Hello and welcome to living in the Lehigh Valley, a health and wellness show for everyone.

I'm your host, Brittany Sweeney.

Coming up on this episode, there's a new player amongst the Lehigh Valley 's health care executives.

We meet her and her advocacy for one of the region's fastest growing population segments.

Plus, cutting back on sodium.

The FDA is out with some new recommendations for food companies who add salt to their products.

And more on food.

Local culinary experts share ideas on how to make your Thanksgiving meal just a little lighter this year.

But first, Genesis Ortega joins us with a profile of a new leader with one of the Lehigh Valley's health care systems.

Genesis, it's great to see you.

- Likewise, Brittany.

- So what do you have for us?

- Well, Brittany, as you know, the pandemic has really highlighted disparities in health care for certain groups, not just here in the Lehigh Valley but I think across the United States as well.

- Sure.

I actually spoke to a group of health care leaders earlier this year in a round table setting who said the same thing.

It was such an important topic.

- And I've done a lot of reporting through the Hispanic center of the Lehigh Valley and it's crucial for them.

Especially because Latinos continue to be the fastest growing group in the Lehigh Valley.

Within the health care industries, experts agreed that improvements can be made through equitable access for the Latino population.

Astrid Gonzalez Parrilla is the new senior vice president of operations at Good Shepherd rehabilitation network.

She offers a fresh perspective to health care access and highlights some comparisons between here and her native Puerto Rico.

- Astrid Gonzalez Parrilla is new to Good Shepherd rehabilitation network.

- My role here as vice president of clinical operations so I will have responsibility for the inpatient rehab hospital.

I get the honor of working with very smart people that are very committed to the mission of the organization and then we will be responsible for making sure that we provide exceptional service at all levels of care.

- She comes to the organization from Florida, but her interest in health care reaches back before that.

- I am a practitioner.

I can provide care but we have also had experiences on the other side so I have a nephew that survived a car accident.

He sustained a traumatic brain injury so, yes, I have a couple people that have served as an inspiration for me.

- But her main source of inspiration comes from a traumatic experience she lived through as a child in Puerto Rico.

- My mom was an occupational therapy assistant.

My mom survived a stroke when she was only 26 years old.

So I was four years old at the time, and, obviously, she recovered.

I had the opportunity to be exposed to what rehabilitation was and she has been my inspiration.

- And now she uses her experience and her influence to advocate for more representation for people like her across the board.

- We are very fortunate in this country that we have access to care but we need to make sure that we have access to equitable care, which means that we need to have representation of the Latino community at all levels of the health care system.

Right?

So it's not just people in administration, but we need to have people in the medical field because, culturally, it is easier for us to identify with people and to understand the cultural differences.

- At Good Shepherd, she oversees the adult and pediatric inpatient rehab hospitals in Allentown and Bethlehem.

She also has responsibility for the long-term acute care hospital in Bethlehem, as well as long-term care facilities for 160 residents in the Lehigh Valley.

She's using her first few weeks at Good Shepherd to get acquainted with staff.

- I think my first goal is to make sure that I get the opportunity to meet the people doing the work.

We are in an industry that we help people through people.

And I believe that when leaders can connect with the hearts, minds and souls of the people doing the work, we have met our target.

- She meets with directors like Benita Cobham, who oversees professional excellence for Good Shepherd.

- Can you tell me a little bit more about how the interdisciplinary team and rehabilitation is helping those people recovering from Covid?

- So, one of the important parts of what you asked me is the interdisciplinary team, and we know it is made up of the physician, the therapist, case management, but an important piece of that is a family member.

Because this person is going back home to the family, and the patient themselves.

So we have to include them in the plan of care.

It is made up of a total team, including the family.

- It's my biggest draw to come to the organization strictly because of the sense of community that's here.

The patients were the first ones to really drive that home.

They don't really give you the opportunity to not be involved in a family-like environment and they really thrive on that sort of atmosphere.

- I love the fact that you're talking about family, right?

Because I think that is the kind of culture that we have created here.

And members of this community have been touched by Good Shepherd, that you are empowering your team members to build those connections with the residents, the patients, with other team members, right?

We help people through people, and I have been extremely, extremely impressed about that.

- Having these conversations are important for Parrilla Gonzalez.

- One of the things that we want to do is to make sure that people have number-one access to care, equitable care and that they get the same services at all levels of care, including rehabilitation.

- Parrilla Gonzalez will have the opportunity to connect with not only staff but the community as a whole, especially with Good Shepherd's latest project.

- We are going to have a brand-new hospital.

We want to be the destination for rehabilitation.

A culture of innovation.

We want to make sure that people see the Good Shepherd as mission driven, right?

So we are here to inspire hope and that's our main goal.

- Good Shepherd recently broke ground in Center Valley on a new inpatient rehabilitation hospital.

It will be four stories with 76 private beds and is expected to open early in 2023.

So there's a lot of work in store for Parrilla and I'm sure we'll be hearing more from her.

- She's doing great things.

And in addition to being Hispanic, she's a female in a role that you don't typically see women in.

- That's absolutely right.

I mean, you've done a lot of health care reporting.

How many times do you see a woman in an executive position?

- You don't.

You don't see it as often, I think.

It's not equal yet but we're getting there and with people like her, I think it's baby steps to that equality at the top.

- And I think it will bring a fresh perspective.

I mean, she's coming in with a lot of good ideas from her work in Florida and Puerto Rico, so I think it will be something that she'll be able to use here, her experience here in the Lehigh Valley.

- Awesome.

Best of luck to her.

Can't wait to see what she does.

Genesis, thank you so much.

- Thanks Brittany.

- Next up, the Food and Drug Administration is encouraging companies to reduce the amount of salt in packaged, processed and prepared foods.

Now, the experts are weighing in on how this move may benefit our overall health.

The Food and Drug Administration is out with a voluntary sodium guidance for food providers, aimed at gradually reducing a person's salt intake over time.

- The idea is that over the next 2 1/2 years, that by reducing the high sodium food items that we most frequently consume, by reducing the sodium in those foods by just a small amount, we can help reduce the average American's overall sodium intake.

- Suzanne Ickes is a dietician with Sodexo, the food service provider contracted by Lehigh Valley Health Network.

She says the new guidelines out this fall are aimed at lowering high blood pressure and heart disease.

- They're not asking for a large reduction.

They're actually asking for a very small reduction.

I believe the amount might be about 12%.

- One of the biggest changes that commercial food production can do is change from sodium chloride to potassium chloride.

There have been numerous studies that have actually shown switching out sodium chloride for potassium chloride has had a major positive cardiovascular benefits.

- Dr Darin Mazepa is a chiropractor and holistic health practitioner in Emmaus.

Like Ickes, he feels the move is a step towards promoting healthy eating practices.

- We're blessed in Lehigh Valley to have so many local farmers and farmers markets and farm stands.

The first thing you can do is buy fresh, buy local.

Don't buy a canned vegetable.

Go buy a real vegetable.

That's a simple thing you can do because you know what is in it is what came out of the ground.

- Ickes agrees that prepared processed and packaged foods have been a culprit all along.

- 70% of the salt that we consume doesn't come from the salt shaker.

It comes from the convenience foods and restaurant foods that we consume.

- She says the average person should only have about a teaspoon of salt per day.

A cup of canned soup can get you to almost 1/3 of the way to that day 's sodium intake.

To put that in perspective, she uses a platter of barbecue wings for example.

- You've got 600 mg of sodium from the barbecue sauce and then maybe you have a blue cheese dressing and some hot sauce.

This hot sauce has 400 mg per tablespoon.

I could have a few wings and I could easily have 1,000mg of sodium so I'm halfway there.

- So keep that in mind next time you order, she says, but there are ways that we can add flavor without the sodium.

- I think we're all familiar with lemon, right?

We use lemon juice on fish.

We can also use it on vegetables and pasta to add a lot of flavor.

If you want to go with something that has more of a Thai flavor, you could use lime juice.

That's very good.

Fresh tomatoes are great because they have a naturally salty taste, even though they are not high in salt.

- Other ways to boost flavor are to add things like onions, garlic, fresh ginger and spices, but the dietician says choose onion and garlic powder instead of onion and garlic salt.

- Vinegar adds a lot of flavor to foods and you can add it to stews, you can add it to soup.

I tell people to take balsamic vinegar and add...

I add almost a tablespoon to a large bowl of soup if it doesn't have a very salty taste, and it gives it a hearty, good flavor.

- Aside from food, Dr Mazepa has one more word of advice.

- Get out in nature.

That's another thing.

Sweat.

Another way of getting salt out of your body is to sweat it out.

So exercise is a really great thing.

Exercise is both physical but it's mental and emotional too.

- According to the FDA, reducing sodium intake has the potential to prevent hundreds of thousands of premature death and illnesses in the coming years.

Speaking of eating, Thanksgiving means food and family, but if you're looking for ways to lighten up that annual feast, for you and your family, our own Grover Silcox might have a tip or two.

Grover, welcome.

- Thank you.

Good to be here.

Yes, you know, Thanksgiving is that one day of the year when many of us throw cares and calories to the wind and chow down.

- That's true.

That's the day for it, right?

- Absolutely!

But if you did want some options, I have a few tips, especially for dessert.

- We don't skip it, though, right?

- No!

No way!

- OK. Good.

- Actually, I consulted with the folks at Northampton Community College 's culinary arts program.

Usually I consider Thanksgiving my one day a year, as I said, to stop fretting over calories and simply dive into all that good stuff.

Turkey, stuffing, cranberry sauce, mashed potatoes and tons of pumpkin pie.

But this year, after losing 50 pounds, not bragging, I thought it wise to see if there was any way to lighten up that traditional overload, so I called in experts to suggest a scrumptious healthy dessert that wouldn't weigh me down like a hefty wedge of pecan pie.

Today, the staff and students of Northampton Community College's culinary arts program are preparing to make a lighter dessert option for Thanksgiving.

- I call Thanksgiving it's like the chef's Super Bowl.

- Chef Francine Marz serves as director of the culinary arts program.

A graduate of Johnson and Wales University's prestigious culinary school, she brought years of real-world experience to NCC 's program.

Her staff include seasoned chefs to guide students in every aspect of the culinary profession.

- The culinary program at Northampton community College I think is an exquisite one.

What's so wonderful about it is you can get done in a year or you can go on and get the associate's degree.

- Culinary students learn in a working kitchen and NCC's public restaurant, the Hampton Winds.

- We go through everything from basic skills, understanding baking and pastry, uh, the culinary foundations, cost control, everything, and then you move into the restaurant class and then evening restaurant class, so you get a little bit of everything.

- Chef Francine shared the challenges of making Thanksgiving dinner for the calorie conscious.

- You know, a turkey on Thanksgiving, it's a pretty heavy meal.

You know, you could kind of get around it a little bit, you know, having white meat and things like that and maybe getting some of the fat out of the gravy.

But, you know, desserts are just insanely packed full of calories.

I don't know, you have the pie and the pie crust, and then you've got the whipped cream on top and the sauces, but there are some ways to actually change things up.

You can utilize fresh fruit a little bit more in addition to adding again some spices so that you get a really great flavor but also something interesting and different.

- But could a piece of fruit compare to a wedge of pumpkin pie?

Well, NCC's pastry chef Katie Horan, along with three of her students - Matt Rowland, Sarah Miller and Christoph Dominguez - set out to prove it can.

- Today I'm going to be making a spiced poached pear with red wine, and this is a little bit of a lighter Thanksgiving dessert.

We are going to be using Bosc pears, but you can use Bosc are Anjou or whatever you like.

Then we have our red wine.

I have 4 cups of red wine.

I'm using a Merlot for the fruitier notes that it has but you can really use any red wine.

We're adding a cup of honey as the sweetener in this.

Chose to do honey instead of granulated sugar.

And then we're going to be spicing it with cinnamon, cloves, some star anise, some orange so you get those bright, nice, deep fall flavors in your pear.

The peel of the orange has a lot of flavor so we're going to start with that, and then we're going to add the juice of it as well just to use the whole fruit.

Now that it's at a boil, I'm going to lower the temperature and we're going to get these pears peeled.

You don't want to peel them too early because they'll brown very easily, so you want to wait until your liquid is almost ready to start doing that.

We're just going to gently drop in these pears to our simmering liquid.

So we just want to make sure that these are completely covered with our poaching liquid.

So something to help do that is making a little parchment paper circle, and you can just place that right on top.

And then we're going to let this simmer.

So once this is done poaching for 25 minutes, I'm going to put my pears and my poaching liquid in here and let it sit covered in the refrigerator overnight so that it can continue to soften the pears and steep it with that delicious flavor that we made.

So we have our poached pears from yesterday, and you can see how much color they've picked up.

You could poach your pears up to five days in advance.

They can sit in that poaching liquid in the fridge for five days, so it's definitely a nice do-ahead project.

With this poaching liquid, you could actually poach pears again or you could also make a sauce with it, which is what I've done.

I've taken about two cups of my liquid out, and I reduced it on the stove to make a really nice, syrupy consistency as a more condensed sauce on your plate.

I'm going to get some gloves on so I can cut this open.

OK, so we don't want to have these seeds in it, so we're just going to scoop out the center on both sides with the little melon baller here.

And then I'm going to take my paring knife and try to cut out a little bit of the stem here as well.

And then serve it with a little bit of gingersnap cookie, just to bring in that spice a little bit more, and a vanilla frozen yogurt.

And then, if you want to be really fancy this Thanksgiving, you can use a little bit of edible gold leaf.

So this is a much lighter dish to finish a really heavy, delicious meal.

All right, Grover, would you like to come and try this?

- Yes, I would!

- All right!

- All right.

- Mm!

You know, you put this on top of a big piece of pumpkin pie.

No, no!

- It would be perfect!

- Who needs pumpkin pie?!

This is delicious.

Job well done.

Thank you so much.

- Thank you so much.

I'm glad you enjoyed it.

- I'll see you!

- Leave it to the staff and students at NCC's Culinary Arts School to create an edible work of art, to win the hearts and taste buds of family members and even certain reporters looking for lighter alternatives to those heavy, calorie-laden holiday pies.

I can tell you first-hand that dessert was delicious.

As you can see, pastry chef Katie Horan and her students turned a simple pear into a work of art with edible gold leafing and all.

It could be a show stopper on Thanksgiving and a bit lighter than the traditional pumpkin pie.

- That looked absolutely delicious.

My mouth is watering right now!

- Yes.

You didn't see me wolf it down completely, but I did.

- So it was good?

It was a good one, even though it's a little lighter?

- Absolutely, and the program itself is just great.

I mean, the culinary arts program at Northampton Community College began in 1994.

It's a two-year program and students graduate, they become bakers, chefs, executive chefs, sous chefs, restaurant managers, and they have real-world experience in their public restaurant, the Hampton Winds.

- And what's their job prospects when they get out of that school?

- Well, according to the director chef, Francine Marz, students are getting hired even before they graduate.

- Wow.

Thanks, Grover.

- You're welcome.

Thank you.

- Well, folks are known to overeat on Thanksgiving Day, but did you know, according to the Calorie Control Council, the average American takes in 3,000 to 4,500 calories during their Thanksgiving celebration?

Many of us know watching what we eat and how much we eat is beneficial to our overall health.

I want to welcome Dr Ron Freudenberger, a cardiologist with Lehigh Valley Health Network.

Dr, thank you so much for joining us.

- My pleasure.

- So right off the bat, we want to know the best advice for eating especially as the holidays are ramping up.

This is a big time for eating and lots of delicious food.

What tips do you have for us?

- Moderation, and watch what you eat.

Really eating the right types of food.

Low sodium, low cholesterol, low carbs, if you can, is really important to everyone's overall health and the wellbeing of all the people in our country.

- Sure.

So keep it in the back of your mind.

Why is it so important to make sure that you're watching what you eat and maintaining a healthy diet?

Why is that so important for our health?

- Diet really contributes a lot to our cardiovascular health in particular.

If we have a lot of sodium or a lot of cholesterol in our diets, it drives our blood pressure up and the cholesterol drives deposits inside the blood vessels supplying our heart, our brains and other organs.

And the combination of the two - high blood pressure, high cholesterol - really is the main factor in causing atherosclerosis or blockages in blood vessels supplying the heart, so it's very, very important that we watch what we eat.

- We heard a little bit from the FDA that they're asking food companies voluntarily to lower the sodium in the canned, prepared, those kinds of foods.

Why is it so important?

Why is sodium so bad in high amounts?

- I was really happy to hear that the government made that formal recommendation.

When you eat sodium, sodium pulls fluid in from your tissues inside your blood system and it increases the volume of blood that's in your system, which then increases your blood pressure.

And high blood pressure is very bad for risk for developing heart disease, stroke and many other diseases.

High blood pressure and high sodium also, with increased volume circulating, is very bad for people who have congestive heart failure.

It can put them into the hospital with really one high-salt meal.

- It sounds like lowering the sodium is a start to a healthy lifestyle.

It sounds like that can be, if you're eating too much salt, that can be a catalyst for many other problems.

- Absolutely.

Salt drives blood pressure and salt drives fluid retention.

So if you have a problem with your heart handling extra fluid, salt is what drives that.

And by increasing the amount of fluid that your body has to deal with, that is what raises blood pressure.

In fact, many of the medicines that we use, the diuretics in particular, are medicines that make your kidneys get rid of salt.

And fluid will follow the salt into your bladder and out of your body.

And if we eat salt, it counteracts that entire process.

- So, Dr Freudenberger, here's the big question.

Do we have to cut salt out completely?

You know, everybody likes to sprinkle a little salt, make their food a little bit more flavorful.

There are ways to do that, but do we have to cut out all of the salt?

- The less salt that we have in our diets, the better, particularly if you have high blood pressure or if you have congestive heart failure.

Those are the two most important populations of people who have to be very careful about their salt intake.

- We learned that prepared foods, previously prepared foods, canned foods, packaged foods, convenience foods if you will, they're all high in sodium, but what are some of the other foods that we should kind of stay away from if we are trying to lower that salt intake?

- Really anything that's processed, anything that's in a can.

Those are the main foods that are high in sodium content.

Even low sodium canned foods are actually lower, they're not actually low, so you have to really look at the sodium content on your cans or whatever you're putting into your mouth, because it is what drives blood pressure elevation and which in turn really is one of the main drivers of why we spend so much money on health care in this country.

We have bad eating habits, we eat a lot of sodium, we have a lot of high blood pressure, we have a lot of obesity, and those things are what contributes, in my opinion, to one of...to the big problem of the amount of money we spend and the percentage of GDP that we spend on our health care.

- And so this time of year, do we see a spike in high blood pressure or heart problems around the holidays?

Because, like I said before, people tend to eat a little bit more during these times when they're gathering with their families, lots of comfort foods, so do you see a spike in problems around this time?

- We actually do.

We see certainly more patients coming to the emergency departments with congestive heart failure.

The salt causes fluid retention and can end up in your lungs and make it very difficult to breathe.

And a lot of times we see people ending up in really dire straits after having even one high-salt meal.

And one other important thing to remember, aside from low sodium is not low - it's lower, is that the salt substitutes are also not very good.

They're mainly potassium chloride and regular table salt as sodium chloride.

Too much potassium is not good for you also, so be careful what salt substitutes you use.

- Sure.

It comes back to what you said earlier.

Everything in moderation.

I want to just talk a little bit about the pandemic.

We heard over the pandemic a lot of patients were not going to their routine checkups.

Some people were not even going into the ER with serious problems because of the coronavirus pandemic.

Did you see a lot of that in your line of work?

- Absolutely.

So the hospitals, certainly during the first shutdown, we shut down as many other centers around the country, the non-urgent procedures, because we had to and we were concerned about it.

And now we are seeing, with the latest Delta variant spike, we've seen more hospitalizations.

Our hospitals are very full.

And we are starting to see people who've delayed health care, delayed preventative medicine, come back to us in a worse state than they would have been if they'd got the regular health care that they needed.

- So you're pretty busy at this point as we're moving through this pandemic?

- We're very busy.

So the Delta variant increased our hospitalization rate, particularly in those who are not vaccinated, and those people stay in the hospital for a long time.

And then we had all of the regular patients and then all of the patients who didn't see doctors for a long time are unfortunately ending up in worse shape and in our hospitals.

- All right.

One more question for you before we let you go.

Anything that folks should take with them as they move into the holiday season and start to prepare their Thanksgiving meals and holiday meals?

- Sure.

Healthy eating is really important.

You can have really good food that is not high in sodium content.

You can have really good food that is not rich in carbohydrates.

Just really think about it.

And I like to tell my patients, "Your calories is like a budget."

So if you know what your budget is, spend your calories wisely and don't waste it on things that you don't like and don't waste it on junk food.

- Some great advice right there.

Dr Ron Freudenberger from Lehigh Valley Health Network, thank you so much for joining us today.

- My pleasure.

- On the next episode of Living in the Lehigh Valley, Covid shots for kids.

As approval comes for vaccines for children ages five to 11, we'll speak to a pediatrician about what parents need to know.

That's it for now.

Join us next time on Living in the Lehigh Valley.

I'm Brittany Sweeney, hoping you stay happy and healthy.