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youth fitness program, childhood obesity, nutritional education, Registered Dietitian, weight loss, child, weightParents who struggle to get their children to eat more fruits may want to try offering more apples.

This simple fruit, which comes in a variety of flavors and colors, was by far the most favorite fruit of more than 3,100 children ages 2 to 19 surveyed for a study recently published in the journal Pediatrics.

The study also found that most children are not eating nearly enough fruit in their diet. Only four in 10 children under the age of 18 ate the recommended one to two cups of fruit every day, according to the study. Furthermore, one-third of what counts as fruit came from drinking 100 percent fruit juices.

Drinking juice might not be as unhealthy as drinking soda, but too much juice can cause children to easily gain weight because it’s packed with sugar and calories. Consistently drinking juice can also hinder efforts for many children trying to lose weight. Although many parents are well aware of childhood obesity,  more than one-third of children and adolescents continue to be overweight or obese, according to the federal Centers for Disease Control and Prevention.

The findings highlight an important challenge for parents. Not only are fruits an important source of nutrients for children that promote health and protect against chronic disease, but they also are associated with a decreased risk of diabetes, stroke, cancers and other deadly conditions, according to the American Academy of Pediatrics.

Researchers discovered that over half – 53 percent – of fruit consumption came in the form of whole fruits, which have the greatest health benefits. Apples, apple juice, citrus juice and bananas were responsible for almost half of total fruit consumption, according to the study.

Apples comprised about 20 percent of fruits consumed while apple juice accounted for 10 percent.

The remaining top choices for fruit included:

  • citrus juices
  • bananas
  • melons
  • berries
  • citrus fruit
  • fruit salads
  • grapes
  • peaches
  • nectarines

Source: American Academy of Pediatrics

+ Does your child need help losing weight or understanding the importance of good nutrition? At Bon Secours In Motion, we provide children with the opportunity to learn how to have a healthy lifestyle through our Youth Fitness program, which promotes physical fitness and nutritional education in a safe and fun environment.

Pregnancy, Weight Gain, Childhood, Obesity, Risk, PreventionPregnant women experiencing back pain may find some relief through exercise.

In fact, physical exercises before and during pregnancy can be effective in preventing and reducing low back and pelvic pain, according to a news release from the American Academy of Orthopaedic Surgeons.

Hormonal changes during pregnancy can affect a woman’s muscles, ligaments, bones, and joints that make up the musculoskeletal system.

According to a new literature review in the September issue of the Journal of the American Academy of Orthopaedic Surgeons, these hormonal changes during pregnancy can cause many joints to flex beyond normal limits due to ligament laxity, weight gain, and a shift in the body’s center of gravity.

Indeed, the impact on the spine can accentuate low back curvature and thrust and tilt the pelvis forward, causing pain.

Low back pain is a common medical condition associated with pregnancy; nearly half of pregnant women experience it. As ligaments which connect bones to each other stretch and the uterus expands as the baby grows, they put excessive stress on the spine and pelvis.

This can lead to low back pain, pelvic girdle pain, or both, said study author Zbigniew Gugala, MD, PhD, in a news release.

“Low back/pelvic girdle pain is especially common in pregnant women who are older, overweight, or have a history of back pain during a previous pregnancy,” Gugala said. “Women who already have joint hypermobility or are bearing more than one child at a time are also at higher risk.”

However, so far, the correlation between lumbopelvic pain and maternal weight gain during pregnancy or birth height or weight of the newborn has not been established. While pain typically begins at the 18th week of pregnancy and ends between the 24th and 36th weeks of pregnancy, many women, continue to have back pain after delivery.

“About half of women with low back pain during pregnancy continue to experience pain after delivery, sometimes for up to a year,” Gugala said. Pain management during pregnancy is usually focused on conservative treatments.

“Physical exercises before and during pregnancy can be effective in preventing or reducing low back and pelvic pain. But before beginning any exercise regimen, the expectant mother should check with her doctor,” Gugala said.

To help reduce the risk of low back pain and pelvic girdle pains during pregnancy, women should ask their doctor about correct posture, relaxation techniques and how to avoid sudden movements that could lead to extreme joint stretching in the spine and pelvis.

Exercise can also be helpful. Pregnant women should remain active by continuing normal daily activities and work, if possible. Daily routines should incorporate supervised flexibility, stretching, and muscle-strengthening exercises.

Source: AAOS news release

+ Learn about the physical therapy program at Bon Secours In Motion specifically tailored for pregnant women experiencing pain.

This blog was written by dietitian Judy Mitnick, MS, RD, CDE, CSSD.

Let’s face it: we live in a fast-paced, stressed-out world.  Some stress is vital to being a productive member of society.  We all need goals and deadlines, but excessive stress over time leads to anxiety, illness and hurts us in our efforts to improve our health.

In fact, overeating and/or eating unhealthy foods are two of the top reported habits Americans note as a result of stress. All of these extra calories are sure to lead to weight gain.  Additionally, the stress itself produces changes in the body’s hormonal balance, leading to hormone-induced cravings for high-fat, high-sugar foods (comfort foods) and the storage of fat, particularly abdominal fat. It can become a viscous cycle!

While we can’t eliminate all of the stress that faces us every day, we can plan ahead to address many of the stressors that can literally make us sick and tired.  Experts talk about the four A’s of stress management:  Avoid, Alter, Adapt, or Accept. Every situation may warrant a different management strategy (one of the “A’s”).

One example:  If getting to work on time is always stressful due to traffic, altering the route or leaving earlier can reduce this stress. Similar strategies can be used to directly address the overeating that can result from stress.  Some examples include:

  • Regular eating during the day:  A stressful day followed by a traffic filled ride home is a recipe for “pigging out” as soon one walks in the door from work.  Bringing food for lunch as well as a late afternoon snack containing some protein can at least take hunger out of this equation.  Good snacks include a yogurt, a small container of Hummus and raw carrots, or a piece of fruit and a string cheese stick.
  • “Decompressing” before entering the kitchen! :  By making a habit of taking at least 15 to 20 minutes to “switch gears” from work to home mode, one is less likely to inhale food as a way to calm down.  As above, this is easier to accomplish if that snack with protein was consumed close to quitting time.  This gear switching might be accomplished by changing into comfortable clothes, taking a bath, or even going for a short walk outside.  A more relaxed (and not starving) person is much more likely to make healthier food choices and eat reasonable portions than one who is famished and fried!
  • Practicing mindful eating and adding some accountability to eating: So many of us tend to “check out” when we are eating, especially if we are eating in response to stress or after a stressful day.  Keeping a food journal or using a phone app to record what is eaten ( right as it is eaten or right after), pulls us back into the moment and refocuses us to what we are about to eat.

Stress is a part of life that isn’t likely to ever completely go away.  Managing overall stress and awareness of our eating responses to stress can help minimize the negative effects on our health and our waistlines!

Alex KThis blog was written by Alex Kenefic, Registered Dietitian, at Bon Secours In Motion Physical Therapy and Sports Performance.

You need to eat well to fuel your top performances in races. Try out these tips to do your best at any distance:

For all exercise

High intensity, short duration athletes have different nutrition needs from endurance athletes.  General healthy nutrition, however, is important for both.  You need to eat enough calories from high quality carbohydrates, proteins, and fats will ensure healthy training and top performance as well as proper repair and replenishing after exercise.

Hydration is essential to all types of exercise as well.  Dehydration decreases muscle strength, power, and endurance.  During training, weigh yourself before and after a run so you can replenish 24oz of fluid for each pound lost.  Having sips of a sports drink every 15-20 minutes during activity will also help prevent hyponatremia, or overhydration.

1 mile, 5K, and 10K

Carb loading is unnecessary for exercise less than 45 minutes.  Eating a small carbohydrate snack can help for a 45-90 minute workout and is most helpful for exercise that is 90 minutes or longer.  This snack could be fruit, a granola bar, whole wheat crackers, or dry cereal.

Half Marathon, Full Marathon, Ultra-Endurance Races

Long-race athletes have higher carbohydrate requirements before, during, and after exercise.  An average male marathoner consumes 8 grams of carbohydrates per kilogram of body weight per day. This would equal 654 grams of carbohydrate spread out during the day for a 180 pound (81 kilogram) person.

Choosing quick and easy carbohydrates will make eating this large amount more tolerable.  Choose compact, low-fiber forms particularly on race day such as pasta, white rice, sports bars/gels, and high carbohydrate drinks (juice, chocolate milk, smoothies).  Avoid high fiber foods like beans, whole grains, and produce on race day to prevent gastrointestinal problems.

Carb loading three days before a race can be an effective way to store more available energy in the form of glycogen in muscles and liver.  Glycogen is stored with water, so don’t be alarmed if you feel stiff or heavy during this time. The feeling usually goes away with exercise.

Protein needs are increased as well during high intensity and high duration training, particularly after exercise for muscle repair and growth.  Choose lean proteins such as deli chicken or turkey, Greek yogurt, tuna, eggs, or low fat cheese.

Experiment with different food combinations and timing of meals during training.  Do not try anything new on race day.  Every athlete is different; find what works or your body and your activity.

+ Get a personalized nutrition plan from one of our registered dietitians! 

Ricasa Jocelyn MD portraitThis blog was written by Jocelyn Ricasa, MD, sports medicine physician at Bon Secours Medical Associates.

You have been happily hitting your stride and then it seems like with every step, your stride has started to hit you back on the outside of your knee! What causes that pain?  It might just be a four-letter diagnosis that all runners hate to hear: ITBS, or Iliotibial Band Syndrome.

The iliotibial band is a strip of non-flexible tissue that starts from a muscle on the outside of the hip, runs down the outside of the thigh, past the end of the femur (thigh bone), past the outside of the knee, and finally inserts on your tibia (shin bone)  just below the knee.  Yes, it is a really long strip of tissue!   As the knee bends and straightens, the IT band slides back and forth over the bony prominence on the outside of the end of the femur.

The main symptom of ITBS is pain on the outside of the knee, which stems from the friction of the IT band snapping back and forth. Runners also hate the word “friction!”

How do you fix it?  Start with the usual four-letter treatment:  RICE (Rest, Ice, Compression, Elevation).  Scale back on the training, and seek professional help sooner rather than later, so it doesn’t hold you back.

How do you prevent it?  Train smart. Run on level surfaces (watch those banked roads!), alternate which way you run around the high school track, augment your running regimen with cross-training, and get professional help when choosing your footwear.  Happy IT bands = happy runners!

youth fitness program, childhood obesity, nutritional education, Registered Dietitian, weight loss, child, weightChildren who are overweight and struggle to lose weight may face another serious issue: bullying.

Parents across four nations all agree that the No. 1 reason children are bullied is because they have a  weight problem. Being overweight was perceived to be a more common reason for bullying than a child’s race, ethnicity or religious beliefs, according to the survey of 3,000 adults.

Roughly one-third of American children and adolescents are considered to be overweight or obese, according to federal statistics.

Children who are bullied can suffer physical injuries, social and emotional distress and even death, according to the federal Centers for Disease Control and Prevention. They may become depressed, have anxiety, sleep problems and poor school adjustment. Adolescents who bully others face a higher risk for substance abuse, academic problems and violence later in adolescence and adulthood.

The survey was conducted in the U.S., Canada, Iceland and Australia because researchers said these countries have comparable rates of obesity as well as similarities in societal factors such as the way each culture values thinness.

“Given high rates of childhood obesity in these and many other countries, both school-level and policy-level remedies may be needed to address weight-based bullying on a broad level to improve quality of life for youth with obesity,” said Rebecca Puhl, Ph.D., the study’s lead author, professor in the Department of Human Development and Family Studies at UConn, and Deputy Director of the Rudd Center.

The study, published in the journal Pediatric Obesity, also found:

  • At least 70 percent of survey participants across all countries perceived weight-based bullying in youth as a common problem.
  • At least 69 percent across all countries viewed weight-based bullying as a serious or very serious issue.
  • Between 75 and 87 percent of participants across countries agreed that school-based efforts should promote awareness about weight-based bullying and implement policies to better protect students from weight-based bullying.
  • At least 74 percent across countries supported government efforts to strengthen existing anti-bullying laws to include provisions to address weight-based bullying.

“Our findings echo recent research from the U.S. showing that parents favor strengthening school-based policies and state laws to address weight-based bullying,” Puhl said. “The time may be ripe to implement school-level policy changes to ensure that vulnerable youth are protected.”

Source: Rudd Center for Food Policy & Obesity at the University of Connecticut news release

+ Learn about the Youth Fitness Program at Bon Secours In Motion, which promotes physical fitness and nutritional education in a safe and fun environment. Our team of experienced sports performance specialists, physical therapists, athletic trainers, and nutritionists have the training and expertise necessary to help young kids achieve their health and fitness goals.

Bon Secours In Motion, female athlete triad, injury, risk, bone, stress, Female athletes – no matter their age – who have low energy levels and abnormal menstrual cycles may be at risk for bone stress injuries and fractures as well as sports-related injuries, according to a new study.

The symptoms  – known as “the female triad” – include feeling like you have very low energy levels, experiencing menstrual cycle abnormalities, and having low bone mineral density, said orthopaedic surgeon Elizabeth Matzkin, MD, lead author of the study. The study appears in the Journal of the American Academy of Orthopaedic Surgeons.

“Low energy availability can mean taking in inadequate calories or expending more energy than the body is designed to do,” Matzkin said. “It can result from poor nutrition or eating habits or any type of eating disorder. Any combination of these conditions can lead to premature bone loss in females.”

Both athletes and non-athletes participating in any sports and exercise can develop symptoms of the female athlete triad, according to a news release from the American Academy of Orthopaedic Surgeons. The concern for female athletes is that as the number of symptoms increase, so does their risk for sustaining a bone stress injury.

According to the study, the increased risk is substantial:

  • 15 percent to 21 percent with one symptom;
  • 21 percent to 30 percent with two symptoms; and,
  • 29 percent to 50 percent with all three symptoms.

The study authors also found that female athletes diagnosed with poor nutrition or low energy availability are two to four times more likely to sustain a sports-related injury. Female athletes who self-reported menstrual cycle abnormalities had a nearly three times greater risk of a bone and joint injury.

“Proper nutrition and energy balance are key to staying healthy in athletes of all ages. But maximizing bone health when you are young is paramount to your bone health later in life,” Matzkin said. “It is important for young females to maximize their bone density until about the age of 25—anything lost before then cannot be regained. After age 25 we can only hope to maintain what we have.”

The findings apply to millions of women and girls who play sports. Participation in sports by women and girls has increased from 310,000 individuals in 1971 to 3.37 million in 2010, according to the AAOS. At the same time, sports-related injuries among female athletes have skyrocketed.

As participation in sports by women and girls continues to increase and become more competitive, it is important to prevent, diagnose, and manage the components of the female athlete triad, the study concludes. Although the female athlete triad poses a great health risk, the benefits of participation in sports significantly outweigh the risks.

“Any athlete who falls under the ‘umbrella’ of the triad should be questioned by their physicians and educated regarding all of the components and potential health risks of this condition. By preventing premature bone loss in young female athletes, we can potentially prevent future fragility fractures,” Matzkin said.

Source: American Academy of Orthopaedic Surgeons news release

+ Learn about the Benefits of Arthroscopic ACL Reconstruction Surgery. Considered the “gold standard” for ACL injury, arthroscopic surgery allows surgeons to visualize injuries more clearly with minimal disruption to surrounding muscles and joints.

+ Will you be recovering at home from an orthopaedic surgery? Read about physical therapy programs at Bon Secours In Motion.

Woman jogging by lakeExercising and playing team sports as a teenager can have long-lasting benefits for women, a new study shows.

In fact, exercising during adolescence may even reduce the risk of dying from cancer and other causes later in life.

A large study, which included about 75,000 women in China, has found that women who exercised up to 80 minutes weekly as adolescents had a 16 percent lower risk of death from cancer and a 15 percent lower risk of dying from any causes.

Exercising for 1.3 hours a week had a positive impact, according to the study, published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Even greater benefits were seen for women who continued to exercise as adults — they enjoyed a 20 percent lower risk for death from all causes.

“Our results support the importance of promoting exercise participation in adolescence to reduce mortality in later life and highlight the critical need for the initiation of disease prevention early in life,” said Sarah J. Nechuta, MPH, PhD, assistant professor of medicine at Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center in Nashville, Tennessee.

Although the study shows an association between exercise and a lower risk for death, it does not prove that exercising leads to lower mortality, researchers said. Further studies are needed.

The research adds to an ever-growing list of potential benefits for exercise. Not only can playing sports help children build their confidence and improve their self esteem, but exercise may also improve school performance and help teens maintain a healthy weight.

Nechuta noted that “understanding the long-term impact of modifiable lifestyle factors such as exercise in adolescence is of critical importance and can have substantial public health implications for disease prevention over the course of life.”

Source: American Association for Cancer Research

+ Does your child need help with exercise and nutrition? At Bon Secours In Motion, we offer a youth fitness program to help children learn about choosing healthy foods and how to make exercise fun.

Although eating more fruits and vegetables adds nutrients to a person’s diet, reduces their risk for disease and helps manage body weight, very few American adults are including them at mealtime.

In fact, only one in 10 American adults actually eats the recommended daily amount of fruits and vegetables, according to a report from the federal Centers for Disease Control and Prevention. Federal researchers interviewed hundreds of thousands of Americans in a 2013 telephone survey to collect the data.

FAN9007030Health authorities say the problems vary across the country with some states faring betters than others. Virginia matched the dismal national averages with 13 percent of adults meeting the fruit recommendations and only 9 percent eating enough vegetables daily. Californians reported eating the most fruits (18 percent met the guidelines) and vegetables (13 percent).

The findings come at a time when doctors and Registered Dietitians have been urging people to replace salty, fatty and sugary foods with fruits and vegetables – much healthier choices.

How much fruit and vegetables each person needs per day depends on their age, gender and level of physical activity. A good rule of thumb is to make half your plate – at every meal – fruits and vegetables.

The problem could be addressed by promoting fruits and vegetables in grocery stores and restaurants and making them more accessible in community settings and at work, federal health officials wrote in their report.

“For example, work sites can make it easier for employees to make healthy food choices and create social norms that support healthy eating by creating policies to ensure that fruits and vegetables are provided at work-site gatherings, including meetings, conferences and other events,” the report states.

It’s not just adults who aren’t eating enough fresh and non-processed foods – 60 percent of children ate less fruits than recommended and 93 percent consumed fewer vegetables than recommended.

Instilling better eating habits earlier in life might lead to better practices later in life, federal authorities wrote. Places where children learn and play can have a strong role in improving their diet.

“School districts, schools, and early care and education providers can help increase children’s fruit and vegetable consumption by meeting or exceeding current federal nutrition standards for meals and snacks, serving fruit and vegetables whenever food is offered and training staff to make fruit and vegetables more appealing and accessible,” the report recommends.

Adding fruits and veggies to your diet only takes a few minutes of planning. Consider these tips from the CDC:

  • Make half your plate fruits and vegetables.
  • Grab fresh or dried fruit to eat on the go. Bananas make an easy portable fruit.
  • Bring cut-up vegetables or fruit from home when you will need a snack somewhere.
  • Add fruits and vegetables to your favorite snack or recipe. Parents can often “hide” vegetables by adding pureed ones to muffins or casserole dishes.
  • Always serve fruit and vegetables to party guests.

Source: Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report July 2015

+ Learn how to choose healthier foods for better nutrition and weight loss through the Nutritional Analysis program at Bon Secours In Motion.

+ Does a child in your life need help losing weight and making better food choices? The Youth and Fitness program at Bon Secours Sports Performance specializes in helping children of all ages improve their health through physical activity and nutrition.

Woman jogging by lakeBy: Erin Ludwig, MS, ATC, VAT/L, Supervisor of Athletic Training Services, Bon Secours Sports Medicine

With the summer months upon us, whether you’re running, playing a pickup game of basketball or going for a power walk, make sure you take care of  your body when the temperatures rise.

Exercising in hot weather puts extra stress on your body. When exercising in the heat, you can potentially risk serious illness. Both the exercise itself and the air temperature increase your core body temperature. To help cool itself, your body sends more blood to circulate through your skin. This leaves less blood for your muscles, which in turn increases your heart rate.

If the humidity also is high, your body faces added stress because sweat doesn’t readily evaporate from your skin, pushing your body temperature even higher. In addition to circulating the blood throughout the body to cool itself, your body also uses fluids (sweat) to cool itself, causing an increase in need for fluid intake during these times.  If a person is unable to meet the fluid needs of the body, a heat illness can occur.

Heat-related illnesses occur along a spectrum, starting out mild but worsening if left untreated. Heat illnesses include:

  • Heat rash – a skin irritation caused by heat
  • Heat cramps – painful muscle contractions that cause the affected muscles to feel firm to the touch
  • Heat syncope – a feeling of lightheadedness or fainting caused by high temperatures, often occurring after standing for a long period of time or standing quickly after sitting for a long period of time
  • Heat Exhaustion – medical condition characterized by sweaty, clammy skin, weakness, rapid pulse, dizziness, nausea, headache, fatigue, and irritability
  • Heat Stroke – medical emergency characterized by hot, dry skin, temperature over 105, rapid pulse, unconsciousness, disorientation, headache, fatigue, and irritability


If you develop any of these symptoms, you must lower your body temperature and get hydrated. Stop exercising immediately and get out of the heat. If possible, have someone stay with you who can help monitor your condition. If your symptoms do not improve within 30 minutes, seek medical attention.

By taking some basic precautions, your exercise routine doesn’t have to be sidelined when the heat is on. Below are some tips on how to avoid heat related illnesses.

  • Know your fitness level.
  • Drink plenty of fluids – water and sports drinks are your best choices. Increase your fluid intake before, during and after exercise and take frequent water breaks. Don’t wait until you are thirsty. Avoid sugary drinks, alcoholic beverages, and caffeine.
  • Watch the temperature and adjust your activity accordingly.
  • Get acclimated – if you’re used to exercising indoors or in cooler weather, take it easy at first when you exercise in the heat and gradually increase the length and intensity of your outdoor exercise.
  • Dress appropriately – lightweight, loose-fitting clothing helps sweat evaporate and keeps you cooler.