good morning. this is "news 4 your nday." hello. i'm pat lawson muse. the holidays are here and they're not only a busy time, but fo many they'r stressful time. they can take a toll on your physical and mental health. so how do we make the most of the season without letting the season get the best of us? we've invited a group of doctors to give us their best advice. the gw school of medicine and health sciences focuses on chronic disease management, minority health, sexual health and obsity. welcome, dr. knight. >> thank you for having me. >> is it safe to say that most of us gain weight during the

holidays. >> that is true. >> how much? >> the average american is going to fin at lease pounds during the holiday season. if you're dealing ith weight challenges, it could be as much as ten to 15. >> is that weight that tends to stay on or people tend to take off after the holidays are over. >> the average person not dealing with weight ises will take that off over time. many of us will have a new year's resolution of losing er weight, so time that will come off. maybe you've been losing some weht in the fall season and now you've gained an additional five pounds, a lot of times that takes you off track and can lead you to a path of weight regain. >> we wait all year for the holidays, for the pecan pie and sweet potato pie. you've got treats at home, h treats whe family, with your friends, at the office. os it possible to get through thedays and enjoy the food that you've waited so long to

savor withong ruin your health? >> it is possible, and that's what i want to tell patientsth whe come to see me. if i tellthem, i want you to not eat what you love, they'll t nod andome back and see me. be strategic about doing it. i want you tny things in moderation, not all the time. 's almost like you get four free tickets. i want you to use those tickets very wisely. you're going the use that ticket when you have that favorite aunt who brings theri fa dish that you won't get all year. >> only four tickets'l if. >>give you an extra one. >> recent data shows americans continue to put on the pounds, severe obesity is rising in this country. clinically speaking, what's the difference between being overweight and being ese? >> those are terms that correlate with the body mass

index, something we calculate based on your height and weight. it's different for everybod meone who is only 5'1", a certain weight can be okay for them or even overweight. but someone w is 6'1", that will be different on them. you can easily look online. >> the longer you remain overweight, does it do longer term damage? >> definitely. when we think about chronic seases that affect so many people in the community, whether it's high bloodp ssure, diabetes, cholesterol, a variety of issues are affected by excess weight. that's why we take it so seriously. >> so in terms of strategies, you mentioned the tickets. pick wha you want and use -- eat small >> yes. . >> does that work psychologically? >> it can work. >> does it satisfy?

>> it can be satisfying. a lot of people ll skip meals before the holiday dinner, i won't have breakfast or lunch so i can use my room for dinner. you're get there, ravenous and you've run out of your four tickets. forget the tickets, i'oing to enjoy. have a small meal. don't come to the dinner extremely hungry and look at what's in front of you. say, you know, i'm going have some of that, some of that and i'll pass on that. enjoy and savor the meal. eat slowly, don't eat too ra idly. a lot of times people think as soon as the food hits my stomach, i'll feel full. it can take up to 20 minutes for your brain to realize yore full. take your time, enjoy the conversation. after about 20 minutes, look back at the buff and say d i want seconds or not? that's the strategy about kbg minds ul when it co eating that helping a lot of patients. >> are people beginningo accept the fact that we are getting heavier? >> i think it's boming more of

a norm for patients. a lot of patients will say, i don't want to lose too much ight because people will think i'm sick. it's become normal to see people that are a little heavier. we kno wit's correlatth health. i don't want you to lose weight because i want you to have a certain size dress. i want you to be healthy. i want you to avoid the progression of the conditions that affect the community. >> dr. michaelknight, i have my five tickets. >> use it wisely. how tove p unnecessary injury during the winter holidays. we'll be right back. managing my type 2 diabetes wasn't my top priority.

until i held her. i found my tresiba® reason. now i'm doing more to lower my a1c. once daily tresiba® controls blood sugar for 24 hours for powerful a1c reduction. tresiba® is a long-acting insulin used to control high blood sugar in adults with diabetes. don't use tresiba® to treat diabetic ketoacidosis, during episodes of low blood sugar, or if you are allergic to any of its ingredients. don't share needles or insulin pens. don't reuse needles. the most common side effect is low blood sugar, which may cause dizziness, sweating, confusion, and headache. check your blood sugar. low blood sugar can be serious and may be life-threatening.

injection site reactions may occur. tell your prescriber about all medicines you take and all your medical conditions. taking tzds with insulins like tresiba® may cause serious side effects like heart failure. your insulin dose shouldn't be changed without asking your prescriber. get medical help right away if you have trouble breathing, fast heartbeat, extreme drowsiness, swelling of your face, tongue or throat, dizziness or confusion. i found my tresiba® reason. find yours. ask your diabetes care specialist about tresiba®. holidays can leave you stressed, overweight and, if you're not careful, injured. joining us is dr. raj rau, orthopedic surge at gw's school of medicine and health

services. we don't necessarily think of the hol or of winter as a particularly dangerous time. butou say it a time that we really need to prepare for? >> i think that's right. winter is not a dangerous time. ree holidays not a dangerous time. they're a time to have some fun and enjoy the outsided enjoy the snow and have fun. but we do need to be careful because it's not part of the routine for the rest of the year. our environment is different. the types of w activities do are sometimes different. we need to be mindful about the way we do things in the witter. >> ware some of the most common injuries that you see in your practice during winter and during the holidays? >> some of the simle and c things we see are people getting up on ladders trying to put ornaments up on the christmas tree or getting up on a ladder trying to put lights up in or around the house. if the ladder is not secure or if they lose their balance on the ladder, it's very easy to

stumble, fall and sustain anything from a minor sprain to a moreignificant fracture. we every year unfortunately seem to find ourselvesalking about someone who has died from shoveling snow. people who exercise all year long can still be susceptible to injury when shoveling snow. what is it that we need know about doing that? >> well, most times nothingisad oing to happen when we're shoveling snow. but sometimes, particular if we're older, or if we have pre-existing coronary vessel disease which is when the blood 't get to the heart muscle as well as it should, if we don't have good blood supply to art muscle, sometimes when it's cold outside, ande ife exerting ourselves shoveling, the muscle nds even more blood

supply and if it doesn't get it, then sometime the muscle of the heart can die and that's what's known as a heartck at >> and does this just happen to the person who has a cardiac issue? can it happen to someone who has no problems with their cardiovascular -- le who an happen to pe don't know they have any problems, but typically there is some underlying cardiac disease which predisposes the indivual to get that heart attack while they're shoveling. >> when you talk about preparing for the change of the seasons, preparing for the gold, the tough season, the hard season, what are some of the simple things we should do to get our ready. and minds is stretching sufficient? >> i think stretcher is not just for winter, it's all year-round. it's good to being limber and have axe regularcise program. it doesn't need to be anything vigorous. itimcan be ase as walking, swimming, a gentle bicycleri .

these should all be good enough for most of us. but specifically for the winter, there a lot of simple things we can do. we've got to make sure that we have sho that have good tread on them, that don't allow usto slide or fall on a slippery surface. make sure you have gloves that have good padding. if you do stumble or fall, you can protect yourself a little bit better. >> you mentiongloves. i wear them, but winter is very painful. i have arthritis in a couple of myfingers. does the cold makewo thatse or is it just in my mind? >> no, it's not innd your some people will get flare-ups t joint pain in winter time. if that happens to you, make sure you bundle up.e mare you get layers of clothing, and you should be okay. >> what's your best advice forgetting through the hlidays

d enjoying them without the stress of worrying abo all of these things? >> i think bundle up, stay warm, use a ladder cefully and sensibly, if you need to put ornaments up on your christmas tree or put lights up. when you're shoveling, don't try to finish the whole driveway or lkway in one session. spread it out over several sessions. use the shovel sensibly, bend at the knees. don't try to fillle the w shovel off with snow and toss it off to the side. >> like i. >> but use the shovel to push the snow out of the way. i think you'll have a good winter and good holiday see zblon if you like to run and walk, you see people out there in terrible weather. they're the diehards. they run, they jog, they walk and you think, well you should do that in the warmer weather. they are very committed to get

out in snow and cold temperatures. sometimes they wear shorts and they're still running. >> if you're able to dot, if you're comfortable doing it, if you're well rotected from the cold, i think it's good to do. >> well, we are glad to know that a little g stretching will a long way during the holiday season. thank you, dr. raj rao of gw's orthopedic surgery department. coming up, the season and the risk to your physical and mental health. c

they say, atin age you just stop caring. i wonder what age that is. simply ageless foundation with olay. tones, hydrates, and reduces the look of wrinkles. from covergirl. stress is bad any time of ut the year,he holidays can really give you the blues. dr. ian choi is a professor ofne medit gw mentals o services. dr. brian lieberman. we all know that stress is bad, ut when you know you're in trouble and need to seek help?

>> just because it's a holiday time, it'si herbal important not to push off listening to the signs that your bodys giving you. if you ear developing chest pain, shortness of breath, palpitations, you shouldn't wait until after the holidays to seek medical attention. you're just as vulnerable at that time, maybe more vulnerable. >> you say december is a tough time c fordio patients or patients who are at risk having cardio events. >> that's right. it's colder in the winter. blood vessels are more restricted. it's going toraise your blo pressure. that will increase the likelihood of developing problems. op of that, it's the holiday-related stress on top ot that an contribute to problems. your body is, you're having more adrenaline, stress hormones are elevated, blood pressure is higher. if you have a predisposition, to heart disease, one might be

diagnosed at that time. ev >> dr. lieberman, people get the holiday bes. are the folks who get holiday blues people who get the blues during the rest of the ea >> if people suffer from some kind ofn, a medical depress they're going to be at greater vulnerability for any kind of stress and theid hs come with a lot of stresses. >> what are the most common triggers? is it associating the holidays with a negative event? is it the lack of light? expectations? >> es, the brain is probably the most complicated organ in r body, it's also if most unique. there can be as many reasons for the holiday blues as there are individuals, but there a clustering things. one problem is expectations. people expect the holidays should be a time of joy. oftentimes they remember back to their childhood, to the best holiday eve i wh doesn't quite meet up with that expectation, they fees

as ething is wrong. there's also a lot of pressure during the holidays, the to pressurave the perfect christmas tree, the perfectis chas party. for people with financial difficulties, it can be particularly difficult. >> dr. choi, you've told me that hristmas and new year's are the days when you see more heart attacks than any other days of the year. >> that's right. in the northern hemisphere it's christmas and new year's and i think the reason is people are putting off seeking medical care. if you're starting the have symptoms, you shouldn't wait until after theid hs. you shouldn't tell yourself, i'm just going to take care of entertaining my guests and relatives over the christmas holiys and i'll make that appointment first thing in the new year. if things are going wrong, seek medical attention at that time. >> you've also mentioned the super bowl. >> it's intereneing. ery interesting study that i read that shows how important

stress is in contributing to heart disease, is they looked at very tight super bowl games. inhe fans that live the losing team's town were more likely to have heart tacks than those on the winning side. >> unbelievable. m >> streses a difference. >> for both of you, we know stressful events like death or divorce, moving, a breakup can imact your health. recent studies show even small daily stress factors impact you over the long haul. >> your body has this natural fight or flight response to stress. if it's always there, if you're always under low levels of st ess that canill contribute to having elevated blood pressure which makes it more likely to develop heart disease. >> dr. lieberman, does that contribute to depression? >> it does. shot-term stresses can actually be good for us. they're certainly not pleasant, but they ca help us to grow emotionally. those chronic every day constant

stress that doesn't go away, those are actually toxic to the brain. they cause an hormone called cortisol, the stress hormone an that can lead to cell death in parts of the brain. >> daily struggles sitting in traffc, for example, trying to finish your responsibilities at rk, getting the kids to school and then to soccer those are stressors. hey're daily and you can't avoid those. >> you can't. most people can deal with them well. i think we could all deal with them better than we do. deep breathing, learning not to take things so seriously. the kindsf chronic stressors more likely to cause long-term damage are the more serious ones, people in abusive relationships, people who work in a xic work environment. those are the ones going on and on every day are the most destructive. >> coming up, some strategies to

help you manage your holiday stress. we'll be right back.

welcomck. now that we know the perils of the holidays, the trick is to get through it, to get through it without having a heart attack or some other health event. dr. rmlie, to get through it with some sense of joy even if it's not a happy time of the

year. what do you suggest? >> i make two suggestions. your emotions are can't make them go away. if you're feeling sad about the holidays, there's a reason for it. you shoulder probably just allow that emotion to express itself. at the same time realize you may be doing things to make it worse. our brains work in two modes, present mode and future mode. for some reason we tend to spend the majority of our time in future mode, what do i need to prepare for the next thing, what's coming next? what do i need to expect? what ought to be happening? that's stress mode. in the holidayas s it's important to put yourself in the present, enjoy tie bel lights. enjoy the sounds, enjoy the happiness around you anddon't worry about what's going to happen next. >> that sounds very simple and sounds satisfying. >> and it's very hard, very difficult to do. >> dr. choi, you mentioned salt and alcohol which are tough to

avoid during the month of december. >> it's hard to avoid because when we're in that holiday seas we're outith company, sometimes we're not preparing our own foods. at that point -- especially for patients that have different cardiovasclar diseases, if they have a history of atrial fibrillation, alcohol may kpab bate it. if they have history of heart failure, salt intake could lead to shortness of breath. akese are the things where the holiday season us out of our normal routine. the things we're supposed to avoid are harder to avoid. the key is making sure that you don't lgoverinduring the holidays as well. >> you both suggest doing things with people. everybody doesn't have family. everybody is not married or coupled and everybody doesn't enjoy drinking and partying.lo we down and we tend to eat more. group activities? h>> ik group activities are a great way that, even if you'ri h guests coming in from out

of town and let's say your normal exercise routine that you're not able to avoid because you have company over, find a group activity tonjoy as a family. it's ali great way to soc with your friends or perhaps relatives and well as get in a nice workout. >> what about people who really prefer to be alone and don't wanu to be a others during the holidays? >> they just have to accept that and not feel bad about it andha say's okay, everybody is different. but i would recommend they give it a true. somtimes there's nothing than makes us more unhappy than thinking about ourselves. if we can be with other people, thinking about other people, it's a lot more enjoyable. >> does life get better in january and february? >> it gets worse. we have the darkness of the winter and not the celebrations to look forward to. short days in january and february are difficult. from an evolutionary point of view, that's a time when we're supposed to slow down. in our modern world we can't.

we're driving ourselves against our biology. >> dr. choi? >> your cold makes a difference. blood vessels are more restrictive. it will make thin difficult on your heart. that's the reason why the winter months are so difficult for patients with heart disease. >> your advice to heart patients during the winter months? >> my advice is don'tet out of your routine. if you have an exercise program, stick wi make sure you take your medications. no one knows your health better than your doctor does. if you have a relative coming from out of town andu gives strange advice -- never happens in my family in case they're watching -- make sure you stick with your regiment. >> dr. brian choi and daniel lieberman, thank you. happy holidays to you. >> that's "news 4 your sunday." i pat lawson muse. thanks for watching.

we are in weather alert mode. good morng, i'm adam tuss. >> and i'm an give gogie goff. this rain hasd.ot stop >> it's really annoying. >> and record breaking. >> didn'te break a record for the wetst day. >> for yesterday? i'll have to double check on that. i knt -- >> it's in the top 10. straightur facts >> i saw it. it's been an insane amount of rain. >> i know we set a record yesterday f