Do You Need to Be Worried Your Kids Are Getting Too Much Caffeine?

Caffeine2-FBIf you’re among the 64 percent of American adults who drinks at least one cup of coffee every morning, you may know exactly how much to drink and what time to stop drinking to avoid any unpleasant caffeine side effects such as jitters and insomnia. What you may not know is that an increasingly wide variety of foods and beverages contain significant amounts of caffeine, making it nearly impossible to accurately gauge yours and your children’s daily intake.

The tragic story of 16-year-old Davis Allen Cripe underscores why counting caffeine milligrams is important. The South Carolina teen, who was found to have no undiagnosed heart condition, died from a rapid, irregular heartbeat called arrhythmia caused by an overdose of caffeine. Cripe’s friends told the coroner that within two hours of his death, he drank a large diet Mountain Dew®, a McDonald’s café latte and an energy drink.

Dale Yoo, MD, a cardiac electrophysiologist at Medical City McKinney, confirmed that caffeinated drinks can absolutely affect your heart rhythm.

“Anything that’s a stimulant or increases the stress on your heart will increase your adrenaline and your heart rate,” Dr. Yoo said. “Things like coffee, tea and herbal supplements will increase your adrenaline and heart rate. Drinks like 5-hour ENERGY®, Red Bull® and Monster Energy® have a lot of taurine and caffeine that can also increase the stimulant effect on your heart and increase the risk of arrhythmia.”

In addition to soft drinks and energy drinks, caffeine is being added to a growing list of products, including marshmallows, oatmeal, jelly beans, waffles, gum, mints, sunflower seeds, syrup and even water. It can be found in chocolate, ice cream (those with chocolate or coffee flavors) weight loss pills and over-the-counter pain relievers  This prompted the FDA last year to announce an investigation into the safety of caffeine in food products, with special attention paid to its effects on children and adolescents.

Because caffeine is not a nutrient, but a naturally occurring chemical found in items such as tea leaves, coffee beans and cacao (used to make chocolate), the FDA does not require the amount in a food or beverage to be listed on nutrition labels unless it is added. Many of these products also contain hidden caffeine or other stimulants. Here’s what to look for:

  • Sugar
  • Guarana
  • Taurine
  • Kola nut
  • Yerba mate
  • Cocoa or cacao

How much caffeine is too much?

According to the FDA, a safe amount of caffeine for healthy adults is up to 400mg a day. That’s anywhere from three to five eight-ounce cups of regular coffee, depending on the bean source and brewing method. For children and adolescents, the American Academy of Pediatrics’ recommendation is to avoid energy drinks entirely — which the CDC says sent 1,499 adolescents to the ER in 2011 — and limit caffeine for ages 12 to 18 to 100mg daily.

We’ll never know for sure exactly how much caffeine Davis Cripe ingested, but we can estimate it thanks to his friends’ report:

Large diet Mountain Dew: “Large” is a relative term, but even if he had a “small large” at 20 ounces, that’s 91mg of caffeine — nearly the AAP-recommended limit of 100mg. A Long John Silver’s large is 40 ounces with a whopping 180mg of caffeine and 7-11 has soda cups much bigger than that.

McDonald’s café latte: These espresso-based drinks come in small, medium and large. Espresso has about 64mg of caffeine per ounce.

Small cafe latte (12 ounces)

Medium café latte (16 ounces)

  • 142mg caffeine, 13g sugar

Large cafe latte (20 ounces)

  • 178mg caffeine, 16g sugar

Red Bull energy drink (12 ounces): The type and size of energy drink Cripe had is unknown, so we’ll use this popular one.

  • 111mg caffeine, 37g sugar

In our example, Cripe would have ingested a minimum of 273mg and a maximum of 468mg of caffeine in a short period. And this may be a very low estimate, as the American Academy of Pediatrics says some energy drinks can contain more than 500mg of caffeine.

Research debunks myth that coffee improves alertness and mood.

We all know the negative effects of caffeine. The FDA says that it can make you:

  • Jittery and shaky
  • Unable to fall asleep, stay asleep or get a good night’s sleep
  • Experience
    • rapid, uneven heart rate (arrhythmia)
    • raised blood pressure
    • headaches, nervousness, anxiety and dizziness
    • dehydration
    • heartburn
    • dependency and the need to drink increasingly more

But other than that, coffee is good for you, right? While coffee in moderation has been shown to reduce the risk of several diseases, including certain cancers and stroke, it’s most likely the health benefits of coffee’s antioxidants that are responsible, not the caffeine. Look for other ways to get antioxidants, including eating lots of healthy fruits and vegetables.

As to coffee’s magical brain-enhancing powers, study results from Johns Hopkins Medical School (featured on Forbes.com) show that caffeine-related performance improvement (a boost in mood and alertness) is nonexistent without caffeine withdrawal. In other words, the kick that you get from your morning cup of Joe is really just caffeine taking you back to “normal” for a short time.

If someone in your family is feeling the effects of too much caffeine, one of our many Medical City ER locations across North Texas has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you.

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How to Prevent Your Own Heart Attack

senior-couple-heart-fbHere’s some news to make your heart sing: Cardiovascular diseases are completely preventable for at least 95% of people just by changing diet and lifestyle, according to a study published in the medical journal, the Lancet. And not only preventable, but usually reversible simply by applying these changes.

This is exciting, because it means that your heart health is in your own hands! Everything you eat, drink and do (or don’t do) is either contributing to heart disease or heart health.

treat-the-hearts-mobile-test

Here’s what the Lancet study says are 4 of the top 9 risk factors for heart disease and how you can manage them so that you don’t end up in the ER — or worse.

  1. Smoking

David Engleman, MD, an interventional cardiologist at Medical City Las Colinas, says smoking is not just a major risk factor for lung cancer, but is also a major risk factor for heart attacks and strokes. The problem, Dr. Engleman says, is that smoking causes a number of things that increase your risk for these debilitating and largely preventable diseases.

Smoking causes:

  • An increase in the development of plaque within the arteries of the heart
  • Plaque to become inflamed, fragile and more likely to rupture and break off into the bloodstream
  • Blood to become sticky, increasing the risk of clots developing on the plaque as it moves through arteries, causing heart attacks

“The good news about smoking,” said Dr. Engleman, “is that if you stop, a number of those things can improve very quickly. Within several weeks of quitting, your blood starts to thin out and the plaques start to stabilize. Very quickly, we see a decrease in the incidence of stroke and heart attacks.”

  1. Abdominal obesity
  2. Daily consumption of fruits and vegetables

Being overweight or obese is a significant risk factor for many conditions, including heart disease. Not eating enough fruits and veggies is a risk factor, too, because they contain antioxidants and nutrients most people don’t get enough of. But a healthy diet can help you overcome both of these risk factors.

Adopt a healthy eating plan to help you get to and maintain a healthy weight (ask your doctor what that is for you) and provide your body with powerful nutrition.hearts-of-texas-healthy-heart-graphic_web

  • 4 to 5 servings EACH of fruits and vegetables daily
  • 6 to 8 servings of whole grains daily
  • At least 2 servings of fish high in omega-3s weekly
  • Nuts
  • Legumes (peas, beans, lentils, soybeans, peanuts)
  • Seeds
  • Low-fat dairy
  • Little to no added sugar
  • Little to no red meat (lean cuts if you must eat)
  1. Regular physical activity

Here’s another two-fer: regular exercise will not only strengthen your heart, which is a muscle, but like eating healthfully, it can also help you maintain a healthy weight. Try for 150 minutes of moderate aerobic activity, 75 minutes of vigorous aerobic activity or a combination of both every week. Be sure to include muscle-strengthening activities two or more days a week. Check with your doctor before beginning any exercise program.

(The other 5 risk factors mentioned in the Lancet article are: abnormal lipids, hypertension, diabetes, alcohol consumption and psychosocial factors.) 

Should you have a heart screening?

If you experience any of the symptoms of a heart attack, you should call 911 or seek immediate medical treatment. Kara Bader, RN, a cardiovascular nurse practitioner at Medical City Arlington, explains what to look for.

According to Michael Isaac MD, an interventional cardiologist and Medical City Dallas’ medical director for cardiovascular quality, if you have no symptoms but two or more risk factors, you should follow up with your doctor. These risk factors include:

  • High blood pressure (hypertension)
  • Diabetes
  • High cholesterol
  • Smoking
  • Excess weight
  • Early family history
    • Male family member 40-50 with heart disease
    • Female family member 50-60 with heart disease

Do you know how healthy your heart is? Our free Heart Risk Assessment can help you pinpoint your personal risk factors for heart disease so you can start taking steps to decrease them today.

If you or someone in your family experiences chest pain, one of our many Medical City Healthcare emergency locations or Accredited Chest Pain Centers has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City Healthcare ER near you.

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How to Keep Holiday Stress from Harming Your Heart

Family sleeping on sofa at ChristmasEmergency room doctors have coined the term “Christmas coronary” to describe the more than 30 percent increase in heart attacks and heart-related problems that occur during the winter months — especially on Christmas, the day after Christmas and on New Year’s Day.

To find out who is at risk for holiday heart attacks (hint: age and gender don’t factor in), why they happen more frequently and tips to prevent them, we recommend Beware of Binging and Other Tips to Prevent Holiday Heart Attacks.

Holiday Heart
treat-the-hearts-of-texas
Christmas coronary sounds as bad as it is, but “holiday heart” — another doctor-named seasonal trend — seems as if it could be a Christmas movie (it is) or a description of what happened to the Grinch’s ticker when he gave the presents back.

Unfortunately, it’s not as jolly as it sounds. Dale Yoo, MD, a cardiac electrophysiologist at Medical City McKinney, says that if you leave the symptoms of holiday heart untreated and let it go on too long, it can lead to more serious conditions, including atrial fibrillation (AFIB), stroke and diabetes.

As the leading cause of death for both men and women in the U.S., heart disease should get used to being nicknamed. But you shouldn’t have to suffer with it, no matter which name it goes by.

So we asked Dr. Yoo to explain holiday heart and give his best advice for avoiding it this winter.

“Holiday heart can affect anyone of any age who is under stress. And today, that includes young people as well,” said Dr. Yoo. “If you are experiencing any of the symptoms below, you should make an appointment with your doctor for a checkup.”

 Symptoms of holiday heart can include:

Stress causes holiday heart.

“What do we typically do during the holidays?” said Dr. Yoo. “Our routine is disrupted and we compress a lot of activities into a very short period of time, such as hosting friends and family members, shopping, going to parties, cooking, cleaning and decorating, all of which can put additional stress on our hearts.”

Stress causes a release of hormones, including adrenaline and cortisol, which constrict blood vessels, increase heart rate and raise blood pressure. Over time, chronic stress can enable these conditions to become permanent.

Holiday heart stressors include:

  • Eating rich foods loaded with fat and sugar
  • Eating more food than normal
  • Drinking more alcoholic beverages and less water
  • Drinking more caffeinated beverages and less water
  • Staying up late and not getting enough rest
  • Exercising less than normal (who has time?)
  • Stressing over all of it

Dr. Yoo’s top 3 tips to prevent holiday heart (and other heart problems).

  1. Make sure you get enough sleep based on your age:
  • 12-14 years old / 9-11 hours
  • 15-17 years old / 8-10 hours
  • 18-64 years old / 7-9 hours
  • 65 years old and up / 7-8 hours
  1. Drink lots of water: Drinking 40 ounces of water daily can cut the risk of dying from a heart attack by 41 percent for women and 54 percent for men, versus those who drank less than 16 ounces. But more is better!
  1. Decrease (or eliminate) additional sources of adrenaline (caffeine), including:
  • Coffee
  • Tea
  • Herbal supplements
  • Energy drinks, such as 5-hour ENERGY® and Red Bull®

Additional ways to keep your heart from doing the holiday Hokey Pokey:

  • Stay well nourished: Maintain a healthy diet and indulge in just a few seasonal treats.
  • Move as much as you can: If you can’t get to the gym, take the stairs at work or find a place to walk at lunch.
  • Be happy! For a list of 10 holiday stress-busters from Radhika Vayani, DO, an internal medicine physician at Medical City Alliance, watch the video below:

Find out your risks for heart disease and start taking steps to decrease them today with our free Heart Risk Assessment.

We wish you and your family a very safe and happy holiday season, but if your heart skips a beat, one of our many Medical City Healthcare emergency locations has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Visit FastERTX.com to find a fast Medical City Healthcare ER near you.

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Do You Know How to Avoid Overindulging at the State Fair of Texas?

state-fair-fb

You can have your hot dog and eat it too with our healthy tips and nutritious, delicious fair food makeover recipes.

Have you spent the last few weeks convincing yourself that corn dogs qualify as vegetables? Is your mouth watering for one of the Big Tex Choice Award finalists like the Deep Fried Bacon Burger Dog Slider on a Stick (a ground beef patty stuffed with a hot dog, cheese and bacon packed inside a Hawaiian roll skewered and topped with a pickle, dipped in tempura batter and deep fried)?

If so, then the State Fair of Texas must be upon us — it runs September 30 through October 23 — and you, my friend, are gleefully planning to derail your otherwise healthy eating habits with these and other artery-clogging, emergency-room-worthy, deep-fried fat-laden fair foods.

But it doesn’t have to be that way.

You can avoid the heartburn and indigestion (or worse) of a post-fair-fare coma (as well as a mad dash to the restrooms) and still enjoy your fair experience. Last year, one family did it “Amazing Race” style by splitting into teams and agreeing to share just one fried specialty item, choosing healthier options for main meals, skipping sodas and counting steps — with the winning team scoring extra tickets for rides and games.

If competition or food sharing isn’t your thing, try our tasty recipe substitutions that will leave you just as satisfied as their calorie- and fat-laden inspirations. Bonus: these original recipes were created by DFW-area high school culinary students, are easy for younger kids to make, contain at least half a cup of fruits or veggies per serving and are delicious and nutritious enough to be served year-round.

Kids Teaching Kids delicious, nutritious “fair” food.

We asked Amy Haynes, a Registered Dietitian Nutritionist at Medical City Dallas and Medical City Children’s Hospital, to help us choose a few fair-worthy Kids Teaching Kids recipes you can make at home. Here are her picks.

Vanilla ice cream cone vs. Berry Cone

Ice cream cones aren’t just for ice cream in this tasty, low-fat Kids Teaching Kids fruit-filled cone, with only 2 grams of fat. Fill that same cone with its namesake (ice cream), and you’re looking at 7 grams of fat and 27 grams of sugar per serving, on average. Most important, our version provides valuable nutrients from the fruit and 9 grams of healthy protein from the Greek yogurt.

Original version:

DQ vanilla ice cream cone, small
230 calories/7g fat/26g sugar/6g protein/0g fiber

Healthier version:

Kids Teaching Kids Berry Cone
130 calories/2g fat/10g sugar/9g protein/3g fiber
By chefs Alexandra E. and Josh C. from The Colony High School

Chefs Dolly Hernandez and James Delory from The Colony High School demonstrate how to make Berry Cones.

Amusement Park Funnel Cake vs. Waffle Taco

Another deep-fried favorite providing an alarming 44 grams of fat per cake is challenged by this Kids Teaching Kids recipe with no frying required. Our healthier recipe uses waffles as the “cake” and offers nutritious and tasty toppings with significantly fewer calories and fat grams per serving as compared to this amusement park classic.

Original version:

Amusement Park Funnel Cake with Powdered Sugar
760 calories/44g fat/16g sugar/0g fiber

Healthier version:

waffle_tacoKids Teaching Kids Waffle Taco
150 calories/1.5g fat/14g sugar/3g fiber
By chefs Kayla Pinales and Ariane Mitchell from Mesquite High School

Ingredients (makes 1 serving)

  • 1 whole wheat waffle
  • 1/2 cup blueberries
  • 2 oz. vanilla non-fat Greek yogurt

Directions

  1. Lightly toast waffle in the toaster
  2. After it has cooled, scoop yogurt on top
  3. Put blueberries on top
  4. Fold like a taco and enjoy

Corny dog vs. Dawg Wrap

This Kids Teaching Kids recipe reminiscent of a corny dog provides only 4.5g of fat and an impressive 8g of dietary fiber. Compare that to the traditional jumbo corn dog at 19g of fat and only 2g of fiber.

Original version:

Jumbo Corn Dog
460 calories/19g fat/10g sugar/2g fiber

Healthier version:

state-fair-dawg-wrapKids Teaching Kids Dawg Wrap
160 calories/4.5g fat/4g sugar/8g fiber
By chefs Kellie Baxter, Jesse Bellows, Jake Long and Hayden Hagmann from The Colony High School

Ingredients (makes 1 serving)

  • 1 low-calorie whole wheat tortilla
  • 1/2 slice 2% American cheese
  • 1/2 cup of fresh spinach, tightly packed
  • 1/2 turkey hot dog

Directions

  1. Place tortilla on plate
  2. Place cheese on tortilla
  3. Add spinach
  4. Heat hot dog in microwave for 15 seconds
  5. Place hot dog on the wrap and heat for 20-30 seconds; let cool 10 seconds
  6. Roll up the tortilla
  7. Wait 45 seconds before eating

We hope you have a fun and memorable trip to the State Fair of Texas this fall, but if eating too much fried food leaves you in distress, one of our many Medical City Healthcare emergency locations has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Visit FastERTX.com to find a fast Medical City Healthcare ER near you.

Additional Sources:

CalorieKing.com

Know the 5 Killer Spices that Destroy Bacteria in Food

oysters-fbUnpasteurized juice … raw sprouts … undercooked meat … uncooked eggs … raw oysters. Is this a formula for the latest trendy health shake? No, it’s more like a recipe for why 1 in 6 Americans gets food poisoning each year. But it goes beyond that to include foods we didn’t think we had to worry about, like bagged salads from Dole, Costco’s rotisserie chicken salad, tomatoes from Chipotle and — the sweet treat that punched Texans in the gut — Blue Bell ice cream.

According to Jill Elliott, a registered dietitian nutritionist with Medical City Dallas Hospital and Medical City Children’s Hospitals in Dallas, 128,000 Americans end up in the ER annually due to food poisoning from a smorgasbord of sources: deli meats, soft cheeses, cucumbers, spinach, even caramel apples and peanut butter. The list — or should we say listeria — goes on.

Many of these foods are supposed to be healthy for us, so how can we eat them and not get sick? First, it’s helpful to recognize the symptoms of food poisoning. If you’ve never had it, think of your worst bout with the stomach flu. The problem is, symptoms may appear almost immediately or they may take weeks to develop, so it’s often hard to pinpoint what you’ve contracted and where you may have picked it up unless you’re tracking everything you eat and drink.

A good rule of thumb is to seek immediate medical treatment if you suspect food poisoning because it can be much more serious than the flu. Infants, the elderly, pregnant women and those with a weakened immune system are especially at risk.

The second, and most important, thing we can do is practice contamination prevention measures. Elliott recommends these eight precautions:

  • Wash hands and preparation surfaces thoroughly before touching food
  • Cook foods thoroughly
  • Set your refrigerator to 40⁰F and your freezer to 0⁰F (or lower)
  • Drink and eat only pasteurized juices, milk and milk products
  • Use separate cutting boards and preparation surfaces for meat and other foods
  • Don’t ingest raw eggs
  • Don’t eat prepared food that has been outside a refrigerator for more than two hours, or one hour in very hot weather
  • Always rinse fruits and veggies and dry with a clean paper towel, even if they will be peeled

Why the extreme caution with produce? Cutting or biting into food that has bacteria on the outside will drive the bacteria deeper into the food. This is also true of meat, which is why you should insist on a well-done steak in a restaurant that tenderizes theirs by piercing it with sharp instruments, and why you should be equally wary of ground meat products, such as hamburgers.

If you’re not into grilling wait staff about their meat preparation procedures, you may want to grill at home instead. Researchers at Kansas State University found five “killer spices” that can make your ground beef (and other foods) safer and maybe even more delicious. These killer five include garlic, cinnamon, oregano, cloves and sage.

K-State killer spice “recipes”

A 1 percent ratio (2 to 5 teaspoons) of garlic powder to two pounds of ground beef kills 90-97 percent of E.coli.

A 3 percent ratio (2 to 5 tablespoons) of dried plum mixture (prunes) to 2 pounds of ground beef kills more than 90 percent of major food-borne pathogens, including E. coli, salmonella, listeria, Y. enterocolitica and staphylococcus. Plus, it adds antioxidants and makes a moister meatloaf.

Just 0.3 percent of cinnamon (roughly a piled-high teaspoon) to 64 ounces of apple juice kills about 99 percent of E.coli.

While killer spices can help protect you from killer bacteria, keep in mind they’re no substitute for a vigorous hand scrubbing and a fully cooked meal. You can also monitor current food poisoning outbreaks via the Center for Disease Control and Prevention’s website.

If you do get a bad batch of something, one of our many Medical City Healthcare emergency locations has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City Healthcare ER near you.

jill-elliot-headshotJill Elliott, RDN, LD
Registered Dietitian Nutritionist, Community Outreach Programs Medical City and Medical City Children’s Hospital

Jill Elliott has a passion for great food and engaging others in better nutrition.  In her spare time, she can be found in her kitchen, slicing, dicing and cooking up appealing ways to include healthful, flavorful foods in everyday meals for the whole family.  Teaching piano lessons and getting outside with her loyal canine companion are two of her favorite activities.

Sources:
http://www.cdc.gov/listeria/prevention.html
http://hcanorthtexas.com/hl/?/11854/Food-Poisoning
http://www.foodsafetynews.com/2015/09/the-5-most-dangerous-foodborne-pathogens/#.VstUS_krKcw
http://www.eatright.org/resource/homefoodsafety/four-steps/wash/hand-washing
http://www.eatright.org/resource/homefoodsafety/four-steps/cook/complete-list-of-cooking-temperatures
https://www.k-state.edu/media/webzine/0101/plums.html
https://www.k-state.edu/media/webzine/0101/food.html
https://www.k-state.edu/media/webzine/0101/juice.html
http://www.cdc.gov/foodsafety/outbreaks/