Fabulous Fungi

Mushrooms are not a true vegetable but a fungus. They have no roots or leaves, do not flower or bear seeds, and do not need light to grow. There are approximately 38,000 varieties of mushrooms, some edible and some highly toxic.

Their history is rich and revered. The Chinese used them for medicine. The Egyptian pharaohs declared them a food suitable only for royals. The French were the first to cultivate mushrooms in caves in the early 17th century. In the late 19th century, mushrooms were being grown commercially in both Europe and the United States. Farmers in Pennsylvania developed a method for growing mushrooms indoors, which is how most mushrooms are grown today. Many wild varieties are cultivated in this manner, which has allowed them to become more affordable and widely available.

The flavor of mushrooms comes from glutamic acid in part, which is a natural form of monosodium glutamate (MSG). MSG contains a considerable amount of sodium while fresh mushrooms are virtually sodium free.

Since they are not colorful, mushrooms had been thought of as lacking significant nutritional content, however, they do supply key nutrients. They are a decent source of the B vitamins niacin and riboflavin (they contain some B6 and folate too), iron, potassium, selenium, and vanadium (recently identified as an essential trace mineral in humans). They are a good source of dietary fiber. They contain the cholesterol-lowering soluble fiber beta glucan and they have also been discovered to contain antioxidant levels similar to other colorful vegetables. They are very low in calories with one cup of raw mushrooms supplying approximately 20 calories.

Mushrooms contain some vitamin D. When they are exposed to sunlight at the end of their growing cycle, they will produce a significant amount of vitamin D. They are one of the few foods to contain natural vitamin D. Look for the sunlight mushrooms in your local grocery store.

It used to be that the white button mushrooms were the only variety available in the marketplace. Now, varieties abound, cultivated and wild, fresh and dried. Mushrooms can transform the flavor of a dish adding an earthy rich flavor.

Mushrooms are highly absorbent and their contact with water should be limited when cleaning. With that said, they are 80% water and you will notice that they release water when being cooked. It is recommended that they be cleaned by wiping them with a damp towel or brush. Depending on what is being cooked, I often times will rinse them quickly in water to remove most of the dirt.

For more information about mushrooms visit Fresh Mushrooms, Nature's Hidden Treasure.

Pasta with Mushrooms and Shrimp

1# pasta shells (I recommend whole wheat)

2 T. unsalted butter + 2 T. olive oil

1 large clove garlic, minced

1 # fresh mushrooms, trimmed and sliced

3/4 # medium shrimp, shelled and deveined

½ cup chicken broth

½ tsp each salt and freshly ground pepper

½ cup freshly grated Parmesan cheese

1 T. chopped fresh parsley


1. Cook pasta according to package directions.

2. In a large skillet, heat butter and oil over medium heat. Add garlic, sauté 1 minute or until softened. Increase heat to medium high, add mushrooms and sauté for 5 minutes or until tender. Add shrimp, sauté for 3 minutes or until cooked through. Stir in chicken broth, salt and pepper. Bring to a boil; reduce heat and simmer 1 minute.

3. Drain pasta; place in a serving bowl and toss with cheese and parsley. Add mushroom-shrimp sauce; toss. Serve immediately.

Makes 6 servings

Snack Attack: The Art of Healthy Snacking

It’s 3 pm and your stomach is grumbling. You decide to eat an apple but the cookies a coworker brought to work are looking mighty good. You eat the apple hoping that the cookies will leave your mind; an hour later they are still there and you eat six. So much for good intentions.

Snacking behavior can make or break a healthy eating plan. Most people go wrong with snacking by leaving it up to impulse. Meals are planned, but what people snack on is left up to whim. The myriad of unhealthy snack foods available in the supermarket doesn’t help impulse control either.

The first defense in taming the inner snack beast is to eat a healthy breakfast. A study of obese people trying to lose weight showed that those who regularly ate breakfast lost more weight than those who skipped the morning meal. Those who skipped breakfast ate more calorie-dense foods later in the day. Breakfast should be more substantial than just a cup of yogurt and coffee. An egg on whole wheat toast with lean ham and cheese, an orange and tea will fit the bill. In a hurry, grab an oat English muffin smeared with peanut butter and a banana and pick up your Starbuck’s coffee on the way to the office (hold the café mocha).

Another important guideline is to avoid eating when not hungry. This may seem like common sense, but snacking clearly plays a role in obesity. Almost a quarter of the American population is obese and obesity related diseases account for over 300,000 deaths per year. Eating because of boredom, anxiety, anger or because food just looks good will lead to weight gain in the end.

Eating smaller, more frequent meals that incorporate healthy snacks has been shown to reduce overall stomach capacity. Over time, one feels more satisfied with less food. It is believed that this is the reason why people who “graze” tend to be leaner.

In general, snacks should contain from 200-300 calories. Consider that an apple has approximately 60-100 calories; it is no wonder that an apple alone may not satisfy hunger. Spread a little peanut butter on your apple or dip it yogurt and your hunger is more likely to be quelled. Protein contained in peanut butter and yogurt increases the feeling of fullness and prevents hunger from coming back too quickly.

Keep in mind that all healthy diets allow favorite foods and treats. Snacking on cookies may not seem like a good idea when trying to lose weight, but allowing a treat at some point in the day may keep one from losing their fortitude.

Snacking Basics

1. Don’t eat if you are not hungry.

2. Don’t skip breakfast.

3. Eat smaller, more frequent meals.

4. Plan your snacks and choose the right foods (whole grains, fruits, vegetables, nonfat dairy, lean protein).

5. Think out of the bag! Avoid foods marketed and sold as snack foods as they tend to be high in refined carbohydrates, sodium and fat and low in fiber.

Snack Ideas

There are any number of good snack ideas out there. Choose foods that you like and find satisfying. Eat enough food to abate your hunger, but not so much to tip the scale.

1. ½ sandwich (peanut butter, lean meat, veggies) on whole grain bread with milk.

2. Nuts. Limit to approximately ¼ cup per day.

3. 3-4 fig cookies with milk (look for whole wheat variety in the organic food section of grocery store).

4. ¼ cup granola with 6 oz. low fat yogurt.

5. Sliced fresh fruit with yogurt.

6. Sliced fresh fruit with cheese.

7. Apple or banana with peanut butter.

8. Bowl of whole grain cereal with low fat milk.

9. Oatmeal cookies with low fat milk.

Keep in mind that every time you eat, you have an opportunity to do something good for your body, mind, and soul.

What kinds of healthy snack do you find satisfying?

Herbs And Spices Pack More Than Flavor

Adding flavor to your food can be good for your health

When you think of herbal remedies, what comes to mind?  Is it black cohosh, ginko biloba, or echinacea?  Well, look no farther than your spice rack for the healing powers of these unassuming flavor enhancers.  Packed with phytochemicals, these leaves, stems and seeds may ward off a wide range of illness--from cancer to Alzheimer’s disease.  Read on to learn more.

Cinnamon

The bark of a tropical evergreen tree, cinnamon, is used to impart a sweet, spicy flavor to desserts and savory dishes.  An alternate role cinnamon may play is to inhibit bacterial growth, specifically Listeria monocytogenes, which is particularly dangerous for pregnant women, seniors, and those with compromised immune function.  Cinnamon steeped in hot water with tea may act to calm the stomach, lessening nausea and vomiting. Cinnamon may also play a role in blood-sugar regulation.  Of forty-nine herbs, spices, and medicinal plants tested by the US Department of Agriculture for their ability to regulate insulin, cinnamon ranked the highest.

Ginger

A twisted, knotted root common in Indian and Asian cooking, ginger may lessen pregnancy and chemotherapy-related nausea.  Recent research shows that ginger may also help to alleviate arthritis pain.  These findings, although promising, are relatively new and no recommendations are made for ginger to replace traditional osteoarthritis treatment.

Oregano

Oregano is a member of the mint family whose main components, thymol and carvacrol, are potent antioxidants capable of preventing lipid peroxidation and neutralizing food-borne bacteria, such as E. coli, Listeria monocytogenes, and salmonella.  Oregano exhibits stronger antioxidant power than vitamin E.  Other culinary herbs with strong antioxidant activity are rose geranium, sweet bay, dill, purple amaranth, and winter savory.

Rosemary

The use of rosemary in cooking dates back to 500 BC.  It has been used as a food preservative and as a cosmetic fragrance, as well as for medicinal purposes.  It is loaded with a variety of phytochemicals that are proving to be important in the realm of disease prevention.  It has been shown to be beneficial to heart patients, preventing low-density lipoprotein cholesterol oxidation, as well as helping to preserve memory by reducing inflammation and neuron damage.  Carnosol, one of rosemary’s chief constituents, may play a future role in the treatment of liver disease and leukemia.

Sage

The ancient Greeks and Romans used sage as a homeopathic remedy.  Spanish sage may have a future as a treatment for age-related cognitive decline.  It has been shown to mimic the action of certain anti-Alzheimer’s medications.

Thyme

Also a member of the mint family, thyme exhibits strong antioxidant and antimicrobial activity.  Its oils have been shown to disable respiratory pathogens, including those that cause influenza and pneumonia.  It may play a role in cognitive function as well.  Thymol, a primary phytochemical in thyme, may maintain optimal fatty acid balance in aging neurons.

Turmeric

Grown in India and other tropical areas of Asia, turmeric has antioxidant and anti-inflammatory properties owing to the phytochemical curcumin.  Two areas where turmeric’s effects are being shown are in the prevention of Alzheimer’s disease and certain forms of cancer, particularly those of the stomach and colon.

Despite the use of culinary herbs and spices in folk medicine for centuries, research into their ability to prevent disease is young.  They are best consumed in whole food form.  Individual plant chemicals isolated from the herbs may not have the same beneficial actions.  So add a little spice to your life, you may be healthier for it.

The Fallacy of Moderation



What does moderation really mean?

 Moderation is a word that has been used quite often when describing healthy eating and drinking patterns. Webster's Collegiate Dictionary defines moderation as avoidance of extremes or tending toward average. What does this really mean when we are talking about food? Does it mean one cookie a day or one less cookie than we usually eat? Perhaps it means that we don't eat the whole cookie jar? Does it mean once a day, once a week, once a month or once a year? The problem is that it can mean anything that we want it to mean. This isn't good enough when we are talking about promoting healthy eating behaviors. To say "all things in moderation" to me seems like an excuse to maintain the status quo, which arguably is average.

Paula Deen announced this week that she has had type 2 diabetes for the past three years. Her announcement mentioned very little about following healthy dietary habits. Rather, she stated that she has always been a advocate for moderation (there's that word again). Deen's recipes are not known for being healthy and it must be extremely embarrassing for her to have developed a disease that has a strong tie to dietary factors. Regardless of the cause of diabetes, diet and exercise are integral for its management. They are much too important to be passed off by the use of a non-specific word such as moderation. Deen's announcement this week motivated me to write this blog post, but this post is not about her.

The food industry loves the term moderation for the very reason that it is non-specific. Hershey's has created the Moderation Nation to help consumers find balance in their lives. Part of their message is that 100 calories a day of chocolate can fit into your balanced diet. That's fine, if you do not need to lose weight, but about one third of American adults are obese. George Blackburn, MD, PhD, Chief of the Nutritional/Metabolism Laboratory, and Director of the Center for the Study of Nutrition Medicine, which are affiliated with the Beth Israel Deaconess Medical Center in Boston, Massachusetts, reports that for a vast majority of obese Americans, as little as 200 calories a day prevents them from losing the 20-30 pounds necessary to gain significant health benefits(1). That is less than a small package of M&M's (240 calories). Often, that 100 calorie treat becomes a 200 or 300 calorie "nibble" especially when the whole package contains more than 100 calories. The concept of moderation keeps consumers buying products, which is the primary concern of major food manufacturers and restaurants. In the case of Deen's Savannah, GA restaurant, it keeps the line of patrons circling the block waiting to be seated. Moderation promotes sales and keeps the customers coming through the door.

Last month the marketing research group NPD discovered that Americans are following MyPlate guidelines only 2% of the time. That translates to seven days out of the year! That surely is not moderation and I would argue that the message of moderation is not working. MyPlate promotes such a simple concept and advises Americans to consume half of their plate from fruits and vegetables. It doesn't get much easier than that!

So what can we do that is better? The National Heart, Lung and Blood Institute in collaboration with the National Institute of Diabetes and Digestive and Kidney Diseases developed the WeCan Program to teach children and families how to choose healthier diets and exercise more. This program uses the Stoplight Approach to teach which foods should be eaten every day (green light), which foods should be eaten in smaller quantities and less often (yellow light) and which foods should rarely be eaten (red light). Another way to define this approach uses the words "Go, Slow, and Whoa." These three simple words convey more meaning than the word moderation and help to underscore that not all foods can be eaten regularly in moderation if you are trying to lose weight. This approach can be used to teach adults how to better control their food intake too and shows great promise in some area weight management programs.

Stoplight symbols have been added to packaged foods in some European countries to help consumers choose healthier diets. It's doubtful that food manufacturers would allow such a system in the United States because many food products would be labeled yellow or red which could potentially negatively impact sales. You can understand why manufacturers prefer the use of the term "moderation" when it comes to promoting healthier diet habits.

Smart phone users can benefit from using the Fooducate application which independently grades thousands of grocery food items and provides a stoplight color code and letter grade to help consumers make appropriate food choices. The app also discusses the reason for the grade so that you can better understand what makes a food more or less healthy.

I encourage you to make a pertinent comment on this post. I will send a copy of The Little Black Book of Foodspiration by Yvette Quantz, RD, CSSD, LD to the first 20 people who leave a comment. If you are one of the twenty, please email me at info@rochesternutrition with you name and address.

Resource:
1. Blackburn, GL and Waltman, GA. Expanding the Limits of Treatment-New Strategic Initiatives. J Am Diet Assoc. 2005;105:S131-S135.

Resistant Starch: The New Carb on the Block

Resistant starch is the next hot topic that you’ll be hearing about in the news, and I’m not talking about the laundry. This is nutrition science discovering new things about how foods impact our health. In the early 1980’s it was discovered that a component of starch could not be absorbed by the small intestine and passed into the large intestine where it was digested by bacteria, releasing beneficial compounds for the cells of the colon. It was identified as resistant starch (RS). RS is different from dietary fiber because it is bound along with other starchy carbohydrates, not the bran or the germ.




RS can be found naturally in legumes, seeds, whole grains, under-ripe bananas, raw potatoes, and (to a lesser extent) processed starchy foods that have been cooked and cooled, such as breads, cereals, potatoes, rice and pasta. A brand of corn has been engineered to contain a large amount of RS for use in food manufacturing; it is called high-amylose corn (Hi-Maize). This isn’t the corn that you eat at your dinner table. High-amylose corn is processed into flour and added to baked goods to decrease the overall absorbable carbohydrate and increase the RS of a product.



There has been a surge of recent research looking at the health properties of RS. Much of the research uses processed products such as Hi-Maize. Some benefits are improved glycemic control, decreased insulin secretion, decreased cholesterol levels, increased fat burning and improved colonic health. Negative effects have been discovered too, especially with highly purified RS diets that do not include the other components of dietary fiber. There is a concern for increased risk of colon cancer in this situation.



The consumption of RS in the US is currently estimated to be about 3-6 grams per day. In developing countries where unprocessed starch consumption is high the intake ranges from 30-40 grams per day. RS intake in China is about 18 grams per day. Research has identified the beneficial intake of resistant starch to be between 10-20 grams per day. With RS, more is not necessarily better, and a healthful intake can be as little as 5% of total carbohydrates.



Over-processing of foods diminishes RS content along with many other nutrients. This is one plague of industrialized food production. Our goal for healthy eating should be to include whole grains, legumes, and seeds while decreasing processed baked goods. Processed and engineered foods are no match for the panoply of nutrients that whole foods provide.



Engineered RS has been developed to be a functional food, a food or dietary component that may provide a health benefit beyond basic nutrition. I wonder if eating high-amylose corn muffins, pasta, or bread will benefit the consumer as much as the manufacturer. Only time, and more research will tell.

Nutritional Beauty

A healthy diet can make you beautiful inside and out

A growing consumer trend is to eat well for naturally glowing skin, strong shiny hair, and inner holistic radiance. We clearly are what we eat, and this mantra applies to more than just health.




Nutritional products have long been used topically to promote beauty. Honey masks, olive oil hair conditioning, and oatmeal baths can trace their roots back to ancient times. Retinol, a vitamin A derivative, and alpha-hydroxy have been shown to improve sun-damage or wrinkles when applied to the skin. Many cosmetics contain antioxidant vitamins, minerals, and plant chemicals. Most recently vitamin K has been discovered to lighten dark circles under the eyes.



The idea of promoting beauty can also be applied from the inside out. A top nutrient in this category is water. Without proper hydration, skin can seem dull and less supple. Antioxidant vitamins C and E, beta-carotene, and essential fatty acids are next in line. Antioxidants neutralize compounds that damage the body including skin. It is no lie that eating your fruits and vegetables can make you more beautiful. A recent study looking at the amount of vitamin C women consumed in their diet showed that those who ate the least amount of vitamin C from food had the most wrinkled appearance. Vitamin C is important for the synthesis of collagen, a protein that helps maintain skin elasticity. Fruits and vegetables are the main source of vitamin C. Another recent study showed that eating more carotenoid containing fruits and vegetables gave the skin a tanned hue when compared with study participants who did not eat the carotenoid containing foods. Carotenoids are the yellow to deep red pigments found in foods. You may say that eating fruits and vegetables provides skin a healthy glow.



The next big beauty secret believed by some estheticians is controlling inflammation from the inside out; not just reacting to a skin problem. Barry Sears, PhD president and founder of Zone Labs, Inc., contends that “inflammation links to all chronic disease, skin degeneration, and the aging process. To stop inflammation, balance protein and carbohydrate ratio at each meal.” Omega-3 fatty acids found in cold water fish such as salmon, walnuts, flax and chia seed exhibit anti-inflammatory properties. An increased intake of linoleic acid, and omega-6 fatty acid found in nuts, whole grains, most vegetable oils, eggs and poultry, is also associated with more youthful looking skin in research studies. Conversely, high intakes of saturated fat and refined carbohydrates abundant in the typical American diet are associated with a more wrinkled appearance.



Companies looking to capitalize on this trend are introducing products containing antioxidants, omega-3 fatty acids and phytochemicals. Will they make you more beautiful? Perhaps, if you already eat in a healthful manner, but drinking a special concoction won’t help if you are eating doughnuts for breakfast, sub sandwiches for lunch and pizza for dinner. And if you smoke, all bets are off. The aging effect of smoking undoes any good that a healthy diet or special supplement provides. Research shows that what matters more than eating a particular food or nutrient to prevent aging is to follow an overall healthy diet. People eat foods in combinations, not one at a time. It is the interplay of nutrients together that seems to provide the greatest anti-aging benefit. Here’s one more reason to eat your fruits, vegetables, whole grains, nuts and seeds. They can make you look marvelous.

Reducing the Costs of Our Healthcare System

Lifestyle interventions are required to adequately address the rise in obesity 

Medicare has recently decided to cover Intensive Behavioral Therapy for Obesity (IBTO). This landmark decision is very important because obesity will now be recognized independently from co-morbidities such as diabetes and heart disease. Medicare recipients who are obese without other health problems will be allowed to receive IBTO without co-pay in the hope of preventing the development of chronic diseases associated with obesity. The potential for saving healthcare dollars is great, but there is one caveat of this new coverage: The most qualified professionals to provide IBTO are excluded from directly billing Medicare for this service.



Intensive Behavioral Therapy for Obesity will include:

1. Screening for obesity in adults using measurement of BMI calculated by dividing weight in kilograms by the square of height in meters (expressed in kg/m2);

2. Dietary (nutritional) assessment; and

3. Intensive behavioral counseling and behavioral therapy to promote sustained weight loss through high intensity interventions on diet and exercise.



Patients who meet screening eligibility are entitled to:



• One face-to-face visit every week for the first month;

• One face-to-face visit every other week for months 2-6;

• One face-to-face visit every month for months 7-12, if the beneficiary meets the 3kg weight loss requirement.



Medicare names primary care physicians, clinical nurse specialists, nurse practitioners, and physician assistants as being the only professionals who can bill Medicare for IBTO and the primary care clinic as the only site where IBTO can be provided. This leaves out registered dietitians and clinical psychologists, whose training qualifies them over primary care practitioners to most effectively provide this service. Patients who desire to work intensively with dietitians or psychologists will have to pay for these services on their own.



After reviewing the ruling posted on Medicare’s website and looking over the references that were provided in support of IBTO coverage, I’m stumped by this decision. Many of the references cited had dietary interventions provided by registered dietitians. A 2004 article published in the Annals of Internal Medicine by the Centers for Disease Control and the Primary Prevention Working Group names dietitians among the most qualified providers to administer lifestyle interventions. This same article states, “even the most highly motivated physicians typically have minimal education or training in lifestyle intervention, and they usually have inadequate access in their practice to the resources needed to support lifestyle intervention. Well-intentioned attempts by physicians to practice “lifestyle medicine” with scarce resources can lead to embittered rejection of health promotion.” The article then goes on to state, “No efficacy study had physicians directly involved in delivering interventions.”



Dietitians bill insurance at 85% of the physician rate. It doesn’t make fiscal sense to allow primary care providers to bill at a higher rate for IBTO when they are not trained in this technique and they do not have the time to provide such involved therapy. I hope in the future that Medicare sees the value that registered dietitians and clinical psychologists bring to the treatment of obesity and allows them to bill for this service independently from primary care providers.


Please support the effort to urge Medicare to allow registered dietitians to directly bill for obesity services by signing this White House petition by January 7, 2012.


Reference:
Centers for Disease Control and Prevention Primary Prevention Working Group.
Primary Prevention of Type 2 Diabetes Mellitus by Lifestyle Intervention: Implications for Health Policy. Ann Intern Med. 2004; 140:951-957