Effort To Control Opioids In An ER Leaves Some Sickle Cell Patients In Pain

Effort To Control Opioids In An ER Leaves Some Sickle Cell Patients In Pain


India Hardy has lived with pain since she was a toddler — ranging from dull persistent aches to acute flare-ups that interrupt the flow of her normal life.

The pain is from sickle cell disease, a group of genetic conditions that affect about 100,000 people in the U.S., many of them of African or Hispanic descent.

Sitting in the afternoon heat on her mom’s porch in Athens, Georgia, Hardy recollected how a recent “crisis” derailed her normal morning routine.

“It was time for my daughter to get on the bus, and she’s too young to go on her own,” Hardy recalled. “I was in so much pain I couldn’t walk. So, she missed school that day.”

Sickle cell disease affects red blood cells, which travel throughout the body carrying oxygen to tissues. Healthy red blood cells are shaped like plump and flexible doughnuts, but in people with sickle cell disease, the red blood cells are deformed, forming C-shaped “sickles” that are rigid and sticky.

These sickle-shaped cells can cause blockages in the blood vessels, slowing or even stopping normal blood flow. An episode of blockage is known as a sickle cell “crisis” — tissues and organs can be damaged because of lack of oxygen, and the patient experiences severe spells of pain.

‘It’s Like Torture’

Hardy tries to manage these crises on her own. She’ll take a hot bath or apply heating pads to try to increase her blood flow. Hardy also has a variety of pain medications she can take at home.

When she has exhausted those options, she needs more medical help. Hardy would prefer to go to a specialized clinic for sickle cell patients, but the closest is almost two hours away, and she doesn’t have a car.

So, Hardy often goes to the emergency room at nearby St. Mary’s Hospital for relief. Until recently, the doctors there would give her injections of the opioid hydromorphone, which she says would stop her pain.

Then, some months ago, the emergency room changed its process: “Now they will actually put that shot in a bag which is full of fluids, so it’s like you’re getting small drips of pain medicine,” Hardy said. “It’s like torture.”

It’s the same for her brother, Rico, who also has sickle cell disease and has sought treatment at St. Mary’s. The diluted medicine doesn’t give the same pain relief as a direct injection, they say.

Striking A Balance

St. Mary’s staffers explain that they’re trying to strike a balance with their new treatment protocol between adequate pain treatment and the risk that opioid use can lead to drug dependence.

It’s a local change that reflects a national concern. The U.S. is in the midst of an addiction and overdose crisis, fueled by powerful opioids like hydromorphone. That crisis has made medical providers more aware of the risks of administering these drugs. More than 47,000 Americans died in 2017 from an overdose involving an opioid, according to the Centers for Disease Control and Prevention.

That has prompted some emergency room leaders to rethink how they administer opioid medications, including how they treat people, such as Hardy, who suffer from episodes of severe pain.

“We have given sickle cell patients a pass [with the notion that] they don’t get addicted — which is completely false,” said Dr. Troy Johnson, who works in the emergency room at St. Mary’s. “For us to not address that addiction is doing them a disservice.”

Johnson proposed the ER’s shift to intravenous “drip delivery” of opioids for chronic pain patients because of personal experience. His son has sickle cell disease, and Johnson said he has seen firsthand how people with the disease are exposed to opioids when very young.

“We start creating people with addiction problems at a very early age in sickle cell disease,” Johnson said.

He brought his concerns to the director of the ER, Dr. Lewis Earnest, and found support for the change. Hospital officials say they also consulted national guidelines for treating sickle cell crises.

“We’re trying to alleviate suffering, but we’re also trying not to create addiction, and so we’re trying to find that balance,” Earnest said. “Some times it’s harder than others.”

St. Mary’s says the new IV-drip protocol is for all patients who come to the emergency room frequently for pain, and most of their sickle cell patients are fine with the change.

Caught In The Crossfire

The national guidelines cited by St. Mary’s also say doctors should reassess patient pain frequently and adjust levels of opioids as needed “until pain is under control per patient report.”

Some people who work closely with sickle cell patients, upon hearing about the new approach to pain management at St. Mary’s, called it “unusual.”

“When individuals living with sickle cell disease go to emergency departments, they are living in extreme amounts of pain,” said Dr. Biree Andemariam, chief medical officer of the Sickle Cell Disease Association of America.

It’s more common for ERs to give those patients direct “pushes” of pain medication via injection, she noted, not slower IV drips.

People with sickle cell disease aren’t fueling the opioid problem, Andemariam said. One study published in 2018 found that opioid use has remained stable among sickle cell patients over time, even as opioid use has risen in the U.S. generally.

“If anything, individuals with sickle cell disease in our country have really been caught in the crossfire when it comes to this opioid epidemic,” Andemariam said.

She suggested that ER doctors and nurses need more education on how to care for people with sickle cell, especially during the painful crisis episodes, which can lead to death.

A study of some 16,000 deaths from 1979 to 2005 related to sickle cell found that men in the group lived to be only 33, on average. Women didn’t fare much better, living to an average age of 37. The same study suggested that a lack of access to quality care is a factor in the short life spans of people with sickle cell disease.

Researchers who study sickle cell say the opioid epidemic has made it harder for patients with the condition to get the pain medication they need. The American College of Emergency Physicians is focusing on the problem, asking federal health officials to speak out about sickle cell pain and fund research on how to treat it without opioids.

“We in the physician community are looking for ways to make sure they get adequate pain relief,” said Dr. Jon Mark Hirshon, vice president of the group. “We recognize that the process is not perfect, but this is what we’re striving for — to make a difference.”

Considering A Move To Find Relief

In the meantime, India Hardy said she feels those imperfections in the process every time she suffers a pain crisis, and she’s not alone.

In addition to her brother, Hardy said she has another friend in Athens with sickle cell disease, and that friend has also reported difficulty in finding pain relief at the St. Mary’s emergency room.

“It’s just really frustrating, because you go to the hospital for help — expecting to get equal help, and you don’t,” Hardy said, her voice breaking. “They treat us like we’re not wanted there or that we’re holding their time up or taking up a bed that someone else could be using.”

Hardy filed a complaint with the hospital but said nothing has changed, at least not yet. She still gets pain medication through an IV drip when she goes to the St. Mary’s emergency room.

At this point, she’s considering leaving her relatives and friends behind in Athens to move closer to a sickle cell clinic. She hopes doctors there will do a better job of helping to control her pain.

This story is part of a partnership that includes WABE, NPR and Kaiser Health News.

California’s first surgeon general settles in

California’s first surgeon general settles in

Video Courtesy of MAKERS


This article was originally published on Capitol Weekly


California’s head cheerleader on improving statewide health says it’s all about “bringing people together.”

And after almost a year on the job as the state’s first surgeon general, Dr. Nadine Burke Harris exudes optimism, saying she has enjoyed an “absolutely phenomenal outpouring of support” from various factions of California’s vast health care sector. 

Harris, 44, a San Francisco Democrat, is a nationally recognized expert on the effects that childhood trauma (Adverse Childhood Experiences, or ACEs) has on victims during their entire lives – even into old age. She was appointed to the position in January by Gov. Gavin Newsom. California is the fourth state to have a surgeon general, joining Arkansas, Pennsylvania and Florida. Michigan eliminated the position in 2o10.

The surgeon general position is Newsom’s brainchild, although the specifics of the job are vague. Harris is sort of an advocate and promoter of the administration’s health care policies.

Separating children from their parents, as has been the practice for illegal immigrants scooped up by federal authorities along the U.S.-Mexico border, “is a recipe for childhood stress,” she told a recent gathering of the Sacramento Press Club.  She supports state Atty. General Xavier Becerra’s legal moves against the practice.

In her press club appearance, Harris was careful not to stray outside generally accepted tenants of health care. She and her husband, for instance, have seen to it that all four of their children are vaccinated, not only for the children’s health, but to protect others and gain “herd immunity.”

She also took pains not to create any blaring headlines. Asked specifically whether she supported “Medicare for All,” she said “Access to care is critical, no matter how it happens” and she was willing to “leave it to my policy colleagues as to how to get there.”

The surgeon general position is Newsom’s brainchild, although the specifics of the job are vague.

Harris is sort of an advocate and promoter of the administration’s health care policies. The heavy lifting in California health care, however, is performed by the 16 departments — including the Department of Health Care Services, the Department of Public Health and the Department of Managed Health Care under the jurisdiction of the Health and Human Services Agency. A major player also is Covered California, the state’s entity that puts into effect the federal Affordable Care Act.

Harris, who has a Master’s Degree in public health from Harvard, a medical degree from UC Davis and served a residency at Stanford, is the founding CEO of the Center for Youth Wellness (CYW)

In the Jan. 21 news release announcing Harris’s appointment, Newson said Harris “will urge policymakers at every level of government and leaders across the state to consider the social determinants of health, especially for children. Her work will focus on combating the root causes of serious health conditions — like adverse childhood experiences and toxic stress — and using the platform of Surgeon General to reach young families across the state.”

Harris, who has a Master’s Degree in public health from Harvard, a medical degree from UC Davis and served a residency at Stanford, is the founding CEO of the Center for Youth Wellness (CYW), a group Newsom described as a “national leader in the effort to advance pediatric medicine, raise public awareness, and transform the way society responds to children exposed to adverse childhood experiences and toxic stress.” 

She heads the Bay Area Research Consortium on Toxic Stress and Health, a partnership between CYW and UCSF Benioff Children’s Hospitals, to advance scientific screening and treatment of toxic stress, and serves as a member of the American Academy of Pediatrics’ National Advisory Board for Screening and on a committee for the National Academy of Medicine.

Capitol types involved in health care issues have questions.

Will Harris lobby for particular solutions to health care costs? On drug abuse? What about her relationship with the big Department or Public Health? Will there be an occasion where she might engage in head-to-head conflict with the Trump Administration, a la Becerra? (Early indications are she won’t.) Just how much clout will the engaging and idealistic Harris have within the Administration and with the Legislature?

“We are in a critical inflection point,” Harris told a gathering at the south san Francisco campus of Genentech during a discussion about the impacts of childhood trauma and adverse experiences. “Eight years ago, I would go into a room of 1,000 people and and I’d ask, “How many folks have heard of this before?” Literally three hands would go up. Two years ago, I gave a talk at the White House and I asked the same question, and every hand in the room went up. A new generation of scientists, teachers, doctors — people across disciplines — are recognizing the science, and leading the way.

“So, I believe that 20 years from now, we are going to be having a totally different conversation,”  she said.

What psychiatrists have to say about holiday blues

What psychiatrists have to say about holiday blues

Video Courtesy of Sister Circle TV


This time of the year brings a lot of changes to the usual day-to-day life of hundreds of millions of people: The weather is colder, trees are naked, snowy days become plentiful and friendly critters are less visible around the neighborhood. Especially in the Western Hemisphere, this time of the year is also linked to a lot of joyous celebrations and traditions. Most children and many adults have been excited for this time of the year to come for months, and they love the aura of celebrations, with their gatherings, gifts, cookies, emails and cards.

Alas, there are also millions who have to deal with darker emotions as the world literally darkens around them.

The holiday blues – that feeling of being in a lower or more anxious mood amid the significant change in our environment and the multitude of stressors that the holidays can bring – is a phenomenon that is yet to be researched thoroughly. However, as academic psychiatrists and neuroscience researchers, we have seen how several factors contribute to this experience.

Why feel blue in the red and green season?

There are many reasons to feel stressed or even downright overwhelmed during this time of year, in addition to the expectations set around us.

Memories of holidays past, either fond or sad, can create a sense of loss this time of year. We may find ourselves missing people who are no longer with us, and carrying on the same traditions without them can be a strong reminder of their absence.

The sense of burden or obligation, both socially or financially, can be significant. We can get caught up in the commercial aspects of gift giving, wanting to find that perfect item for family and friends. Many set their sights on special gifts, and we often can feel stretched thin trying to find a balance between making our loved ones happy and keeping our bank accounts from being in the black.

Holiday parties, fun though they may be, can also bring conflict.
My Agency/Shutterstock.com

It’s also a time for gathering with those close to us, which can stir up many emotions, both good and bad. Some may find themselves away from or without close connections and end up isolated and withdrawn, further disconnected from others. On the other hand, many people find themselves feeling overwhelmed by the combination of potlucks and Secret Santas stacking up through multiple invitations, be it at school, work, or from friends and family – leaving us with the difficult position of not wanting to disappoint others, while not getting totally depleted by all the constant socializing.

Great expectations

People often feel disappointed when reality does not meet expectations. The larger the mismatch, the worse the negative feelings. One of us (Arash) often finds himself telling his patients: Childhood fairy tales can set an unrealistic bar in our minds about life. I wish we were told more real stories, taking the bad with the good, as we would get hurt less when faced with difficult realities of life, and learn how to especially appreciate our good fortunes.

Fairy tales rarely come true, but people seem to hold out hope that they do.
Shamilini/www.shutterstock.com

These days viewers are showered with Christmas and New Year’s Eve movies, almost all of which sound and feel like fairy tales. People get married, get rich, fall in love or reconnect with their loved ones. Even unhappy events within “A Christmas Carol” conclude with a happy ending. These all, besides exposure to only happy moments and beautiful gifts (courtesy of Santa), dazzling Christmas decorations, and picturesque family scenes on social media, often set an unrealistic expectation for how this time of the year “should” feel.

Reality is different, though, and at its best is not always as colorful. There may be disagreements about hows, wheres, whats and whos of the celebration, and not all family members, friends and relatives get along well at parties. And as we feel lonelier, we may find ourselves spending more time immersed in TV and social media, leading to more exposure to unrealistic views of the holidays and feeling all the worse about our situation.

When is blue a red flag?

While many experience the more transient “holiday blues” this time of year, it is important not to miss more serious conditions like seasonal mood changes, which in its most severe case leads to clinical depression, including Seasonal Affective Disorder. SAD consists of episodes of depression or a worsening of existing depression during the late fall and early winter. The person may feel depressed and hopeless, or they may find it difficult to focus, sleep, or be motivated – they can even feel suicidal. As our emotions can color our thoughts and memories, a depressed person may remember more negative memories, have a more negative perception and interpretation of the events, and feel upset about the holidays.

In such cases, the sadness is “coincident” with the holidays and not caused solely by its circumstances. It is important to seek professional help with SAD, as we have effective treatments available, such as medications and light therapy.

What to do to minimize the blues?

  • Set realistic expectations: One readily available strategy is simply reframing the beliefs we have about what the holidays “should” be like. Not all parties will go perfectly. Some decorations may break, or kids may wake up grumpy or not be exhilarated by their gifts – but it doesn’t have to stop us from enjoying all the good moments.
  • Set firm boundaries: Too many invitations to social events? Too many financial demands? Set clear limits about what you are able and willing to do, whether that means declining some social events and setting your own limit on spending this year, focusing more on meaningful experiences over expense. This can be spending time with loved ones or getting creative with homemade gifts.
  • Feeling alone? There are many ways to steer clear of isolating this time of year. Reaching out to friends, volunteering at animal shelters, local charities or attending community meetups or religious events can be a great way to stay connected while also bringing happiness to ourselves and others.
  • Making new memories: Starting a new tradition, either solo or with loved ones, can help create fond new memories of the holidays, no longer overshadowed by the past.
  • Take care of yourself: It’s important to remember the value of self-care, including eating and drinking in moderation (as alcohol can worsen a depressed mood), exercising (even a short walk), and treating yourself this holiday season by doing something you enjoy.

While the holiday blues are most often temporary, it’s important to identify when things have crossed over into clinical depression, which is more severe and longer lasting. It also impairs daily functioning. For these symptoms it is often helpful and necessary to seek professional help. This can consist of counseling or use of medications, or both, to help treat symptoms.The Conversation

Linda Saab, Assistant Professor of Psychiatry, Wayne State University and Arash Javanbakht, Assistant Professor of Psychiatry, Wayne State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Black Mothers Get Less Treatment For Postpartum Depression

Black Mothers Get Less Treatment For Postpartum Depression

Video Courtesy of Thriving With Baby


Portia Smith’s most vivid memories of her daughter’s first year are of tears. Not the baby’s. Her own.

“I would just hold her and cry all day,” Smith said.

At 18, Smith was caring for two children, 4-year-old Kelaiah and newborn Nelly, with little help from the partner in her abusive relationship. The circumstances were difficult, but she knew the tears were more than that.

“I really didn’t have a connection for her,” said Smith, now a motivational speaker and mother of three living in Philadelphia. “I didn’t even want to breastfeed because I didn’t want that closeness with her.”

The emotions were overwhelming, but Smith couldn’t bring herself to ask for help.

“You’re afraid to say it because you think the next step is [for the authorities] to take your children away from you,” she said. “You’re young and you’re African American, so it’s like [people are thinking], ‘She’s going to be a bad mom.’”

Smith’s concern was echoed by several black women interviewed for this story. Maternal health experts said some black women choose to struggle on their own rather than seek care and risk having their families torn apart by child welfare services.

Nationally, postpartum depression affects 1 in 7 mothers. Medical guidelines recommend counseling for all women experiencing postpartum depression, and many women also find relief by taking general antidepressants, such as fluoxetine (Prozac) and sertraline (Zoloft).

In March, the Food and Drug Administration approved the first drug specifically for the treatment of postpartum depression, which can include extreme sadness, anxiety  and exhaustion that may interfere with a woman’s ability to care for herself or her family. The mood disorder can begin in pregnancy and last for months after childbirth.

But those advances help only if women’s needs are identified in the first place — a particular challenge for women of color and low-income mothers, as they are several times more likely to suffer from postpartum mental illness but less likely to receive treatment than other mothers.

The consequences of untreated postpartum depression can be serious. A report from nine maternal mortality review committees in the United States found that mental health problems, ranging from depression to substance use or trauma, went unidentified in many cases and were a contributing factor in pregnancy-related deaths. Although rare, deaths of new mothers by suicide have also been reported across the country.

Babies can suffer too, struggling to form a secure attachment with their mothers and increasing their risk of developing behavioral issues and cognitive impairments.

‘I Was Lying To You’

For many women of color, the fear of child welfare services comes from seeing real incidents in their community, said Ayesha Uqdah, a community health worker who conducts home visits for pregnant and postpartum women in Philadelphia through the nonprofit Maternity Care Coalition.

News reports in several states and studies at the national level have found that child welfare workers deem black mothers unfit at a higher rate than they do white mothers, even when controlling for factors like education and poverty.

During home visits, Uqdah asks clients the 10 questions on the Edinburgh Postnatal Depression Scale survey, one of the most commonly used tools to identify women at risk. The survey asks women to rate things like how often they’ve laughed or whether they had trouble sleeping in the past week. The answers are tallied for a score out of 30, and anyone who scores above 10 is referred for a formal clinical assessment.

Uqdah remembered conducting the survey with one pregnant client, who scored a 22. The woman decided not to go for the mental health services Uqdah recommended.

A week after having her baby, the same woman’s answers netted her a score of zero: perfect mental health.

“I knew there was something going on,” Uqdah said. “But our job isn’t to push our clients to do something they’re not comfortable doing.”

About a month later, the woman broke down and told Uqdah, “I was lying to you. I really did need services, but I didn’t want to admit it to you or myself.”

The woman’s first child had been taken into child welfare custody and ended up with her grandfather, Uqdah said. The young mother didn’t want that to happen again.

Screening Tools Don’t Serve Everyone Well

Another hurdle for women of color comes from the tools clinicians use to screen for postpartum depression.

The tools were developed based on mostly white research participants, said Alfiee Breland-Noble, an associate professor of psychiatry at Georgetown University Medical Center. Often those screening tools are less relevant for women of color.

Research shows that different cultures talk about mental illness in different ways. African Americans are less likely to use the term depression, but they may say they don’t feel like themselves, Breland-Noble said.

It’s also more common for people in minority communities to experience mental illness as physical symptoms. Depression can show up as headaches, for example, or anxiety as gastrointestinal issues.

Studies evaluating screening tools used with low-income, African American mothers found they don’t catch as many women as they should. Researchers recommend lower cutoff scores for certain African American women in order to better identify women who needs help but may not be scoring high enough to trigger a follow-up under current guidelines.

Bringing Treatment Home

It took Smith six months after daughter Nelly’s birth to work up the courage to see a doctor about her postpartum depression.

Even then, she encountered the typical barriers faced by new mothers: Therapy is expensive, wait times are long, and coordinating transportation and child care can be difficult, especially for someone struggling with depression.

But Smith was determined. She visited two different clinics until she found a good fit. After several months of therapy and medication, she began feeling better. Today, Smith and her three daughters go to weekly $5 movies and do their makeup together before big outings.

Other mothers never receive care. A recent study from the Children’s Hospital of Philadelphia found that only 1 in 10 women who screened positive for postpartum depression at the hospital’s urban medical practice sites sought any treatment within the following six months. A study examining three years’ worth of New Jersey Medicaid claims found white women were nearly twice as likely to receive treatment as were women of color.

Noticing that gap, the Maternity Care Coalition in Philadelphia tried something new.

In 2018, the nonprofit started a pilot program that pairs mothers with Drexel University graduate students training to be marriage and family counselors. The student counselors visit the women an hour a week and provide free in-home counseling for as many weeks as the women need. Last year, the program served 30 clients. This year, the organization plans to expand the program to multiple counties in the region and hire professional therapists.

It was a game-changer for Stephanie Lee, a 39-year-old who had postpartum depression after the birth of her second child in 2017.

“It was so rough like I was a mess, I was crying,” Lee said. “I just felt like nobody understood me.”

She felt shame asking for help and thought it made her look weak. Lee’s mother had already helped her raise her older son when Lee was a teenager, and many members of her family had raised multiple kids close in age.

“The black community don’t know postpartum,” Lee said. “There’s this expectation on us as women of color that we have to be … superhero strong, that we’re not allowed to be vulnerable.”

But with in-home therapy, no one had to know Lee was seeking treatment.

The counselors helped Lee get back to work and learn how to make time for herself — even just a few minutes in the morning to say a prayer or do some positive affirmations.

“If this is the only time I have,” Lee said, “from the time I get the shower, the time to do my hair, quiet time to myself — use it. Just use it.”

This story was reported as a partnership that includes The Philadelphia Inquirer, WHYY, NPR and Kaiser Health News.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

AIDS Awareness Month: The Black Church & HIV

AIDS Awareness Month: The Black Church & HIV


HIV primarily affects white gay men. You can contract HIV by getting tested for the virus that causes AIDS. Active church members aren’t at risk for HIV.

When NAACP researchers spent a year talking with black faith leaders in 11 cities, they found myths like these continue to circulate among their pews and pulpits. Those findings led the nation’s oldest civil rights organization to mount a campaign calling on black churches to speak out about the disease that disproportionately affects African-Americans.

In “The Black Church & HIV: The Social Justice Imperative,” the National Association for the Advancement of Colored People acknowledges that pastors may have reservations about addressing AIDS from the pulpit.

“However, this issue is too great to ignore,” reads a warning in a 24-page “pastoral brief” that accompanies the manual.

“The only way for us to help our congregations is to understand all aspects of HIV, so that we can help our community rebound from the impact of this epidemic.”

The Centers for Disease Control and Prevention predicts that one in 16 black men and one in 32 black women will be infected by HIV.

The pastoral brief, sprinkled with Bible verses, includes a “modern-day parable’’ of a minister who tried to “pray the gay” out of a heterosexual man after he received his HIV diagnosis. It later quotes a Houston minister who feared being in the same room with relatives with HIV/AIDS.

The NAACP recommends partnering with health organizations on HIV/AIDS prevention and treatment. The group compares the church’s need to address HIV to Jesus’ ministry healing the sick and advocating for the oppressed.

“As we make efforts to address the HIV crisis, the Black Church should not be a place where people experience HIV stigma and discrimination, but rather a place of healing, support, and acceptance,” the brief says.

The 66-page manual asks churches to dispel HIV myths and spread the truth. For instance, most black women get HIV through heterosexual sex, and there is no risk for transmission of HIV through testing.

“Regardless of our church activity or engagement, as long as we are having unprotected sex or sharing needles in our communities, we are at risk for contracting HIV,” the manual notes.

The NAACP urges churches to be a “safe space” for HIV prevention and treatment, even if they have to start small: “We understand that incorporating HIV activism into a spiritual setting may be perceived as a difficult process, but it is possible to begin with small steps even in the most conservative environments.”


Webinar: Taking Action This National Black HIV/AIDS Awareness Day

Take Your Christmas Celebrations from “Ho Hum” to Happy and Healthy

Take Your Christmas Celebrations from “Ho Hum” to Happy and Healthy

This holiday season, spice up your parties, gatherings and get-togethers with a few delicious recipes from acclaimed chef, Huda Mu’min. Video Courtesy of Roland S. Martin


For many, the holiday season comes with family, friends and lots of food. As part of the Healthy for Life 20 by 20 initiative, to improve the health of Americans, Aramark and the American Heart Association tapped into their experts to assemble a list of healthy tips and tricks to help navigate the holiday season, without sacrificing the flavor or fun of celebrating.

Aramark, the largest food service provider in the United States and one of the largest employers of registered dietitians in the world, and the American Heart Association, the leading voluntary health organization devoted to a world of longer, healthier lives, have teamed up to empower and inspire individuals and families to make better food choices every day, including the holiday season.

Whether it’s cooking for a crowd, or making smart kitchen swaps, Aramark and the American Heart Association will help you put together a winning holiday game plan.

COOKING FOR A CROWD

Aramark chefs serve two billion meals a year, so they’re used to cooking for a crowd every day of the week. Whether for a cocktail party, weekend brunch or holiday dinner, these easy tips will make cooking for a crowd a lot less daunting.

  • Ask around. Before you get too far with your planning, note anyone who has a food preference, allergy, intolerance, or any other dietary needs or restrictions. While some guests may follow a vegetarian or vegan diet, plenty of people are thinking more plant-forward in general. Come up with a mix of meat, poultry, seafood, and plant-forward offerings so every guest has a selection of dishes to enjoy. It’s a good idea to have at least one meatless main dish for guests who follow a vegan or vegetarian diet.
  • Plan ahead. Think about what you can take care of in the days leading up to your event. Shopping is a no-brainer. Review all your recipes and check your pantry to compile one master shopping list before you even set foot in the grocery store. Again, buying in-season produce will help you save money, as will buying in bulk, which large parties often require anyway. Once home, take stock of your cookware and serving dishes, laying them out with sticky notes so you know which food will go in which dish.
  • Welcome helping hands (big and small). If someone offers to help in the kitchen or contribute something, take them up on it! Even kids can get in on the game: Let them toss a salad, set the table, or handle washing the pots and pans. It’s one less thing for you to do as the host, and one more way to inspire their love of healthy home cooking.

SMART KITCHEN SWAPS

There are plenty of healthy baking swaps to lighten up your favorite Holiday treats. Considering swapping out some of the items high in calories, sodium or saturated fat, for a healthier alternative.

  • One cup of unsweetened apple sauce can be swapped out for one cup of sugar
  • One cup of mashed bananas can be used to replace one cup of melted butter or oil
  • Greek yogurt can be used to swap out for different ingredients such as sour cream, butter, oil and heavy cream, but the ratios can vary
  • Instead of a fruit pie try making a fruit crisp for the holidays, it has fewer calories
  • Try replacing cream in recipes with regular or low-fat milk
  • Use herbs and spices, like rosemary and cloves, to flavor dishes, instead of salt or butter

EAT WELL, BE WELL TIPS

You can eat well and be well this holiday season, with these tasty treats, party tricks and simple strategies from the experts at the American Heart Association.

  • Include lots of seasonal, colorful fruits and vegetables. Do you decorate for the holidays with a lot of color? Treat your plate the same way. Fruits and vegetables will add flavor, color and nutrients to holiday favorites. And they help you feel fuller longer so you can avoid the temptation to overeat.
  • Navigate holiday parties like a boss. From the obligatory workplace parties to family get-togethers, your calendar may be bursting with opportunities to eat and drink outside of your regular routine. Make a plan that will help you resist plowing through the buffet table, like having a healthy snack beforehand.
  • Sprinkle in opportunities to be active. Keep the inevitable indulgences in check by staying active. Enjoy some winter sports, for a change of pace, or schedule in a quick walk or workout before you head to the next party. Remember, every little bit helps you get closer to the recommended amount of physical activity.

HOLIDAY HEALTH AND SAFETY

These tips from Aramark’s safety experts will keep safety top of mind when preparing a holiday feast.

  • Wash your hands. Hands must be washed AFTER using the restroom, coughing, sneezing and handling raw foods and garbage. Always wash your hands BEFORE starting to prepare food and in between tasks. Handwashing is critical to preparing safe food.
  • Thaw frozen food properly. It is recommended that a refrigerator is used to thaw frozen food, so plan ahead. For every 5 pounds (2kg 270g) of large frozen food, allow 24 hours of refrigerator thawing time. Place the food in a tray or container deep enough to collect any draining fluids to prevent contamination of other foods in the refrigerator.
  • Use proper cooking temperatures. Cook raw meat products to the minimum internal temperatures as stated on the product packaging. Insert a thermometer (digital is preferred) at several spots including the thickest part of the meat. Achieving the proper internal minimum cooking temperature is critical to preparing safe food.
  • Store and reheat leftovers safely. Leftovers must be cooled to below 70°F (21°C) within 2 hours, and then to 41°F (5°C) or below within 4 hours. Large items should be broken down into smaller items by either physically breaking items apart or placing the item in multiple small shallow containers. Keep refrigerated leftovers for 3 days from initial cooking or freeze for longer storage and reheat leftover food once to 165°F (74°C) for 15 seconds.

HEALTHY MENU IDEAS

It’s possible to eat healthy during the holidays without FOMO, or a lot of effort. Here are some favorite recipes from Aramark and the American Heart Association that will bring new flavors and twists on holiday favorites to your table.

Visit www.fyp365.com for more holiday tips and healthy recipes.