Fitness Facts & Ideas – PediaCast 409

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  • This week we review bicycle safety (hint: helmets are REALLY important!). Then our Pediatrics in Plain Language Panel returns as we consider fitness facts and ideas for all ages. Whether the sun is shining… or it’s raining… or even the middle of winter… we share practical tips for having fun and staying fit. We hope you can join us!

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  • Bicycle Safety
  • Fitness Facts & Ideas

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00:00

Announcer 1: This is PediaCast.

[Music]

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello everyone, and welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike, coming to you from the campus of Nationwide Children's Hospital on Columbus, Ohio.

It's episode 409 for July 12th, 2018\. We're calling this one "Fitness Facts And Ideas". I want to welcome all of you to the program.

Summer is in full swing here in Central Ohio, which means lots of kids are outside on the playgrounds, hiking through the woods, riding bikes. We covered lots of details about summer safety a few episodes back. In episode 406, to be exact, including bicycle safety.

01:13

However, we do have some new numbers out from the Center for Injury Research and Policy that sheds light on the number of bicycle injuries seen around the United States, the mechanisms of those injuries, so what causes them, and some updated tips for keeping your kids safe as they ride bikes this summer.

So, we'll review the data and outline the recommendations for you in just a moment, so that you and your kids can be safe as you ride bikes, which is a healthy thing to do.

Speaking of health and fitness, the bulk of our program this week is going to cover up fitness facts and ideas. And, I love how this comes full circle. I mentioned our summer safety podcast episode 406 and our pediatrics and plain language panel, which is Dr. Alex Rakowsky and Dr. Mary Ann Abrams. They joined me for that one.

02:04

They're back today, only this time, instead of exploring safety, we planned to consider how to stay fit, regardless of the time of year. Whether it's a sunny day, or it's raining, or even in the middle of winter, and whether you're a toddler, a child, or a teenager, or you have one of those living in your home.

What are some things that we can do as parents to encourage our kids to stay fit? Of course, here's a good question: What exactly do we mean by staying fit? What exactly is fitness?

There are lots of angles that we could take. For our purposes, we're going to think about, of course, physical fitness, physical activity, and sleep, and nutrition. We're also going to consider mental health including development and thinking skills, all important aspects for staying fit.

So, it's not just going to be about physical fitness. We're also going to talk about nutritional fitness and mental fitness during all times of the year and regardless of your child's age and that you've done make up of your family.

03:07

We're going to lay down some facts and just as important, perhaps more important, we'll explore some very practical tips for staying fit whatever your age, whatever the weather is outside, whatever the time of year. So, stay tuned for that. I promise this to be a fun and hopefully, very useful, practical conversation for you. 

First, so, I do want to remind you about an upcoming conference we have here in Nationwide Children's Hospital. It is the 2018 Pediatric Pearl conference and we're calling this one "Harnessing The Power of Social Media To Improve Heath Outcomes". It's going to happen here on the campus of the hospital in Columbus, Ohio on Thursday, August 30th, 2018 from 8 AM to 4 PM and we're going to cover all of this for category 1 CME credit. We're going to cover social media engagement for and by healthcare professionals.

04:04 

So, we're going to talk about how do you set goals in social media. What is it you're trying to accomplish? How do you figure out who your target audience is going to be? How do you go about thinking about their needs and trying to match your educational goals with your audience's needs? How do you engage effectively on Twitter and Facebook content creation? How do you find other people's digital content that is useful and share it in an effective way?

And then, we're going to talk about blog writing and then I love this one: troll control. How do you control the trolls? You can't really control them, but you can respond professionally and appropriately when folks attack you online and we're talking about this because we do have a lot of pediatric providers in the audience and I just want you to know about it.

We're also going to cover some general pediatric topics, especially in the afternoon portion of the conference. We're going to talk some pediatric gynecology, gender dysphoria, and youth tongue-tie dyslexia.

05:03 

I know, lots of big words there, but again, a large number of listeners are pediatricians and nurse practitioners, position assistants, nurses, and students of all sorts in the medical fields. So, I just wanted you to know about this conference. I think it would be helpful, kind of a unique one. You know, talking about social media and turning that into continuing medical education because medical providers' engagement in social media is so important.

I have a link for you in The Show Notes for this episode 409 over PediaCast.org. You can find out more information by following that link.

Alright, let's move on to a quick word on bicycle safety. A new study conducted by researchers in the Center for Injury Research and Policy of the research institute at Nationwide Children's Hospital investigated bicycle-related injuries among children treated in hospital emergency departments in the United States and found that despite a decrease in the rate of injuries over the 10-year study period, there were still more than 2.2 million bicycle-related injuries.

06:05 

Investigators published their findings in the journal "Accident Analysis and Prevention". They say between January 2006 and December 2015, more than 2.2 million children, ages 5-17 years of age or treated in US hospital emergency departments for bicycle-related injuries. This averages to 608 injuries per day or 25 injuries every hour.

The majority of accidents involve children 10-14 years of age, 46%, and boys, 72%. The most commonly injured body region was the upper extremities, 36%, followed by the lower extremities, 25%, the face, 15%, and head and neck, also 15%.

The most common types of injury were bruises and scrapes, those represented 29%. Cuts, 23%, overall traumatic brain injuries resulted 11%,of total injuries, or most common among kids 10-14 years of age, 44% of them, and about 4% of patients were hospitalized for their injuries.

07:08 

Injuries most frequently occurred in the street, 48%, or at home, 37%. Helmet use at the type of injury was associated with a lower likelihood of head and neck injuries and hospitalizations, but there was no significant change in the rate of injury among helmet users over the study period.

Motor vehicle involvement increased the odds of bicycle-related traumatic brain injuries and injury-related hospitalizations. Dr. Lara Mackenzie, principal investigator in the Center for Injury Research and Policy and senior author of the study says, "Wearing a helmet while riding a bike is the best way to decrease the risk of serious injuries".

We want parents and kids to keep riding their bikes, but it's important for all riders to wear a helmet. Take your children shopping for bike helmets. You can find ones that fit them and they can choose a style they like. This way, they will be more likely to want to wear the helmet.

08:01 

Bicycle helmet laws have been effective in increasing helmet use among children,but fewer than half the states in the United States have laws and they're not always enforced. Since bicycling is one of the primary modes of transportation for children, it is imperative to make roads safer for kids and decrease bicycle motor vehicle collisions.

Proven provision efforts include share the road campaigns, increasing bicyclist visibility with bright, reflective materials,creating cycling lanes on the road, and providing bicycling education courses.

All important things, but again, the single most important thing you can do to ensure your child's safety on a bicycle is to make sure he or she is wearing a properly-fitted bike helmet and you should wear one, too, to protect your own noggin, yes, but also to model the importance of wearing a helmet for your children.

Alright, let's move on, a couple of really quick housekeeping items.Don't forget you can ask a question if there's a topic you'd like us to talk about here on the program. Easy to get in touch, just head over to PediaCast.org and click on the contact link.

09:06 

Also, I want to remind you, the information presented in every episode of PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. So if you have a concern about your child's health, be sure to call your doctor and arrange a face to face interview and hands-on physical examination.

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at PediaCast.org.

Let's take a quick break and I will be back with our pediatrics in plain language panel, Dr. Mary Ann Abrams and Dr. Alex Rakowsky as we consider fitness facts and ideas that's coming up right after this.

[Music]

10:14 

Our pediatrics in plain language panel joins us again this week. You were called that Dr. Mary Ann Abrams is an assistant professor of pediatrics at the Ohio State University College of Medicine and a pediatrician with a hilltop primary care center at Nationwide Children's Hospital and Dr. Alex Rakowsky, also an assistant professor of pediatrics at Ohio State and a pediatrician with Olentangy Primary Care at Nationwide Children's.

I really appreciate, as always, both of you joining us again this week.

Dr. Alex Rakowsky: Thank you.

Dr. Mike Patrick: Dr. Abrams, let's actually start with you. As usual, the beginning of these pediatrics and plain language episodes, just remind us. What do we mean by plain language?

Dr. Mary Ann Abrams: It's nice to be here again, Dr. Mike. Thanks and nice to have a chance to talk again about plain language and how important it is.

11:00 

Plain language just means using words, living room language, words that we understand in day-to-day, usage, not special technical terms or words that have a special meaning in medicine or in other technical fields like law or mechanical stuff with your car.

And also, just to keep in mind that no matter what the word we use is, it can sometimes have special meaning to people and they may not quite understand what we mean so, it's always good for us as expositions in nurses and members of the healthcare team to make sure people do really understand by asking them to tell us in their own words the important information that they need to know or to act on when they go home.

Dr. Mike Patrick: Can I have them teach back? No?

Dr. Mary Ann Abrams: Perfect, exactly.

Dr. Mike Patrick: So, I'm telling, these are the instructions in the terms that I hope you understand. But please, tell back to me what it is that I have asked you to do so I could, you know, just double check to make sure that we're on the same level there.

12:00 

Now, there may be terms that people have not have the opportunity to ask their physician about and of course, if you are confused by a particular term or jargon, or something technical, we'd always encourage you to ask your child's doctor about hose questions that you have.

But, let's say that, you know, you don't see your doctor for a while. Folks can write in and ask us, too. Right?

Dr. Mary Ann Abrams: That would be great. We would welcome that and we can learn from that as well because sometimes, we don't even realize that the words we use are confusing to people so, we would welcome questions and even words that present difficultly to people.

Dr. Mike Patrick: Yes, so, if you head over to the contact page at PediaCast.org and there is a topic that you'd like to hear our panel talk about more or there's a jargon, medical terms, technical terms, let us know what those are and we'll do our best to explain those.

So, we're talking about fitness facts and ideas and there's really a lot that we can think about with regard to fitness. And, what we've done today, each of us have taken sort of a different angle on fitness and so, Alex, this episode is going to be talking about physical activity. Mary Ann's going to talk about nutrition and I'm going to talk about mental health.

13:11 

And, we're just going to just sort of explore particularly what you can do as a parent, what you can do at home as a family to really strive for fitness in these three realms. And so, let's start. Alex, just give us a little bit of an introduction to physical fitness.

Dr. Alex Rakowsky: I'm starting to become an older guy so, I've noticed through the years that for a lot of patients and families, physical fitness is more of a definition where they're trying to match up with something that they should be doing I'm a bigger believer there's more of a mindset change.

So, physical fitness is not just going to the gym for aerobic reasons. We're trying to get better lung capacity or you lift weights to get stronger. It really is just to get more active overall in life. I think during this hour, I want to spend more time to kind of discuss ways to increase your daily activity both as an individual and as a family to kind of help physical fitness.

Dr. Mike Patrick: Great idea. And, Mary Ann, what do you think about nutrition as we think about fitness?

Dr. Mary Ann Abrams: I'd like to build on what Alex just said, too, that a lot of times, people have a misconception or they're confused about nutrition and fitness and think that they have to eat either something that's boring. You hear people talk about eating plain food with lots of fiber. They talk about eating straw or grass and obviously, that's not appealing, nor is that really healthy.

Really, I talk about nutritional fitness as having a well-balanced diet that's mostly healthy but, that doesn't mean you can never eat something that's extra special or really delicious because I think the best rule of thumb is moderation in all things. So, don't ever do anything and the other thing is to make it part of your daily habits,the way you eat most of the time.

15:04 

Not going on a special diet every so often, or binging and then not eating. Just building these healthy eating and nutrition habits into your daily patterns.

Dr. Mike Patrick: So, rather than strict rules, it's really just more than overreaching a healthy way to think about nutrition and as we move on with our conversation, we'll talk about some ways, hopefully that are practical for families to do that.

And then, a sort of angle that I'm going to take is what I would consider cognitive fitness.

Dr. Alex Rakowsky: What's cognitive?

Dr. Mike Patrick: See, that is, and we're trying to do plain language here. Cognitive means a term related to the mind. And so, mental health, behavioral heath thinking. So, we're just going to talk about mental health development, thinking, and sort of staying fit in terms of with our minds and our mental health and that's the angle that I'll be talking about.

15:59 

I wanted to begin in each of these three areas just to share some facts. Just some fitness facts, little nuggets of information that parents can use in their families. So, Alex, what are some fitness facts related to physical fitness?

Dr. Alex Rakowsky: So, a few facts, the first is that fitness is not just exercise. It's actually sleeping well, eating well, don't forget to, staying active, being engaged with just activity with yourself and your whole family and loved ones. Some basic facts are that kids who exercise, especially preteens and teens lower rates, statistically lower rates of anxiety and depression.

For kids who do struggle with anxiety/depression, exercise seems to help them out. For families that exercise together, there are lower rates of obesity. For kids and families, adults who exercise are at lower risk of high blood pressure,lower rates of MI's or heart attacks down the road.

17:00 

And, there are actually some studies that have shown. This is mostly European data, that kids who actually exercise, I forget the exact number of minutes per day depending on the study, do better in school because exercise, the theories, that keeps your mind a little bit more sharp.

So, exercise is not just to kind of stay in shape o have a beach body or because my doctor said I weigh too much. It's really just changing the way you physically do things to kind of keep your body more in tune, but it's just like tuning up a car.

Dr. Mike Patrick: Absolutely. And, some nutrition facts that you would like to share, Mary Ann.

Dr. Mary Ann Abrams: I think, the unfortunate fact that is may, or may not be well known is that unfortunately, about a third of children in the United States are either overweight or obese, according to the way we measure those things. When children go to the doctor now, that's once they turned age two, that's something we start to keep an eye on.

18:02 

Because we know how you grow as a young child, predicts how you grow as an older child, as a teenager, as a young adult, and as an adult. And, we're learning more and more about the trajectory or the path that your life would follow if you're heavier as a child.

So, it's a lot easier. We all know as adults to make changer when you're younger so, it's better to try to build these healthy eating and activity patterns, and when children are younger, when it's a little easier for them to make changes, to change that path that they could be on if they are heading to being on heavier weight.

 And, why is that so important? Because we know that when people are heavier, they are much more likely to have problems with diabetes, high blood pressure, heart problems, liver problems, and we are seeing younger children and teenagers having those issues when we never use to see them before.

19:10 

So, changing that is one of the facts that I think is really important to talk about and work on.

Dr. Mike Patrick: I also have some facts that relate to mental health and behavior development type fitness, and I have three of them. They each come from a different book that we have recently interviewed the authors for on PediaCast. They're books that the audience is familiar with but they're just little nuggets that of information that I wanted to pull out that are evidence-based and they're all in the links in the Show Notes. I'll put links to each of these books.

The first one comes from Dr. Anne Zachry's called "Retro Toddler" and an article that was reported in the annual review of psychology that she talks about which was published in this article by Kean and his colleagues in 2011.

20:01 

 Basically, this article said,"To develop problem solving skills, toddlers need to be adaptable, curious and persistent." Those are three characteristics of toddlers that you can nurture in order to improve their problem solving skills later on life. So, I just wanted to think about each of those three descriptors.

Adaptable. What does that mean? Really, it's okay.

Dr. Mary Ann Abrams: Doctor, what's a descriptor?

Dr. Mike Patrick: Very nice. So, a thing that describe. Descriptor, a word describing or trying to make it more clear. What does it mean when we think about kids being adaptable, curious or persistent? And, in terms of adaptable, you know, one way you can think about this is, kids often times get disappointed. And, a lot of times, parents don't want to disappoint their kids.I mean, 'cause you want your kids to be happy and you want to be happy as a family.

21:00 

But, it's okay to sometimes disappoint them and to redirect them and say,"Hey, I can be happy with something else." Or, any different situation or, you know, we didn't get to go to the zoo today, but maybe the alternative thing that we're going to do can be just as fun and a lot of that depends on how a parent sort of redirects the conversation and finds fun things to do and so, as you teach your kids that it is okay to be disappointed about one thing.But, hey, we can get excited about something else and that can help to promote adaptability.

Also, we want to encourage kids to be curious and toddlers ask a lot of questions and it's really easy to get sort of tired or the questions and just to give quick answers and move on to something else, but those questions are important.

So, you know, keep encouraging your kids to ask lots of questions even when it annoys you because that will help their curiosity. And then, don't squelch persistence, encourage it.And, even sometimes, reward it. 

22:02 

So, you know, the kid keeps asking for the same thing, over and over and over again, rather than just know. Maybe as they ask again and again, figure out a way that they could get there. You know, maybe you can't have it now, but we could do it later, so to encourage them to be persistent about some things or if they're failing at something, you know to encourage them to keep at it and keeping persistent.

So, anyway, just some characteristics that might help in the future. I think that's a fact that's born in research. And then another, this one I found interesting. This one was reported by Tracy Cutchlow and her book is "Zero to Five: 70 Essential Parenting Tips Based on Science" and she reported a survey among mothers who are married and have a household income of at least $50, 000 a year. These are the moms that she rooted this project surveyed that she reports on.

22:58 

And, it said that 75% of these mothers said that working part time or not at all would be ideal so that they perceive that "If I could not work, I could stay at home" or "If I could only work part time, then I would be happier".

So, she looked at research that sort of compared moms who worked full time, part time, and not at all in the realm of mental health and so, she has the references in her book. 

But, what the research study has found is that one, parent mothers who work part time compared to stay-at-home moms actually had less depression. They had better general health than stay-at-home moms. They had less social isolation, which then affects mental health and they also had a greater ability to develop new skills which also affects mental health.

 And there, that now, part time moms compared to full time work.There was less work family conflict and there was more sensitive parenting compared to both stay-at-home moms and full time moms.

24:04 

So, the sum of all that would be just to consider if it's possible, one parent working part time, if you can afford it, if you can plan for it and that could affect your child's fitness by one parent being there. And, you know, managing these other fitness parameters of a child, you know, their physical activity, their nutrition, you know, that sort of thing. Parameters, I know, parameters is bad.

These fitness ideas, sometimes it's hard coming up with other terms. But, this will likely improve the mental health, not only of the family, of the kids, of the parent, and so just, you know, consider, and it doesn't have to be a mom,I don't think. I mean, you could have a full time mom and a part time dad, but just this idea that having one parent who is not at the work site 40 hours a week.

You know, maybe helpful if you could swing it. Obviously, not everybody can, right?

24:57 

Dr. Mary Ann Abrams: I think the other is that, a parent who is home is also feeling fulfilled in sort of the adult part of their life, too, because they do get the chance to go out and do work in whatever form that is, which is a positive thing.They get some social relationships in their work and they'd feel good about that, too, so, they're happier, whether it's the mom or the dad so they are able to do all these other parenting things. It's how far it gets.

Dr. Mike Patrick: So, something to think about. And then. my third one comes from this article and I would get to where the book was in just a minute where they've reported on this. But, should we be weary of overscheduling our kids? And this came out of this journal of school health in August of 2011 written by Steve Brown and his team.

And, the name of the article was "Are Kids Too Busy? : Early Adolescents' Perceptions of Discretionary Activities, Overscheduling, and Stress".

26:00 

I know there's come big words there. So, basically, what the research did is that they look to 882 kids. They were all ages 9-13 at 9 different health education centers in the United States and the surveys just ask lots of questions about home and school life. And, it measured children's feelings that they needed more free time, that they just didn't have enough time to do the things that they wanted to do.And then, also, just their levels of stress like, how stressed do you feel that you are?

And, they did find some patterns and that these kids were more likely to feel like they were overscheduled, that they needed more free time and that they were more stressed if these things were true:

One, if they had 3 or more hours of screen time every day. So, the thought is, I mean that screen time you look at, well, that could have been free time. But, if you're spending 3 or more hours of your day in front of the TV, suddenly there's all these other things you have to do and people are demanding of you, and you feel like "I don't have enough time to do everything and I'm more stressed", but if you decrease the amount of screen time that may actually help you not feel stress cause then you would have more time.

27:09 

Dr. Alex Rakowsky: And this would be fun screen and this would be really worth it.

Dr. Mike Patrick: So, this is more discussion. This is more…

Dr. Alex Rakowsky: …fun stuff. Yes, on my own.

Dr. Mike Patrick: Things I want to do, not the things I have to do. Okay, and then another thing that was associated with this. It's harder not to use technical terms, isn't it? 2 or more hours of nightly homework. So, I mean, this is something schools should really pay attention to. The kids feel more stressed, more like they don't have enough time to live they're in school all morning, all afternoon and then have more than 2 hours of homework at night.

So, I mean, that's one way that parents can have the key for their kids within school districts and school should partner with families to maybe, cut that down a little bit so, it's not more than 2 hours.

And then the third one I thought was interesting is that when kids choose activities by themselves. Without the input of their parents, they're more likely to pick too many things and get overscheduled.

28:06 

And so, if parents partner with their kids and say, "Okay, let's pick which of these two activities are most important or do you think you's like to do the most?" But, it's easy as a parent, you know you want to encourage your kids to be successful in everything they do and the next thing you know, they're involved in baseball, and they're swimming.

And, you know, there's just too many things to do in one time that maybe if parents help their kids with scheduling, that could help them out. And then, by the way, these ideas of scheduling and being overscheduled kind of come from a book by Pam Lobley, who we've also had on this show called "Why Can't We Just Play?" and she introduced something called the "Do Nothing Summer" where her family has an experiment of just, "We're going to take a summer and not do anything." Not doing anything scheduled, they're just going to play, but, you know, sleep in a little bit, have fun, do some fun things in the neighborhood,but not scheduled the whole summer".

They didn't do it every summer, but they did it as an experiment and their kids really enjoyed it and I'll put links to all of these shows or all these books in the Show Notes and if any of you are interested, just search for those authors and you'll find the PediaCast where we interviewed those.

29:09 

Dr. Mary Ann Abrams: I think that's a good point whether you do it a whole summer on being scheduled or not. But,a lot of people look for child cared in the summer, and a lot of times they say,"I'm just looking for somebody to drive my kids everywhere." That's because kids don't drive. 

And, I think people tend to get into this mindset of,"I need my child to be going, doing something official, even if it's just taking them to the pool." But, all the time, and just this idea of unstructured, unscheduled time where the kids come up with what they want to do and they stimulate. It causes them to make fun things out of ordinary objects or make a game out of something every day. I think that is what is getting lost in our highly structured society and also with the screen time.

30:04 

You know that you can get your answer right away on Google. You can look things up so you don't get time for that creative and critical thinking.

Dr. Mike Patrick: Absolutely.

Dr. Mary Ann Abrams: Can I ask another question? This is a real question about you. When you talk about that article, you said thought looked at kids in health education centers and I don't know if you got to answer that, but what is a health education center?

Dr. Mike Patrick: That is a really good question and I wondered that myself, and I was hoping you wouldn't ask me, but, the article just described it as that, and I don't know if that's I consider an after-school program, or we don't really know how it operates.

Dr. Mary Ann Abrams: It would be interesting to find out.

Dr. Mike Patrick: See, sometimes, we don't even know the answers and we admit when we don't. So, I could have just made something up. Alright, let's just become role practical here. So, as we think about physical, nutrition, and mental health, what are just some ideas this summer that families can put into practice in terms of helping their kids stay fit?

31:09 

I thought what we'd do is sort of think about it in terms of toddlers, school age kids, and teenagers as we think of these things so that parents, regardless of how old your kids are at home, unless they're infants, to choose some ideas. So, Alex, you want to start with physical fitness.

Dr. Alex Rakowsky: I think there's some overriding or sorts of concepts that can be used for any age. And I'll start off with, get the whole family involved.

So, there are a lot of things you could do as a family that can involve any of the age groups and I think it builds up a bonding like some of the books that you mention where support that kind of have that bonding built-in.

The second thing is, keep it fun. So, fitness shouldn't be like,"I have to go run 5 miles or I have to go to gym for 2 hours". We do things as humans so we find them enjoyable. So, mix it up, try to find something that you find enjoyable and it kind of comes to the third point is, be creative.

32:00 

And, a lot of people tend to think,"I don't have money for the whey or the park is too far away". There may be other things you can do fitness wise in summer that  you don't think about in the traditional way, but sort of think outside the box. So, I think those are like 3 caviars. They kind of start of with all of the sort of the age groups.

For toddlers and actually any of the ages, I love walks. Most cities will have like a park system of some sort and even in Ohio where we have like some more harsh strains and we're talking about this before the program.

You know, summer time around here is gorgeous and you could always go in the evening to a park in their parks that are really everywhere. If you don't have a park near you, then there may be just a safe walk. You could walk around, I enforce you work on a clinic that is not in the best thing we're going to have. You know, families are afraid to go for walks in the depth of winter, but in summer time, they feel comfortable doing it.

32:59 

In a lot of schools, we're actually open after playgrounds in the summer time for kids just to play. So, if you are in a neighborhood that does not have a park or is not safe at the neighborhood for a walk at night, there are school districts like, for example, we both work in a place called "Hilltop Clinic". The schools near our area actually open up their playgrounds during the day and a lot of other parents say it was really a safe place to go.

So, for toddlers, just get outside, do things, explore. It may be something simple as we're not going to the water, we could just go to the park to a swing one day, heavy walk around one day, playing the sandbox one day, etc.

As far as, let's say older kids, right?

Dr. Mike Patrick: School age kids. Most such as playground stuff, too and taking for walks, you could do all those things.

Dr. Alex Rakowsky: And then you could start adding like, the pool and where you could actually have a lot of public pools open so, Columbus for example, has a fairly good public pool system. Again,most cities tend to have that and then just try thinking outside the box for weekends when you have the time.

34:01 

So, you could go canoeing and there are some places where it's very affordable just to kind of go down a safe river or go putt putt golfing or go for a hike, you know, 3 miles away at some sort of state park or national park.

So, with the older kids, I think you could even start expanding a little bit more. Plays fortune ever did before. So, for example, throw a baseball around, go shoot hoops, and you know, playing basketball, golf, throw a football. Join a fight of football sort of, you know, pick up league which a lot of places have just, you know. 

Like, in a town, we live as a pick up soccer league. So, you can come like a Sunday afternoon they'll pick people and you can just play a game. For people your level. I'm not playing against Messi because it'd be painful for Messi, and Messi for me.

And then the last, for teenagers, you can even expand it even more. So, in that kind of situation, there are places that have like outside climbing walls.

35:00 

We have a park here in the city that has an outside climbing wall. For two dollars you could have a teenager go up and have a walk a couple of times. You can do more adventurous things like, now you can do canoeing or you can do kayaking or go to a park that's a little more challenging or you know, drive a little bit further 'cause you're not worries about toddlers fuming in the back seat. You can drive 2 or 3 hours to a kind of state park and go hiking.

So, a lot of these outdoor activities keep it fun, I'm a big believer in keeping it mixed up. I think people like variety, and they may like something that you never thought about before and a lot of the park systems, a lot of the libraries have brochures about things that are going on and it just may be worth while just to kind of check upon it.

I know how it comes alive in the sort of earth wave spring, summer and fall like 5K's for example. You may not be a runner, but you can walk a 5K and help raise money for a cause which teenagers really like to do and then in some activities, you get to meet other people, you get a t-shirt, you may get a ribbon.

36:04 

So, I saw it once, you know I have to be a runner to do that.

Dr. Mary Ann Abrams: You've made me think of a couple other things, Alex, ice skating. You know, summer time is a great time to go ice skating, especially if it is boiling hot because that it a great way to cool down. People may think of skating in the winter, but you made me think about indoor activities when it's really hot.

And the other thing is, if you're only going to have two things for your children, I would say, get balls, get a Nerf ball that you could play with inside and a round rubber plastic ball. It's amazing what people start to do when it's just sitting there. People will pick it up, they'll throw it, they'll shoot it, they'll kick it, they're play for square, what a great universal tool toy.

Dr. Alex Rakowsky: I want to mention cornhole because it's a mid-west thing. I grew up in the east coast. I had no idea what cornhole was.

37:04 

So, I'm going to have to define this because I think it's plain language to define cornhole. So, it's essentially just like this big wooden ramp you could throw on bean bags into and it doesn't make any sense to actually play it and that's a great sport and you know, it;s not really aerobic, it's not really sort of, like, you know, you're not going to like decrease your blood pressure. It actually might increase your blood pressure playing cornhole against people.

But, as long as those activities were held by kids, "Let's go outside and play cornhole". It may be hot, but you could sit in the shade while you're waiting for your turn and everyone goes outside and the next thing you know, it sort of deteriorates until," I'll just go play football" or "Let's go for a walk" because now you got him outside.

So, it's a great one just to kind of get people and you can actually live like in a townhouse or old house and just having your front lawn and have neighbors come by and just play cornhole.

Dr. Mary Ann Abrams: And people join in.

Dr. Mike Patrick: So, I left her on frisbees, but the ones with the cut-out in the center, they're way easier to throw.

38:06 

So, if you have a regular frisbee, I'll have a little trouble, you know, guiding it where I want it to go. But it just seems like the ones with the holes in the middle are a little bit more predictable. So, if you're new at frisbees, those ones are sort of a ring. I would encourage you to try one of those out. Those are fun to throw.

Okay, so what about nutrition in the summer time?

Dr. Mary Ann Abrams: Well, the first thing I think that comes to everybody's mind, the thing we hear all the time is stay hydrated. Right, so, you know…

Dr. Alex Rakowsky: What does stay mean?

Dr. Mary Ann Abrams: Don't move,no. Hydration, it means drink plenty of liquids and the best liquid to drink is water. I think the myth here is because of advertising, everybody thinks,"Oh, I'm running around or it's warm, so I have to have a sports drink" and we know that sports drinks in general are not that good for you.

38:59 

They're full of sugar, they have a little bit of salt. But, for the most part, you don't need a sports drink unless you are going to be out working really hard for a long period of time on a really hot day. 

So, water, cold water, you know, put it in a pitcher, keep it in the fridge so it's cold when you come in and you're warm or put it in a water bottle. You could freeze water bottles and then take them out with you so they stay cold and kind of melted at a course of the day. You can flavor them with sliced fruit. Drink plenty of water so you pale up and feel active and don't get dehydrated which can make you feel, you know.

Dehydration means you don't have enough water in your body, and then you start to feel tired and you can even have other symptoms that are worse.So, having the right approach to drinking lots of liquids anytime, but especially when it's hot. 

Another thing I think is really fun, especially in the spring or early summer,but even throughout the summer is to in a kind of ties in with activity for all ages because different ages come to different things is go pick fruit.

40:07

You know, strawberries, blueberries, peaches, apples in the fall. It's such a great activity. It's physical and toddlers can pick little bits of berries and other kids can pick buckets full or baskets full.

So, you learn, your in touch with nature, your picking healthy foods and then you can take them home and make all kinds of fun things with them so you get creative, you get healthy, you can free some, you can make a fun dessert, you can have fun salads.

So, thinking of those kinds of activities, hey, it's a great fitness activity and it's also a great nutritional activity and it's outdoor.

Dr. Alex Rakowsky: I've had a few patients who the parents say,"My kids won't eat any vegetables at all" and it's a common sort of finding in a lot of towns and cities don't have community gardens.So, the mom one year just decided or like few of the moms decided to just to kind of get involved with community garden right down the street from them.

41:01 

And they kids, when they try the tomato off the vine the first time or cucumber off the vine the fist time, they were like,"Oh, these things are very good". Next thing you know, the kids get a little bit more adventurous.

So, when you have the garden, it's also a physical activity and two, just tasting a fresh fruit or vegetable is amazing for a lot of kids.

Dr. Mary Ann Abrams: Specially when they're the ones who help to grow it and take it home and then help prepare it. You know, whether that means cutting it up with a plastic knife or making a recipe or taking some fruit and making a smoothie with it, with a little guidance depending on their age. It's sort of like, farm to table so, it's a great way, again, active, healthy and it's obviously a great thing in the summer time because so much produce comes in.

Dr. Mike Patrick: And with the community gardens, it is easy even if you live in a city to be able to find some greens based to do that.

Dr. Alex Rakowsky: We have a community garden in front of one of our clinics and there's always some space where parents or patients can come by and say,"I'd like to have 2×2 plotting".

42:03 

Dr. Mary Ann Abrams: And then, you know, another kind of rule of thumb is the best way to think about what you eat is to think of half your plate being full of fruits and vegetables and then the other half is divided up between a protein which is usually made of sometimes fish, it can be beans, it can be beef, chicken, pork, turkey and then the other one fourth of the plate is what we call grains which can tend to be a confusing term that refers to things like potatoes, bread, tortillas, rice, spaghetti.

So, kind of thinking about, especially again in the warm weather, it's easier to have half that plate be fruits and vegetables and to get the kids thinking about,"How am I going to make this like, half fruits and vegetables?" It can be easier than you think.

Salad goes a long way and a few went picks some berries, you got those and kind of thinking about it in that layout, you can even get those divided plates at the store to help everybody kind of stay on the pattern.

43:07 

Only one serving of grain per meal, you can have all the fruits and vegetables you want.

Dr. Mike Patrick: And folks, if you want a visual of that, I think MyPlate Taco is a great place to stop. Half my plate last night at dinner was vegetables because we had these green beans that you know, the squeaky kind and my wife put just like a teaspoon of maple syrup and then heated them up, and then they were just so delicious. I know there were some carbs there…

Dr. Mary Ann Abrams: That sounds so good!

Dr. Mike Patrick: Carbohydrates, sugars, it was really good, but not overdone. So, it was delicious.

Dr. Mary Ann Abrams: You made me think of another, specially summer time thing that teenagers might be a little bit more interested in but younger kids, too, it's a great time to try the herb garden and again, herbs can be kind of adventurous eating for some people, but for others, it's not, but it's a great chance for people to start finding ways to add flavor that doesn't just include salt and pepper or sugar. 

44:06 

So, trying to grow a couple of things like maybe some chives for chive and onion flavor, some basil and also to get people used to those flavor because they're not used to those. It's easy to say,"I don't like those".

But, we know it takes a lot of time to learn to like a new flavor. I tell people 15 to 20 times, it's just like training your muscles. You train your taste buds and you have to acquire, learn those new flavors.

So, growing your own herb garden even if it's just one or two is another great activity and you can even do that year round in the house.

Dr. Mike Patrick: Absolutely. As we think about mental health in the summer time, the bottom line here is to get outside for me, too.

In toddlers, just getting them outside and letting them get dirty. You know, I mean, obviously, you're going to supervise them, you want to be safe, you don't want your child eating rocks. But, it is okay to get dirty.

45:08 

You know, just to get outside and play in the ground and you know, with whatever it is, whether it's cars. You know little cars, you make it roads or you're playing with the shovel, and digging, and whatever it is, it's okay to get dirty and a lot of times I think we, you know, kind of would don't want to have to clean up messes and sort of avoid that.

And then the other thing is is really do something out of your every day-to-day on occasion. So, if you live in the city, you know, visit a farm. There a great farm for those in Central Ohio. It's not too far of a driveway. It's between here and the Dayton area called Young's Jersey Dairy and that's a fun place to go. You can see them milk the cows, they have corn mazes and in the fall, they have putt putt mini golf, but there's also lots of farm kind of stuff there you can do or see. And if you live on a farm, visit the city.

46:01 

The Columbus Short North has a gallery hop the first Saturday of every month. That's really a lot of fun. You could take your older kids and even some younger kids, too, through their and just look at art and you just sort of experience of the city and just something different than your usual day-to-day in terms of, then, that helps mental health in terms of development and thinking about new things and other things, being exposed to stuff. I will put a link to those two places in the Show Notes.

Whatever zoo in your area,  a lot of times, they'll have free educational programs, that can be fun. And then this is something that doesn't cost any money at all that I think older kids and teenagers would really enjoy that we'd do from time to time with our kids and that is. to have like a scavenger hunt in Metro Park or State Park, really, you can do this anywhere.

And, one of the ways that we do is we come up with a list of items and this is especially for older kids who have phones and cameras on their phone.

47:00 

And so, then, whatever this list of items is, then you have to go take a picture of an example of those items and then you get back together and everybody votes on who took the best picture related to that one and you can tally it up and get recreative, you know, a scoring then they can get a pic where you're going to go up for ice cream or something and then they get a pic where you're going to go, you know, the winner. You know, it's just something fun, different, get outside.

Dr. Alex Rakowsky: And, people might think that it's kind of whole, keep up one. The Pokemon game came out two years ago with every kid in the neighborhood wandering around looking for Pokemon which weren't even real so, anyway, so people say, there must have been a chance of a teenager coming out, taking a picture of a flower, but they're going out trying to find Pikachu in the imaginary space and it literally got hundreds of thousands of teenagers outside the house so, it's actually a great idea. There's a proof that it worked.

Dr. Mike Patrick: Yeah, I was playing it.

[Laughs]

And, I think, especially if you do it as a family, as as kids, school age kids, you're sort of nurturing  this family time in doing crazy fun stuff like that and you just sort of make up and be creative.

48:08 

The more you do that as a family, the more, especially when they're younger than when they get older, it's not as you know, it's not as crazy.

Dr. Alex Rakowsky: If I can have the mental health stay busy and unfortunately, we've been seeing, along we have a lot of teenagers with suicide ideation currently admitted and in clinic, we're seeing,"Oh, you missed that completely".

[Laughs]

So, kids are actually thinking about taking their lives, unfortunately, suicide ideation.

Dr. Mike Patrick: They have the idea of suicide.

Dr. Alex Rakowsky: Even at clinic, I've seen a lot of depressed teenagers and actually, the common thread we've been seeing in a lot of these patients is,"I have too much to sit here on the house and think and during at school, I have some structure, I have my friends. During the summer, I'm just in the house and you know, doing nothing".

So, I think it's important for teenagers to do something.

49:01 

'Cause, if your friend got outside and find Pokemon or do some kind of activity, get a ball, you know, cook together, just to kind of have an hour to a day to kind of get give structures and a lot of families, unfortunately, are busy with jobs where it's hard to find out time to kind of teens during the day,but have the teens come up with something for like an hour a day where they get to meet other teenagers, other people from the family, just to kind of things,you know, that are more fun.

Dr. Mary Ann Abrams: Another nice thing that's free, especially for kids, teens may enjoy the art at the Columbus Museum of Art. They have free four-hour sessions on Thursday evenings where teens could come and explore different kinds of art and technology, tech things.

So, it's no cost and again, it's cool, like, it's also cool if it's hot outside and it's something that they may not thought about or known about and I don't know, did you mention festivals, Mike?

50:03 

Dr. Mike Patrick: Oh yeah, no.

Dr. Mary Ann Abrams: 'Cause we have so many in our community and those are free.

Dr. Mike Patrick: Those can be really a lot of fun 'cause you could go explore a different place and a lot of times, they sort of center around some theme you know, just like the corn festival, strawberry festival.

Dr. Alex Rakowsky: Dandelion festival.

Dr. Mary Ann Abrams: And you may try different foods, too. Whether it's funny ways to have strawberries, or pumpkins, or apples, or ethnic foods that you might not try otherwise, too.

Dr. Mike Patrick: Yeah, this is something that does cost a little bit, maybe it's not something you do every summer, but have you ever been to see Tecumseh.

Dr. Mary Ann Abrams: Yeah, that's awesome!

Dr. Mike Patrick: The outdoor drama. I highly recommend it, I think it would be great, especially older kids, teenagers would love this. It's an outdoor drama featuring this particular one. But, there are scattered ones around the country, too and there may be a different one in your area. But it's an outdoor amphitheater and this one features the life of Tecumseh who is a legendary Shawnee American, native American leader.

51:03 

And, it's just the time of European expansion in the Ohio in the late 1700's and just the life and there's lots of horses, there's action, there's a lot, you know, canon fire and a good story that's been going on for 45 seasons at the Sugarloaf Mountain Amphitheater in Chillicothe, Ohio and I'll put a link in the Show Notes or so.

But, I think you know, it's just something to getting different. You know, and especially, in terms of development and thinking and it's that you can talk about it all the way home. You know, how did that make you feel? Yeah, good stuff.

In the summer, we had a pretty good summer so far, this year but, you know, sometimes we get these strings of rainy days. So, as we think about physical fitness, nutrition, mental health, what are some things more indoor activities for rainy days or even in the winter time, you know, that we could think about?

Dr. Alex Rakowsky: There's a lot of things you can try inside and it really depends on the budget size of your house. So, if you do have like, a garage or basement, you can put a cornhole in or you could have a little bit of a kickball then, definitely kind of set that up.

52:09 

We'll set up a pingpong table sometimes in the basement where we can just have the kids you know, as they've gotten older, we use it less and less, but you got to play pingpong in the depth of winter and still get some activity.

A lot of our patients live in a park bench or VRBO homes so they don't have this much space, but even then, they have these videos that you can watch that you do exercise along with them.

So, for example, you could do zumba and get a YouTube video of doing Zumba for 15 minutes at home and there are literally hundreds of these videos that you can get, depending on the age group, your interest, who you favorite character is, you know, you can actually dance with the Disney princesses for toddlers and it's just amazing that right you can get just off of a cellphone.

If you could hook up to your screen, great. If you just have a little screen, then the kids could still see it.

53:01 

So, using your cellphone as a resource to kind of do some dancing at home or any kid of activity.

Dr. Mary Ann Abrams: That thing is great exercise.

Dr. Mike Patrick: And, kids love to do it.

Dr. Alex Rakowsky: We have something called "cardio blast" which makes much rooms. It has like this 15 minute. It should be on our website. It's this 15-minute sort of exercise regimen, I'll give you a copy that we can PyPost. Kids can just do it and you literally need your room and on a staircase to get this done and then,the staircase can be replaced with something else. It's like running in place, walking in place, doing crunches, doing lunges, doing jumping jacks.

It's actually kind of fun to do and we've had some of the kids compete against each other how much they can, how many lunges they can do in that 30-second time frame that you're doing them.

Dr. Mike Patrick: For the littler kid, you could combine that with a like, "Mother, may I?" you know, kind of thing.

Dr. Alex Rakowsky: A lot of schools and churches actually will have evening open time. Specially, if you live in an area where a lot of families can afford YMCA's or some of the rec centers.

54:03 

One rec center, so, for example, Columbus does have a few rec centers and most of these do have… I grew up in Philadelphia and rec centers were boys and girls culture, literally everywhere.

And then, the second thing is that a lot of local schools and their churches will have like a Tuesday afternoon open gym where usually, it's monitored by a few parents and a lot of times a lot of teachers would volunteer to do this.

We actually, my oldest two sons volunteered in a place in the Hilltop, one of which is a basketball league. I'm on a place called "Ronda Race" and it was just essentially an open evening where the local kids could just kind of come and play basketball or just goof off and it was chaotic. They did it as sort of High School volunteer hours and they loved it. 

It was a great way for these kids to kind of come on a rainy day and just expend some energy and it ran basically, all fall, winter and into spring and it was just phenomenal.

55:00 

And again, it was a free program for the kids. And, just be creative. There's a lot of things you can do physically. I mean, getting up from your studying, just walking around.

And then, for cold weather also, I love cold weather, someone does odd balls that likes to walk in the snow and I like it when let's say, 20 degrees outside and speaking of afternoon, we just actually did a study that show that walking in the cold improves your immune system.

So, every time I walk outside and it's very cold, I convince myself I'm helping my immune system, but my wife and I both love the cold, so there's a lot of nice walks you can do for a little snow on the ground and they are fairly safe. It's just really nice when you're walking outside, seeing the snow fall.

Dr. Mike Patrick: You know, we hear and you probably hear parents say this a lot, "You know, if you get cold, then you're going to get sick". Like that, it hurts your immune system, but it's viruses that make it sick. Exposure to those in the wintertime when everybody's indoors and close together in the classrooms and, but not necessarily the cold.

Dr. Alex Rakowsky: Actually, the studies have shown that the more you get outside within reason.

Dr. Mike Patrick: Yeah, we're not talking about hypothermia.

Dr. Alex Rakowsky: You can actually get, you know…

56:02 

Dr. Mike Patrick: I said hypothermia.

Dr. Alex Rakowsky: I completely ignored that. I'm sorry. Water.

[Laughs]

Dr. Mike Rakowsky: Cold, cold. Your body is cold.

Dr. Mary Ann Abrams: Too cold.

Dr. Mike Rakowsky: Yes, too cold.

Dr. Mary Ann Abrams: A really good point of getting outside, even when it's cold. It is a common myth with adults you get sick. Just that whole message of dressing layers.

You know, put on a sweater, put on a light jacket, put on a heavier jacket, put on a hat, and have some gloves, and as you get active, you can shed that top jacket and you may shed the next one, take it off.

So, it's fine to be outside and even if you get a little wet, you're playing in the rain, and it's not icy or something like that, get outside.

Dr. Mike Patrick: And, even…we're talking about rainy days. You know, if there's not lightning and thunder, and it's not a torrential downpour with you know, high winds, tropical storm, hurricane kind of thing, you know, kids can enjoy going out and playing in the rain.

57:02 

Dr. Mary Ann Abrams: Totally. The muddier, the better.

Dr. Alex Rakowsky: As suppose as if you're a dog.

[Laughs]

Dr. Mike Patrick: And your kids with your dog.

Alright, so let's think nutrition for those rainy days.

Dr. Mary Ann Abrams: Rainy days and winter, so, the bad weather days.

So, a couple of things that come to my mind, again, it's coming back to,"What can you do with new foods, new tastes, new flavors, or foods you already know that are healthy and nutritious to make you fit?" 

So, finding fun recipes or fun ways of preparing things. We have a handout that we use that`is just two pages of pictures of fun ways to make funny faces, and Christmas trees, and pumpkin faces out of common foods.

So, I think that it is something creative and something fun to do and also may encourage kids to try a food that they might, otherwise, not.

58:01 

And also, trying to involve the kids in preparing the food, again, we talked a little bit before about you know, plastic knife with supervision when they're little, all the way up to actually making dinner for your mom and dad, so it's ready when they get home on a summer afternoon when the parents have been working and the kids have some time.

And, another thing I think, especially in the winter, you tend to think about soup.Soup is such a great food because you don't just have to open a can, you can make your own soup.

You start with some, you know, you can get some broth and you just start adding things and, I go through my refrigerator and I find a little bit of leftover vegetables,and I have a leftover onion, and I throw in a few pickles, and slice a couple of olives, and a little bit of leftover tuna. Well, tuna fish, any chicken, and oh, there's a bottle of salad dressing with half an inch of stuffed almond.

Dr. Mike Patrick: You can make soup of anything.

Dr. Mary Ann Abrams: Yeah, and every single batch of soup is different and delicious.

59:01 

So, make your own soup. There's lot of fun stories about how people make soup. It's a community thing. So, it's a great way to use leftovers and try new combinations of food and it can be pretty healthy, especially if you dump all those leftover vegetables in there.

And, one other thing, the "Local Matters" is an organization here that offers evening cooking classes about 3 or 4 times a month and those are downtown, near Parsons Avenue and you can sign up ahead of time.

They have different themes. The one I went to was "soups" and those were recipes and absolutely delicious. They provide the ingredients, you'd learn how to make them. They're healthy, they're nutritious, they're easy, they're delicious.

You get to take in the leftovers and you basically pay what you can or choose to pay. So, some people don't pay anything, and some people pay a lot.

Kids can go, grandparents can go, married people can go, families can go, but they fill up fast. 

1:00:07 

So, hopefully we put the link to that on the website, too. 

Local Matters is another great way to…and the time I went to the one with the soups, it was a cold, winter night. So, it was just great.

Dr. Alex Rakowsky: If I could put in a plug also for local libraries, we've been in three different cities since we got married and in all three cities, library systems, in all three areas, library systems had cooking classes or some demonstrations in the depth of winter and it seems to be the norm to kind of have these things or these are open to teenagers or even just the families from Arlo collaborative east of town has something for the toddlers where they can actually learn how to do some things really Christmas, decorating Christmas cookies.

But, I think it's a forgotten resource and a lot of libraries usually aren't that booked up in the depth of winter and they'll have some really interesting classes about nutrition and how to cook and usually it's like local people just volunteer their time. They'll just spend time with teenagers, showing them how to make grilled cheese sandwiches for once a grilled cheese sandwich making thing one time in the DC area. I was like,"How complicated can this be?" and after and hour and a half, it was a lot of fun that kids really liked it. I liked it, the best grilled cheese sandwich for the longest time.

1:01:17 

Dr. Mike Patrick: If you check out my Instagram to look for PediaCast on Instagram, I've been posting a lot of pictures from our new Hillyard Library which is part of the Columbus Metropolitan Library System, but it's a new library and they have so many activities and resources. It's just this beautiful new library, I think the largest branch now.

And, I was actually trying to work on some media projects there 'cause it's a nice space to work and overhead, I heard,"Oh, they're having this activity on how to make sound with electricity."

[Laughs]

So, of course. I got to go see this and it's a little distracting. But, a lot of fun, yeah. There's great activities.

Dr. Alex Rakowsky: I think we under utilize our library systems and almost every system has a library system.

Dr. Mary Ann Abrams: And you can get fun cook books at the library for, especially like cookbooks for children so the recipes are simple and again, trying things in different ways, healthy ways, new ways, and that way, you don't have to go buy a cookbook, but check out a couple of cookbooks and do that together or have your babysitter during the summer.

1:02:20 

Make something with your kids instead of feeling that they have to go out.

Dr. Alex Rakowsky: One more resource that tends not to be thinking about these outreach programs for colleges, so you'll actually have Ohio State has an outreach program, community outreach program where you can actually…

We lived here near the New York campus and they'll have there nutrition majors, actually give lectures about certain things.

There are a lot of community colleges and a lot of major colleges who'll have their students and their professors provide free classes for the public.

Somebody stays on the library, somebody stays in their campus, but it's a nice way to see another part of the city that may not be aware of. I don't know, there's a college in my town, but they may have something fun going on and it's usually for free.

1:03:03 

And again, it's called outreach programs and Ohio State has a robust one which we just started discovering this year and I learned how to grow turnips at an outreach program.

Dr. Mike Patrick: Very nice. Yeah, that's great.

Dr. Mary Ann Abrams: And the last plug I have is, don't forget about breakfast.

A lot of people, especially during the summer, kids sleep in. During the winter, they're busy and they'd race out the door and we, adults, also tend to skip breakfast and we do know that even a small breakfast is important to kind of help balance your metabolism, the way your body burns calories throughout the day.

Dr. Mike Patrick: Can you explain metabolism?

Dr. Mary Ann Abrams: Thank you. And, even though you may not feel really hungry, it helps put some energy into your brain so you can pay attention and concentrate whether you're at school, at work or even playing.

And, don't feel stuck with having to have cereal as the only thing. 

1:04:01 

You can have hard-boiled eggs, you can have yogurt, you can have peanut butter on whole grain toast, you can have oatmeal and add lots of fruits and yogurt and things like that. So, and if you want to have one one slice of cold pizza for breakfast, that's okay, too.

Dr. Mike Patrick: Yeah, great ideas. Just to add to that in terms of indoor stuff and winter things as we think about our mental health.Of course, for toddlers, there's lots of fun things you can do indoors and if these kind of save it for those special days.

Whether it's finger painting, or playing with Play-Doh, you know, just lots of things, pick something you don't do all the time and have fun with it, you know, on those rainy days.

For the older and depending on the age of your child and there's lots of different ways to choose from, board games, you know, break out the Monopoly. Break out Shoots and Ladders for the younger kids.

And, it seems now in lots of communities, more and more of these game stores are popping up that actually allow you to play games inside the stores.

1:05:06 

You know, they want you to buy a game. But, they have a table set up and they have a ton of sample games and you can just sit there for a couple of hours and play a new game and decide, you know, if you like it or not.

There's one of those up in the Dublin area that we've gone to several times.

And, I'm sure in your community, wherever you are, just look for these game stores that are sort of popping up. That's a lot of fun, easy, you know, get out of the house but still on a rainy day or in the winter. It can be fun to do.

Speaking of winter, you know, make snow angels, build snowmen, you know, think back to maybe what you did as a kid and if your kids have a chance to do some of those things, it's a good opportunity to go outside and have a little fun snowball fight, lots of fun that we had.

And then, puzzle or you know, thousands of pieces. Rainy days and winters are a great time to work on a puzzle together as a family.

1:06:04 

Or, learn a new card game. When we say, you know, you want to decrease the screen time, but I kind of don't count when you are all around the screen together, doing something interactive.

So, like in our family, we love to play Mario Kart. I know it is screen time, but you are talking to each other and you are engaged and interacting and competing, and there's a social component to that. And so, you know, I don't put that in the same category as sort of mindless television. That makes sense.

Dr. Alex Rakowsky: I also kind of have, we have a funny artist daughter and her goal every sort of major holidays to come up with decorations for like $20 or less.

So, she'll actually go to, we'll go to the dollar store, to like, Hobby Lobby or some place and get cardboard, colored paper, need scissors, some string, and she'll string up like, pumpkins on the front window or she'll string up for Christmas like, you know, angels on the front window.

1:07:02 

And, she's managed to like, 10 different holidays under times of year and everybody comes down and helps her out to do it and it takes a couple of hours. For her, it takes a couple of days. It's a nice activity where the whole family's involved. It keeps you from spending too much time from the screen, unless we're playing Mario Kart and then, it gets you out of the house to buy these things and think creatively.

That's a cheap, really easy thing to do.

Dr. Mike Patrick: Speaking of screens and creativity, also, producing a film. You know, having your kids, you know, they can write a script, they can act it out and with phones, you don't need a fancy camera. Just do it on your phone and if it's good, upload it on the Youtube and share it with the world and you know, you could encourage your kids to do that sort of thing, too.

Well, lots of I think, terrific ideas and hopefully, we've given parents some ideas on how to stay fit this summer whether it's outside, on a rainy days, and even into the fall and winter months.

1:08:00 

Not only physically fit, but also as we think about nutrition and what we're eating, and also just sort of what we're doing activity-wise and behavior in mental health. Hopefully, we've given you some great ideas on that and we have links to a lot of the things that we've talked about in the Show Notes for episode 409 over PediaCast.org.

And once again, I just want to put the idea in your head as an audience. If there are topics that you would like our panel to talk about, especially complex things, maybe, that you'd like to hear explained simply or terms, medical jargon, technical words.

Hopefully, we've caught most of them. I'm sure, if I listened back through all them," Ugh! We should have caught that one." 

But, you know, as physicians, it is difficult sometime 'cause we use these words so often. You know, to really think about how parents are hearing the terms and if there are confusing terms that you've heard and you'd like us to address those or explain them, please write in. Just head over to PediaCast.org, click on the contact link.

1:09:00 

Alright, so, Dr. Mary Ann Abrams and Dr. Alex Rakowsky, both with Ambulatory Pediatrics here at Nationwide Children's. Once again, it was such a pleasure having you in the studio today. Thanks very much.

Dr. Alex Rakowsky: Thanks very much.

Dr. Mary Ann Abrams: Thank you, it's fun.

[Music]

Dr. Mike Patrick: We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. We really do appreciate that.

Also, thanks to Dr. Mary Ann Abrams and Dr. Alex Rakowsky, both with Ambulatory Pediatrics here at Nationwide Children's. We really appreciate them being a part of our pediatrics and plain language panel.

1:09:59 

You know, we're just trying to have a little fun with it. A lot of times, as pediatric providers, as medical providers in general, we do tend to use some big words without always thinking about who we're talking with and what words they've come across in their vocabulary.

And so, we try to not use, but you know, I use technical terms but then try to explain what it is I'm saying. But, in these pediatrics and plain language episodes, we really try to be intentional about catching ourselves using big words and then explaining things in a little bit of a different way. So, hopefully, you're enjoying that.

We're going to have the panel back again in October and next year in 2019\. The plan is about once a quarter to have them stop by the studio and to join us for a conversation, and you're ideas on what those conversations could look like or appreciated as I mentioned, as we mentioned. So, please do head over to PediaCast.org and use the contact page.

A lots of links in today's episode, I'm going to add some more that I've been thinking about, especially for those of you who are here in Central Ohio, just some ideas of fun things to do, whether be summer, or rainy, or winter.

1:11:07 

I mentioned the board game store up in Dublin, Ohio. It's called "Beyond The Board" and I'll put a link to that one. It's a great place to go and just play some games and maybe discover a new game for your family.

I'll also put a link to Tecumseh, the outdoor drama we talked about, the Columbus Short North Gallery Hop, the Columbus Zoo and Aquarium, the Newport Aquarium down in the Cincinnati area, the Center of Science and Industry or COSI is the science museum here in Columbus. It's a lot of fun, you probably have one in your hometown or a big city near you, as well. Young's Jersey Dairy and then those books that we've talked about will be in the Show Notes, as well.

There was a couple of other things to Local Matters and the 15-minute Cardio Blast, all of those link will be on the Show Notes, so check it out over at PediaCast.org. Episode 409 is the one you'll be wanting to look for.

1:12:01 

Don't forget, you can find PediaCast on all sorts of places. We are on the Apple Podcast app, iTunes, Google Play, iHeartRadio, Spotify, most mobile podcasting apps.

If there is an app that you've come across that you'd like to use and listen to other podcasts and PediaCast is not a part of it, let us know and we'll get the show added to their line up, as well.

We also have a landing site as I've been mentioning, PediaCast.org. It has our entire archive of past episodes, so you'll find 409 of them there.

All the Show Notes for each episodes are transcripts, so you could read the content if you'd rather read than listen and our Terms of Use Agreement, very important and that contact page I keep talking about, all there at PediaCast.org.

Also, I want to remind you that we are part of the Parents on Demand Network at parentsondemand.com. It's a collection of podcasts for moms and dads. That collection includes PediaCast, along with many other terrific podcasts for parents, including the Mom & Mind podcast with your host, Dr. Kat. She is a psychologist and perinatal mental health specialist.

1:13:05 

So, what does perinatal mean since we're doing plain language this week? It just means around the time of birth. So, pregnancy, the birthing process, and then when you have a young infant at home, so, she's a mental health specialist, and there are mental health issues that creep up during pregnancy, during child birth, when you bring that baby home.

And, she interviews mom, dads, experts, and advocates to bring light to the difficult parts of new parenthood, including postpartum depression, but extending the many other areas, as well.

It's a very well-developed podcast, over 100 episodes. And, some recent topics include postpartum anxiety, so anxiety after you have your baby, psychotherapy for new moms, healing emotions with self care, the afterbirth plan, so what happens after baby comes home? You know, you may have a birthing plan for the birth, but what-are-you-going-to-do-when-you-get-the-baby-home stuff to consider.

1:13:59 

Also, some shop talk, for other psychologists, as she talks about certification in perinatal mental health so, check that out.

And, as you're checking out podcasts, if you enjoy the podcast you're listening to, please consider leaving a review for that podcast. Whether it's PediaCast or any other podcasts, reviews are so helpful and if you think about it, we all really do depend on reviews as we decide what we are going to do with our time.

So, our family, we're going to try a new restaurant, we're looking at Yelp. If you're going to buy an item, you look at reviews on the Amazon. You think about Rotten Tomatoes with movies.

And so, those reviews really are important and if you enjoy the podcast that you're listening to, regardless if it's PediaCast or other podcasts, it's just so helpful if you can just take a couple of minutes out of your time and leave a review, really important.

We also appreciate it when you talk the show up with your family, your friends, neighbors, coworkers, babysitters, anyone who takes care of kids or has kids and this includes, by the way, your child's pediatric healthcare provider, please let them know about PediaCast so, they can raise awareness among their other families and while you have their ear, let them know we have a podcast for them, as well.

PediaCast CME which stands for Continuing Medical Education. Similar to this program, we do turn the science up a couple of notches and free Category 1 Continuing Medical Education credit for those who listen.

Shows and details are available at the landing site for that program, PediaCastCME.org. It's also available on Apple podcast, iTunes, Google Play, iHeartRadio, Spotify, and most mobile podcast apps. Simply search for PediaCast CME.

Thanks again for stopping by and until next time. This is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long, everybody.

[Music]

1:15:59 

Announcer 2: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.

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