Managing Holiday Eating

by Ellen Michal, RD, LDN, CDE—Lifestyle and Disease Management Center, Duke Raleigh Hospital

Holidays are a source of great joy. They can also be a stressful time for people trying to prevent weight gain.

Food is part of our culture and opportunities to celebrate begin with Halloween, peak in December and decline by April. This represents half a year of maintaining a vigil against over consumption. Setting up a strategy for each event can overwhelm even the most organized individual. Strategies are great but they can’t compare to a strong daily routine.

Building a daily routine has a number of benefits to keep the extra pounds away. If we practice anything, whether it’s a sport or musical instrument, we become more proficient. As we improve, that practice becomes more embedded in our behavior. When something disrupts the practice cycle we notice it and can respond with minimal effort. The same is true for food. Having a routine increases our awareness. When celebrations happen we are more likely to notice drifting away from a habit and can adjust quickly. How often have we delayed a change by saying, “I’ll start tomorrow,” knowing that we probably won’t. That does not feel good and does not help our self-efficacy. The reverse is also true. When something has been working well we are more likely to say, “I give myself permission to have a tiny piece of cake, but that’s all I need. The way I feel today is much more important than chocolate flavored flour, butter and sugar.” Success begets success.

Let’s start with our mindset. Our thoughts precede our actions. Start thinking about your routine. Being attentive to these concerns drives the thought that drives the action.

Happy holidays!

Living with Epilepsy: Life without Limits

Epilepsy PhotoSeizures may be part of your life, but they shouldn’t control it. Duke Medicine invites people with epilepsy, their families and caregivers to join us for a daylong symposium with experts on current issues facing people with epilepsy. Meet fellow patients and learn more about:
• Advocacy
• Medical Marijuana
• IOM Report: Epilepsy Across the Spectrum: Promoting Health and Understanding

This event will take place Saturday, November 1 from 9 am until 5 pm at the Trent Semans Center. Registration and breakfast will begin at 8 am. Snacks and lunch will be provided.

Admission is free. Click here to register online or call 888-ASK-DUKE.

Enjoy Fall Fruits and Veggies


Elizabeth Villalta, MS, RD, LDN

Registered dietician Elizabeth Villalta of the Duke Center for Metabolic and Weight Loss Surgery shares ways you can incorporate fall’s finest fruits and vegetables into your meals.

As we head into fall, there is no need to decrease our produce intake. We should (and can) continue to eat a variety of fresh fruits and vegetables. Fall is a great time for squash, cranberries, ginger, mushrooms, passion fruit, sweet potatoes, turnips and more. Below are a few ways you can enjoy fall produce.

Acorn Squash
Acorn squash can be added as a side dish or sauce, or steal the show as the main entrée! If you’re tired of the same old spaghetti dinner, try cooking thinly sliced acorn squash just like you would spaghetti. Acorn squash is fat free, cholesterol free, sodium free and a good source of vitamin C. One-half cup of acorn squash contains just seven grams of carbohydrates, where one-half cup of spaghetti contains 21 grams. Click here for more ways to enjoy acorn squash.

Cranberry is another fall classic that is low in fat and sodium and a good source of vitamin C and fiber. While this fruit is often thought of with a big turkey dinner, cranberries can be added to breakfast cereal, trail mix and even dessert. For more ideas on adding cranberry into your diet click here.

It isn’t just for carving! Pumpkin can be incorporated into everything from soup and salad to muffins and dessert. Are you looking to try a new smoothie recipe? Try adding pumpkin into your shake! Pumpkin seeds are also a fun seasonal treat and a good source of protein. Click here for 10 great ways to add pumpkin into your fall diet.

For the Caregiver

seniorsAre you currently the caregiver for a sick or hospitalized loved one? While you are making sure your loved one’s needs are being met, don’t neglect your own. Caregiving is a stressful and time-consuming job. You may neglect your diet, normal exercise routine and sleep needs. You may find you have little or no time to spend with friends, relax or just be by yourself for a while. But down time is important. Don’t be reluctant to ask for help in caring for your loved one. Find out more about how you can ease the stress of caregiving at the resources below.


Administration on Aging

Family Caregiver Alliance
National Center on Caregiving
Online support groups and articles on caregiving

Duke Family Support Program at Duke University Medical Center

Eldercare Locator
800-677-1116 or
Help with locating aging services throughout the U.S.

Medicare or 800-MEDICARE
Official U.S. government site for people with Medicare

National Academy of Elder Law Attorneys
Legal help for seniors and people with special needs

National Alliance for Caregiving
Support for family caregivers and the professionals who serve them

Caregivers Action Network
Support for caregivers of chronically ill, aged or disabled loved ones

Duke MyChart Frequently Asked Questions

Duke MyChart is an online tool that enables you to help manage and receive information about your health. With Duke MyChart, you can:
• Request medical appointments.
• View your health summary from the Duke MyChart electronic medical record.
• View test results.
• Request prescription renewals.
• Access trusted health information resources.
• Communicate electronically and securely with your medical care team.

Below are answers to some frequently asked questions about Duke MyChart.

How do I sign up?
Patients will be issued a Duke MyChart activation code during their clinic visit. This code will allow you to log in to and create your own username and password. If you were not issued an activation code, you may contact the clinic or Duke Customer Service at 919-620-4555 or 800-782-6945 8am-5pm Monday, Tuesday, Wednesday and Friday or 8am-4pm Thursday.

When can I see my test results in MyChart?
Your test results are released to your Duke MyChart account after your physician has reviewed them. This is generally within 1-12 days.

Why are certain test results not shared electronically via Duke MyChart?
Your provider is able to determine which types of test results are able to be accessed through Duke MyChart. Further, tests of a very sensitive nature are not released to Duke MyChart.

If I send a message to my doctor or nurse, when can I expect a reply?
Your healthcare team is committed to responding in a timely manner. You will generally receive an answer within 1-3 business days. Please note Duke MyChart should not be used to communicate urgent situations. Please contact your medical center if the situation requires immediate attention or dial 911 if it is an emergency.

I forgot my password. What should I do?
Contact Duke Customer Service at 919-620-4555 or 800-782-6945 8am-5pm Monday, Tuesday, Wednesday and Friday or 8am-4pm Thursday to request a new, secure password. You may also click the “Forgot password” link on the sign-in page to reset your password online.

How is Duke MyChart secure?
We take great care to ensure your health information is kept private and secure. Access to information is controlled through secure activation codes, personal usernames, and passwords. Each person controls their password, and the account cannot be accessed without that password. Duke MyChart also uses the latest technology to automatically encrypt your session. Unlike conventional e-mail, all Duke MyChart messaging is done while you are securely logged on to our website.

Who do I contact if I have further questions?
If you have any questions about Duke MyChart, please call Duke Customer Service at 919-620-4555 or 800-782-6945 8am-5pm Monday, Tuesday, Wednesday and Friday or 8am-4pm Thursday.

Check out more Duke MyChart FAQs here.

Summer Water Safety

Dad applying sunscreenStay safe this summer at the beach or the pool by following these tips from

  • Apply a broad-spectrum, water-resistant sunscreen over your whole body 30 minutes before going outside. The higher the SPF, the better it protects against UVA and UVB rays. Reapply every two hours.
  • The sun’s UV rays are strongest between 10 a.m. and 4 p.m., even if it’s cloudy. Seek protection with beach umbrellas, wide-brimmed hats, sunglasses, long-sleeved shirts and pants.
  • Each adult needs almost a gallon of water or other fluids per day to stay fully hydrated if you’re physically active or exposed to hot conditions.
  • Drinking alcohol can impair your judgment and speeds up the dehydration process. The sweating, vomiting and diarrhea that can go hand-in-hand with too much drinking can result in even further dehydration.
  • A small first aid kit can help prevent minor mishaps from spoiling your day. Make sure your kit includes aloe gel for sunburn relief, triple-antibiotic ointment, pain relievers, waterproof bandages, hydrocortisone cream for insect bites, hand sanitizer, insect repellent and a cold pack for swelling.
  • Some beaches, lakes or rivers allow or rent kayaks, canoes or motorized watercraft. Make sure all boat passengers wear appropriately fitting life jackets.
  • Rip currents can occur at any beach with breaking waves, including lake shores. Be aware of the daily water conditions and the location of the closest lifeguard. If you get caught in a rip current, don’t fight it. Remain calm. Swim or float parallel to shore. Once out of the current, swim toward shore.

To learn more water safety tips, click here.

Your Nutrition Label is Likely to Change for the Better

Ellen MichalBy Ellen Michal, RD, CDE, Lifestyle and Disease Management Center at Duke Raleigh

Do you find nutrition labels a conundrum–a difficult riddle to solve? Well, you aren’t alone. The Food and Drug Administration (FDA) is proposing to update the Nutrition Facts label (found on most food packaging in the United States) to help consumers make more informed food choices.

Suggested changes include:

  • Require information about Added Sugars. Many experts recommend consuming fewer calories from added sugar because they can decrease the intake of nutrient-rich foods while increasing calorie intake.
  • Update daily values for nutrients like sodium, dietary fiber and vitamin D and require manufacturers to declare the amount of potassium and vitamin D as they are new nutrients of public health significance.
  • Continue to require Total Fat, Saturated Fat and Trans Fat, but remove Calories from Fat because research shows the type of fat is more important than the amount.
  • Change the serving size requirements to reflect how people eat and drink today, which has changed since serving sizes were first established 20 years ago. By law, the label information on serving sizes must be based on what people actually eat, not on what they should be eating.
  • Require packaged foods (including drinks) that are typically eaten in one sitting be labeled as a single serving and that calorie and nutrient information be declared for the entire package. For example, a 20-ounce bottle of soda, typically consumed in a single sitting, would be labeled as one serving rather than as more than one serving.
    • For larger packages (24-ounce bottle of soda or a pint of ice cream) that could be consumed in one sitting or multiple sittings, manufacturers would have to provide dual column labels to indicate both per serving and per package calories and nutrient information. This way, people would be able to easily understand how many calories and nutrients they are getting if they eat or drink the entire package at one time.
  • Make calories and serving sizes more prominent.
  • Shift the Percent Daily Value to the left of the label so it comes first. This is important because this value tells you how much of certain nutrients you are getting from a particular food in the context of a total daily diet.

If adopted, the proposed changes would look like this.

Original vs. Proposed

Nutrition Facts