Horizon, Host: Ted Simons

January 3, 2006


Host: Michael Grant

New Year Nutrition


  • Research shows that most people gain an average of 5 pounds over the holidays. ASU Nutrition Professor Dr. Carol Johnston joins us to talk about ways to kick off and keep those resolutions.
Guests:
  • David Englethaler - state epidemiologist


View Transcript
>>> Tonight on "Horizon," flu season is in full swing and Arizona is seeing some of the heaviest flu activity in the nation. If you haven't had your flu shot yet? Is it too late? Plus is to improve your health, reduce your weight on your list of New Year's resolutions, we have ways to get started. And plans to form an alliance of organizations to better diagnosis and treat autism. Those stories next on "Horizon." Good evening. I'm Michael Grant. Arizona is one of four states currently experiencing what is called widespread flu activity in the last couple of weeks. The number of lab-reported flu cases in the state has tripled. As of today, there are more than 1400 of those cases. Hospital emergency rooms are strained, schools and businesses feeling the impact. Here with the flu update is state epidemiologist David Englethaler. Happy New Year to you.

David Englethaler:
Happy New Year to you, Michael.

Michael Grant:
I want to say it was, yeah, about two weeks ago when seems like flu is breaking out all over.

David Englethaler:
Certainly in Arizona and throughout the southwest. It's really where it's hitting first this year. It's been about two or three weeks we have seen an escalating number of cases in Arizona. There's plenty of flu activity out there.

Michael Grant:
Is widespread actually -- is that a term that engages flu activity?

David Englethaler:
It's an official term. We look at four different levels. We look at local activity, sporadic activity, regional activity and widespread and those all refer to the level of activity within the state. And all the states follow these. And Arizona is really jumped from local all the way up to widespread in the last few weeks. And it's a pretty dramatic jump and watching the cases double and triple over the past couple of weeks is not necessarily alarming but certainly a good sign that there's intense flu activity throughout the state.

Michael Grant:
I was going to say those terms sound to me to be pretty self-explanatory but I would assume that widespread means that you are having problems in flagstaff and you are also having reported cases in sierra vista.

David Englethaler:
We are seeing pretty much cases in every county in the state right now is being reported to us. So through the four corners of the state there's lots of flu going on.

Michael Grant:
Now, what kind of flu is it this year?

David Englethaler:
Well, there's two main types of flu that affect humans. Influenza A and B. Influenza B-A is more common. 98\% of what we are seeing is influenza A. that's the same around the country. The vaccine seems to be covering the strains of flu that have been typed but there's always that outside chance there might be another strain out there might pop up that, 20 cause the season to become worse so we are watching that pretty closely.

Michael Grant:
How does that compare to last year, David?

David Englethaler:
Last year if you remember, we had the flu vaccine shortage but thankfully we had a very late flu season. It didn't really hit us until February, March. It was very mild. Right now we are way further ahead than we were last year. And actually, then, further ahead than in several previous years.

Michael Grant:
Is there any way to know what it is that gives us a last year where you have it late and less severe, and this year where you all of a sudden it just went up like a rocketship couple, three weeks ago?

David Englethaler:
It's difficult to predict. Sometimes you can tell by the end of one season what may be happening but what's a better predictor what's happening around the world in other parts of the world prior to the flu season hitting here. We didn't really have any indicators to tell if we were going to have a serious or severe season this year. But it really did hit us with a wallop and it hit in California and Arizona first and that's pretty unusual. It usually hits the east coast and moves its way west but this year it's, we are first on list and it will move its way throughout the rest of the country.

Michael Grant:
We mentioned southwest and western portions of the country. So it is, it's now moving east?

David Englethaler:
Yeah. We are really seeing cases all over the country but we are seeing local and sporadic activity, whereas Arizona, California, New Mexico and Utah have this widespread designation where they are seeing it throughout the states and it stay that way for several weeks until we get to the top of the peak and then it starts to drop off. We don't know what this is going to happen but we will have flu activity for the next several months in Arizona.

Michael Grant:
If you have not yet gotten flu shot, is there a reason to do so?

David Englethaler:
Yeah, absolutely. Especially if you are at high risk for serious illness or death we know flu is going to be here for some time. As I mention for a few more months so it's in the too late to go vaccinated. We urge those who have high risk, chronically ill, elderly, very young children, those people have been vaccinated with especially with the amount going on.

Michael Grant:
It does take some time, though, to develop the immunity, does it not, after you get the shot?

David Englethaler:
Two to four weeks depending on your immune system to develop full immunity but you are a step ahead of when you get exposed to flu down the line and again you could get exposed a couple months from now and getting vaccinated now will certainly help protect against that.

Michael Grant:
We had talked about this a few weeks' back but still adequate supplies of the vaccine?

David Englethaler:
Yeah. I think there's probably some areas of the state where there's lower amounts of vaccine than others. There's plenty of supplies here in the valley and in other parts of the state that we hear about. Down in Tucson and Pima region they have used up a lot of supplies they have had and they are still waiting for more to come in. We heard more is on its way. We are not in any kind of shortage. There's still plenty vaccine. We urge them to get vaccine. Relatives and family members of individuals who have high risk. But that's only one piece of it. I think a much better and more important piece is that people really got to make sure they are washing their hands and using hand sanitizer doing things to help spreading flu. If you get sick you have a civic responsibility that you are not affecting your neighbors. So really stay home from work, stay home from school if you are sick. Especially if you have been identified with their influenza until you don't have symptoms. This will help prevent spread.

Michael Grant:
One of the things you have been working on during the holiday season is the conference coming up this Friday called "Arizona Prepares." tell us about that.

David Englethaler:
This is actually a pretty exciting summit meeting we are putting on. The secretary of health and human services, Michael Leavitt, will be coming out along with the directors for centers for disease control and we are holding a summit. Really it's almost like a town hall. We are trying to bring in those community members that may not have been involved in planning. We have been doing a lot of government planning. We want to do community planning and preparedness so business, schools, individuals and families, church, the faith-based organization, volunteers, all of those individuals are going to be part of this summit meeting that's going to be held on Friday at the Orpheum theater.

Michael Grant:
We have the information on it including a website address up on the screen. Targeted specifically, David, toward what sorts of issues?

David Englethaler:
It's really targeted towards the community and about, I should say it's really about pandemic influenza preparedness. It can relate to other disaster preparedness but we want to make sure that Arizona is prepared as it can be to deal with the pandemic should one occur. We are not expecting one to occur. We are not in the middle of one now but should one occur we need to be as prepared and that means making sure the community is prepared, not just the government. It's going to take everybody responding together so we are targeting the businesses, the schools, and again individuals and families and what everybody can do to not only prepare themselves but prepare their communities.

Michael Grant:
Conference itself open to the general public?

David Englethaler:
It is. It's going to be limited to seating so first come, first served, and the information you showed up on the screen shows people how toke find out more information about the conference.

Michael Grant:
All right. David Englethaler, thanks very much for the flu update and best of luck on the conference on Friday, "Arizona Prepares." Research shows most people, including myself, gain an average of five pounds over the holidays. Then losing weight becomes a top New Year's resolution. But how to drop the pounds and keep them off is often a challenge. Hidden calories in eating out can sabotage a diet. Sometimes filling an oversized plate or bowl can have us unknowingly eating too much. In a minute, more on some ways to control what we eat. First Merry Lucero looks at how food package labels can help.

Merry Lucero:
After the holiday splurging, one of the most common New Year's resolutions is to lose weight. To get an idea where to begin, I spoke with Amy Hall, a certified nutritionist who practices in Tempe and works with mountainside fitness to counsel members on their diets.

Amy Hall:
What I first do is look at their food diary and see what they are doing. A lot of times people come to me thinking they are doing things completely healthy and I am like their last resort. I can't figure out what's wrong and soon as we go over it we realize how much height flour they are having, how much saturated fat, eating things that seem like things they are healthy just based on food labels.

Merry Lucero:
Nutrition experts say a good way to begin to get a handle on your food intake is portion control.

Amy Hall:
With my clients just even the first week or two what I have them do is say, you know what, pour yourself a bowl of cereal. Pour yourself a dish of pasta and go back and measure and how many serves you have base on the label. We were talking with the granola cereal. This is about a cup. Ok. Most people usually if they are pouring themselves a bowl of cereal. We poured it in this bowl. This is, granted, a big bowl but most people fill a cereal-sized bowl or this sized bowl and then they feel like they didn't get anything. This is a serving. But if you took the thing straight off the here and started pouring it you would end up with a lot more and refill it and not think twice but when you look at the label there's 250 calories in this bowl right here.

Merry Lucero:
Do you find in your practice people pay attention to the nutrition guidelines or the packaging or do they not even look at the serving size and they just ignore what's on the cereal box?

Amy Hall:
I don't think they ignore the labels. I think they look at the calories and look at the fats. But they don't look like the serving size and how many servings are in a container. They will take a candy bar or a nutrition bar and they will think they are getting one serving. They you would double everything that's in that package and that's the part that's most deceptive and that's just marketing tactics. But when people learn how much is in a serving of their favorite food it makes a big difference how much they want to eat or if they actually want to eat that particular brand of food.

Merry Lucero: To experiment, we asked people at the gym to pour themselves a bowl of cereal. The oat cereal came in at nearly two cups. Two servings. A serving of granola is half a cup. The amount poured was just a little more than that. And that is without the milk.

Amy Hall: You add the milk and then it puts like about 350 calories in. And then if you have anything to drink or if you have a piece of fruit to round it out you are well over into 500 calories at breakfast time. And granted some of it might be healthy, but if you look at sugar content you might not be getting what you think you are. You are still hungry an hour later. You are still hungry because you didn't get that much or the right combination of foods.

Merry Lucero:
For cereal hall recommends using a smaller bowl and adding a serving of fruit and a tablespoon of almonds to have a more balanced meal. Just one of many ways to help keep that New Year's resolution.

Michael Grant:
Here with more good ways to keep track of what we are eating is Dr. Carol Johnston, a professor of nutrition at Arizona state university. Happy New Year to you. Ok. The standard resolution is, I am going to eat less, and I am going to exercise more. Can you give --

Carol Johnston, Ph.D.:
That's pretty overwhelming I think for a lot of people. It's great advice. Most people do need to eat less and exercise a little more but most people don't know where to start. And so my suggestion I was going to offer a couple suggestions how people can target their resolution a little tighter.

Michael Grant:
Sure.

Carol Johnston, Ph.D.:
One, this is all based on quite a bit of scientific evidence. There are a couple tricks that people might want to know and one is, sugared beverages. People consume quite a few sugared beverages every day and they have quite a few calories and for example, 12-ounce can of coke is 150 calories. And so if people could just make the resolution perhaps to eat less sugared beverages that would help.

Michael Grant:
You know what I think misleads a lot of us particularly if it's a fruit drink. Let's put Cokes or Pepsis or your weapon, your beverage of choice to one side. But if it's a fruit drink you think, hold it, it's good for me. It can contain a ton of sugar.

Carol Johnston, Ph.D.:
That's right. That's absolutely right. And interesting, a little bit of scientific information here, what's interesting people could not compensate for those calories and so if I gave you, say, a piece of birthday cake at 11:00 in the morning to celebrate somebody's birthday and you had that piece of cake, say, that was 200 calories. When you go to eat lunch an hour later, you will compensate for most of those calories just intuitively. Some of it's probably cognition, some of it's probably your gastric release of different molecules. But you will compensate for most of those calories. But if you drank 200 calories of soda at 11:00 in the morning, you would go off to lunch and not compensate for those calories. And so we think -- nutritionists think that's a great place to target is to be more aware of drinking calories and to try to drink more water or more tea, or even the artificially sweetened beverages.

Michael Grant:
Or ice water.

Carol Johnston, Ph.D.:
Exactly.

Michael Grant:
If you can --

Carol Johnston, Ph.D.:
Ideally, right. Right.

Michael Grant:
Right. All right. Exercise more. Particular tips on that? Again a lot of --

Carol Johnston, Ph.D.:
I think people are a little overwhelmed because they are expected to go to the gym and it can be a lot simpler than that. 20 minutes of walking is about 100 calories. And so what I tell people is just walk 20 minutes in the morning and walk 20 minutes in the evening. And if you complement that with eating one or two or drinking one or two less beverages there's 400 calories right there for you. And that's usually what people are over consuming. This gradual weight gain we are seeing in people.

Michael Grant:
Right.

Carol Johnston, Ph.D.: --
Is usually due to only 200 or 300 calories a day. If you can drink 200 less calories and walk 20 or 40 minutes a day, you can easily achieve what you need for a gradual weight loss.

Michael Grant:
Is the regularity of the exercise important, too? I mean, obviously any exercise is good. But --

Carol Johnston, Ph.D.:
Right. What I am suggesting is something you could do every day. Because I think going to the gym is overwhelming to a lot of people. But most people can get out and walk around the block, and if they just walk briskly like I said, twice a day, 20 minutes each time, that's two, 300 calories. And I don't think it's overwhelming.

Michael Grant:
How do you know what your ideal weight is? And how frequently should you monitor that? How often should you get on the bathroom scales?

Carol Johnston, Ph.D.:
I think you should weigh yourself regularly because I think it helps people to know if they are creeping up in their weight. And you really have to keep track of that. I think it's a good idea to weigh several times a week. And maybe to mark it down and just keep track because over several months, if your weight is going up slightly and it's going up a pound a month or after six months you are a couple pounds, three, four pounds heavier, you need do something about that.

Michael Grant:
What about the ideal weight itself? Are many of the things we hear fairly accurate in terms of --

Carol Johnston, Ph.D.:
Yes. What I suggest is people calculate their B.M.I., which is body mass index. And you can go to a website to do that. The CDC has websites so if you go to the computer and google body mass index, you will come up with a site that will do the calculation for you. It asks you your height and your weight, and it will calculate your B.M.I. and then it will compare it to the standards. People should have a B.M.I. less than 25.

Michael Grant:
Ok. Now, I think surveys show that most of us eat out at least a couple of times a week. Do I --

Carol Johnston, Ph.D.:
My guess it's more than that.

Michael Grant:
That's -- I said at least.

Carol Johnston, Ph.D.:
Right.

Michael Grant:
Do I give up eating out or are there ways that I can eat out but do it more smartly?

Carol Johnston, Ph.D.:
I think people should be advised to maybe eat out twice a week. In other words, to keep it at a minimum. And I am including carrying in. So eating food from outside the home to twice a week. We do that much more often than twice a week. If you think about lunch, people eating lunch or getting snacks from vending machines, if you can sack your lunch, prepare a lunch, take it to work, take your snacks with you and make the resolution to only eat food away from home several times a week, you would be fine. If you would limit it to that. When you do eat away from home portion size as we saw just a minute ago, portion size is probably the big it is culprit.

Michael Grant:
Do most restaurants give you too big a portion? I mean is the kind of thing where you need to affirmatively I need to leave a third of this?

Carol Johnston, Ph.D.:
Let them give you those portion sizes but half of it goes home with you. Make that, make that point when you first get your food that you would like a doggy bag and divide nit half and put half in the doggy bag and off meal for your next meal. So you don't have to eat everything they put in front of you.

Michael Grant:
More and more restaurants have gone to some information, you know, on the menus and those kinds of things about, oh, you know, heart healthy, other information.

Carol Johnston, Ph.D.:
Right.

Michael Grant:
Is that -- is that good, accurate information?

Carol Johnston, Ph.D.:
Oh, oh.

Michael Grant:
I wonder --

Carol Johnston, Ph.D.:
I would say it's probably accurate. I think it's good that people need to be more aware of what they are eating. They need to understand where the fat is, where sugar is and salt is. If you are only going to go out to eat once or twice a week I would say go out and enjoy it but only eat perhaps half of what they put in front of and you take the rest home. I think that we can enjoy going out to eat if we limit it to several times a week. And the rest of the week, you know, cook at home. Learn to prepare foods at home. Take your lunches with you. And then when you do go out and eat on those special occasions you can go ahead and eat what they serve you but perhaps only half of what they serve you.

Michael Grant:
And I suppose be realistically, realistic in your goals. Don't think you're going to knock off, you know, 15 pounds in the next --

Carol Johnston, Ph.D.:
That is so true. Your goal should be a year from now. January 1,2007, what do you want to weigh? And maybe it should be 10 pounds less than today. And that should be your goal.

Michael Grant:
Dr. Carol Johnston, thank you very much for the tips. I am going to try.

Carol Johnston, Ph.D.:
Good luck. And happy New Year.

Michael Grant:
Autism is reaching epidemic proportions in this country. Treatment offer requires a myriad of experts from speech therapists to behavioral experts. Finding resources and care often an overwhelming task for parents with autistic children. Now as Pam White reports, help may be on the way.

Andrea Taube:
Imagine going to a foreign country without a road map or travel map, nothing. You don't know the language, where to go for help. That's how we felt.

Pam White:
Andrea says her son was in perfect health when he was born. But after receiving a round of immunizations when he was 13 months old, he was never the same.

Andrea Taube:
Everything went downhill. He is not talking anymore. Very quiet. He started flapping, spinning, spinning meaning, you know, rearranging whatever he is looking at. Over here.

Pam White:
After doing their own research and consulting different doctors, the family's worst fears came true.

Andrea Taube:
It's my life has never been the same. Come here. It's ok.

Pam White:
In December 2003, Lucas was officially diagnosed with autism.

Andrea Taube:
It's really hard. My marriage is difficult. I have another son. I have my own life. And Luke's life. All four of us are affected by it every single day.

Pam White:
Autism is a developmental disability that can severely affect a person's ability to communicate and socially interact with others.

Andrea Taube:
It's a mixture of emotions really. Most of all, the number one feeling was helplessness. I don't know how to help my son. I don't know where to start.

Dr. Pamela Crook:
And with the spectrum, each individual needs a different kind of treatment. What works for one may not work for the next so you really have to think about what's important for that particular child.

Pam White:
Dr. Pamela Crook is a speech pathologist who has worked with autistic children for more than 13 years.

Dr. Pamela Crook:
There's no one place where parents can find out what's happening so lieutenants say your pediatrician says your child may have autism. Then what's the next step?

Andrea Taube:
Everything has to be ordered on the Internet. Everything has to travel to Phoenix to get it. You know, you have to be in a waiting list to be able to see a doctor.

Dr. Pamela Crook:
Once you get the diagnosis, then the issues really start to happen. What do I do?

Pam White:
If you don't know someone with autism, you will soon. It's become the fastest growing developmental disability in the nation.

Dr. Pamela Crook:
It is growing. It's growing at a rapid rate. I think the centers for disease control says it's about one in 250 live births and this was in 2003. Those are their latest statistics. It continues to increase. It's to the point of epidemic proportions.

Pam White:
How is a child diagnosed and treated in Tucson?

Jaswinder Ghuman, MD:
The parents are suspecting something is going on. Parents are, of course, have always suspected something going on but somehow the child was never really recognized.

Pam White:
Dr. Jaswinder Ghuman is an authority on autism. She moved here after practicing in Maryland.

Jaswinder Ghuman, MD:
Seems to me that things in Tucson are not up to par with other, some other places.

Pam White:
Autism ranges from those who are severely affected to those who can lead highly functioning lives. Andrea says Lucas's condition is in the mild to moderate range.

Andrea Taube:
It's always a guessing game. It's, if you -- when you communicate with your child, you know, it's simple. Verbal. You still do a little, you know, psychological manipulation, you know, with your questions. But to this child it's always, you have to find, like that. Ok. He will cry. You have to figure, what do you want? You have to think. You guess.

Pam White:
But no matter where they are in the spectrum, all people with autism usually have problems in three areas: communication, social relationships, and restricted patterns of behavior. So treatment requires experts from a variety of disciplines.

Jaswinder Ghuman, MD:
And not just my sitting in my office and a speech pathologist in their office and another person sitting in their office. We really need to come together and figure out what's the best way to help this child.

Pam White:
Now plans are on the table for an autism center, a place where parents and their children can get all the help they need.

Dr. Pamela Crook:
We are a group of three not for profit who have combined forces with the University of Arizona speech and language clinics and we are all coming together for one reason and that's to better serve individuals with autism. In Tucson and the surrounding area. And our center will have a multidisciplinary diagnostic focus so we will have a child psychiatrist working with the speech pathologist and a psychologist, occupational therapy, physical therapy, nutritional counseling. We will all come together in one place to do a diagnostic session or a number of sessions. That will give the parents all kinds of information and that will guide the treatment. And that's, that's the piece that makes us novel, unique.

Pam White:
No one knows what causes autism. Hopefully soon there will be answers. In the meantime, because autism is such a complex disability, those who are affected by it and their families need all the support and resources they can get.

Andrea Taube:
The earlier the diagnosis, the earlier exposure your child or your daughter or son to treatment, the better they get. I mean, some people are even recovered, recovered. Meaning they lead normal lives. They are in mainstream schools. You can't even tell they are autistic.

Mike Sauceda:
2006 edition of the state legislature is about to gather at the state capitol in phoenix. What lies ahead for this year's session, two house leaders, one republican, one democrat, sit down to talk about their priorities for the next few months. That's Wednesday at 7:00 on Horizon.

Michael Grant:
On Thursday we will talk about the drought and its ongoing effects on the state and on Friday, of course, the journalist roundtable edition of Horizon. That's very much for joining thus evening. I'm Michael grant. Have a great one. Good night.

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