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Parents have difficulty estimating sugar content in kids’ food

UofL providers daily see problem newly researched by German institute
 Parents have difficulty estimating sugar content in kids’ food

Common foods consumed by children, such as pizza, orange juice and ketchup, contain more sugar than parents think they do, say UofL pediatric medical and dental providers.

A recent study from researchers at the Max Planck Institute in Berlin verifies what several University of Louisville physicians and dentists see in their practices: Parents, though well-meaning, are not good judges of the amount of sugar in common foods their children consume.

In the study, published in the International Journal of Obesity, about three-quarters of parents surveyed underestimated the total amount of sugar in foods commonly found in the diets of children: orange juice, pizza, yogurt, ketchup, granola bars and more. The biggest divergences occurred in foods thought to be “healthful”; for example, more than 90 percent of the 305 study participants underestimated the amount of sugar found in yogurt by an average of 60 percent.

More concerning was the fact that parents’ misjudgments tended to be related to their children’s body weight. Those children with the highest body mass index tended to have parents who made the greatest misjudgments of sugar content.

Heather M. Felton, M.D., medical director of the UofL Pediatrics-Sam Swope Kosair Charities Centre, and Hector Martinez, D.D.S., M.Sc., of the UofL School of Dentistry, aren’t surprised. It is a situation they see virtually every day in their practices.

“This happens quite a bit,” said Felton, who is a fellow of the American Academy of Pediatrics (AAP). “Parents simply don’t know how much sugar is in the food they feed to their children. They believe they are feeding healthy meals and can’t understand why their child is overweight.

“Generally speaking, you should limit your younger child’s intake of added sugar to 12-16 grams a day – that’s about 3-4 teaspoons. For pre-teens and teens, it should be no more than 8 teaspoons.”

Although the German study only examined medical health and sugar underestimation, Martinez says the problem is a contributing factor to dental problems as well.

 “Sugar contributes to tooth decay,” Martinez said. “If left untreated tooth decay can be painful -- and painful teeth will affect a child’s performance in school,” Martinez said.

Preventing cavities and decay is the first line of defense, he said. Martinez also urges parents to find a dental home for their child, and schedule a dental exam, cleaning and fluoride treatment. For children experiencing extreme decay, the UofL School of Dentistry offers Silver Diamine Flouride, a 58-percent solution that stops decay in its tracks.

Both Martinez and Felton echo a point made in the study: Food labeling needs improvement. The study authors recommend a “traffic-light system”: a red dot on the label for high sugar content and a green one for minimal sugar. 

“Food labels can be confusing because they list ingredients in terms of percentages of daily recommended values,” Felton said. “Parents may read that a container of yogurt has 25 grams of sugar, but they often do not know how that should fit into their child’s diet.

“Plus, parents are busy and don’t have time to thoroughly read labels, let alone keep track of how many grams of sugar their children consume in a given day. A simpler labeling system would help enormously.”

For now, the providers recommend that parents “assume that there is too much sugar in food and try to cut back where you can,” Felton said. “Instead of buying yogurt with fruit or other flavorings already in it, for example, buy plain yogurt and add your own fresh fruit to it. Don’t add sugar to the breakfast cereal you give to your children. Serve them water or milk instead of highly sweetened juices or sodas.”

“The worse thing parents can do is allow their children to drink juice or anything other than water in a sippy cup all day, which disrupts the ph balance of the mouth,” Martinez said. Better, he says, to drink juice or milk in one sitting rather than over the course of several hours.

Martinez and Felton also reminded parents of juice drinking guidelines released a year ago by the AAP.  The recommendations urge parents, when possible, to feed their children whole fruit rather than juice, where fiber and other nutrition can be gained. And, the Academy has reduced the quantity of fruit juice for children according to age:

  • No juice for children younger than 12 months.
  • 1-3 years – Limit fruit juice to a maximum of 4 ounces per day (1/2 cup)
  • 4-6 years –  No more than 4-6 ounces (1/2 cup –  ¾ cup)
  • 7-18 years – Limit juice to 8 ounces per day (1 cup)

Following these guidelines will at least limit sugar intake and help lead to healthier smiles and bodies, Martinez said.

 

 

 

 

Wendy Novak Diabetes Center at Norton Children’s Hospital earns certification for inpatient diabetes care

Care provided by UofL Physicians pediatricians and pediatric specialists
Wendy Novak Diabetes Center at Norton Children’s Hospital earns certification for inpatient diabetes care

Kupper Wintergerst, M.D.

The Wendy Novak Diabetes Center at Norton Children’s Hospital, staffed by University of Louisville Physicians pediatricians and pediatric specialists, is now one of three centers nationally to earn recognition for its treatment of children with diabetes.

The Joint Commission, the premiere national health care accrediting organization, granted the center a Certificate of Distinction for Inpatient Diabetes Care, making the center one of only three in the country to receive the designation. The others are Boston Children’s Hospital and Children’s Medical Center of Dallas

“The certification was made possible through our partnership with the University of Louisville and our joint vision to develop one of the most comprehensive diabetes programs in the nation,” said Emmett C. Ramser, chief administrative officer, Norton Children’s Hospital. “We’re always striving to provide the best service to our patients, families, and the community, and are proud these efforts have been nationally recognized.”

The certification is the result of a focus on improving diabetes care, particularly for children moving between the hospital and outpatient care settings. At UofL, outpatient services are provided in the Wendy Novak Diabetes Center location in the Novak Center for Children’s Health.

“We’ve seen the number of children with Type 1 diabetes increase dramatically in recent years,” said Kupper A. Wintergerst, M.D., division chief of pediatric endocrinology and director of the center. “Caring for children with diabetes, especially those who are newly diagnosed, requires a coordinated approach so that patients are successful once they leave the hospital. By coordinating care on all levels, we can better support patients and families living with this disease.”

Norton Children’s Hospital underwent a rigorous review to assess its compliance with standards on quality, safety, transitions of care, handoff communications and other key attributes. More than 1,200 children currently are being treated for Type 1 diabetes by specialists at Norton Children’s Hospital and the University of Louisville. Approximately 150 children are diagnosed each year.

 

Parents: Don't share the slide with your kids

Parents: Don't share the slide with your kids

A seemingly simple and fun activity that parents may want to share with their children could have serious medical repercussions, as evidenced by a video currently popular on Facebook.

Sharing a ride down a slide with your child may appear to be fun but it could cause serious injury, said Heather Felton, M.D., medical director of the UofL Pediatrics - Sam Swope Kosair Charities Centre. Felton cites a USA Today photo showing a playground accident that broke a 1-year-old girl’s leg, leading to national attention to slide safety for little ones.

In a video shared to Facebook on an incident that took place in 2015, Heather Clare of Huntington, N.Y., shared footage in which she put her 1-year-old daughter on her lap and took her “down a slide during a family outing at a local park.” The child’s “right foot caught the side of the slide, snapping her tibia and fibula.” In her Facebook post, Clare advocated “for warning signs at playgrounds telling parents not to ride down slides” with their kids.

Felton agrees. ““From 2002-15, there were 350,000 children under the age of five who were injured on slides, according to the Centers for Disease Control. A 2017 study published in the journal of the American Academy of Pediatrics showed that more than 350,000 children younger than 6 years old were injured by going down a slide in the United States between 2002 and 2015,” she said.

“In the majority of cases, children experienced a fracture after their foot caught the edge or bottom of a slide while sitting on a parent’s lap.”

For the safest outcome, Felton said, parents should allow their child to go down slides alone.

 

Now open, for Kentuckiana's children

First patients seen at Novak Center for Children’s Health
Now open, for Kentuckiana's children

Eleven-month-old Zayne Richard is all smiles as he enters the new Novak Center for Children's Health.

Physicians and other providers at the Novak Center for Children’s Health began seeing patients this week, marking the facility’s official opening.

“We are thrilled that the years of careful planning and construction are behind us, and we have opened our doors,” said Kimberly Boland, M.D., interim chair of the University of Louisville Department of Pediatrics. “This facility enables us to transform how we deliver care by having multidisciplinary teams located in one space so they can meet simultaneously with our patients and their families.

“This eliminates substantial inconvenient delays and obstacles for our patients to receive the very best care in the most efficient way possible.”

Maranda Griffith and son Zayne RichardAmong the first patients seen in the new facility was 11-month-old Zayne Richard, a patient of pediatric cardiologist Craig H. Alexander, M.D. Zayne was born with an atrioventricular canal defect, which occurs when there is a hole between the heart's chambers and there are problems with the valves that regulate blood flow in the heart. He also has Down’s syndrome.

UofL doctors successfully treated Zayne for his heart condition with surgery in February, said his mother, Maranda Griffin, who brought him in Tuesday (June 26) for follow-up echocardiogram and electrocardiogram tests to monitor his heart.

Griffin praised the new Novak Center. “This is so nice,” she said, laughing before adding, “nicer than the old office we went to in the Children’s Hospital Foundation Building. It’s much bigger. There is so much more room for Zayne’s stroller, and parking is so convenient, just across the street in the (Chestnut Street) garage.

“It’s so much lighter and brighter too. I love it.”

The new 176,000-square-foot facility at 411 E. Chestnut St. enables providers with the UofL Department of Pediatrics and UofL Physicians to accommodate an anticipated 135,000 patient visits annually in the new center – now one of the largest and most technically advanced pediatric outpatient centers in the United States. The building’s namesakes are retired CEO of Louisville-based Yum! Brands David Novak, his family and their foundation, the Lift-A-Life Foundation.

animal-color gridDesigned in kid-friendly colors, the facility features several public areas with soft seating and interactive screens to entertain children while they wait to see providers. But the waiting shouldn’t be long, Boland said: “We have implemented the latest in technological advances, the Real Time Locator System (RTLS), to help move patients and providers to their appointments without lengthy wait times.”

Each floor in the eight-story building has a different predominant color and animal theme to help both children and grownups identify it. Because the Novak Center houses general, specialty and subspecialty pediatrics services in a single building, patients and their families have all their needs handled in one convenient location.

Among the features of the building’s design:

  • lobbyAll pediatric providers are in a single building to ensure a multidisciplinary approach in providing care.
  • Innovative clinical and research programs not only provide the latest advances in treatments and cures but also create and develop them.
  • The environment enables staff to explore new initiatives, including holistic life style approaches to diseases and conditions that impact children.
  • Both basic and clinical research is carried out at the site and will help UofL attract new researchers as faculty.
  • Education and training provided to medical students, residents and fellows is enhanced, giving them first-hand experience with interdisciplinary learning they can take directly into the patient exam room. 

Also included in the facility is the Wendy Novak Diabetes Center, created in 2015 with support from the Novaks to provide comprehensive diabetes care as well as access to clinical research trials that sometimes are patients’ only chance at diseases management and survival.

The services of the Wendy Novak Center are augmented with the facility’s up-to-date kitchen. “We are going to invite the world-class chefs of Louisville to teach families how to prepare menus and foods that are diabetic-friendly and can actually improve lives,” Boland said. “Some of these chefs have diabetes themselves so they can speak and teach from first-hand experience.”

To learn more about the scope of pediatric health care at UofL, including how to make appointments, visit www.UofLPhysicians.org.

 

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UofL associate vice president V. Faye Jones to be honored for focus on diversity and health equity

Inclusive Equity Award recognizes UofL professor’s efforts to provide inclusive education in health-care professions
UofL associate vice president V. Faye Jones to be honored for focus on diversity and health equity

V. Faye Jones, M.D., Ph.D., M.S.P.H.

Louisville Central Community Centers, Inc. (LCCC) will honor V. Faye Jones, M.D., Ph.D., M.S.P.H., associate vice president for health affairs/diversity initiatives at the University of Louisville Health Sciences Center, for her work in educating future health-care professionals with a focus on diversity and instilling health equity. The Inclusive Equity Awards Gala will be held Tuesday, June 19 beginning at 6:00 p.m. in the Old Walnut Street Atrium at 1300 W. Muhammad Ali Blvd., to honor six community leaders in equitable inclusion.

Jones, a professor of pediatrics in the UofL School of Medicine, has more than 29 years of medical experience in practice and training future pediatricians. In her administrative role at the health sciences center, she focuses on diversity initiatives and health disparities, overseeing the integration of equitable and diverse health-care activities throughout the health sciences center. In addition to training and mentoring future physicians in the UofL School of Medicine, Jones directs programs to introduce and assist underrepresented students in achieving acceptance and success in medical professional careers through pipeline programs designed to recruit and retain diverse and underrepresented students. Her passion lies in creating a community where health equity is a reality.

The awards gala will raise funds and awareness for LCCC’s mission of self-reliance and service to the Russell neighborhood and the larger community, as well as efforts to help improve the circumstances of low-income, disadvantaged families throughout Louisville. LCCC programs include an early childhood learning center, Kids Arts Academy and a dynamic Teen Leadership Council for school age youth. LCCC also provide programs that seek to increase economic equity and mobility for family leaders.

This Trustees of Inclusive Equity Awards Juneteenth Celebration is symbolic of a significant date that marks strides to promote upward mobility, self-development, respect for all cultures, and true equitable opportunities for all. With that backdrop, LCCC wants to highlight community and corporate leaders who are innovative in their approach to advancing equitable inclusion in corporate, organizational, healthcare, nonprofit and community settings.

In addition to Jones, honorees include:

  •  Mark Wheeler, President, Central Bank Jefferson County, Companies of 1,000 or more employees.
  •  Peggy Arthur, Account Manager, BB&T, Companies of 500-999 employees.
  • The Louisville Defender, weekly newspaper, Companies of less than 500 employees.
  • Dr. Tim Findley, Sr., Division VP, Kindred Healthcare, healthcare.
  • Cathe Dykstra, President and CEO, Family Scholar House, non-profit organization.

Tickets for the event are available at louisvilletickets.com. Visit www.lcccnews.org for more information.

UofL pediatrician echoes study finding: high school pitchers should not also play catcher

UofL pediatrician echoes study finding: high school pitchers should not also play catcher

Pitchers who also played catcher were more than three times likely to have shoulder or elbow injuries.

High school baseball players who both pitch and catch suffer more injuries than pitchers who play other positions, reports a new study, and it is advice shared by a UofL pediatrician.

Heather Felton, MD, medical director of the UofL Pediatrics – Sam Swope Kosair Charities Centre, advises parents, coaches and providers to be aware of the study’s findings. “Clinicians, coaches and parents can use this information to determine secondary positions for pitchers to decrease injury risk,” she said. “The findings suggest that pitchers should not play catcher as their secondary position, in order to allow adequate time for recovery and to decrease their overall throwing load.”

High rates of shoulder and elbow injuries are common among young pitchers. Nationally, pitchers incur 73 percent of injuries among high school baseball players, and about 10 percent of them require surgery, the researchers noted.

According to the study from the University of Alabama and published online recently in the Journal of Athletic Training, pitchers who also catch are at a nearly three times greater risk of injury, because catchers throw significantly more than other field positions. Monitoring pitch counts is not enough, the study authors said.

Throughout the course of the study, pitchers reported 24 throwing-related shoulder or elbow injuries. Five occurred among pitcher-catchers, an injury rate of nearly 16 percent. Nineteen injuries occurred among pitchers who played another position, but not catcher, for an injury rate of about 5 percent.

 

UofL names new chief of pediatric cardiac surgery division

Alsoufi also will serve in same role at Norton Children’s Hospital
UofL names new chief of pediatric cardiac surgery division

Bahaaldin Alsoufi, M.D., comes to UofL from Emory University.

Bahaaldin Alsoufi, M.D., has joined the Department of Cardiovascular and Thoracic Surgery at the University of Louisville and Norton Children’s Hospital as the new chief of the Division of Pediatric Cardiac Surgery. He will practice with UofL Physicians - Cardiovascular and Thoracic Surgery. Alsoufi joins UofL after being on staff at Emory University.

“In Bahaaldin Alsoufi, we have an accomplished teacher, researcher and clinician,” said Department of Cardiovascular and Thoracic Surgery Chair Mark Slaughter, M.D. “His expertise will be a great asset in contributing to our continued success in providing best-in-class care to our pediatric patients.”

“We’re excited to have Dr. Alsoufi join Dr. Erle H. Austin III and Dr. Deborah J. Kozik in helping us provide the most advanced care for children at the Norton Children’s Heart Institute,” said Steven T. Hester, M.D., division president, Provider Operations, and system chief medical officer, Norton Healthcare “Dr. Alsoufi will be part of a team that includes many heart specialists from UofL Physicians. This group collectively performs more than 17,500 procedures annually including heart transplants, open heart surgeries, catheterizations, electrophysiology and noninvasive tests, such as echocardiograms.”

Alsoufi is board-certified by the American Board of Surgery, American Board of Thoracic Surgery, American Board of Congenital Cardiac Surgery and the Royal College of Physicians and Surgeons of Canada. He has served as associate professor in the Division of Cardiothoracic Surgery’s Section of Pediatric Cardiothoracic Surgery at Emory in Atlanta since 2013. Prior to his appointment at Emory, Alsoufi served in a number of positions at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia.

Alsoufi is lead or co-author on 150 peer-reviewed journal articles and has presented at more than 100 international, national, regional and institutional conferences. His clinical interests include neonatal cardiac surgery, single ventricle palliation, valvular heart disease in children and adults with congenital heart disease and pediatric heart transplantation. His research interests include clinical outcomes research, valvular heart disease, heart transplantation and extracorporeal membrane oxygenation, known as ECMO, which is the process of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange to sustain life.

Additionally, he serves on the editorial board of multiple international journals including the Journal of Thoracic and Cardiovascular Surgery and the World Journal of Pediatric and Congenital Heart Surgery. He is interested in quality, teaching and clinical outcome research and has received a number of teaching and academic rewards.  

Alsoufi is a native of Syria where he earned his M.D. degree from Damascus University. He completed a general surgery internship at Union Memorial Hospital in Baltimore and a general surgery residency at the University of Massachusetts in Worcester. He completed a cardiothoracic surgery residency at Oregon Health Science University, Portland; a fellowship in adult cardiac surgery at Toronto General Hospital, University of Toronto, Canada; and a fellowship in congenital cardiac surgery at the Hospital for Sick Children also at the University of Toronto.

 

A new era in medical care for children begins

The Novak Center for Children’s Health represents paradigm shift in pediatric care
A new era in medical care for children begins

David and Wendy Novak, left, and their family stand with the architect's rendering of the Novak Center for Children's Health in July 2017.

A new era in medical care for children will begin this June when the Novak Center for Children’s Health at the University of Louisville opens to patients and their families.

A preview of the new 176,000-square-foot facility was held Thursday evening (May 31) for supporters and friends of the university, including the building’s namesakes, David and Wendy Novak, their family and their foundation, the Lift-A-Life Foundation.

The retired CEO of Louisville-based Yum! Brands, David Novak headed the lineup of dignitaries launching the building’s debut, including University of Louisville Board of Trustees Chair David Grissom, UofL President Neeli Bendapudi, Ph.D., and UofL Executive Vice President for Health Affairs Gregory Postel, M.D. Honored among the group were the Novaks’ daughter, Ashley Novak Butler, for her leadership with the project along with others who played a role it: Tony and Lisa Christensen, the WHAS Crusade for Children, Bruce Henderson and Henderson Services, Lynnie Meyer and Emmett Ramser of Norton Healthcare, and the former vice president of advancement at UofL and current Kosair Charities President Keith Inman.

David Novak lauded the facility for creating the environment where a new paradigm of health care for children will be fostered. The Novak Center will house all general, specialty and subspecialty pediatrics services in a single eight-story building, meaning patients and their families will be able to have all their needs handled in one convenient location.

An anticipated 135,000 patient visits will occur annually in the new center – now one of the largest and most technically advanced pediatric outpatient centers in the United States.

David Novak noted the vision of the center: “UofL has the world-class minds; it needed a world-class center. It is so gratifying to be here tonight and see that we are on the cusp of opening a building that has the potential to impact generations to come.”

“This magnificent facility promises to change how health care is delivered to our children with no child turned away from that care,” Grissom said. “Its design for efficiency of care was not by accident; a number of UofL staff spent a tremendous amount of time exploring the best practices from throughout the nation and took the best of those to implement here in Louisville.”

Bendapudi reminded the crowd that implementing such change takes ongoing support. “Progress cannot occur without generous support from our community,” she said. “We could not be able to improve how health care is delivered to every child who comes to our door if it were not for the generosity of supporters such as the Novak family and the Lift-a-Life Foundation.”

Postel outlined many of the building’s features: “For too long, we have required our children and their families to move from building to building, office to office, to see all the providers who meet their health care needs. This facility changes that,” with:

  • All pediatric providers in a single building to ensure a multidisciplinary approach in providing care
  • Innovative clinical and research programs that not only provide the latest advances in treatments and cures but also create and develop them
  • An environment that enables staff to explore new initiatives, including holistic life style approaches to diseases and conditions that impact children
  • A site where both basic and clinical research will be carried out and will help UofL attract new researchers as faculty
  • Enhancement of the education provided to medical students, residents and fellows, giving them first-hand experience with interdisciplinary learning they can take directly into the patient exam room

The total patient experience was at the forefront of the facility’s design, Postel said. “In addition to the excellence in patient care provided here, we looked at the ‘softer’ touches – light-up benches along the skybridge (connecting the building to the parking garage); using colors to identify floors so that no matter what language people speak, they can find the right floor; coding the floors with animals representing regional and Kentucky wildlife to pique children’s interest; and much more.”

Designed in kid-friendly colors, the facility features several public areas with soft seating and interactive screens to entertain children while they wait to see providers. But the waiting shouldn’t be long, say UofL Department of Pediatrics providers: The latest in technological advances, the Real Time Locator System, will help move patients and providers to their appointments without lengthy wait times.

Also included in the facility will be the Wendy Novak Diabetes Center, created in 2015 with support from the Novaks and currently housed in the Children’s Hospital Foundation Building. The Wendy Novak Diabetes Center provides comprehensive diabetes care as well as access to clinical research trials that sometimes are patients’ only chance at diseases management and survival.

The services of the Wendy Novak Center will be augmented in the new facility with the addition of an up-to-date kitchen. “We are going to bring in the world-class chefs we have in Louisville to teach families how to prepare menus and foods that are diabetic-friendly and can actually improve lives,” Novak said. “Some these chefs have diabetes themselves so they can speak and teach from first-hand experience.”

The Novak Center for Children’s Health will be staffed by faculty physicians practicing with UofL Physicians and will open for patient appointments in June. To learn more about the scope of pediatric health care at UofL, visit www.UofLPhysicians.org.

The Novak Center for Children's Health is located at 411 E. Chestnut St. Budget to construct the new facility was $79 million. Messer was construction manager for the project.