On Nutrition

Snack Attack: The Art of Healthy Snacking

2012-02-02T08:00:00.001-05:00

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

2012-01-30T13:47:00.000-05:00

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

2012-01-20T09:31:00.003-05:00

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

2012-01-09T08:00:00.001-05:00

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

2012-01-05T14:59:00.001-05:00

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

2011-12-19T09:31:00.000-05:00

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

Medicare Chooses Inferior Care for Obesity

2011-12-02T08:27:00.003-05:00

Preventing dietitians from becoming providers for obesity care is not in the best interest of patients

I received some good news the other day. Medicare has agreed to cover Intensive Behavioral Counseling for Obesity for eligible Medicare beneficiaries. And then I read the statement released by the Centers for Medicare & Medicaid Services (CMS). Registered dietitians and psychologists will be excluded as obesity care providers. According to CMS obesity counseling must be provided by a “qualified primary care physician or other primary care practitioner and in a primary care setting.” What does this mean? A "qualified primary care physician", according to the Social Security Act is a physician who is a general practitioner, family practice practitioner, general internist or obstetrician or gynecologist. A “primary care practitioner” is defined as a physician with a primary specialty of family medicine, internal medicine, geriatric medicine or pediatric medicine or a nurse practitioner, clinical nurse specialist, or physician assistant." Obesity services must be provided in a primary care setting which CMS defines “as one in which there is provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. Emergency departments, inpatient hospital settings, ambulatory surgical centers, independent diagnostic testing facilities, skilled nursing facilities, inpatient rehabilitation facilities and hospices are not considered primary care settings under this definition.”

The bottom-line is that registered dietitians who are highly trained to intensively counsel obese individuals will not be allowed to bill Medicare for obesity intervention and private nutrition practices that are established and operated by dietitians are not considered an appropriate setting by CMS for nutrition education of these individuals.

I cannot say for certain what was really behind the decision to exclude dietitians from becoming Medicare providers for obesity counseling because Medicare's explanations seem lame to me. The American Dietetic Association described CMS's action with regards to the exclusion of dietitians as follows:

it appears that CMS excluded RDs for two reasons:

1. CMS believes it lacks the statutory authority to include RDs as providers outside of diabetes and end stage renal disease; and

2. CMS believes it is important that preventive services be furnished in a coordinated approach as part of a comprehensive prevention plan within the context of the patient’s total health care. As such, they believe primary care practitioners are best qualified to offer care in this context.

Apparently Congress has not charged dietitians in the fight against obesity but dietitians are allowed to help people with diabetes and end stage renal disease. Many people with diabetes are obese and when I am counseling them for diabetes management, weight management is always a part of the intervention.

As for "preventive services being furnished in a coordinated approach as part of a comprehensive prevention plan within the context of the patient's total health care," what Medicare fails to see is that it doesn't matter how well care is coordinated if it is inadequate. To date primary care intensive obesity intervention consists of MDs and NPs telling patients that they need to lose weight and referring them to a dietitian. Now that MDs and NPs will be able to bill for counseling for obesity they can remove the dietitian from the equation and bill their services at a much higher rate than the RD would bill and provide less than adequate nutrition counseling possibly after attending a weekend course on obesity management to supplement their one medical scool course in nutrition. I don't mean to disparage doctors, but they are not trained to provide comprehensive nutritional intervention. My husband is a physician and he is the first to admit that most doctor's knowledge about nutrition is lacking. Think about it this way, does Medicare require that physical therapy be provided under the primary care physician's watchful gaze in a primary care setting?

I am always dismayed when I read press releases about new scientific discoveries related to obesity in which the final sentence in the release states that this information can be used to develop a drug to combat obesity. Obesity fighting drugs that have already been released are often recalled because they pose a serious risk to health and can cause death. Humans have existed for thousands of years with minimal obesity until now. We know how to combat obesity and it is not a pill. It is inexpensive but labor intensive and it does not make research and drug companies incredibly wealthy.

A cynical interpretation of this whole debacle is that lobbying from Big Pharma helped to ensure that the practitioners who can prescribe medications would be the only ones whose obesity related services could be covered by Medicare.

It is sad to me that some highly qualified nutrition and behavioral therapists (dietitians and psychologists) will be excluded from treating Medicare recipients. Patients who want to see dietitians and psychologists for nutrition and behavioral counseling will have to pay for these services out of their own pockets (again).

What do you think? Will Medicare provide the most comprehensive treatment for obesity by the most qualified providers?

“Gout” You by the Toe? Kick It with Good Nutrition

2011-11-29T15:06:00.000-05:00

Lifestyle contributes to gout

Gout has long been viewed as a malady suffered by the wealthy, those with means to afford rich foods and wine. Today, gout is the most common form of inflammatory arthritis suffered in men, effecting 3.4 million adult men and an increasing number of postmenopausal women. The incidence of gout is on the rise and lifestyle factors play a significant role in its occurrence.

Gout is characterized by on overproduction of uric acid or a decreased excretion of urate in the kidney. Uric acid is the end product of purine metabolism. Most purines are contained in the human body as DNA. Cells of the body are constantly turning over with the release of genetic material and their consequent breakdown to uric acid. Foods and beverages that we consume can also contribute to the overall uric acid load in the body. When the uric acid level of the body is elevated, crystals can form in the joints. These crystals activate an inflammatory response, which brings on the pain and swelling of gout. The big toe and ankles are common joints affected.

Gout has been shown to be related to the metabolic syndrome, a cluster of features which increase the risk of heart disease and diabetes. Overweight and obesity seem to play a role in both gout and metabolic syndrome. Maintaining a healthy body weight is import in the control of gouty inflammation, however, sensible eating is important. Following a low carbohydrate, high protein diet for weight loss can exacerbate gout.

High protein foods tend to contain more purines with the potential to raise uric acid level, though not all high purine foods have the same ability to cause an attack of gout. Beef, lamb, pork and fish are primary offenders and should be eaten less often and in smaller amounts. A small portion is considered three ounces and is the size of a deck of cards. Most restaurants serve meat in portions of six ounces or greater. Plant foods higher in purines do not seem to bring on gout and do not need to be limited. These include whole grain breads and cereals, oatmeal, wheat germ, wheat bran, mushrooms, green peas, spinach, asparagus and cauliflower. These foods have other health properties that may protect against gout. Low fat dairy products seem to protect against gout and it is recommended to eat at least two servings a day. Dairy products are low in purines and increase the excretion of urate. Vitamin D may also play a role in gout. Many people who have gout are deficient in vitamin D. Urate may prevent the activation of vitamin D, which is believed to have anti-inflammatory properties.

Alcohol has long been known to be a risk factor for gout. Beer is high in purines but alcohol in general may also be implicated. Alcohol is dehydrating and poor hydration increases the risk of gout. Alcohol intake should be controlled; especially beer and special attention should be paid to drinking enough water. This is particularly true when traveling. Many people experience gouty attacks while on vacation. They are dehydrated from their travels and imbibe more than they would at home.

Other diet and lifestyle factors important in the management of gout are:

• Reduced fructose consumption. Fructose is the only sugar that increases urate. Fructose is found most in soft drinks, sweetened juices, apples and oranges.

• Increased fruit and vegetable consumption (except apples and oranges). These foods are known to decrease inflammation with the potential to lower urate.

• Increased vitamin C intake. Vitamin C found in many fruits and vegetables decreases urate. Supplementation of 1500 mg vitamin C daily may be helpful. Vitamin C supplementation should be split throughout the day (500 mg with meals three times a day is suggested).

• Cherries are known for their anti-inflammatory ability. Consumption of cherries and cherry juice decrease gouty attacks.

• Increased physical activity is associated with decreased risk of gout.

As with all diet and lifestyle recommendations, do not undertake dramatic changes in your habits without supervision and advisement from your physician.

How Are We Teaching Our Children to Eat? Some Comments on McDonald's

2011-07-27T15:18:00.003-04:00

Unfortunately, eating fast food regularly is a reality for many families

I'm not quite sure what to think about McDonald's pledge to improve the nutritional offerings of their trademark Happy Meal. By the end of 2012 all Happy Meals will automatically include apple slices and the calorie content will be decreased by 20%. This is good, but will it really make a difference in battling childhood obesity? The bottom line for me is that allowing your kids to grow up eating McDonald's food (or any fast food) is like throwing them in a swimming pool without lessons and expecting them to know what to do. Let me explain.

When my kids were young, I would meet other mothers at a Maryland McDonald's so our kids could play. Our local McD's had a Playplace for the kids to climb and run. After an hour of play, we would buy the children Happy Meals. I noticed that my kids and my friend's kids would eat only a very little bit. We ended up throwing at least half of the meal away. The kids were little (under 5 years) so of course they couldn't eat the whole meal. We did this a few times and there were times that I did this with my kids alone. Despite being in the metropolitan Washington DC area, I was lonely and isolated from my friends because it took at least an hour to get anywhere. Letting my children play at McDonald's got us out of the house.

When I moved to Rochester, NY my two older children were 4 and 2 years old. I began stopping in at the corner McDonald's at lunch time on occasion. As I sat watching my kids barely eat their meals I finally got some sense. By continuing to take my kids to McDonald's I was teaching them to like fast food. In the world of nutrition and health, I was teaching them how to drown.

McDonald's will most likely benefit from all the hoopla surrounding their recent press release. Consumers will view the company as caring and wanting to improve the health of children. I don't believe it! Large companies care about their finances. If they truly cared about childhood obesity, they wouldn't market their foods to children with toys. The toys in Happy Meals will still be offered. McDonald's wants your children to learn how to like their food so that they will continue to eat it as they grow up.

I read through several comments at the end of one of the online articles about this topic. One reader suggested that McDonald's trash should be evaluated for all the wasted Happy Meal produce. I'm sure that there are a lot of wasted hamburgers, chicken nuggets and French fries in that trash too. We give up so easily when teaching our children how to eat better. We stop offering vegetables because they won't eat them not knowing that the simple act of consistently offering healthy foods is important.

My question to those who give up trying to feed their kids healthy foods; would you stop teaching them math just because they are having difficulty with subtraction? The way to work towards combating childhood obesity is to feed your children lots of vegetables, not buying them the "healthier" Happy Meal.

I'm giving away the family cookbook No Whine with Dinner by fellow RD's Janice Newell Bissex and Liz Weiss. Comment on this blog post by August 31st, 2011 and you will be entered to win this cookbook to help your kids eat healthier (just in time for the new school year)!

Nutritionists Blog About MyPlate

2011-06-06T13:08:00.001-04:00

A more simple model for healthy eating

MyPlate is barely a week old and the nutrition world is buzzing about it. If you are curious about what this new icon is and what it might might mean to you, read on.

I'm happy to share a link with you that is a collection of blog posts written by dietitians (myself included) on the new MyPlate. Much thanks goes the Janet Helm of Nutrition Unplugged for organizing this list. Enjoy reading the various comments on MyPlate from nutrition professionals and add to the discussion with your own comments if you feel so moved. We'd love to hear your voice!

MyPlate Blog Link

Keeping Your Food Focus in an Attention-Grabbing World

2011-06-06T12:14:00.003-04:00

Isn't all yogurt probiotic?

It seems that almost every month there is some new concept in nutrition that seeks to grab our attention. Many eating styles and food products are developed to help people adopt these "new" eating principles. Some examples of these are the Paleo Diet, Atkin's Diet, glycemic index, raw foods diet, gluten-free diet, juicing and super foods (this list goes on and on). There is a lot to grab our attention and the end result for many people is not better health and vitality, but a short stint following an unmanageable eating pattern, a little weight loss, and more weight gain down the road. All of this is for the privilege of spending a small fortune.

I'm not saying that diet and nutrition principles don't have merit. A gluten-free diet is vital for people with celiac disease and the rest of us could probably stand to consume less refined wheat products. Rather, I think we lose our focus on eating a healthy diet by being drawn into food fetishes that may not make any sense for us. As an example, I've heard many people claim that they won't eat carrots, grapes or watermelon because they contain sugar. To equal the amount of sugar in a 12-oz can of Coca Cola Classic you would need to eat 4 cups of watermelon, 10 large carrots, and 45 grapes. Some people might be able to eat this much, but I'm sure that they would be quite full and not able to eat much for a period thereafter which is not the case when you drink a can of Coke. Also, consider that natural foods such as carrots, grapes and watermelon contain nutrients that promote health.

I was recently asked my opinion about Joe the Juicer who has a website called Fat Sick and Nearly Dead. Joe found "religion" (health) through juicing and now is on a crusade to transform the world. There is some sensible nutrition advise promoted on Joe's website and it is this advise that is responsible for transforming lives. Juicing is the vehicle that is used to promote a more plant-based diet. If you can live on juice, then this is the diet regimen for you. If not, then you better pay attention to adopting healthy lifestyle habits that you can maintain, and forget the juice.

When adopting a healthy lifestyle, ask your self this question: Can I maintain this change over my lifetime? If the answer is no, figure out what you can do to be healthier and establish SMART goals for yourself. A SMART goal is specific, measurable, attainable, realistic and time-lined. A SMART goal will lead you to the healthy lifestyle you are seeking, one goal at a time.

My kids often joke about being distracted by shiny objects. There is a lot of "nutritional glitter" out there vying to take your attention away from more sensible practices. Trust in your common sense and your ability to stay the course. It may not be as dramatic as juicing, buying amped up yogurt or getting your stomach stapled. But it is what works. Slow and steady wins the race, as long as you stay on the course.

MyPlate Introduced. Now What?

2011-06-03T11:22:00.003-04:00

The endless junk food aisle

Yesterday was a big day in the world of nutrition. The 20 year old Food Pyramid was retired by the USDA and the new MyPlate was unveiled. The new food guide shows a plate with four sections for the basic food groups: grains, fruits, vegetables and protein. To the side is a cup of dairy. The new food icon was introduced by USDA Secretary Tom Vilsack, US Surgeon General Regina Benjamin and First Lady Michelle Obama at a press conference yesterday morning. Vilsack commented that the personal health of the nation is as important to the wellbeing of the country as its fiscal and economic health. It is an issue of national security when many youth are too overweight and unfit to protect the country. Dr. Benjamin concurred that childhood obesity is one of the greatest challenges facing our nation. She stated that the goal of the new food icon is to provide clear and simple information based on science to guide the American people to make healthier food choices. First Lady Michelle Obama commented, "What is more simple than a plate?"

Michelle Obama goes on to say that there is still work to be done in leading our nation toward health. I can't agree more! I like the simplicity of the icon and the message to the American people to eat less that is a central tenet of the Dietary Guidelines. But I wonder if this new food guide will have any impact upon the way that Americans eat?

At the Future of Food Conference in Washington, DC last month, Secretary Vilsack commented that the way farm subsidies are appropriated will change with the new Farm Bill. He hopes to empower more small family operated farms which means decreasing (or ending) the subsidies paid to larger agribusinesses. To me, this is a more important step in changing the US food and health environments than the combined efforts of the new MyPlate, Dietary Guidelines and universal health insurance. The endless aisles of junk foods, cereals and beverages are directly related to subsidies paid to grow corn, wheat and soy which allowed the creation of cheap processed foods. Cheap processed foods are bad for health for many reasons, one of which is that they displace healthier foods such as vegetables, fruits and whole grains. When soft drinks and junk foods are more expensive and vegetables and fruits are less expensive, Americans will buy less junk. When we see smaller displays of junk foods at the grocery store, then we'll know that we are moving in the right direction.

Vilsack goes on to say at the MyPlate press conference yesterday that you have to walk the talk. He tells a story of how the new icon influenced him recently at a dinner where he was served a piece of steak that covered more than half his plate. He purposefully didn't eat it all. I hope Congress has the same good sense when it comes to passing a Farm Bill that will change the US food and health environments. Congress will have to turn a deaf ear to the wealthy and powerful food lobbies and do the right thing for the American people by voting to reduce subsidies to large agribusiness. Our national security depends upon it.

Moving Beyond SAD: Embrace the Mediterranean Lifestyle

2011-05-27T14:38:00.000-04:00

The Mediterranean Diet Pyramid

The standard American diet is often referred to as the acronym SAD. The SAD is indeed sad when we consider the impact that it has upon the health and wellbeing of Americans. The increase in chronic diseases such as heart disease, cancer and diabetes is of great concern. Lifestyle choices have a large impact on the development of chronic illnesses. In 2005, one of every two adults had at least one chronic illness. With the current increasing trend in obesity, this number is expected to rise with serious social and economic outcomes.

The SAD is a result of US farm and economic policies. Laws were created throughout our history that gave advantage to companies. These companies in turn controlled what crops farmers would grow and how food was developed from them. High fructose corn syrup and soy protein isolate are two examples of food additives cheaply created from subsidized corn and soy crops. Processed foods flooded the markets and Americans responded by buying them up. It appears that now the devil is collecting what is due. What is truly sad is that our children won't even have a chance. Obesity rates in children have skyrocketed with a concomitant increase in chronic diseases. Many healthcare professional are expecting children born today to have shorter lifespans than their parents.

Across the globe, people developed eating patterns that were consistent with their natural environments. This way of eating offered people the greatest advantage for survival. The Mediterranean diet is a prime example of this. I can wax poetic on the benefits of following a Mediterranean diet pattern, but there are wonderful resources that already exist. Instead, I'd like to focus on a few of the Mediterranean eating and lifestyle habits that Americans can easily follow in their natural environments.

1. Tend a garden: This is not a foreign concept in American history. Most families used to have to grow their own food. Gardening has become almost quaint with our busy lifestyles and the greater availability of convenience foods. If gardening is too challenging you can frequent farmer's markets weekly or join a Community Supported Agriculture group. Either way, you'll be connected to the land and the life-giving foods that come from it.

2. Plants, plants and more plants: Place focus on eating more plant-based foods. We certainly aren't lacking for protein in the US. What we are lacking is eating more plants. Every meal and snack of the day should contain plant food. We can explore eating a wide variety of fruits, vegetables and whole grains that offer a bounty of nutrients.

3. Go fishing: I mean this metaphorically, but if you actually can go fishing more power to you! Replace eating beef and pork with fish. The fish in the market today is fresher than ever and there are many wonderful options that come from our lakes, rivers and oceans.

4. Be a little nutty: Nuts are a plant-based source of protein and healthy fats. Many nuts such as almonds, pistachios, walnuts, pecans and peanuts are cultivated in the US. Nuts can be used to enhanced the flavor of recipes or they can be a satisfying and nutritious snack when paired with a fruit or vegetable.

5. Cook and eat together: Nurturing is an innate human instinct, although some are more in tune with it than others. Our convenience-oriented environment has made it more difficult to become in tune with our more natural nurturing instincts. Cooking food to share with your family and friends is a great bonding activity. It is part of being human. Get everyone involved and enjoy the experience!

6. Get on your feet: Gardening, cooking, and walking to the market are all activities that support health. Life used to be very physical and now we have to exercise to replicate what we used to do on a daily basis for survival. An interesting thing is that all the exercise in the world won't save you if you sit for hours on end in a day.

A new US Food Guide will be unveiled June 2nd, 2011. Word has it that it will be very different from the Food Guide Pyramid of the last decade. A new icon was developed to more simply help Americans adopt the Dietary Guidelines into their lives. Whether or not the Food Guide is wonderful, all Americans can make little changes to move them to a healthier and closer relationship with the land that they live on.

How to Mindlessly Eat Better

2011-05-20T23:49:00.000-04:00

Arrange your home and work environments
to help you to make healthy food choices

The food industry knows what we like. Sugar, fat, and salt have incredible power over us, and for a very good reason—survival. I recently had an opportunity to interview and attend a lecture by Brian Wansink, PhD, behavioral psychologist and author of Mindless Eating: Why We Eat More Than We Think. We are programmed to love the taste of sugar, salt and fat according to Wansink. Our ancestors knew that sweet berries were safer to eat than bitter ones, and that they supplied us with much needed quick energy to help us build civilizations and flee danger. Fatty foods provided energy reserves to help us through periods of famine. Salt helped our active forbearers to retain water and prevent dehydration. Finding convenient food was also important for survival. The less time prehistoric humans spent in the pursuit of food, the less risk they had of encountering something that would pursue them as food. The concerns that our ancient ancestors had for survival are not as relevant to us today, but our preferences for sugar, fat, salt and convenience persist. Do not blame the food industry for the overabundance of convenient foods loaded with sugar, salt and fat. Dr. Wansink contends that the food industry’s only concern is to sell you the foods that you want. “They could care less if you eat it” he claims.

Our desire for sugar, salt, fat and convenience paired with a very marketing savvy food industry are a part of the reason we have become the fattest nation on earth. We make over 200 food decisions in a day, and many of those decisions are mindless. Dr. Wansink’s research shows that calorie consumption is greater when we are cued to eat mindlessly. He also discovered that no one is immune to it. Wansink studied graduate students who were trained to understand the concept of mindless eating, and found that they were just as likely to engage in eating mindlessly as anyone else. Education and intelligence do not prevent mindless eating.

It seems the answer to mindless eating would be to become more mindful of what we put into our mouths. However, Wansink believes that mindfulness requires too much energy to maintain. Instead he believes that we should adjust our environment to allow us to mindlessly eat better.

Eating Cues

There are many cues that promote mindless eating and they very often trump hunger. The cues around us suggest when it is time for us to eat; we may habitually eat at a certain time or take a specific amount of food because that is what we are used to doing. We develop unhealthy habits that we engage in frequently simply because they have become normal. Wansink has discovered that we can eat on average 20% more or less without being aware of it. He calls this the mindless eating margin. Big portion sizes and giant-sized packages have helped us to become accustomed to eating more. Making a few small changes can help us to eat less. The following is a list of cues that promote mindless eating with suggestions how we can re-engineer our environment to mindlessly eat better.

• Dish and Utensil Size: Larger plates, bowls and serving spoons can encourage us to eat about 25-30% more food.
Mindlessly Eat Better: Use smaller plates, bowls and spoons when serving and eating food.

• Glass Shape: We pour a greater volume of beverage in short wide glasses than in tall narrow ones. A study conducted on bartenders showed that they over poured beverages an average of 37% in short wide glasses.
Mindlessly Eat Better: Drink only from tall thin glasses.

• Food Package Size: The larger the food package, the more we tend to eat.
Mindlessly Eat Better: When buying larger packages for value repackage the food into smaller portions at home right away and hide the extras.

• Variety: When presented with a greater variety of food we will eat more total food than when we are given fewer food choices.
Mindlessly Eat Better: Provide a greater variety of healthy foods during meals such as offering two vegetables and/or a piece of fruit every time you eat.

• Visibility: If we see food we will most likely eat it. In one study, participants ate 71% more candy when the candy in the dish was visible.
Mindlessly Eat Better: Place healthier foods in visible locations and less healthy foods in less visible locations in your workplace and home.

• Family-Style Meals: We tend to take more food per serving and take additional servings of food when it is offered family-style.
Mindlessly Eat Better: Serve foods such as vegetables and fruits family style and serve entrées and bread, rice or pasta from the counter. Having to get up from the table to serve more food provides enough pause for us to determine if we are still hungry.

• Distractions: Eating while doing other activities such as reading, working on the computer, watching TV or eating with other people promotes mindless eating.
Mindlessly Eat Better: Eat only fruits and vegetables when doing other activities. When eating with other people, pace yourself to be the last one to start eating and the last one to finish eating to avoid taking extra food.

Wansink says that, “it is easier to change your environment than to change your mind.” He is currently involved in a program called The Smarter Lunchroom Initiative whose mission is “to design sustainable research-based lunchrooms that subtly guide smarter choices.” Most lunchroom changes cost less than $50. By making healthy foods more visible (serving fruit in a nice bowl in a well-lit area) and offering a greater variety of healthy choices (two vegetables instead of one) schools can significantly promote healthier eating among students.

These strategies can also be used in home and work environments. Anyone can make two easy changes to eat better. You will hardly notice that you are hungry with a daily decrease of about 100-200 calories, but you will be establishing new eating patterns that will lead to significant weight loss and improved health over time. Don’t let another day, month or year go by without making a consistent change. Think about it, in a year you could be ten pounds heavier if you do nothing or ten pounds lighter if you change your environment.

This article will be published in Rochester Healthy Living.

Note to Americans: Celebrate National Nutrition Month All Year Long

2011-03-09T11:17:00.002-05:00

Define yourself as a healthy eater

March is National Nutrition Month. This is a big deal to dietitians and those who work in the field of nutrition and aspire to help Americans to adopt healthier eating and lifestyle habits. I wonder, has the rest of America received the memo?

Nutrition impacts so many aspects of health. What we eat deserves the greatest of care and attention the whole year, not just on one designated month of the year. What is it going to take to finally get Americans moving in the right direction to make healthy food decisions most of the time?

Eating healthy is not an all or nothing proposition and perhaps dispelling this myth is the first place to start. Let's embrace food for its nourishing properties and celebrate its flavors, textures and aromas for what they are, delicious! Eating healthfully does not mean that you can never eat pepperoni pizza (or cake or whatever your favorite food might be). In fact, including your less healthy favorite foods in your diet from time to time may be helpful in actually adopting a healthier diet overall.

This brings me to my next point; our skewed taste perception. Many of the foods that are sold in grocery stores and restaurants in America are loaded with fat, sugar and salt. Our tastes veer naturally toward these compounds in foods, but what we taste most often are not the naturally occurring elements in foods, rather the concocted flavors created by food engineers. The politics behind this is enmeshed in our agricultural system (farm subsidies), and food industry (food lobbies) and presents a huge hurdle for Americans to jump over in order to make healthy eating easier. I don't have a clear solution for this problem, other than to encourage Americans to go back to what is natural (unfortunately, the definition of natural is meaningless on food packages) and naked, food in its natural state prepared with ingredients that were not created in a lab. There is hope that we can regain our taste for real food. Taste perception is not static, it changes over time. I can attest to this myself as I have worked to wean my taste away from sweet and salty foods. I can now barely tolerate these flavors in most manufactured foods. I would much rather add my own sweetness to oatmeal with raisins than eat sweetened packaged oatmeal and I notice how salty most foods taste in restaurants.

Nutrition should be on our mind every day as we choose what we eat. The nutritious foods that we eat are also delicious, from the whole wheat cinnamon toast with butter and a full bowl of berries that I ate for breakfast this morning; the homemade pea soup I'm having for lunch with an over-sized red delicious apple; to the red beans and brown rice, pecan cornbread (from a package with ingredients that are foods, not chemicals) and roasted asparagus that I am making for dinner tonight.

Upon learning that I was a dietitian, a gentleman once commented that he felt sorry for my husband. I replied back, "My husband is the luckiest man in the world. He gets to eat the most delicious and nutritious food!" Our perception of healthy foods should stress how wonderfully delicious they truly are so that we celebrate National Nutrition Month all year long!

Facebook Moratorium

2011-03-04T08:00:00.003-05:00

The social network connection

I often wonder why I spend so much time creating my online presence using social media tools such as Facebook. There are a few reasons that I use Facebook professionally. It is a great tool for staying connected with my colleagues and keeping on top of cutting edge news in my field. It also serves as a valuable resource for getting my message out to my clients, although I question if I'm really reaching my ideal client. It's difficult to tell the impact that I'm having without getting feedback in the form of comments. I carefully look for information to post to help others make positive diet and fitness changes and have only once been made aware of the value of this work to my audience. It is important to me to stay connected with my audience but difficult to to so when I wonder if I even have an audience.

Social media is a time sink. Facebook and Twitter eat up time that I should spend doing other things to grow my business. There already is enough to keep us tethered to our computers without the addition of Facebook and Twitter. In the back of my mind I think that I should spend more time in endeavors that will make money rather than posting free information for an invisible audience.

To make matters worse, I have been gaining weight lately despite exercising regularly. I can't help but think that all this sitting behind a computer is a bad thing for humans in general. My recent weight gain has spurred me into action. I have decided to impose a moratorium on Facebook and Twitter for the next week. Every time that I think about checking my social media accounts I will do ten jumping jacks and ten push-ups instead. One of the purposes of my social media existence is to inspire others to improve their lifestyle. I can think of no better place to start doing this than with myself. The calories we burn when we exercise are a small fraction of what we burn in a whole day. Our goal should be to pursue activity all day long. So whenever I have the urge to post an article, picture of food, recipe or any other tidbit that I find interesting, I will be active instead. I wonder how many jumping jacks and push-ups I will complete in a week. I'm sure that I will be doing quite a few of them. Social media has become a big part of my professional life in the past couple of years.

I will return to sharing information on Facebook and Twitter after a week, but I will incorporate my new habit of activity before every interaction. I encourage everyone else to attach some form of physical activity to your more sedentary pursuits.

To Health!

What are some of your impressions about social media?

What Do Box Tops for Education Really Promote?

2011-02-15T12:12:00.000-05:00

I collect Box Tops for Education for my daughter's elementary school. One or two products that I buy are involved in the program and I dutifully clip the box tops for the school. I recently noticed a commercial for Pillsbury® Toaster Strudel® Pastries promoting their affiliation with the Box Tops for Education Program. It got me thinking: How healthy are the food products that are involved the program?

"Box Tops for Education is a program created by General Mills to provide funding for education." This is the description of the program on the eHOW website. The official Box Tops for Education website claims to have raised over $320 million for schools since 1996 (each box top collected is worth ten cents). Compare this with the annual cost of obesity which was recently stated as $147 billion per year, and the benefit of the Box Tops program pales in comparison! With increasing rates of overweight and obesity in kids, it's pretty important that programs designed for schools promote healthy eating habits.

I surveyed the food products involved with the program and created three categories: healthy, pseudo-healthy, and refined. I classified each food in a category for each division of food products (refrigerated, frozen, beverages, etc.). This is by no means a scientific study and my criteria for healthy vs. pseudo healthy foods is perhaps a bit blurred (I classified Juicy Juice as a pseudo-healthy food. Consumed in small amounts, it is fine, but even 100% juice can contribute to weight gain when over-consumed). If a food contained a majority of whole grains, was in its natural state, contained lower amounts of sodium, and had limited added sugars, I considered it a healthy food. Food products close to their natural state, but with some added sugars (or high natural sugar content) and added ingredients to bump up their dietary fiber were considered pseudo-healthy. Foods with a high amount of refined grains and sugars (including artificial sweeteners) and higher in sodium were classified as refined foods (notice how I didn't call them unhealthy, although it is implied).

As you can image, most of the food products promoted by the Box Tops for Education program are processed. You can view the participating products for yourself. The list changes often as new products are added and limited products are deleted. Of the one hundred and eighty-eight products that I looked at, 14.3% were healthy, 14.8% were pseudo-healthy, and 70.7% were refined. These results are not so impressive, especially when it comes to feeding our kids!

Ehow suggests using the program only for products that you normally buy. But we all know that this is not really how promotions and coupons are intended to be used by their creators. They want us to buy their products and the more we buy the better. It behooves manufacturers to offer promotions to encourage us to buy; if we think that they are socially minded in the process, all the better for them. I wish they would just donate money to the schools without pushing us to buy products, but that's not how America works.

Fortunately, there are non-food products that are involved in this program, so you don't have to worry about contributing to childhood obesity because you want to clip a few box tops. Even better is the online program. There are many participating stores selling many non-food products that will provide a multiple of box tops per every $10 spent.

I'll continue to clip the box tops for the three food products that I regularly purchase and resist the urge to buy more because I think that I'm helping my daughter's school by doing so.

How Food Can Help You Score in Love

2011-02-14T10:49:00.001-05:00

Set the stage for love by following a healthy diet

The connection between food and love goes much deeper than eating certain foods to increase arousal. The right foods convey vitality, endurance and improved blood circulation; all very important for a special night with that special person. There is no mystery; a healthy diet sets the stage for a fulfilling romantic experience. We’ve all heard it before; eat more whole grains, fruits, vegetables, nuts, seeds, and fish. Not eating this way yet? Well you should, and here is another good reason why: what’s good for your health is also good for your mojo. We are just beginning to understand how the array of nutrients we get from unprocessed foods impact our bodies; from the phyto (plant) chemicals in blueberries that help relax your blood vessels, allowing blood to flow through them more freely, to boosting your libido by eating enough zinc from meat, whole grains, legumes, and seafood (oysters, a famed aphrodisiac, are high in zinc). If you abuse your body with foods high in saturated fat and refined carbohydrates, over time you’ll increase your risk for heart disease and diabetes, two chronic diseases with serious negative ramifications in the love department.

A little foresight is required to set the tone for a romantic evening. Follow a few simple guidelines to help you get ready for that perfect encounter.

1. Eat Breakfast: Eating breakfast is the best way to assure that you have the energy to make it through the day and into the night. Breakfast foods such as oatmeal, fortified cereals, milk, and eggs provide a good dose of B-vitamins, which will keep your libido soaring and the stress of courting under control. One of the B-vitamins, niacin, is important for the secretion of histamine, a chemical that your body needs for arousal.

2. Limit Caffeine and Alcohol: In moderation, both are fine, but tip the scale in the direction of excess and your night of romance could be railroaded. More than three cups of coffee can act as a diuretic and cathartic; where a little caffeine and alcohol may help keep you alert and relaxed, too much and you could spend most of the night in the bathroom rather than with your love interest.

3. Minimize Foods that Create Unpleasant Odors: Many foods that create odors, such as garlic, onions, curried dishes, broccoli and cauliflower are good for you. You still want to eat these foods, but not on date night. The alternative is to persuade your date to eat them with you, that way you will both be blissfully ignorant about how you smell to the world.

The best aphrodisiac is to feel good about yourself. The confidence that you exude because you feel good about the way that you look and feel can make you irresistible to others. A few types of foods can help add to your appeal. If you want to be assured of a “sure-thing”, try one or more of the following:

Celery: Celery doesn’t come to mind when you think about passion, but this unsuspecting vegetable releases pheromones—chemicals that naturally turn us on—with every bite. Munch a few stalks, and you could give another meaning to the term “rabbit food”.

Chocolate: Chocolate contains chemicals that heighten the love experience. One is phenyethylamine—called the “love molecule” because it is suspected to cause the feeling of bliss lovers experience. The other, methylxanthine, is a stimulant responsible for increasing skin sensitivity. Chocolate rightly earns its reputation as a treat for lovers.

Vanilla: The scent of vanilla has been shown to be relaxing, putting people in the mood for intimacy. Light a few vanilla candles and serve vanilla ice cream with a chocolate dessert and you and your intended will soon be in the mood for love.

Adventures in Soup Making

2011-02-11T13:00:00.004-05:00

Delicious and easy red lentil soup

We love soup in my house. I began making soup a more regular part of our meals a few years ago. I started by using prepared organic broths. There are many easy recipes out there making soups with prepared broths. The only problem is that they are high in sodium. Yes, I know that you can buy low sodium broths and this is a good option, but I have flavor fatigue from most commercially prepared broths. As my husband and I are pushing the second half century of our lives, I think that it is better to prepare more homemade soups with homemade stock.

This may seem like a daunting task, but really, it isn't. You can prepare your soup or broth when you have more time. Once you get familiar with what tastes good to you, you'll be able to "wing it" without a recipe. I still like to find a great soup recipe like Red Lentil Soup from The Best of Bloodroot, Volume Two, but most of my soup adventures are flying by the seat of my pants. I throw all kinds of combinations of food into a pot and typically the results are great.

I'll share the recipe for Red Lentil Soup as this one is really out of this world and it can teach you some soup-making skills. After the recipe, I'll include some guidelines for mixing up your own creations.

Red Lentil Soup

2 cups red lentils
2 large onions, sliced
8 cloves garlic, sliced
3 T. fresh ginger, sliced
2 T. grapeseed oil
2 tsp. ground cumin
2 tsp. ground coriander
8 cups water
1/3 c. low sodium tamari
2 cups canned diced tomatoes (low sodium is best)
pepper to taste (only add salt if you really have to after you serve the soup)

Spiced Oil Garnish

4 T. grapeseed oil
1/2 tsp. dried red pepper flakes
1/2 tsp. whole cumin
1/2 tsp. turmeric
1-2 sliced green onions

1. Pick over and rinse lentils (I admit that I usually skip this step-I rarely find rocks in my legumes).
2. In a large stock pot heat oil and saute ginger, garlic and onions with cumin and coriander for about 2 minutes.
3. Add lentils, water, and low sodium tamari. Add tomatoes (the original recipe says to drain the tomatoes. I add the whole can, including the liquid. I use a 28 oz. can of organic diced tomatoes. It is not low sodium and I do not add any extra salt). Cover and bring to a boil. Simmer until lentils are tender, about half an hour (I find that red lentils cook quickly since they are so small).
4. Puree soup until smooth. You can use a blender, but this is a big task. The soup is hot and you have to blend it in batches. I can't tell you how many times I've had hot soup going everywhere. It is definitely not fun and enough of an annoyance to prevent future blended soup adventures. I suggest using a hand held immersion blender. It will make this step much easier.
5. Season with pepper.
6. To make spiced oil garnish, heat grapeseed oil in a small pan and add red pepper flakes, cumin and turmeric, stirring for a few seconds.
7. To serve, ladle hot soup into bowls and drizzle a spoonful of spiced oil on top. Sprinkle with sliced green onions (the recipe calls for cilantro. I much prefer green onions).

Serves 6 to 8 people

Hints for Creating Your Own Soups

1. Begin by making soup a few times following a recipe. I tend to make vegetarian soups so I look for vegetarian recipes. Bloodroot is my new favorite cookbook and if you're looking for amazing vegetarian recipes, I highly recommend it. I've learned a lot about flavor combinations by following recipes.

2. Choose healthy ingredients. I encourage you to make soup the main part of your meal. To get the nutrition you need you should include healthy sources of protein, carbohydrate, fat, vitamins, minerals and antioxidants. In food lingo that means lean meats, legumes, whole grains (barley, brown rice, wild rice, quinoa, millet, etc.), and lots and lots of vegetables (don't forget the greens. Soup is a great way to eat greens)!

3. Season for flavor and that doesn't mean salt! You can use a little salt or salt containing foods such as canned legumes or tomatoes, but experiment with a variety of flavors from spices, herbs and flavorful foods (garlic, onion, lean meats, citrus peel, dried mushrooms, etc.).

Add a variety of vegetables, herbs and spices to your soup

4. Go for color. Colorful foods have antioxidants and add to the appeal of food. I'll add onion skins to my stock because I like the color that it gives the broth. I'll also add beets. Nothing looks prettier than a red vegetable soup in a white bowl.

Colorful foods add nutrition, flavor, and eye appeal

5. Be daring. When you've made soup a few times you'll begin to improve upon what you've made. Perhaps you may decide that a stalk of lemon grass would enhance your recipe. Or you might like to add a bit of lime zest or some coconut milk. Get out of your comfort zone and explore new flavors.

Soup can be served as part of a larger meal or it can be the main dish. I often serve it as the main dish. I'll round out the meal with crusty whole grain bread and a salad containing a variety of interesting greens.

One of the benefits of eating soup is that it promotes a feeling of fullness that can help decrease calorie intake. If you've stuck around long enough to read this statement, it should motivate you to experiment more with homemade soups.

Please share your adventures in soup making. I'm always looking for interesting combinations of flavors to add to the pot!

To your health!

PS: When my son was 18 months old he commented on his grandfather eating soup. As he couldn't pronounce his "s" it sounded like, "Papa eating poop." Papa replied, "I hope not!"

Porcini and Quinoa Stuffed Peppers

2011-02-10T13:00:00.001-05:00

Porcini and Quinoa Stuffed Peppers served with Tamari Roasted Cauliflower and Sauteed Escarole

Talk about making half of your plate vegetables, this meal does more than that! I was looking for a good recipe to serve as a substitute for meat stuffed peppers. I came upon a quinoa stuffed pepper recipe, but I didn't love the flavor. So, I made my own. I love the flavor that the dried mushrooms add to the quinoa. I also added diced potatoes for a couple reasons. My kids love potatoes and their flavor really enhances this recipe. Also, my teenagers are athletes and they need a lot of carbohydrates, especially my son who has type 1 diabetes. I'm always looking for a balance of healthy high fiber carbohydrates and protein to feed my son to prevent the blood sugar crashes that can happen about 8 hours after his training.

Along with the healthy protein and carbohydrate from the quinoa, there is an abundance of antioxidants and nutrients from all the other ingredients in this meal. I hope you enjoy these recipes!

Porcini and Quinoa Stuffed Peppers

1/2 oz. dried porcini mushrooms

1 garlic clove, minced

1 small onion, diced

1 small leek, cleaned and sliced

1 c. quinoa (I used red)

2 T. grapeseed oil

5 red bell peppers

1 stalk celery, diced

1 large carrot, diced

1 medium potato, diced

scant 1/2 tsp. salt

pepper to taste

2 1/2 tsp. low sodium tamari

If you are unfamiliar with how to clean a leek, follow the link for directions.

1. Preheat oven to 375 degrees F.
2. Soak porcini mushrooms in 1 c. hot water for about 15 minutes. When soft, drain through a cheese cloth, saving mushroom broth. Dice the mushrooms.
2. Cook quinoa in 1 1/4 cup water or vegetable broth.
3. Core and wash peppers, removing seeds.
4. Heat grapeseed oil in a pan over medium-high heat. Saute onion and garlic for 1 min. Add leeks and saute another minute. Add celery, carrot, mushrooms and potato and cook for another 5 minutes or until potato starts to brown.
5. Reduce heat to low. Add cooked quinoa and mushroom broth. Season with salt and pepper. Cook until liquid is absorbed.
6. Stuff peppers with quinoa mixture, dividing the mixture equally among the peppers and filling them to the top.
7. Place stuffed peppers in a baking pan. Drizzle 1/2 tsp. low sodium tamari on top of each pepper. Add about 1/2 c. water to the bottom of the pan and bake the peppers 30 minutes or until cooked through.

Serves 5

Tamari Roasted Cauliflower

1 small head cauliflower split into florets
1 T. grapeseed oil
1 T. low sodium tamari

1. Mix all ingredients together on a rimmed cookie sheet.
2. Roast at 375 degrees F for about 20 minutes or until browned and tender. Stir half way through cooking.
3. Serve and enjoy! It couldn't be any easier!

Sauteed Escarole with Spiced Oil

The spiced oil in this recipe comes from a vegan cookbook that I have been using a lot lately. The Best of Bloodroot, Volume Two has many wonderful recipes. I highly recommend it!

4 T. grapeseed oil
1/2 tsp. dried red pepper flakes
1/2 tsp. whole cumin
1/2 tsp. turmeric
1 T. low sodium tamari
8 c. chopped escarole

1. Make the spiced oil. Add grapeseed oil, red pepper flakes, cumin and turmeric to a small pan and heat over medium heat until aromatic. This will take only a few seconds once the oil gets hot.
2. Add 2 T. of the spiced oil to a wok. Heat over medium-high temperature. Add escarole and saute for a couple minutes, until escarole is half wilted.
3. Add tamari and serve.

Save the extra oil to use in other dishes. It provides the nutritional benefit of capsaicin and curcumin, two plant chemicals with health properties. It also tastes out of this world!

My 500-Calorie Lunch

2011-02-09T12:46:00.002-05:00

Koshari with a side of Sugar Snap Peas

It started as dinner a couple of nights ago. I made a recipe of Koshari, Egyptian lentils and rice, from my new vegan cookbook, The Best of Bloodroot, Volume Two. It was a simple recipe to make. Dinner was ready in less than an hour. The flavor was delicious and my 13 year old daughter took second helpings, a rare event in my house!

Fortunately, the recipe made enough servings to eat as leftovers for lunch! I love eating leftovers for lunch! This particular recipe fares well served as a leftover. The flavor is enhanced with time and the texture stands up well to "fridge time." I describe the flavor and method of making this recipe similar to a healthy version of Rice a Roni. Recipes like this prove that we don't need to rely on convenience items for a quick (and much more delicious) meal or side dish.

Koshari
Egyptian lentils and rice

1 1/4 c. basmati rice
1 1/4 c. French (green) lentils
2 large Spanish onions, thinly sliced
1/3 c. olive oil
1/2 tsp. red pepper flakes
3 cloves garlic, sliced
2 c. very fine vermicelli noodles, crumbled
Kosher salt to taste
1 1/2 c. fresh tomatoes, diced

1. Rinse rice. Cover with water in a bowl and let soak while preparing other ingredients.
2. Pick over and wash lentils. Cover with 2 1/2 c. water and cook until tender (I added additional water as they cooked. I didn't use a lid and some of the water evaporated. I suggest using a lid).
3. Heat olive oil in a pan being careful not to overheat it to avoid smoking. Add onions (I chopped my onions. I don't enjoy eating long strings of onions). When onions are transparent, add red pepper flakes (you may use less depending on your tolerance to spicy foods) and garlic. Continue cooking, stirring occasionally, until onions just begin to caramelize. Remove onions to a bowl using a slotted spoon.
4. Add crumbled noodles to the frying pan (I used very thin Japanese wheat noodles, but the recipe calls for fides or shehriah available in Greek or Arabic stores). Saute noodles in remaining oil until brown and crisp, stirring occasionally to prevent burning. Turn off heat and set aside.
5. When lentils are soft, add drained rice to the pot and continue cooking until rice is fluffy (make sure to cover with a lid). Add onions and noodles and turn off heat. Add salt to taste (I didn't add any salt as I used a 28 oz. can of organic diced tomatoes which were plenty salty).
6. Add tomatoes to the lentil/rice mixture. Serve hot or at room temperature.

For lunch, I microwaved a cup of sugar snap peas in a tablespoon of water for a minute and sprinkled them with a teaspoon of low sodium tamari (my new wonder seasoning--I use it instead of salt in many recipes).

I'm not positive that this is a 500-calorie lunch. I call it this in the title to show that it is OK and appropriate to eat this much for lunch. Base your lunch on healthy foods that are nutritious and satisfying. Of course, everyone's calorie needs are different. Don't short change yourself by eating too little and then overindulging on junk food later.

Bon Appetit!

My 500-Calorie Bowl of Cereal

2011-02-08T14:56:00.000-05:00

I admit that I don't always eat breakfast immediately upon waking up in the morning and sometimes I wait until I've finished my early morning workout. I eat breakfast every day, but I'm often not hungry first thing in the morning. One or two hours after waking up, when hunger kicks in, I look forward to eating a healthy and satisfying breakfast.

With the release of the new Dietary Guidelines a week ago, I've been paying particular attention to the recommendation to make half of my plate fruits and vegetables. Dietitians have been recommending this for years. Half of all the foods that we eat in a day should be fruits and vegetables. Breakfast is a great place to eat a full serving (or two) of fruit. It's also a great place to eat whole grains and satisfy the Dietary Guideline to make half of our grains whole.

How do you pick a healthy breakfast cereal? I choose a whole grain cereal, either cooked or dry. The first ingredients listed on the package should say "whole" and the list should not be excessively long or contain unrecognizable ingredients. I also look at fiber and sugar. I don't always choose the highest fiber cereal because sometimes it comes with too much sugar. Currently, I'm eating Cascadian Farm Organic Multigrain Squares. Three-quarters of a cup has 2 grams of dietary fiber and 4 grams of sugar. I eat about one and a quarter cups which is 3 grams of fiber and 6 grams of sugar. The calories listed on a cereal box are the last thing that I look at. I find that many of the low calorie breakfast cereals are anemic; they don't provide much nutrition and can leave you hungry an hour later. I'd much rather eat a cereal with substance, and for a cereal to have substance, it must have some calories.

To my bowl of cereal, I add a hefty portion of fruit. I easily add more than a cup of fruit. I'm trying to fill half of the bowl with fruit. I add my own fruit rather than choose a cereal with fruit-like pieces that may or may not be real fruit. All this fruit provides me with a bounty of antioxidants, nutrients and fiber, and it fills me up. I top off my cereal with a scant quarter cup of nuts for added nutrients, fiber and protein and a full cup of milk (I prefer soy milk) for more protein.

My 500-calorie bowl of cereal sufficiently fuels my morning activities and meets my nutritional needs. I'm not hungry again until lunch, at which time I'm ready for my 500-calorie leftovers!

The Cost of Inactivity

2011-01-26T15:20:00.001-05:00

To stay healthy throughout life, you've got to move it!

Very few things in life are static, especially the human body. From birth through old age, the body is continually changing. It is important to realize that when we put off regular exercise, our bodies are not just frozen in time, they’re fading. Physical activity stimulates most organs to work at their best. We are made to move, and if we don’t, all body systems are affected, right down to the cellular level, where our ability to transfer oxygen for energy can be diminished. This is evident in a person's inability to run between airline gates to catch a connecting flight, or carry laundry baskets up and down the stairs. Inactivity impacts the brain, muscles, heart, blood vessels, bones, liver, gut, sleep, anxiety, depression, self-esteem, and the ability to use glucose (to name a few).

Diabetes

Insulin sensitivity deteriorates with inactivity. Type 2 diabetes is characterized by the body’s inability to utilize the insulin it produces. The cells of the body become insulin resistant. Insulin carries sugar from the blood into the cells of the body. Without the ability to do this, blood sugar levels rise and diabetes develops.

Type 2 diabetes is a sedentary disease, in that regular exercise reverses the damage. Insulin sensitivity increases with exercise and the cells of the body become better at taking in and processing glucose. The impact of activity on diabetes is striking. Every two hours of weekly TV watching is linked to a 14% increase in the risk of diabetes. Conversely, every hour of brisk walking per week confers a 34% lower risk of developing diabetes. That’s something to think about the next time you are too tired or busy to put on your athletic shoes.

The Heart

Exercise affects the heart in several ways. Not only does it strengthen the pump, but it also impacts the pipes. In recent years, researchers have discovered that physical activity makes the lining of blood vessels more flexible, from the largest artery to the smallest capillaries. This allows blood vessels to relax, permitting more blood to be sent to the heart. Think of it in terms of pumping blood through a rubber hose instead of a concrete pipe. This is particularly important if a vessel is partially blocked.

Regular exercise also increases HDL (good) cholesterol. This is the type of cholesterol that leaves the arteries instead of sticking to them. For those who already have heart disease, exercise can lower your risk of dying from it. Take that to heart!

Stroke

Active people are 25% less likely to have a stroke than sedentary folks.

Exercise affects the arteries to the brain in the same way as the heart. Most strokes occur when a blood clot gets stuck in a partially blocked artery leading to the brain. Hemorrhagic stroke occurs when a blood vessel in the brain bursts. High blood pressure is a risk factor for any type of stroke, and regular aerobic exercise lowers blood pressure in 75% of people.

Muscles

If you don’t use it, you lose it. The metabolic cost of maintaining muscle is high. Muscles require a lot of energy, so if you don’t use them, they become a luxury for the body to maintain. As we age, we become increasingly inactive and lose muscle mass. Anyone can rebuild muscle with strength training. The earlier you start, the better, but even those of advanced age can benefit from carefully pumping a little iron. Strong muscles can help to prevent the frailty that makes older people lose their independence. Regular exercise is one way to stay out of a nursing home.

Weight

Inactivity and weight gain go hand in hand. When you lose your muscle mass because of inactivity, you need less energy (calories) to maintain what is left. Due to inactivity, it becomes possible to gain weight with a modest calorie intake, and nearly impossible to lose weight. The rate of weight gain is slow, perhaps 1-5 pounds a year, but over 10 years the pounds add up and the loss of physical fitness is significant.

In order to avoid becoming overweight or obese, 45-60 minutes a day of physical activity is needed. If you’re already overweight or have lost a lot of weight, you need more – between 60-90 minutes of physical activity a day to avoid regaining weight. If this seems daunting, just 30 minutes of exercise a day is enough to reduce the risk of many chronic diseases without significant weight loss.

Bones

Bones are living tissue. Every day, minerals move in and out of our bones in response to the demands of daily living. If you stress bone, it responds. If you don’t, the balance between bone gain and loss shifts toward bone loss. Research shows that strength training preserves bone better that walking or running, and can increase bone density. The amount that a bone is stressed, or overloaded, determines whether bone formation is stimulated. A small number of repetitions (8-15) with a heavy load can do the trick.

Regular physical activity has also been shown to prevent certain types of cancer, depression, dementia, and improve immunity. If exercise were a pill, it would be called a wonder drug.

To reduce health risks associated with inactivity, at least 30 minutes of moderate-intensity aerobic exercise five days a week or 20 minutes of vigorous aerobic exercise three days a week are required. To maintain lost weight, 60-90 minutes a day of exercise is needed. To build muscle and prevent bone loss, strength train at least twice a week with a weight heavy enough to lift eight to fifteen times.

The good news is that it is never too late to start moving. People well into their 90s can benefit from regular exercise. And if you’ve been moving all along, you can reach your 90s with vitality and independence. The only “magic bullet” out there that I know of is physical activity. So commit yourself to exercise. Schedule it in your date book. As a well known athletic company says, “Just do it!”

Small Changes for a Healthy New Year

2011-01-03T12:39:00.000-05:00

Start with small achievable goals

Another year has begun. It’s a good time to start a diet and exercise program, many of us think. We have to be ready to do more than think. Like getting married or starting a family, there is no perfect time to begin a health regimen. What’s most important is to have the resolve to make small changes in your lifestyle that will be far-reaching over the long run, and to stay the course. Change too many undesirable habits at once, and you could end up abandoning your efforts altogether.

The changes that you make must have significant value to you. It is not enough to just want to lose weight, exercise more or eat healthier. There needs to be some type of internal motivation that drives you to achieve these goals. Take the time and explore why it is important for you to make these changes, and then start making (and mastering) one small change at a time. The following is a list of lifestyle changes that current research has shown will benefit your health, from promoting weight loss to decreasing the risk of cancer. Some you may already do; others you may need to work on. Take it one small step at a time.

Eat Breakfast. It’s the best way to control your weight. Start the morning with whole grain cereal. Breakfast is a great place to get fiber in your diet. Look for cereals where the first ingredient listed on the label is a whole grain, like oatmeal or whole wheat. Add berries or other fruit and a full cup of low fat milk.

Exercise. Give up the excuses; you have to do it to stay healthy. Sixty to ninety minutes of daily exercise is recommended to promote weight loss and maintenance. If you can’t meet these recommendations don’t be discouraged, any movement helps.

Eat Low Fat Dairy. The jury is still out on whether low fat dairy can promote weight loss, but dairy is important for other reasons. The calcium that it provides can stave off osteoporosis and has been linked to improving blood pressure. Recent studies have shown that men who consume low fat dairy regularly have a reduced risk for developing type 2 diabetes and gout. Women that get plenty of calcium and vitamin D may have a reduced likelihood of developing PMS. Get 2 to 3 servings daily of milk, yogurt or low fat cheese.

Add Vitamin D. It promotes the absorption of calcium and is very important for bone health. It may also improve muscle strength, reducing the risk of crippling falls in the elderly. Vitamin D has also been shown to reduce the risk of developing the most aggressive form of prostate cancer. It may be difficult to get enough vitamin D from your diet. If you live in the northern half of the country, your skin isn’t making any vitamin D from October through March. Vitamin D supplementation is recommended for most people, but the amount of supplementation is still being debated. Supplementing with 1,000 to 2,000 IUs of vitamin D daily is considered safe, however some people may require more. The rest of the year, expose some skin (arms and legs) without sunscreen to the sun for 20 to 30 minutes. People with darker skin may require up to six times more sun exposure.

Eat More Fruits and Vegetables. The evidence is mounting, if you don’t eat enough of it, you’re at a health disadvantage. From arthritis to weight loss, fruits and vegetables have been shown to improve health. No wonder the dietary guidelines increased the daily servings. Eat the rainbow. Five to thirteen daily servings are recommended.

Eat More Dark Leafy Greens. Some vegetables are better than others. This is where Popeye was right. Spinach and other colorful greens may help prevent cataracts, stroke, and the cognitive decline associated with aging (and possibly even Alzheimer’s disease). This is one of the biggest changes that most people need to make in their diets.

Choose Healthy Fats. Switch from saturated animal fats and trans fats to monounsaturated and polyunsaturated vegetable oils. All fats have about 120 calories per tablespoon, so don’t add vegetable oil, but replace unhealthy fats with it. Olive oil is good, but so is canola oil. Minimize fats from dairy and meats by choosing lower fat varieties.

Eat More Fish. It’s the easiest way to get those omega-3 fats that are so good for us. Plan a fish meal twice a week (yes, tuna fish sandwiches count, but fried fish is a no-no). Omega-3 fats are good for your heart, immune function, and your brain (those who eat fish twice a week show less mental impairment with age). They have also been shown to fight inflammation, which benefits your joints too.

Hydrate. The first thing you should do in the morning and the last thing you should do before bed are to drink 1-2 cups of water. Sip water all day long and eat foods with high water content such as cucumbers, lettuce, tomatoes, soup, apples, and oranges (you get the picture). Being well hydrated will also help you look your best.

Get An Extra Hour of Sleep Each Night. Sleep is when your body repairs the physiological damage done each day. Most of us burn the candle at both ends and then trudge through the day feeling like a zombie, going from one cup of coffee to the next. A good night’s rest will help us look and feel our best and can help our weight loss efforts too.

During the next few weeks, I will discuss each of these recommendations in more detail. I will provide more practical tips and recipes that can help you make 2011 an incredibly healthy year!

Why You Should Pack Vegetables in Your Kid's Lunch

2010-12-16T11:16:00.002-05:00

Don't forget the vegetables!

Many parents tell me that they do not pack vegetables in their children's lunches. My mother never packed vegetables in my lunch. I can't say that I would have eaten them had she packed them, but I enjoyed snacking on vegetables at home as a kid. When you think about what is served for lunch in restaurants, typically vegetables are absent. It is common to see sandwiches and fries or chips with a small fruit or kale garnish. When I eat lunch with my daughter at school, I notice that children who bring their lunches often have sandwiches, juice pouches, pretzels or some sort of crunchy snack food, and maybe some fruit or a cookie. Vegetables are MIA. Perhaps we're not used to eating vegetables at lunch daily so we don't put them in our kid's lunches. Perhaps we're concerned that our kids won't eat them.

As parents, we teach our kids many things. One very important thing that we teach them is what they should eat to gain the energy and vitality to become contributing members of society. Kids push back against our recommendations. That is the nature of being a kid. Does that mean that we stop making recommendations?

When it comes to packing vegetables in our kid's lunches, why do we hesitate? Is it so bad if our kids throw away a snack bag of vegetables? The lesson that you teach by offering vegetables at lunch is that they should eat them. I think this lesson is more important than a little bit of food waste (believe me, kids throw away more than their vegetables). This is part of the learning process. What is the worst thing that could happen by not offering your children vegetables at lunch? They could grow up not eating vegetables regularly, choosing instead a diet filled with processed foods which can cause them to suffer from one or more of the many chronic diseases associated with diet.

Here's how you can encourage your kids to eat more vegetables by packing them in their lunches:

1. Discuss with your children the types of vegetables that they enjoy eating. Choose those vegetables to pack in their lunches.

2. Offer variety. Even a favorite vegetable can get old if eaten every day. Try cauliflower, cucumber, cherry tomatoes, baby-cut carrots, bell peppers, broccoli, green beans, mushrooms, zucchini, radishes or sugar snap peas. All of these vegetables are good raw. Many kids seem to prefer raw vegetables over cooked vegetables.

3. Offer a little bit of dip to make eating vegetables more enjoyable. Use a mini container and fill it with a small amount of ranch dressing, hummus, tzatziki, or other dip.

4. Start young. By the time your kids are ready to go to school, they are old enough to be eating vegetables daily at lunch.

5. Start small. Begin by offering a small snack bag of vegetables. Hopefully by the time your kids reach high school, they'll be eating a larger sandwich bag filled with vegetables.

6. Talk with your kids at home about what they ate for lunch. Ask them if they ate their vegetables. If they say no, gently encourage them to eat their vegetables (there are lots of good reasons for your kids to eat vegetables, an important reason is that you love them and want them to thrive).

7. Never give up. By offering vegetables to your children at lunch you are setting an example about what they are supposed to eat.

I have my own challenges in getting my children to eat their vegetables. My 13 year old daughter has been sick too much already this school year and I point out to her that she skimps on much of the healthy foods that I serve her. I'll keep trying because it is that important.

The Enigma of Blood Sugar Control

2010-12-05T16:00:00.002-05:00

My son has type 1 diabetes. I've blogged about our struggles with this disease before. My son would love for me avoid sharing our personal experiences with respect to him, but I'm on a mission to better understand how diabetes is controlled and to help other diabetics in the process.

To me, the expression "blood sugar control" seems like an oxymoron. It is elusive at times and often we are left scratching our heads as to why our son's blood sugar becomes high or low (even though I'm a dietitian and my husband is a physician). Diabetics, especially teenagers, can take these values personally and may feel like they have failed in managing their health. There are so many factors that affect blood sugar. Understanding why blood sugar becomes high or low is very complicated. Lately, I feel like we've been chasing our tails and I need to know more about diabetes to help my son understand more and manage his disease without excessive emotion.

As I educate myself, the nuiances of blood sugar control are becoming more apparent. I have decided to post a "pearl of wisdom" on my Facebook page daily to reinforce the concepts that I am learning and to share that knowledge with other diabetics or those responsible for caring for a person with diabetes. I invite your comments, experiences, and knowledge on this topic here on my blog as well as on Facebook and Twitter. I'm hoping to impact hundreds of people and create an online comminuty of diabetics sharing their experiences and wisdom. Please pass this on to your diabetic family, friends, and coworkers. To your Health!

Kids in the Kitchen

2010-11-30T11:25:00.002-05:00


My daughter enjoyed cooking at a young age

My youngest daughter turned seven at the end of September. One of her birthday presents was a "real" cooking kit with kid-sized cooking utensils. She has been asking me to cook with her since she got it. My response to cooking with my kids is mixed. As a dietitian, I'm thrilled that they have an interest in preparing food. I see a great opportunity to teach them about the healthy foods that we all need to eat more often. As a mother, I'm hesitant to cook with them. I'm so tired of cleaning up messes all the time and the surest way to a messy kitchen is to have your kids cook. I have come to realize that the kitchen is my area of control. Unless I'm cooking with a clone, I prefer to cook alone. Despite my need to feed and nurture with food, I'm not the most nurturing person the kitchen. I watch commercials of parents cooking with their kids and wonder why I'm not as happy as those parents seem when I am cooking with my kids.

Being aware of my flaw, I have been trying to overcome it and have been pleasantly surprised at how helpful my kids can actually be in the kitchen (hold on a minute while I adjust my blinders)! My two older children each had to plan and prepare a meal for a seventh grade class. I was impressed at how conscientious they were to choose a healthy menu and how much pride they had in executing the whole meal themselves. Of course, they came to me for guidance, but they did all the chopping, cooking, and cleaning. What a great school project! I now find myself focusing on the "teaching moments" that I have with my kids in the kitchen. Put the caps back on containers and put them away when you are finished using them. Don't lick your fingers, but if you do, you must wash them (we wash our hands a lot in my kitchen). Completely disassemble the blender when you are washing it, including the rubber seals. By focusing on what I can teach my children as we cook I am creating my kitchen clones, but I'm also teaching them about food safety, healthy eating and how to be more efficient while cooking.

I've had a few food-related surprises with my kids recently. This past Thanksgiving weekend, my seven year old daughter took an active part in preparing one of the many meals that my family serves during this time. She helped her grandma prepare for a dinner party and was there every step of the way from grocery shopping, cooking and setting the table. She even served herself Brussels sprouts at the meal and ate them all! My middle child and oldest daughter has gotten in the habit of making me and my husband breakfast. We are often awakened on a Saturday or Sunday morning to the smell of brewing coffee. This past month she didn't even ask us to take her to the mall later that day! Finally, my son, who is the first born, completely surprised me when he told me that he was joining the cooking club in high school. I can't tell you how proud I am of that, especially when he mentioned that many of his friends don't see the value of cooking when you can get prepared foods on any street corner. These are my sweet rewards for allowing my kids to make a mess in our kitchen! The mess is such a small thing compared to the lifelong skills you teach your children by allowing them to cook. I'd love to hear your stories about cooking with your kids. Perhaps some of them have gone on to become chefs, teachers or scientists. The skills learned from cooking can be used in many ways.

5 Healthy Tips for Your Best Holiday Season Yet!

2010-11-23T12:30:00.001-05:00

Keep your healthy habits through the holidays

'Tis the season for overeating and inactivity, but it doesn't have to be. You've worked hard all year to change unhealthy habits and now it's time to run the gauntlet of holiday parties and coworkers bringing cookies and treats to work. If you can make it through the holidays unscathed while practicing your healthy habits, you are truly a new person. Here are five tips to keep you focused on having a happy and healthy holiday season.

1. Be positive. Positive emotion is necessary for behavior change. To flourish, we should exhibit three positive emotions for every negative emotion. Flourishing is like navigating a sail boat. Negative emotion is your rudder and positive emotion is the sail that soars high into the air. Your sail should be three times as high as your rudder to keep you on course. Of course, you need both a sail and a rudder to navigate. The trick is to have enough positive emotion to balance the negative. We typically focus too much on negative feelings, so lighten up and be positive. You can track your emotions at positivityratio.com. Emotions change daily, so track yours often. It might help you focus a little more on the positive aspects of your life.

2. Catch up on your ZZZ's. During the holidays, most people overstuff their days and weekends with activity and short change sleep. Adequate sleep is vital for health. Lack of sleep is a risk factor for diabetes, heart disease, obesity, accidents and it lowers your immunity. You may have to resist the urge to be a party animal, but getting enough sleep will ensure that you enjoy your celebrations to the fullest. Allow at least one day a week to catch up on your sleep. You might have to delegate some holiday shopping or cooking, leave a party early once in a while, and resist the urge to stay up late watching TV, playing video games, etc.

3. Keep moving. The best way to avoid weight gain over the holidays is to move daily. Face it, we are made to move and without movement we couldn't survive. Preserve your regular exercise routines as much as possible. If you notice that you can't exercise as much as you used to, wear a pedometer and track your activity as daily steps. The goal is to log at least 10,000 steps a day which is equivalent to walking about five miles. I did this last year between Thanksgiving and New Year's. It was a great way to keep moving. When I noticed that I was short of my goal, I would take the dogs for another walk (god for the dogs as well as me) or take an extra lap in the mall while shopping. Taking a walk after a larger meal is also helpful. The artery clogging effects of one high fat meal can literally be visualized. Fortunately, so can the health promoting effects of one bout of activity. So get up after your meal and take a walk!

4. Maintain your weight. Most people only gain about one pound over the holidays, but that one pound hangs around long after the holidays are over and is often joined by more pounds the next year, and the next, and the next... Setting your sights on weight loss may be too difficult at this time. The goal should be to maintain what you've already lost. You have to measure this somehow. I encourage my clients to weigh themselves daily. You will notice small changes in your weight that you can equate to your eating and exercise habits. If you notice a weight increase in one day, examine what you ate earlier. If you ate a meal in a restaurant, chances are the meal was excessive in calories, fat, and sodium. You can make corrections in your eating and activity and work to bring your weight back to where it was. If you don't measure, you won't know to correct. Before you know it that one pound will be sitting on your hips or mid-section and will be hard to lose.

5. Be thankful. There is so much flurry around the holidays that is is easy to forget what they are about. Enjoy the time that you are allowed to be with your family, friends, colleagues and coworkers. Humans are social beings and having a supportive community around us is one of the best ways that I can think of to be happy and healthy. We bring the burden of the season upon ourselves. It is within our power to lighten that burden with humor, love, kindness, thoughtfulness, friendship and thankfulness.

I wish you the best holiday season yet!

Do Your Food Values Make You an Elitist or an Oddball?

2010-11-20T15:57:00.001-05:00

I can't help but feel a little odd!

Sometimes I can't help feeling odd, a little eccentric and different from most people. I'm consumed with passion for being a dietitian and spreading the message of how much better life can be when we eat healthy foods responsibly, exercise regularly and get adequate sleep each night. I think about food all the time. It's not odd to think about what you do in your profession, even when you're not working. I feel odd because of the blank stares I get when I tell people I'm vegetarian. I feel odd when there is nothing for me to order in a restaurant except a salad or processed veggie burgers. I feel odd when I won't let the server in a restaurant refill my children's beverages, except with water. I feel odd because I suggest that people cook more meals at home using fresh ingredients rather than serving Tyson chicken tenders. I feel odd because I won't eat the foods that many other Americans will eat. Does that make me an elitist? Am I perceived as thinking that I'm better than others because I won't eat fast food? The truth is I'm not an elitist and I've been known on occasion to buy fast food for my children, albeit the smallest meal and beverage that I can buy. But feeling odd because of my food values is a feeling that I can't seem shake.

This feeling of being odd became overwhelming when my thirteen year old daughter asked me to buy a birthday present for a friend. As we drove to Wegmans, my daughter told me that she wanted to buy her friend's favorite chocolate which happened to be Hershey's. I recently wrote a blog post on my views about Hershey's and have banned Hershey products from my house in lieu of fair trade and organic chocolate (elitist?). I apologized to my daughter that we would not be buying her friend's favorite chocolate. As a thirteen year old will do, she pushed back exclaiming that four bars of chocolate wouldn't make a difference to the world. An argument ensued and ended with my retort that she was asking me to be a hypocrite. We entered the store and proceeded to buy several bars of fair trade and organic chocolate. I went home feeling the burden of my values. I disappointed my daughter and felt like I didn't "fit in" in a world where trading commodities and making money was more important than human life, protecting the environment, or any other value that is different from popular opinions.

Even though the pendulum of popular belief with respect to food is swinging in my direction, I still feel the burden of my beliefs heavy on my shoulders. In a world where the majority of adults are overweight and greater numbers of children are becoming overweight and obese, I'm hopeful that the choices I make in small measure will influence others, who in turn will influence even more people. But then I wonder...am I a food fascist (sic)?

I asked my daughter if she told her friend that I wouldn't allow her to buy Hershey's chocolate. She did and her friend enjoyed the fair trade chocolate that she gave him. I felt a little vindicated when she told me that another friend replied, "Oh yeah, I know about Hershey's. They stink!" Perhaps I'm not that odd after all.

Hungry? The Quest for a Healthy Body Image

2010-10-18T15:08:00.002-04:00

Hungry by Crystal Renn discusses how a young woman working in the modeling industry develops an eating disorder under the pressure to be thin to get work and how she conquers it through her own will and determination. Renn tells the story of her transformation from an unhappy, hungry and unsuccessful model to the successful, internationally acclaimed, confident and happy plus-sized model she is today. Renn serves as an inspiration for size acceptance to women everywhere.

There are many campaigns promoting healthy body image from the Dove Campaign for Real Beauty to Fat Talk Free Week, a campaign to promote the end of body-centric comments which can have a negative impact on body image and possibly lead to eating disorders. With the fashion industry, it seems that changing the focus from thin to healthy is an uphill battle.

I interviewed professional model and registered dietitian, Maye Musk, MS, RD, about the modeling industry and how she navigates her role as both a model and a nutritionist. Musk's comments are candid and humorous. She states that health and the health of models are not truly important to the fashion industry. Clothes are made in one size and the models must fit into these clothes. Somewhere along the line someone decided that clothes look better on smaller models. Musk defines these finer boned models as "freaks of nature." This is her humorous way of stating that very few women naturally have the body type to wear the clothes that are being designed. "The clothes are made for skinny 12 year old boys," she says. To get a chance to model these clothes, young models starve themselves. "You can see the muscle wasting on the arms and thighs. The models are truly emaciated."

In her nutrition practice, Musk counsels ballet dancers, actors and models, many of whom are trying to obtain this unrealistic ideal. She counsels them on the value of good nutrition and how beauty relates to it. She states that "general good health provides the energy to model." That energy in turn translates the model's movements into a beautiful work of art. The movement of a healthy model in clothing has the power to captivate, so that even a still photo is dynamic. To model, Musk claims, one needs to look fabulous. The amount of fat doesn't matter.

The modeling industry has adopted the minimum healthy Body Mass Index (BMI) for its models which is 18.5 kg/m2. BMI is a mathematical equation and is defined as weight in kilograms divided by height in meters squared. Despite this, Renn was encouraged to maintain a weight of 95 pounds on her 5'9" frame, a BMI of 14 kg/m2. Renn's body revolted from her abusive eating and exercise habits and she began to gain weight despite them. Her metabolism downshifted so much that she could gain weight while still eating very little. The outcome for many women in this situation is death, but for Renn, her ambition is what I believed saved her. Her desire to live and succeed were strong and she took plus-sized modeling by storm.

Thanks to the efforts of Renn, plus-sized modeling is taking on a new status, but it still has a long way to go. I find it ludicrous that "plus-sized" is defined as anything sized 8 or greater. The average American woman is a size 14. That's the world of fashion and Musk doesn't foresee it changing very much any time soon. American women walk a fine line between overweight and health. Many of us are overweight and do not engage in healthy eating and exercise habits. It doesn't help that we have an unrealistic ideal to be compared with. As a health practitioner I would not define Renn as overweight. I'm hopeful that her efforts will encourage American women to be the best and healthiest that they can be.

A Quickie in the Kitchen

2010-08-14T17:22:00.002-04:00

I love to cook, but lately I haven't had much time for cooking. This bothers me to no end because food and healthy eating are my profession. Apparently, I need to listen to some of my own advice. We can all benefit from some quick suggestions for getting a healthy meal on the table. Here are some tips that help me to prepare healthy meals for my family in a hurry.

1. Plan Ahead: This means actually thinking about what you can make for the week.

Find Recipes: I usually go to my favorite healthy eating website, Eating Well. There are many wonderful recipes here that can be made in less than an hour. This can be necessary if you're coming home after a long day. You can search for new, quick, healthy and delicious recipes to add to your grocery list or you can search for recipes with ingredients that you have on hand. I recently found a recipe for Spiced Eggplant-Lentil Salad when I searched for recipes using eggplant. Yes, I still have to go to the store for some fresh ingredients, but I'll be using up the eggplant that has been sitting in my refrigerator for the past week.
Three Meal Rule: I usually plan to cook three new meals a week. This way I'm not overwhelmed by planning a whole week of meals. I make extra to have as another meal or to take leftovers for lunch. You can recycle leftover food and create new meals. Leftover meats and vegetables can be used to make casseroles, stir-fries, salads, stews and soups.
Make a Grocery List: Part of the planning process is making a list. This helps you get through the store faster and can minimize less healthy impulse purchases.

2. Stock Your Pantry and Refrigerator/Freezer: Buy healthy staple foods that make it easy to prepare a quick meal. These are foods that you may eat more regularly and that you can use in recipes such as:

Healthy breakfast cereals
Low fat dairy and dairy substitutes (fortified soy, rice and almond milk and cheeses)
Low fat and low sodium lunch meats
Lean meats and meat substitutes
100% whole wheat bread
Fresh and frozen fruits
Fresh and frozen vegetables
Canned tomato products
Canned beans (legumes)
Brown rice (quick cooking varieties are available)
Whole wheat pasta
Herbs and spices
Olive and canola oil
Vinegars
Sauces (Many of these are high in sugar and sodium and should be used sparingly to enhance the flavor of meals. Some of my all time favorite sauces come from the Texas-based company D.L. Jardine's)
Broths (chicken, beef, vegetable and no-chicken broth, which is a vegetarian broth that has a chicken broth flavor)

3. Shop: To make quick and healthy meals you need to have healthy foods on hand. This means that you have to go to the food market. I'm not as well organized as one of my nutrition mentors who only needs to shop once a month (now that's a well stocked kitchen!). I usually plan one large shopping trip a week (usually on a weekend or in the evening when the number of shoppers is less) and another smaller trip mid-week. A good rule to follow for mid-week shopping is to get only the things that you really need such as some fresh produce and milk. If I have to shop for more items after work, typically we'll be eating grilled cheese sandwiches for dinner. I don't have time to shop and cook after work.

4. Learn How to Use a Knife/Food Processor: One of my jobs in my family as a kid was making salads. I dutifully cut vegetables using a paring knife as my mother instructed me. This was a chore and took longer than I wanted. I hated being asked to make a salad. It wasn't until I worked for a caterer in college that I learned how to correctly use a knife. What a difference choosing and using the correct knife makes! Cutting vegetables quickly and efficiently can actually be fun! This is probably the most important skill for cooking (remember to keep your knives sharp!). Food processors are also available for quickly cutting up vegetables. I tend to only use mine if I have a lot to chop as cleaning it is sometimes a bigger chore than chopping. And if you are really in a rush, you can use bagged chopped vegetables. It's always good to have options!

5. Utilize Your Kitchen Helpers: My mother was clearly doing this when she would ask me to make salads. Your kitchen helpers can set the table, wash dishes, and stir the pot for you. A great principle to follow is anyone who eats should help with meal preparation and clean up (thanks goes to one of my dietitian colleagues for suggesting this).

6. Clean as You Cook: My husband actually helped me learn this. His job in his family was clean up. Clean up is so much easier when you clean as you go. While I'm waiting for something to cook, I'll wash a few dishes. I'm a much happier cook when my cooking space is uncluttered and clean.

7. Minimize Distractions: When you're tired after a long day, distractions can make you lose your momentum and the next thing you know you'll be ordering out for pizza. Don't sit down at the computer, don't turn on the television and don't pour yourself a drink until you have a head start on your meal. You may need to delegate other household tasks to the denizens who share the house with you.

8. Experiment: Try making up your own recipes. With practice you will figure out flavor combinations that you enjoy. You'll be surprised at some of the great meals you come up with. You'll also make a few duds, but don't worry, you won't poison anyone. I've had the experience of not liking some of my own creations, but my family seems to eat them anyway, and sometimes they like them even when I don't. I've probably instilled enough guilt in them to simply appreciate the fact that I am cooking for them. I think I'd appreciate an underwhelming meal if someone prepared it for me too.

9. Lighten Up: Sometimes it's OK to eat grilled cheese. You can make a healthy meal using all kinds of shortcuts as long as you balance it with fruits, vegetables and whole grains.

10. Enjoy: Sometimes we need little reminders about how to make quick work of meal preparation so that we can have more time to enjoy other things in life. Who knows, maybe you'll even be able to enjoy the process of meal preparation more, which will make you a happier person overall. Hopefully, you'll free up time to enjoy the other rooms of your house too.

A World of Oats

2010-08-11T10:28:00.000-04:00

Guest blog post by Laura Williams

Oats are a gluten-free cereal grain and are the third leading cereal crop produced in the United States (after wheat and corn) and the fourth most important crop worldwide. They were once considered a weed, but are now a popular staple of the British Isles like Scotland, Ireland and Wales. The grain was introduced into the Americas in 1602 by a sea captain who planted them in one of the islands off the coast of Massachusetts. Today, nearly half of the world's oat crop--more than 4 billion bushels a year--is grown in the United States and Canada. Oat kernels look very much like wheat in structure with an outer covering of bran, which protects the starchy endosperm and the germ that sits at the bottom of the grain. Whole grain oats contain seven B vitamins, vitamin E, and nine minerals, including iron, magnesium, selenium, manganese, phosphorous and calcium. Oats are very high in protein, containing about twice the protein of wheat or corn. But the most important nutritional advantages of oats are the soluble fiber and the GLA (gamma linoleic acid), an essential fatty acid. The soluble fiber is what gives oatmeal its gummy texture; it also has many beneficial effects on health. Regular use of oats in the diet can be helpful for managing several medical conditions. They have been shown to help control blood sugar levels, which is beneficial for people with both type 1 and 2 diabetes; to reduce cholesterol levels, which may help prevent heart disease; and to reduce plaque build up in the arteries which may help prevent atherosclerosis.

Different forms of oats:

• Oat groats: This is the whole oat grain, with only the outer hull removed. Oat groats are extremely nutritious, but they need to be soaked and cooked a long time. Oat groats are usually processed into one of the other forms below.

• Steel-cut oats: Produced by running groats through steel cutters, chopping the groats into smaller pieces and creating a chewy texture. Steel-cut oats still contain the whole grain and oat bran, and are also very nutritious.

• Rolled oats or old-fashioned oats: Steaming groats and then flattening them with a roller makes rolled oats.

• Quick-cooking oats: Steaming and flattening steel-cut oats makes quick-cooking oats.

• Instant oatmeal: Produced by rolling more thinly and steaming longer or partially cooking the oats. Instant oatmeal will also have salt, sugar, and in some cases artificial sweeteners added to it.

You can also grind rolled oats yourself to make oat flour.

Oats can be included in the diet in the form of oatmeal, cold cereals, baked products, granola bars, etc. Any way you include oats in your diet, you will still receive their beneficial effects.

Some recipes to try using oats include:

Muesli

Ingredients:

2 cups oats (quick or old fashioned, uncooked)

2 cups apple juice or apricot nectar

1-1/2 cups sliced fresh fruit (any combination of banana, peaches, nectarines or strawberries)

8 oz vanilla low-fat yogurt

2 T chopped nuts* (optional)

1 T ground flax seeds* (optional)

Preparation: Combine all ingredients except nuts and fruit; mix well.

Cover; refrigerate 8 hours or overnight.

Serve cold; add fruit and sprinkle with nuts, if desired. Refrigerate in airtight container up to 4 days

Oatmeal Raisin Cookies

Ingredients:

3 cups old fashioned oats

1 cup flour

½ tsp cinnamon

½ tsp baking soda

¼ tsp salt

1 cup honey or maple syrup

¾ cup softened butter

½ tsp vanilla

1 egg

½ cup raisins

Preparation: Preheat oven to 375 F. lightly coat cookie sheet with vegetable oil. Combine dry ingredients and mix well. Mix honey/syrup, butter, and vanilla until smooth. Add egg. Blend in dry ingredients, mixing thoroughly. Stir in raisins. Place rounded spoonfuls of blended ingredients onto cookie sheet and bake for 10 minutes. Makes 50 cookies.

I made three batches of these cookies each using a different sweetener (1 each with honey, maple syrup, and sugar) and would definitely recommend using maple syrup.

Laura is a senior at Syracuse University majoring in dietetics and minoring in hospitality management. She hopes to become a Registered Dietitian. Laura has a passion for cooking and baking.

Diabetes From a Personal Point of View

2010-08-02T07:03:00.002-04:00

The dates of some experiences can be imprinted on one’s memory for a long time. I don’t think I’ll ever forget the day that my son was diagnosed with type 1 diabetes at 8 years of age. He had been excessively thirsty for a few days, and was drinking a lot of water. A couple days prior to his diagnosis, I remember him coming home from school and telling me in amazement that he went to the bathroom twenty times that day! My husband and I scoured the internet looking for any other explanation than the one that we knew was most obvious. In medicine, they have a saying: If you hear hoof beats it’s probably a horse, not a zebra. This means that what is most obvious is most likely. In our case it was a horse, type 1 diabetes.

When I was a nutrition student learning about diabetes, I struggled to get my mind around all that was necessary to manage the disease. Diet, medication and physical activity are all very important in controlling diabetes, and none of it is simple. I am still learning how complex diabetes management is every day. My son is now a 15 year old athlete. He has risen to the challenges of diabetes better than many adults would have. He knows how important physical activity is for his blood sugar management, and after trying several different sports he found a sport that he loves, rowing. Diabetics used to be discouraged from participating in sports because of the risk of low blood sugar. Now, we view physical activity and athletics as an important part of keeping a diabetic person healthy throughout life. The advent of the insulin pump has allowed us to fine tune the delivery of insulin such that athletics is not considered as dangerous as it used to be.

Since my son has been diagnosed with diabetes on March 16, 2004 he has had several seizures related to low blood sugar, all of them occurring during sleep. He’s always recovered relatively quickly from them, and was alert enough to drink juice to bring his blood sugar back up. His most recent seizure on July 7, 2010 was different. By now, my other children are well versed in their brother’s diabetes management. My 13 year old daughter has helped me administer juice to her brother and witnessed the multiple daily finger pricks to check blood sugar and injections of insulin. On this warm day in July, she frantically called us at work to let us know that our son was having a seizure. I left for home grateful that she would be there to give him juice. While I was en route she tested his blood sugar and administered glucagon, a quick acting sugar to help raise blood sugar in unresponsive diabetics. When I arrived the situation had not improved. Another injection of glucagon failed to bring him around. I was relieved when my husband, a physician, arrived home to help, but nothing that we did brought our son back to his normal mental status. We called 911.

I’m happy to say that my son has made a full recovery and the only lasing effect from this day was his inability to train athletically for about a week due to headaches from a lumbar puncture that was part of his hospital evaluation. We replay the events leading up to this day and try to figure out what contributed to it. I never expected my son to have a seizure that we couldn’t bring him out of. I now wonder if we should have been better prepared to understand how different the needs of a diabetic athlete are compare to other athletes and other non-athlete diabetics. I’ve since learned that to correct for a low blood sugar, a diabetic athlete can require twice as much carbohydrate as a non-athlete diabetic. I’ve also learned that dehydration can impact a diabetic athlete differently than a non-diabetic athlete. I never wanted to understand as much about diabetes as I do now. My experiences with my son have motivated me to learn as much as I can about this disease to help him and other diabetics, athlete and non-athlete alike, to take control of their lives!

No Free Refills!

2010-06-07T10:51:00.003-04:00

I'm often asked by people if they can eat all they want of a certain food. Perhaps vegetables or fruit? What about diet soda? You're not going to like what I have to say, but there are no free refills when it comes to healthy eating. In fact the notion of "free refills" perpetuates mindless eating. There is and should be a limit to what we consume. By eating all that we want, we tend to overeat (think about the last time you ate at a buffet). Shouldn't we stop and evaluate our level of hunger before eating more?

Hara hachi bu is an Okinawan expression that means eat until you are 80% full. This was traditionally practiced by the Okinawans who were among some of the longest lived people on the earth. Their diet consisted mostly of vegetables, whole grains, fruits, legumes including soy foods, fish and very little amounts of meat. Sadly, younger generations of Okinawans may not live as long as their elders because they seem to prefer a more western diet, with a nice helping of western diseases to boot.

As a 15 year old athlete, my son has a healthy appetite. I'm fortunate that he likes most foods and with a dietitian for a mother, he gets more than his fair share of vegetables, whole grains and legumes. He often desires second or third helpings. I'll ask him if he's still hungry before digging in a second time. His reply has often been, "well, I'm not full." I don't believe that fullness should be the gauge that we have had enough to eat, but rather absence of hunger. Fullness is the gauge that we have overeaten. This is food for thought in a world of overabundance. It takes real discipline to practice hara hachi bu when we are being bombarded by food advertisements that make us want to eat more with excessive portion sizes on every street corner. A mere 100-200 hundred calories a day extra can prevent us from obtaining weight loss, and over time promote weight gain. It's something to think about when you want to eat more because something tastes good, but you are no longer hungry.

To those who question why we shouldn't eat as many vegetables as we want, after all they are low in calories; I say sure, eat plenty of vegetables. Most people don't eat enough. But no food should be eaten unchecked. A recent article in the New York Times told of an 88-year-old woman who developed life threatening hypothyroidism from eating two to three pounds of raw bok choy daily for several months. She believed that it would help control her diabetes. Instead it suppressed her thyroid. This is an extreme example, but it shows that you can get too much of a good thing.

My challenge to you, try practicing hara hachi bu for a week. Be mindful about the food that you eat and stop eating when you are no longer hungry, but not full.

Diets Don’t Work? …Really?

2010-05-14T14:25:00.000-04:00

Have you ever noticed how an idea gains popularity but the idea may not be true? Drinking eight cups of water a day is one such concept. It seems like a good idea, but there are many people who do fine drinking less and many people who need more. Another such idea is that diets don’t work. This is a common idea circulating within the nutrition community and one that I’m sure many “dieters” have also heard. The purpose of this idea is to move people away from the “dieting” mentality to encourage them to engage in healthy eating and lifestyle habits, and to become more aware of their bodily need for food. It also, unwittingly lays blame with the “diet promoting” community for the failure of dieting efforts.

As a practicing dietitian for 20 years I have to say that diets DO work! I’ve been witness to many people achieving their goals by following a specific dietary plan. The problem is that people can be limited by their ability to follow recommendations consistently. There are all sorts of reasons for this, too numerous to describe, but here are a few: emotional eating related to the need for comfort, lack of time to prepare meals due to social pressures, and medical problems (and medications) that change the body’s response to food.

Perhaps the first myth to dispel is that "diet" is a four letter word. It depends on how you look at it. The word “diet” as a noun describes a way of eating. All living creatures have a diet, ranging from the worms and bugs that birds eat to the broad variety of items my dogs eat – dog food supplemented with small rocks, twigs, shoes, undergarments and broccoli. Change diet into “dieting” and viola—it becomes a verb. This is how many of us are most familiar with the word. Dieting implies that we are doing something to change our eating regimen—not necessarily a bad idea. But when one “goes on a diet” they inevitable must “go off a diet” abandoning all the good changes that they previously made. It seems best to focus on the word diet as a noun to grasp the long term nature of what our commitment should be to a healthy diet. As long as we are living and eating, our commitment shouldn’t end.

Research conducted by the National Weight Control Registry showed that people can lose weight on ANY diet plan. So weight loss doesn’t seem to be the problem as much as weight maintenance. And weight is not maintained when the permanence of an eating regimen is not considered. As is the case with weight loss, there are many diets that are successful in improving other aspects of health. The Mediterranean diet is heart-healthy. The DASH diet lowers blood pressure, and has recently been shown to help prevent kidney stones. And there are many different diet manipulations that can improve intestinal function, reduce the risk of cancer, lower cholesterol levels and control blood sugar. Diets do work!

I agree with my colleagues who espouse the non-dieting approach, but don’t say that diets don’t work. Let’s go back to looking at the word “diet” as a noun and encourage each individual to choose the best diet to achieve and maintain their health.

Can Vitamin D Protect You From the Flu?

2010-03-21T10:53:00.008-04:00

Vitamin D, termed the sunshine vitamin because it is produced by skin exposed to sunlight, has been in the news a lot recently. We are well familiar with the need for vitamin D to develop strong bones, but a rash of recent studies show that vitamin D also functions as an important regulator of immunity. Vitamin D deficiency is seen in many immune-mediated diseases such as Crohn’s disease, type 1 diabetes, multiple sclerosis, rheumatoid arthritis and asthma. Vitamin D deficient states have also been theorized to increase susceptibility to infections. Because vitamin D is mostly obtained from sunlight, blood concentrations of vitamin D decrease in the winter months, a time when influenza infections become more widespread.

A study released ahead of publication in the American Journal of Clinical Nutrition is one of the first clinical trials to report that vitamin D supplementation in school-aged children can decrease the incidence of influenza A. In this study, a randomized group of 334 children in Japan were given either 1200 IUs of vitamin D or a placebo over a four month period (December 2008 trough March 2008). The study showed a significant decrease in influenza A infection in the children who took vitamin D supplements. Vitamin D increases the production of antimicrobial proteins that inhibit some forms of the influenza virus, and vitamin D’s anti-inflammatory properties may also lessen flu symptoms.

Some of the study results were not as distinctly positive. A decrease in incidence of influenza B was not seen in this study. Various strains of flu have different mechanisms of infection within the body, and some may be more resistant to the effects of vitamin D. Children with asthma did not show a decrease in the occurrence of flu, but it is thought that asthma suffers are more prone to infection overall. Interestingly, the study showed that there were significantly less asthma attacks in the vitamin D supplemented group. Flu incidence was not decreased in the first month of supplementation; previous studies have shown that vitamin D supplements need to be taken for three months before blood concentrations reach a steady value. Therefore the optimal time to begin vitamin D supplementation would seem to be before the start of flu season. The skin loses its ability to make vitamin D from sunlight beginning in mid fall. Flu season typically peaks in November and April. Thus it has been recommended to supplement vitamin D from October through April.

Clearly, more research needs to be done to determine whether or not vitamin D supplementation can prevent the flu in larger, more diverse populations. We know that senior adults are more susceptible to influenza. Vitamin D requirements are also increased in this population as older skin is less efficient at making vitamin D. Overweight or obese individuals have also been shown to have low levels of vitamin D; one study showed that 1 in 3 women and 1 in 2 men were deficient in vitamin D. Though it has not yet been definitively determined that vitamin D supplementation prevents the flu, supplementation with up to 2000 IUs of vitamin D has been shown to be safe, and emerging evidence suggests that it may indeed help to prevent infection with some strains of the virus.

National Nutrition Month® 2010: Nutrition from the Ground Up

2010-03-01T12:41:00.000-05:00

This March celebrates the thirtieth year of National Nutrition Month® whose purpose is to focus attention on healthy eating and physical activity habits to promote health and wellbeing in the American population. It’s difficult to compete in the current food environment with the message of health. You most likely won’t see any TV commercials or advertisements online or in print. But the message for this year resonates; “Nutrition from the Ground Up.”

I asked my family what this meant to them. This year’s theme brings to mind acres of plants growing in the sunshine with various shades of green and gold as far as the eye can see. My six year old daughter thought of butterflies. My mind met hers in a field of strawberry blossoms in May with butterflies fluttering in the air. The thought of foods grown using sustainable practices that are good for the environment and good for us comes to mind. Such practices encourage the butterflies and the bees to pollinate the plants, which then allow the fruits and vegetables to develop. The ground provides the nutrients for growth. So “Nutrition from the Ground Up” means caring for the earth that produces an abundant harvest to nourish us.

Another concept for this theme is the idea of gathering or foraging for food. Mushrooms, nuts, legumes, and wild berries are gathered in forests, groves and meadows and can often be found near the ground (nuts historically were collected on the ground after falling from trees). The nutrients these foods provide are varied with myriad health benefits. Although we are not gathering and foraging for these foods ourselves anymore, we should include them in our diets routinely to reap the health benefits that they provide. A variety of nuts provide heart-healthy fats to prevent heart disease and stroke; they range from omega-three polyunsaturated fats in walnuts to monounsaturated fats in cashews, almonds and peanuts. Legumes (peas, beans, lentils, and soybeans) are a wonderful combination of soluble and insoluble fiber with a good dose of protein; they help to manage blood sugar levels, which can help in the management of diabetes. Foraging for food also includes a level of physical activity. This physical activity used to be our way of life, but is now so greatly lacking on any given day. We should wander the ground again in our pursuit of health and vitality.

Perhaps the deepest issue here deals with something that is hidden under the ground. Like an iceberg, there is so much more to discover underneath. The iceberg analogy is one that I commonly use when describing the science of nutrition: what we currently understand about the interplay of nutrients on our health is only a small part of the story. Most of it is vast and hidden from view, despite all of our science. Dedication and patience is required to learn about the wonders yet undiscovered, just the same as the dedication and patience we must have in the pursuit of our health goals, whether they involve weight loss or disease management. “Nutrition from the Ground Up” speaks of discovery; finding a carrot buried deep within the ground, discovering how nutrients impact our health, and finding that healthier and happier person within ourselves.

Ask what “Nutrition from the Ground Up” means to you and your family.

To Weigh or Not To Weigh

2010-02-08T10:32:00.009-05:00

Should you weigh yourself every day? Good question! We used to teach restraint with the bathroom scale. We thought that it was better to weigh only once a week so that you could see your progress over time and not be fixated on the slight fluctuations that happen in normal weight management. Well, data from the National Weight Control Registry (NWCR) show otherwise. People who are successful losing weight and maintaining weight loss, weigh themselves daily. The logic is that if (or when) you gain a couple of pounds, you will correct for that gain with more activity or decreased food intake. This is an important skill to master in weight loss and maintenance.

Energy balance is maintained when energy intake is equal to energy output. But this equation is not easy to achieve, in fact, it probably is never achieved on any one day. The best that research has been able to show is within 50 to 100 calories of input or output. So there is never a day when we burn 2000 calories and eat 2000 calories. Maybe we burn 2014 calories and we eat 2115 calories. And the next day we burn 2354 calories (we exercised that day) and we eat 2274 calories. And that's how it goes. We need a tool to be able to measure the effect that this has on our body. The scale is such a tool. Whether you hate it or not, it can keep you honest about what you are really doing.

My recommendation to my weight loss clients now is to start with weekly weights until about five pounds are lost. Then it's time to weight daily. I know how much work goes into losing weight and I want my clients to be successful and not regain lost weight. The key with monitoring weight is to weigh on the same scale at the same time of day, wearing the same clothing (it is best to wear no clothing or minimal clothing). Write it down in your journal (because writing everything down increases your chances of success) and move on. At the end of the week go back and look at your weights and write a summary of your progress. It may go something like this:

Started the week at 155.6 pounds. Weight went down to 154.3 by midweek. Ate Chinese food for dinner at the end of the week and noticed that weight went up to 155.1 pounds. Probably holding extra water from all the salt in the restaurant meal
the night before. Finished the week at 154.7. Lost almost one pound this week.

Now, weighing daily is not good for people who struggle with eating disorders. If you are aware of disordered eating patterns, you will require both diet and psychological/behavioral therapy and you will have recommendations made by eating disorder specialists. The rest of us need to stop hating the scale. When we hate the scale, we hate ourselves. It's just a number that helps us measure progress toward our goal. We expect to see drastic changes in a short amount of time, but research again shows us that those who are most successful with maintaining weight loss, lose weight very slowly, 1/4 to 1/2 pound a week. So when the scale tells you that you've lost 0.4 pounds in one week, feel confident that slow and steady wins the race!

The Value of a Training Buddy

2010-02-06T13:13:00.000-05:00

My friend Linda hates to run. Linda and I train together. She told me this during one of our training sessions. I tolerate running, but can't say I love it either. I can manage one or two miles of interval running (preferring only one mile), but have never run long distances or entered any races. We train with another friend, Tim, who is a veteran runner. A while ago I decided that to continue to improve in physical fitness and to meet weight loss and management goals that people should continually challenge themselves. You have to do what you hate. So I made Linda run. She complained, but she did it. I wanted to quit too, but I did it also. We kept each other going. Tim kept challenging us and encouraged us to enter a 5K. We set the goal to run in the Jingle Bell Run in early December. We trained for a couple of months and we did it! It was a lot of fun! Our finishing times were not that great, but that wasn't our goal. While out shopping for new running shoes a while back, Linda expressed an interest in completing a 10K. OK, we can do that! We told Tim. Tim runs in a race almost every weekend during running season. Again Tim challenged us. How about running the Boilermaker 15K in Utica, NY in July? A 15K is a little more than we wanted to do, but I thought that we could do it (Linda was pulled along in this decision). We have plenty of time to train. Linda tolerates running now and is going out on her own. I think she even misses it when she can't get out for a run.

That's where Linda and I are right now. We're trying to get as much mileage under our feet as possible this winter. We spend two days training inside on the treadmill and as many days outside as we can considering the Rochester winters. Running long distances on the treadmill is agony. We'll run two miles and practice speed intervals on the treadmill. Linda hates this and doesn't see the point. Her 15 year old son tells her to stop complaining and to just do it. And she does. My goal is for us to complete the Boilermaker in 90 minutes. Ten minute miles seem easy for shorter distances, but we're running 9.3 miles. This is uncharted waters for us. Linda and I are now running five miles in an hour. This is beginning to seem easier to both of us.

Today, I met Linda in the bitter cold to go running. Sidewalks were not cleared and we had to run in the busy streets from time to time. We weren't sure how far we wanted to go today, but we both felt good during the run, despite not quite getting warm. We ran five miles, including a nice hill at the end of the run. Linda kept a good pace and we were both thrilled to be honked at by a gentleman driving by at the end of our run. Linda's goal now is to run six miles in an hour. That's a pretty good goal for someone who doesn't like running. I think Linda does like running now, she just doesn't love it! Hmmm...that sounds like another challenge.

Research shows us that when we engage in diet and exercise goals with other people our chances of success are greater. It's also important to set goals. Starting with small goals makes the challenge seem less difficult. But it's important to set new goals along the way, continually challenging ourselves. Humans are social and the camaraderie and encouragement that we receive from others can be tremendous. Conversely, others who do not share our goals can tear us down. Seek out those who will support you in your goals. I feel lucky to have Linda and Tim and the other friends who will be running and training with us! I'm really looking forward to putting many miles under my feet with good friends next to me!

My Stressed Out Entrance Into the Blogosphere

2010-01-29T16:10:00.000-05:00

I consider myself typical; three kids, two cats, two dogs, a husband, a job, and volunteer work. I'm stressed out! Who isn't? I feel pretty equipped to manage my stress most of the time, though sometimes panic rears its ugly head. Stress can have a negative impact on the human body and coping strategies are necessary to maintain a level of productivity and vigor. For me, eating well and physical activity fit the bill. Getting a healthy meal on the table for my family after a day of work or setting aside time for physical activity can seem pretty daunting. Often, I think that we impose restrictions on ourselves to keep us from living a healthier life. We almost expect to fail, so we don't really try. Smoking cessation programs teach us that many people have to quit smoking several times to finally be successful. So, with failure comes success...eventually, if you never give up! Life is worth living fully with good friends, good food, lots of physical activity, and of course some stress. So, this is what my blog is about. Hopefully, I can navigate it like this picture drawn by my six year old daughter; with a smile on my face!