6 Myths Busted!

Breast CanCer

Heartburn or Heart attack?

know the difference

the secret to

controlling Hunger

+join the

pink army

inspiredTampa Bay

the health and wellness magazine of Florida Hospital

fall 2015

FH.F15.cover.1.indd 1 11/4/15 3:55 PM

FHWFR-10062

FH.F15.Welcome.1.indd 1 11/4/15 11:17 AM

LocaL update Find out about all the new

developments at your local

Florida Hospital.

6 Breast cancer Myths BustedMyths about the disease abound.

Here’s the real deal.

don’t ignore your coreLearn 3 key facts for maintaining

fitness.

protein, expLainedA Florida Hospital

expert fields key

questions.

6

10

11

heart attack or heartBurn?It can be hard to tell the

difference, so get it checked!

pack heaLthy!Follow these 5 tips to make

lunch a nutritious success for

your family.

12

14

fLorida hospitaL (844) 504-9378 | Fall 2015 3

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8-9

10

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In ThIs Issue fall 2015

“When you have the choice

BetWeen Being right and

Being kind, just choose kind.”

FH.F15.TOC.REV.indd 1 10/22/15 10:37 AM

150 pounds

Surgery helpS a Tampa woman achieve dramaTic weighT loSS—and regain her life

Farewell to

“i feel 100 percenT beTTer,

and have way more energy.”

—marie fiSher

JohnDietrick, M.D.

fall 2015 | inSpiredTampabay.com4

In baseball terms, marie Fisher was

down to her last strike. Her weight had ballooned to nearly 350 pounds, and she had developed obesity-related sleep apnea on top of her existing

asthma. Her pulmonologist asked her if she had thought about weight-loss surgery. “He said, ‘I want you to go to a seminar by Dr. Dietrick,’” says Fisher, 46, of tampa.

that’s John Dietrick, m.D., a general and bariatric surgeon with Florida Hospital tampa. the hospital has regular seminars supporting

the bariatric program. Having tried everything in the book to lose weight, Fisher says, “I needed something drastic.” and when her pre-surgery blood work revealed she was pre-diabetic, “that would have been my third strike.”

Fisher is far from alone in her struggle. more than one-third of U.s. adults—almost 79 million people—are obese. Obesity is related to serious health conditions, including heart disease, stroke, type 2 diabetes and certain types of cancer. not only does this cost the nation an estimated $147 billion in annual medical spending, it also costs people who are obese: they spend on average $1,429 more a year on

their own health care than those of normal weight.

For these people, diets are not the answer, says Dr. Dietrick. “Diets are fghting mother nature,” he says. “the body has a survival mechanism that signals us to eat as much as we can whenever we can. If you wonder why two-thirds of americans are overweight or obese, you have to start with the way the body is programmed.” this is why diets have only about a 5 percent chance of lasting success for obese people, and surgery is the best—and often only—option, with a success rate of about 80 percent for that same group.

“surgery provides a limitation to

FHT.F15.weightloss.1.indd 22 10/22/15 10:40 AM

the volume of food someone can

eat at one time, so it provides satiety

[the feeling of fullness] earlier than

it would come otherwise,” he says.

“Another reason surgery works is it is

a permanent change. When folks diet

they are often successful while on

the diet, but the majority of diets are

not programs people can continue.”

Dr. Dietrick performs most bariatric

surgeries using the da Vinci Surgical

System. This robotic surgery is

quicker, more precise and safer

than traditional open surgery, with

fewer complications and less pain.

Along with technology, though,

comes the human touch. Despite

the technological advances, Dr.

Dietrick is still focused on the patient.

“I think our profession is a service

to individuals, and I consider it a

privilege to perform any procedure

for a patient,” he says.

Fisher was impressed that

Dr. Dietrick wanted her to see a

psychiatrist to be sure she was

mentally ready to commit to drastic

weight loss. “It is a huge change in

your life,” she says. She underwent a

procedure called sleeve gastrectomy

in March 2014. Her stomach was

reduced to about one-third its

normal size. “The next morning I was

drinking fuids, sitting up and walking

around, and I went home that night,”

she says. She stayed with her dad

for two days, but was home after that

and back at work the next week. “I

thought I would be in more pain, but

I used no medicine after leaving the

hospital,” she says.

The results have been dramatic.

Now down to 207 pounds, she has

been off asthma medication for

months. Her sleep apnea is greatly

reduced and she is no longer pre-

diabetic. There are many non-health

benefts as well. “The frst time I

could go into a regular store like

Macy’s or Walmart and try on size 14

jeans, I sat in the dressing room and

cried,” she says. “I hadn’t seen size

14 since junior high.”

Thanks to the program’s follow-

up care and support, she also

understands how to eat and

exercise, which is critical in achieving

successful weight loss. “I feel 100

percent better, and have way more

energy,” she says. She even signed

up for the company’s team in the

annual Heart Walk in November;

“Before surgery I never would have

attempted to walk three miles,” she

says.

Fisher’s goal is to reach 150

pounds, but she has another

objective in mind as well. “I have a

deal with my father that when I hit

200 he will take me on a ride on his

Harley,” she says. “He even bought

my helmet already.”

John Dietrick, M.D., using the da Vinci Surgical System.

Upcoming eventsFlorida Hospital Tampa offers Surgical

Weight Loss Seminars to educate the

public about bariatric weight-loss surgery,

explain the treatment options available

and help people determine if they are

candidates. The seminars are held at

the Life Hope Medical Offces, 4th Floor

Conference Room, Suite 490, 3000

Medical Park Drive, Tampa.

To learn about upcoming seminars, speak with Candie, our

bariatric nurse coordinator, at (813) 615-7871. You can also visit

yourplacetostart.org and fhtampa.org.

florida hospital (844) 504-9378 | Fall 2015 5

FHT.F15.weightloss.1.indd 23 10/22/15 10:41 AM

breast cancer

myths, busted Misconceptions abound —Here’s tHe real deal6these days it seems you almost

need a medical degree to separate fact

from fction when it comes to protecting

yourself against breast cancer. From

controversies over mammograms to

questions about reducing one’s risk of

the disease, it’s easy to be perplexed. but

the truth isn’t really so elusive. here are

six misleading statements you may have

heard about breast cancer—corrected.

1“No one in my family had breast

cancer, so I won't get it.”

“that’s a common mistake,” says charles

cox, m.d., a Florida hospital surgical

oncologist, one of the national pioneers

of a breast cancer diagnostic technique

called sentinel node biopsy. dr. cox

also performs genetic research on the

disease and trains physicians in china.

fall 2015 | inspiredtaMpabay.coM6

FH.F15.breastcancer.2.indd 22 10/22/15 10:38 AM

“There is so much press about the

genetic risks of breast cancer that

women fgure it is always genetically

inherited.” Not so. More than 85 percent

of women diagnosed with breast cancer

have no family history of the disease,

according to the American Cancer

Society. But it’s having a frst-degree

relative (mother, sister or daughter) with

breast cancer that doubles your risk and

having two frst-degree relatives increases

your risk threefold.

2 “A mammogram can actually

cause breast cancer.”

False! When a mammogram is taken, the

amount of radiation a woman receives is

much too small to cause a malignancy.

In fact, it’s less than the amount you’re

exposed to on a cross-country fight. “The

benefts signifcantly outweigh the risks,”

Dr. Cox says.

He suggests a baseline mammogram

for most women between ages 35 and

40, then annual screenings from age 40

on. “I recommend that women with dense

breasts or a history of benign cysts get

3-D mammography, which is available at

Florida Hospital,” he adds. “Compared

with conventional mammography,

it provides almost a 45 percent

improvement in cancer detection and a

nearly 35 percent reduction in call-backs

for more X-rays.”

3 “A cancerous lump feels different

from a benign lump.”

“That’s baloney,” Dr. Cox says. “It’s also

a myth that if a lump is painful, it isn’t

cancer.” It’s true that about 90 percent of

cancerous masses are not painful, but

some can cause pain, especially if they

grow beyond two centimeters. “There

is no way for you to know if it is cancer

until there is a biopsy,” he says. “Any lump

needs to be evaluated carefully.”

4“Mammograms are the

same wherever you go.”

Not so. “Some women go to different

locations for their screenings, doctor

visits and treatments, but they can’t be

sure of quality and consistency,” says

Vijay Ferris, M.D., a general surgeon with

Florida Hospital. “Women should go to

ACR-accredited breast centers like ours

for higher-quality images and a more

accurate diagnosis. We screen, perform

biopsies, offer counseling—it’s a one-stop

shop. Going to a dedicated breast center

will give you better results.”

5“Breast cancer is preventable.”

There is no proven way for healthy

women to prevent cancer, but you can

reduce your risk. “The best thing to do

is exercise,” Dr. Cox says. “A large study

shows that walking just 30 minutes a

day reduces the risk of breast cancer

by 30 percent, and if you already had

the disease your risk of recurrence is

reduced by 70 percent.” He suggests

sticking to a low-fat, high-fber diet to

lower the risk of all types of cancer.

6“If I get breast cancer I

will probably die from it.”

On the contrary, says Dr. Cox, “with early

screening and detection, 90 percent

of breast cancer patients survive.” So

be sure to stay up-to-date with your

mammograms and do your self exams,

he advises.

Join the Pink ArmyThe Florida Hospital Pink Army was created to increase awareness about

early detection of breast cancer. The second most common form of

cancer found in women, breast cancer is a formidable enemy, but it can

be beaten. Join women across Tampa Bay as they get screened and

learn more about the lifesaving benefts of annual mammograms and

early detection—all while having a great time!

Find fun and informative breast cancer awareness events hosted

in conjunction with Florida Hospital, and schedule your mammogram

online when you visit JoinThePinkArmy.com or call (855) 808-PINK

(7465). The most important part of the Pink Army is spreading a

lifesaving message to those you love.

Where to get yourmAmmogrAm

Call (855) 808-PINK (7465),

to schedule a mammogram

at one of these breast

centers:

Florida Hospital

Carrollwood

Imaging Center

7171 North Dale Mabry Hwy.

Tampa, FL 33614

Florida Hospital

North Pinellas

Breast Center

1395 S. Pinellas Ave.

Tarpon Springs, FL 34689

Florida Hospital Tampa

Breast Care Center

3000 Medical Park Dr.,

Suite 100

Tampa, FL 33613

Florida Hospital

Wesley Chapel Center

for Women’s Health

2700 Healing Way, Suite 102

Wesley Chapel, FL 33544

Florida Hospital

Zephyrhills

The Simpson Breast

Health Center

7050 Gall Blvd.

Zephyrhills, FL 33541

florida hospital (844) 504-9378 | Fall 2015 7

FH.F15.breastcancer.2.indd 23 10/22/15 10:38 AM

LeAnne And Stephen FuLLer oF LAnd

o’ Lakes were watching their son, Forrest,

play soccer about three years ago when

they noticed something unusual. “he seemed

hunched over, as if he wasn’t confdent,” says

LeAnne. She and Stephen were concerned,

and when Forrest, then 13, saw his pediatrician

for a physical exam, the doctor suggested

they see an orthopedic specialist. that doctor

diagnosed an abnormal curve in his spine

known as Scheuermann’s kyphosis.

Kyphosis (pronounced ki-Fo-sis) comes

from a Greek word for bending forward,

which describes the condition accurately: a

pronounced forward bending or rounding of the

spine. Scheuermann’s usually afficts children—

boys more often than girls—as they approach

their teens. there is no known cause, and for

Spine Surgery putS a young athlete back in the game

Helping a teen

stand tall

fall 2015 | inSpiredtampabay.com8

FHT.F15.forrest.3.indd 22 11/4/15 11:17 AM

many children it produces no

symptoms and poses no threat.

More serious cases can result in

a progressive deformity that can

cause discomfort or breathing

problems and may require

surgery.

The Fullers took Forrest in for

observation every six months,

and by the fall of 2014 his

deformity had grown larger, to

the point that their orthopedist recommended

corrective surgery. Seeking a second opinion, they

visited Geoffrey Cronen, M.D., a

pediatric orthopedic surgeon at

Florida Hospital Tampa. “He was

recommended by several friends,

and we felt really comfortable

with what he told us,” LeAnne

says. “He had plenty of time to

talk with us, and he was very

thorough.”

“Forrest’s curve was particularly

progressive, and we reached the

point where surgery was the only option,” says Dr.

Cronen, a member of the Florida Medical Clinic

Orthopaedic Surgery Spine and Spinal Deformity

Division. The relatively complex surgical procedure

required is called posterior spinal fusion, and Dr.

Cronen is one of only a handful of surgeons in the

state able to perform it.

During the surgery, Dr. Cronen makes small

cuts in the bone to loosen the deformity, then

puts screws and rods into the vertebrae to hold

the spine in the proper position. He then carefully

places bone grafts that will grow over the implants,

making them permanent. The operation originally

required people to be put in casts for up to several

years and often required multiple surgeries. Now,

thanks to modern instrumentation and surgical

techniques, patients like Forrest go home in three

to four days.

Forrest had a very easy recovery from surgery,

LeAnne says—“and he was a couple of inches

taller, which he liked. When they stood him up in

the hospital, it was kind of a shock to see him so

straight and tall.” Patients gradually resume normal

activities over a month or two, and can do anything

they want within six months. Forrest was back at

school in three weeks. “He even played basketball

for the school team two months after surgery,”

LeAnne says. “His coach was pretty nervous, but

he had no problems.”

Now 16 and a strapping 5-foot, 11-inch high

school junior, Forrest will join his high school

soccer team this fall. He will continue to follow up

with Dr. Cronen to monitor his recovery. Forrest

should have no limitations in pursuing his dream,

which for now includes college and perhaps

studying law enforcement.Opposite left, Geoffrey Cronen, M.D., shows patient Forrest Fuller some of his basketball skills. This page, an X-ray shows Forrest’s spine before surgery.

“He was recommended

by several friends, and

we felt really comfortable witH wHat He

told us. He Had plenty of time

to talk witH us, and He was very

tHorougH.” —leanne fuller

florida Hospital (844) 504-9378 | Fall 2015 9

For more inFormation, call us

at (844) 85-ortHo, or visit us on-

line at rangeoFexpertise.com.

FHT.F15.forrest.3.indd 23 11/4/15 11:17 AM

YOUR BODY’S CORE PLAYS

a crucial role in your health,

strength and agility. But if

you’re like most people,

there are things you may

not know:

The core is where all your

movement comes from. Daily

activities such as raking the

yard, picking up a child, lifting

groceries—any movements

of the extremities—start

there. “People think the core

is just the abs and back

muscles,” says Jonathan

Phillips, M.D., Florida Hospital

sports medicine physician.

“They should think of it

as the entire pelvic girdle:

hamstrings, hip fexors,

glutes, abdomen and back.”

A weak core could be

causing your lower-back

problems. If the muscles of

your lower back, glutes and

even hips are weak, you

probably have poor posture.

This puts stress on your

spine and related muscles,

tendons and ligaments.

“Often back problems

are from poor pelvic

stabilization,” Dr. Phillips

says. “The spine sits on the

pelvis, and support comes

from both the muscles and

the skeleton.” Weak core

muscles fail to support the

spinal column properly,

which puts stress on the

nerves and leads to back

pain.

Your regular workout is

probably not working your

core—unless it involves

Pilates or a similar exercise.

Running doesn’t adequately

work the core; nor does

lifting weights, cardio-based

workouts, most sports

activities or even crunches

alone. “Many people just

focus on their abs, and don’t

have a whole picture of what

the core is,” says the doctor.

“If you don’t have a balanced

approach to strengthening

those muscles, you will

have defcits that can cause

injury.”

Fortunately, it’s easy to

include core work in your

ftness routine. Push-ups,

standing squats, planks and

balancing on one leg can

work the core, as can:

Holding a position, as

is done in Pilates and in

planks, in which the trunk

is maintained in a straight,

tight position for 10 to 30

seconds or more.

Stretching, which

increases fexibility and

actually strengthens

muscles, helping them work

in balance. “The hamstrings

are especially important—

keep them fexible to

maintain proper pelvic

function,” Dr. Phillips says.

Back extension exercises

are also useful, but work

with a personal trainer or

ftness consultant to be sure

you do them correctly.

3 key facts for maintaining fitness

Don’t ignore your core

top workouts4

The Harvard Medical

School weighed in with its

top exercise picks:

Walking

strengthens bones,

heart and lungs;

burns calories; helps

lower blood pressure and

cholesterol; and improves

mood and outlook.

Weight training

boosts muscle

and bone strength

and allows you to

do more with less

strain and pain.

SWimming

offers a great

cardiovascular

workout; strengthens arm, leg

and core muscles;

and doesn’t overstress joints.

tai chi

is a Chinese martial art that

can help build better balance,

a stronger heart and a

calmer mind. Research

indicates that it may

also enhance

the immune

response.

fall 2015 | inspiredtampabay.com10

1

2

3

FH.F15.core.3.indd 22 10/22/15 10:38 AM

What do dietary proteins do

for the body? almost everything!

they build muscles, bones and skin;

they help make hemoglobin, the

part of red blood cells that carries

oxygen throughout the body too.

But beware: too much protein is

too much of a good thing. Inspired

Tampa Bay interviewed adriana

Guzman Quiles, Florida hospital

clinical dietitian, about this basic

food building block:

How much protein

should we eat?

“a healthy diet should have between

30 and 35 percent of its calories

from protein. at least 30 percent

of that protein should come from

legumes (peas, beans and bean

products such as tofu).”

Can a diet high in protein

aid weight loss?

“it can, but some studies have

shown that weight loss from such

diets isn’t sustained in the long

run. protein can help make you feel

full so you’ll do less snacking, but

emphasizing protein-rich foods

to the exclusion of other foods

is not recommended. an excess

of protein can cause dehydration

and kidney problems. For healthy

weight loss, you need a reasonable

balance of protein, healthy fats and

carbohydrates.”

What are some

protein-rich foods?

“Beans, seeds (including quinoa and

pumpkin seeds) and nuts are rich

in protein. eggs and dairy products

such as cheese, milk and yogurt

are also great. Meat is another

protein source, but the protein in

meat comes with saturated fat, and

the american heart association

recommends getting no more than

5 to 6 percent of your daily calories

from saturated fat. if you decide to

have beef occasionally, make sure

it’s labeled ‘extra lean.’ sirloin tips,

top round roast and top sirloin steak

fall in this category, according to the

Usda. and watch serving sizes.”

I’m glad you mentioned

serving sizes. What is

a good guide?

“one serving of lean meat is two to

three ounces, or about the size of a

computer mouse.”

Is it a good idea to eat

protein after a workout?

“defnitely. But you can also

combine it with a carbohydrate—

enjoying a peanut butter smoothie,

for example.”

What are some other healthy,

protein-rich snacks? “i recommend that my patients try

cottage cheese with fruit, peanut

butter on whole wheat toast, yogurt

with nuts such as almonds, or fruit

and cheese.”

Protein, explained

A FLoridA HospitAL expert FieLds Key questions

FLoridA HospitAL (844) 504-9378 | Fall 2015 1 1

FH.F15.protein.2.indd 22 10/7/15 3:14 PM

Heart attack—or heartburn?

What We call heartburn has nothing to do With

your heart. it’s really acid refux, a common condition that

develops when digestive acids fow out of the stomach,

which is designed to handle acid, into the esophagus,

which is not. the acid burns, and because the esophagus

and heart are close neighbors, the resulting pain in the

chest is often mistaken for heart pain. sometimes people

think they are having a heart attack and rush to the

emergency room.

the opposite mistake is also made: People experiencing

angina—heart pain—think it’s just acid indigestion and fail

to rush to the emergency room. and that can be a

big problem.

doctors at Florida hospital see both kinds of situations

in tampa bay, and it’s important for you to know what to

do in the event of chest pain. in fact, it can make a life-or-

death difference. so if you’re having chest pain of any kind,

don’t let embarrassment or uncertainty stop you. go to an

emergency room and get checked out.

in 2014, Florida hospital handled more than 200,000

emergency room visits in the tampa bay area. the er

physicians in these hospitals are all board-certifed in

It can be hard to tell the dIfference so get It checked

fall 2015 | InspIredtampabay.com12

“a heart attack can present Itself

In many dIfferent ways. you need to treat any

chest paIn serIously.”

—alexander rosemurgy, m.d.

FH.F15.hearthealth.2.indd 22 10/22/15 10:39 AM

Emergency Medicine, but even they

have to do formal tests to make a

formal diagnosis. The reason has to

do with basic anatomy. The nerves in

your chest are distributed in such a way

that it is diffcult to determine where

the pain is coming from, says Wenzel

Tirheimer, M.D., Florida Hospital Medical

Director at one of the largest Emergency

Departments in Tampa Bay. Pain from

many points of origin—including the

appendix, the gallbladder and the rest of

the gastrointestinal tract—may appear

in different locations in different people

and therefore can be hard to pin down

without further testing.

“The symptoms of multiple medical

problems are often related and overlap,”

Dr. Tirheimer explains.

MANY KINDS OF CHEST PAIN

There is a distinct diagnosis called

noncardiac angina, or chest pain not

due to heart problems. “This is a real

identifable issue,” says Alexander

Rosemurgy, M.D., a nationally recognized

gastrointestinal surgeon specializing in

minimally invasive and robotic surgery

at Florida Hospital. It has other possible

causes besides acid refux, such as

esophageal spasm, pneumonia or some

types of ulcers. But they can all feel

like cardiac discomfort. “Even people

who have had a heart attack often can’t

distinguish the difference,” says Dr.

Rosemurgy.

These two physicians in different felds

agree about the importance of getting

chest pain checked out right away. “A

heart attack can present itself in many

different ways,” Dr. Rosemurgy says. “You

need to treat any chest pain seriously.”

DON’T JUST WAIT

That means calling 911 or having

someone else drive you to an ER. “Go

and be seen by a doctor rather than

sitting home waiting and hoping,” Dr.

Tirheimer says. “If it is a heart attack, the

faster you’re treated, the better your odds

of a full recovery.”

Conversely, learning that your pain is

not heart-related will be a huge relief. “If I

can tell a patient, ‘It seems more like your

stomach or gallbladder, and not anything

life-threatening,’ that’s a big reduction in

their anxiety level,” Dr. Tirheimer says.

Once a heart problem is ruled out,

doctors can fnd out what is causing the

pain. Tests depend on the symptoms,

health history, age and other factors.

Some patients are admitted to the

hospital for observation and further

testing, while others are sent home with

follow-up instructions. But stay attuned

to your symptoms. “If your frst doctor

doesn’t see anything and you go home

but feel worse, come back,” Dr. Tirheimer

says. “Sometimes it isn’t until later that a

disease declares itself.”

Your frst move with chest pain should

be to seek immediate medical attention.

Says Dr. Rosemurgy: “It’s always better to

be safe than sorry.”

Heart attack can be different in women

As with men, the most

common heart attack

symptom in women is chest

pain or discomfort. But,

according to the American

Heart Association, women

are more likely than men to

experience other symptoms,

including:

l shortness of breath

l pressure or pain in the

lower chest or upper

abdomen

l dizziness, lightheadedness

or fainting

l upper back pressure

l nausea, cold sweat or

vomiting

l extreme fatigue.

Unfortunately, women often

delay getting attention for

themselves. In fact, the AHA

also reports that 81 percent

of women said they would call

911 for someone else showing

heart-attack signs, while only

65 percent would call for

themselves.

How to AvOID rEFlux

If your chest discomfort turns out to be heartburn rather than a cardiac

problem, that’s a relief, because heartburn is much less dangerous.

But it’s still troublesome, as reflux (GERD) can lead to esophageal cancer.

Try these simple steps to reduce the occurrence of acid reflux:

l Avoid alcohol, cigarettes, aspirin/anti-inflammatories and citrus.

l Raise the head of your bed about six inches; this lets gravity help

keep your stomach acids down.

l Don’t eat close to bedtime or late at night.

l Try some over-the-counter antacids.

If symptoms persist, see your doctor.

Source: American Heart Association

florida hospital (844) 504-9378 | FAll 2015 13

FH.F15.hearthealth.2.indd 23 11/4/15 2:05 PM

For many parents, the hostess twinkie’s return

to the marketplace sparked a smile of nostalgia—and a

frown of concern. we may recall that spongy treat from

our own childhoods, but it’s not on our nutrition plan for

our children—or ourselves, for that matter. But don’t de-

spair: when it’s time to pack a lunch, for yourself or your

family, a creative approach can put healthy eating on the

midday agenda:

1 MAKE IT FUN FOR KIDS. if children see a healthy

lunch as something enjoyable, says megen erwine, a

Florida hospital registered dietitian/nutritionist, they will

be more apt to eat it. “kids get bored easily,” says erwine.

“try approaching the same meal in different shapes or

in different containers.” During the school year, perhaps

your picky eater will enjoy selecting a special lunch box

featuring a favorite superhero. trade in aluminum foil for

small tupperware containers. as for the lunch itself, erwine

suggests preparing food in fun shapes. “kids love bite-size

items, so use cookie cutters to cut sandwiches,” she says.

and make the lunch colorful, with bright fruits and veggies

such as cherry tomatoes, grapes and carrot strips.

2 BE A GOOD ROLE MODEL. the “do as i say,

not as i do” model of parenthood is as obsolete as

the 8-track. “Lunch is the most overlooked meal by most

people i talk with—our busy lives make it problematic,”

erwine says. “as adults we need to spend more time to

create healthy lunches for ourselves.” and that doesn’t

just mean eating more spinach. she suggests aiming

to include foods from four food groups at each lunch:

whole grains, veggies-and-fruits, dairy and protein. “try

to include about 10 grams of fber and 15 grams of protein

in adult lunches,” she says. “that should provide plenty of

energy to sustain you all afternoon.”

3 USE A GRADUAL APPROACH. Let’s face it: if

kids reject a food at home, they’re sure as heck not

going to eat it from a brown bag when they’re beyond

your gaze at school. erwine recommends introducing an

unfamiliar food at home several times, in small amounts,

before adding it to a packed lunch. Don’t give up if a child

discards a new food at frst. “research shows that kids

need to be exposed to a new food up to 20 times before

they even try it, let alone like it,” she says. “so consistency

is important.”

4 SEEK BALANCE. aim to include the four food

groups as you pack a lunch, and emphasize fruits

and veggies over meats and cheeses—the latter are

nutritionally important, but tend to be overrepresented on

our plates. “we forget that we need vegetables more often

than just at dinner,” erwine says. make veggies more fun

with healthy dips, like hummus or ranch dip made with

Greek yogurt, to dip your carrots and celery.

5 PROMOTE SMART SNACK FOODS. new govern-

ment standards took effect in the 2014–15 school year

for snack foods sold in school vending machines and a-la-

carte cafeteria lines. Doughnuts, candy bars, high-fat chips

and sugar-flled sodas are gone, while granola bars, light

popcorn, low-fat chips and fruit cups are now favored. add

foods from two specifc food groups, erwine suggests, such

as celery with peanut butter or veggies with guacamole.

5 tips to make lunch a nutritious success for

your family

Pack healthy!

FALL 2015 | inspiredtampabay.com14

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