UVA Health System Blog

Stories about the patients, staff and services of UVA


Vim & Vigor: Angelina Jolie, Genetic Testing & Controlling Diabetes

On February 7, 2014 | At 8:39 am

In August 1982, Thomas P. Loughran Jr., MD, was working in Seattle when a woman with a mysterious blood illness was transferred to his hospital. That patient and her condition changed the path of Loughran’s research forever.

Sudden cardiac arrest patient Helen Trimm with dog

Read about patient Helen Trimm’s cardiac arrest scare in Vim & Vigor.

Loughran and his research are featured in the Spring 2014 issue of UVA’s family health magazine, Vim & Vigor. Check it out for stories about:

  • Angelina Jolie’s double mastectomy and BRCA1 and BRCA2 genetic testing
  • Controlling diabetes without drugs
  • How much to hover when your kids are playing
  • The jobs that are hardest on your heart

Read the online version now.

Live in Virginia? Sign up to get Vim & Vigor in the mail for free.


Recipe Review Thursday: Citrus-Beet Salad

On February 6, 2014 | At 10:30 am

We’re trying new heart-healthy recipes every month and will share the results with you. All recipes are from Club Red, UVA’s heart health club for women.

Citrus-Beet Salad
Beets are one of my favorite vegetables. I like them so much I don’t even mind the red hands I usually end up with after chopping them.

beet-citrus saladTip 1: Always make sure you’re wearing an apron when you’re dealing with these guys, as their beautiful shade of red will manage to find itself on your clothing without you even noticing!

Beets tend to be characterized as having a very earthy flavor that people often don’t enjoy. The citrus in this recipe cuts that earthiness out entirely and gives it a sweet and tangy taste. They also can take awhile to cook, and although I followed the boiling instructions in this recipe to make my salad, you can cut the cooking time down by buying canned beets or using your microwave to speed up the cooking.

Tip 2: Wait for the beets to cool all the way before dicing them. Your hands will thank you later.

This salad is a great, refreshing pairing with any main dish and makes great leftovers for lunch the next day! Usually green salads with dressing don’t hold up very well but this is a salad that will hold out for a few days.

Stars: 3.5 out of 5

Filed under : Healthy Living,Heart,Recipes | By
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Watch These 10 Quick & Easy Healthy Heart Habits [VIDEO]

On February 3, 2014 | At 8:52 am

Worried About Your Heart Health?

These 10 Quick Heart Tips will help you get started on the road to heart health. Watch now!


Sports Concussions and Traumatic Brain Injury: Making the Invisible Visible

On January 30, 2014 | At 9:00 am

In the last few years, American culture has become more conversant in the language of concussion and traumatic brain injury (TBI). Press coverage of both military veterans and football players experiencing extremes such as suicide has forced these tough-minded institutions to investigate and treat these unseen and often ignored injuries.

Concussions, TBI from football, military action, falls, accidents all proper care.UVA, the NFL and TBI

UVA’s brain injury team, in fact, has played a leading role in performing the research and services to help treat and prevent brain injuries that occur on the field or in the line of duty. Both neurologist Michael Jaffee, MD, who has facilitated information-sharing on concussions between the Department of Defense and the NFL, and neuropsychologist Jeff Barth, PhD, member of the NFL Players Association’s Mackey-White Traumatic Brain Injury Committee, came to national attention for their work in a recent book and PBS documentary, “League of Denial.”

Donna Broshek, PhD, credits the NFL publicity around brain injury for raising awareness that has helped all athletes take concussions seriously.

“Now that the NFL is publicizing concussion safety and supporting concussion legislation for youth, it has had a big impact. We used to talk for years about safety and concussions and people would think we were making a big deal out of a minor injury. Because of so many publicized, very sad stories of former NFL players, it’s raised awareness of concussion safety.”

Broshek, and her colleagues Howard Goodkin, MD and Jason Freeman, PhD, are members of the concussion advisory committees for Charlottesville and Albemarle school systems. Broshek and Goodkin are also actively involved in the concussion management programs at St. Anne’s-Belfield School. Broshek points to another change with a major impact on the safety of young athletes: “Virginia passed a state law in 2011 mandating public school education and concussion safety protocols. It’s made a huge difference. Schools have to worry about sports concussion now; they have to manage it and follow a protocol for managing it, so the awareness has really increased. People realize you have to take it seriously, you can’t ignore it.”

The Double Whammy: Why Concussions Get Worse

So what makes a concussion so harmful? According to Broshek, it’s all about 1) the invisible nature of brain injury, and 2) the risk that increases when more than one concussion occurs.

Broshek explains, “People tend not to realize the seriousness of concussions because they can’t see them. An ankle break, knee brace – it’s so obvious that there’s an injury. A brain injury? It’s often invisible.”

Failing to recognize when a concussion has occurred and not getting appropriate rest to allow the brain to heal leaves people vulnerable to more concussions. For people under age of 24, “if they get a second impact within a very short period of time, it can cause exponential problems. So it’s really getting people out of activity after a concussion, giving them some time to rest, and beginning a gradual return to activity.”

The severe problems experienced by former NFL players seem to occur after years of “concussions and multiple subconcussive blows, just hit after hit after hit after hit with no rest periods.”  Rest is an important part of concussion management.

TBI and Concussion: It’s a Chemical Thing

What makes an injury a TBI, not just a concussion? “It’s an indication of severity. Concussions fall within the realm of mild brain injury. People often think TBI means that the injury is permanent,” Broshek says. “Most concussions cause temporary symptoms.”

“The interesting thing about a sports concussion is basically it’s a transmission of forces to the brain, so it doesn’t necessarily have to be a hit to the head – even a hit to the body can cause forces to be transmitted to the brain.”

For example, “when you’re watching a sporting event, and you see two players collide, and one player might get hit hard in the chest and the head snaps back and forward and what that actually causes is an acceleration-deceleration injury. The brain is moving back and forth in the skull, and that causes a metabolic disruption in the brain,” says Broshek.

This explains why concussions have been so invisible and ignored: Because this kind of injury typically doesn’t affect the structures of the brain, CTs and MRIs (brain scans) typically don’t show damage. “So you won’t see anything on an image, but it causes a neurochemical change so the chemicals that keep the brain functioning smoothly tend to get disrupted,” she says.

How the Brain Reacts After a Concussion

Perhaps surprisingly, the neurochemical reactions following a physical blow are responsible for the symptoms of a concussion. Because the brain operates on glucose, when the concussion happens, “The brain needs more glucose to get back to its starting point, but at that point the body can’t deliver the glucose to the brain, so there is an energy crisis in the brain. And that’s why people feel dazed, some people pass out, have a loss of consciousness, feel confused, or nauseous … anything that the brain does could be disrupted – all the thinking abilities, the brain’s ability to maintain your balance, and vision problems such as double or blurred vision.” Symptoms start to disappear as the chemicals in the brain return back to normal.

Concussions don’t just happen to athletes, of course. Little kids might fall out of trees or off bikes; seniors come in having experienced falls and car accidents. Broshek explains that both the very young and the very old tend to have more severe accidents and their injuries can be more complicated and harder to recover from, 30 days or longer.

How to Recover from a Concussion

The first thing a concussion requires for healing: Rest. Not only does the brain need to reset, but people should avoid physical activity that could risk another injury while recovering from the first.

Broshek’s advice is simple: Get good rest, eat well and avoid alcohol. Recovery time depends on gender and age, but is usually 5-10 days for a healthy adult.

Broshek emphasizes, though, that going too far in the direction of rest can actually be unhealthy for a healing brain. “Exercise is good for the body; you sleep better, think better, it improves your mood. You might not return to competitive sports just yet, but you need to get moving again after an initial period of rest. Exercise helps with cognitive function: Memory and learning. We recommend a gradual return to physical activity under the supervision of an athletic trainer so that exercise is started gradually while symptoms are monitored.”

Complicating Factors of TBI

Despite all the pioneering research the UVA team has done and continues to perform, Broshek underscores that “there are a lot of people who have played football, but not everybody has had those kind of devastating neurologic injuries we hear about in the media, so we don’t really know why some athletes are at greater risk for a poor outcome than others.”

For her, concussion injury often depends on factors unique to the individual. Broshek and other sports team health care providers recommend a baseline cognitive and physical assessment of players before an injury takes place, which then makes it easier to detect a concussion when and if it should happen.

“We do see concussions with prolonged symptoms and slower recovery” Broshek says. That’s when she looks for complicating factors like anxiety, history of multiple concussions, learning disabilities, ADHD, or other medical conditions —  all of which can affect concussion recovery.

Understanding the brain remains Broshek’s life work.

“There is so much we’ve learned about the brain — how it works, what different parts do, how the way you choose to think can affect your brain physiology — but there’s still so much we don’t know.  We do know that the brain is the source of who you are – your intellect and your personality – and protecting it is our goal.”

Visit the new Brain Injury and Sports Concussion Clinic


Sleep, Belly Fat, and Making Weight-Loss Last: Q&A Part 5 Fad Diets

On January 25, 2014 | At 9:16 am

In this final installment of our Fad Diets Q&A series, UVA nutritionists Carole Havrila and Katherine Basbaum explain how sleep and belly fat relate and give us their best advice for sticking to a diet plan.

Healthy foods & a balanced diet still rank the as the best way to lose weight and stay fit.

Healthy foods and a balanced diet still rank as the best way to lose weight and stay fit.

Q: Tell me about how sleep and belly fat relate to weight-loss.

Havrila: There is science that validates that elevated cortisol levels (a stress hormone) happen when we lack enough sleep or are consistently stressed out. While these states are correlated with higher cortisol levels and more belly fat, the only way to get that off is to care for the whole body. You must reduce calories and exercise to lose total body weight.

Basbaum: The stomach or abdominal area is indeed one of the more dangerous places on the body to carry excess weight: As fat accumulates and “pads” the spaces between the abdominal organs (“visceral fat”), you have increased risk of metabolic disturbances, cardiovascular disease and type 2 diabetes.

Regarding lack of sleep, that can indeed lead to weight gain; there are specific hunger and satiety hormones (ghrelin and leptin) that can get thrown off if you’re consistently not getting a good night’s sleep. This means that not only will you be likely to consume more calories throughout the day, you will also have more trouble burning them off.

Q. Best tips for sticking to a diet or weight-loss plan?

Havrila: Accountability is a very powerful thing, so if you are really worried you will gain weight then keep a daily log of what you are eating/drinking (you can do this online with apps like MyFitnessPal or Sparkpeople). These keep a tally of your calories and can be helpful to keep you on track when you are considering that extra cookie.

Fad Diets: Final Thoughts

Fad diet advertisements often distort key facts about the body in order to sell their products.

Here are 5 things from this series to remember the next time you’re tempted to believe otherwise:

  1. Detox-diets, cleanses and any plan that removes a food group entirely could put you at risk of missing nutrients you need. If you have health issues, fasts and cleanses can even hurt you.
  2. Diets that focus on eating large amounts of saturated fat found in many meats, butter, full-fat dairy, etc., can be bad for your heart, and that hurts your overall health.
  3. Extreme diets are often so hard they backfire.
  4. You don’t need to cleanse; your body detoxifies itself.
  5. Every weight-loss plan requires diet and exercise to be successful.

What do YOU think?

Was this series helpful? What surprised you? What diet will you try — or try to avoid — next? Tell us below.

Filed under : Healthy Living,Nutrition,Women's Health | By
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Detox, Gluten-Free, Vegan: Best & Worst Diets, Q&A Part 4 Fad Diets

On January 24, 2014 | At 9:08 am

Which are worth trying, which will prove a wash?

Gluten-free foods are gaining popularity.

Gluten-free foods are gaining popularity. But are they really healthy for everyone?

In this fourth installment of our Fad Diet Q&A series, UVA nutritionists Carole Havrila and Katherine Basbaum make their picks for best and worst diets on the popular market.

Q. What about the diets that got top ratings in a recent US News & World Report article: DASH, TLC diet, Mayo Clinic, Weight Watchers, Flexitarian, Volumetrics, Biggest Loser, Ornish, Engine 2, Flat Belly diet, Abs diet?

Havrila: I believe that these diets mentioned do work and can work if followed, and the calories are not severely limited (below 1200 calories for women and 1500 for men). The DASH diet, Mayo Clinic, Weight Watchers, Flexitarian, Volumetrics and vegan/vegetarian diets are all reasonable diets that work successfully when followed. Vegan diets require planning to make sure that important nutrients are included but are healthy diets in general.

Basbaum: For the fourth year in a row — when taking into consideration ease of use, nutrition, safety, effectiveness for weight loss and protection against diabetes and heart disease — US News & World Report has named the DASH diet as the best overall diet for 2014. Why? Because it’s smart, balanced, realistic, tried and true.

 Q. What fad diet makes you cringe the most?

Havrila: Detox diets that advocate large amounts of dietary supplements in addition to restrictive diets and enemas or other detoxification methods. These could potentially be dangerous to those on prescription medications and/or having cancer treatment.

Basbaum: Definitely the gluten-free craze that has been happening for the past couple of years. If you have a genuine, medically diagnosed intolerance to gluten, or if you have celiac disease, then a gluten-free diet is warranted. But as a weight-loss tool, it’s potentially dangerous and may even cause weight gain if you don’t do it right.

Next Up: Sleep, Belly Fat, and Making Weight-Loss Last, Fad Diets Q&A Part 5


Diet Dangers for Cancer & Heart Patients, Q&A Part 3, Fad Diets

On January 23, 2014 | At 8:45 am

It’s one thing to experiment with fad diets when you’re relatively healthy. But people dealing with health issues, especially cancer and heart problems, need to be extra careful.

In this third installment of our Fad Diet Q&A series, UVA nutritionists Carole Havrila and Katherine Basbaum tell us what diet elements could be dangerous and which could help.

Q. If someone has a heart condition or is in cancer treatment, are there certain diets to avoid?

Havrila: For cancer, any diet that would be restrictive in total calories or protein or both would likely worsen the nutritional status of a patient receiving cancer treatment and would not be recommended. This includes:

  • Fasts (juice or otherwise) that are prolonged
  • Severe macrobiotic diets that eliminate many foods and are very low in total calories
  • Any diet that would include the use of high amounts of dietary supplements, as they may interfere with medicines patients use or even interfere with cancer treatments

Basbaum: For heart disease, I’d say stay away from the Atkins-type diets, the ones that encourage large amounts of high-fat animal protein like steak and bacon. These foods are high in sodium and saturated fats, two of the things we recommend eating in moderation when eating for heart health.

Q. What kind of diets aid prevention of heart issues and cancer?

Havrila: In terms of cancer prevention, plant-based diets rich in legumes and beans, fruits and vegetables and whole grains. Meat is a “condiment” and not the centerpiece of the meal. Diets for cancer prevention are controlled in calories to help patients maintain or achieve a healthy weight. Processed meats are eaten sparingly, if at all, and red meat is limited to 18 ounces a week.

Basbaum: For heart health, your diet should focus on high-quality lean protein (both plant and animal-based), low-fat dairy, whole grains, low sodium (less than 2000 mg/day), and having the majority of dietary fat coming from either polyunsaturated or monounsaturated fat sources, i.e. olive oil, canola, nuts, seeds, avocado.

Next up: Detox, Gluten-Free, Vegan, Fad Diets Q&A Part 4


Weight-Loss Wonder Ingredients: Q&A Part 2, Fad Diets

On January 22, 2014 | At 8:54 am

I know, I know: You can’t always trust an infomercial. But we live in a fast-food world, and those of us interested in losing weight would love to find a single magic ingredient to do the work for us.

Coconut oil, turmeric, & other supplements supposedly encourage healthy weight-loss.

Coconut oil, turmeric and other supplements supposedly encourage healthy weight loss.

In this second installment of our Fad Diet Q&A series, UVA nutritionists Carole Havrila and Katherine Basbaum offer a reality check.

Q. What about weight-loss claims for wonder ingredients? Recently, I’ve been curious to see magazines touting turmeric, coconut oil or garcinia cambogia. Can adding just one of these or other ingredients really make you lose weight all by themselves?


  • Be skeptical if the product or diet promises a quick fix, if it recommends approaches based on limited, hard-to-find studies or a single study, if it lists good and bad foods or if it sounds too good to be true.
  • Do some research on credible websites.
  • Ask your dietitian, doctor or pharmacist to help.
  • Understand that diet pills and dietary supplements are not regulated as drugs are. Therefore there is a risk of contamination or a risk that products marketed and sold with these ingredients may not even have these ingredients in them.
  • Remember, some weight loss or diet pills have been associated with liver failure and even death.

Basbaum: When it comes to specific foods or herbs that are touted in the press as miracle weight-loss foods, remember a couple things:

  1. If it sounds too good to be true, it probably is.
  2. Even if there is some solid evidence that supports its weight-loss claims, you still have to do all the other things that are traditionally needed for weight loss if you want to see significant results, i.e., healthy diet and exercise.

Next up: Diet Dangers for Cancer & Heart Patients, Fad Diets Q&A Part 3

Filed under : Healthy Living,Nutrition,Women's Health | By
Comments : 2 |

Juice Cleanse? Think Before You Drink: Q&A Part 1, Fad Diets Series

On January 21, 2014 | At 8:10 am

I’ve known people who have gone on juice-only diets for months and lost tons of weight, as well as people who have lasted only a day. I’ve been tempted to try one myself. After all, who doesn’t like juice? Who doesn’t want to be clean?

Juice cleanses have high sugar.In this first installment of our Fad Diets Q&A Series, UVA nutritionists Carole Havrila and Katherine Basbaum give their take on juice cleanses and other plans that remove entire food groups from your diet.

Q.  Juice cleanses: They’re very popular right now. Do they really work?

Havrila: Any plan that eliminates entire food groups (except for vegan diets) and has people eating only select foods for a length of time is very hard to follow. A juice cleanse is hard for many to do as it is a fast of sorts. People need to be prepared for hunger and possible GI side effects of an all-juice diet. Anyone with diabetes or significant health issues runs the risk of dangerous side effects from a juice diet.

Basbaum: “Cleanses” that last 2-3 days may help someone jumpstart a weight-loss effort, but unless you plan to transition immediately from the cleanse to a healthy eating and exercise plan, as soon as you return to solid food, the weight will return.  And as far as the “cleansing” abilities of these diets, it is unnecessary; your body naturally detoxifies itself every single day.

Also, since so many of my heart patients also struggle with type 2 diabetes or pre-diabetes, I would hesitate to recommend a diet that included so much liquid sugar.

Q. The Mediterranean diet hit the news this year, and I constantly run into people who rave about the Blood Type Diet. Thoughts on those two?

Havrila: Studies have shown that people eating vegan diets or a Mediterranean diet have less incidence of some diseases. These two diets often are followed by people who have healthier lifestyle practices in general.

The Blood Type diet, however, is one of those diets that does not have the science behind it, yet has people avoiding certain foods entirely, so they may be risking missing out on some important nutrients. (What is the Blood Type Diet? There’s new research about it out today.)

What do you think? Have you tried these diets? Did they work?

Tell us in the comment section below.

And come back tomorrow for Weight-Loss Wonder Ingredients: Fad Diets Q&A Part 2


Fad Diets Q&A: The Truth Behind the Hype

On January 20, 2014 | At 10:00 am

I’m a sucker for fad diet advertisements. And it’s hard to escape them. They’re everywhere, from the grocery aisle to TV to Facebook. Fat-melting miracle pills, body-shaping supplements, diet plans that are easy and fast and require no exercise at all.

Such amazing claims! If you’re like me, you can’t help but fixate on them. Crammed between pictures of anorexic celebrities and mountains of shiny candy, these diets seem like they could be real. If one of them works, I could eat the candy and look like a celebrity, no problem.

There are actually quite a lot of problems with most fad diets. Like many at this time of year, I’m embarking on a challenge to get fit and lose weight.

The fit part is key. As a woman in my late 30s, I know that heart disease is the number one killer of women. It’s time to get in good shape.

Could Any of These Fad Diets Help?

The short answer? No, according to nutritionists Carole Havrila and Katherine Basbaum. Havrila works for the UVA Cancer Center, while Basbaum is a clinical dietitian for UVA’s Heart & Vascular Center.

Fad diet books tout quick weigh-loss plans.

Fad diet books tout quick weight-loss plans. How many do YOU own?

Their advice? When it comes to weight-loss, “if it sounds too good to be true, it probably is,” Basbaum said.

So, which diets deliver and which offer empty promises and calories?

Stay tuned for our nutritionists’ answers to all your fad diet questions, including:

  • Are juice cleanses safe?
  • Which fad diets work?
  • What are the most effective of the popular diet plans?
  • What diets prove healthy for people with cancer or heart concerns?
  • Do wonder ingredients really make a difference?
  • What does sleep and belly fat have to do with weight loss?

First up: Juice Cleanse? Think Before You Drink, Fad Diets Q&A Part 1

Look for Part 1 tomorrow!