Alexandra Barbieri MS, RD, CDN, a Registered Dietitian (RD) at Littauer makes the Leader Herald Sunday edition once again Posted on May 31, 2016 by Dakota PikeAlexandra Barbieri MS, RD, CDN, a Registered Dietitian (RD) at Littauer discusses healthy choices for losing weight. See this story from The Leader Herald…Lifestyle ChangesEven small changes can have big results in weight lossMay 29, 2016By PATRICIA OLDER, Leader HeraldGLOVERSVILLE – After four heart attacks, the doctor told John Lee had a decision to make – lose weight or die.“I’ve always been big and I have always had a problem with my weight,” said Lee. “Then I had four major heart attacks and my doctor told me I either had to lose weight or I’d be in the ground.”He decided he wanted to live.Lee made an appointment with a bariatric surgeon and attended an orientation to see if he could be a candidate for gastric bypass surgery. He was.“They told me I was a candidate, but I had to lose 10 percent of my weight before they could do the surgery,” said Lee who weighed in at almost 455 pounds at his heaviest.It took about six months for him to take off the 45 pounds with the doctor’s help and in January 2010, Lee had the surgery. But to be successful, Lee would have to make lifestyle changes in the way he ate and in his daily routine in order to continue to lose and to keep it off.“[The doctor and his team] set me up with a basic plan and it was pretty easy to follow,” said Lee, who admits his love for fast food didn’t help the process. “The hardest part is not being able to go to McDonald’s – I still have the cravings for a burger.”Alexandra Barbieri, dietitian at Nathan Littauer Hospital, said even subtle changes can help someone with losing weight and keeping it off.“If you make small changes like taking three less bites of a hamburger or taking no sugar in your coffee or going for a small, 20-minute walk will help,” said Barbieri. “You can burn 80 to 100 calories in a 20-minute brisk walk and it is calories in and calories out and it is one of those small changes you can do to reduce caloric intake. One of my favorite quotes is from Mark Twain – ‘Habit is habit and not to be flung out of the window by any man, but coaxed downstairs a step at a time.'”Continuing, Barbieri said for weight loss, a person needs to reduce their daily calories by 500 to 700 calories a day. “You can do it through either diet or exercise or a combination of both,” said Barbieri. “That will give you a total of 3,000 calories a week and you will lose about a pound a week.”She said some of the ways to lose weight include monitoring what you eat, wearing a fitness bracelet or using one of the many free applications for smart phones and computers and by moving more.“If you watch what you eat by self-monitoring, you become way more aware of just how much you are eating,” said Barbieri. “Portions are important and the fitness bracelets help with self-awareness because we all think we are moving more than we are.”She suggested parking farther away in the parking lot when going to the grocery store, taking a short walk after work before getting in the car to go home and cleaning.“Taking small steps of any kind will eventually become a habit for you,” said Barbieri. “Do what you can to fit it into your daily routine – try wheat bread, brown rice, wheat pastas. Have meatless Mondays or where you fix a dinner with leaner meats such as chicken without the skin, fish, and pork loins.”She said even too much of a good thing can be bad for weight loss.“Remember it is calories in and calories out – you can even have too many vegetables,” said Barbieri. “Think of your plate like a pie chart and fill half the plate with a vegetable, one-quarter with your whole grain pasta, rice or beans and one-quarter with your lean protein such as beef, chicken or fish and then maybe a small side of fruit.”Continuing, Barbieri said everyone should get a minimum of 30 minutes a day of activity as well.“Try to find something you like to do biking, walking, cleaning, sports, yard work, swimming – remember, 20-minutes a day, twice a day can burn a couple of hundred calories right there,” said Barbieri. “If you focus on your physical activity and diet, it will lead to a more probable success rate.”She said most people tend to diet by eliminating specific food groups and while they do work, the weight loss all goes back to calories.“I love the app Fitness Pal,” said Barbieri, adding there are dozens of applications available for little to no cost. “It is all about accountability and with one of these programs you can have the community [to interact with] so if you are having a bad day, you can see others who have had one too and not feel so alone.”She said people do not need a smart phone or computer to keep track of their eating and activity levels. “Just writing it down is good,” said Barbieri. “Once you do, you can really see what you eating and how much exercise you are getting.”Lee said he also tries to stay on track with his weight loss and activity.“Instead of ice cream I have cool whip on my sugar-free jello,” said Lee, who is down to 237 pounds at his last weigh-in. “And for my snacks I have wheat Cheerios.”Noting that he wants to be able to help others with their weight loss, Lee said he just takes each day as a gift.“This is no game – you have to have will power,” said Lee, a self-proclaimed whiz at budgeting for meals. “If there is anyone who wants help losing weight, I’d be more than willing to help them.”As for his continued success, Lee says he takes it all in stride.“It is one step at a time,” said Lee. Littauer dietician Alexandra Barbieri makes a salad for lunch in the hospital cafe
The Leader Herald helps NLH educate the community on caffeine consumption Posted on April 5, 2016April 5, 2016 by Dakota PikeCaffeine and Children Children, teens consuming more caffeine through ‘energy drinks’ April 3, 2016 By PATRICIA OLDER, Leader HeraldNathan Littauer dietician Alexandra Barbieri discusses the impact energy drinks can have on children, teens and young adultsGLOVERSVILLE -With slick advertising campaigns, many regularly featuring high-level athletes promoting their accomplishments and posing with a can of the latest energy drink, children and teens are caught up in the craze and are buying into the marketing they must have it. As a result, more adolescents are consuming large amounts of caffeine, and the consequences, say experts, can be serious. “The most recent study shows 73 percent of kids are consuming caffeine and those studies are showing kids are now drinking more energy drinks,” said Alexandra Barbieri, registered dietician at Nathan Littauer Hospital and Nursing Home. “These studies are showing kids are consuming more energy drinks and these kids are ingesting one to three of these drinks at a time and not drinking enough water.” Barbieri said that while the effects of caffeine on teens and children has not been studied enough to draw any solid conclusions on the health ramifications, she did cite some studies which show drinking caffeine produces an increase in heart rate, blood pressure and irritability. “Unfortunately, caffeine has not been studied too much in adolescents, only adults,” said Barbieri. “However, a study I found did show a relationship between students who drank energy drinks resulted in insufficient sleep duration. Caffeine can also cause increased heart rates and elevated blood pressure.” Continuing, she said energy drinks have between 142 mg. and 240 mg. of caffeine for 16 fluid ounces, with the daily national suggested amount not to exceed 400 mg. One cup of coffee can have between 95 mg to 200 mg. of caffeine. “[The toxicity] is dose dependent – how it affects one 15-year-old could affect another differently,” said Barbieri. “But caffeine toxicity can come with only two cups of coffee – imagine what these energy drinks can do.” According to the American Academy of Pediatrics, the maximum amount of caffeine for adolescents is no more than 100 mg. a day. A study published in the Journal of the American Medical Association in November 2015 found that a single 16 ounce energy drink – they used Rockstar for the study-released the stress hormone norepinephrine by 70 percent. The hormone is released during times of increased stress, such as testing time for college students. It also showed increases in blood pressure and heart rates. Continuing, Barbieri said one of the issues adolescents face with the energy drinks is the marketing and government regulation. “They are mostly marketing to young, adolescent boys and the [Federal Drug Administration] does not regulate [energy drinks] since they are considered diet supplements because of the addition of herbal supplements,” said Barbieri. The energy drinks, such as Rockstar, Monster and AMP, have ingredients such as ginseng, guarana and milk thistle. She said consumers, especially parents, need to be aware of what they are buying and what their children are buying. “Parents need to know the difference between sports drinks and energy drinks,” said Barbieri. “Sports drink are good for hydration. Energy drinks – we don’t know the long-term consequences. They are full of sugars and caffeine” She said one of the scariest aspects of the energy drinks is the easy availability to anyone. “I was told [by a store clerk] that a two-year-old with two bucks could buy one,” said Barbieri. She said one energy drink is even named Cocaine. “Tell me what you think that name implies,” said Barbieri. Continuing, she said parents can help by being aware of what their children are drinking when not around them. “People follow suit with what other people are doing and the magic question is how do we get kids back on board,” said Barbieri. “Looking at alternative sources of energy is important and thinking how are you going to hydrate yourself after an athletic activity.” She said today’s fast-track lifestyle lends itself to helping keep children from buying into the marketing of the energy drinks. “Kids wants what is free, convenient and fast. The more you load up in the house, the less likely they will reach for [energy drinks,]” Barbieri said. “If we give them something easy and reliable and convenient, they’ll reach for it.” Coconut water, she said, is one good source of hydration for kids after an athletic event. “They need the electrolytes with prolonged physical activity, but they can even use sodium-fortified coconut water,” said Barbieri, adding that parents can look at the first three ingredients of any drink to get an idea of what their children are consuming. “There have been overdoses on Rockstar, Red Bull and caffeine shots,” said Barbieri. “In other countries, like Turkey, Australia and Denmark they are actually banned or have warning labels.” Cheryl McGrattan, vice president of marketing for Nathan Littauer, said parents will ask a child what they had for lunch, but not what they are drinking throughout the day. “It is common for a parent to ask ‘What have you eaten for lunch today?’ but not what have you had to drink,” said McGrattan. “How frightening is it an 8-year-old can take their $3 and buy a Red Bull?” Locally, energy drinks are not available in local schools, although they are at Fulton Montgomery Community College. “We really do not use them because they are not allowed by the federal guidelines for the ala-carte menu,” said Teal Carpenter, nutrition director for Gloversville Enlarged School District. She said that a vending machine at Boulevard Elementary has the sports drink Gatorade G2, but only because the gymnasium and school field are used for athletic practices and events. “There is Gatorade in the vending machine outside the Boulevard gym because of team practices and we do sometimes use it at the high school vending machines, but other than that, we offer 100 percent juice, water and milk,” said Carpenter. Gatorade is considered a sport drink. Dustin Swanger, president of Fulton Montgomery Community College, said energy drinks were available to students attending the college. “My position is they’re in college and it is not like they’re young children attending school in school district,” said Swanger. “They’re adults and they are going to buy them at the store or on campus.” Barbieri said the key for parents is to become aware of what their children are consuming outside of the home. “We can look at alternative sources of energy and rely on whole foods,” said Barbieri. “There is water, green tea and green tea smoothies and chocolate milk. We just have to think how we are going to get our kids back on board and drink what is good for them, not what is being marketed to them.”The Leader Herald,Sunday, April 3, 2016