It is still the topic of sugar!

By Cate Moriasi

Last month Kate’s blog post considered the issue of sugar addiction and here I am again talking about sugar a few weeks later. I agree with Kate’s idea of “the triad of sweetness beginning at Halloween,” or what others celebrate as Fall Festival. I exercise a certain degree of discipline when it comes to what I eat but this “triad of sweetness” is a challenge. I looked at my teenage daughter piling up covers ripped from chocolate and other candy that our neighbor had brought as a gift to her. As I hoped that she would stop herself without me having to say anything, my mind rushed through the upcoming days and festivities going right into the first few months of 2021, of course praying that we will safely navigate through this truly unprecedented 2020.

It seems as if before we fully recover from the sweet goodness of the Thanksgiving and Christmas holidays, the sweet Valentine comes along, paving way for sweet Easter. A few years ago, we filled more than half of the Easter eggs with coin money and the rest with candy, and marveled as we saw the disappointment on our children’s faces. They actually started carefully looking through the eggs so they could select the ones with candy.  The conversation that followed related to us trying to understand why the kids preferred candy even when they could use money to buy whatever they wanted, including candy. Of course, having a sweet tooth myself, I could see how hard it would be for a child to curb the instant gratification that the piece of candy brings and how disappointing it would be to open the plastic egg expecting to find candy but instead finding a dime or a quarter.

The struggle is not only with children but with adults too. During the recent Fall Festival at our church, a friend found me eating my second serving of a caramel pecan cream slab pie. She laughed and asked, “aren’t you the one who posted that article on sugar?” I said yes and proceeded to give my excuse. First of all, I think the servers had learned the popularity of that pie from last year so they cut very small pieces. Towards the end of the function I found a few pieces of this pie left and I allowed myself to get a second helping- one more tiny piece as I convinced myself. I explained that after I tasted that pie for the first time, I felt like I needed to get the recipe. But by the time I got home, I had come back to my senses and realized that it would be a bad idea for me to make the pie. Therefore, I decided that I will wait for the next year’s Fall Festival to grab a bite. Needless to say, in addition to that pie, I enjoyed some bite-sized caramel-glazed cake doughnuts before the Fall Festival was over.

You are probably wondering where I am going with all these stories. It is to acknowledge that even when we know the harmful effects of added sugar, the battle is real for those of us endowed with a sweet tooth. It is also to acknowledge that this is a battle we can fight to obtain a significant degree of victory. From my circles, I know the good news confirmed by the American Heart Association (AHA) that most American consumers want to have less sugar in their diets and are willing to give up a favorite sugary product in favor of finding a healthier alternative. I also love what they said in the same article, “The willingness is there. For now, your best defense is education.” So how do you move from willingness to actually reducing added sugar in your diet? Education is at least the first half of the battle and the AHA has done a great job providing information in easy to read articles or infographics.

Some of the questions I have heard commonly asked by friends trying to make changes are: Is brown sugar better for you than white sugar? What about honey? Well this is one of the issues addressed in the articles you will find on the AHA website. Here is an excerpt from the article, “But high fructose corn syrup isn’t the only type of sugar contributing to our over consumption.  Some sugars are assumed to be healthier than others, but added sugars like agave nectar, honey, maple syrup, coconut sugar, or date sugar have a similar effect on the body as other added sugars.”

You can visit their website to find information about main sources of added sugar in the diet,  tracking added sugars in food, tips for cutting down added sugar, and many others, including taking control of excuses to overindulge. So how did education or knowledge about the effects of sugar help me, considering my overindulgence during the most recent Fall Festival? Well, that knowledge has been the foundation for me to exercise control and discipline over what I eat for majority of the time. I have had to develop strategies like keeping tempting food items out of my house, reducing eating out and using the no-calories sweeteners like stevia or monk fruit, which are plant based, to prepare a sweet dish. The point is, once you know the effects of sugar you can come up with a strategy that works for you to cut down on sugar consumption, especially as we go into the season of festivities. Thankfully, our bodies can be weaned off added sugar so that when you choose to give in to the pie craving like I did, your body will let you know. It took me several days to get over the unwellness I felt after appeasing my taste buds with the sweet goodies during the Fall Festival.

Even for children, education is a critical step. For instance, in the story above about my daughter, I finally had to say something about how much candy she was consuming in that sitting. I’m not sure she would have stopped on her own but her response to me was, “mom these are actually tiny pieces and I’m planning to work them off.” We have of course previously had the conversation about the daunting amount of physical activity that would be required to work off a seemingly small amount of added sugar. We have also talked about the fact that you can eat some added sugar but there are recommended amounts even children shouldn’t exceed on a regular basis for the sake of their health. We have also helped our children visualize how much added sugar different foods and drinks contain, with respect to recommended amounts. Even when it is hard, my daughter’s knowledge about the effects of added sugar makes this conversation easier and helps her choose better options more often than she would be able to without that knowledge.

It is in this light that Kate and I wrote a book, “Atherosclerosis Attack: Traffic Jam in Your Arteries,” to give middle schoolers the opportunity to understand the impact of their daily lifestyle choices in a FUN way. If you haven’t yet, buy a copy of Atherosclerosis Attack for the child you care about. This book allows children to discover for themselves through a story, how their diet & exercise choices affect a real disease and what they can do about it, while learning the science about one of the major lifestyle-related chronic diseases affecting Americans.

Is sugar addicting?

By Kate Coughlan

Is sugar addicting?

Halloween begins what I like to call the triad of sweetness. With Halloween, the candy that we do not give out stays in our home for us to eat then we dive into November which taunts us with sweet pies for thanksgiving. Moving forward we head to Christmas, with candy, cookies and more sweet treats! Of course sugar is not only found in these sweet treats, but also the stuffing and bread we eat during these times.  But is sugar addictive? We know that the brain has pleasure centers that when activated makes us feel happy or content. With certain chemicals such as nicotine, it enters the brain and activates a multitude of neuronal pathways that end in the release of dopamine in what are known as our pleasure centers of the brain. As more nicotine is taken in, the pathway becomes desensitized hence more nicotine is needed for a desired effect.   There is biochemical data that supports the activation of this pathway and the desensitization of this pathway leading to nicotine addiction.  Other drugs work in the same manner. The model for addiction is also measured on certain behaviors such as using a specific drug despite the poor outcomes both mentally and physiologically as well as excessive consumption marked by a lack of control.  In addition to the aforementioned behaviors other behaviors associated with addiction include binging, craving and withdraw symptom’s (1).

Is food addiction real? Do you ever feel cravings for certain foods? Do you ever binge on food that is not deemed healthy? The question is do these feelings have a connection with brain chemistry.

Does sugar activate these pathways in the brain? The food addiction model has been accepted in the scientific world since the 50’s but there is some evidence that calls into question this model in humans hence separating scientific opinion on whether food addiction follows that of other addictions. Most of the models for sugar addiction come from work in animal models with few being derived from human subjects. For addiction to be validated there are 11 criteria based on the Diagnostic and Statistical Manual of Mental Disorders (DSM). In mouse studies five of the eleven categories were supported by animal data. For example, mice will increase their sugar intake over time and develop cravings as measured in behavior tests for addiction (2). In 2008, the Yale Food Addiction Scale (YFAS) was developed to explain food addiction in humans (3).  The YFAS is a questionnaire to measure the addictive behavior of an individual with regards to processed foods, but does not include any biochemical data that show changes in brain chemistry.  This study was also modified to look at children’s addictive behavior to various foods (3). The study used a more simplified language in the questionnaire and the questionnaire was administered to 75 children ranging from lean to obese (see example questionnaire below). Despite the small sample size (75 children), the study demonstrated that it is a useful tool for assessing addictive-like behavior in children similar to adults model.

Questions from the YFAS include

In other words, our eating habits are based on both psychological and neurobiological factors. Whether eating certain foods cause changes in brain chemistry in certain people holds true will require further investigation, but the reliance on food as a source of comfort, pleasure and want is real. So how do we handle such urges with regard to foods that contain sugar? As with any addictive behavior the key is to ween away slowly from it. I will use soda as an example.  I am a soda fanatic, and it does not make me feel great in the long term!  But I want it, I crave it, however, as I reduce my soda intake over time, eventually I no longer have those urges, however, if I decide to drink it again then those urges come back.  It is about discipline, which for me is extremely hard as I enjoy soda. But in order to maintain a healthy lifestyle we must start with good habits when we are young.

Our book, Atherosclerosis Attack, uses a story to help children see how what they choose to eat, like sugar affects a real disease. If you have not yet obtained a copy for your younger loved one, we encourage you to obtain one from Amazon or Barnes and Noble.

  1. Hoebel BG, Avena NM, Bocarsly ME, Rada P. Natural addiction: a behavioral and circuit model based on sugar addiction in rats. J Addict Med. 2009 Mar;3(1):33-41. doi: 10.1097/ADM.0b013e31819aa621. PMID: 21768998; PMCID: PMC4361030. 
  2. Wiss, D. A., Avena, N., & Rada, P. (2018). Sugar Addiction: From Evolution to Revolution. Frontiers in psychiatry9, 545. https://doi.org/10.3389/fpsyt.2018.00545
  3. Gearhardt, A. N., Roberto, C. A., Seamans, M. J., Corbin, W. R., & Brownell, K. D. (2013). Preliminary validation of the Yale Food Addiction Scale for children. Eating behaviors14(4), 508–512. https://doi.org/10.1016/j.eatbeh.2013.07.002

The Power of Your Immune System Could Very Well Depend on You

By Cate Moriasi

Your body is equipped with systems that work together to enable proper body function. The immune system plays the role of defender, defending your body against intruders like the Corona virus responsible for the current COVID-19 pandemic. This virus has brought the importance of having a strong immune system to the attention of many since survival depends on the body’s ability to fight off the viral infection. Fortunately, this has been the case for most of the people who have been infected by the virus.

Even though the number of people who have died from COVID-19 is a small fraction of those who are infected, these statistics don’t ease the pain for the ones that have suffered loss. Learning more about this disease has made it possible to identify groups of people who are at increased risk of getting seriously sick or dying. People with underlying medical conditions including those with lifestyle-related (diet & exercise) chronic diseases such as obesity, type 2 diabetes, and coronary heart disease made the list.

How these underlying conditions make the outcomes of COVID-19 infection worse, could be as simple as the viral infection overwhelming body systems that are already overwhelmed with the constant battling of the chronic disease. It could be that COVID-19 makes the specific chronic disease worse like it is suggested to worsen heart disease. Or it could be that these chronic diseases have already compromised the immune system such that it just cannot fight COVID-19. This seems to be one reason type 2 diabetes and obesity increase the risk of serious sickness and even death from COVID-19.

Obesity is a complex disease involving an excessive amount of body fat.” Type 2 diabetes is a chronic condition that affects the way your body metabolizes sugar, resulting either from reduced ability of the body to produce insulin or making the body resistant to the effects of insulin. Obesity causes defects in some immune cells in addition to increasing the risk for type 2 diabetes. And in the case of type 2 diabetes, high blood sugar weakens the immune system making it less able to fight off COVID-19.

These chronic diseases don’t develop overnight but over a life time. Little by little as you make your daily choices of what to eat and whether to exercise or not, you prevent or pave the way for these lifestyle-dependent diseases. As these diseases get established, your immune system suffers. This underscores the importance of you making choices that protect your immune system in order for it to defend you at a later date. The other name for type 2 diabetes, adult-onset diabetes, is becoming obsolete because there are increasing numbers of children developing type 2 diabetes, probably due to increasing obesity in children.

The aim of our chronic disease patrol efforts is to partner with caretakers to help children take charge of protecting their health starting at an early age and reduce the burden of chronic diseases later in life. To that end, we wrote and published a book, Atherosclerosis Attack, meant for middle schoolers. The Atherosclerosis Attack book allows children to discover for themselves through a story how their choices affect a real disease and what they can do about it. Learning and incorporating the information presented in our book early would allow kids to adopt lifestyles that would be helpful in preventing not only atherosclerosis and associated heart issues but also other lifestyle- dependent chronic conditions such as obesity and type 2 diabetes.

Bottom line is, taking care of your immune system is a lifetime job. It begins with you as it is your decision on what foods will be available for your child. Unfortunately, as they grow older and more opinionated, it becomes harder to make them eat or do what you know is good for them. You still care that they are healthy, but day after day you are faced with endless breakfast, lunch or dinner negotiations and constant reminders to your child to put away the electronics and get moving. Our book can help you. So give that child you care about an opportunity to really understand the impact of their daily lifestyle choices in a FUN way. Buy them a copy of Atherosclerosis Attack, work through it with them, so you are on the same page, and experience the power of useful knowledge. See what a parent/reviewer writes about the book.

Implementing interactive activities while reading Atherosclerosis Attack.

By Kathleen Coughlan

All books have lessons to be learned. This could be conflict resolution, how to deal with a bully, or even how-to problem solve.  Many ask me how I would classify our book; my response is that it is not a science textbook but nor is it a Harry Potter novel.  Our book is unique in that it allows kids to really take a hands-on approach to learning while using a fun action filled book. In these uncertain times, continuing to raise children in a hands-on world while fostering creativity is tough. Our book allows students to enhance their reading skills and to engage in the book with science-based activities we as educators deem curriculum.  As the child engages in the material from the book, they are challenged to reflect on their eating habits and activity levels. This allows the child to take control of their life by promoting healthy choices and the reason behind these choices.

Cate and I are collaborating with educators from the public schools to develop a curriculum for our book. More recently we had the opportunity to develop and submit curriculum to an online summer camp (CAMP SCBWI) which focuses on food and nutrition. This curriculum is posted on our website (https://chronicdiseasepatrol.com/upcoming-book/) as downloadable files for all to use alongside the book. For this curriculum we focused on Chapters 12-17 of the book as these are the chapters that emphasize nutritional value.   

So, what would you expect from this curriculum?

In the book, the scientific sleuths talk about the defenders and villains of the body with regards to factors leading to atherosclerosis. They include discussions on salt, carbohydrates, and fats in this process, breaking down each as a defender, villain or in some cases both.

In one activity, the child uses the book to research whether a molecule is a villain or defender of the body.  The child digs deeper by providing an example of a food source that has that molecule in it.

For example on page 115 of the book it states “Fiber, the soluble one, like fiber in oatmeal. It’s the one we need to reduce absorption of cholesterol. Scientists say it holds on to water and makes a very thick mix in the intestines, which makes it hard for absorption.”  This provides the child with information about soluble fiber and allows them to make a connection that fiber is a defender as it prevents cholesterol from being absorbed into the blood stream.  The child can then investigate foods that are high in soluble fiber such as oatmeal. The child uses the table below to fill out the villains and defenders and lists some examples of foods that may contain these molecules.

As the curriculum builds, it allows the child to apply these concepts to real world applications. For example, the students have a lesson focused on reading a food label and calculating total caloric intake, a lesson that will serve them well for a healthier life.  In addition, the child can reflect on their own eating habits by filling out a food journal which is presented in the curriculum as a formatted table to guide the child to not only write down the food eaten but also think about the foods they selected (see abbreviated table provided below).

The activity book is filled with critical thinking type questions that force the child to engage in the book and in the activities without being too challenging that the child feels overwhelmed.  Moreover, if needed, an answer key is provided for the parent to assist in managing the child’s progress.

Our book, Atherosclerosis Attack, uses a story to help children see how what they choose to eat, like sugar, affects a real disease while the curriculum challenges the child to apply this concept to their own life. Although the book is fiction, the science behind it is based on fact which has been validated using the scientific method. Hence, using the curriculum along with the book is a wonderful teaching tool!  If you have not yet obtained a copy for your younger loved one, we encourage you to obtain one from Amazon or Barnes and Noble. Also check out the curriculum at https://chronicdiseasepatrol.com/upcoming-book/, scroll down to facilitator’s guide.

Check back with us soon as a full set of curricula with fun hands on learning will be available soon!

Understanding Food Labels

June 4 2020

Kate Coughlan and Cate Moriasi

In normal times, grocery shopping for me was like any other shopping experience. I had no list, no plan and perused the isles while grabbing items that looked good. I had no worries as the grocery store was a few miles from my house and if need be, I could always stop by again after work. Meal prep for us was on a day by day basis depending on what we had in the house and what we were willing to stop and get.  Having said that, in normal times I was not panicked, and I read food labels for salt content and other nutritional value. This all changed during the pandemic both for the good and bad. During the beginning parts of this pandemic, my food shopping was a mission. I made a list and organized it by isles, skipping those isles that were not the list. I was quick, grabbing items without looking at the food labels and hoping for the best.  On the plus side, the pandemic made me meal plan and not shop haphazardly, thereby picking junk food I did not need, on the negative side I ignored food labels. As things appear to be calming down, I have found that grocery shopping during the pandemic taught me two important lessons: 1. Take the time to look at food labels and 2. Make a shopping list.   Below are hints and cautions when reading a food label that I have learned over the years.

With regards to the food labels what do I look for and what have I learned over the years about food labels?  The food label is mandatory per the Federal Drug Administration (FDA). The major categories on a food label include: Serving size, Calories and amount per serving, Total Carbs, Sugars, Added Sugars, Fiber, Fats (Saturated, Unsaturated and Trans fat), sodium, list of ingredients, and %DV.

Resources:

https://www.fda.gov/food/nutrition-education-resources-materials/new-nutrition-facts-label https://www.diabetes.org/nutrition/understanding-food-labels/making-sense-of-food-labels

Serving size:

The serving size is the most important components as the nutritional parameters are based on it. This can also cause issues for buyers, because if one does not pay attention to the serving size, calories, salt, fats and carbohydrates may add up quickly. Let’s take a look at the example below.  At first glance the label draws your attention to the calories which state 25.  You think to yourself, that is not too bad, 25 calories, especially when you look at a bag of potato chips which have a 160 calories. 

The food label for the olives has a total fat content of 2.5 g whereas in the chips the total fat is 10 g. According to the labels neither contain trans fat, and the saturated fat is 0.5 g in olives vs. 1.5 g in chips.  Looking at the sodium content, the olives have 230 mg whereas the chips have 170 mg. As expected, the chips have carbohydrates whereas the olives do not.

 OlivesChips
Calories25160
Total Fat2.5 g10 g
Sodium230 mg170 mg
Total Carbohydrates0 g15 g

However, this comparison is not taking into account the serving size!  Let’s say you eat 15 chips and 15 olives, what will the numbers look like if we take into account serving size.

 OlivesChipsOlivesChips
Amount you eat  1515
Serving size415415
Calories2516093.75160
Total Fat2.5 g10 g9.375 g10 g
Sodium230 mg170 mg862.5 mg170 mg
Total Carbohydrates  0 g15 g

To calculate this, take the number of olives eaten and divide by the serving size (15/4 = 3.75). Then multiply all the food label amounts by 3.75 to get the actual nutritional value (red text). WOW!  Because the values were based on such a low serving size (4) eating more than 4 olives can really increase the calories, fat and sodium levels that you consume.  Of particular note is that now the 15 olives no longer have the attractive 25 calories, and the fat content is now similar to the same amount of potato chips. Although realistically, who eats just 15 potato chips!  What is really astounding is the sodium levels. The 230 mg was high to begin with but eating more than 4 really increased this to levels that may be concerning especially for those with high blood pressure.  The main point is to make sure you do not get taken in by the large bold text that claims the calories as one must take into account serving size!  

Total Carbohydrates:

 The food labels below are from sourdough and multigrain bread.  The serving size is the same at 1 slice although the sourdough bread (32 g) is a bit more food compared to the multigrain bread (27 g).

Let’s take a look at the total carbohydrates which is 15 g for the sourdough and 12 g for the multigrain.  If you look at the label, the components under the total carbohydrates do not add up. Why?

 SourdoughMultigrain
Total Carbohydrates15 g13 g
       Dietary Fiber1 g1 g
       Total Sugars0 g2 g
           Includes added sugars0 g2 g

The total carbohydrate include the fiber (listed above), Sugars (both natural and added, with specific amount of added sugar), and starch (https://www.fda.gov/food/new-nutrition-facts-label/added-sugars-new-nutrition-facts-label#:~:text=1.,to%20eat%20in%20a%20day). The remaining carbohydrates in the total once you subtract fiber and sugars is that of starch.  Starch is a polysaccharide that consists of many sugar molecules that are held together by chemical bonds. The total sugars listed are the natural sugars along with the added sugars, and the added sugars are specific amount added to the food.  For the multigrain bread the total sugar content is 2 g with all 2 g coming from added sugar and none coming from natural sugars.

The reform to the Nutrition Facts label by the FDA required that the amount of and percent Daily Value for Added Sugars be declared. This was to enable consumers to construct diets more consistent with the Dietary Guidelines for Americans. This change was in response to an acknowledgement that Americans on average are consuming Added Sugars in amounts that exceed recommended limits.

It’s possible that America’s sweet tooth has developed over the years as sugar has increasingly been added to more foods. This increase has seemed to parallel an increase in all sorts of health problems and currently there is plenty of evidence that added sugars play a significant role in these problems.

We probably all know that once one develops a sweet tooth, the habit is very hard to break. Cate and I’s goal through these posts and the book we have written is to help children who are still at an impressionable age get information that can help them make simple choices that would help them adopt lifestyles that would reduce the burden on chronic diseases later in life. Our book, Atherosclerosis Attack, uses a story to help children see how what they choose to eat, like sugar affects a real disease. If you have not yet obtained a copy for your younger loved one, we encourage you to obtain one from Amazon or Barnes and Noble.

Please stay connected with us on FacebookTwitterInstagram and Pinterest

Heart Health During the Quarantine Period

By Cate Moriasi

My pastor called the times we find ourselves in “unique”. I thought about this word and it seems to capture a lot of what is going on during this COVID-19 pandemic period. For many, this means a lot of pain and heartache because they are infected and battling the disease. Some have lost loved ones and are experiencing unthinkable pain. For others their businesses, investments, jobs and livelihoods are in trouble. Then there is the quarantine that has kept the majority in their homes. I had never had to associate with the phrase “stir crazy,” until I heard it about 3 times from different people within a couple of days. Well, now I know that it describes a condition of being “distraught because of prolonged confinement.”

These unique times have given all of us an opportunity to step back and reflect on what really matters. One of the things that is certain during these uncertain times is that life is fragile. As we consider what we have believed to be important and realign our priorities, hopefully we consider the condition of our hearts – whatever that looks like for each one of us.

One of the things Kate and I focus on, as chronic disease patrol agents, is the condition of the physical heart you feel beating in your chest. Our goal is to encourage your young ones to start safe guarding their heart health at a young age. You might wonder why I would bother with this topic during this “unique” time.

Well, I was surprised when I saw people rushing for toilet paper in Walmart. I definitely hadn’t done a good job anticipating what was coming with the looming quarantine. A couple of days into the quarantine I realized I didn’t have oatmeal. No big deal, I thought, I will just run to Sam’s club, do a good job keeping 6 feet from everyone, grab my usual big pack and return home. You can imagine my feelings when I couldn’t find my regular rolled oats at Sam’s, Walmart and several stores I usually don’t buy groceries from, like Walgreens. Oatmeal has been my breakfast staple for more than a decade and I guess the frustration was not being sure how to replace it within the short time I had given myself for grocery shopping. I ended up visiting more stores than I had planned, stores that were quite crowded and I still didn’t have oats at the end. I switched to online stores with no success.

But my frustration didn’t last long as I realized that people had stocked up on oats as a sign that they care about the condition of their physical hearts. Of course, this maybe because of the long shelf life of oats but there are plenty of less healthy options with a long shelf life, so the fact that oats were stocked up was satisfying. As this is my passion, I settled for not having oatmeal and thankfully my freezer had some oatmeal cups that I had prepared sometime back, following recipes in the Trim Healthy Table book. Now oats are back in some grocery stores but before then, I actually got some from a friend, who had an extra container that her husband bought not knowing she had already purchased oats. My hope is that all the youngsters stuck at home are eating oatmeal and other health alternatives. For more information on why oatmeal is heart healthy visit the following website:  https://www.hsph.harvard.edu/nutritionsource/food-features/oats/.

It has also been encouraging to see that items like beans and cauliflower rice have been selling out too. But while I was still celebrating the possibility that people are choosing to eat healthy during this time, I realized that along with some stores having to ration eggs the sugar isles were also emptying out. The quarantine has forced people to cook more, but more of what? It is tough to focus on healthy eating under the circumstances we find ourselves in. I have had to prepare some comfort food just to lift our spirits. In fact, we are having to work very hard not to fall for the temptation of regular comfort eating that we know is not good for our hearts.

I believe we are not the only ones struggling in this regard, so I decided to share a couple of ways that families can choose to be intentional about protecting their hearts during this time.

1. Choose to shop for heart healthy foods.

Grocery shopping has become a challenge but we all have to find ways to make it happen, and while at it, why not make it count. Whenever you get an opportunity to shop, choose heart healthy options. Now that we are at home, we need more snacks and the last time I was at Sam’s I considered buying chips which would make a really easy snack for my kids but I decided against it. Fortunately, I was still able to get fruit so I stocked up on apples and oranges instead. I considered buying some dried fruit, unsalted or lightly salted nuts, skinny popcorn and other healthy options available in the grocery stores. My daughter also found some healthy recipes for smoothies and I bought the ingredients. The point is to make a conscious choice not to make too many unhealthy alternatives available at home. If you are one of those buying eggs, hopefully you are choosing to prepare healthy recipes instead of sugar-loaded desserts for each day you are at home.

2. Work with your children to discover and prepare heart-healthy recipes.

One of the things our family has had to work hard at, is to find activities that will occupy our kids and minimize the time they spend on technology, with no more gym to go to. We have tried several things including pulling weeds from the backyard and it was amazing that we got better attitudes after pulling weeds than after a couple of hours of Nintendo Switch. However, the best part has been involving them with cooking. We made our first carb–free pizzas and each of them assembled theirs as they desired and were really happy with what they made. The process used up quite a bit of time, kept us on our feet and it was fun for the whole family. If getting your kids to eat healthy has been a struggle, this is the time to involve them in finding healthy recipes and let the family work together to prepare them. You might be surprised with what they come up with, like I was when my daughter asked for ingredients to make a smoothie that had okra as one of its ingredients. If you are not sure where to start, we have a couple of posts on our blog that you can read to get ideas, including, How to use my plate and Eating for your taste buds or your body? And there are other website with healthy recipes like, https://www.hsph.harvard.edu/nutritionsource/recipes-2/home-cooking/

3. Also, if you haven’t yet, use the opportunity for your kids to read our book, Atherosclerosis Attack: Traffic Jam in Your Arteries and learn all they can about starting early to safeguard their health. You can get your copy from Amazon or Barnes and Noble.

Please stay connected with us on FacebookTwitterInstagram and Pinterest and share your ideas on how you are maintaining a heart-healthy lifestyle during the quarantine.

Finally, this unique time is very difficult for many.  Let’s look for opportunities to be grateful in the midst of this trying time and look for opportunities to creatively help others while honoring the mandated quarantine and praying that this COVID-19 will be eliminated from our world sooner than later.

“You Are Never Too Young to Start Heart-Healthy Living”

By Cate & Kate

We have talked about a couple of people who have been affected by heart complications in the recent past. These ladies in their 40s and early 50s were getting on with their normal lives. One died of a sudden heart attack and one is alive because the constant discomfort she felt caused her to search for answers, which resulted in medical intervention that saved her life. It is important to note that a heart attack can happen to even younger people. For example, statistics reported in an article published last year (September 2019) indicated a rise in heart attacks in people in their 40s, 30s and even 20s. One factor that can be a lifesaver is knowing the symptoms of a heart attack and these can be different for men and women.

Heart attack symptoms: Men vs. women

MenWomen
Squeezing chest pressure or pain
Jaw, neck or back pain
Nausea or vomiting
Shortness of breath



Chest pain, but not always
Pain or pressure in the lower chest or upper abdomen
Jaw, neck or upper back pain
Nausea or vomiting
Shortness of breath
Fainting
Indigestion
Extreme fatigue

As one scientist puts it, “preparation for a heart attack comes down to actively trying to prevent the heart attack by eliminating as many risk factors as possible.” This is in agreement with the advice from the American Heart Association encouraging us to do whatever we can to lower our risk of a heart attack – “because for many people, their first heart attack is disabling or even fatal.”

A heart attack happens when blood flow that supplies the heart with oxygen and nutrients is cut off, leading to death of the heart muscle. Usually the underlying culprit is atherosclerosis, a process by which plaque deposits in arteries causing them to narrow or causing a complete blockage as a result of plaque presence. This process of atherosclerosis takes place slowly, usually starting in childhood and showing no symptoms until a heart attack occurs. Granted, there are factors beyond one’s control that increase one’s chance of getting a heart attack, which include age, gender and heredity. Fortunately, there are several factors that we can control. These include, cholesterol, blood pressure, diabetes, stress, exercise, diet and avoiding smocking or exposure to tobacco smoke.

American Heart Association advises that it is beneficial for a person to understand their risks for heart attack and then embark on heart attack prevention – this prevention should start early in life. We wrote Atherosclerosis Attack to provide a fun way for middle schoolers to learn about this important topic. The atherosclerosis story is told through the eyes of children and seeks to help other children understand why they need to start at a young age to work towards lowering their risk of a heart attack.

This book is also beneficial to the parents and care takers who want to help their loved young ones be proactive about preventing a heart attack. The reasons behind the need to start at a young age are presented in a story that children can identify with and would provide them with a clearer understanding of why they need to make certain dietary and lifestyle choices. To assist with learning about and executing healthy living, the book provides some great resources in the last chapter to help engage schools, students and parents. In addition to those resources, here we provide a few more tips and links to keep the family in an active role regarding prevention of chronic diseases.

Getting kids interested in healthy living: Using Pinterest, YouTube and other social media platforms, it is easy for parents to design an experiment that kids can do to actively engage in the science of healthy living.

How much sugar is in what you eat and drink? A food label lists the amount of sugar in a substance, but often 22 g or 12 g is not visualized well with kids or adults. Hence in this visual experiment, kids can measure the amount of sugar into baggies and see firsthand the amount of sugar in their favorite soda, juice or fruit.

Nimali Fernando, MD: In response to the growing rates of childhood obesity, pediatrician Nimali Fernando MD, MPH started the website https://doctoryum.org/ in 2011 to teach her patients and their families about the benefits of healthy eating. What started out as a recipe and parenting site, grew to a bigger project of teaching a healthy lifestyle to the greater community. You can check her website for webinars, recipes and other fun items that emphasize cooking as a whole family affair.

PBS Website: This website contains creative games that enable young kids to engage in healthy living and learn about the human body. It offers exciting games, printables, recipes and videos.  And best of all, it is free! The following links will show you examples of what you can find on the PBS website. https://pbskids.org/games/healthy-habits/ and https://pbskids.org/lunchlab/

CDC Website: This website contains a downloadable book with fun coloring pages, games and stickers that demonstrate healthy eating and regular activity. https://www.cdc.gov/family/kidheroes/index.htm

If you don’t already have a copy of Atherosclerosis Attack for your children or those in your care, we encourage you to get one from Amazon  or Barnes and Nobles and explore how you can help your children learn to be become a force against the unwelcome intruder of their bodies.

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Atherosclerosis is a Big Word Worth Knowing

By Cate Moriasi

One question I have heard several times in the last few weeks is, “Athero…….., how do you say that word?” That question has often come after someone says congratulations on getting your book published. Atherosclerosis Attack is a book we published to help middle school students learn about atherosclerosis through a story that they can identify with. Of course, we have received feedback that the book communicates the message about atherosclerosis well and would benefit readers of all ages.

When we decided to write this book, we knew that atherosclerosis is a big word, a difficult word, not an everyday word, a word that seems like it should belong on the spelling bee list. However, whether we know how to say this word or not, it is affected by decisions we make every day regarding how we take care of our bodies. Atherosclerosis happens when plaque builds up in your arteries, the blood vessels that carry oxygen-rich blood. This leads to narrowing of the blood vessels and restricting the flow of blood to other parts of your body. Also, if a piece of the plaque breaks off, it gets carried by the blood, and gets stuck, completely blocking off blood supply leading to serious complications like a heart attack, stroke, or other conditions depending on which artery is blocked.

Even so, why is it important to bother children with a big word like atherosclerosis? The answer is, atherosclerosis is a disease that doesn’t develop overnight but over a life time. In fact, according to American heart association, atherosclerosis may start in childhood and progress rapidly for some people in their 30’s even though it usually doesn’t become dangerous until they are in their 50’s or 60’s. The danger is that atherosclerosis develops silently; for instance, someone may not have any symptoms until they have a heart attack. But atherosclerosis is preventable because it is very much affected by diet and exercise.

So hopefully you understand why we would like to make atherosclerosis a common word even for children. In reality, atherosclerosis is an everyday word whether we can pronounce it or not. This is because it is affected by the choices we make daily about what we put into our bodies, one meal at a time, and whether we choose a physically active lifestyle or not. Kate and I want to make this word part of children’s vocabulary because the best remedy against atherosclerosis is prevention – developing a preventative lifestyle. We believe it is possible to get children excited about knowing this big word, and having that knowledge can affect their diet and exercise choices. Children have a great imagination and a tremendous ability to learn, and we seek to give them reasons to learn and care about the big word, atherosclerosis.

My husband asked our son how he got into the spelling bee and his response was, “well, I was able to spell most of the words the teacher gave us, including the bonus word, cholesterol.” He was quite excited about being able to spell the word cholesterol that had become a part of his vocabulary because we often talk about it at home. The reasons other children might be interested in learning a big word like atherosclerosis might be different. But why not give children an opportunity to learn a word that prefers to remain a silent part of their daily lives even with the dangers it poses, dangers which need to be exposed for the long-term well-being of the children. If you don’t already have a copy of Atherosclerosis Attack for your children or those in your care, we encourage you to get one from Amazon  or Barnes and Nobles and explore how you can help your children learn to be become a force against the unwelcome intruder of their bodies.

Now, to help with the pronunciation, click on the following volume emoji 🔊. It should take you to the Merriam Webster dictionary and once there, click on the volume emoji to listen to the pronunciation of atherosclerosis \ ath·​ero·​scle·​ro·​sis \ a-thə-ˌrō-sklə-ˈrō-səs  

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Introducing Atherosclerosis Attack

By Cate Moriasi

Kate and I are excited to announce that our book, Atherosclerosis Attack, which we have talked about in some of our posts, is finally published and available on Amazon in paperback and kindle edition.

We have written this book for middle schoolers, using a story to teach them about atherosclerosis, the underlying cause for most heart-related deaths. Atherosclerosis happens when plaque builds up in one’s arteries, and depending on which artery is affected different complications can result. For example, a heart attack can result if the arteries that supply blood to the heart are affected. Atherosclerosis doesn’t occur overnight; it develops over many years and may start during childhood even though complications from atherosclerosis usually don’t manifest until later in life.

The good news is that atherosclerosis can be prevented or at least its progression slowed down because it is largely dependent on lifestyle choices such as diet and physical activity. Many adults are aware of the importance of adopting or maintaining a healthier lifestyle and are actively working towards it. However, many parents struggle to get their children to eat healthy and some give up because it’s a battle that is too difficult to fight.

Just imagine if children knew exactly how sugar negatively impacts their bodies, what would they do? I’m sure they will still want to consume that sugary item to satisfy their craving. However, they might be willing to work out a plan to help them balance their cravings with what they know they need to do for their well-being.  Many children hear their parents say certain things but the ‘aha’ moment might come from someone else saying the same thing.

Atherosclerosis Attack, is a science fiction book written to help children understand how a real disease, atherosclerosis, develops and how it can be prevented. The engaging and adventure-packed story will challenge young readers to think differently about what they eat and how that relates to a real disease. Using the story format that makes learning fun, we teach children about nutrition, exercise, cholesterol, and developing good habits that have the potential to last a lifetime. As children learn that life is full of choices, our hope is that the information they get out of this book would make it easier for them to make healthier choices. Our goal is to inspire children to take charge and be heroes of their own health.

This book was largely inspired by my then eight-year old’s interest in my atherosclerosis research. He saw images on my computer and asked what they were. I explained to him that they were pictures showing atherosclerosis in blood vessels of mice. His response was, “What? What did you say?” So, we worked on the big word but he kept asking questions, wanting to know more. After the explanation of how the nice-looking blood vessels belonged to mice that had eaten fish oil and the not-so-good-looking blood vessels belonged to mice that ate bad food, he asked if that could happen to people and I told him, “yes.” When he said he didn’t want atherosclerosis in his blood, I realized that a child had understood something I would never have expected him to understand. This book project came together when my friend and colleague said, without knowing my interaction with my son, that she would like to communicate science in a fun way to children.

Here is a short description of the book. “Twelve-year-old Victor Valens and his eleven-year-old cousin Sal Sultus live on opposite sides of the country until Sal and her mother move next door to the Valenses. The children struggle to get along, and their world is further shaken when their grandpa gets sick. They try to understand the disease that has struck him and determine that the underlying cause is a deadly disease with a big word, atherosclerosis. They partner up to create a simulated computer adventure and travel into the world of atherosclerosis.”

We hope you can get a copy for your middle schooler, read along with them if possible, and start the conversation regarding what they learned about protecting their bodies and what they can do to start making small changes that will benefit their bodies in the long run. The book can be used in home or school settings. We are also working on a facilitator’s guide that will be useful in guiding conversations and getting the young readers to think about what they read and how they can apply it. If you enjoy the book, please post a review on Amazon.com and on your favorite social media sites. Thank you and please stay connected with us on Facebook, Twitter, Instagram and Pinterest.

How to Use MyPlate

For more information visit MyPlate and Choose MyPlate

By Cate Moriasi

Through our blog and book, Atherosclerosis Attack, we seek to empower children to be proactive in making healthy choices and protecting their bodies from diet-related chronic diseases, starting at an early age. MyPlate, which was published by the USDA based on Dietary Guidelines for Americans, is a great tool that can be used to help children visualize what they need to do regarding food choices. It is simple enough for children to understand and it is not only a good conversational starter about what the child should be eating but it has the potential to stick with them for a lifetime. As in the picture below, MyPlate shows a single meal with a plate divided into four different food groups: fruits, grains, protein, vegetables and a fifth side portion of dairy. The picture also depicts portion sizes of the different food groups that should be consumed; for example, the half side of the plate should have more vegetables than fruits.

This tool is simple, even though it comes with additional recommendations such as using whole instead of refined grains, using a variety of lean proteins, a variety of fruits and vegetables, low fat dairy and limiting added sugar and salt. Many people are probably using it as a mental guide to make their kids’ plates but they could push it further by involving their children. Recently, I asked my 7th grader if she had ever heard of MyPlate and her response was “yes.” “At school?” I asked. “No, you told me about it,” she responded. If MyPlate has been taught or presented at school, she somehow does not remember. However, she was able to describe the contents of MyPlate and the implied proportions perfectly. “Isn’t half of the plate supposed to be fruits and vegetables, with more vegetables than fruits? She asked and went on describe the rest of the contents.

That’s why I believe it is important for caregivers to have the conversation about this simple visual tool with children, as soon as they can understand. I regularly use MyPlate as a guide when I make my daughter’s plate or to guide her when she makes her own plate.  We hadn’t talked about it for as long as I could remember, but she remembered it accurately from whenever we talked about it. Somehow children figure out, very early in life, what tastes good and what doesn’t. What they usually don’t know are the long-term effects of not eating certain things like vegetables. Most children try their best to eat vegetables because mom probably said they can’t have dessert if they don’t. This approach may work for some children who can develop an acceptance for certain foods, such that they are able to select them without mom threatening to withhold dessert.

For many other children like mine, it’s essential to give them better reasons to choose well for their bodies. The conversation about MyPlate is great for those who always seem to resist until they hear another person saying the same thing mom has been saying. MyPlate can be blamed on science. I have had to tell my daughter that, it’s not me who is trying to supposedly “torture” her with vegetables and prevent her from enjoying sweets. But rather, scientists have studied food patterns and health and they have determined that if we consume certain foods over a long time, or fail to consumer others, we are hurting our bodies, one meal at a time, even when we don’t feel the damage right now.

So how can you go about incorporating MyPlate in a food conversation with your child? The first thing is for the parent or caregiver to familiarize themselves with MyPlate. Parent and teacher resources are available to use with children starting in kindergarten. One option to start the conversation is to discuss with the child what he or she knows about eating well. Ask them what eating well means to them and why they think it is important. Follow this with a picture showing what scientists have determined as eating well, to help resolve some questions the child may have in their mind. You can then ask them about each of the five food groups, for example, the kind of vegetables she/he likes.

As you work your way through the food groups, discuss what could make each of the food groups unhealthy, for instance adding sugar, lots of fat and salt. But what can the children do about all the fun things they like to eat but are not good for their health? We can help them understand that those things can be saved for special occasions. Definitely baby steps, and not drastic changes, are needed in this regard. For example, choosing to add broccoli or another vegetable to the plate or 100 %juice instead of soda. However, the most important thing is to make these changes fun. There are several resources available in MyPlate and Choose MyPlate websites, including posters, games and recipes.  

I especially like the Choose MyPlate website and would encourage you to explore it with your child and learn more about each food group. You can browse it by audience and visit MyPlate Kids’ place, among others like MyPlate, MyWins, which has ideas about making healthy choices based on your personal eating style. But my favorite is MyPlate Kitchen. You can browse MyPlate recipes based on: the course you are interested in, for example appetizer; the kind of food group and nutrition focus, for example protein with reduced sodium;  the cooking equipment you want to use, for example electric grill; the cuisine, for example Mediterranean or American; and/or the amount of money you want to spend. The website also has an option of creating your own cookbook online, which might be a fun activity for some children. I hope you will find time to explore MyPlate and use available resources to help your child’s journey of making one healthy choice at a time, to safeguard their health.

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