August 2008

Find proper shoes and inserts

Wisconsin Partnership for Activity and Nutrition offers resources to health care professionals

Decoding health claims

NEW Kids welcomes new staff member 

Rite-Hite Family YMCA staff help families through NEW Kids at the Y Program

Find proper shoes and inserts

By Stacy Stolzman, MPT

When children and adults are physically active, proper footwear is essential to prevent injury, joint pain and unnecessary fatigue. As the foot hits the ground with physical activity the impact is carried throughout all joints in the body. Proper alignment and shock absorption help to prevent pain in the foot, ankle, knee, hip and back.

Children and adults should wear supportive athletic shoes that are securely tied when doing physical activity. Flip-flops, sandals and untied shoes do not provide proper support and require the foot and leg to work harder than necessary. This can lead to fatigue in the foot, ankle, leg and back. Ultimately, physical activity will not be tolerated as well due to this fatigue and pain.

If patients have a normal medial arch in the foot, most tennis shoes will provide adequate support for the body during physical activity. If patients have a flat arch, over-the-counter inserts are a good option to support the medial arch of the foot and provide proper alignment. Spencos^R are one style of over-the-counter insert that help to prevent over pronation. They are available at most sporting goods stores and online. Spenco^R inserts are available in full and ¾ lengths and usually cost less than $30 a pair.

Custom inserts may be prescribed for your patients if over-the-counter inserts are not providing adequate shock absorption and alignment control. A referral to a custom orthotist should be made to evaluate and create custom orthotics. Custom orthotics can cost from $200 to $500 per pair and are covered by some insurance plans. Custom orthotics may address numerous problems of the foot in addition to pes planus.

When speaking with families about proper footwear, keep these tips in mind:

• Recommend that families check all shoes and inserts for wear at least every 30 days.

• Excessive wearing of the outsole, loss of shoe counter support, or wearing out in the midsole, indicate it is time to replace the shoes.

• Most shoes and over-the-counter orthotics lose their shock absorption and alignment control properties within 90 to 120 days of regular physical activity.

• Children's feet have potential to grow until the growth plates in their bones close. Growth plates in children's bones do not finish closing until age 15-17 in boys and 13-15 in girls.

• Remind families to consult with a shoe store to have their child's feet measured for length and width to ensure proper sizing of footwear before purchase.

Wisconsin Partnership for Activity and Nutrition offers resources to health care professionals

By Michele Polfuss, RN, MSN, APNP

As a health care provider you are busy seeing patients and reading journals. You may be missing out on a great resource that is at your fingertips. The Wisconsin Partnership for Activity and Nutrition provides statewide leadership to decrease overweight and obesity, increase physical activity and improve nutrition.

WI PAN began in 1999 as a small workgroup initially known as Wisconsin Nutrition and Physical Activity Workgroup. Today, WI PAN has more than 200 members who come from a variety of public and private organizations, programs and coalitions. All members share the common goal of improving the health of Wisconsin residents through improved nutrition and increased physical activity. WI PAN provides statewide leadership for interventions, activities and policies in the area of overweight and obesity prevention and management.

WI PAN has a comprehensive Web site that offers information about local coalitions, policy development, legislative tools, facts and statistics, training opportunities and a diverse supply of resources. Other resources available on the site include:

• The Wisconsin Nutrition and Physical Activity State Plan. A guiding document that can be utilized by public and private sector organizations to influence public policy, community, organizational and individual and family changes.

• Documents such as What Works in Healthcare. A four-page document that provides evidence-based strategies that can be utilized to screen and prevent overweight and obesity in the healthcare setting.

New WI PAN members always are welcome. For more information, contact Mary Pesik at (608) 267-3694.

Decoding health claims

By Jennifer Allen, RD

As consumers are becoming more aware of food labeling, manufacturers are using more health claims to sell their products. The Food and Drug Administration has strict guidelines about what terms can be used and what criteria must be met to use them. However, there are some terms that often confuse and mislead our patients.

Consider educating your patients about these popular terms:

• Low calorie: Less than 40 calories per serving.
• Low sodium: Less than 140 mg of sodium per serving.
• Low cholesterol: Less than 20 mg of cholesterol and 2 grams or less of saturated fat per serving.
• Reduced (fat, sugar or calorie): 25 percent less of the specified nutrient than the original product.
• Good source of (calcium, vitamin C, iron or fiber): Provides at least 10 percent of the daily value of a particular nutrient or vitamin per serving.
• High in (calcium, vitamin C or iron): Provides 20 percent or more of the Daily Value of a specified nutrient per serving.
• High fiber: Five or more grams of dietary fiber per serving.

Some terms to watch out for:

• Made with: This does not mean the same as "Good source" or "High in." Manufacturers especially like to use this term with whole grains. Remember to always look for the word "whole" as the first ingredient in the ingredient list.
• Natural: This term is very misleading and should not be used to guide healthy eating choices. For example, high fructose corn syrup recently was approved by the FDA as a "natural" ingredient.
• Organic: While the term organic is tightly regulated, consumers often get confused about the connection between organic products and potential health benefits. Thus far, research has not shown significant differences between the nutrient contents in organically grown and nonorganically grown products.

NEW Kids welcomes new staff member

By Brian Fidlin, PhD

We are very pleased to introduce Laure Demattia, DO. Laurie has been involved with the NEW (Nutrition, Exercise, Weight Management) Kids^TM Program for several years and now is expanding her role to include more direct patient care. Demattia has a special interest in the area of managing the chronic care issues associated with obesity, making her a perfect fit for the NEW Kids program.

With Demattia's arrival, the NEW Kids program will continue to provide the best possible care to patients experiencing weight problems and medical comorbidities. Demattia's arrival also continues to allow us to decrease the amount of time patients have to wait when being referred into the program and the next available initial evaluation.

Please join me in welcoming Demattia. Contact me with any comments or suggestions on how to improve the services we offer to you, your patients and your colleagues.

Rite-Hite Family YMCA staff help families through NEW Kids at the Y Program

In collaboration with Children's Hospital of Wisconsin, he Rite-Hite Family YMCA (formerly the Schroeder YMCA), located at 9250 N. Green Bay Road in Brown Deer, Wis., has been an active part of the NEW Kids at the Y program. The friendly staff members who help create and provide programs for NEW Kids at the Y make all participants feel welcome.

Kristi Gorsline is the NEW Kids at the Y Coordinator for the Rite-Hite Family YMCA. She has been in the position for about a year. She enjoys working with kids and families in the NEW Kids at the Y classes. Gorsline, who has a degree in physical education, teaches science and math full-time at an elementary school. She also coaches volleyball.

Ahron Thode also plays a big part in the NEW Kids at the Y program. Thode is a master strength coordinator and head personal trainer for the Rite-Hite YMCA. He has experience coaching youth sports such as soccer and volleyball. Thode works directly with kids to help spark interest and confidence in a broad range of physical and athletic activities. He is a graduate of the University of Wisconsin-Milwaukee.

Since the program started, many kids have successfully lost weight and learned how to make healthier life choices. Gorsline and Thode have seen kids with sedentary lifestyles become active, healthy individuals. One of the most exciting memories for Gorsline was getting kids to try new vegetables they had never tasted before. Many of the parents and kids found out they actually like edamame (soy beans) and planned to incorporate it into their diets.

Both Gorsline and Thode have found all of their clients were able to make healthy changes in their lifestyles. They know it's not just about losing weight, it's about creating healthy habits. Many of the families became more conscious of their food and beverage choices and those choices resulted in losing weight. Gorsline and Thode provide the support the families need to be successful.