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Healthy Eating Choices When Shopping

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SARA LOMAX-REESE:     We are joined in our ShopRite studio by Dr. Donee Patterson, who we are always thrilled to have. She is a family medical physician with Einstein. Welcome, Dr. Donee.

DONEE PATTERSON, MD: Thank you. Thank you for having me. 

LOMAX-REESE: Absolutely and also with is Theresa Shank and she is Einstein's outpatient registered dietician and we are going to hear a little bit later from Sandy Brown, who is the cofounder, with Jeff Brown, and a board member of Uplift, which is Brown's nonprofit, which deals with food deserts and a lot of things with making sure that healthy, nutritious food is available in communities of color. So we will hear from Sandy Brown a little bit later and we might, we might, we just might hear from Lisa Neri and she is a certified registered nurse practitioner at the Einstein Fast Care Center here in the Brown ShopRite on Cheltenham Avenue. We really encourage you to come down, check us out. We will be here until 1:00. Come down and sample these wonderful, healthy snacks. It's a great time. The Super Bowl is on the horizon on Sunday and if you are thinking about losing weight, if you want to lose weight, need to lose weight to create better health for yourself and your family then this is the place to be to get some encouragement, some inspiration and some information around healthy living, healthy eating, right here where it all happens at Brown's ShopRite. So first off I want to bring Dr. Donee Patterson into the conversation. We are regularly talking with Dr. Donee about a variety of health issues. We have been focusing a lot on weight and obesity and weight loss in this New Year in January. So Dr. Donee, why don’t you just kind of give us the high level why this particular conversation zeroing in on nutrition is so critical for our community?

PATTERSON: Absolutely. We know that obesity is a challenge for many people and for children and adults and so we, again, we were focusing on weight loss and exercise and just really talking about how it is very important for our health. We know from statistics that decreasing your weight, even a minimal amount of weight, can decrease your risk of diabetes and improve your diabetes in certain cases. It can decrease some risk of certain cancers. It can lower cholesterol and lower blood pressure. So we've been talking about weight this year, but we wanted to bring it to where it all starts. It all starts in the grocery store where we shop and where we buy for our families and once we get it home those are the choices that our families have. So we want to make sure that people are picking the correct things while they're in the grocery stores and we thought it was awesome to have a licensed nutritionist here with us to answer any questions and to have some foods to sample and try and to just kind of sort out some of those kind of confusing things that happen in the grocery store where there are 60,000 different choices of different foods and we can help you to kind of sort out what might be healthiest for your family because a lot of times our spouses don't know, our children don't know, but we want to help sort that out.

LOMAX-REESE: And we don't know.

PATTERSON: And we don’t know. Absolutely.

LOMAX-REESE: A lot of times we don’t know.

PATTERSON: Absolutely. 

LOMAX-REESE: I want to bring Theresa Shank into the conversation and Theresa is the outpatient registered dietician for Einstein. Theresa, we know that about 900,000 people in Philadelphia are overweight or obese, including over 150,000 children, in fact it is now more common to be overweight or obese then to be a healthy weight and we know that that is exacerbated in the African American community. So I want to ask you, Theresa Shank, what are some of the things that you are seeing in your practice as you treat people and talk with people about healthy nutrition and addressing their health challenges through food and nutrition? 

THERESA SHANK, RD: Well I see a lot of different people and the demographic is wide and typically it is usually pre-diabetes is the most concern that I have right now with a lot of my patients. A lot of it is attributed to higher weight and also sugar-sweetened beverages. So that's something that I definitely talk about in almost every instance through my counseling. 

LOMAX-REESE: You know, I was at Starbucks yesterday and Starbucks, not every institution has, or food institution has, the calories labeled in terms of what you are consuming so I think it is kind of a reality check to find out, a lot of times we think about what we eat in terms of hard food, in terms of calories, but we don’t necessarily have the same awareness around what we drink. I was looking at these calories and of course I wanted a mocha peppermint latte at Starbucks and I saw it was like 400 calories, just that one drink, and I've started exercising and I know when I am on the treadmill it takes me 45 minutes to work off 250 calories walking so I was like, "Wow. I am going to undo all of that work just drinking this coffee drink." So I want to see if you guys can talk a little bit about cultivating this sense of awareness, not becoming obsessive about what we eat, but really some concrete tips for allowing people to manage how they shop, how they eat, in a more proactive way, and I will start with you, Dr. Donee. 

PATTERSON: I just want to mention that one pound is 3,500 calories. So if we decrease our calories by 500 calories a day, then you can actually lose a pound a week and I say this because everything is supersized nowadays. Even a bag of Doritos, the larger bag of Doritos has about 400, 450 calories in it, so just eating one extra bag of Doritos in a day can erase everything that you've done to exercise for that day. So we really want to encourage people to think about portion sizes. We are not saying you can never have chips or never have a treat, but you can maximize the calories that you eat by just changing to a baked chip and then using a smaller bag so you still get that crunch. You still get that chip, but you don't have the extra large supersized bag that erases your calories and then you end up gaining and you don't realize a pound a week, four pounds a month, couple of pounds extra a year, you don’t realize that they add on and add on throughout the year. So if you think about that portion size, it really does make a difference in your waist line. 

LOMAX-REESE: Theresa Shank, one of the things that I found as I have gotten older is it is harder and harder to lose weight and it is so much easier to gain weight. What used to kind of just fall off is no longer falling off it is like compounding. So can you talk a little bit about the impact of age and weight and what are some of the things that we can do as we age to be a normal and healthy weight. 

SHANK: As you age, the equation is the same as when you are younger and when you are older and it is all about moving, so not only are we watching what we are eating, we also have to watch how we are expending our days. So even just as little as walking 10,000 steps a day, that sounds like a lot, but it actually equates out to moderate exercise. So getting a pedometer would be something to watch out for. You want to make sure that you are getting that exercise in every single day. That's very vital. As you age, watching your calories, but also watching your physical activity as well.

LOMAX-REESE: I want to just let people know we are broadcasting live from the Brown ShopRite right here on Cheltenham Avenue and folks are starting to come in and check us out. You are listening to 900AM WURD on air, online and in the community. I am Sara Lomax Reese and I am really excited. This is my maiden voyage here at the Brown ShopRite talking about health and nutrition, and we are partnering with the Einstein folks, they have a Fast Care Center right here inside ShopRite. If you need blood pressure screenings, if you need some healthcare assistance, right here it is a one-stop shop, right here at the Brown ShopRite. Today we are talking about healthy eating, healthy nutrition, healthy shopping, because it all starts right here. One tip that I would give is don’t go food shopping when you are hungry.

PATTERSON: Yup, that's perfect. 

LOMAX-REESE: Do not go food shopping when you are hungry because you will end up buying much more then you actually need and probably the stuff that you are buying is not as good for you as it should be. What were you going to say Dr. Donee?

PATTERSON: I said absolutely. Don't go shopping when you are hungry and another tip that, Theresa, you can comment more on is a lot of times our kids want a treat. They want a snack. I want us to not always think about rewarding them with food, but if we are giving them a treat, when you look at the label, something that starts with sugar, if the ingredients start with sugar, I want you to avoid that. Sugar or heavy syrup I want you to avoid that. 

LOMAX-REESE: Or high fructose corn syrup.

PATTERSON: Or high fructose corn syrup and if the ingredients, if there are more then five ingredients or things that you really don’t understand or can't read, I want you to avoid those as well. Try to lean towards more fruits, more vegetables as snacks, they can use carrots and dip as snacks. They can use peanut butter and apples as snacks, but also if there are other kinds of snacks just avoid the first ingredient being sugar or high fructose sugar.

LOMAX-REESE: And, Theresa Shank, please?

SHANK: Also on those snacks, something that you can watch out for is just simple things like the sugar content. Not only looking at it in the ingredients, but on the label. You want to make sure that these added sugars aren't in your children's diet, nor in your diet. So making sure that these snacks have less then eight grams of sugar is something that is more friendly towards weight loss.

LOMAX-REESE: Let me ask because a few years ago, maybe more then a few years ago, it was all about fat content. People were buying non-fat, fat-free, everything was fat, fat, fat, fat, fat. People continued to get fatter eating non-fat food. Now it seems like there is more of a focus on sugar then fat. So can you talk a little bit, Theresa, about the evolution of nutrition in terms of what we should really be reading on the labels? What are the things that count?

SHANK: It's really looking at the numbers because it is kind of a give and take. When you have something that is lower in fat you have to increase the sugar content and also the sodium content and vice versa. So when you are lower in sugar it is going to increase in fat. You want to make sure that you are reading the ingredients list just like Dr. Patterson had said. So looking to see what the most abundant ingredient is. The first ingredient listed is the one that is most concentrated in that snack. How it has all evolved is oh are artificial sweeteners better for us or is low fat? Really you want to stick to the mindset of choosing whole foods, meaning, okay, sugar if you are eating fruit, that sugar that is delivered with that fruit is nutrient-rich, so when you are choosing products see what types of nutrients you can get out of it. So I always say go with color. Whatever has color in it and it is from the whole source, that's the best snack to have.

LOMAX-REESE: But you don’t want to get something that has a color and a number.

SHANK: No, not Fruity Pebbles, not Fruity Pebbles, artificial coloring.

LOMAX-REESE: Right, so artificial colorings, we want to stay away from anything that has a color and a number. So if you are reading the label and it says, you know, red 5 or red 2…

SHANK: Red 40 such as in Doritos. That's something that you really want to watch out for, especially because studies show that that's linked to ADHD as well in children.

LOMAX-REESE: We are talking today all about health and nutrition. We are talking about weight loss, healthy weight loss by changing the way that we eat, changing the way that we shop, changing the way that we cook and we are doing it all live here at the Brown ShopRite right on Cheltenham Avenue. We are really excited to be here with the Einstein docs to talk about this very important issue. It is January. It is the end of January and we are looking at ways to be at a healthy weight, ways to eliminate diabetes and hypertension and high cholesterol. All of these things are connected to our lifestyle, connected to what we eat and how much we eat and when we eat, and all of those things, so we are in the right place at the right time. Come down and join us at Brown ShopRite right here on Cheltenham Avenue. Get your questions answered. Come have some delicious healthy food snacks and maybe take a tour of the ShopRite and get an idea of how to make some healthy choices. I want to ask you two, supermarkets are set up in a very deliberate way and so give us a sense of how you should navigate the supermarket when you come. You are not going to come hungry, but how should you maximize your health consciousness and healthy nutrition when you come to a supermarket. Dr. Donee?

PATTERSON: We recommend people to come prepared. So you have a list. We have some grocery lists here, some shopping lists here for you to pick up, but you can just do it on a regular sheet of paper. We recommend you to come prepared and we recommend for you to start in the fruit and vegetable section and spend most of your time in that area. Now different grocery stores are set up differently. They may have the bakery right where the fruits and vegetables are, but we want you to spend most of your time in the fruit and vegetable section and then navigate throughout the store and go by your list. We really recommend for you to come planned and prepared. 

LOMAX-REESE: Theresa Shank?

SHANK: Also to stick to the perimeter of the grocery store is an old trick. Typically right when you enter there's the fruits and vegetables. As you progress in then you have the meat and the dairy section and you circle you way around to the front. So trying to stay on the outside of the shopping centers is where most of your healthful, whole foods are and then when you travel inside the inner aisles you want to make sure that you are picking whole grains, which is typically where the cereals and bread products are and then you are done with your shopping trip. 

LOMAX-REESE: A question about that - because that's another thing. I think that labeling has gotten more and more confusing so you know if you see something that says wheat, tell us about what is whole grains, because even like Fruity Pebbles now says whole grains. There's all kinds of manipulation and labeling that encourages, makes it seem like something is healthy, but it actually isn't. How do we negotiate that? Theresa?

SHANK:  So you want to make sure that you are looking on the ingredients label. That's the most important. The first ingredient needs to read 100% whole wheat or whole grain. If it says enriched whole wheat flour, then that is nothing but glorified white flour in a product. So as long as it says 100% whole wheat or whole grain as the first ingredient, that's a good choice and that indicates that it is a whole grain product. 

LOMAX-REESE: We are going to take a quick break. We are broadcasting live from Brown ShopRite on Cheltenham Avenue. We are excited to be talking about health and nutrition, food and shopping and cooking and giving you tangible tips and strategies for encouraging health and wellness for yourself and for your family. So we are going to take a quick break. We've been talking with Dr. Donee Patterson and Theresa Shank. We are going to bring Sandy Brown up in just a minute to talk to us about Uplift, a non-profit that's a part of the Brown ShopRite empire. Don't go away. We will be back in just a minute. And we are back. You are listening to 900AM WURD. We are broadcasting live from Brown ShopRite right here on Cheltenham Avenue and we are partnering with Einstein Healthcare Network. They have a wonderful center in this Brown ShopRite. It is called the Fast Care Center and they provide all kinds of healthcare services right here on the premises and we are talking today about healthy nutrition, healthy eating, healthy cooking and where better to do it then in a supermarket. Right now we are joined by Sandy Brown and Sandy is the cofounder and board member of Uplift. Sandy, welcome.

SANDY BROWN: Thank you. Thank you very much. 

LOMAX-REESE: Tell us about Uplift. We know a lot. Brown ShopRite is very visible in the community, but what is Uplift all about?

BROWN: Okay, so Jeff and I have been operating our supermarket company for close to 25 years and as we have expanded into urban communities, and we have seen that there is not as much access to things as in other communities, that's when we really started focusing on having fresh food access consistently in some communities which have been labeled as a food desert per say, but basically they are communities that just don’t have convenient fresh food access and through this entire process we developed our non-profit. The full name is called Uplift Solutions and we started it about five years ago to bring healthy fresh food that's affordable to communities that are low-access and that basically we would not only do it here in the city of Philadelphia, like we've done such as at our Parkside store in West Philadelphia, but we are working with communities across the country to open supermarkets in areas that do not have this fresh food affordable access. In the process of doing all of that, that's when we also saw that there's a lot of things that these communities don’t have, it is not just about fresh food, but healthcare is a big issue and they just do not have that ease of quality healthcare other then going to an emergency room, which at the end of the day is very costly to society and it is not even good care for them. They are like a number. They are not even really getting the help that they need. That's when we opened up this clinic here. It is called the Einstein Fast Care Health Clinic and it has really been doing fabulous. It is very affordable. We take most insurances and if you don’t have insurance it is on a small cost. You can come for a lot of different things, which we will hear about later from one of the nurse practitioners, Lisa, and you can just walk in. You do not need an appointment. We even give you a beeper if there's a couple people ahead of you. You can do some shopping while you are waiting. 

LOMAX-REESE:  That's very efficient. I like that.

BROWN: Very efficient and it is very personable care. They talk to you. You can get flu shots here. You can get medical forms filled out for your children, but let's say you have an ear infection or strep throat. They can help you here and they can even, if you need a prescription, write it and you can have it filled right here in our pharmacy. 

LOMAX-REESE: Wow, that's fantastic. That's very forward thinking and I know that you and Jeff are speaking all over the country, as you mentioned, because the model that you are creating is something that other places in the country are trying to duplicate. What are some of the things that are not here yet that are on the horizon?

BROWN: Okay. Well, probably the biggest thing on our forefront is this clinic concept because we feel that it could be a really great alternative with the healthcare that will be coming in the near future. While Brown super stores does offer benefits to our employees, there's a lot of organizations that historically have not done that, and as people start to get healthcare they are going to have options and need a place to go. So we are going to be opening another clinic, probably this summer, in our new store at the ShopRite of Fox Street, which will be opening probably in the July/August timeframe and that will be run - we really focus on having a healthcare system that's local to that community so Einstein is local here and then they can direct you to their hospital staff if you need additional care. In that community we are going to be partnering with an organization called RHD, Resources for Human Development, and in fact, we are going to be having a big community meeting on January 31. It is going to be at 6:30 at the Dobbins High School and you can hear more about these clinics. So we are looking to expand that whole program. We also are going to be looking to expand nutrition services. So having like what we have here today. We have community rooms in all of our stores and we really want to start an educational process, so Uplift Solutions has a whole arm just focused on healthcare and we are looking to expand, to offer classes, nutritional counseling and all of those types of things as well.

LOMAX-REESE: If people want more information about just what's coming, if anything is coming to their neighborhood, how would they contact Uplift Solutions?

BROWN: We are located, you can come to our web site, it is www.upliftsolutions.org. They can go on there and there's all kinds of information. The other way is if they come into their ShopRite, they can usually find out information about programs that we will be offering. So if you come into the ShopRite of Cheltenham, for example, we will, in the near future, be having, especially with our clinic here, having nutrition services and offering classes. That's something we are hopefully going to start rolling out in the next three to six months. 

LOMAX-REESE: Go ahead, Dr. Donee.

PATTERSON: I did want to mention about the clinic that they have very good hours. They have extended hours and they have weekend hours as well. They go up to 8:00. It is a walk-in clinic, as she mentioned, so you don’t actually need to call and make an appointment. You just come and walk in. We are not saying that it totally replaces having continuity of care with a primary care doctor, but if you need something they are here and if you need a doctor in addition to that they can help direct you. 

LOMAX-REESE: Excellent. I really want to thank you, Sandy Brown. I think that one of the things that is a hallmark of Brown's ShopRite is they are so well-organized and stocked and you really cater to your community. There is a lot of Caribbean food. There's a Halal food. There's all different kinds of diverse offerings that are customized to the people that you serve so there is a real cultural competency that you guys infuse into what you do. 

BROWN: Thank you. Thank you and this new store that is opening this summer, it'll be located at Fox and Roberts Street. We are actually going to have an entire international market within it. Again, we will have all types of cultural foods based on that individual community so we are really excited about that. 

LOMAX-REESE: Excellent. Well, I want to thank you so much for having us here today and hopefully we will be able to do a lot more of these kinds of broadcasts. 

BROWN: Great. Thank you.

LOMAX-REESE: That's Sandy Brown and she is the cofounder of Uplift Solutions and a board member and one of the forces behind the wonderful work that Brown ShopRite does in the Philadelphia community. So, ladies, going back to our nutrition focus for the broadcast, I am wondering, and maybe Dr. Donee you can talk a little bit about this as a family physician, because childhood obesity is also a very, very big issue and it is on the rise. We know that there are statistics that say that this generation of children may be the first generation that don’t live as long as their parents because of this very serious issue of childhood obesity. What are some of the things that we as parents need to be conscious of in terms of how we cook and shop and prepare food for our children?

PATTERSON: I think we need to emphasize to our children that with every meal, they need to eat a fruit or a vegetable, and it is hard to do, but you can train your children to know that. As they become preteens and teenagers they'll go in the refrigerator and pick fruits and vegetables out themselves. But also the other choice is when they're in restaurants, to continue to eat fruits and vegetables when they are eating out as well, which is also a very hard decision to do. One thing that I struggle with is cereal in the morning. I used to cook every single day for my children and then they decided that occasionally they want cereal. Theresa, the nutritionist we have here with us, she and I, we go back and forth sometimes about that because it was hard to get my children to eat very, very low sugar cereal. I struggled with that for a while and I had guilt behind that because I didn't want them to eat very sugary cereals. I came up with a compromise that we wouldn't eat any cereals that are higher then 12 grams of sugar, but my kids also eat lots of fruits and vegetables and so there are cereals out there. I won't advertise for those brands, but there are cereals that your kids will like that are out there instead of buying a cereal that just has like two grams of sugar and then they have to add sugar to that. I didn’t want that. Do you have a comment about that, Theresa? I just wanted parents to know not to have guilt behind that, but that we have to balance that out.

SHANK: Exactly. Balance is key. So what I said to Dr. Patterson is that, okay, if your children are going to have a higher sugar cereal then balance out through the day. Don't have other added sugars in your meals. Another thing that you can do is try to naturally sweeten the cereals, such as putting sliced banana or blueberries or even frozen fruit on top of the cereal. That could also help, but it is about balance, so you really want to just target one goal for yourself and your family and go with that. So if having a cereal with a little bit higher content sugar then just don’t have as much ice cream for dessert later on in the evening, something like that is what's really key. 

PATTERSON: Right. I want us to all challenge ourselves. If you have never had hummus before, I want all of us to go out and look for that and try to see if your family will enjoy that. Try a healthier brand of peanut butter. Try a baked chip instead of a fried chip or instead of fried, tortillas. I want us to all challenge ourselves. Once a week consider trying a new fruit or vegetable. If you really haven’t done cauliflower, maybe find a recipe for cauliflower, and see if your family likes that, or a star fruit, something that may not be on your table all the time, but just challenge yourself to try something new, try something different. I myself I am going to try that as well, and I think that we will all be healthier if we try to integrate more fruits and vegetables and find new recipes and ways to integrate them into our daily lives.

SHANK: That's a wonderful suggestion.

LOMAX-REESE: No, I was just going to ask about that because I think one of the things that has been lost, a lost art, is cooking. A lot of people don’t cook very much anymore. It's either microwaved or fast food and the reality is the cheapest food is often the most unhealthy and the most widely available, particularly…

PATTERSON: Sometimes tasty.

LOMAX-REESE: …and with lots of sugar and salts and unhealthy ingredients, but my question is what are some of the things that you can suggest to encourage people to cook more because most people are working long hours, they are working when they get home, they're stressed out, they might have to run their kids around, or what have you, and people often are just trying to get the quickest, easiest thing that they can for themselves and their families. Suggestions around how to make cooking and food preparation more accessible and affordable and easier. Theresa Shank?

SHANK: Frozen fruits and vegetables are actually very affordable. Picking those and choosing them for meals, such as even just adding them to a lower-sodium canned soup. That's going to be more beneficial and accessible to doing something like that. Also making one day out of the week a family day, if you are able to do that, and everyone get in the kitchen together. It is so very important that you implement a family effort there. Having the kids helping you cut, they're really actually going to enjoy that. I mean, safety comes first, but getting to be a whole family effort with cooking.

PATTERSON: I mean, you can teach math lessons with cooking, about measuring and how to sift things out. You can teach science lessons about how things go from chemical change to physical change if you scramble an egg. You can kind of integrate that into everyday living. You can also prepare things in bulk. You can buy chicken and you can make them into several different meals. You can definitely get your kids involved. Beans - they are something that you can cook in a large quantity. You can freeze them. You can pull them out and also just to remind people that the cost in cooking for yourself and buying fruits and vegetables for yourself, yes there is a cost on the front end, but there's also healthcare costs on the back end and so if we are healthier now, that's less blood pressure medicine. That's less cholesterol medicine. That's less diet pills. There are things that have long-term costs as well.  

LOMAX-REESE: I want to stay on that note for a minute because I think that that's the thing. A lot of times food and nutrition are digested separately from health consequences. They are not looked at as totally connected and I think part of that is a failure of our healthcare system that a lot of times it is like prescription meds are the first line of defense as opposed to lifestyle changes because lifestyle changes are harder. It takes a longer time and it is much more comprehensive, but it can really make a huge difference. So let's talk about the impact of diet on health and wellness and the ability to really, like you said, lower your blood pressure, lower your cholesterol, change your diabetes numbers, all of those things, specifically through changing your diet. 

PATTERSON: Absolutely. That's one reason why we really wanted to have these programs all year long on WURD, to do preventative medicine. People may notice we don't talk about any drugs on this program because we really want people to think ahead of time about being healthier and if you can eat more fruits and vegetables you can lower your blood pressure in many cases. You can lower your cholesterol. You can decrease your risk of diabetes and cancer and so that's what we are really emphasizing through all of these programs and so today we want to just hit home that if you do the homework ahead of time and cut down on some of the salts and the sugar-sweet beverages that we can make up some of that difference in the back end with added weight and added blood pressure and added cholesterol. I want to tell people about if you eat lots of, if you leave home with nothing else today, I want you to remember to eat the rainbow and to remember things like the red fruits and vegetables, strawberries and apples, they have lycopene and ellagic acid in it and they can help with arthritis and decrease blood pressure and decrease cholesterol. Yellow and orange fruits and vegetables - they have beta-carotene in them and flavanoid and vitamin C and they also can decrease blood pressure and decrease cholesterol. The green, leafy green vegetables, they have lots of vitamin C in them. They can help with the immune system and help with digestion. The dark purples like the eggplants and grapes and plums - they are also known to decrease some risk of some cancers, colon cancers and digestive system cancers and to improve the digestive system and improve vision. If we think about eating the rainbow, not a Skittles commercial, but eating lots of different fruits and vegetables, having your plate just filled with lots of colors, healthy colors, not the added dye colors, then you will be healthier. It helps to clean out your arteries and helps decrease your risk of heart attack and stroke. It is not 100% because there are some genetics, but really think about these things as we are feeding our children and feeding our families so that we can live longer more prosperous lives.

LOMAX-REESE: We are going to take a quick break. You are listening to 900 WURD. We are broadcasting live from the Brown ShopRite on Cheltenham Avenue. We are here with the Einstein docs. We are out in front of the Einstein Fast Care Center and we are talking healthy, eating healthy, cooking healthy, shopping and we are going to take a quick break and when we come back we are going to talk with Lisa Neri, she is the certified registered nurse practitioner who is with the Einstein Fast Care Center right here at Brown's ShopRite. Stay with us. We will be back in just a minute. And we are back. We are broadcasting live from the Brown ShopRite at 2385 Cheltenham Avenue and we are talking today with the Einstein docs about healthy nutrition right from the place where it all happens, right in the supermarket where the rubber hits the road and in this particular Brown's ShopRite is an Einstein Fast Care Center. It is a healthcare center that is situated inside this ShopRite and right now we are joined by Lisa Neri and she is a certified registered nurse practitioner who works at that Fast Care Center. Welcome to the program, Lisa.

LISA NERI, MSN, CRNP: Thank you.

LOMAX-REESE: So tell us about the work that you do at this Fast Care Center. It seems like a very revolutionary concept to put a healthcare center inside a food market.

NERI: Yes I think that people are surprised when they find us here while they are doing their weekly food shopping. We are a convenient care clinic. We see a lot of upper respiratory, cold and flu-like symptoms. We see urinary tract infections in women. We see a lot of skin disorders, eczema, psoriasis, ringworm. In addition, we do limited physicals, sports participation physicals for the kids. A lot of times you can't get into your primary care provider that same day, when the kid has to show up for practice, so they can run down here. We are open 10 to 8 Monday to Friday and we are here on the weekends as well, 9 to 5 on Saturdays and Sundays 9 to 3:30. So it is convenient for mom and dad. We do driver license physicals and we also do pre-employment physicals, a few immunizations. We have the tetanus and we have the flu vaccine. 

LOMAX-REESE: So what's the process for coming to this clinic? Is it that you just walk in or do you have to make an appointment if you have a child who needs a sports form filled out, is there any kind of prior contact that has to happen?

NERI: No. No appointment is needed. It is a walk-in clinic. Generally, I have patients come in, they are registered, they're seen, and they're out the door in about 15 minutes, unless five people walk in at the same time. That might be a little bit of a wait, but generally people can get in and out pretty quickly.

LOMAX-REESE: What's kind of the average cost? I know you guys take insurance, but if you don't have insurance what are you looking at?

NERI: $57.

LOMAX-REESE: $57 for anything?

NERI: For anything, yes, for a sick visit, for the physical, the limited physicals that we do. There are some pointed care testings that might be a little bit extra like a rapid strep test would be $13 extra. A urinalysis would be $8. So there's a few incidental fees on top of that $57 sometimes. 

LOMAX-REESE: Have you guys been really busy with all this flu going around?

NERI: Yes, very, very busy, which was a good thing because we could keep people out of the emergency department. They didn't need to be in the emergency department for the flu unless they had more severe complications. We saw an awful lot of people. It was standing room only some days. 

LOMAX-REESE: Wow. We are talking with Lisa Neri and she is the certified registered nurse practitioner for Einstein's Fast Care Center here at the Brown ShopRite and it is a healthcare facility, a healthcare clinic that provides, sounds like, pretty broad spectrum of services for people who can just walk in, whether you have insurance or no insurance you will be seen and you can do it while you are shopping. 

NERI: I will clarify. We are not here to replace the primary care provider and we do not manage chronic disease. This is for acute minor illnesses in particular. This is no the place that you would come to to manage your diabetes or to evaluate your chest pain or acute shortness of breath. We will refill medications for people to bridge them to their next appointment with their primary care provider because for some reason sometimes you just haven’t been able to make that appointment and you are down to your last couple pills and we don’t really want people stopping their medications so we will bridge them to their next visit.

LOMAX-REESE: And what is the relationship with Einstein Hospital? So if somebody comes in here and their blood pressure is through the roof, do you triage them to Einstein or what is that process?

NERI: We would. It would depend on their symptoms and their presentation. If warranted we might even send them to the emergency department, but if not, we would be in contact with their primary care provider to see if they would like to make some medication change at the time or to initiate some medication and then get them in the next day or so to see their primary care provider. 

LOMAX-REESE: Final question. I am sure you have worked in other healthcare settings other then here in Brown ShopRite. What's the biggest difference of working within a supermarket as opposed to in kind of a freestanding healthcare setting or in a hospital? 

NERI: Well, you never know what's going to walk through that door. 

LOMAX-REESE: The element of surprise.

NERI: I have no schedule. I would say that one of the really nice things about having the clinic here is how much the community seems to appreciate us being right in their neighborhood. I think that's very much appreciated by the people here where you mostly need to take a bus or walk where you need to go and I think that having Einstein right in their shopping center has been a benefit to many of the folks here. It is easier to get to sometimes then the doctor's office or to take two buses to the ER.

LOMAX-REESE: I bet. Well, I want to thank you. We have been talking with Lisa Neri. She is a certified registered nurse practitioner here at the Einstein Fast Care Center in the Brown's ShopRite here on Cheltenham Avenue. Thank you so much.

NERI: Thank you.

LOMAX-REESE: All right. I know you have a lot of work, a lot of people waiting on you so we will release you. Thank you so much.

NERI: Thank you.

LOMAX-REESE: We are going to go back to our conversation about nutrition and healthy eating with Dr. Donee Patterson and with our nutritionist, Theresa Shank, who is with Einstein, the registered dietician outpatient for Einstein. Before we switched gears, Theresa, or during the break, I wanted to ask you about meat and I know we just have a few minutes left, but that's such a complicated question. Do you eat meat? Don’t you eat meat? The health benefits or the health detracting elements of meat. Tell us what your take is on meat.

NERI: Everyone can eat meat. Meat should not be considered a bad food. There's no such thing as a bad food, but when you are choosing your meats, you want to make sure, even aside from if you have heart disease or not, you want to always choose the leaner meats, typically chicken, turkey or fish. Red meat - yes, it can be healthful in some ways, but it is higher in cholesterol and saturated fat then the leaner meats that I just mentioned. So when you do buy red meats, or even pork, you want to make sure that you are buying a leaner ratio. So look for the 90/10 cuts of beef. Those are 90% lean with 10% fat. Ground turkey also is a good option to have as well. There's a lot of people asking well is turkey better then regular meat or not? Ground turkey also is just as lean as a 90/10 ratio of red meat. In terms of deli meats, you want to make sure to always ask for a reduced fat, reduced sodium version of a deli meat. A lot of people I don't feel know that that's an option to have. 

LOMAX-REESE: Because if you don’t ask for the low-sodium they are very high in salt.

SHANK: Very, yes, very, very high in…

LOMAX-REESE: Even the turkeys and things like that?

SHANK: Right, right, so the turkey, whether it says smoked or roasted, that implies that there's more salt because in that cooking process added salt is involved. So, yes, even the reduced sodium versions can have up to 380 milligrams per two ounce portions so it is always best to choose that reduced option.

LOMAX-REESE: All right. Well that is great information. We are just about out of time. This hour has flown by. We have been broadcasting live from Brown ShopRite here on Cheltenham Avenue. We've been talking with the Einstein docs and we've been broadcasting right out in front of Einstein's Fast Care Center right in front of the Brown ShopRite here on Cheltenham Avenue. Final thoughts, Dr. Donee?

PATTERSON: Well, as usual, we have a $25 gift card, ShopRite gift card of course, that we are giving out to anyone who can answer the very simple questions that we have posted on our Einstein Facebook page. You can go there and the first person that answers it will get a $25 ShopRite gift card and I want to always encourage you to remember your children and remember what they're eating because we are the ones shopping for our children. Encourage them to eat fresh fruits and vegetables and we want to encourage you to eat less processed foods and to really monitor the salt in your diet. It is possible and if we do the homework ahead of time we can decrease the long-term risk of diabetes and heart disease and high cholesterol. Let's do the homework and let's think about picking something new every week, a new fruit or vegetable. 

LOMAX-REESE: And, Theresa Shank, do you have any final thoughts?

SHANK: Right. You can buy those new fruits and vegetables around the perimeter. Remember always try to shop the perimeter. Buy reduced fat versions of your meats and your dairy products and also try to set up a goal weekly with you and your family so that you can have the healthier advantage.

LOMAX-REESE: I want to thank everyone who was responsible for us being here today, Jeff Brown and Sandy Brown and Mark Blackwell, who helped us set everything up here at ShopRite and, of course, our Einstein specialists and experts, Dr. Donee Patterson and Theresa Shank and Lisa Neri, who is right here at the Fast Care Center at Einstein's center here in the Brown ShopRite. Come on down and there's a few more healthy snacks. You can get some good ideas for the SuperBowl, that hummus and some apple and peanut butter, good things for your kids, good things for you. We are out of time. I want to thank you guys so much for sharing such great information. Next up is Keeping It Real with Al Sharpton. Remember to make health your number one priority. Celebrate the healer within and always, always practice peace. Namaste.


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