Where’s Dr. Jen? (Part 1)

Hi, everybody!  My family and I are on the road for Christmas and I wanted to check in to give you a peek at where we’ve been!

Last Saturday we left Cleveland and started a 2-day trek to parts south.  My sister and her family live in Charleston, South Carolina and my parents live in Georgia.  The plan was to meet in Charleston and spend Christmas together.  It’s been 5 years since we were all together for Christmas and we couldn’t wait!

We moseyed our way south, taking our time and dividing up our trip into bite-sized chunks.  Saturday night we stopped in Charleston, West Virginia (which is a very pretty little city in the Appalachians, on the banks of the Kanawha River).  Jack, our Elf on the Shelf, popped up in our hotel room and had the boys very excited.  Having him watching helped them behave, I’m sure!

Sunday night we stayed in Charlotte, North Carolina at a Doubletree next to a big mall.  After dinner we had a turn through the mall to finish our LAST last-minute Christmas shopping.  Jack again turned up and kept an eye on things.

Monday we rolled in to Charleston and were greeted by six excited people (and two excited dogs).  My nieces Maggie and Anna were happy to see their cousins.  They haven’t been together since summer 2013.  Anna (who is 5) referred to Chris and Nick as (respectively) the “big one” and the “little one,” to everyone’s amusement.

Jack got to meet Maggie and Anna’s Elf, Weezie, and the two of them kept the littles guessing.  One night they cozied up together inside a glass vase with ginger-spice cookies.  On Christmas Eve morning the kids found them tucked up in the Christmas tree.  And of course when Christmas morning came the Elves had gone back to the North Pole with Santa.  They’ll be back next Thanksgiving time!

Santa (and Santa’s helpers) did their work well, and everyone was happy with their gifts.  Christmas morning saw the typical colossal mess and just a little of the typical sibling squabbles.

We did the usual family stuff, fun and food and mess and time-outs.  Here are a few of my favorites!


There were a few new restaurants and a few old ones that have become favorites.

Pies & Pints – A great beer-and-pizza place.  They have gluten-free pizza crust and a wonderful veggie sandwich that I love.  Just hold the cheese, thanks!  We went to the one in Charleston, West Virginia, this time, but there is a location in Worthington, Ohio, outside Columbus too.

Mellow Mushroom – I am always happy when we find a Mellow Mushroom.  We first found them in Pigeon Forge, Tennessee, and there’s also one in Gatlinburg.  There are two locations in Columbus and now there’s one in Rocky River!  Food Babe is lobbying them to release their ingredient list and I hope that when they do release it I’m still able to eat there!

Cowfish – We found this restaurant in Charlotte when we were there in 2013.  One word – AWESOME!  If you’re in Charlotte you MUST go there!  Omnivores and herbivores alike agree the food is amazing.

Joey Bag a Donuts – I know, I know.  Not healthy.  But deeeee-licious!  And there’s only one, so unless someone opens a franchise in Cleveland I’m safe!


SkyZone – This is a GREAT place to wear out your kids.  They also have SkyRobics, although I didn’t get a chance to go.

Wild Blue Ropes – Also a great way to wear out grownups and kids alike.  Ropes courses are SO much fun!  There was a girls’ volleyball team there doing a teambuilding exercise while we were on the course.  We were having a great time, but doing the course blindfolded while a teammate talked you through it?  No thanks!

We left my sister’s house today and I am now sitting in the living room of my rental unit, with the balcony door open and the soothing, rhythmic sound of surf filling the room (along with the click of computer keys, ha).  Where’s Dr. Jen?  Check in next week and I’ll tell you!  Merry Christmas everyone, and be safe!  I’ll be back in the office Friday.

QUESTION:  How was your Christmas holiday?  Did you travel?


Does Calcium Cause Heart Disease?

There has been a lot of talk recently some very confusing research published in the literature about calcium supplements and heart disease risk.  Some studies seem to show that increased calcium intake protects against heart attacks, and some seem to show an increased risk.  So what’s the right answer?

Does calcium cause heart disease?

First of all let’s talk about why people (especially women) take calcium supplements in the first place.  Calcium supplements are recommended in women to prevent the bone loss that leads to osteoporosis.

Women start to lose bone mass at about age 30 and it really accelerates after menopause.  50% of women over 50 will have an osteoporotic fracture.  Hip fracture is a leading cause for women to wind up in a nursing home, and 50% of women who suffer a hip fracture will die within 1 year.  Preventing osteoporotic fractures is a big deal.

Does it make any sense that taking extra calcium would be dangerous?  Well let’s think about that.  Calcium is required for life.  Calcium is required for proper function of the heart, blood vessels, muscles and nervous system.  The blood level of calcium is VERY tightly regulated.  In fact, one of the reasons osteoporosis happens is that the body is willing to sacrifice bone strength to maintain that blood level of calcium.

What happens when you take calcium?  First of all the digestive system can only absorb about 500 mg of calcium at one time, so if you take more than that it just goes out in the stool.  Calcium is absorbed and goes into the bloodstream where some of it is taken up by the cells if they need it.  Some of it is put into the bone if there is new bone being built (this is complicated but requires bone-building cells called osteoblasts in addition to magnesium, vitamin D and other trace minerals).  Anything the body doesn’t need gets released into the urine and excreted.

If you don’t get enough calcium in your diet, the body goes to the bank.  The bank is, of course, the skeleton.  The blood level of calcium must be maintained to keep the nervous system and circulatory system working right.  So if you don’t get enough calcium in your diet, over time calcium is released from the bones and the bones get weaker.

Why do some researchers think calcium causes heart disease?  There have been studies published in the last 5 years that were designed to look at calcium intake and osteoporosis risk.  When the researchers went back and reanalyzed the results, sometimes the cohorts with a high calcium intake have a higher number of heart attacks.  Sometimes they have a lower number.  Sometimes they have more in men but fewer in women.  It’s all very confusing.  The thing to remember though is that these studies were NOT designed to look at heart attack risk, they were designed to look at osteoporosis risk, and it’s dangerous to make firm conclusions about associations found in ad hoc analysis.

There WAS, however, a study published this year that WAS designed to look at calcium intake and heart attack risk.  Researchers followed almost 75,000 women for 24 years and found that women who took >1000 mg of calcium supplements per day had an 18% LOWER risk of cardiovascular disease (heart attack and stroke) and a 29% LOWER risk of heart attack than women who took no calcium supplements.  The researchers did good statistical analysis and factored in age, body mass index, dietary calcium, vitamin D intake, and other CVD risk factors.

What does this all mean?  The bottom line is that calcium supplements help prevent bone loss in women who don’t get all the calcium they need from their diet.  While the research isn’t clear that calcium supplements prevent heart disease (although it is reassuring) it DEFINITELY doesn’t support the conclusion that calcium supplements CAUSE heart disease.

Which calcium supplement should you take?  Taking calcium alone isn’t a good idea.  After all, your bones need more than just calcium for strong mineral matrix.  And calcium competes with magnesium in the digestive tract so taking calcium alone decreases magnesium absorption.  As I wrote recently, most of us don’t get enough magnesium in our diets as it is!  Vitamin D is also required, especially if you live in a northern climate where the winter sun isn’t strong enough to help your skin make vitamin D (like here in Cleveland).

The best calcium supplement for bone health has calcium, magnesium and vitamin D as well as trace minerals needed for strong bone matrix.  As you know, I work with the Shaklee Corporation (you can look here for my reasons why) and Shaklee’s OsteoMatrix is a great choice.  The caplets are small and easy to swallow (no enormous chalky horse pills!) and don’t cause constipation as some calcium supplements can do.

Be aware that OsteoMatrix contains vitamin K (also needed for bone health) and may not be a good choice for those who take Coumadin to thin the blood.  Shaklee’s Chewable Cal Mag Plus is better – calcium, magnesium, vitamin D and trace minerals but no vitamin K.  And they make a great antacid for those with occasional heartburn!

Calcium is required for life.  Your body will steal it from your bones to keep your heart, muscles and nervous system working right.  If you’re not getting enough from your diet you should definitely consider supplementing.  It’s good for your bones and NOT dangerous for your heart.  That’s the bottom line.

QUESTION:  Have you been told by your doctor to take extra calcium?  Have you been told by your doctor to AVOID taking calcium supplements?


Avoiding Colds And Flu

Well it’s that time of year again.  I saw my first confirmed case of influenza this week.  The flu season is early this year and seems to be considerably worse than in recent years.

So with all the coughing, sneezing and misery going around, what are the best ways of avoiding colds and flu?

Some of the best measures are pretty obvious.  Some might surprise you!

1.  Get a flu shot

So flu is already here.  Is it too late to get a flu shot?  No.  Although it’s true that it takes about 2 weeks to get full protection from the vaccine, the flu season hasn’t peaked yet.  The flu shot will give you some protection from exposure late in the season, but if you’re exposed in the next week or two, it won’t help too much.

2.  Wash your hands

This is still the best way to avoid all sorts of infections that are transmitted by touch.  Colds and flu are transmitted by the spread of infected secretions.  So when a sick person coughs, sneezes or blows his nose, the infected secretions are both spread through the air and land on surfaces.  When touch the surfaces with live viruses on them, then rub your eyes, touch your nose or eat your dinner, you get infected too.

A 15-second wash with hot soapy water is the best way to reduce the risk of infection.  At this point there are enough concerns about antibacterial soaps that I’m not recommending anyone use them.

3.  Manage your stress

When you are stressed, your immune system doesn’t work as well.  There is good evidence that stress impacts your immune system and decreases your ability to fight infection.

Meditation is a good way to decrease your fight-or-flight hormones and decrease your stress.  See more in a recent blog post, Meditation for Stress Relief.

4.  Sleep

Sleep deprivation is a big stressor.  When I’m not getting enough sleep I definitely am more prone to catching colds and other infections.  Adults need 7-8 hours of sleep in general, and children (including teens!) need up to 10 hours of sleep per night.

5.  Supplements

There are a ton of supplements out there that are touted to boost immunity.  How do you know what’s worth taking?

(Before I get into my recommendations I want to remind everyone that I work closely with the Shaklee Corporation.  You can read my reasons for recommending Shaklee products here.)

Well, first you have to check out the scientific research.  For instance, a high-quality multivitamin has been shown to reduce the number of sick days over the course of a year.  It makes sense that, given the fact that our food supply is less nutritious than it was in the past, supplementing with a high-quality multivitamin would help fill the gaps.  Specifically, lower folic acid and zinc blood levels seemed to correlate with days of illness.

Another supplement proven to lower the risk of infection is a good probiotic supplement.  Probiotics have been shown to decrease the duration of respiratory illnesses in healthy adults and children (see the article abstract here).

There is one supplement on the market that has been proven to naturally raise interferon levels.  Shaklee’s Nutriferon is a patented immune support supplement and many of my patients rely on it to help avoid infections in the wintertime.

If you’d like to learn more about any of these products, click the following links:  Vita Lea (multivitamin), OptiFlora (probiotic) and NutriFeron.

Want to know what I do?  ALL OF IT!!  I am surrounded by germs all day every day, both at work and at home!  I do my very best to sleep and eat healthy every day.  I wash my hands all day long.  I manage my stress as much as possible.  I got my flu shot this year.  And I take my supplements every day.

QUESTION:  What do you do to stay healthy in the winter?  What’s your regimen like?




Saying No To Your Child

Yep, sometimes you have to do it.  Saying NO to your child is something all of us parents know and hate.  It seems guaranteed to provoke a tantrum, especially when your child is in that difficult two-to-three-years age range.  However, saying NO to your child in a constructive and proactive way can actually head off the tantrums and lead to a child feeling MORE powerful rather than less.

So how can we guide and correct our children’s behavior in a way that doesn’t lead to one long drawn-out power struggle?

1. Set boundaries

Kids crave boundaries.  This seems very counterintuitive for those of us in the trenches of kid-raising (because kids are professional boundary-pushers).  Once they understand them, the presence of boundaries makes kids feel very safe.  Predictable limits make their lives, well, predictable.

When kids know the rules, they can predict with reasonable accuracy what will happen when they behave certain ways.  When they DON’T know the rules (or worse, when there ARE no rules) they never know what’s going to happen.  Sometimes bad behavior is punished, sometimes it’s rewarded (because even negative attention can be rewarding) and sometimes it’s ignored.  Not knowing what will happen is stressful.

Consider how you would feel if your boss at work were inconsistent in your feedback.  Sometimes your work is praised, other times ignored, other times criticized, and you’re not sure why.  That would be very stressful.  Not knowing what to expect is difficult for everyone, including kids.

Even though kids will push the boundaries, a predictable response from Mom and Dad gives them the unspoken message that we love them enough to keep them safe, that there are consistent rules that apply in society, and that they are NOT above the rules.

(Taking a lesson from recent current events, I would submit that many of our young people’s problems are a direct result of them not understanding deep down inside that they are NOT above the law and that the law DOES apply to them.)

2. Give choices

Whenever you possibly can, DON’T tell your kids what to do.  Give them two or three equally acceptable choices, then let THEM choose which they want to do.  It’s important that whatever they choose is perfectly fine with you.

For example, when your kids are getting dressed in the morning, even if they barely know their colors, let them pick their clothes.  Hold up two shirts and ask them which they want to wear.  Jeans or sweatpants?  Skirt or shorts?  White socks or green ones?  Who cares what they’re wearing?  Guess what.  THEY DO.  It is much more important to them than it is to you.

Even if they’re too little to dress themselves, if they picked their clothes they have made a good choice.  When kids make good choices they learn an important life lesson.  They CAN make good choices.  This builds self-respect and a feeling that they are effective.  Everyone needs to feel effective.  It also gives them a much-needed feeling of control.

3. Redirect

What happens when they what something that isn’t on the parent-approved list?  That’s an example of boundary-pushing and is absolutely normal.  You just say “Sorry, pumpkin pie is not on our list of breakfast choices today.  Do you want cereal or a bagel?”

This is the traffic equivalent of presenting a detour sign instead of a roadblock.  This is a very sophisticated way of saying “no” that flies under the radar with kids.  It doesn’t feel like “no,” and offering choices again right away makes the child again feel like they are in control of the situation.

After a whole day of offering choices to your child, sometimes it’s time to pull rank and deliver marching orders.  If your child is balking at taking a bath you can say “Hey.  You got to choose all day long, now it’s my turn to choose.  We’re going to take a bath now.  While the tub is filling up, do you think you can pick out some good books to read before bed?”  Here again we’re offering choices as a redirection for not letting them choose something (no bath) that isn’t on the parent-approved list of options.

Kids are smart.  Believe me, I know what I’m talking about, from personal experience!  Luckily they also generally come equipped with parents dedicated to helping them grow up safe and healthy.  Saying NO to our kids is definitely on the un-fun parent job list, but if you do it right, it can be used to INCREASE a child’s sense of control and effectiveness, not shoot it down.

For more parenting ideas like this, please check out the “Love and Logic” parenting series of books by Foster Cline and Jim and Charles Fay.  They are available from local bookstores and also from Amazon.com.

QUESTION:  What was the most creative redirect you ever pulled on your child?