A concussion is a brain injury that may result when the head hits an object or a moving object strikes the head. It can occur from a fall, sports activities and motor vehicle accidents. It may result in a bad headache, altered levels of alertness, or unconsciousness. Significant movement of the brain (called jarring) in any direction can cause you to lose alertness (become unconscious). How long you remain unconscious may be a sign of the severity of the concussion. Most people who have a concussion never pass out. You can have a concussion and not realize it.

Concussion temporarily interferes with the way your brain works, and it can affect memory, judgment, reflexes, speech, balance, coordination, and sleep patterns.

Symptoms of a concussion can range from mild to severe. They can include:

• Drowsiness or hard to arouse
• Confusion, feeling spacey, or not thinking straight
• Headache
• Loss of consciousness
• Memory loss (amnesia) of events before the injury or immediately after
• Nausea and vomiting
• Seeing flashing lights

The following are emergency symptoms of a concussion. Seek immediate medical care if there are:

• Loss of consciousness
• Convulsions (seizures)
• Muscle weakness on one or both sides
• Persistent confusion
• Persistent unconsciousness (coma)
• Repeated vomiting
• Unequal pupils
• Unusual eye movements
• Walking problems

Head injuries that result in concussion often are associated with injury to the neck and spine. Take particular care when moving patients who have had a head injury.

While recovering from a concussion, you may:

• Be withdrawn, easily upset, or confused
• Have a hard time with tasks that require remembering or concentrating
• Have mild headaches
• Be less tolerant of noise

The doctor will perform a physical exam and check your nervous system. There may be changes in your pupil size, thinking ability, coordination, and reflexes.

Tests that may be performed include:
•    EEG (brain wave test) may be needed if seizures continue
•    Head CT scan
•    MRI of the head

If the concussion occured during a sporting event and resulted in a headache, confusion, or change in alertness, a trained person must determine when that person can return to playing sports.

Children with concussion symptoms should avoid sports and from being overly active during recess, physical education classes, and other playtimes. Ask your doctor when your child can return to normal activities.

When your child can safely return to normal activities depends on the severity of the concussion. Some children may need to wait 1 to 3 months.

Ask your child’s doctor if it is okay before the child participates in any activity where there is a risk of hitting or injuring the head. Specifically, ask when your child can:

• Play contact sports, such as football, hockey, and soccer
• Ride a bicycle, motorcycle, or off-road vehicle
• Driving a car (if they are old enough and licensed)
• Ski, snowboard, skate, or participate in gymnastics or martial arts

An adult should stay with you for the first 12 – 24 hours after the concussion. Going to sleep is okay. However, someone should wake you up every 2 or 3 hours for the at least the first 12 hours. They can ask a simple question, such as your name, and then look for any changes in the way you look or act.

Complications from a concussion can include:

• Bleeding in the brain (intracerebral hemorrhage)
• Brain injury that results in physical, emotional, or intellectual changes

The second impact syndrome (SIS) is when a person gets a second concussion while still having symptoms from a first one. This raises the risk for brain swelling, which can be deadly.
How to prevent Concussion?
Attention to safety, including the use of appropriate athletic gear, such as bike helmets and seat belts, reduces the risk of head injury.

References
1.    PubMed Health
2.    Ropper AH, Gorson KC. Clinical practice: concussion. N Engl J Med. 2007;356:166-172.
3.    Hunt T, Asplund C. Concussion assessment and management. Clin Sports Med. 2009;5-17.
4.    American College of Sports Medicine.

Researchers found that adults with higher intakes of milk and milk products scored significantly higher on memory and other brain function tests than those who drank little to no milk. Milk drinkers were five times less likely to “fail” the test, compared to non-milk drinkers.

Researchers at the University of Maine put more than 900 men and women ages 23 to 98 through a series of brain tests – including visual-spatial, verbal and working memory tests – and tracked the milk consumption habits of the participants. In the series of eight different measures of mental performance, regardless of age and through all tests, those who drank at least one glass of milk each day had an advantage. The benefits persisted even after controlling for other factors that can affect brain health, including cardiovascular health and other lifestyle and diet factors. In fact, milk drinkers tended to have healthier diets overall, but there was something about milk intake specifically that offered the brain health advantage, according to the researchers.

In addition to the many established health benefits of milk from bone health to cardiovascular health, the potential to stave off mental decline may represent a novel benefit with great potential to impact the aging population. While more research is needed, the scientists suggest some of milk’s nutrients may have a direct effect on brain function and that “easily implemented lifestyle changes that individuals can make present an opportunity to slow or prevent neuropsychological dysfunction.”

New and emerging brain health benefits are just one more reason to start each day with low-fat or fat free milk. Whether in a latte, in a smoothie, on your favorite cereal, or straight from the glass, milk at breakfast can be a key part of a healthy breakfast that help sets you up for a successful day.

The 2010 Dietary Guidelines for Americans recommend three glasses of low-fat or fat free milk daily for adults and each 8-ounce glass contains nine essential nutrients Americans need, including calcium and vitamin D.

Source: Reproduced with editorial adaptations from the study.

Crichton GE, Elias MF, Dore GA, Robbins MA. Relation between dairy food intake and cognitive function: The Maine-Syracuse Longitudinal Study. International Dairy Journal. 2012; 22:15-23.

Most fitness programs like Yoga, Tai Chi, Pilates incorporate core strengthening into their fitness regimen.

In general, there are about 29 pairs of muscles that comprise the core. These core muscles acts together to stabilize spine, pelvis during basic movements. The core is important in athletic activities because it provides stability and mobility.

Here are some basics of core strengthening before you begin an exercise program:
1.    A core strengthening program should be done in stages with slow gradual progression involving groups of muscles hips, pelvis, spinal colums and abdominals.
2.    Should start with restoration of normal muscle length and mobility to correct any muscle imbalances.
3.    Apart from strengthening and stabilizing superficial core muscles, it is important to activate and strengthen deep core muscles through pelvic exercises.

A true core workout program develops dozens of muscles attached to the hips, pelvis, lower back, and abdominals.

Here are the major muscle groups in the abdominals and the hip/pelvic region that form the foundation of core.

The abdominals: Abdominals protect the back and acts as the foundation of strength.

Rectus Abdominis – located along the front of the abdomen, this is the most well-known abdominal muscle and is often referred to as the “six-pack” due to it’s appearance in fit and thin individuals.

Erector Spinae- This group of three muscles runs along your neck to your lower back.

The Obliques: External Obliques – located on the side and front of the abdomen. Internal Obliques – located under the external obliques, running in the opposite direction.

Transverse Abdominis – located under the obliques, it is the deepest of the abdominal muscles (muscles of your waist) and wraps around your spine for protection and stability.

The Hip muscles:

Hip Flexors – located in front of the pelvis and upper thigh. The muscles that make up the hip flexors include: psoas major, illiacus, rectus femoris, pectineus, sartorius

Gluteus medius and minimus – located at the side of the hip

Gluteus maximus, hamstring group, piriformis – located in the back of the hip and upper thigh leg.

Hip adductors – located at inner side of the  thigh.

Benefits of core strengthening:

1. A Strong Core Reduces Back Pain
2. Weak and unbalanced core muscles are linked to low back pain. A balanced core helps maintain proper posture and reduce strain on the spine.
3. Core strengthening improves Athletic and sports performance.

Because the muscles of the trunk and torso stabilize the spine from the pelvis to the neck and shoulder, they allow the transfer of power to the arms and legs. All powerful movements originate from the center of the body out, and never from the limbs alone. Before any powerful, rapid muscle contractions can occur in the extremities, the spine must be solid and stable and the more stable the core, the most powerful the extremities can contract.

Source: Core Stability Exercise Principles; Venu Akuthota,1 Andrea Ferreiro,1 Tamara Moore,2 and Michael Fredericson31Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO;2Sports and Orthopedic Leaders Physical Therapy, Oakland, CA; 3Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Stanford, CA.

Reporting online in the journal Urology, researchers found that 30 children and adolescents who sought treatment for bedwetting all had large amounts of stool in their rectums, despite the majority having normal bowel habits. After treatment with laxative therapy, 25 of the children (83 percent) were cured of bedwetting within three months.

“Having too much stool in the rectum reduces bladder capacity,” said lead author Steve J. Hodges, M.D., assistant professor of urology at Wake Forest Baptist. “Our study showed that a large percentage of these children were cured of nighttime wetting after laxative therapy. Parents try all sorts of things to treat bedwetting — from alarms to restricting liquids. In many children, the reason they don’t work is that constipation is the problem.”

“The definition for constipation is confusing and children and their parents often aren’t aware the child is constipated,” said Hodges.

Hodges explained that guidelines of the International Children’s Continence Society recommend asking children and their parents if the child’s bowel movements occur irregularly (less often than every other day) and if the stool consistency is hard.

“The kind of constipation associated with bedwetting occurs when children put off going to the bathroom. This causes stool to back up and their bowels to never be fully emptied. We believe that treating this condition can cure bedwetting.” Said Hodges.

Children in the study ranged from 5 to 15 years old. The constipated children were treated with an initial bowel cleanout using polyethylene glycol (Miralax®), which softens the stools by causing them to retain water. In children whose rectums remained enlarged after this therapy, enemas or stimulant laxatives were used.

“The importance of diagnosing this condition cannot be overstated,” Hodges said. “When it is missed, children may be subjected to unnecessary surgery and the side effects of medications.”

Source: Reproduced with editorial adaptation from press release – Wake Forest Baptist Medical Center

First and foremost, sea salt and table salt have very little chemical makeup. They both contain at least 97.5% sodium chloride. The difference lies in the way they are produced, which results in different appearance, textures and taste. Sea salt is derived directly from the ocean or sea and is mostly unrefined. The salt water is evaporated then dried for extraction of the crystals. Because it is unrefined, it contains trace amounts of other minerals. These trace minerals are thought be the reason it is more flavorful and more natural, or “healthier” in some eyes. Most gourmet chefs love the taste and texture of sea salt.

Table salt is the more common type of salt. It is extracted from salt mines and heavily refined. During this process, most of the trace minerals are removed, substances are added to keep it from clumping, and Iodine is added. This originated back in the 1920’s when people were thought to be deficient in Iodine. This trace element is essential to our bodies but only needed in small amounts.

By weight, sea salt and table salt have the same nutrient value. For one teaspoon of salt, there is 2,300 mg of sodium. It is recommended to limit your sodium intake to 1500-2400 mg per day, depending on any medical conditions that may further limit your daily allowance. For the average American, we consume around 3400 mg per day, and up to 75% of that is added by the manufactures. You will get enough sodium through the foods you eat. To keep healthy, you may want to think twice the next time you pick up a salt shake of any kind.

Resources: Click to find out more about the effect that salt has on health-WASH (World Action on Salt and Health)

Here are some guidelines for setting effective goals:

1.  Set realistic goals:  This is the most important aspect in goal development.  Most individuals know what their ultimate aspirations are, but these are often too ambitious causing frustration and discouragement when they aren’t reached.  For instance, knowing what you would like your eventual health and fitness status to be is essential, however, this is your end goal, not the one you will focus on daily.  Instead, set smaller goals that you can effectively work toward each week or month that will conclude with you reaching your ultimate objectives.  For example, if your goal is to lose 50 pounds in 1 year, your realistic goal might be to lose 6 to 8 pounds this month.  Or, if you want to participate in an 80 mile bike ride next summer, your initial goal might be to ride 10 miles this month.  Each month following, you will increase that mileage goal by a specific amount.   (If you don’t yet have a bike, purchasing one or borrowing one from a friend might be your first goal!)

3.  Be specific:  Each goal you set should include numbers, dates, and detailed information.  In the examples above, particular numbers are included in each goal.  This is good, we don’t want ambiguous goal setting as then you won’t be aware when or if you actually fulfilled it!  Specific goals help to clearly measure your successes.

4.  Be positive: For example, instead of writing, “my goal is to not gain weight this month”, write, “I am going to gain health this month by losing six pounds”.  Instead of wishing you could participate in a long bike ride, but thinking it is out of the question, realize that you can push yourself to achieve the task.  “I am going to participate in this bike ride next summer.  This month I will ride 10 miles.”

5.  Write your goals down:  Get a journal, a white board, a calendar, or whatever else might work for you and write your goals here.  Look at them often and check them off once you have reached them.      Reward yourself for your achievements and notice the increased confidence you’ve developed in your ability to reach your set goals.

6.  Realize that you might run into barriers.  When setting goals you may want to brainstorm about barriers that might come up during your course of action.  Think about how you would overcome these situations so that you could still achieve your goals.  For example, if your goal is to go to the gym four days each week this month, what would you do if your child got sick for a week?  You could make sure you have the number of a trustworthy babysitter nearby, or you could think about at-home exercises you could do in place of your gym work during those days.  Being prepared will help you stay on track and not lose sight of the goals you set.

Source:

Personal Goal Setting

The American College of Sports Medicine (ACSM) released their updated physical activity guidelines in 2007.  The amount of physical activity advised for individuals under 65 years old, might come as a surprise to some of you.  It’s recommended that healthy adults within this age group (18 to 64 years old) perform 30 minutes a day, five days per week, of moderate-intensity cardio, and this is just to maintain health.  Remember, at a moderate-intensity work load, your heart rate will increase, you should sweat, and conversation will be breathy, but possible.  On a scale of 0 to 10 (10 being most difficult), moderate-intensity activity is a 5 or 6.  If you prefer shorter exercise bouts, 20 minutes of intense cardio (conversation would be very difficult at this work load and reach a 7 or 8 on the intensity scale), three days per week is sufficient.  It is important to note that if your goal is weight loss, or even maintenance of weight loss, 60 to 90 minutes of cardio is recommended!

Now you that you know what your daily cardio goal is, we need to add in a second component: strength training.  Many individuals do not realize the importance or benefits of strength training and often fail to include it in their exercise routine.  Lifting weights, however, is just as important as cardio.  Weight lifting aids in the reduction of bone loss (prevents osteoporosis) and increases your metabolism, the rate at which you burn calories. Women in particular often steer clear of lifting weights out of fear of “bulking up”, which in reality should not be a huge concern.  Osteoporosis and a decreased metabolic rate are much more likely to occur in women than large muscle growth!  To meet the strength training recommendations, choose 8 to 10 strength training exercises and complete 8 to 12 repetitions of each exercise.  This should be done twice each week.

As discussed earlier, a challenging task is fitting these lengthy exercise bouts into an already busy day.  Here are some tips:

1) Don’t think you have to belong to a gym.  Get a pair of running shoes and hit the sidewalk.  Yoga mats, Thera-Bands, stability balls, and weights can easily be purchased from almost any department store (even Marshalls or T.J.Maxx). This would be a great way to get in some of that recommended strength training while avoiding the gym crowds.

2) Don’t think you have to do it all at once. Take a walk or jog in the morning before work, and try to get in another walk during your lunch break or later that night, even after dinner.

3) Add in small bits throughout the day.  You can increase your number of steps a number of ways:  when running errands, park at the back of the lot; when you have the option of taking the elevator, escalator, or stairs, opt for the stairs; if you’re visiting a friend who lives within a mile of you, take a walk rather than a drive.

4) If you do belong to a gym, go straight there following work.  If you go home prior to the gym, tendency is that you won’t want to go back out.  Don’t let yourself think that the day is over after work, and stop by the gym for a quick workout.

5) Try incorporating active activities into your leisure time.  Go for a walk, a hike, or a bike ride with your friends, children, or spouse rather than a movie.  Join a recreational sports team to meet people who have your similar active interests.

6) Discover what time of day is best for you to reach your peak workout potential.  If you are a morning person, then wake up earlier than usual and get your exercise in before the day begins.  If you’re a night owl, then the opposite schedule may be best for you.

7) Most importantly, realize that your health is important to you and all of those close to you.  Take the initiative to make your well-being a priority.  If you are too busy, too tired, etc., perhaps a lifestyle change is in order to make time for yourself.

Sources:

National Center for Health Statistics. Chartbook on Trends in the Health of Americans. Health, United States, 2008. Hyattsville, MD: Public Health Service. 2008.

Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2007 Morbidity & Mortality Weekly Report 2008;57(No.SS-4).

Finkelstein, EA, Fiebelkorn, IC, Wang, G. National medical spending attributable to overweight and obesity: How much, and who’s paying? Health Affairs 2003;W3;219–226.

American College of Sports Medicine

Dieting and Nutritional Deficiencies

A special diet such as a vegetarian, vegan, low-calorie or low-fat regimen may result in the formation of dark eye circles. Individuals who do not consume meat, such as vegetarians and vegans, are often lacking in vitamins and minerals, specifically vitamin B12 and iron. Iron is important for carrying oxygen in your blood and distributing it to your muscles. Iron comes primarily from meat sources, but also from oysters, beans, and spinach. Unfortunately, the bio-availability of iron found in vegetable sources (non-heme iron) is not as high as that from meat (heme iron), so an individual who eats iron-rich vegetables may still develop the deficiency. Iron deficiency, or anemia, can cause pale, easily bruising skin, along with dark circles under the eyes.

Over-Exercise and Energy Depletion

Excessive exercise without proper caloric consumption may lead to overall energy depletion, weakness and fatigue. Even if weight loss is your goal, fueling your body is essential. Energy depletion will not only decrease your ability to exercise successfully, but will also negatively affect your overall health, oftentimes resulting in weak nails, brittle hair, or dark eye circles. Consuming healthy amounts and types of fats, such as omega-3 fatty acids, polyunsaturated fats, and monounsaturated fats should aid in preventing energy depletion and vitamin deficiencies that may lead to dark eye circles. Individuals who consume little to no fat may not absorb essential fat-soluble vitamins like vitamins A, D, E, and K. It is best to consume a diet comprised primarily of fruits, vegetables, complex carbohydrates, low-fat dairy, nuts, fatty fish, and olive oils. Also, try not to depend solely upon a multi-vitamin to meet your nutritional needs.  Obtaining your vitamins and minerals from whole food sources is ideal.

Hydration and Electrolyte Balance

Proper hydration and electrolyte balance are imperative to a healthy appearance. Although over-consumption of sodium is common, if you avoid salt and/or exercise and sweat excessively you may need to reconsider your intake. Sodium, along with potassium and magnesium concentrations, determine the condition of your electrolyte and hydration status.  Also, if you do not drink much water, dehydration could be a significant factor influencing your weary appearance.  The average adult loses approximately 10.5 cups of water each day (6.3 cups as urine output, 4 cups through breathing, sweating, and bowel movements).  The Institute of Medicine recommends men drink 13 cups of fluids each day and women drink 9 cups.   If you exercise, you need even more fluids. If you are exercising intensely for more than one hour, consider drinking a sports drink that contains the necessary electrolytes. Your skin, muscles, heart, and other organs need water and electrolytes to function properly.

Caffeine

The influence of caffeine on health remains a controversial topic. Some research supports the theory that caffeine is a protective health substance, while other evidence suggests it is a harmful product.  Science has determined, and many of us have personally experienced, that caffeine does play a role in preventing and/or reducing fatigue, however, researchers have yet to elucidate how caffeine really does affect us. If you are drinking a lot of caffeine each day, try to cut your consumption back to a low to moderate level; over-consumption of caffeine may lead to dark eye circles in some individuals. However, if you recently quit consuming caffeine, associated fatigue and adjustment to this dietary change may have initiated yours.

Allergic Shiners

Dark semi circles under the eyes, also known as “allergic shiners” can be indicative of a food allergy. These circles are thought to be due to sinus pressure and increased blood flow near the area. If you are your child has sinus problems accompanied with dark eye circles, food or other allergies such as hay fever, eczema, and asthma could be the cause.

References

• Mayo Clinic: Dark circles under eyes
• Mayo Clinic: Coffee and health
• Office of Dietary Supplements: Dietary Supplement Fact Sheet: Iron
• Faqs: Vitamins, Fat-Soluble
• Food Reactions: Milk Allergy: Causes, symptoms, and treatment

To those women out there:  although cardio does aid to improve both health and appearance, strength training is essential as well.  Not only will strength training make you stronger and firmer, but it’s been observed that individuals burn approximately 100 additional calories over 24 hours following a strength training workout.  Also, by increasing your muscles mass (which occurs when you lift weights) your overall metabolic rate, the rate at which you burn calories, has the potential to increase up to 15%. So, while cardio is important (especially for weight loss), strength training must be given more credit.  If your objectives are to lose weight, tone up, or to simply gain health and fitness, the only way to reach your ultimate health goals is to combine your cardio with a weight lifting program.

In 2004, the CDC reported that only 17.5% of adult women (21.9% of men) strength train two or more times per week.  To see a difference in your appearance and tone those muscles, the Mayo Clinic recommends doing 2 to 3 strength training sessions per week, that last about 30 minutes each.  By doing just this much, you can increase your strength by 50% within 6 months or less.

There are also many other health benefits associated with strength training.  According to the CDC, strength training can reduce symptoms of myriad diseases and chronic conditions including, but not limited to: arthritis, diabetes, osteoporosis, obesity, back pain, insomnia, and even depression.

It’s reported that 1 in 3 women over the age of 50 will experience an osteoporotic fracture, as post-menopausal women can lose up to 1 to 2% of bone mass each year.  Strength training increases bone mass and reduces fracture risk in women of this age range, which is yet another reason why women need to lift weights.

Clarifying Some Misconceptions

Let’s make truth of this common misconception that lifting weights will cause women to develop large, bulky muscles.  Because women do not naturally have high testosterone levels, they should not develop that masculine shape as a result of adding strength training into their exercise routine.  So, unless you spend hours in the gym lifting incredibly heavy weights (and consider using steroids) you won’t develop the body builder, muscle-bound look.  But, by lifting some moderate to heavy weights a few times each week you will get the toned figure you’ve been trying to attain.

Another common misconception among women is that lower weights with higher repetitions is the best method for toning muscles and gaining strength.  Again, although this does provide some benefit, try switching your routine.  Next time you’re at the gym lift heavier weights, but with fewer repetitions.  For example, increase the dumbbell weight for your bicep curls by five pounds.  Do 3 to 4 sets of 10 to 12 repetitions (so you will curl that dumbbell about 12 times, rest, and repeat that “set” 3 to 4 times).  For an extra challenge, you can increase the weight of your dumbbells after each set so that by your final rep you are fatigued (a good indicator of “fatigue” is not being able to do one more curl after what should be your last).   Be sure to use proper technique to avoid any injury, and be cautious when you are first attempting to increase your weight.  For maximum benefit, listen to your body, but learn to challenge it at the same time.

Sources:

CDC MMWR Trends in strength training-United States, 1998-2004. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5528a1.htm

Moreover, the increased risk for gestational diabetes seen with animal fat and cholesterol appeared to be independent of other, dietary and non-dietary, risk factors for gestational diabetes. For example, exercise is known to reduce the risk of gestational diabetes. Among women who exercised, however, those who consumed higher amounts of animal fat and cholesterol had a higher risk than those whose diets were lower in these types of fat.

“Our findings indicate that women who reduce the proportion of animal fat and cholesterol in their diets before pregnancy may lower their risk for gestational diabetes during pregnancy,” said senior author Cuilin Zhang, M.D., M.P.H., Ph.D., of the Epidemiology Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), one of three NIH institutes supporting the study.

The researchers concluded that changing the source of 5 percent of dietary calories from animal fat to plant-derived sources could decrease a woman’s risk for gestational diabetes by 7 percent.

Resources:
1.    The U.S. Department of Agriculture website, ChooseMyPlate.gov, contains information on healthy eating for children and adults, as well as health and nutrition information for pregnant and breast feeding women.
2.    National Institute of Child Health & Human Development.
3.    What is Gestational diabetes?
4.    For complete Story, click here.