurses and teachers out there!)  If so, you are setting yourself up for problems down the road.  If the bladder gets stretched out it will get weak and not empty as well as normal.  This can lead to incomplete emptying (where there is still urine left in the bladder after voiding) and can cause infections and kidney damage.

The other side of the coin is the overactive bladder, where every time the bladder gets a little urine in it you feel like you need to go.  People with overactive bladder may need to go every hour, or even more often.  If you know every gas station with a clean bathroom on the east side of the city, this may be you!

Some people are very sensitive to the “stretch” sensation and may feel they need to go even if it’s not needed.  You may also have a bladder that tends to spasm and contract when it’s not time to go.  Men may have problems with their prostate that make it feel as if they need to go more frequently than normal.

Bladder training for the overactive bladder consists of waiting a few minutes after it feels like you need to go.  This will gently “stretch” the bladder and de-sensitize the urgency sensation.  Even starting with just a two-minute timer will make a difference.  You can gradually lengthen the time you wait.  It takes patience, but it is so important!

If these behavioral changes don’t help, please see your doctor.  Also, if you develop sudden bladder symptoms you should see the doctor, this may be an infection that needs treated right away.

If you’re like the woman in the commercial and you feel like you’re a prisoner of your bladder, there are things you can do to improve your symptoms yourself.  Your doctor can help too, and if all else fails, urologists like Dr. Wyneski have got lots of tools in the toolbox!

QUESTION: Do you have problems with your bladder?  What has helped you?

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