Folic Acid A Key To Healthy Babies

When I saw this headline on the cover of yesterday's paper (sorry I was going to link to the article, but for some reason the Sunday cover story isn't listed on the Salt Lake Trib's website, weird I know), I was a little surprised, I mean research proved this in the 1980's. The problem is that health care officials and educators assume that people know this and they stop harping on the matter, but every year a new group of women enter their child bearing years and need to hear this information. And even though I have gotten on this soapbox before, I am going to share a few important facts about folic acid and urge moms everywhere to share this with their friends and with their daughters.

• Folic acid occurs naturally in foods like fruits and vegetables, but our bodies absorb it best in it's synthetic form. To get your daily RDA of folic acid from your diet you would have to eat 200 red apples.
• Insufficient folic acid can lead to birth defects (or defects that result in miscarriage) including defects of the brain, skull, spine, heart, arms, legs, face, hard palate (cleft lip and/or palate) and urinary tract. A mother can reduce the risk of her child having these defects by 50-70% by taking 400 micrograms of folic acid a day.
• The most crucial time for you to be getting folic acid is in the first 28 days of pregnancy. Most women don't even know that they're pregnant in the first 28 days. 
• Hince why, EVERY woman in her child bearing years should take a folic acid supplement.
• Folic acid is used to create and repair DNA (necessary for cell production), which is why it is so vital during early pregnancy. The first 28 days are when your little bundle of joy goes from 2 microscopic cells to a something with a heart beat. Isn't that just phenomenal to think about?
• Folic acid is crucial not just for the growing baby, but mom too. During pregnancy folic acid demands increase because it is needed to produce the new cells that are making up the increased blood volume, and general increased everything that come with pregnancy.
• According to a March of Dimes survey in 2009, only 11% of women took folic acid before pregnancy.
• Apparently there is a myth going around that multi-vitamins will make you fat. This is false. However, if your multi-vitamin has iron in it and you're not drinking enough water, it can make you constipated which can lead to bloating and discomfort. Stay well hydrated and you should be fine. 
• Since 1998 the U.S. Food and Drug Administration mandated that folic acid be added to white flour, bread and pasta, which has resulted in about 1000 fewer children born with neural tube defects each year. 
• Many Hispanic women have genetic deficiency that interferes with the metabolism of folic acid. Which means that they should be taking even more folic acid.
• The average life-time cost of spina bifida per person in the United States is $532,000. 
• Currently the Center for Disease Control and Prevention, the March of Dimes, and the Spina Bifida Association along with corn and flour tortilla manufacturers are working with the FDA to supplement corn tortillas, a staple for many Hispanic diets. It is estimated to cost $3 million per year, but will save $145 million in direct medical costs for defects.
• If you are a woman living in Utah you can sign up for free vitamins at poweryourlife.org 

Food Storage Friday: Lentil Soup

So this week I tried something different, lentils. Lentils are high in protein, iron, fiber and folic acid. They cook faster than beans and when stored in #10 cans have a shelf life of approximately 30 years. Not to mention super cheap, I bought a pound bag for 98 cents. They're pretty much a super food, and a great way to add protein to your long-term food storage. Why is it that I've never had these things before? This recipe seemed like a good one to try because it includes so many food storage ingredients and it cooks in the crock pot.

French Lentil Rice Soup
Food Storage Ingredients
6 cups chicken or vegetable broth
1 cup lentils, sorted and rinsed
3 Tablespoons uncooked rice
1/3 cup dried onions
1 teaspoon dried thyme
1/3 cup dried carrots
1/2 teaspoon salt
dash of pepper

Fresh Ingredients
1/2 green bell pepper, diced
2 Tablespoons minced garlic
3/4 cup water
sour cream (optional)
pesto (optional)
parsley (optional)
dried Italian seasoning (optional)

1. Stir all but optional ingredients together in crockpot. 2. Cook on low for 8 hours or high for 4-5 hours. 3. Remove 1 1/2 cups of soup and puree until almost smooth. Stir back into soup. (Make sure that the blender is vented when pureeing hot liquids.) 4. Garnish as desired.

I will be the first to admit that this is not something that I'm going to crave in the middle of the night. I felt the fresh pesto improved it, as did the dried Italian seasoning. My husband likes it and has even chose it over leftover pizza for lunch one day. Sometimes you cook with food storage not because it tastes better than your alternatives (and sometimes it does) but because you're just getting comfortable with your options so if it comes down to "We are eating only food storage" you know what to do. I feel like this is one of those meals, but at least it's packed with lots of nutrients which makes me feel a little better about it.

Strawberry Pretzel Dessert

Recently I discovered a large bag of stale pretzels in my pantry. Not being one to waste food this is what I made with it and it was sooo yummy. I combined a recipe for a pie that I made in high school for a girl's choice dance (which pie came out of my date's nose when he started laughing uncontrollably, yeah haven't made it since) and one I found in The Essential Mormon Cookbook.

Strawberry Pretzel Dessert 
2/3 cup butter, melted
2 1/2 cups thin pretzel sticks
1 package (8 oz) neufchatel
1 tub (8 oz) whipped topping
1 Tablespoon lemon juice
1 Tablespoon vanilla
3/4 cup white sugar
2 cup water
1 large package of strawberry-flavored gelatin
3 cups of frozen strawberries or raspberries
1 can (20 oz) crushed pineapple, undrained

1. Crush pretzels and mix with butter into a crust in a 9x13 pan. 2. Bake for 10 minutes @ 400. 3. Remove and cool. 4. Combine neufchatel, whipped topping, lemon juice, vanilla and sugar. Spread over pretzel crust. Make sure that all parts of the crust are covered and there are no gaps between the edge of the pan and the whipped topping mixture.  5. Bring water to a boil. Dissolve gelatin in water and cool until syrupy. 6. Puree strawberries in the blender. 7. Mix strawberries and pineapple into gelatin. 8. Pour over top of whipped topping mixture. Refrigerate several hours until firm.

It doesn't plate fantastic, but I would have to say this is pretty darn amazing for something that I threw together using just what I had in my freezer and pantry.

Home Remedy for Sore Throats: Apple Cider with Mulling Spices

Friday morning I woke up with a sore throat and thought "Why did I agree to come into work today?" After hitting the snooze alarm I remembered something about bills, my unit needing me and it only being a couple hours, then dragged my tired booty out of bed. I work in Pediatrics and I generally don't get sick, because I am exposed to a wide variety of nasty bugs in many forms on a regular basis and after a year or so that builds up a super immune system. That is I don't get sick as long as I get enough sleep and keep the stress down. (Unfortunately neither Wednesday or Thursday were low stress days.) If I don't keep the stress down there are any number of nasty bugs just waiting to make themselves at home. Solution: Treat symptoms while they are mild.

Growing up, whenever we had sore throats or various upper respiratory illnesses my mom would make hot lemonade or hot apple cider for us. (My grandma was a firm believer that if you added a teaspoon of Everclear alcohol to some hot lemonade and gargled it, it would kill anything that was lurking in your throat. It probably does, but I can't say that I have ever tried it.) So I filled my thermos with hot apple juice, lemon and mulling spices and I was good to go. I didn't realize how much my throat hurt until the apple cider was there to sooth it.

Now some of you may be asking, 'what are mulling spices?' Mulling spices turn ordinary hot apple juice into spicy yummy goodness. If you purchase them they are generally overpriced, but they are very easy to make. (Another trick I learned from my mom.) Plus when you make them yourself you have an excuse to smash things with a hammer, which can also help with stress. (Helpful Hint: I found that the cheapest place to buy spices is in the little bulk baggies at the health food store. The last time I bought them they were about 25% of the cost at the grocery store.)

Mulling Spices
6 cinnamon sticks
1 small whole nutmeg
1/2 cup of whole cloves
1/2 cup whole allspice
1 whole orange peel, cut into little pieces and dried
1/4 cup dried cranberries (optional)
1/4 cup thinly slice dried pears (optional)

1. Smash cinnamon sticks and nutmeg with a hammer. (Preferably with spices in a bag.) 2. Mix ingredients together. 3. Mix one heaping teaspoon of spices per cup of beverage. (Some people tie their spices into little cheesecloth bags before soaking them. I am way too lazy for that.) The longer the spices have to soak in the juice the better the flavor. If you are going to make big batch, a crock pot is a good option. You don't have to limit yourself to mulling in apple juice. Most clear fruit juices will work.

I've been drinking a lot of this stuff over the past four days. (I use the same spices a few times and keep refilling my thermos with hot juice.) My throat feels so much better. I like to add a tablespoon of lemon or orange juice to it as well (I had a voice teacher in college who swore by putting lemon juice in her water to ward off sore throats). I'm not saying that apple cider is a replacement for medicine when necessary, but there is a great deal to be said about getting plenty of fluids and Vitamin C. Both of which are necessary for healing. Plus the spices do great things for you too. Cinnamon helps with circulation, digestion, anxiety, stress, diabetes, menstrual cycles and is a mild natural antibiotic (which is why it is found in some toothpaste.) Cloves also improves digestion, eases throat irritation and coughing, and is another natural antiseptic. (I read in a few places that it has officially been endorsed by the FDA as a stopgap measure for tooth pain.) Allspice has pain relief and antiseptic properties. Nutmeg aids with digestion, but it's thrown in this mix for flavor. I think it's pretty awesome that all of these spices that I'm using to help things taste better are actually helping my body heal at the same time.

Food Storage Friday: Apple Almond Oatmeal

Before making this breakfast I had never actually made oatmeal other than of the instant variety. I like that this recipe uses a crock pot, has few ingredients and they are all ingredients that I have on hand anyway. I liked that it has almonds in it because a breakfast of just oatmeal doesn't have enough protein to get you through the morning. I also like that the apples make it so there isn't much sugar required. Plus you wake up to your house smelling like cooked apples.

Apple Almond Oatmeal
Food Storage Ingredients
1 cup steel-cut or old-fashioned oats
1 cup apple juice
1/4 cup sliced or slivered almonds
1/2 tsp cinnamon
1/4 tsp nutmeg
1 tsp vanilla
1/2 tsp brown sugar

Fresh Ingredients
1 & 2/3 cup of apples, peeled and chopped
1 cup water

1. Combine ingredients in a small slow cooker. Cook for 8 hours on low. Makes 3 servings.

A few notes: Yes, I realize that the picture looks just like ordinary oatmeal, which is less than appealing, but I promise the cooked apples very much improve it. I'm sure that I could have very easily used dried apples instead of fresh and just added more water, but we have lots of fresh apples here so that's what I used. If you are making for more than 3-4, this recipe can be doubled or tripled. I could have easily doubled it in my small $5 slow-cooker. I really liked the almonds, my daughter didn't. Perhaps next time we will try it without and I can just sprinkle them on afterward.

So what is in the Healthcare Reform Act anyway?

Last week I attended a nursing education conference. One of the speakers talked about the Patient Protection and Affordable Care Act gave a descent summary of the changes that it will make on health care in the United States. I've heard a lot about what is and isn't in the PPACA, but I've heard conflicting things. There's a reason for the that. The PPACA is almost 2,400 pages long and it is very complex. 2,400 pages, that's massive. I like to read, but I don't think I have ever sat down and read anything that long. (The KJV of the Bible is only 1590 pages and I think that's the longest book I have ever read in its entirety.) I think that I can safely assume that most people aren't reading that document in its entirety, making it difficult to know what it actually says. So I thought I would sum up what I have learned and share it with all of those moms out there who are wondering how this is going to effect them and their families.
Here are some of the big changes that it includes:

• Individual Mandate
• Premium and Cost-sharing Subsidies
• Employer Responsibility
• Guaranteed Issue
• Insurance Exchange
• Medicaid/CHIP Expansion
• Wellness Programs
• Payment Reform

 Ok, I work in health care and I still didn't know what half of those things meant until someone explained it to me, so I'm going to try to explain them so my readers can also know what's going on with their health care.
Individual Mandate- This means that the government requires that every individual has some kind of health insurance coverage. If they don't have coverage they have to pay fines. (This doesn't begin until 2014.) Right now there are a lot of young healthy people who don't have insurance because they don't utilize health care often enough to make health insurance coverage cost effective for them. One of the principles of individual mandate is to spread the risk (cost) of insuring older sick people over a larger group of people.
Premium and Cost-sharing Subsidies- This means that there are limits on how much a person should be expected to pay for health insurance. And there are subsidies to assist people with their health insurance premiums up to 400% of the national poverty level. For example let's say you have a family of 4 and you make $42K annually. That puts you in the 150-200% of the national poverty level range. The most that you are allowed to pay for your health insurance is 6.5% of your income. This is good news for a lot of people. There are so many people that I know who make too much money to qualify for Medicare, but are fairly crippled by their health insurance premiums, especially if they are not able to get them through an employer. To see where you would fall on the  subsidy chart go here. This one also starts in January, 2014.
Employer Responsibility- This means that all companies that have at least 50 employees are required to offer some kind of health insurance to them, or pay fines. Companies with at least 200 employees must automatically enroll all of their  full-time employees in health insurance, although employees can opt out and receive vouchers that they can use for a health insurance plan of their choosing. Coming January, 2014.
Guaranteed Issue- This is a big one. This means that insurance companies can not deny you coverage for a preexisting condition, and they have to renew your policy also. I can think of dozen people that I personally know who this will help. My best friend's mom with cancer, my neighbor with diabetes, my father-in-law with a rare genetic disorder, a former co-worker whose husband has sleep apnea, a friend's son with cerebral palsy are just a few. Everyone of these people are hard-working, tax-paying Americans who because of they have "preexisting conditions" and are unable to get insurance through their employers, do not have health insurance. Some have been lucky so far, others have been almost crippled by medical bills. For children, guaranteed issue started September 23, 2010 (Hooray!) and will start January 1, 2014 for adults.
Insurance Exchange- By January, 2014 states will be required to set up health insurance exchanges, which are like marketplaces. It's a place where people can compare rates and programs, and hopefully factoring in some competition will improve the available product. But they won't be available for everyone.
Medicaid/CHIP Expansion- This means that more of those people who right now make "too much" money to qualify for Medicaid/CHIP will be eligible. And even if states have budget short-falls they will not be able to cut funding here until 2019.
Wellness Programs- All qualifying insurance companies will have to provide preventative wellness programs to infants, children and adolescents, such as well-child checks and immunizations. This is effective September 23, 2010. (I love this, because I believe that preventative medicine is more cost-effective. And I think that it is sad that some people who do have insurance still don't get these things done because it costs them too much money.)
Payment Reform- Medical billing, murg. I know that for me at my job I now have more paper work. (Although compared to some I have nothing to complain about.) I know that Medicare payments are being modified drastically. And Medicare will increase their payments to primary care providers by 10%, because they want to encourage more good doctors to be primary care providers. Having quality primary care will save everyone money. But the bottom line for most Americans is that will taxes will go up to fund these changes.
A few other interesting points- There are now no lifetime limits. So my chronic pediatric patient who burned through more than one million in health care dollars in his first year of life can actually have health insurance as an adult. There are no annual limits. So if you have something catastrophic like a mangling car accident your insurance company can't say "Sorry we won't pay for your prosthetic leg because you've already cost us too much money this year." Dependents must be eligible for coverage until the age of 26. (And if you're married and under 26 you still qualify to be on your parents insurance.) This will make getting through college and graduate school so much easier for a lot of people. When I was in college I knew a guy who only went to school one semester a year because he had to spend the rest of the year working full-time to afford the insurance that was available (and required) from the university. This would be huge for people like him. Goodness it would have made my life a lot easier going through college too. And there will also be limits on how much profit insurance company administrators can make. It's about time.

Halloween Costumes on the Cheap

I am ready for Halloween!
I bought a BuyCostumes.com Groupon ($30 for $15) last weekend which I used to buy this for Thing One.

Out of pocket, including shipping, the Groupon and star wand=$21 (Normally $47 + tax). Another thing about BuyCostumes is that every day they have a couple of costumes that are ridiculously marked down. Today there are a cute mermaid and a little red riding hood costume normally $50 each down to $3.99.  They also have several cute Animal Planet infant/toddler costumes for $10 each (every day). Economy shipping is 4.99. You can get 20% off with code "creepy20" Definitely worth looking at. (Oh and they participates in Ebates too.)

For Thing Two we decided on a dragon costume from Old Navy.

Online they are $20, but there is a code for 30% off ( SAVEBIG today only), bringing it down to $14, but then you have to pay for shipping unless you spend $100 or more. (One perk of buying online, besides the convenience, is that you can get a Upromise or Ebates kick-back.) At my local Old Navy all of the costumes were marked down to $16. On Tuesdays if you use your Old Navy card you can get an additional 10% off or you can use your bucks back like I did to get it for FREE. (You can't use a percent off discount and bucks back in the same transaction at Old Navy stores.) I have bought Old Navy Halloween costumes in the past and have always been happy with them. The fleece ones are really great if you live somewhere that has snow at Halloween. (This year we will probably be at Grandma's for Halloween, so that means us too.) It has been my experience that as the month of October rolls on there are more sales and discounts available at Old Navy. If you wait until the last Friday of October, that is when they usually have their big 50% off everything sale (for the first 50 customers). And by then the costumes will be marked down to only a few dollars each. The problem is that if you wait that long the selection diminishes. As it was today I grabbed one of only 2 dragons and the only one in his size. But the hamburgers are cute too and there were plenty of those.

This morning while we were at Target (picking up Beauty and the Beast!) we checked out their costumes too. They also had several good options ranging from $12-$40. They seemed to have more of the "St George weather" variety of costumes.