Northern Westchester Hospital Dietitian Discusses the Role of Food in Cancer Prevention

The Shopping Basket: A Tool To Control Your Cancer Risk

By Stephanie Perruzza MS, RD, CDN

picnic-basketAs a dietitian, I am keenly aware of the impact that food and nutrition have on health and well-being, and I am truly passionate about educating others in this aspect. With April being Cancer Control Month, I wanted to take the opportunity to share some information on what you can do to reduce your cancer risk. Many of us have been affected by cancer in some way, and it’s empowering to know that eating a well-balanced diet with an emphasis on plant foods is one thing that you can do to help reduce your risk – and it’s easy to do, just grab a shopping basket.

Research shows that 1 in every 3 cancers is linked to poor diet and lack of physical activity. The guidelines for reducing your cancer risk are similar to that of reducing other chronic diseases.
1.    Fruits and vegetables. This includes non-starchy vegetables and the more variety the better to ensure you are getting an array of vitamins and antioxidants. Good options include tomatoes, beets, broccoli, dark leafy greens like spinach, kale, as well as berries, grapes, and citrus fruits like grapefruit and oranges. “Eat the rainbow” every day and you’ll be sure to get a wide variety in your diet!
2.    Fiber-rich foods. In addition to fruits and vegetables, whole grains such as whole wheat breads or pastas, oatmeal, barley, brown rice to name a few contain ample amounts of fiber.  Beans and legumes are also a great source of fiber.
3.    Choose lean protein. Select chicken, fish, eggs and vegetable protein sources such as beans, legumes and unsalted nuts when possible. Limit your intake of red meats and if you do consume, choose leaner cuts that include the words “loin” or “round” and have smaller portions.
4.    Avoid saturated and trans fats. Full-fat dairy, cheese and processed food items like luncheon meats, bacon, sausage and snack foods contain saturated fats. When reading food labels look for and avoid partially-hydrogenated oil on the ingredient list.
5.    Limit sodium. Canned products such as soups and vegetables are often high in sodium. Look for low-sodium soup varieties, and rinsing canned vegetables before use can reduce the sodium content by about 40%.

In addition to focusing on diet, there are a few other factors to keep in mind:
•    Maintain a healthy weight. You have a higher risk for cancer if you are overweight or obese. Together, engaging in regular exercise and making healthy food choices can help with weight control.
•    Limit Alcohol. Studies have shown that consuming alcohol in excess can increase your risk of certain types of cancers. Limit your intake to no more than one alcoholic beverage per day for women and two per day for men, preferably with a meal.
•    Exercise Regularly. Aim to get 30 minutes each day or 150 minutes of moderate physical activity each week as a general goal.
•    Avoid Tobacco. Smoking and chewing tobacco has been linked to various types of cancer specifically oral cavity and lung. Talk to your doctor about ways to quit.

Editor’s Note: Nutrition consultation is also part of Northern Westchester Hospital’s Health & Wellness Program. The Health and Wellness Program is designed to support our patients in parallel to their medical treatment plan after they receive a diagnosis of cancer. Patients of NWH physicians have access to the Program at no charge.

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Sleep Expert at Northern Westchester Hospital Explains Sleep Apnea, Symptoms, Dangers, and Treatment Options

Sleep Apnea: Symptoms, Dangers, and Treatment Options

By Dr. Praveen Rudraraju, Director of the Center for Sleep Medicine at Northern Westchester Hospital

What is sleep apnea?
Sleep apnea (AP-ne-ah) is a common disorder where you have one or more pauses in breathing or shallow breaths while you sleep.

What are the signs of sleep apnea?
Most people who have sleep apnea don’t know they have it because it only occurs during sleep. A family member or bed partner might be the first to notice signs of sleep apnea. The most common symptoms are snoring and daytime sleepiness. But these symptoms may not be seen in everyone, which delays diagnosis in most people. Other symptoms that are seen in sleep apnea are non-restorative sleep, morning headaches, nocturia (urinating multiple times at night), and insomnia. One or more symptoms may be present in most patients. There are some people with no symptoms.

The most common type of sleep apnea is obstructive sleep apnea. In this condition, the airway collapses or becomes blocked during sleep. This causes shallow breathing or breathing pauses.

What are the dangers of sleep apnea?
Untreated sleep apnea leads to many health problems:
•    increased risk of high blood pressure, heart attack, stroke, obesity, and diabetes
•    increased risk of, or worsened, heart failure
•    arrhythmias or irregular heartbeats
•    an increased chance of having work-related or driving accidents

What treatment is available for people diagnosed with sleep apnea?
Treating sleep apnea is very important. Treatment should be individualized based on history and anatomy.

Some of the treatment options are:
•    CPAP machine – it’s a small machine that is by the patient’s bedside which blows air gently to keep the airway open
•    dental devices can be custom made by certified dentists, which can help in some cases
•    Provent therapy – these are small nasal valves that cover the nostrils that help in some patients with their sleep apnea or snoring
•    Winx machine – this is a small machine that is by the patient’s bedside which is attached to a mouth piece that is inserted into the mouth
•    surgery – there are several surgical options which are indicated in small groups of patients

Editor’s Note: Visit the Center for Sleep Medicine at Northern Westchester Hospital and take our quiz to see if you might be suffering from a sleep disorder.

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New York Cardiology Chief on Controlling Cholesterol and Reducing Risk of Cardiovascular Disease

How to take control of your cholesterol levels…starting today!
(part 3 of 3)

By Dr. Robert Pilchik, Chief of Cardiology at Northern Westchester Hospital

What’s the best way to bring your HDL and LDL cholesterol levels into the safe zone, and significantly reduce your risk of cardiovascular disease? On your own. That’s right – through diet and exercise. And if you’re a smoker, quitting is a must.

You may be amazed how effective lifestyle changes are in lowering “bad” LDL cholesterol and raising “good” HDL cholesterol, and how fast you can achieve your goal.  (For more information on LDL and HDL cholesterol, read Parts One and Two of this series.) In three to four months, diet and exercise alone can produce more than a 30 percent reduction in LDL cholesterol, which is often enough to put you into the safe zone. What’s more, exercise is the only way to raise HDL cholesterol (which vacuums artery-blocking LDL cholesterol from your body).

If your cholesterol levels aren’t great, but aren’t terrible, I’ll tell you to lose 20 pounds, exercise and reduce the amount of saturated fats in your diet. If within three months, you’re making progress, we don’t need to use medication. If you start off with LDL numbers through the roof, I’ll prescribe diet, exercise and cholesterol-lowering medication. Once I see that you can maintain your diet and exercise routine, we cut back on the medication and ultimately get rid of it altogether.

To lower LDL I also prescribe 30-40 minutes of aerobic exercise at least three to four times a week. “Aerobic” doesn’t mean a leisurely stroll once around the track! It means you’re breathing hard, breaking a sweat and your heart rate is above 100 beats a minute. The more you exercise, the more LDL your body expels. And as I mentioned, exercise is the only known way to raise HDL cholesterol.

You also need to make dietary changes to help bring cholesterol levels into the safe zone: Limit intake of foods with saturated fats (red meat, milk, butter, cheese, coconut and palm oils), which directly increase your body’s LDL cholesterol. Replace saturated fats with unsaturated fats, found mainly in fish, legumes, nuts, seeds and oils from plants; because chicken is lower in saturated fats, it’s a great choice. Completely avoid trans-fatty acids. Many patients’ first question is, “How often can I have red meat?” The answer depends on whether you’ve had heart disease. In general, I advise not more than once a week.

What if your cholesterol numbers are great? Can you have all the ice cream you want? No – you need to maintain those good numbers. For you, I recommend the same exercise routine as for improving cholesterol levels.  And I urge you to gradually shift to a way of eating more in synch with the heart-healthy “Mediterranean” diet that emphasizes fruits, vegetables, whole grains, beans, nuts and healthy fats, moderate consumption of dairy and low consumption of meat.

Statins are the cholesterol-lowering medication of choice. They work by inhibiting your liver’s ability to produce LDL cholesterol. Statins are exceptionally effective, lowering LDL levels as much as 50 percent.  However, if cholesterol-lowering medication brings your LDL cholesterol within the safe zone, this does not eliminate the need to exercise and make heart-healthy dietary changes. It takes all three together – exercise, diet and medication – to reduce your risk of heart disease.

Tasty Tips for a Healthy Heart

  • Replace red meat with fish and poultry
  • Replace full-fat dairy products with reduced-fat dairy, such as skim milk and partially skim milk cheese
  • Replace butter with vegetable-based oils such as olive, peanut, canola, sunflower, corn, soybean and flaxseed
  • Increase your intake of nuts, particularly almonds, walnuts and pecans
  • Add avocados and olives to your diet
  • Eat more heart-healthy salmon, trout and herring

Editor’s Note: This is Part Three of a three-part series that empowers you with knowledge and practical ways to keep your cholesterol levels in the safe zone, thereby dramatically reducing your risk of life-threatening heart disease. Part One helps you understand how your cholesterol levels affect your heart’s health. Part Two gives you a handle on those puzzling cholesterol numbers.


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Northern Westchester Hospital Registered Dietitian Offers Ideas to Enjoy the Taste of Eating Right

The Taste of Eating Right

by Stephanie Perruzza, MS, RD, CDN, Northern Westchester Hospital

March is National Nutrition Month, an annual nutrition education campaign sponsored by the Academy of Nutrition and Dietetics.  The Registered Dietitians at Northern Westchester Hospital want to encourage everyone to celebrate by focusing on making healthy food choices!  Specifically, by keeping this year’s theme in mind: “Enjoy the Taste of Eating Right.”

Most consumer research has shown that individuals are likely to choose foods that taste good, healthy or not; as dietitians, we completely understand – we eat what tastes best!  Spend some extra time enjoying your meal choices by combining flavors and nutritious foods to build a healthy plate. Continue reading

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Northern Westchester Hospital Maternity Nurse Shares Resources for New Parents

New Parents have Q’s…
…Here’s Where to Find the A’s

By Maureen Varcasio, RN at Northern Westchester Hospital

iStock_000019586817Medium2Having a baby requires parents to learn new skills in order to care for their newborn and themselves. Much of what you need to know can be learned from the nurses while you are still in the hospital. However once parents are discharged home they may still have questions or new questions can arise. For example:  What should I do if my baby won’t nurse or won’t stop crying? Do I have Postpartum Depression? or Am I bleeding too much? Here’s where you can turn for answers… Continue reading

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Northern Westchester Hospital Colorectal Cancer Surgeon Stresses Importance of Colonoscopy

Turning 50? It’s Time for a Colonoscopy.

By Dr. Jerald D. Wishner, FACS, FASCRS, Co-Director, Institute for Robotic and Minimally Invasive Surgery and Medical Director, Colorectal Surgery Program at Northern Westchester Hospital

50_Cupcake_HiRezOne of the most common killers is colon cancer, yet fewer than half of eligible Americans get a colonoscopy. It’s a statistic that is really bothersome to me. A colonoscopy is the gold standard of colon cancer screening, and the research proves it saves lives.

Colon cancer begins in polyps inside the colon, and it can take five to eight years to develop. The promise of a colonoscopy is that, if pre-cancerous polyps are found, the doctor can remove them during the procedure. With mammograms, the hope is that you’ll find cancer early; Colonoscopy takes that a step further by actually preventing cancer from developing in the first place by removing these precancerous polyps.

One of the biggest misconceptions of colonoscopies is that they’ll be painful or uncomfortable. I’ll admit it; it doesn’t sound like fun, but most people will barely know they’ve had one. An anesthesiologist sedates the patient, making the procedure painless. Other than some post-colonoscopy grogginess and a little bloating, you won’t feel a thing. The toughest part is the day before, when you have to take laxatives to clear the colon.

People also find the procedure embarrassing, but a little embarrassment is much better than colon cancer. Who should be screened? Every American at age 50; people with symptoms or a family history of colon cancer should get one sooner. If a parent or sibling was diagnosed with colon cancer, plan to go in when you’re 10 years younger than the family member’s age at diagnosis. For example, if dad was diagnosed at 55, you should get your first colonoscopy at 45.

If the screen turns up precancerous polyps, your doctor may schedule you for another colonoscopy within a few years. However, if there are none, you can wait another seven to ten years before you get screened again. Just don’t put off that first screen. If you wait until you have symptoms such as pain or you’re not moving your bowels, it will be very difficult to cure you. The cancer has had a chance to grow and your chances of recovering will be much lower.

Should a colonoscopy detect cancer that can’t be treated during the procedure, surgery is the next step. There have been advancements in the surgery for colon cancer, something that is unique to Northern Westchester Hospital: Colorectal surgeons at the hospital can now use robotic surgery. That means much smaller incisions, less damage to surrounding tissues and organs, and a much faster recovery.

The crucial message is that you need to be screened at age 50. I had one patient who got a colonoscopy on his 50th birthday. Of course, that’s not necessary. But be sure to schedule an appointment as soon as possible afterwards: Colonoscopy is not nearly as bad as you think, and we can save countless lives each year. There’s no debate about that.

Visit to learn more about robotic surgery at Northern Westchester Hospital.

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Tips for Reducing Salt in Your Diet

Spice it Up and Toss the Salt

Kimberly Stein, RD, CDN

In today’s food culture, most of us are consuming far too much sodium. The current recommendation for sodium according to the 2010 Dietary Guidelines for Americans is less than 2,300 milligrams per day. That’s equivalent to about the size of one teaspoon. The recommendation for African Americans, individuals age 51 and older and anyone with high blood pressure, diabetes, or kidney disease is no more than 1,500 milligrams each day.

Yes, it’s true that we do need sodium in our body for normal functions, such as maintaining blood pressure. However, it’s when our sodium intake skyrockets that it can become dangerous causing hypertension (high blood pressure), or fluid retention in people with certain medical conditions, but controlling the amount in your diet may be easier than you think. Here are some simple tips to keep your sodium intake in check: Continue reading

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Help for Daylight Saving Time Sleep Problems

Spring Forward with Ease

By Dr. Praveen Rudraraju, Director, Center for Sleep Medicine, Northern Westchester Hospital

Dr. Rudrarju PraveenThe hour time change will affect some people more than others due to difficulty adjusting their circadian rhythm. By altering the clock our internal clock becomes out of sync or mismatched with our current day-night cycle. Here are a few tips that might help you ‘spring ahead’ with ease: Continue reading

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Adjusting to Daylight Saving Time for Children

Sweat Dreams

By Dr. Lewis Kass, Pediatric Sleep Specialist, Northern Westchester Hospital

Kass,(Lewis J. Kass, MD)Children’s busy schedules may have more of an impact on their sleep than daylight saving time.

In today’s world the one hour time change is the smallest of the issues that affect our children’s ability to get to sleep. Most school-age children are so over scheduled that they come home exhausted. From school to swim or basketball or soccer practice to piano lessons to homework then ending the day with television or video games or tablet time, a child’s day should’ve ended long before a bedtime that is frequently later than it should be.

Continue reading

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New York Dietitian Gives Tips on Healthy Snacking

National Snack Food Month

by Stephanie Perruzza, MS, RD, CDN, Northern Westchester Hospital

89792455compr-nutrition monthYes, you read this title correctly. There is a National Snack Food Month, and it’s in February. Snack foods tend to get a bad rep with stereotypical offerings like chips, cookies and soda on frequent advertisements. The good news is that snacking can fit into a healthy diet and lifestyle – just be sure to keep these few tips in mind:

  1. Calorie Control – you don’t want to overdo it and have your snack turn into a meal. Portion your snacks out and keep them between 150-225 calories.
  2. Snack Wisely – Choose nutritious food choices (see our examples below) and don’t snack mindlessly. When your mind is preoccupied, you eat more; so sit down and focus on your meal and hunger/fullness feelings. Continue reading
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