Friday, July 31, 2009

Chicago says, “Walk the Walk”

Nearly 3,000 readers have voted in the Chicago Tribune online poll asking, “With the nation’s obesity crisis worsening, some advocates say it’s increasingly critical for health care workers to “walk the walk” and serve as role models. Do you agree?” An overwhelming 75.1% of readers reported “yes”. And, I agree.
In the nutrition world, I expect to be judged by my patients based on my weight status. This makes sense to me, and it’s only fair. When I worked at Rush University Medical Center for a summer, I recall seeing the masses of doctors and nurses outside smoking. Let’s just say I didn’t think highly of their actions. Same goes for staff at my current job. While completing my dietetic internship, even a respiratory therapist in a nursing home missed a code blue because he was out on a cigarette break. Oh, the irony.
The article uses the non-health related example of finances. Financial advice may not be best sought by a CPA who had just filed bankruptcy. Duh. But for doctors and dietitians, for example, what’s the goal? Perfection?
The article opens in talking about Sharon Salomon, a Phoenix-based Registered Dietitian. She says that while she teaches clients how to eat right and lose weight, she would use the word “fat” to describe her own physique. Professional deal-breaker? Surely to some, and I can’t blame people for discrediting a professional unable to live-up to their own advice.
As for myself, I don’t claim to be the epitome of health or nutrition, but I do practice what I preach: moderating the bad and always working to increase the good. When I encourage patients to consume more fruits and vegetables, I affirm this by saying that we ALL need to eat more fruits and vegetables, as it’s difficult for ANYONE, myself included, to consume 5-9 of those babies a day! Being healthy is very difficult, and today’s day and age creates an environment in which temptations are impossible to always dodge.
I commit to being a role-model for patients, family, friends, and loved ones. While I’m not perfect, I do make a conscious effort each and every day to make it a healthier one.
[1]. Deardorff, Julie. Weighty Issue Rages in Surgeon General Debate. Chicago Tribune. July 28, 2009.

Thursday, July 30, 2009

Lunch slump much?

I got a blog request this week from my friend up in Chicago. She wants to know lunch and snack ideas, as well as times of the day to be eating. Kristin, here you go…it’s a long one!

Eating right while managing a busy career and life can certainly be a challenge, but it’s also certainly very manageable if you keep things fresh, exciting…and plan ahead! As far as times of the day to be eating, this certainly varies on an individual basis. Personally, I bring with me everyday to work a snack to have before lunch, as well as one to have after lunch, which is typically in the car on my way home from work.
Ideally, I don’t recommend going more than 5-6 hours without eating. And 3 smaller meals with 2-3 healthy snacks a day is a great routine to get into. However, listening to your body is extremely important as your body will tell you when it’s hungry. If you’re not hungry, save the snack or have a later lunch. No reason to eat when you’re not hungry. Unless, of course, you’re my husband and refuse breakfast…in which case I recommend stock-piling a box or two of granola bars or cereal in your desk drawer. I force Mark to do this, and he typically has a mid-morning breakfast at work each day. The times at which you eat during the day should fit with your schedule. Find a pattern that works for you and be flexible. Packing things that aren’t too messy, labor-intensive or time-consuming to prepare ahead of time is also key.
Make snacks satisfying – include both carbohydrate and protein in a snack so that they are more satisfying and filling. Great snack ideas include:
- apple slices dipped in ½ c. fat-free yogurt
- 1 ½ sheets of graham crackers and 1 c. low-fat/fat-free milk
- 1 medium banana and 1-2 Tbsp peanut butter
- small handful of almonds
- apple and a 1 oz. slice of cheddar cheese
- string cheese and wheat crackers (6-7)
- a slice of bread or 6-7 crackers with 1-2 Tbsp peanut butter
- a high-fiber granola bar
- 1 serving of animal crackers and an 8 oz. glass of milk
- a Luna bar
- a fat-free/sugar-free pudding cup
- 2/3-3/4 c. cottage cheese and peaches/pineapple/melon
- 2-3 Tbsp hummus and 6-7 crackers
- 1 oz. meat and 1 oz. cheese with 6-7 crackers
- carrots, celery, cucumber, and bell pepper slices with 2 Tbsp light ranch dressing
…to name a few ideas!

As for lunches, here’s some ideas. Those asterisked have recipes below! Be creative…plan ahead…enjoy!

- almond butter and apple slices on wheat bread
- tuna salad in a pita
- chicken salad flatbread (Flatout is a popular, healthy brand)
- crab salad in a whole wheat, high-fiber tortilla
- egg salad* sandwich on whole wheat
- cracker sandwiches made with 2% cheese and lean luncheon meat (turkey, ham, roast beef, chicken)
- cold whole-wheat pasta salad with low-fat Italian dressing (include 2% cheese cubes, turkey pepperoni, salad peppers, olives, bell peppers, artichoke hearts, onion, and cherry tomatoes
- cherry tomato, mozzarella, and fresh basil pita with Flaxseed Lemon Vinaigrette*
- BLT sandwich on whole wheat*
- pear and Swiss cheese sandwich on whole grain bread with Flaxseed Lemon Vinaigrette
- taco salad with 1 serving of whole grain tortilla chips
- grilled mozzarella and tomato sandwich on whole wheat
- Chicken Caesar salad pita (use bagged low-fat Caesar salad mixes – just add grilled chicken strips!)
- Pin wheels – roll-up luncheon meat, cheese, veggies, and condiments in a tortilla and cut into rolled bites held together with toothpicks
- Cold pizza!
- Leftovers!
Other suggestions:
- Pre-mix mayonnaise made with canola oil (see Monday’s blog) with yellow, brown, or honey mustard to mix delicious flavors…and cut out fat and calories!
- Make your lunch the night before.
- Commit to trying a new lunch each week
- Aim to make your co-workers jealous of your packed lunches – it’ll happen if you put in a little effort!
- Include something you love – if you’re a salty kinda person, opt for a bag of baked chips for a side to your meal, and if you’re a sweets kinda person, opt for a small cookie or pudding cup to compliment your meal

Recipes (taken from The Flexitarian Diet by Dawn Jackson-Blatner)

Egg Salad
1 boiled egg, chopped**
2 boiled egg whites, chopped**
2 tsp. mustard
1 Tbsp light canola mayonnaise
1 stalk celery, chopped
½ c. cucumber, chopped
Dash of pepper
2 slices of whole wheat bread

Mix the ingredients together and spread onto bread.
**Substitute tofu for the egg for a vegetarian meal!
Nutrition Information: 310 calories, 11 g. fat, 693 mg. sodium, 5 g. fiber

BLT (Balsamic, Lettuce, and Tomato) – This is a favorite of both mine and my parent’s!
4 Tbsp hummus
2 slices of whole grain bread, toasted
¼ avocado, mashed
Romaine lettuce
Tomato, sliced
1 Tbsp balsamic vinegar

Spread hummus on one slide of toast and avocado on the other. Top hummus with lettuce and tomato, and drizzle with vinegar. Close sandwich and enjoy!
Nutrition Information: 370 calories, 15 g. fat, 434 mg. sodium, 9 g. fiber

Pear and Swiss Sandwich
2 slices whole-grain bread, toasted
1 small pear, thinly sliced
1 oz. (1 slice) Swiss cheese
2 tsp. mustard
Nutrition Information: 300 calories, 6 g. fat, 440 mg. sodium, 9 g. fiber

Universal Lemon-Flax Vinaigrette

¼ c. lemon juice (1-2 lemons)
¼ c. flaxseed oil
¼ c. white balsamic vinegar
1 Tbsp Dijon mustard
1 clove garlic, minced
Salt and pepper to taste

Whisk all ingredients together. Keep in fridge up to 7 days.
Nutrition information (2 Tbsp): 88 calories, 9 g. fat, 59 mg. sodium, 0 g. fiber

Get to packin’!

Wednesday, July 29, 2009

Melts in your mouth, not in your hands...and more

You may have heard rumors about green M&M dye and "mojo" but the blue M&M dye may have its perks, too. And proof of it.

Research at the University of Rochester Medical Center found that rats suffering from spinal cord injuries were able to walk again after being injected with the compound Brilliant Blue G (BBG). BBG is the same dye found in blue M&Ms and blue Gatorade, go figure. Side effect: the mice turned blue [1]. I think it’s rather adorable, don’t you?

Previous research performed in 2004 looked at adenosine triphosphate (ATP), also known as the “energy currency of life”, and its effect on spinal cord injuries. The results found that oxidized ATP blocked the affect of ATP which caused harm due to the sudden influx of ATP which killed off healthy cells after an injury. What does this matter? Well, BBG acts in the same way as oxidized ATP following spinal cord injuries -- favorably. In spinal injuries among rats which cause immobility, those treated with BBG were able to walk again while those left untreated never regained their mobility [1].
Why is this important? Approximately 15% of humans suffering spinal cord injuries receive steroids; the majority of spinal cord injuries (85%) are left untreated. Steroid treatments work moderately well, at best. Treatments such as BBG provide ground-breaking research. While BBG does not offer a cure, it offers more potential improvement than ever before [1].
Researchers are currently looking into getting the first clinical trial for BBG use on humans to be approved [1].
[1]. Blue M&Ms Linked to Reducing Spine Injury. CNN. July 28, 2009.

Tuesday, July 28, 2009

Eat This, Not That: Mayo

I had a blog topic request from my amazing mommy. So, mom, here you go!
Her topic proposal: Mayo with olive oil. She said in an email, “I’ve seen it advertised and on the shelf today. Us consumers will need to know it it’s good because it touts the words olive oil. If it is indeed beneficial, how much?”
Simple answer: It’s a condiment that contains calories, fat, and in some cases cholesterol. It should be used in moderation.
Reality, however, is not omission from the diet. So, let’s discuss.
Between the choices offered by Hellmann’s, my recommendation in order of “dietary preference” would be:
  1. Hellmann’s Canola Cholesterol-Free
  2. Hellmann’s Low Fat
  3. Hellmann’s Light
  4. Hellmann’s with Olive Oil
  5. Hellmann’s Real Mayonnaise
The logic?
The lowest option calorically is the low-fat Hellmann’s measuring in at 15 calories and 1 gram of fat per serving (1 tablespoon). The problem with it is the ingredients – water and modified cornstarch being the two main ingredients. Also, the sodium (while not high) is higher than any other Hellmann’s product. It is also the lowest in “good fat” – mono and polyunsaturated fatty acids (MUFAs and PUFAs).
Hellmann’s Canola Cholesterol-Free comes in as #1 in my book because it is 50% lower in calories than Hellmann’s Real Mayonnaise, contains no saturated fat, no cholesterol, and is lower sodium than the Hellmann’s made with olive oil. The olive oil product contains 5 more calories than the canola product and 5 milligrams of cholesterol, as well as 0.5 grams of saturated fat. Also, the olive oil product is not made of pure olive oil, but also contains soybean oil. Further, when you log-on to, the olive oil product is asterisked and noted to not contain olive oil. If that’s confusing and unclear to a dietitian, it’s certainly unclear to consumers.
Canola oil is a heart-healthy oil and inexpensive. It offers similar MUFA and PUFA content as olive oil, and can be used diversely in cooking and baking.
Mom: Buy the Hellmann’s Canola Cholesterol-Free. Love you!

Monday, July 27, 2009

Moon Grub

This is more for fun than it's probably Trivial Pursuit-worthy.

Flying to the moon requires more compact, efficient, high-tech nutrition than that required on flights to say…Mercury (duh, right?). Designed using “scientific nutrition”, astronauts are certainly not bragging about “pills and paste”, the space-ready food served on their menus in the past. Such products were designed to provide calories, vitamins, and minerals... however, astronauts won’t eat the stuff. The “pills and paste” are packaged in squeeze tubes or as bite-size cubes coated in gelatin to keep crumbs from escaping. Warren Belasco, author of “Meals to Come: A History of the Future of Food” describes the food as “edible biomass, food for function, not for the soul [1].” No kiddin’.
Astronauts were losing a lot of weight not only in part to the extremely unappetizing food, but also in part due to their increased energy needs. While “floating” sounds easy enough, a lot of energy is expended in space as opposed to gravity-ridden Earth. The calcium needs of the astronauts are also increased as bones regenerate more slowly in space.
However, Apollo astronauts were the first to have hot water aboard their space craft which allowed for dehydrated foods which were packaged like the military’s meals ready to eat (MRE’s) [1]. Unfortunately, the foods were typically consumed out of a pouch, allowing them to eat with a spoon versus the retired “pills and paste” alternatives in the past [2].
Flying in space causes a shift in body fluid to the head causing a decreased sense of smell. Because 85-90% of what we taste is what we smell, astronauts commonly use hot sauces, soy sauce, and other bold flavors to season their food and increase the flavor. Overall, the advances in selection and quality for our space crews have drastically improved. Those working for NASA have 180 varieties of freeze-dried foods from which to choose. They can even opt to include some of their favorite foods in the form of freeze-dried. A menu cycle is typically 7-days and many shuttle crews allow on foods representing their country to share with other astronauts. Carbonated products such as colas, however, are avoided as they cause “dry burps” when mixed with gravity.
Moral of the story: foodies probably wouldn’t be too thrilled about the cuisine in space. I’ll stick to my day job, that’s for sure.
[1]. LaRue Huget, Jennifer. Houston, We Have a Menu. The Washington Post. July 21, 2009.
[2]. Suddath, Claire. What Do Astronauts Eat in Space? Time. July 20, 2009.

Sunday, July 26, 2009

My music > Your music

Mark loves girly music -- Madonna, Celine Dion,'s kind of embarrassing, but also a trait I find rather endearing (only a wife could say that!). So as he headed out for a run this morning with his headphones on, I could, of course, hear some "Material Girl" penetrating loud enough for me to hear. I gave him an eye roll and a smile...and he gave me blogging material.

Some good tunes are essential for enjoying a workout. My top 5 are eclectic, to say the least, but maybe they'll enhance your workout play list, too.

In no particular order...

1. Madagascar 2 Soundtrack, Big and Chunky -- it's not the whole song...but I had to get the little animals dancing - get the whole song, though...surely some motivation there!

2. Machine Head, Bush -- if you're huffing through a run, the lyrics will help you out!

3. Nicole Scherzinger feat P. Diddy, Come to Me -- not the best sound quality...but the dancing sure is!

4. Gaelic Storm, Nancy Whiskey -- This song was played every week in a spin class I took with a lovely gentleman named Vince. Vince was incredibly buff and incredibly quirky - this song...has stuck. Very bizzare choice, I know, and you must download one that is NOT a live performance...YouTube was not much help in finding a quality version of that rare song.

5. Bob Sinclar, Love Generation -- Spring Break '06 in Acapuloco. I'll say no more!

What are YOUR favorite workout tunes? Help me out, too! Post your answers in a comment for all to see, please!

Saturday, July 25, 2009

Denny's Downer

If you enjoy a good'ole Denny's breakfast anything like my family -- brace yourself. In keeping with yesterday's topic of sodium...turns out, Panera may not be a leading offender.

A consumer activist group in New Jersey sued Denny's Corporation this week because of the "dangerously high" levels of sodium found in their meals. As previously discussed, the recommended daily allowance for sodium is 1,500 milligrams for a hypertensive individual, and up to 2,300 milligrams for a healthy individual (some sources stick with 1,500 mg for all). Some menu items at Denny's more than double Panera's worst offender with nearly 6,000 milligrams of sodium. *blink*

As for the health implications of such foods, we know that diets high in sodium are major causes for hypertension, which is associated with heart disease and stroke -- two of the leading causes of death. The Executive Director of the Center for Science in the Public Interest, Michael Jacobson, is quoted in saying, "For those Americans who should be most careful about limiting their sodium, such as people middle-aged and older, African-Americans, or people with existing high blood pressure, it's dangerous to eat at Denny's. Denny's customers deserve to be warned about the considerable health risks posed by many of these meals" [1].

As for Denny's...they have no comments at this time (duh).

It'll break my brother's heart to hear that the Denny's Meat Lover's Scramble which contains two eggs with chopped bacon, diced ham, crumbled sausage, cheese plus two bacon strips, two sausage links, hash browns, and two pancakes weighs in at an astonishing 5,690 milligrams of sodium -- a scary 379% of the recommended daily allowance [1].

But the bleeding doesn't end there. A Denny's Spicy Buffalo Chicken Melt with seasoned fries will provide 4,880 milligrams of sodium while an added bowl of Denny's Clam Chowder would together boast a staggering 6,700 milligrams of sodium for the meal - an amount that should be consumed over the course of 4 1/2 DAYS. Medically speaking, the body has a difficult time ridding of that amount of sodium and excess sodium in the body can lead to fluid retention and accumulation in the lungs, presenting potentially severe medical consequences over time [2].

And, it doesn't stop there. EVEN the smaller meals advertised specifically for children and seniors contain sodium in excess of the daily recommended intake [2]. Scary, isn't it? Dr. Stephen Havas of Northwestern University explains high sodium intake to be one of the nation's top health threats. He goes on to share that by reducing 50% of the sodium content in packaged and restaurant foods, there would be 150,000 saved lives each year. If that's not evidence enough for change, I don't know what is.

Beware of Denny's! Though my hypertensive father doesn't read blogs, this one will be printed and snail mailed to Chicago. While I know my parents look forward to retirement and "Lumberjack Slams" (850 calories and 3180 milligrams of sodium), the Food Police, as I'm so lovingly referred to, says "NO!" to Denny's. Back to the kitchen, Maaaaaaaaaaaaa... also known as Jan's Bar and Grill.

[1]. Activist Group Sues Denny's Over Sodium Levels. Reuters UK. July 23, 2009.
[2]. Unsafe Sodium Levels at Denny's Prompt Class Action Lawsuit. CSPI Newsroom. July 2009.

Friday, July 24, 2009

The DL on Panera

Did you know “Panera” translates to “time of bread” in Latin? But, of course!
Even in the current economic state, with most restaurants suffering the worst quarterly decline in 28 years, Panera is experiencing otherwise. Since 1981, the franchise has opened 1,264 stores in 40 states. There’s another 80 stores opening this year, which is about the same number as last years’ openings. Panera has even raised two menu item prices: bagels and soup. There is also a new addition to the Panera menu: a $7.59 chopped cobb salad [1].
While Panera sports hefty prices, I continue coming back for more. Those baguettes are worth fasting for breakfast in order to fund the addiction (I’m only half kidding…we should all eat breakfast). Though Panera is known for the use of wholesome ingredients and lack of fried foods, the menu still very much so requires navigation in order to be healthy.

Q: What does the RD order at Panera?
A: You-Pick-2: ½ smoked turkey on sourdough (light on the mayo) with Garden Vegetable or Black Bean soup.

Top 5 “best” picks:
1. Panini: Turkey Artichoke Panini (750 calories, 27 g. fat, 7 g. saturated fat)
2. Signature Sandwich: Asiago Roast Beef (710 calories, 32 g. fat, 13 g. saturated fat*)
3. Café Sandwich: Mediterranean Veggie (610 calories, 13 g. fat, 3 g. saturated fat)
4. Salad: Classic (170 calories, 11 g. fat, 1.5 g. saturated fat)
5. Soup: Vegetarian Garden Vegetable (120 calories, 1 g. fat, 0 g. saturated fat)

Top 5 “worst” picks:
1. Panini: Chicken Bacon Dijon (940 calories, 36 g. fat, 13 g. saturated fat*)
2. Signature Sandwich: Chipotle Chicken on Artisan French (1070 calories, 55 g. fat, 15 g. saturated fat*)
3. Café Sandwich: Sierra Turkey (970 calories, 54 g. fat, 12 g. saturated fat)
4. Salad: Chopped Chicken Cobb (490 calories, 35 g. fat, 8 g. saturated fat)
5. Soup: New England Clam Chowder (450 calories, 34 g. fat, 20 g. saturated fat*)

Crazy, huh? Just this week I made a “Which is the better burger?” handout for my patients on the local burger hot spots like Sonic, McDonald’s, Carl’s Jr., and Burger King. While not a single burger exceeded 1,000 calories, the Chipotle Chicken on Artisan and the Sierra Turkey reach that 4-digit mark…one we probably want to avoid at all costs. Similarly, not a single burger exceeded 2,000 mg of sodium, while every sandwich on Panera’s menu met or surpassed that amount**. And while Carl’s Jr.’s Famous Bacon Cheese Six Dollar Burger comes in at a sickening 950 calories and 1980 mg sodium, Panera keeps up with the best of’em in keeping us with excess poundage [1].
Want to check-out the damage in your usual order? Check it out:
*Exceeds the recommended daily allowance.
**2,300 mg of sodium is the recommended limit while 1,500 mg of sodium is recommended daily for those with hypertension
[1]. Horovitz, Bruce. Panera Bakes A Recipe For Success. USA Today. July 23, 2009.

Thursday, July 23, 2009

Beyond "Baby Fat"

Maury Povich is infamous for his obese babies episodes (a close second to paternity testing, of course) featuring children who are double…triple… even quadruple the weight that is recommended for their age and length. While I’ll admit to partaking in the Maury episodes in the past myself, the reality is scary. Some go as far as to call such cases that of child abuse. What do you think?
USA Today ran a recent article on this very topic: does extreme childhood obesity qualify as child abuse? Jerri Gray, a South Carolina resident, was arrested in June with charges of criminal neglect despite her claims of doing all that she could to help her son lose weight. Her son, Alexander, tipped the scale at 555 pounds at the age of 14 and this unfortunate story has made nation-wide headlines [1].
Those opposing the charges, take the stance that if and when Jerri Gray is found guilty, “you have set a precedent that opens Pandora’s box,” says Grant Varner. Fortunately and unfortunately, I guess…I have to agree. In recent years, Texas, Pennsylvania, New York, New Mexico, Indiana, and California have toyed with the same predicament: what quantifies as a abuse when it comes to childhood obesity [1]?
Because the health implications of obesity many times don’t become chronic until adulthood, it makes it difficult to charge parents with child abuse, explains Linda Spears, Vice President of Policy and Public Affairs for the Child Welfare League of America. As for our South Carolina mother charged with criminal neglect, she could not comment as she has signed an agreement with a film documentary company for exclusive rights to her story [1]…what a winner of a mom, huh? If 555 pounds wasn’t evidence of abuse, benefiting from your son’s morbid obesity ought to be.
Some states are taking strides to reduce the rates and severity of childhood obesity, however. Twenty states (up from 4 states five years ago) have passed laws requiring schools to perform BMI screenings on children and adolescents. And while physical education is required in every state, the requirements “are often limited, not enforced, or do not meet adequate quality standards.” Not surprisingly, the CDC reports the number of obese children more than doubling in the past twenty years among children 10 to 17, and more than tripling among adolescents [1].
Rob Jones, a corporate wellness expert, advocates for charges being placed on parents rearing severely obese children. He explains that when parents give children drugs harmful to their health (illicit or not), they would be held responsible in court. Jones argues the same should hold true for food. Jones poses the question: is killing your children by way of food acceptable? Well, it’s not necessarily acceptable, but obesity does not necessarily put a child in immediate danger, either. Oh, the loopholes!
Keep yourself healthy and lead by example for your children. Introducing foods at a young age is key and participating in family meal times is integral to family togetherness and the maintenance of a healthy weight.
[1]. Barnett, Ron. S.C. Case Looks on Child Obesity as Child Abuse. But Is It? USA Today. July 22, 2009.

Wednesday, July 22, 2009

Today's Confessions of a Dietitian

Sonic. 44 ounces, please. Now...

If you've never tried Sonic's
Diet Cherry Limeade, you're missing a little piece of heaven. Sonic hosts their daily "Happy Hour" between 2 and 4pm where these amazing slushes are half off - SCORE! Mmmm...

While I almost decided to write, "It's DIET, don't judge" on my 44-ouncer (that sits on my desk all afternoon as I counsel the overweight and the diabetics), I recalled how conveniently guilt-free my indulgence is. For a mere
25 calories, I can partake in my afternoon delight...shamelessly. And so, I do.

When I was paying at Sonic today, however, I got to thinking about Sonic etiquette. I'm from the north as we know, and Sonic's are NOT more frequently spotted than gas stations anywhere but Oklahoma. So I quizzed local Oakie's as to whether or not tipping your carhop was an appropriate gesture, and if so, what's an appropriate tip?

Consensus: "Keep the change." I'm down with that, except that my $2.08 habit (not during 2-4pm) would run me another $0.92 on a daily basis. I don't make enough for that, now! I decided $2.50 was a fair compromise, and I loaded up my change receptacle in my car.

Crisis averted. But in all seriousness, you should grab yourself a little sip of heaven next time you pass by a Sonic. It won't disappoint.

Disclaimer: Sonic Diet Cherry Limeade is highly addictive. Consume with caution.

Microwaving plastic...hmmm...

Lily and I are flying solo this week, as Mark is at headquarters for business. The last thing I wanted to do last night was cook, so I popped in a SmartOnes -- SantaFe Style Rice and Beans, I believe it was called. Anyways, those things don't fill up this heifer, so I decided to add in more corn...which I happened to have in one of those steamable bags. I read the directions: 4-5 minutes on high. Now, I admit, I reheat leftovers in tupperware which I've been told is bad (but is it?!)...but the steamables bag...that just seemed way more wrong than my reheating-in-tupperware laziness. So, of course, I researched this morning as I sipped my daily vice: cappuccino. As for me and my tupperware, I am in luck. The FDA approves microwave-safe plasticware for chemical leaching onto food when heated. Any plastic products emitting unsafe amounts of chemicals onto foods are deemed unsafe for retail sale. And what about those leftover fajitas sitting in Styrofoam I plan to eat for lunch? Well, those can likely be reheated in the same fashion [1].

Similarly, Mayo Clinic dietitian, Katherine Zeratsky, discussed this same topic in a January 2009 article on the heating of plastic and the release of dioxins. Firstly, dioxins are cancer-causing substances found in soil, water, and animal fat. They are commonly created from forest fires and the burning of household trash. Reheating food in plastic, however, is also discussed as being safe from this credible source, as well [2]. The American Cancer Society concurs, too. So...

Microwave safety tips [1]:

- If you're like my family and think anything with a lid is reusable storage, please be advised that margarine tubs, cottage cheese tubs, yogurt containers, and plastics of the like are typically NOT microwave-safe

- If you're not sure whether or not a plastic is microwave-safe, play it safe and transfer it to a plate or glass dish - Remember to vent or leave open a jar any plasticware being reheated

- Use wax or parchment paper when reheating food on a plate rather than plastic wrap -- plastic wrap, while being heated, should not touch food

I'm glad my corn-bulked meal was A-okay, and now I'm even more-so looking forward to those fajitas at lunchtime...reheated in styrofoam.

[1]. Microwaving Food In Plastic: Safe or Not? The Harvard Medical School Family Health Guide. July 2006.
[2]. Zeratsky, Katherine. Does Microwaving Plastic Food Containers Cause them to Leach Dioxins into Food? MayoClinic. January 2009.

Tuesday, July 21, 2009

I'll take a pass, Dr. Atkins

The Physician’s Committee for Responsible Medicine (PCRM) reported a case study showing serious risks related to the Atkins diet [1]. For those that don’t know, the Atkins diet is the ultimate low-carbohydrate diet. WebMD explains the diet as being controversial…to say the least [2]. However, during the 1990’s, it was the diet craze…even for yours truly.
Sporting an excess 80lbs many years ago, I, too, gave the Atkins diet a shot. I vividly recall breakfasts consisting of bacon, eggs, cheese, and sausage. Um, hello cholesterol and saturated fat? It makes me ill even thinking about it today. Dr. Atkins, however, advocated for such: the ultimate low-carb diet, stating that it would improve health and memory function [2].
Let’s approach the science of the Atkins diet for just a second, because the diet does produce (temporary) weight loss. After a mere 2 ½ months, I was down 30-40 pounds. However, I’d bet just about anything that my lipid panel and blood pressure were up. Even at the ripe age of 14. The weight loss effects come from the lack of carbohydrates being consumed in the diet. The production of usable glucose: the source of energy for the body, particularly the brain, can cause serious strain on the body, especially organs such as the kidnies. Also, with carbohydrates unavailable, the body begins to breakdown it’s own fat stores, creating carbon fragments called ketones. This breakdown in the body puts oneself into a state of ketosis: the goal state for those following a low-carb diet seeking weight-loss. Ketogenic states tend to suppress the appetite which aid in producing weight loss. However, unpleasant side effects also pop-up when ketonic, such as unusual breath odor and constipation [2].
While fruits, vegetables, and whole grains are forbidden during the initial 2-week phase of the diet, they are gradually added back in. Effectively…supposedly. In my own experience, after maintaining a prolonged ketogenic state (albeit I surely didn’t know it was called that 10 years ago), the reintroduction of carbs into my diet caused major weight gain. Duh. Those 30-40 lbs were back in no time, and about 10 more joined in the following months. Please note, this was pre-nutrition education!
Low-and-behold, I got off easy post-Atkins. A case study published in the American Dietetic Association presented PCRM research on one man – a previously healthy 51-year-old now suffering from high cholesterol, atherosclerosis (hardening of the arteries), and erectile dysfunction after following the Atkins diet as discussed above. His poor wife…”unusual” breath odor and erectile dysfunction…
In one month’s time, the case study subject’s LDL (bad cholesterol) went from a health 85 mg/dl to an unsafe 154 mg/dl – a level most doctors would prescribe statins for. Eventually, the subject landed himself in the ER with symptoms of chest pain. The cause: a near total blockage of a coronary artery! For obvious reasons, the subject discontinued the low-carb diet and within 2 months had completely resolved his health problems.
If that’s not scary, I don’t know what is.
A shout-out to all the diabetics and weight-loss seekers out there: carbohydrates are an integral part of your diet – they are NOT the devil! Choose your carbohydrates wisely, however: whole grains, whole-wheat products such as rice and pasta, fruit, vegetables, and low-fat dairy.
[1]. Kraus, Peggy. Atkins Diet Blamed for One Man’s Chest Paid and Artery Blockage. Examiner, Tulsa. July 18, 2009.
[2]. The Atkins Diet. WebMD: Healthy Eating & Diet. Accessed July 21, 2009.

Monday, July 20, 2009

100+: the fastest growing age segment!

That's right! The US and Japan lead the world in populations of centenarians as a population growing 20x the rate of the total population by 2050. In 1950, there were only a few thousand over the age of 100 while today there are an estimated 340,000 worldwide [1].

Why is this?

Demographers declare medical advancements and improved diets are to thank. How'bout it, nutrition!? Genetics, lifestyle factors, and doctors willing to treat chronic diseases aggressively are also key contributors to the climb in age [1]. There's so such thing as "too late" in today's medical field to reverse the progression of disease. Nope, nope, nope!

While Japan leads the projected number of centenarians at 627,000 by the year 2050, the US is not far behind. We come in second with an estimated 600,000 come 2050, which is up from the current 75,000 in the 100+ age segment [1].

What does this mean for Medicare and Social Security? Well, it means something better if we each do our part in preserving our health. The cost of chronic disease management is perverse...obscene, even. The reality is, the younger generations may be SOL when it comes to government assistance come post-retirement age. 401k anyone?

Though the average American lives to be 78, most Americans would like to live to 89. Twenty percent of Americans would like to live to 90 with 8% wishing to live to see 100 [1]. With those goals and aspirations, we'd better aim to better our health or else it could certainly feel like a really long life.

Well, I'll have you know, I take my health very seriously and I intend to preserve it to the best of my abilities. It's a personal aspiration of mine to live to be 100+. When I was growing up, every Sunday at church there was the cutest little old lady who used to handout candy to kids as they exited the sanctuary. Every week she was there. While I appreciated the candy, I had come to appreciate her over the years. It wasn't until after her passing that I learned she was nearly 103 years of age. She was mentally sharp as a tack, and physically well enough to never require mobile assistance. She even posed in a Harley Davidson photo shoot on her 100th birthday I later found out. Seriously though, what a woman!

I see much of the same in my own 86-year-old Grannie. I'm sure you recall my boasting of her dance moves at my recent wedding reception...but here's a new story for you. On my way home from work last Friday I gave her a ring. I figured she would be heading downstairs to have dinner shortly (she lives in an independent living facility), but I tried her anyways. Turns out, she invited her "friend" Bill over (I use the term "friend" loosely. Grannie likes gentlemen, and has forever required several leading "friends" in her life. Bill just happens to be geographically desirable, however). They ordered in a pizza and were listening to music together. Maybe she was planning on showing off her dance moves, I'm just not quite sure. She did mention he was handsome. But, my point is...besides some short-term memory loss, the use of a walker (by choice), and some controlled hypertension, the woman is kickin' strong. You go, Grannie!

Aging can be a beautiful process, and I look forward to it...because I plan to do what it takes to do so gracefully. Kudos to those over 100 or well on your're my inspiration!

[1]. Yen, Hope. Starting to Get Crowded in 10o-Year-Olds' Club. The Washington Post. July 20, 2009.

Sunday, July 19, 2009

Quit to get ahead?

With the endless cycles of yo-yo dieting among Americans seeking weight-loss, what gives? Celebrities such as Oprah have shelved the concept of "diet" and begun seeking something more important than weight loss: health.

An article entitled, "Tossing Out the Diet and Embracing the Fat" found in last week's New York Times discussed the current health trends regarding weight-loss and diets. With recent movements such as Health at Every Size (HAES) supported by Linda Bacon, the dieting empire is receiving hard looks.

Years ago when I worked for Weight Watchers for a brief two-year stint, I had members return three...four...five...maybe even ten times to "recommit". Several winners of the Biggest Loser, NBC's hit show, can't keep the weight off...even under the watchful, malicious eyes of all of America. What is it we can do to make habits habitual and ritual?

As I've said many times before, health and weight status are not synonymous. Steven Blair, professor of exercise science, epidemiology, and biostatistics at the University of South Carolina (who is also a "fat and fit" advocate) explains that by looking at someone's fitness, you can determine their risk of death. Further, Blair goes on to state, "obese individuals who are fit have a death rate one half that of normal-weight people who are not fit." Somewhat to the contrary, Walter Willett, the nutrition department chairmen at the Harvard School of Public Health, explains that virtually all overweight individuals would be better off at a lower weight [1].

So, the New York Times article poses a valid question: If yo-yo dieting often leads to weight gain, does quitting ever lead to weight loss? [1]

The new size-acceptance/fat-acceptance movement suggests living your life as though you've reached your goal weight and to act on ambitions postponed while trying to become thin [1]. Surely an interesting thought.

While every health professional preferences different approaches to health, I believe that tayloring approaches to produce behavior change based on the individual trumps any one approach. Hence, I will continue to educate myself on all theories and approaches in an effort to better reach all of my patients where they need to be met.

As for me, my current needs will be met with a refreshing glass of Chianti. It was a tough hockey game today! Cheers!

[1]. Katz, Mandy. Tossing Out the Diet and Embracing the Fat. The New York Times. July 15, 2009.

Saturday, July 18, 2009

Fiction: Eating healthy is too expensive

I hear this excuse on a daily basis, even from my husband. But let's call a spade a spade: an excuse is just excuse. Not to be mistaken for a reason. Even in working with a low-income population in rural America, it's my job to make proper nutrition a feasible reality to everyone and on any budget.

Eating a more nutritious, balanced diet does not require breaking the bank. How one can justify fast food for every meal (DOLLAR/VALUE MENU OR NOT!) as a less expensive alternative to balanced home-cooked meals is sorely mistaken. The toll is not only on their waistline and their wallets, but on their overall health status.

So, 10 ways eating healthier doesn't have to cost you more:

1. Buy seasonal products. Fresh artichokes will run you $1.99-2.99 each right now, yes. Darn. Ouch. But a $0.10 ear of corn? Compare that to the canned or frozen versions. You're coming out well ahead, guaranteed.

2. Research. I make regular trips to Aldi for avocados, bell peppers, and other fresh produce. I'm saving bundles. And if you take lessons in guacamole-making from yours truly, you can make 4x the amount of guacamole from scratch as you can buy at Taco Bell or Taco Bueno.

3. Portions: if you're eating less volume, you can save lots of money. What a thought!

4. Water is cheaper than soda, shakes, Slurpees, etc. So is Crystal Light.

5. Use "heartier proteins" (to quote Katie Cavuto, the RD on The Next Food Network Star) such as beans in your meals. Beans are an excellent source of protein and fiber...and they're PACKED with vitamins and minerals.

6. Canned and frozen products are perfectly nutritious options for getting in your fruits and vegetables. While fresh is preferred, consuming fruits and vegetables from any source is a far step above consuming none at all. Be sure to rinse your canned vegetables to rid of excess sodium, and buy your fruit in water or natural juices. Anything packed in syrup (light or heavy) should be avoided.

7. Buy the generic. I love Fiber One bars and they're sold in bulk at retailers like Sam's Club. Walmart, however, has a generic brand with identical nutritional content and ingredients for 30% less cost. You'll find this is commonly true in snack foods and grains, such as cereals.

8. Items such as turkey pepperoni, turkey kielbasa, reduced-fat peanut butter, light or sugar-free syrup, and turkey hot dogs cost the exact same as their high-fat and/or high-calorie counterparts. Choose the healthier option!

9. Create meals using cheap, staple items such as potatoes and eggs. These products offer loads of nutrients, but as with all foods, should not be eaten in excess. Breakfast for dinner, anyone?

10. Substitute similar products. Lean ground beef comes with a heavier price tag than it's 80% lean version. So, opt for ground turkey instead.

And please, never forget the price tag of poor health. The cost of chronic diseases such as hypertension, hyperlipidemia (high cholesterol), and diabetes will eventually weigh down much more than your pocket. Consider the emotional, physical, and economical costs your friends, family, and loved ones will pay for your ill-health. The toll is much greater than the cost of that which we choose to fuel our bodies.

Scare tactics are never a first resort, but hindsight is always 20-20 when it comes to our health: don't wait until it's too late to make positive changes in order to preserve your health.

Friday, July 17, 2009

Food competition

I am a self-proclaimed foodie. I love eating, I love cooking, and I love restaurants. I love it all. When my friends and I are planning a get-together, it typically involves a restaurant. And same goes for many people. Forbes published a recent article on women and the competitiveness surrounding dieting, body-image, and food choices, particularly in restaurants. My first thought: I don’t do this.
After a little self-reflection, I admit…I sometimes do fall into this trap, as well.Very much so unbeknown to me until now, by the way.
The first thing that popped into my head: cart surfing. Admittedly, I cart surf. When I'm standing in line at the grocery store, I do look to see what consumers are buying. Sometimes, their carts reflect their weight status...other times not. However, I like to call this "market research"...not cart judgment.
I have a friend or two whose metabolisms I envy. Health aside, I do wish cheeseburgers, french fries, Hamburger Helper, and homemade chocolate chip cookies were staples in my diet…without the addition of unwanted pounds, hyperlipidemia, and hypertension, however. There are definitely those out there who are just blessed. And while we like to dwell on the unfair luck of those individuals, we must recognize that they are far and few between. And we must recognize, that we cannot "keep up with them," as my mother used to explain as the ice cream truck slowly passed by my off-the-charts physique since the age of...birth.
On the flip side, there are those individuals who make you feel at ease and judgment-free when consuming something that may be.... “recommended in moderation.” As a kid growing up, my best friend and I would egg-on one another's poor food selections and converse about our diet short-comings at length. A lot. Surprise: we were both "chubby" kids, to put it nicely. We'd seek each other out to induldge in our local favorites: wings at Shanahans, falafel at Grape Leaves, et cetera. When we surround ourselves with or are surrounded by individuals consuming a diet we know to be not ideal, we do feel comfort when indulging in the same fashion, and we become desensitized to the implications and results of our actions. This is one huge reason obesity tends to appear in entire family and friend units, and not just scattered throughout.
That friend I just mentioned...she's visiting Mark and I this weekend. I'd better not let her drag me down, right? :)

While I follow a fairly steady diet of “80-20” (80% spot-on healthy eating, 20% more lenient intake), I readily admit that my dining out falls into my 20% allotment. I am a dietitian and a regular exerciser...but when I enter a restaurant don't expect me to be ordering grilled chicken and/or a salad! Sorry to disappoint, but I can make that at home a heck of a lot better for way less money. Limit the damage, have a plan, and eat moderately - that's my restaurant "Plan of Attack".

For so long, my now husband and I were in a long-distance relationship -- Italy-to-Chicago and Chicago-to-Michigan. When we were together, it was typically a whole to-do and we celebrated. Dinner, drinks, and maybe even the occasional dessert. He could surely reason as to why I didn’t boast the 115 lb figure suggested for my height…according to BMI standards, right? Yet, after living together for several months now, and with a steady diet of my cooking, I think he’s come to find out that my 80-20 really is 80-20…and I wasn’t just kidding myself. (Duh).
Read the Forbes article. Laugh a little. Eat, drink, and be merry…consciously. Darn us mean, conniving women!

Thursday, July 16, 2009

Rodents get hooked up…again

Those rodents…they’re always reaping the benefits of new weight-loss drugs. Luckily for them, the drugs many times work effectively and they are left sans a few ounces and moving up the hierarchy of rodent hood, strutting their improved sleek, trim bodies.
Research at Indiana University, lead by Richard DiMarchi, looked into drug therapies to increase metabolism while suppressing the appetite. Outcome: it’s working in rodents. The critters lost 25% of their body weight and 42% of their fat mass….after just one week [1]. WHAT is this miracle drug…and when and where can I get some, right?
Most interestingly, the drug is comprised of two FDA-approved drugs: Byetta and Glucagon. Byetta is a drug therapy used in the treatment of diabetes [1]. A recent (separate) study on Byetta showed that when combined with diet and exercise, the drug produces weight loss. One-hundred and fifty-two obese men (BMI > 30 and an average weight of 241 lbs) were split into 2 groups. Roughly 25% of the study participants has pre-existing glucose tolerance, a risk factor for the development of type 2 diabetes. One of the groups received 10 micrograms of exenatide (Byetta) twice a day while the other group received a placebo. For a 24-week period, both groups were put on a diet and exercise program. After six months, those taking the exenatide (Byetta) lost 3x more weight (11 lbs) than those taking the placebo (3.5 lbs) [2].
Experts comment saying:
“This has potential…It’s long been known that combination therapies can work well – that is, multiple drugs at the same time to treat chronic illness, viruses, et cetera…With this paper, we see that a single drug is developed that acts in two different ways, which is a littler different. It’s like getting one drug to work in two distinct ways.” –Keith-Thomas Ayoob, associate professor in the department of pediatrics at the Albert Einstein College of Medicine in Bronx, New York.
“Remember, even though these are mice, the treatment is affecting two receptor systems that exist in humans.” – Dr. Lou Aronne, weight-loss author and obesity expert.
I had a patient just last week asking about Hydroxycut made with Ephedra. He said, "Man, I used to eat whatever I wanted with that stuff and I looked gooooood!". My reply, "There's likely a reason it's no longer legal in the US my friend,."

While the evidence is in support of this new miracle drug (on mice, anyways), does the bottom line not yet remain: eat less, move more? As I tell all my patients, being thin and being healthy are NOT synonymous!! Make it a health(ier) one today and everyday.
[1]. Canning, A. and Childs, D. A New Weight Loss Quick Fix? ABC News Health. July 14, 2009.
[2]. Thomas, Jennifer. Diabetes Drug Byetta May Aid Weight Loss in Obese Patients. ABC News Health. June 12, 2009.