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Holiday diet doesn't mean punishment

As we enter the holiday season, try to keep in mind that the
word "diet" is derived from a Greek word that means "way of
life," not a punishment for overeating. Food rightly occupies a
special place in holiday celebrations, says Terri Brownlee,
nutrition director at Duke University Diet and Fitness Center.
But there are many techniques we can use to strike a healthier
balance in the way we prepare and eat holiday foods.

Below are a few suggestions from Duke's Diet and Fitness
Center to get you thinking differently about holiday foods:

If you or a family member are following a weight-loss
regimen, be realistic. Try to maintain, not lose, weight during
the holidays.

Pre-plan several simple, quick healthy meals to avoid
indulging in quick, high-fat alternatives. Have these meals
readily available for reheating. This strategy will also give
you more time to do other fun holiday activities.

Focus on fruits, veggies and high carbohydrate starches:
these are low fat, filling and give you energy. Apples,
cranberry dishes, baked squash, pumpkin, breads and pastas are
good choices.

Be selective about higher fat foods: don't try to cut out
holiday favorites like eggnog and candied sweet potatoes, but
choose smaller portions and fill your plate with lower fat
choices.

Consider skipping alcohol; beer, wine and mixed drinks
contribute a significant number of calories and decrease
awareness of other foods you are eating.

Avoid baking food for gifts. The temptation to sample may be
too great. And give away items you receive to a local food bank
or homeless shelter; some will accept home-baked gifts like
breads or cookies.

Center entertainment around non-food events such as ice
skating, renting a holiday movie or singing carols.

Offer to bring a favorite low-calorie dish to holiday
parties, then you know there will be at least one "safe" item
available. Arrive fashionably late and stand far away from
buffets so you're not tempted to nibble constantly. Indulge in
conversation instead. If you spend less time around food,
you'll have more time to talk with holiday visitors.

Germs travel, too

Families and friends aren't the only ones taking trips
during the holidays; germs do their share of traveling over the
season.

"You need to realize that when it comes to rhinoviruses
(cold viruses), there are hundreds of them! And the immunity to
any one may be relatively short," says Dr. Larry Wu, a
physician in Duke's community and family medicine department.
That means you've got a good chance of "meeting" a strain
you're not immune to this season, especially if you're going
away or having company from out of town.

Foreign travel is most problematic, but any time you're in a
confined space with a crowd for a period of time - say an
airplane or train trip - conditions are favorable for viruses
to hitch a ride with you to your destination.

It's good to be aware that you'll likely make the
acquaintance of strange viruses the next month or so, because
there are a few things you can do to give illnesses the cold
shoulder. Most of the infectious illnesses we think of as
common in the winter - colds, flu, pneumonia - spread through
close contact. According to Mary Oden, infection control
coordinator at Duke, the No. 1 way to wash your hands of
unwelcome bugs is just that: keep your hands clean and keep
them away from your face.

"It all comes down to hand washing," she says. "Simple hand
washing can decrease so many infections. That, and common-sense
hygiene, like covering your mouth and nose with a tissue when
your sneeze or cough, and disposing of the tissues
properly."

And yes, disposable tissues have a slight edge over the
gentleman's handkerchief. Fewer exposures to hands and germs
make the difference, Wu says.

Other things you can do to slow the migration of germs
during the holidays:

Get your flu shot now, and if you're visiting people at high
risk for flu, like the elderly, those chronic diseases like
diabetes and heart disease, those with immune system problems,
and health care workers, encourage them to get immunized, too.
Make a point to get plenty of quality sleep. Reduce stress as
much as possible - exercise can help. If you're transporting
food or offering a buffet, keep food at its proper
temperature.

But don't think germs have to put a damper on the holiday
spirit. Cold viruses transfer from hand to hand at a 76 percent
efficiency rate, Wu says, but at 8 percent of the time through
kisses. You can still hang that mistletoe.

When holidays are sad

The holidays are stressful and emotionally charged for many
people, leading some to approach the holidays with
indifference, fear, apprehension and pain, says Duke clinical
nurse specialist Ursula Capewell. That's true for families
whose loved ones live a long distance away and are unable to be
physically present for the festivities. But these feelings and
emotions are even more intense for people mourning the death of
a loved one.

"For some, the holiday season may seem unbearably painful,"
Capewell says. "Regardless of one's age, relationship to the
deceased, or circumstances surrounding the death, preparing to
survive the holiday season may become especially
difficult."

One important survival step for those so affected is to plan
ahead, she says. "Decide in advance those things that you are
able to do and still make the day meaningful and special.
Invite other family members and friends to help with some of
the holiday chores that you are unable to do at this time."

Other tips Capewell suggests:

Accept and allow yourself to feel the pain.

Allow yourself to feel whatever you feel.

Take charge as you are able.

Be patient and gentle with yourself.

Turn to others for comfort and support.

Remember to remember.

Begin new rituals.

Winter's silent threat

The holidays are traditionally a time of warmth and family.
But if precautions aren't taken in creating that warmth, the
family can end up spending their time together in the
hospital.

Each year, as the temperatures outside drop, the number of
people seen by Duke physicians for carbon monoxide poisoning
rises. The culprit is kerosene heaters used inside an
improperly ventilated house. And what makes it so frustrating
for these physicians is that simple precautions will ensure
that the carbon monoxide created by the combustion of kerosene
doesn't cause health problems.

"All it takes is opening a window a crack in the room with
the heater," advises Duke Dr. Bryant Stolp, who specializes in
hyperbaric medicine. "Especially since houses today tend to be
airtight, it is very important to allow for some
ventilation."

Stolp said that once November rolls around, he'll treat up
to 30 people a year in Duke's hyperbaric center, which contains
specialized chambers where oxygen under pressure can help force
the carbon monoxide out of patients.

"We also tend to see them groups, or whole families at a
time," Stolp says.

While kerosene heaters are the major culprits, other sources
of errant carbon monoxide include cracked heat exchangers in
gas furances or blocked chimneys.

The symptoms of carbon monoxide tend to be flu-like, Stolp
says, such as headaches, dizziness and blurred vision. In
addition to educating the public about properly ventilating
houses when using kerosene heaters, Stolp has advice for
physicians who may treat the victims of such poisoning.