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“Eggs-citing” News, Recipes

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EggsBy Gina O’Toole, RD, MPH, CLEC, CHOC Children’s Clinical Nutrition and Lactation Services

Eggs take the spotlight this month as Easter approaches, but the question remains: Should we consume them at all?

The answer is a resounding yes! Though previously shunned, eggs now have the green light for eating. Though the cholesterol content of eggs was previously thought to increase the risk of heart disease, we now know that eating a diet high in saturated fats and trans-fats (hydrogenated oils) increases the risk of heart disease more so than eating cholesterol itself.

The most recent recommendation in 2010 from the American Heart Association allows 300mg per day of cholesterol. One large egg contains 213mg, about 2/3 of the recommended daily value.

The facts about eggs:

  • Eggs are an excellent source of protein, providing 7 grams of high quality protein.
  • Eggs contain just 75 calories each.
  • Eggs have 5 grams of fat (1.6 grams saturated fat).
  • They are a great source of the antioxidants lutein and zeaxanthin, both important carotenoids that reduce the risk of macular degeneration.
  • Choline is a key nutrient in eggs that is important for brain development and memory.

So-called “designer eggs” may contain omega-3 fats. To make these eggs, chickens are fed omega-3 fatty acids which the chickens then further covert into DHA. DHA is a fatty acid important for brain and eye development in babies and children. Moms who eat DHA transfer that DHA to the baby through their breast milk. DHA also plays an important role to help prevent cardiovascular disease.

So go ahead and enjoy eggs this Easter and beyond. Try using your hard-boiled eggs with these delicious recipes:

Herbed Deviled Eggs

8 large hard-boiled eggs

½ non-fat Greek yogurt

1 teaspoon grainy Dijon mustard

1 ½ teaspoon sherry vinegar

1 teaspoon chopped of each: fresh flat-leaf parsley, fresh thyme, fresh chives

Peel eggs and halve lengthwise. Reserve four of the egg-white halves for another use. Pass yolks through sieve using the back of a spoon. Stir in yogurt, mustard and vinegar. Salt and pepper to taste. Sir in herbs.

Either spoon or put yolk mixture in pastry bag to pipe into egg white halves. Garnish with additional herbs

Curried Egg Salad Sandwich (Serves 4)

6 hard-boiled eggs, using four of the six yolks and dice

¼ cup non-fat Greek yogurt

1 medium celery stalk, diced

1 teaspoon Dijion mustard

¼ teaspoon curry powder

Salt and pepper to taste

Mix previous seven ingredients. Spread on whole-grain bread. Top with radicchio and arugula

 

Kids and Tonsils

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Tonsils_300WHEN SHOULD TONSILS BE REMOVED?
Tonsils are removed much less frequently than in the past, but removal may be necessary under specific circumstances. “There are two predominant reasons for removing tonsils and/or adenoids in children,” says Dr. Ahuja, CHOC Children’s Specialists Division Chief of Otolaryngology. “The primary reason is obstruction, or difficulty breathing, sleep-disordered breathing or sleep apnea. The second reason is recurring infection. Tonsils may need to be removed if a child has seven tonsillar infections in one year, or five infections each year for two years, or three infections each year for three or more years, with the infections being accompanied by one or more of the following features: a fever of 1010F or above, a strep throat infection confirmed on a swab from the throat, white coating on the tonsils, large lymph nodes in the or mouth sores.” Surgical removal of the tonsils is called a tonsillectomy. Surgery should be considered only when necessary, but in appropriate situations, it can make a substantial difference in the quality of life.

SIGNS OF TROUBLE
There are many signs that the tonsils are causing a child enough trouble to warrant removing them, says Dr. Ahuja. A child who has trouble breathing, breathes often through the mouth, snores heavily, sleeps poorly, wakes up tired and fussy, exhibits behavior problems like hyperactivity or aggressive behavior, or is significantly underweight because he is having a hard time eating and breathing at the same time may be a candidate for a tonsillectomy, often with adenoidectomy, says Dr. Ahuja.

WHAT ARE TONSILS AND ADENOIDS ANYWAY?
The tonsils are part of the body’s immune system. Specifically, they are two oval-shaped masses of tissue in the back of the throat that trap germs that could enter the body’s airway and cause an infection. Tonsils also produce antibodies to fight infection. Sometimes, they get infected and swollen, and lead to a condition common in kids called tonsillitis. The adenoids are small pads of lymphoid tissue like tonsils, located in the upper portion of the throat, behind the nose. They serve a similar purpose as the tonsils. “The majority of the time if we are removing the tonsils for obstruction or blockage, we remove the tonsils and adenoids,” says Dr. Ahuja.

FAST FACTS

  • Age range of children most commonly affected by tonsillitis: 3 -7
  • Number of tonsillectomy procedures performed annually in children younger than 15 in the U.S.: 530,000+
  • Percent of healthy children who have tonsils and adenoids removed due to obstruction who will show a marked improvement. The success rate falls for obese children, or children with certain birth disorders: 80

    View the full feature on Kids and Tonsils

    Dr. Gurpreet Ahuja

    Dr. Gurpreet Ahuja
    CHOC Children’s Specialists Otolaryngology
    (Ear, Nose and Throat)

    PHYSICIAN FOCUS: DR. GURPREET AHUJA

    Dr. Ahuja is the CHOC Children’s Specialists’ Division Chief of Otolaryngology, and past president of the medical staff at CHOC. He is a Clinical Professor of Otolaryngology at the University of California, Irvine, and Director of Pediatric Otolaryngology training for UCI’s residency program in Otolaryngology. He completed his residency in Otolaryngology/Head and Neck Surgery at the Manhattan Eye, Ear, and Throat Hospital in New York, followed by a fellowship in Pediatric Otolaryngology at the Children’s National Medical Center in Washington, D.C. Dr. Ahuja specializes in pediatric airway reconstruction, pediatric sinus surgery, childhood hearing loss and congenital head and neck disorders. Dr. Ahuja is actively involved in the Orange County community, serving on the Board of Directors of the OC Human Relations Council.

    Dr. Ahuja’s philosophy of care: “My philosophy is to treat every child as I would have my own child treated. It’s
    very important for me to engage the parents in the care of their child and to have them on board with what I am
    recommending so we have a consistent approach to treatment. I always make it a point to follow the standard of care with up-to-date information about the child’s medical condition. I also consider it important to educate the parents about the child’s condition.”

    EDUCATION:
    All India Institute of Medical Sciences, New Delhi, India

    BOARD CERTIFICATIONS:
    Otolaryngology

    More about Dr. Ahuja | CHOC Children’s Pediatric Specialties Otolaryngology

    This article was featured in the Orange County Register on November 12, 2013 and was written by Shaleek Wilson.

Teens and Social Media Safety: Tips for Parents

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Kids_social_media_safetySnap Chat. Whats App. Voxer. With new online messaging and communications applications seemingly popping up daily, parents more than ever need to be mindful of their children’s technology and social media use, health care providers caution.

“Technology is great, but it has consequences, especially on our younger population,” says Dr. Christopher Min, a CHOC Children’s psychologist.

And while valuable, the convenience and speed of social media and technology can also have lasting impacts: Dr. Min estimates that social media or technology use surface in about half of his patient cases, and he’s seen suicide attempts that were related somehow to social media or technology.

“Teenagers’ lives are very much revolving around these things,” he said.  “It’s made teenage culture very unstable.”

Risky behavior and teens

Teens might be more inclined to participate in risky behavior online for both physical and emotional reasons. First, while their bodies and hormonal systems are fully developed, their brains are not, Dr. Min says.

“Brain development is far from over,” he says. “Their brains have not matured to the point that they can always prioritize, put on the brakes and consider consequences before acting.”

Secondly, teens feel significant pressure to be accepted. They also have a distorted perception of what’s normal because they are so encapsulated in their age group, school and circle of friends, he says.

“Acceptance to a peer group is very important,” says Dr. Min. “Adolescents will go to great lengths to be accepted into a group, or to feel like they are.”

Tips for parents

Every parent wants their child to feel comfortable and happy with friends, but they also want them to stay safe. To that end, Dr. Min has several tips for parents of children using social media and technology:

1. Monitor teens’ social media use.

To what extent a parent should track social media activity depends on the child, Dr. Min says, but parents need to be aware how a child uses these tools. Monitoring can be accomplished through regular discussions or more formal means such as sharing log-in information, depending on the child’s responsibility level.

 2. Encourage teens to get together in person.

The underlying reason for social media is create a sense of connectedness, and this can be accomplished faster than meeting in person. Instead, parents can help create connections by facilitating actual meetings with people, Dr. Min says.

“Be that cool mom or cool dad who makes it fun and cool to hang out at the house,” he advises.

3. Remember that parents control access to social media.

Dr. Min reminds parents that they pay for Internet or cell phone access. Parents should exercise authority and reason with teens by stating clear consequences and rewards for social media use.

“In treatment, I like to help parents realize that in the structure of the family, the control has to rest in the parents,” he says. “They don’t need to be powerless.”

Tips for teens

Dr. Min also has advice for teens. He recommends that teens who are ready to post something online instead pause for five to 10 seconds to consider their actions, the post’s meaning and possible consequences.

“This will help them in not posting things that they don’t want cemented on the Internet forever,” he says.

Learn more about psychology at CHOC Children’s.

Tips for Tonsillectomy Recovery

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_T2V0782More than 530,000 tonsillectomies are performed each year in children ages 15 and younger, but the common procedure does require some recovery time.

Children will typically have a sore throat for a week to 10 days following surgery, and they usually feel well enough to resume their normal activities after two weeks, says Dr. Gurpreet Ahuja, an ear, neck and throat specialist and the CHOC Children’s Specialists Division Chief of Otolaryngology.

Children who are otherwise healthy and not obese or underweight typically leave the hospital the same day as their surgery, and most children can return to school a week later, he says.

Dr. Ahuja noted there is a small risk for bleeding after surgery, so children recovering from a tonsillectomy should stay close to home as a precaution. If excessive bleeding occurs, parents should contact their surgeon or physician immediately or take the child to the nearest emergency department.

Here are some tips for parents of children recovering from surgery to remove the tonsils and adenoids:

  • Ensure your child is drinking lots of water and fluids. Proper hydration is important to help prevent fever, bleeding or infections.
  •  To soothe the throat, have the child drink lots of chilled fluids like water and Gatorade, and eat soft, cold foods after surgery such as Popsicles, smoothies and ice cream.
  •  Have the child eat soft foods that are easy to swallow, such as pasta, rice, noodles, bananas and yogurt.
  • For pain management, patients ages 10 and younger can take over-the-counter pain medications such as ibuprofen and acetaminophen. Children older than 10 tend to have a little more pain and discomfort and may need a prescription pain medication. Contact your physician to ask about prescriptions for pain if needed, and also if you have any questions or concerns about your child’s recovery.

Learn more about otolaryngology at CHOC Children’s.

Tips for Mitigating the Risk of Preterm Labor

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Tony Soliman - premature birthsPrematurity is the number one killer of babies worldwide, says Dr. Tony Soliman, a CHOC Children’s neonatologist and director of CHOC’s extremely low birth weight program. Even if a woman does everything right, her baby can still be born prematurely. In this CHOC Radio segment, Dr. Soliman addresses this serious health concern and offers tips for mitigating the risk of preterm labor.

Dr. Soliman encourages women to partner with health care providers even before getting pregnant. Prenatal care and eliminating high risk behaviors, such as smoking, are crucial. In addition, stress can have a huge impact on the health and well being of mom and baby.

Learn more by listening to Dr. Soliman and CHOC Radio host Bryan Mundia.

Get the direct link to the audio file here.

Play

Podcast: Play in new window | Download

Thank you, CHOC Volunteers!

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This week, National Volunteer Week, provides us withBetty Keith-cropped_1 a formal occasion to recognize volunteers at CHOC Children’s. But not a day goes by that CHOC staff, physicians, patients, families and I don’t recognize the important work that volunteers do here.

CHOC is so lucky to have more than 1,100 awesome volunteers who spend more than 9,000 hours a month providing services ranging from office work to cuddling tiny babies.

I want to introduce you to one volunteer in particular: Betty Keith. She and I became friends in 1983, when she first started volunteering at CHOC. Thirty years later, Betty still volunteers once a week and has logged more than 19,400 hours at CHOC.

Q: When did you start volunteering at CHOC and why?
A: I started in June 1983. I love children and I wanted to help them as much as I could.

Q: Tell me about the various work and roles you’ve performed in your time at CHOC.
A: I’ve been all over. I worked in the volunteer office, filed papers in the associate health department, and helped in the gift shop. I’ve worked on the floors, answered phones in the administrative office, and worked with cancer research. I’ve done a lot. All the employees and other volunteers I’ve met through the years are wonderful.

Q: CHOC sure has changed since you first started, right?
A: Oh, my goodness. It has changed so much. It’s a beautiful hospital.

Q: Have you volunteered at other places too?
A: The most important to me is CHOC, but I also volunteered at the city clerk’s office, the library, the Sergerstrom Center for the Arts and South Coast Repertory. I first helped in my kids’ schools. Helping children was important to me, and my husband didn’t want me going out into the working field. I had to do something.

Q: How much longer can CHOC count on your service?
A: I have told everyone that I was going to quit at 20,000 hours. Volunteering keeps you going. You’re getting paid indirectly by the help you give and the satisfaction you get.

Q: When you’re not at CHOC, what else do you like to do in your free time?
A: I go to Bible study, and go to the movies once a week with friends and out to lunch. I have two children, four grandchildren and four great grandchildren.

Thank you for your tens of thousands of hours of service, Betty! Learn more about volunteer services at CHOC.

Almost 50 years ago, the good doctors, nurses and staff at CHOC Children’s took good care of me after an unfortunate tree-falling incident. I have been their biggest fan (and official mascot) ever since. This post is part of my 50 weeks of gratitude tour. Learn more at http://www.choc.org/thxCHOC.

When Illness Sidelines a Young Athlete

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baseball_athlete_illnessBeing sidelined by illness can be difficult for dedicated young athletes, as well as their parents who question when to keep their child off the field and when to send them back.

Depending on symptoms and energy levels, children can often still participate in sports when under the weather, says Dr. Jacqueline Winkelmann, a CHOC Children’s at Mission Hospital pediatrician who works to provide health tips and guidance for young athletes.

If a child’s symptoms are “above the neck,” he or she can usually participate in athletic activities so long as energy levels are appropriate. “Above the neck” symptoms include a runny nose, nasal congestion, sneezing and minor sore throat, she says.

“If you have a mild cold and no fever, and have enough energy, you can still play,” Dr. Winkelmann says.

But even if a young athlete feels well enough to exercise while in the final throes of a cold, he or she must plan on scaling back the intensity of play, she cautions.

“You need to understand that you won’t be able to practice at the same level,” Dr. Winkelmann says. “You need to speak up and tell your coach that you’re not 100 percent.”

However, a child with symptoms “below the neck” – chest congestion, respiratory ailments, gastrointestinal concerns, fatigue, fever or muscle aches – should stay off the field until well, Dr. Winkelmann says.

And though being sidelined by illness might be frustrating for committed athletes, taking a few days – even weeks – off from practice will not result in a significant setback in performance.

“It may take you a while to get back to where you were, but it’s much more prudent to take the time to rest your body when you’re sick,” Dr, Winkelmann says.

Young athletes can do some things to help speed the recovery process and get back on the field faster: Focus on rest by going to bed 30 minutes earlier than usual, Dr. Winkelmann advises. Also, limit dairy, sugar and processed foods, and increase fruits and vegetable intake.

When comes to returning to play, a child, especially one who suffered a respiratory illness, should first feel normal for one to two days after recovery, she says.

And above all, a child needs to trust her body, and mom and dad should listen to their parental instincts.

“I tell kids to listen to your body, not your coach or trainer or parents,” Dr. Winkelmann says. “Parents should trust their gut. They know their kid and their personality.”

Kids and Living with Food Allergies

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Girl WatermelonSIGNS AND SYMPTOMS

A food allergy usually occurs in the first two years of life, says Dr. Ellis, a CHOC Allergy and Immunology Specialist. “It’s important to know that allergic reactions to food typically occur immediately or within two hours of eating the food,” Dr. Ellis explains. “The child might have skin issues like hives (itchy red spots) or develop itchy skin, or the child might throw up. All the organ systems can be involved. The child might wheeze or become short of breath. In severe cases, the cardiovascular  system can be involved and the child could have a drop in blood pressure, feel light headed and faint.”

MANAGING FOOD ALLERGIES
There is no cure for food allergies and the best way to avoid getting sick is avoiding the food. “You have to find out what the child is allergic to. This comes from the family history and then we take a blood test or a skin test to confirm what the family has told the doctor,” says Dr. Ellis. With a serious reaction, an adult should inject the child with epinephrine (adrenaline that reverses the symptoms) and call 9-1-1. “Always have an epinephrine auto-injector. Learn how to read food labels and be careful at high-risk eating areas such as buffets, ice cream parlors and Asian restaurants.”

FOOD FOR THOUGHT
Any food can cause an allergy but a small number of foods are most commonly associated with food allergies. In fact, eight foods/food types account for 90 percent of all allergic reactions. They are: milk, eggs, peanuts, tree nuts (such as walnuts and almonds), soy, wheat, fish and shellfish. Even trace amounts of a food allergen can cause a reaction, including a severe or life-threatening reaction. Peanuts, tree nuts and fish are the most common causes of severe reactions, says Dr. Ellis.

FAST FACTS

  • Estimated number of American children and adults with food allergies: 15 million
  • Annual cost to the U.S. economy related to children’s food allergies: Almost $25 Billion
  • Percentage of children under the age of six with food allergies: 6 – 8

View the full feature on Kids and Living with Food Allergies

Dr. Mark Ellis

Dr. Mark Ellis
CHOC Allergy and Immunology Specialist

PHYSICIAN FOCUS: DR. MARK ELLIS

Dr. Ellis completed his residency at the University of Arizona Health Sciences Center in Tucson and a fellowship in Allergy-Immunology at the University of California, Irvine, Medical Center. Dr. Ellis is chief of the CHOC Children’s Specialists Allergy & Immunology Division and is the Director of the Allergy, Asthma & Immunology program at CHOC. Dr. Ellis specializes in the treatment and management of allergies and asthma. He is a principal investigator for many clinical research studies for adults and children concerning new treatments for asthma and allergies.

Dr. Ellis’ philosophy of care: “I like to identify the problem and educate the family on ways to prevent disease.”

EDUCATION:
Tulane University School of Medicine in New Orleans

BOARD CERTIFICATIONS:
Pediatrics
Allergy and Immunology

More about Dr. Mark Ellis

This article was featured in the Orange County Register on April 7, 2014, and was written by Amy Bentley.