Cook Children’s Female Athlete program was designed with a comprehensive approach to keep female athletes healthy and at the top of their game. Located at the Cook Children’s Multi-Specialty Clinic in Hurst, it focuses on nutrition, mental health and injury prevention and treatment in preteen and teenage athletes.

Krystle Farmer, M.D., sports medicine physician, dreamed of this clinic which has now become a reality for female athletes.

“We see a lot of female athletes who have specific needs,” Dr. Farmer said.

Injury Prevention

The clinic, which opened this summer, sees many athletes who train intensely year-round, or those who participate in sports with a major focus on weight and caloric intake, such as dancers or female wrestlers.

“The red flags we look for are stress fractures, menstrual dysfunction, and recurrent overuse injuries, all of which can be a sign of energy deficiency in athletes,” Dr. Farmer said.

Referrals can be made to other members of the team including a gynecologist, orthopedic surgeon, endocrinologist, psychiatrist or physical therapist.

The clinical evaluation assesses any acute or chronic musculoskeletal concerns. If needed, a mechanical evaluation can be set up separately at the therapy center to assess throwing mechanics, squat form, muscle imbalance and/or pelvic alignment.

X-rays are available in the office when necessary and the clinic’s athletic trainer, Micaela Lozano, DAT, LAT, ATC, ROT, OPE-C, can provide home exercise teaching and personalized programs during the visit.

Nutrition

Frankie Kindy, Registered Dietitian with Cook Children’s Orthopedics and Sports Medicine, provides individualized nutrition counseling. Nutrition is essential for an athlete to be able to perform their best, but unfortunately under fueling is not uncommon in this population. 

Frankie uses information about the athlete’s sport of choice, current nutrition, level of activity, sleep, and more to give personalized recommendations for how each athlete can optimize their nutrition. Each patient receives a document after the visit with their personal goals and recommendations.

“Sometimes I see higher level athletes who have never had access to sports nutrition training,” Frankie said. “It is important for them to get this information, because athletes have very specific needs. I help these athletes tweak their diets to increase their energy, reduce risk of injury, promote recovery, and overall improve performance.”

A major focus of the program is prevention. Dr. Farmer orders bone density testing as well as labs (vitamin levels, inflammatory markers, and/or hormone levels) when indicated. The John and Tracy Sellers Sports Complex at Walsh Ranch is also developing preventative programs, including an ACL Prevention Rehabilitation Program.

“Our goal is to look at the whole athlete, including mind and body, so that we can get to the root cause of any problems and start preventive care so that our athletes perform at their peak levels,” Dr. Farmer said.

Betzavel Segura’s trip to the Down syndrome clinic at Cook Children’s gave the 4-year-old girl the chance to show her skills and her challenges to a variety of specialists.   

She named the colors she knows. She jumped around. And in a game for speech therapy, she practiced making animal sounds.

“For her, it was playing. But for the medical providers it was watching to see what she would do,” said mom Erika Quijas, who calls her daughter Betzi for short.

Betzi has a love for dolls, a knack for puzzles, and a happy attitude most of the time. But she struggles with pronunciation, and she gets frustrated when others don’t understand what she’s saying. And she’s picky about the texture of certain foods. Her parents wanted some professional guidance. 

In a span of four hours at the clinic, Betzi was examined by a pediatric geneticist and met with experts from multiple fields related to her Down syndrome diagnosis. She had fun at the appointment -- and her parents came away with practical advice and information to take back to Betzi’s primary care doctor and teachers in Mineral Wells. 

Every year, about 5,000 babies in the United States are born with Down syndrome, a disorder caused by an extra chromosome. Cells dividing in the embryo have three copies of chromosome number 21 instead of the usual two. The condition can lead to heart defects, hearing loss, eye disease, thyroid problems and other medical concerns. Feeding, development and learning can be affected. 

World Down Syndrome Day connects today’s date (March 21) to the three copies of the 21^st chromosome in a symbolic way to help raise awareness. It’s an occasion for Cook Children’s to spotlight our clinic as a tool that educates, addresses concerns and gives encouragement to families.

First, the full name … Nannie Hogan Boyd Down Syndrome Clinic and Resource Center, affiliated with the Cook Children’s Genetics Clinic. Cook Children’s Rehabilitation Services, Child Study Center, the Down Syndrome Partnership of North Texas and the Nannie Hogan Boyd Trust support the program. The clinic has served an estimated 500 children and teens since it opened.   

“The design was to provide a more comprehensive program for families with children with Down syndrome so they could get all their evaluations in one place,” said pediatric geneticist Mary Kukolich, M.D., who started the clinic in 1998 and continues to lead the team.

Dr. Kukolich said participants across a wide region of Texas are attracted by the convenience of seeing multiple specialties in one stop. Enrollment is limited to four or five patients at a time. Each receives a personalized itinerary.

Clinic Overview

What’s offered? Dr. Kukolich does an exam and genetics consultation to check the patient’s growth, heartbeat, muscle tone, thyroid function and more. Blood tests and X-rays might be ordered.

Available as a bonus: speech therapy, occupational therapy, physical therapy, audiology, nutrition and psychology. The patient’s caretakers choose which specialties they want to go to for screenings or consultations.

When? Every other month. Most slots for the 2023 clinics are already filled, but more dates might be added depending on the level of interest.

Who can sign up? Anyone with Down syndrome from ages 3-18 is welcome. If the child is not already established as a Cook Children’s Genetics patient, a pediatrician’s referral is needed. Clinic organizers recommend a visit every three years.  

Where is it located? 750 8^th Ave., Suite 200 in Fort Worth

What’s the cost? The genetics consultation and audiology visits are billed to insurance; no charge for the rest. 

Clinic coordinator Audrey Hicks, LMSW creates an individualized schedule for each participant.

“I call the patients a month before their appointment and I talk to the parent about how the child is doing. We discuss their development and health, and then we decide which specialists they need to see,” Hicks said.  

“A lot of these kids already have therapies maybe in school or maybe private,” she said. “The clinic gives them an opportunity to have people with fresh eyes who can take another look and give them a new perspective. At the end of the day, each family gets a full report of the findings and suggestions from each of the specialists.” 

Therapists might recommend an extracurricular activity, a new behavioral technique to try, or a resource the family wasn’t aware of. Parents are urged to ask questions and express their concerns on topics such as puberty or options after high school.   

“Families with kids with disabilities can feel very isolated, and this is just another way to help support them, to make them know that we care about them, that we are trying to help the whole picture,” Hicks said.

Betzi’s Experience

When she was 7 months old, Betzi had surgery at Cook Children’s to repair two holes in her heart. She travels to Fort Worth for routine check-ups for cardiology and pulmonology care, as well as eye and ear exams.    

Texas Early Childhood Intervention (ECI) provided speech therapy and physical therapy until Betzi turned 3. Now that she’s 4, her speech and occupational therapy happen at school in Mineral Wells. Her dad, Armando Segura, follows up at home with extra speech practice in fun ways that Betzi enjoys. Armando and Erika were eager to seek out additional input from the Down Syndrome clinic at Cook Children’s. 

Here are highlights from their visit in November 2022:

• The physical therapist watched Betzi jump and checked her hips and muscle tone. The therapist recommended shoe inserts to support her weak ankles.
• The speech therapist advised Betzi’s parents to exaggerate the pronunciation of words while Betzi watched their mouths. Erika asked if talking at home in both English and Spanish was making speech harder for Betzi. (Answer: No.)
• The nutritionist suggested chopping fruits and veggies into smaller bites – or mashing them into smoothies – to work around Betzi’s issue with food textures.
• The psychologist discussed strategies to keep Betzi from flinging her plate when she wants attention at dinner. 

Betzi stayed in a good mood for the entire four-hour session thanks to the juice and snacks her mom packed. The kindness of the clinic staff played a role too in keeping Betzi comfortable and entertained. “They were just really nice and patient,” Erika said.

Erika especially appreciated the tips that the specialists shared and the summary report at the end. She encourages other parents to utilize the clinic. And Erika wants everyone to know that like all people with Down syndrome, Betzi is much more than her diagnosis.

“She plays, she cries, she gets mad just like any other kid does. There’s no reason to treat her differently.”

Schedule an appointment at the Down syndrome clinic by calling 682-885-3951.

Over the past few weeks, we’ve published a series of articles about the mental health crisis shaking the foundation of our youngest generation. It’s been a difficult and heart-wrenching conversation as, together, we’ve opened our eyes to this issue. This week, we want to bring you some good news.

An innovative yet practical collaboration that embeds family therapists into Cook Children’s Neighborhood Clinics (NHCs) is expanding access to mental health services for children in some of Tarrant County’s most underserved communities. It’s a silver lining, if you will, amidst a rapidly growing crisis.

The Crisis

The critical issue of mental health struggles among children isn’t a new one. It’s been lurking under the surface for years. One Centers for Disease Control statistic states that the percentage of children ages 6 to 17 who have ever been diagnosed with either anxiety or depression increased from 5.4% in 2003 to 8% in 2007 and to 8.4% in 2011-2012. To put skin on that, approximately 4.4 million children in the U.S. ages 3 to 17 have diagnosed anxiety, and about 1.9 million have diagnosed depression. Couple that with an inadequate supply of mental health professionals across that country and you have an undeniable gap in mental health care for hurting kids. According to the American Academy of Child and Adolescent Psychiatry, there are only 8,300 practicing child and adolescent psychiatrists in the United States—a country with 74.2 million children.

Pile a pandemic on top of all of that and you have the makings of a nationwide mental health disaster. In many ways, COVID-19 opened Pandora's box. For millions of children, each measure taken to address the virus either triggered a new mental health struggle or exacerbated an existing one. The results are devastating, evidenced by the record number of children attempting or committing suicide. Some as young as 5 years old.

“I would say that, compared to last year, I have certainly experienced and seen a significant rise in the number of patients reporting anxiety, depression and even suicidal contemplation,” said Vida Amin, M.D., Neighborhood Clinics and Population Health Advisor.

The Silver Lining

Cook Children’s Health Care System took note of the adolescent mental health situation and the gap in services years before the start of the pandemic. Concern turned to action when the system began including mental health outreach as one of its yearly strategic initiatives. Over the course of several years, these initiatives have evolved from requiring universal depression screenings for all adolescents to improving access to mental health care for patients of Cook Children’s Neighborhood Clinics in fiscal year 2021. This latest initiative steered the concept of integrating family therapists into the primary care setting.

The program launched in December 2020—perfect timing given the pandemic’s toll. Three licensed family therapists rotate through Cook Children’s seven Neighborhood Clinics each week providing services that range from mental health evaluations to outpatient counseling to education for families and clinical professionals.

In its first month, NHC physicians and nurse practitioners referred a little more than 100 patients to the therapists for evaluation. By April 2021, that number had grown to more than 380 in a single month. So far, more than 111 patients have received outpatient counseling through the program.

Breaking Barriers

This care model helps alleviate three critical barriers for families seeking mental health services—access, cost and a reluctance to trust someone new with something so sensitive.

Right now in North Texas, it can take weeks, even months in some cases, to get an appointment with a therapist. There simply aren’t enough to go around. The same is true for many parts of the country.

“The demand for behavioral health care far outweighs the number of treatment providers in the community,” said Christina Reed, LMSW, director of operations at Cook Children’s Neighborhood Clinics. “It’s just too much for nonprofits and other providers to keep up with. So for us to be able to offer this to our patients gives them that access that has been lacking in the community.”

Beyond adding much needed therapists to the landscape, bringing these services in house improves access by speeding up the referral and evaluation process. It also signals that mental health is just as important as physical health. As therapists share knowledge and integrate their care plans, physicians and nurse practitioners are increasingly looking through the lens of mental health when engaging with their patients.

“It helps to demonstrate that behavioral health care is a part of health care,” said Kelly Rand, LCSW, manager of patient and family support services at Cook Children’s Neighborhood Clinics. “You don't have to go to another office somewhere that you've never been before and that’s not familiar to get that support. It crosses that barrier to where it's not two separate services. It's all health care, and it's all here together.”

Access and cost go hand in hand. If one can be overcome, the other is often the next big hurdle. Many private practice therapists do not accept insurance, especially Medicaid, leaving families no choice but to pay out of pocket.

“We serve primarily Medicaid families,” Reed said. “If you are a child or a family on Medicaid trying to find mental health services, that is challenging and that's no secret. It’s always been challenging. Our families are left without many options because they can't pay cash for a private practice therapist.”

Counseling services at the NHCs are billed to the patient’s insurance provider, be it a private insurer or Medicaid. If a patient is not covered by insurance or Medicaid, therapists connect them to a counseling resource in the community that offers free or sliding scale fee services.  

Opening up about internal struggles can be hard. Knowing who to trust with such personal and sensitive information factors into a parent or child’s hesitancy to reach out. Embedding therapists within the primary care clinics where patients have established relationships and familiarity with providers helps build a bridge between reluctance and trust.

“There is something that our families value when it is a Cook Children’s name behind that referral or service,” Reed said. “When it's their pediatrician saying, ‘it's this person I work with right here that can help you,’ there's a lot of comfort and trust in that in a world that can be really scary. There's still a lot of stigma. There's still a lot of hurdles to jump through, even just internally, when seeking out that service.”

Comprehensive Care

For children who need emergency intervention or more intensive care than can be provided through outpatient therapy, NHC therapists work with Cook Children’s emergency department, behavioral health intake department, partial hospitalization program and inpatient psychiatry program to get patients the level of care they need.

“The NHCs are now performing 200-plus psychosocial assessments and plans of care each month,” said Robert Goodwill, senior vice president and chief operating officer of Cook Children’s Physician Network. “This is an integral part of identifying specific needs related to the level or type of care a child may need. These added resources have resulted in increased counseling sessions at the NHCs as well as the ability to connect patients and families to other services in our system and our community.”

Of the nearly 1,200 referrals NHC therapists have received since the start of the program, depression and anxiety rank as the top two issues.

“Depression and anxiety are by far the most common,” Rand said. “A third one would be ADHD or issues around attention concentration. From there, I would say, issues around some kind of trauma transition or loss. So a death loss, the loss or separation of parents, a traumatic family event, or some kind of big transition in the household. Of course, those things contribute to and cause depression, anxiety and attention difficulties in children.”

As the rising referral numbers demonstrate, this collaboration is bringing critical services to the doorsteps of underserved communities. It’s making the mental health care space easier to navigate and offering help and hope to hurting children.

That sense of urgency for these kids moved the state of Texas to pass a law in 2017 that made it mandatory for all children entering into conservatorship to have a medical exam within three business days after the child was removed from their home.

While the law is an important one to the well-being of the child, the reality of providing timely and thorough medical exams within three days proved to be a difficult task for many parents.

The exam is a medical screening that is intended to provide a baseline of a child’s physical health upon entering foster care. It is also an opportunity for the caregiver to obtain necessary treatment and medications for a child that may not have been obtained at the time of removal, such as an asthma inhaler or eczema cream.

The child abuse experts at Cook Children’s understood the need for foster parents in the community to meet the requirements of the state.

Jamye Coffman, M.D., medical director of the Cook Children’s Center for Prevention and Child Abuse and Neglect and the CARE team​, said it was clear there was an issue and Cook Children’s wanted to aide in the solution.

The result? The Cook Children’s Fostering Health clinic that launched in 2018. The clinic provides comprehensive services for all kids living with foster parents from foster infants to young adults, as well as foster children who have become parents.

Dr. Coffman says one of the goals of the clinic is to help foster parents better understand trauma behavior in children and to take more time with the families than just a quick appointment in a primary care office.

“We knew there was going to be a problem getting children into a clinic within three days, because they would be new patients with insurance and billing issues to figure out,” Dr. Coffman explained.

Cory and Maddie Churchman are foster parents who’ve brought four children through the clinic. The couple express their gratitude for the resource they say “has never failed them.”

“We know several families who’ve had to take their child to the emergency room or urgent care, just to have them seen within three days,” Maddie said.

The Churchman family says many offices won’t accept Medicaid insurance, or the office is full and not accepting new patients, so having the foster care clinic at Cook Children’s alleviates that stress.

The clinic allows an hour per visit for every patient they see. Dr. Coffman says this is important because evaluations usually take time because many children enter their new homes and the foster parents know little or nothing about the child.

“Before they even come in our door, we’ve already gathered medical records, immunization records and trauma history, and spoken with Child Protective Services (CPS) to help those parents transition,” Dr. Coffman explains.

The Churchmans say they are prime examples of not having any information on their children when they enter the home. The family adopted the first child they fostered, a one-year-old girl, and said they had doctors ask them for information they weren’t always able to provide.

“There are many doctors who don’t specialize in foster care who ask us as foster parents things we don’t know the answer to. We don’t know if they’re vaccinated or anything,” Maddie said. “We show up at the (Cook Children’s) clinic, and they’ve already looked into everything, which is a huge help.”

The Churchman family says they tell other foster parents to allow people to help you who are in place to do so.

“They saw a need and they are standing in the gap,” Maddie said. “I just want everyone to know they are there, they get it, and they really want to help you.”

The Churchman family is always eager to take their daughter back to see the staff when they have other appointments for their new foster placements.

“We are very grateful that they’re there for us and continue to do their jobs every single day,” Maddie said.

In 2018, she and her family joined the often overlooked but growing homeless population in Fort Worth. When Dana and her husband became unemployed and could no longer afford to put a roof over their heads, they turned to the Union Gospel Mission shelter for help. It was there that they were introduced to a program called the Homeless Initiative, which aims to provide a medical home for children experiencing homelessness in Tarrant County, a population of roughly 15,000.

“The Homeless Initiative program provides medical care, actually any service that Cook Children’s can offer, to the children who reside in the three shelters in Tarrant County: Presbyterian Night Shelter, Union Gospel Mission and Arlington Life Shelter,” said Pat Ballard, an RN at Cook Children’s and one of the two case managers for the Homeless Initiative. “We do well checks, sick visits, TB testing, we have a flu clinic, we get them up-to-date on vaccines, any specialty doctors that they need, dentists, dental care, dental surgery, we schedule it all.”

The Homeless Initiative began in 2008 as a collaboration between Cook Children’s and former Fort Worth Mayor Mike Moncrief. The goal was to provide a path to medical care for this vulnerable population of children who, too often, were only seen by emergency room physicians.

“Back in 2008, about 98% of homeless children in Tarrant County were using ERs for primary care issues,” said Ballard. “That’s a huge burden for any ER and it puts stress on the whole system.”

The initial goal of the program was to make sure children had a primary care physician through Cook Children’s Neighborhood Clinics. These doctors would provide appointments for things like well checks, ear infections and upper respiratory conditions. It didn’t take long, however, for organizers to realize the need for mental health services and trauma-informed care, which takes a person’s traumatic experiences into account and promotes environments of healing.

“I don’t think we fully understood the problem in the beginning,” explained Denise Coover, LCSW, trauma informed care specialist at Cook Children’s. “Many of these kids have been through a lot of trauma. The more questions we asked, the more we learned.”

Coover joined the program in 2013 and provides on-site behavioral health assessments of children in the three shelters where the Homeless Initiative operates. Many of the questions in her assessment gauge what children have witnessed or endured such as physical and emotional abuse. She adds that being able to talk to the children themselves is key because often, parents don’t know the extent of what their children have been through, especially if they’ve been separated due to time in jail or foster care.

“A lot of our children have witnessed domestic violence. We have a lot of children who make disclosures of sexual assault, physical abuse, neglect and sex trafficking,” Coover said. “When we think about trauma, we have to remember the true definition is an event, or the threat of an event, that overwhelms someone’s ability to cope. If you can think of something that would overwhelm your ability to cope, our children are dealing with that.”

According to the National Center on Family Homelessness, children experiencing homelessness get sick twice as often as other children. They also suffer from more mental health issues such as anxiety, depression and withdrawal.

“We know while these children are in the shelter, this is our opportunity to intervene with them and provide them help,” Coover said. “They can’t wait six weeks, 12 weeks on a waiting list. They need intervention and they need it now.”

To make sure children experiencing homelessness in Tarrant County get the care they need quickly, Cook Children’s provides free transportation to the program’s families.

“We have a 16 passenger shuttle with a full-time, dedicated driver that delivers our kids to every appointment that we make,” Ballard explained. “That means picking up the parent at the shelter, going to school and getting the child, bringing them back to the clinic, whatever we have to do to get that child to an appointment we do.”

And if an appointment interferes with a family’s ability to eat lunch, the driver will make a special stop to make sure parents and children don’t miss a meal.

Another major goal for the Homeless Initiative is to make sure families transitioning out of homelessness have everything they need to succeed. Cynthia Thomas, LMSW, another case manager for the program, spearheads this mission. She says her job is to support and empower families experiencing homelessness.

“I provide strollers, car seats, anything a parent would need. They may need assistance in the education system, or school supplies. My role is to find out what non-health resources are necessary for them to be successful,” expressed Thomas, who works for The Women’s Center of Tarrant County.

While such supplies are necessary for success, Thomas’ main goal is to cultivate life skills families can take with them when they leave the shelters. To foster these skills, she organizes parenting classes several times a week at all three shelters. Thomas works with community volunteers and organizations across Tarrant County to create educational presentations meant to equip parents for raising children and teens.

“When they leave the shelter, we want them to feel empowered and we also want them to be able to speak for themselves,” said Thomas.

Some families need a little extra help with this, especially those who have children with special needs. Thomas often acts as a mentor and spokesperson for these parents who may have trouble navigating the special education system.

“A lot of times, the parent doesn’t understand the verbiage of the special education program, so I will go through it with them so they understand it better,” said Thomas. “One of the most rewarding parts of my job is seeing parents gain confidence and feel empowered. One mother was too afraid to say anything during meetings we had with the school. I was able to watch her learn how the system works, become comfortable and lose that fear.”

It’s been 11 years since the Homeless Initiative began and the impact is visible. As of December 2018, nearly 16,000 children and their families had been transported to medical appointments through the effort. Forty-five percent of those children returned to a neighborhood clinic after leaving the shelters, meaning they were no longer using emergency rooms as their medical home.

“I can go in the clinic two, three years later and I’ll see a mom sitting in the clinic with her kids,” said Ballard. “That’s really nice to see that you’ve made a difference in their medical care.”

The program isn’t intended to be just an appointment at a doctor’s office. Cook Children’s hopes it will be a support system when families need it most.

“It’s a chaotic world right now, but this is one of the things we don’t have to stress about,” said Brown-Bonner. “When I forget something, I get a reminder. They go above and beyond to make sure you’re comfortable and that things are taken care of. I’m very grateful and I know that there are other parents that are as well.”

For the Homeless Initiative team, the work seems never ending, but they know their efforts have a higher purpose.

“We know the outcomes for these children are not good if there’s no intervention medically and emotionally,” said Coover. “But the thing about resilience, that is the ability to bounce back from difficult life experiences, is it just takes one person believing in a child to build the resiliency they will need to succeed.”

"There are a lot of patients who need specialized care or even higher levels of care and it’s really important that in this rapidly growing community that we have that available to these families," said Dr. Hogan, pediatricitian at Cook Children's Pediatrics Prosper Trail.

Dr. Hogan is one of 24 Cook Children's pediatricians currently treating patients in this region of North Texas. She says patients like hers need a place to access specialized and emergency pediatric care without having to drive 30 minutes to an hour away from home.

"A lot families have hardships and are not able to drive that far, or take off work all the time to go to these visits, and having this inpatient hospital and specialized care right her will make it easier for all the families," Dr. Hogan explained.

Construction of Cook Children's Medical Center North is in the initial phases with plans to have a full service hospital completed in 2022. The new hospital will be located on a 23-acre site in Prosper at Windsong Parkway and Highway 380. Having started in October of last year, phase one is already underway with plans to open a primary and urgent care clinic in the fall. An outpatient surgery center and specialty clinic with imaging and lab services will open in 2020.

"I'm really excited about the hospital opening up and being able to refer my patients to specialists, right here in Prosper, and being able to send my patients to get the specialized care that they need, having higher levels of care right across town," said Dr. Hogan. "I think that is going to be really wonderful for the families here."

Currently, Cook Children’s operates eight primary care offices in and around the Town of Prosper. The expansion near Windsong Ranch marks the first time in Cook Children's 101 year history that a full-service hospital has been built outside of Fort Worth.

"Just like the Town of Prosper is family, a close knit community, so is Cook Children’s," said Dr. Hogan. "We are all here wanting your children to be healthy and do better in life and be able to get the care they need to grow up to be happy and healthy adults."

By now you’ve heard about trans fats so much, you may start to tune out how dangerous they can be for your child. We hear these buzz words all the time and it’s hard to tell any more what is and isn’t a serious threat.

How bad are trans fats for you? Toward the end of last year, the U.S. Food and Drug Administration (FDA) made the decision that hydrogenated oils may no longer be generally recognized as safe. That means if a final determination is made (which should be any time now), food manufacturers could no longer sell food products with trans fats or use them as an ingredient without prior FDA approval.

Here are four things you should know about trans fats to help you the next time you’re out shopping or ordering at a restaurant:

1. What are trans fats?

Trans fats are one of the “bad fats.” Some do occur naturally in foods, but most are created by adding hydrogen molecules to liquid vegetable oils. You’ll see them on food labels as “partially hydrogenated oils” or “hydrogenated oils.”

2. Where are they found?

Companies use trans fats because they’re inexpensive, last longer than other fats (increased shelf life), and give foods a good taste and texture. Trans fats are most often found in processed foods or fast foods.  Examples of trans fats are fried foods, baked goods, shortening and margarines, canned frosting and baking mixes. 

3. Why are they so bad?

Trans fats increase your LDL (“bad”) cholesterol and decrease your HDL (“good”) cholesterol.  They can increase your risk for heart disease and stroke, and there’s an association between trans fat consumption and higher risk for Type 2 diabetes mellitus.

4. What should we do?

• Look for trans fats on nutrition facts labels and look for partially hydrogenated oils in the ingredients list. Try to avoid trans fat (0g and no partially hydrogenated oils).
• Cook and eat at home as much as possible.
• Limit processed foods, especially at snack time. Reach for fruit, almonds or a light string cheese instead of chips or processed snacks.
• If eating out, choose baked or grilled proteins and watch “extras” like breads and sauces that may contain trans fat.

Trans fats are dangerous, but the good news is you can protect your kids from them. Start today by reading nutrition facts labels, ingredient lists, and eating at home as often as possible.

"My mom used to say, 'When God closes a door, He always opens a window.' I have found that to be true many times in my life. My life as a pediatrician is a result of crawling through an open window when the door I thought I was supposed to walk through was closed to me."

Jason Terk, M.D., Keller, Keller Parkway

"Florinda Peak, the most amazing Mommy in the world, to 5 year old Dr Sandra Peak who did not want to practice reading… 'You have to learn how to read…because when you do the whole world opens up to you!'”

Sandra Peak, M.D., Lewisville

"The best advice my mother ever gave me was to give to others without expecting anything in return. (She also told me to never go outside with wet hair because I’d catch a cold, but medical school later disproved that. Sorry mom.)"

Diane Arnaout, M.D., Willow Park

"The best advice my mother ever gave me was, “never miss the chance to use a perfectly good bathroom” when you are out of the house."

Audrey Rogers, M.D., Fort Worth, Forest Park

Nicole Wineriter, M.D., Keller, HeritageTrace

"My mom told me to respect (be nice) to the nurses because they can either make or break your day."

Samuel Sheng, M.D., Arlington Neighborhood Clinic

"Encourage others. She always wrote notes to people for accomplishments, during sad times and just because."

Justin Smith, M.D., Lewisville

And finally, our favorite advice ...

"Marry Joan."

Tom Rogers, M.D., Forest Park. Dr. Rogers and his wife Joan have been married 59 years and today, she is a proud mother. "Joan worked to pay my way through medical school, gave me two great kids who are both pediatricians, and has allowed me to work without having to pay attention to small things like finances, maintenance of our house and yardwork. I couldn't be where I am today without her," Dr. Rogers said.

Happy Mother's Day from all of us at Cook Children's ...