December 3, 1999
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ARE THERE NUTS IN THAT FRUIT CAKE? ALLERGIES AND THE HOLIDAYS.
With the holidays come all sorts of delicious traditional dishes. Some people have to be careful when they pick up that piece of fruit cake, however; they may be allergic to much of what's in it.
Food allergies are among the most common kinds of allergies, according to N. Franklin Adkinson Jr., M.D., professor of clinical immunology at Johns Hopkins, and the most common of the food allergies during the holidays is to nuts, an ingredient in many traditional foods. Adults and children who are allergic to peanuts should be especially wary, as peanuts are sometimes used as a thickening agent in holiday soups and gravies, and are hard to see and avoid in these foods. The best advice, he says, is just to be careful. Don't be afraid to ask if nuts are lurking in the pie you're eyeing on the table.
Christmas tree allergies are another, rarer set of miseries that show up during the holidays. According to Adkinson, most people with evergreen tree allergies react to the sap, which triggers a rash much like poison ivy. Others suffer from non-allergic rhinitis triggered by the smell of tree boughs and needles. The rarest form is to the tree's pollen, which appears to sensitize only people who are continually exposed to it such as those who live and/or work in pine bogs or forests.
BUCKLE UP AND MIND THE EGGNOG! HOLIDAY TRAFFIC SAFETY.
Thanksgiving and Christmas are times to spend with family. And consequently that means a lot of time on the road. The National Highway Traffic Safety Administration recorded 6,465 fatal traffic accidents nationwide between November and December 1998. According to Guohua Li, M.D., of the Johns Hopkins Hospital Emergency Department, the best way to avoid traffic during the holidays is to minimize holiday road travel or stay at home. If you must drive, drive rested and make sure seat belts are fastened and young children are properly protected in child safety seats. And always use a designated driver or a taxi or public transportation if you have used alcohol.
HOLIDAY FOOD TIPS FOR PEOPLE WITH DIABETES
Holiday parties and dinners can be full of edible temptations for anyone, but for people with diabetes, yielding to such temptations can be disastrous for their glucose control. This does not mean that diabetes sufferers can't enjoy the festivities. According to Johns Hopkins Diabetes Center nutritionist Gloria Elfert, MS, RD/LD, diabetics shouldn't expect to have perfect glucose management during the holiday season. Her "Helpful Hints" sheet urges people "to remember holidays are all about excesses, and that includes those with or without diabetes." Everyone should accept that fact, she says, and take it in stride.
Her suggestions include taking a regular snack before a party to cut down on temptation; taking small portions of foods at meals, trying to keep stress under control, aiming for more vegetables and salads, and drinking mock cocktails those consisting of flavored waters or other non-caloric beverages -- at parties. And above all, monitor blood sugar more closely to avoid wild swings in glucose levels. Says Elfert: "Don't overdo it, check blood sugars to make sure you are within reasonable limits."
NUTRITION: WAYS TO WATCH YOUR WAISTLINE AT THE HOLIDAYS
For those who want to "battle the holiday bulge," says Lorraine Giangrandi, of the Johns Hopkins Weight Management Center, there are ways to enjoy holiday foods while cutting out a lot of the fat.
If holiday pies are what you love, enjoy the pie filling, but forego the crust you'll cut out a lot of calories that way. If you're baking the pie, use a graham cracker crust and get the same effect. To cut fat out of cakes, replace half the butter or oil in the recipe with applesauce. To enhance the flavor of turkey or other meats without adding fat, use fresh herb rubs or chutneys instead of gravy.
WHEN A DIET IS MORE THAN A DIET: EATING DISORDERS AND YOUNG ADULTS
Many times, the parents of a student are the first to notice the early stages of an eating disorder. It often happens around Thanksgiving, usually the first time students come home after starting school in September. In an attempt to avoid the "freshman fifteen" -- the extra few pounds some kids gain in college -- some students, particularly women, become overly concerned with their weight and eating habits. Should this concern become obsessive, it can develop into an eating disorder such as anorexia or bulimia. Angela Guarda, Ph.D, of the Eating Disorders Clinic at Johns Hopkins Hospital, says signs that a student may be developing an eating disorder include selective avoidance of high-fat or high-calorie foods, isolation from old friends, avoidance of social situations involving food, and obsessive talking about fat and weight. Students may claim that they are just on a diet, but Guarda says that dieting in young adults is the single biggest risk factor for an eating disorder.
If caught early, 50 percent of patients with an eating disorder are curable with treatment, and at least 75 percent of them improve significantly. The chances get lower, though, the longer treatment is delayed.
SEASONAL AFFECTIVE DISORDER: DEALING WITH THE "WINTER BLUES"
Many of us have a hard time getting up in the morning, but for some, it gets abnormally difficult during the winter. Seasonal affective disorder, also known as SAD, is characterized by fatigue and general irritability during the winter months, when sufferers are exposed to less sunlight. "People with SAD also sleep and eat more," says Everett Siegel, M.D., a Johns Hopkins psychologist. "This distinguishes them from people with other depressive disorders." In addition, SAD sufferers generally crave foods heavy in carbohydrates.
Siegel offers suggestions for people who may think they suffer from SAD. "Talking to your doctor is always a good idea," he says, "and information about SAD is available in books and on the Internet." There are several Web sites on SAD, such as The Melatonin and Seasonal Affective Disorder Network (http://hometown.aol.com/mindbend2/index.htm) and the Outside In site (http://www.outsidein.co.uk/). Some people buy light boxes, which simulate sunlight and can have a rejuvenating effect. Siegel says that he has even prescribed vacations in Florida for some of his patients. "None of them have ever complained about that."
Let's face it: the changing of the millennium is a big event. But it's nothing to get nervous or anxious about. While some worry excessively about Y2K, says psychologist Everett Siegel, M.D., a professor with the Johns Hopkins School of Medicine, others tend to become more reflective than anxious as New Year's approaches. Many ask themselves questions such as, "Where am I in my life at this point?" "People may be unhappy with themselves or with where they are in their life at this time of year, but not have a true biological depression," says Siegel. "Big, dramatic media coverage of the millennium can also worsen anxiety for some, causing them to think they should be reacting or thinking in a certain way."
Siegel advises, "Don't miss the forest for the trees. Just because you're feeling down around the holidays, don't blame the millennium." Many people feel blue around the holidays due to Seasonal Affective Disorder (SAD), linked to a lack of sunlight during the winter months. The holidays can also be a time of reflection on life's losses, be they recent or far in the past. Physical ailments, such as anemia, also can cause people to feel "down."
NEW FAMILIES: CHILDREN OF DIVORCE OR REMARRIAGE AND THE HOLIDAYS
Divorce is a sad and painful event for all parties involved, but the first holiday after a divorce or separation can be particularly tough on the children. Leon Rosenberg, Ph.D, a child psychiatrist and professor of psychiatry at Johns Hopkins Hospital, says that the media broadcast a "powerful reminder that others have things better" during the holiday season, which can make children very uncomfortable. Even though children say they're fine, Rosenberg says, "parents should make it clear to the child that they understand that they're going through a rough time and that if they think they're fine now, they'll get better later."
Children who live with a remarried parent can especially have trouble with the first holiday after the marriage, when they are still trying to adjust to the new surroundings. Rosenberg's message for these families is basically the same: make sure children know you understand that they're unhappy, and keep in mind that even amidst the happiness of the holidays, children in a new family situation (be it divorce or remarriage) "have a right to feel lousy" for a little while.