Over the last 30 years, childhood obesity rates have tripled in the United States, with nearly 1 in 3 children considered overweight
or obese. Left unchecked, childhood obesity can lead to serious health issues in children, including diabetes, high blood pressure, high cholesterol, asthma and sleep apnea.
The good news is that small changes in snacks, like swapping those high in fat, sodium and calories for healthier, more filling options, can make a big impact.
Felissa Kreindler, MD, pediatrician at NorthShore, shares some healthy snack options that won’t send the kids running … unless, that is, they always follow a healthy snack with some equally healthy exercise.
What healthy snacks do your kids love?
8 teaspoons dried minced onion
1 tablespoon dried parsley
½ teaspoon paprika
2 teaspoons salt
2 teaspoons pepper
1 ½ teaspoons garlic powder
1 cup nonfat yogurt
1 cup fat-free sour cream
April is National Parkinson’s Disease Awareness Month. All this month, we will feature a series of posts addressing Parkinson’s disease symptoms, genetics, treatment options and more from NorthShore neurologists—Demetrius Maraganore, MD, Aikaterini Markopoulou,
MD, and Ashvini Premkumar, MD— to raise awareness about this common and often disabling neurological disorder.
Ashvini Premkumar, MD
What are the most effective medications for the treament of Parkinson’s disease?
The most effective medications for the treatment of Parkinson’s disease are the dopaminergic medications. Carbdiopa/levodopa is by far the most effective, followed by dopamine agonists and lastly mao-b inhibitors. Non-dopaminergic medications include anticholinergics,
which are sometimes useful for treatment of tremor but have to be used with caution because of the side effect profile, particularly in elderly patients.
What are the most common side effects of carbidopa/levodopa?
The most common side effects for carbidopa/levodopa that we see clinically include: nausea/vomiting, lightheadedness, sleepiness, hallucinations, and dyskinesias.
Do you recommend the early use of carbidopa/levodopa? Delay its use?
The early vs. delayed use of carbidopa/levodopa has been debated for many years. The crux of the debate rests on the concern that early use of carbidopa/levodopa may increase one’s risk for motor complications, namely fluctuations (“on” and “off”
periods) and dyskinesias. The risk is approximately 40 percent within four to six years, particularly among young patients. Whether or not to start carbidopa/levodopa has to be highly individualized decision, which will be based on many factors, including
disease severity, age, co-existing symptoms (i.e. cognitive impairment) and occupational concerns.
Please discuss Neupro transdermal therapy
Neupro transdermal therapy, or the rotigotine patch, is dopamine agonist that is FDA approved for the treatment of Parkinson’s disease. It can be used in early Parkinson’s disease. It also can be used as an adjunctive medication in advanced Parkinson’s
disease as it was shown in studies to reduce “off” time by roughly one hour a day. It has also been approved in the treatment of moderate to severe restless legs. The side effects include: nausea/vomiting, somnolence (sleep attacks), reactions at application
site, dizziness, anorexia and compulsive behavior. The specific benefit of Neupro, like other extended-release dopamine agonists, is that it maintains as constant a level of drug as possible throughout the day.
Some say that exercise eases Parkinson's diease symptoms. What exercises or physical activities are recommended for people with Parkinson’s disease?
We recommend an exercise program that combines aerobic activity and core muscle strengthening. And this should preferably be complemented by exercises aimed at balance and stretching (i.e. yoga and Tai Chi).
Is it safe to ride a bicycle with PD?
This question needs to be routinely addressed by the patient’s treating neurologist. In general, in the early stages of PD, where balance is not significantly affected, it’s considered safe. However, once postural instability becomes noted, either
by reported falls or upon routine examination, then it would be advisable to ride only stationary bicycles.
How can I prevent falls if I have PD?
Prevention of falls should be emphasized at each clinic visit with one’s treating neurologist. The best way to prevent falls is to be educated as to what causes falls in Parkinson’s disease and then to take every precaution to avoid those “missteps.”
We often think that eating healthy means spending more money. You don’t necessarily have to sacrifice on flavor and
the foods you love when trying to eat on a budget. Saving some green in your pocket book can be as easy as becoming a better planner both at the grocery store and in the kitchen.
When you think about stretching your dollars with your food, remember that making smart choices is a small price to pay when it comes to your overall health and wellness.
Kimberly Hammon, registered dietitian at NorthShore, shares the following recommendations for maximizing nutritional value and minimizing costs:
What do you do to reduce your grocery bill? What cost-saving tips do you have?
Aikaterini Markopoulou, MD
What is DBS?
Deep brain stimulation is a type of surgical treatment for Parkinson’s disease. It involves the insertion of electrodes into specific areas of the brain that control movement. The electrodes are connected to a battery that is placed under the skin in the upper
part of the chest. Electrical current that passes through the electrode stimulates these brain areas on one side of the brain. This stimulation results in improvement of tremor and slowness or stiffness on the other side of the body.
Who is a good candidate for DBS?
To be a candidate for DBS surgery a number of conditions have to be met:
Is DBS covered by Medicare?
Yes, DBS is covered by Medicare.
When a patient has bilateral DBS is it necessary to have two stimulators, or will one suffice?
In the majority of Parkinson’s cases, symptoms affect both sides of the body; therefore, electrodes are inserted in both sides of the brain. In some cases where the symptoms affect mostly one side, the electrode can be inserted only in the opposite site of
If you have DBS, how does it affect your ability to get through airport checks, metal detectors, etc.?
Each patient is provided with an identification card that includes information about the implanted stimulator. The TSA agent should offer a private screening or screening with a manual wand instead of the patient walking through a metal detector.
What percentage of DBS surgeries result in complications? What complications might a patient encounter?
The DBS surgery may result in complications both during the implantation and after surgery, which include bleeding at the electrode insertion site that can be fatal, hardware malfunctioning, and infection and symptom worsening. In a large multicenter clinical
trial, 7.5% of patients developed intracranial hemorrhage, 10.6% device-related infection and 8.1% one-sided weakness.
How long is DBS effective?
Studies that have followed patients for ten years have been published and the DBS remained effective throughout the ten-year interval.
Are there any long term risks associated with DBS?
DBS therapy remains a safe treatment option for Parkinson’s patients for at least ten years.
Demetrius Maraganore, MD:
Are the children of a parent with Parkinson’s disease likely to inherit the disease? Is there a greater risk
if the father or the mother has the disease?
My research team conducted family studies that defined the risk of inheriting Parkinson’s disease. The children of Parkinson’s disease patients carry a two-fold risk for Parkinson’s disease. They are twice as likely to get Parkinson’s disease compared to the
children of persons without Parkinson’s disease. However, one needs to consider that the lifetime risk for Parkinson’s disease in the general population is 2%, so the risk of Parkinson’s disease for the children of a patient is 4%, or twice the baseline risk
for the general population. That’s a pretty low risk and I wouldn't recommend any specific lifestyle changes or preventive therapies for the children of patients with Parkinson’s disease.
That said, about 5% of Parkinson’s disease cases are due to an inherited gene abnormality (mutation). In families where multiple members have Parkinson’s disease, the risk may be as great as 50% to the children of an affected person. When there are multiple
family members with Parkinson’s disease, I refer patients for genetic counseling and in some instances we also perform genetic testing.
What are the most important genetic risk factors for Parkinson’s disease?
There are two types of genetic factors that are important to Parkinson’s disease: 1) genes that rarely cause familial Parkinson’s disease (multiple affected members in the same kindred), and 2) genes that are not causal but that slightly increase the risk for
Parkinson’s disease in populations worldwide (susceptibility genes). About a dozen genes have been identified as rare causes of familial Parkinson’s disease, and about a dozen genes have been identified as common risk factors in populations worldwide. The
causal gene mutations are rare, accounting for less than 5% of all Parkinson’s disease cases. The susceptibility gene variants are common—e.g., occurring in 25% of persons in the general population—but they have small effects (no more than doubling the risk
for Parkinson’s disease).
Of all of the Parkinson’s disease genes, the most important is alpha-synuclein because it is both a causal gene in some families and also a susceptibility gene in populations worldwide. In other words, rare variants (mutations) cause Parkinson’s disease in
rare families, while common variations (polymorphisms) increase the risk for Parkinson’s disease worldwide.
The alpha-synuclein gene holds the code for making the protein alpha-synuclein. The protein alpha-synuclein accumulates abnormally in the brain cells of every patient with Parkinson’s disease regardless of the causes. Many scientists believe that it holds the
key to understanding and curing Parkinson’s disease. Our research team at NorthShore has led many of the most important studies of alpha-synuclein and Parkinson’s disease, including studies in families and in populations worldwide. We were also amongst the
first to study the interaction of alpha-synuclein with other genes or environmental factors, or to study the association of the alpha-synuclein gene with motor and cognitive outcomes in Parkinson’s disease.
Are there genetic research studies of Parkinson’s disease at NorthShore? How can I participate?
At NorthShore we are conducting a genetic study called the DodoNA Project. We aim to discover genetic factors that predict how neurological diseases progress in severity and that predict disease outcomes. We aim to use this information to individualize the
care of our patients and to halt the progression of neurological diseases. One of the diseases we are studying is Parkinson’s disease.
We will enroll at least 1,000 Parkinson’s disease patients into the study, and follow them at least annually for several years. To be eligible for the study you need to be new to our Movement Disorders practice within the past year, a resident of Cook or Lake
County and willing to provide a blood sample for DNA extraction and storage. We also require your permission to compare your genetic code with the information that we collect in your medical record.
If you wish to participate, the best thing to do is to request an appointment to be seen as a patient in the Department of Neurology at NorthShore. We can then enroll you into the study after your office visit. You can also support the DodoNA project by joining
forces with NorthShore’s Auxiliary and by supporting the
Hepatitis C, a virus which can lead to chronic liver disease, is spread through contact of already infected blood. Many individuals who are
infected with the hepatitis C virus do not experience symptoms and are not aware of having the virus.
Dhiren Shah, MD, a gastroenterologist at NorthShore University HealthSystem, shares some important information on transmission
of hepatitis C and tips on minimizing your risk:
Who should be screened for hepatitis C?
Is there a vaccine for hepatitis C? To date, there is no vaccine for hepatitis C; however, you should be screened for hepatitis A and B, and get vaccinated if you have not been previously exposed.
What other questions do you have about hepatitis C?
The diagnosis can be hard and may leave you wondering if you’ll ever be able to return to your regular activities. Not everyone
with multiple sclerosis (MS) experiences the same symptoms—ranging from fatigue, numbness, loss of balance and coordination, to speech or muscle problems—and most people with this disease do not suffer paralysis or become severely disabled.
According to the National Multiple Sclerosis Society, more than 2.1 million people in the world are affected by MS. Given that in many cases the signs of MS can be difficult to detect, it’s hard to know exactly how many in the United States are impacted
by the condition.
We do know that for those who do have MS, the journey through the disease can be very debilitating.
Zulma Hernandez-Peraza, MD, neurologist at NorthShore, shares her advice on how to cope with the diagnosis and adapt your life accordingly:
Do you know someone living with MS?
Colorectal cancer is one of the leading causes of cancer deaths in both men and women in the United States. However,
if everyone over the age of 50 were regularly screened, it might be possible to reduce deaths associated with colorectal cancer by as much as 60 percent.
Many women believe that colorectal cancer is a disease that affects more men than women, so they might not be aware of or believe they need to follow current screening recommendations. National Colorectal Cancer Awareness Month this March is the right time
to spread the word that colorectal cancer affects men and women equally and that screening saves lives.
Joel Retsky, MD, Gastroenterologist, shares some important information about colorectal cancer everyone should know, men and women:
If you’re 50 or over and have never been screened for colorectal cancer, make National Colorectal Cancer Awareness Month the month you schedule your first appointment.
Have you been screened for colorectal cancer?
There seems to be a diet out these days to appeal to everyone trying to trim down. And, with the barrage of different diets in the
media, it's hard to know which diets work and which fall short.
What's important in a safe and healthy approach to weight loss? Before starting a diet be sure that your plan includes the following:
It’s balanced. By excluding food groups, your body is at risk of being deprived of the nutrients it needs to function. For example, the popular
Atkins Diet drastically reduces carbohydrates. Carbohydrates are a major source of energy for the cells of the body and also are a main source of your daily fiber needs.
It focuses on portion control. Have you ever seen the MyPlate
icon? MyPlate focuses on portion control and balanced meals by dividing a standard dinner plate into four food groups—fruits, vegetables, grains, and protein, with a side of dairy. Portion control is important to avoid overeating and can help reduce
It teaches lifelong, healthy eating habits. Longevity is impossible with impractical fad diets like The Hollywood Cookie Diet
and The Grapefruit Diet, which severely restrict calories and lack the nutrition (not to mention the variety) that your taste buds crave. By eating balanced meals and controlling portions, weight loss is achievable and can be maintained
throughout your entire life without having to crash diet.
For a healthy, balanced diet with controlled portions always remember to:
Which diet approaches have worked for you?
This article was submitted by Lindsay Sankovsky, Dietetic Intern, and reviewed by Kimberly Hammon, MS, RD, LDN.
Eating healthy and staying healthy is something that millions of Americans strive for every day. Unfortunately, it's not always so easy to eat healthy on a daily basis. With 36% of adults in U.S. considered obese, it's becoming more important for both adults
and children to start eating healthier. The experts from NorthShore University HealthSystem have provided some general guidelines for the recommended intake of each food group, suggestions for creating a healthy meal plan every day, as well as some healthy
Click on our
infographic for more ideas on creating a healthy meal plan with great healthy food substitutions.