Monthly Archives: May 2014

What a Regsitered Dietitian Nutritionist can do for you

By Karen Ansel, MS, RD
Between what you hear on TV and read in the news, eating right can seem like a real challenge. But it doesn’t have to be. “Whether you want to slim down, lower your cholesterol or simply eat better, a registered dietitian [or registered dietitian nutritionist] can help you weed through the murky waters of nutrition misinformation and provide sound, easy-to-follow nutrition advice,” says Jennifer McDaniel, MS, RDN, spokesperson for the Academy of Nutrition and Dietetics.
Here are just a few of the benefits of working with a registered dietitian or registered dietitian nutritionist.
The highest level of nutrition counseling. Anyone can call themself a nutritionist, but only a registered dietitian (RD) or registered dietitian nutritionist (RDN) has completed multiple layers of education and training established by the Academy of Nutrition and Dietetics. In addition to holding a bachelor’s degree, an RD or RDN must fulfill a specially designed, accredited nutrition curriculum, pass a rigorous registration exam, and complete an extensive supervised program of practice at a health care facility, foodservice organization or community agency. What’s more, roughly half of all RDs and RDNs hold graduate degrees and many have certifications in specialized fields, such as sports, pediatric, renal, oncology or gerontological nutrition.
Personally tailored advice. When you see an RD or RDN, the last thing you’ll get is one-size-fits-all diet advice. “A dietitian is like an investigator seeking to learn about your current and desired state of health,” says McDaniel. “At your initial visit, expect to do a lot of talking while the dietitian does a lot of listening.” After learning about your health history, favorite foods, eating and exercise habits, an RD or RDN will help you set goals and prioritize. Follow-up visits will focus on maintenance and monitoring your progress.
Help managing chronic diseases. If you have high cholesterol, high blood pressure, diabetes or cancer it can be hard to know what to eat. “An RD [or RDN] can review your lab results with you, help you understand your condition and provide education about the nutrients that affect it,” says Angela Ginn, RDN, a spokesperson for the Academy. “Then, he or she will help you create an eating plan that includes all the important nutrients that can help you manage your condition.”
Guidance navigating food allergies, sensitivities and intolerances. When you suffer from conditions such as celiac disease, food allergies or lactose intolerance, it’s easy to be overwhelmed by what you think you can’t eat. That can translate into a boring diet and may even lead to nutrient deficiencies. An RD or RDN can teach you how to read food labels so you’ll know which ingredients to avoid and a help you find substitutions to keep your diet balanced and tasty, too.
A weight loss program that really works. Fad diets may sound like the quick ticket to weight loss, but they rarely work for very long. A registered dietitian or registered dietitian nutritionist will partner with you to develop a safe, effective weight loss plan that you can stick with for the long haul. To guide and motivate you, an RD or RDN will use creative and out-of-the-box strategies to help with meal planning, grocery shopping, food journaling and mindful eating.
Now, that’s a recipe for success.

Let our Medical Weight Management Program help you with your weight
goals. Our program includes a personal trainer, a registered dietitian, and a doctor of physical therapy. We are offering a one time introductory rate! Program will start the week of January 20th. Space is limited! Call or email today for more information.

Staying Away from Fad Diets

With all the focus on weight in our society, it isn’t surprising that millions of people fall prey to fad diets and bogus weight-loss products. Conflicting claims, testimonials and hype by so-called “experts” can confuse even the most informed consumers. The bottom line is simple: If a diet or product sounds too good to be true, it probably is. There are no foods or pills that magically burn fat. No super foods will alter your genetic code. No products will miraculously melt fat while you watch TV or sleep. Some ingredients in supplements and herbal products can be dangerous and even deadly for some people.

Steer clear of any diet plans, pills and products that make the following claims:

Rapid Weight Loss

Slow, steady weight loss is more likely to last than dramatic weight changes. Healthy plans aim for a loss of no more than ½ pound to 1 pound per week. If you lose weight quickly, you’ll lose muscle, bone and water. You also will be more likely to regain the pounds quickly afterwards.

Quantities and Limitations

Ditch diets that allow unlimited quantities of any food, such as grapefruit and cabbage soup. It’s boring to eat the same thing over and over and hard to stick with monotonous plans. Avoid any diet that eliminates or severely restricts entire food groups, such as carbohydrates. Even if you take a multivitamin, you’ll still miss some critical nutrients.

Specific Food Combinations

There is no evidence that combining certain foods or eating foods at specific times of day will help with weight loss. Eating the “wrong” combinations of food doesn’t cause them to turn to fat immediately or to produce toxins in your intestines, as some plans claim.

Rigid Menus

Life is already complicated enough. Limiting food choices or following rigid meal plans can be an overwhelming, distasteful task. With any new diet, always ask yourself: “Can I eat this way for the rest of my life?” If the answer is no, the plan is not for you.

No Need to Exercise

Regular physical activity is essential for good health and healthy weight management. The key to success is to find physical activities that you enjoy and then to aim for 30 to 60 minutes of activity on most days of the week.
If you want to maintain a healthy weight, build muscle and lose fat, the best path is a lifelong combination of eating smarter and moving more. For a personalized plan, tailored to your lifestyle and food preferences, consult a registered dietitian with expertise in weight management. A registered dietitian can help you find a realistic, flexible eating style that helps you feel and be your best.

Article from Academy of Nutrition and Dietetics. 

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Why nutrition (weight loss), physical therapy, and strength training are the perfect combination

Keeping the joints rockin’
By Stephanie Scarmo
This article explains perfectly why nutrition (weight loss), physical therapy, and strength training are the perfect combination. Join our Medical Weight Management Program to help you achieve your weight goals. See below article for details!

“Twenty or 30 years ago, osteoarthritis was considered a nuisance disease,” says arthritis expert Roland Moskowitz. “You have some aches and pains that go along with growing old that you just have to live with.”
No more. “We now recognize the impact that osteoarthritis has on daily living and the ability of people to work,” says Moskowitz. Here’s what we’re learning about one of the most common causes of disability in America.


“The heavier you are, the more likely you are to get osteoarthritis,” explains David Felson, professor of medicine and epidemiology at the Boston University School of Medicine.
     Osteoarthritis is caused by the breakdown of cartilage, which can lead to pain and stiffness in the knees, hips, and other joints. (It is a different disease than rheumatoid arthritis, an autoimmune condition in which the body attacks the lining of the joints.)
     When researchers in Norway tracked more than 1,600 people with healthy knees for 10 years, those who were overweight or obese were two to three times more likely to be diagnosed with osteoarthritis
of the knee than those who were normal weight.1
     Among the ways that weight can damage your joints:

  • Load. “Every extra pound increases the stress across the knee joint three to five times,” says Roland Moskowitz. “So you’re increasing your risk of osteoarthritis many times by being overweight.” Moskowitz is clinical professor of medicine at University Hospitals Case Medical Center in Cleveland.
  • Injury. “In addition to the extra stress on the joints, being overweight may increase the risk of injuring the joints, which can lead to osteoarthritis,” notes Carrie Karvonen-Gutierrez, an assistant research professor at the University of Michigan School of Public Health.                                                       In one study, 500 people who were having surgery to repair a torn meniscus were about three times more likely to be overweight than to be normal weight.2 (The meniscus is the cartilage that helps your knees absorb and distribute weight across the joint. See “Rolling Joints.”)                                   “People with small meniscal tears tend to be at very high risk for getting osteoarthritis later,” notes Felson.
  • Inflammation. “We now know that fat cells release inflammatory chemicals that can break down cartilage,” says Karvonen- Gutierrez. Increased inflammation throughout the body might explain why some people get arthritis in the hands, which aren’t weight bearing.                                           “Obesity is the number-one risk factor for osteoarthritis, one that’s preventable and modifiable,” says Karvonen-Gutierrez. “So weight loss is really important.”                                                         Shedding pounds is also important if you have arthritis. In four trials involving a total of more than 450 overweight or obese adults with osteoarthritis of the knee, those who lost at least 5 percent of their body weight reported less physical disability.3                                                                                   In the largest of the four studies, 76 overweight or obese adults aged 60 and older who lost an average of 11 pounds over 18 months reported 24 percent better knee function than 78 similar people who were told that a healthy lifestyle is important, but who didn’t lose any weight.4 (Better function means, among other things, greater range of motion, better ability to bear weight, and an easier time climbing stairs.) The weight-losers also reported feeling 30 percent less pain.

Beyond Weight
Weight aside, your risk of osteoarthritis depends on some things you can control and some you can’t.

  • Strength. “The weaker you are, the more likely you are to develop osteoarthritis,” explains Felson. Weak thigh, calf, and hip muscles can lead to joint injuries like a torn ACL or meniscus. That increases the risk of cartilage loss. If you continue to stress the injured joint, “it could bring on osteoarthritis symptoms and maybe structural damage even earlier,” says Felson.
  • Strenuous use. Overuse from occupations that repetitively stress the joints—landscaping, climbing ladders, or scrubbing floors on your knees, for example—can increase the risk of osteoarthritis.
  • Age & genes. The longer you’ve been using your joints, the more likely they are to wear out. Whether your parents had arthritis matters, too. About half the risk for arthritis of the hip or hand may be determined by your genes.5
  • Being female. Women are more likely to get arthritis than men after middle age. One possible reason, according to the Arthritis Foundation: women’s wider hips put more long-term stress on their knees.

Rolling Joints
Shock absorber. Ligaments connect bones, and cartilage acts like a cushion between bones. If the cartilage
starts to break down, bone rubs against bone. The result: the pain and stiffness of osteoarthritis.

Help for Joints
“If you have osteoarthritis, exercise is one of the most effective treatments we know,” says David Felson.
It’s not that exercise can cure or slow the progression of osteoarthritis.
     “Its benefit is to alleviate pain and increase range of motion, not necessarily to make the structure of the joint better,” notes Felson.
     How can exercise curb pain? “It can lower overall inflammation,” says Allison Bailey, a physician specializing in physical medicine in Cambridge, Massachusetts.
     Inactivity leads to more trouble. “If you don’t keep using an arthritic knee or hip, you can lose flexibility,” says Felson. “Doing weight-bearing exercises keeps muscles strong and flexible, which reduces further
injury to the joints.”
     On the other hand, adds Felson, “doing aggressive physical activity when you’ve injured a joint may not be wise,” because you risk damaging the joint even further.
     Here’s what Bailey and other experts recommend:

PHYSICAL THERAPY AND STRENGTH TRAINING. Strong muscles absorb weight, provide stability, and help the joints move the way they’re designed to. Among 95 older adults with mild to moderate arthritis of the knee, those who were told to do strengthening exercises for 12 weeks reported less knee pain
and climbed stairs faster than those who weren’t told to exercise.6
     Bailey gives patients with mild to moderate knee and hip osteoarthritis some simple at-home exercises.
     “I usually have patients do strengthening every other day,” she says. “The overall goal is to strengthen the quadriceps— the muscles in the front of the thigh—and the gluteal muscles in the buttocks.”
     Bailey has her patients start with gentle stretching. “Then they do two sets of each exercise, with 10 to 12 repetitions each.”
     “You can also strengthen the muscles without doing weight-bearing activities,” notes Moskowitz. For example, if lifting weights hurts, try Bailey’s leg extension exercise without ankle weights. If an exercise hurts, don’t do it, says Felson. “Ask your doctor about exercises that don’t cause you pain.”

AEROBIC EXERCISE. Exercises like walking briskly, jogging, biking, and swimming increase blood flow to cartilage, which gives it the nutrients it needs to stay healthy.
     What’s more, “cardiovascular exercises help reduce the body’s sensitivity to pain signals,” explains Bailey. For instance, people who cycled for 25 minutes felt less pain when researchers applied uncomfortable pressure to one of their fingers after they exercised than before they exercised.7
     “Ideally, cardio should be done daily, or at least six days a week,” says Bailey.
     In 2012, a group of Canadian arthritis experts concluded that walking for 30 to 50 minutes at least three days a week relieved osteoarthritis knee pain. The longest trial they reviewed lasted only three months, though.8
     Some people with arthritis prefer swimming because it puts less pressure on the joints. “If you’re afraid to start moving,” says Bailey, “you may want to consider using aquatic therapies as a bridge to land-based
     While water exercise relieved pain from knee and hip osteoarthritis in four trials, it didn’t improve walking ability or stiffness.9

TAI CHI. The classic Chinese martial art involves a series of slow and gentle movements that combine balance with weight-shifting poses.
     “I recommend tai chi to a lot of my patients, especially because you can do it indoors in the winter months,” says Bailey.
     In a recent meta-analysis of seven small trials, people with arthritis of the knee or hip who practiced tai chi for 40 to 60 minutes a day for at least 12 weeks reported less pain and stiffness and improved function in their joints than similar people who engaged in a non-physical activity like playing bingo.10
     But only two of the studies included people with arthritis of the hip, so it’s not clear whether tai chi only helps the knee.
     “An alternative is gentle daily stretching,” says Bailey. (No good studies have looked at whether stretching or yoga can help relieve arthritis pain.)

1 BMC Musculoskelet. Disord. 2008. doi:10.1186/1471-2474-9-132.
2 Am. J. Prev. Med. 28: 364, 2005.
3 Ann. Rheum. Dis. 66: 433, 2007.
4 Arthritis Rheum. 50: 1501, 2004.
5 Arthritis Res. Ther. 2009. doi:10.1186/ar2531.
6 Osteoarthritis Cartilage 18: 621, 2010.
7 J. Rehabil. Res. Dev. 42: 183, 2005.
8 Arch. Phys. Med. Rehabil. 93: 1269, 2012.
9 Cochrane Database Syst. Rev. 2007. CD005523.
10 PLoS One 2013. doi:10.1371/journal.pone.0061672
N U T R I T I O N A C T I O N H E A LT H L E T T E R   O C T O B E R 2 0 1 3

Medical Weight Management Program by Caruso Physical Therapy and Nutrition, LLC & Pure Fitness 24:
8 week program with a Dr of Physical Therapy, Personal Trainer, and Registered Dietitian. Program starting week of January 20th 2014. Space is limited! We are offering a one time introductory rate. Call or email today.

Caruso Physical Therapy and Nutrition, LLC
1278 Yardville-Allentown Rd Suite 3
Allentown, NJ 08501
Phone: 609 738 3143
Fax: 609 738 3144

Are artificial sweeteners bad?

Consumption of zero-calorie artificial sweeteners in a drink may have an identical effect on gut responses as water, according to newly published human data.

Join our Medical Weight Management Program to learn more about common nutrition topics that interfere with our weight loss goals. We are offering an introductory rate! Space is limited!

Caruso Physical Therapy and Nutrition, LLC
1278 Yardville-Allentown Rd Suite 3
Allentown, NJ 08501
Phone: 609 738 3143
Fax: 609 738 3144

Out of network physical therapy

At Caruso Physical Therapy and Nutrition, LLC, we take a focused and evidence-based approach to rehabilitation/nutrition education.  Our greatest goal is to teach the patient how to manage their care themselves.  That means educating you on what is wrong and the most direct way to fix it.  This ultimately results in fewer necessary visits over the course of your care not to mention an overall reduction in the total cost to health care.  Consider the following example (assuming $100 per visit to keep it simple):

In-Network PT Clinic
20% coinsurance
2 visits per week x 4 weeks = 8 visits
Total cost of care:  $800
Total out of pocket cost: $160
Caruso PTRD (Out of Network)
40% coinsurance
1 visit per week x 4 weeks = 4 visits
Total cost of care:  $400
Total out of pocket cost: $160

The out of pocket cost is the same.  But let’s assume that you need a second month of care:

In-Network PT Clinic
20% coinsurance
2 visits per week x 4 weeks = 8 add’l visits
Add’l cost of care:  $800
Add’l out of pocket cost: $160
Total cost of care: $1600
Total out of pocket cost: $320
Caruso PTRD (Out of Network)
40% coinsurance
1 every 2 weeks x 4 weeks = 2 add’l visits
Add’l cost of care:  $200
Add’l out of pocket cost: $80
Total cost of care: $480
Total out of pocket cost: $240

Less money out of your pocket and a little more than 1/4 of the overall cost to the health care system.  And that is assuming that you would even need that second month at Caruso Physical Therapy and Nutrition, LLC!

Caruso Physcial Therapy and Nutrition, LLC
1278 Yardville-Allentown Road Suite 3
Allentown NJ 08501

609.738.3143 phone
609.738.3144 fax

Medical Complications of Obesity

As you can see from the picture below being overweight and obese can lead to many medical complications. Let us help you reduce your risk and improve your health. Join our Medical Weight Management Program today. We are enrolling now for our next class. Space is limited!

Contact us today:Caruso Physical Therapy and Nutrition
Phone: 609 738 3143609 738 3143

Pure Fitness 24
Phone: 609-286-8502