University of Pennsylvania Health System

Penn Health and Wellness

Tuesday, November 25, 2014

How to Have Your Cake and Eat it Too – Holiday Edition

Lori M. Noble, MD
Lori M. Noble, MD, a primary care physician at Spruce Internal Medicine, located at the new Penn Medicine Washington Square building, offers tips on how to satisfy your sweet tooth this holiday season - and do so in a healthy way.

Last year, I wrote a blog post proclaiming my addiction to all things sweet and shared some tips and tricks that have allowed me to satisfy my sweet tooth without breaking the sugar bank. Well, now the holidays are just around the corner and that can only mean one thing – delicious, decadent food will be all around us, just waiting to wreak havoc on healthy lifestyles everywhere (cue sinister laugh track)!

That may sound a little melodramatic, but the holidays are notoriously a time when people give up healthy eating habits because the temptation is just too great. So this year, I thought I would share some tips that will make it easier to prepare, and enjoy, all those savory and sweet holiday treats – without the guilt.

Call for a Substitute

Recipes often call for heavy, high-calorie ingredients. Most of the time, these can be substituted for much healthier options without sacrificing taste.

For instance, baked casseroles can sometimes call for as many as a half-dozen eggs. You can easily swap the eggs for egg whites (or egg substitute), which come prepackaged in affordable, easy-to-use cartons. This switch will help reduce the fat and cholesterol in many recipes.

Similarly, unsweetened apple sauce can be a replacement for oil in a one-to-one exchange in baked goods. Even that little tablespoon of oil has 120 calories. Those savings can really add up!

On the Side, Please

When preparing your next holiday feast, put all the extras on the side and allow your guests to put as much or as little as they’d like of each on their meal. That goes for dressing, sauces, gravy, extra cheese and any other condiment.

These can add many additional calories and we often don't even realize it. When food isn't smothered in these extras, each person has to be conscious about how much or how little to add and will often wind up using less.

Fruit Is Your Friend

Far be it from me to tell anyone not to indulge in a piece of pie at the end of a holiday meal. That would not be realistic. But, in order to help keep it to just one piece, load up the rest of the plate with a healthy fruit salad topped with low-fat whipped topping. Fruit is high in fiber and much lower in calories than the standard dessert. It helps keep you satisfied and is delicious – a true win-win situation.

Veggies Are Your Best Friend

I know I've made this recommendation before, but that's because it’s so crucial to healthy eating habits, so load up on the veggies! The fall and winter seasons are full of many delicious options – butternut squash, brussel sprouts, pumpkin, broccoli, cauliflower…the list goes on.

Sprinkle your favorite with some salt, pepper and fresh herbs, drizzle with heart-healthy olive oil, and roast in a pan, the oven, or on the grill for a filling, healthy addition to your meal. Anytime you want to go back for seconds of other food items, I challenge you to eat more veggies first and then ask yourself, "Am I still hungry?" More often than not, the answer will be no.

Cut Out the Extra

Many recipes call for more of certain ingredients than are really necessary, with the biggest culprit being butter.

For example, my mom's sweet potato casserole is a must at our holiday dinners, but the recipe calls for almost two sticks of butter! I cut out over half of the recommended amount and no one could tell. Shhh! (If you're nervous about this, do a test batch using less of the selected ingredient so the recipe can be made without a hitch on the real day.)

This year, try some or all of these tips to make your holiday meal flavorful and filling without sacrificing your health.

Interested in developing a personal fitness plan that includes good nutrition? Find a primary care doctor near you and get started!

Monday, November 24, 2014

Penn Medicine in the Community: Upcoming Events

Don't let a little bit of cold, and possibly some snowy weather, keep you from getting out of the house and enjoying this time of the year.

This winter, Penn Medicine will host or take part in numerous events throughout the tri-state area. These events provide our physicians and staff an opportunity to be closer to the people we serve and allow us to be more than simply a health care provider, but also a part of the community.

Penn Medicine Valley Forge at Wilson Farm Park Turkey Trot

What better way to begin your Thanksgiving Day than by participating in an event that benefits a great cause! Join hundreds as they run, walk or stroll to raise money for various programs within the community.

Be sure to set a few minutes aside to say “hi” to the physicians and staff from Penn Medicine Valley Forge. A state-of-the art facility, Penn Medicine Valley Forge provides expert primary and specialty health care, plus a full range of services.

Date: Thursday, November 27
Time: Race begins at 8:45 a.m.
Location: Wilson Farm Park
               500 Lee Rd.
               Wayne, PA 19087

Rittenhouse Tree Lighting Festival

Begin the holiday season with holiday entertainment, character visits, complimentary roasted chestnuts, Santa Claus and more at the Rittenhouse Tree Lighting Ceremony. Once the switch is flipped, Rittenhouse Square will be illuminated by 5,000 multi-colored globes. These lights go along with Philadelphia’s largest Christmas tree - standing at more than 30 feet tall!

Don’t forget to visit Penn Internal Medicine Rittenhouse physicians and staff to learn how they can help you and your family members stay healthy. Penn Medicine Rittenhouse is home to both primary and specialty care physicians. Patients are able to see their primary care physician, and consult with a specialist – all in one location.

Date: Monday, December 1
Time: Festivities begin at 5:00 p.m.
Location: Rittenhouse Square
               18th and Walnut Streets
               Philadelphia, PA 19103

Be Part of the Largest Holiday 5K Race Series Aimed to Fight Arthritis!

Looking for a way to get into the holiday spirit?

Dress up in your best holiday-themed costume, decorate your sneakers with jingle bells and be one of the thousands of runners and walkers who hit the pavement across the nation this winter to fight arthritis, the nation’s most common cause of disability.

The Jingle Bell Run/Walk is a national signature event for the Arthritis Foundation where thousands of people come together to run, walk, and raise money to help fight arthritis in more than 200 cities.

In Pennsauken, meet up with members of Penn Medicine Cherry Hill to fight arthritis. Penn Medicine Cherry Hill is a state-of-the-art outpatient medical facility providing expert primary and specialty health care, plus a full range of medical services.

Pennsauken Event Details
Date: Sunday, December 6
Time: Registration begins at 7:30 a.m.
Location: Cooper River Park
               7050 North Park Drive
               Pennsauken, NJ 08109

Join staff from Penn Medicine Valley Forge for the 2014 Jingle Bell Run/Walk for Arthritis on Sunday, December 14 in Malvern, PA. Penn Medicine Valley Forge is once again proud to be a sponsor for this wonderful event, alongside Penn Radiology, which has locations throughout Pennsylvania and New Jersey.

Malvern Event Details
Date: Sunday, December 14
Time: Registration begins at 8:00 a.m.
Location: Great Valley High School
               225 Phoenixville Pike
               Malvern, PA 19355

Wednesday, November 19, 2014

National Diabetes Awareness Month: Know the Facts

As one of the most prevalent diseases in the United States, diabetes impacts nearly 9.3 percent of the entire population. That translates to around 29.1 million Americans who have diabetes -- with 8.1 million of them undiagnosed -- according to the American Diabetes Association.

There are two common types of diabetes, Type 1 and Type 2. To understand the differences between these types and what it means for the people who have it, it’s important to first understand a few key terms they share: insulin and glucose.

What is Insulin?

Insulin is a hormone produced by the pancreas. Insulin allows your body to use the carbohydrates (sugar) it gets from food sources. It acts as a “regulator” for carbohydrates in your body and prevents your blood sugar levels from becoming too high or too low.

When you eat carbohydrates (sugars), your body either breaks them down for energy, or stores them for future energy needs.

Insulin also helps your body store the sugars and allows the body to release the sugars into your blood stream when your body needs the energy.

What is Glucose?

Glucose, a simple sugar, is an important energy source needed by all cells and organs of our bodies. Glucose comes from various foods we eat, such as fruit, bread, pasta and cereals. Within our stomachs, foods are broken down and then absorbed into the bloodstream.

Type 1 Diabetes

People with type 1 diabetes are not able to make insulin. Without this important hormone to regulate blood sugar levels, they develop high blood sugar called hyperglycemia.

If left untreated, hyperglycemia can cause long-term complications such as:
  • Nerve damage
  • Kidney failure
  • Cardiovascular disease
  • Vision problems
  • Neuropathy, or nerve damage
  • Infections and non-healing wounds
  • Foot complications
There is no current cure for Type 1 diabetes, which is usually diagnosed in children. The Juvenile Diabetes Research Foundation and the Children’s Hospital of Philadelphia are two of the leading global organizations focused on curing Type 1 diabetes, or T1D as it’s also known.

People with type 1diabetes need to take medications (insulin) in order to help their body process carbohydrates.

Type 2 Diabetes

People with type 2 diabetes have insulin in their bodies, but are unable to use insulin effectively. Over time, they become more and more insulin resistant, and their pancreas produces less and less insulin.

Like type 1 diabetes, if left untreated, people with diabetes can experience serious complications such as:
  • Nerve damage
  • Kidney failure
  • Cardiovascular disease
  • Vision problems
  • Neuropathy, or nerve damage
  • Infections and non-healing wounds
  • Foot complications
Type 2 diabetes can be prevented or delayed by maintaining a healthy weight, staying active and eating a healthy diet. Type 2 diabetes is usually diagnosed in adults; however, more children are being diagnosed with type 2 diabetes.

People with type 2 diabetes may need a combination of medications to get their blood sugar levels stable. Depending on the severity of their blood sugar levels, people with type 2 diabetes may also be able to manage their disease with diet and exercise.

Diabetes treatment at Penn

Endocrinologists at the Penn Rodebaugh Diabetes Center specialize in the diagnosis and treatment of type 1 diabetes, type 2 diabetes, pre-diabetes, gestational diabetes (diabetes during pregnancy) and other related conditions.

They work closely with patients’ primary care providers to treat and manage diabetes and related conditions.

Managing Holiday Stress

Elizabeth Y. Fung, DO, a primary care physician at Spruce Internal Medicine, located at the new Penn Medicine Washington Square building, discusses healthy tips for managing stress during the holiday season.

As the brilliant colors of the fall foliage fade and the crisp winter air settles in, a flurry of activities begin and it is now time to prepare for the holidays.

The holiday tradition started as a period of time set aside for religious or cultural celebrations. Today, many of us have an unrealistic or overly romantic notion of what the holidays should be, and often aren’t.

To help, here are a few tips to rekindle the holiday spirit:


  • Put together a list of what you expect from the holidays and be realistic with what can be accomplished.
  • If you’re looking to take it easy over the holidays, consider a vacation or simply a ‘stay-cation.’ Take it easy and relax, refresh and re-energize.
  • If family, friends and feasts are on your holiday horizon, prioritize commitments and schedule them on your calendar. Don’t forget to include time for rest and relaxation.
  • Plan your travels – purchase tickets in advance and arrive early for departure.

Holiday Gatherings

  • If you’re hosting a holiday party, divide up the menu and give guests an opportunity to prepare and “show off” one of their favorite dishes.
  • Prepare in advance – I have a patient who bakes 20 pies the week before her holiday parties in preparation to give to friends and relatives.
  • Those who break bread make bread together - Share in the peeling, dicing, chopping and cleanup in the kitchen. It is a great opportunity for everyone to catch up while preparing the meal.
  • Purchase prepared menu items to reduce the amount of cooking and increase the amount of family time.
  • Avoid overindulgence - have a healthy snack before your holiday parties, continue to exercise and get a good night’s sleep.

Gift Giving

  • Set a budget. You will be surprised how creative you can be with a budget in place.
  • Ask people what they want for the holidays. This eliminates the guesswork and holiday returns.
  • Online shopping – Shop at your leisure. Last year, I did most of my shopping online while on the train to/from work!
  • Get creative with gift-giving. During my medical training, I gave my brother and his wife a “gift certificate” redeemable for a weekend of babysitting my nieces and nephews.

Holiday Blues

  • Surround yourself with family and friends if you’re feeling lonely and sad. Reminiscing about the past, the loss of loved ones or being away from home during this time of the year can be difficult.
  • Volunteer – Helping others can help us better appreciate what we have.
  • Despite your best efforts, if you find yourself feeling severely anxious, persistently sad or hopeless and these feelings are affecting your daily activities, please talk to your doctor.
The holidays are an exciting time celebrating with family and friends. With some planning and a positive attitude, it is possible to be jolly during this season and to find peace and joy as we celebrate.

Happy Holidays!

Any tips you'd like to add?
Leave your thoughts below.

Wednesday, November 12, 2014

Tips To Stay Active This Fall

It seems as though everything is just a bit easier during the summer. People tend to be a little more laid back at work, there are less people on the road because many are on vacation and, with the added sunlight and warm temperatures, being active seems to be much less of a hassle.

Penn Medicine Fall Tips to Stay Active
Autumn, though, is here. Say goodbye to the warm temperatures and hello to shorter days and cooler weather. Perhaps it’s the fewer hours of sunlight, but this time of the year seems to be when many go into hibernation and ease up on their active summer lifestyles.

This doesn’t have to be the case as there are many fun things to do to stay fit during the cooler months.

“The change of seasons is a good time to focus on health and wellness goals," said Ngozi Onuoha, MD, FACP, of Penn Internal Medicine Mayfair. "Autumn is a great season to walk. Walking is a great form of exercise that does not require much preparation."

Here are some other tips to keep you moving and feeling healthy this fall.
  • Make exercise fun: Autumn is synonymous with harvest season. What better way to stay active than to go pumpkin or apple picking with your family or friends? For the younger ones (or those simply young at heart, take part in physical activities such as corn mazes and haunted trails.
  • Sign up for a holiday run: Fall is the season in which many fun runs and events occur. Participate in Halloween runs, turkey trots, reindeer romps, etc. Setting a specific goal, such as a race to train for, increases adherence to an exercise program. Signing up with friends or family will motivate you even more.
  • Enjoy the colors: Grab a friend, and find a local park that has great trails to walk, run, or ride a bike on.
  • Go to a farmer’s market: Many of the root vegetables are in season and are inexpensive. Grab some apples while you’re at it as they’re rich in antioxidants and flavanoids, both of which can reduce cholesterol.
  • Take advantage of the cooler weather: Play catch, walk the dog, get a group of friends together to play ultimate Frisbee or touch football.
  •  Make Fall chores fun: Raking your lawn can be a real workout. Have fun with it (perhaps by jumping in the leaves??).

  • Tell us how you plan on staying active this Fall.
    Leave your thoughts below.
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