March - National Nutrition Awareness Month

“Nutrition from the Ground Up”

 

The month of March is National Nutrition Month, a campaign that is sponsored by the American Dietetic Association.  This year’s theme is titled “nutrition from the ground up” which highlights the importance of increasing the amount of plant-based foods into one’s diet by consuming more whole fruits, vegetables, whole grains, seeds, nuts, and legumes.   The motto also highlights the idea of eating less processed and refined foods and eating more naturally derived foods eaten in their original form.  Also, inherent in the message is the idea that good nutritional habits begin at a young age and families are encouraged to establish healthy food choices in the home as early as possible.   In the next three articles I hope to highlight the advantages of eating a more plant-based diet, elucidate the concerns over choosing organic foods, and provide some practical meal and snack alternatives for your growing families. 

                  In 1939, a dentist named Dr. Weston Price published a book titled “Nutrition and Physical Degeneration” which described a series of nutritional studies performed by Dr. Price, himself, across a diverse cultural pool including inhabitants from the Outer Hebrides of Scotland to the “Jungle Indians” of Peru.  In his studies he claimed to have found that that diseases that affect the modern civilizations in North America such as headaches, dental cavities, allergies, heart disease, asthma, and cancer, were not present in the cultures that maintained their indigenous diets which were based on a variety of natural, whole foods.   However, within a single generation these same cultures that were never exposed to these “Western diseases” experienced all the above listed ailments when they adapted a Western based diet which included refined sugars, refined flours, canned goods, etc.  From these studies, a clear relationship exists between the amounts of refined, processed foods and the prevalence of chronic diseases in a given population.   If processed foods are the bane of our existence, why were they ever developed in the first place?  Refining foods and processing them increases the shelf life of a food item so that it can travel greater distances and it can be stored for greater periods of time without spoiling.  The disadvantages of food modernization is that in the “process” of creating these less perishable foods, we strip out the vitamins, minerals and nutrients that give foods its nutritious value.  In particular, processed foods are devoid of fiber, an essential nutrient that is quite absent in the Western diet.  

Although it is not possible to revert back to our indigenous diets, we can make a conscious effort to increase the amount of whole, natural foods back into our hearths and replace many processed foods with unrefined ones.

 Here are four basic guidelines that you and your family can incorporate this month.  Take each step one week at a time and get children involved in the planning and preparation.   

 

1.)    Set designated times for your meals & avoid skipping any meals

2.)    Choose lean meats and poultry & vary protein with more fish, beans, and nuts

3.)    Include 3 or more whole grain foods per day

4.)    Eat at least 2 servings of vegetables and 2 servings of fruit per day

Note: The United States Department of Agriculture sets a serving size for fruit or vegetables to be equal to about one-half cup. Greens like spinach and lettuce have a serving size equal to one full cup. One serving of sliced fruit is equal to one-half cup; however a single piece of fruit, such as an apple or an orange counts as one serving.

Eat fruits and vegetables that you enjoy.  With time, your body will crave more of these types of foods and your palate may expand to accommodate other varieties. 

Make weekly and monthly goals for you and your family in trying to integrate more whole foods into your dietary culture.  Begin creating healthy eating habits for a lifetime of nutritional success. 

For more information about the National Nutrition Awareness Month please visit http://www.eatright.org/

 

The month of March is National Nutrition Month, a campaign that is sponsored by the American Dietetic Association.  This year’s theme is titled “nutrition from the ground up,” which highlights the importance of increasing the amount of plant-based foods into one’s diet by consuming more whole fruits, vegetables, whole grains, seeds, nuts, and legumes.   However, one can’t speak about plant-based foods without also discussing the benefits of buying and eating organic food in one’s daily diet.  By focusing on fruit and vegetable produce, this article will offer an historical glimpse into the background of growing organic food and also present some general guidelines for how to incorporate organic food choices into one’s daily meals.

In 1908 a German born Jew by the name of Fritz Haber discovered how to convert air into nitrogen fertilizer, an invention that on the one hand has helped sustained the world’s booming population, but on the other hand, has flooded the earth with pollution.   (Fritz received the Nobel prize for this invention in 1918.)[1] The concept of “organic” farming has been around since the beginning of time; however after the industrial revolution and in the “early 1970’s some agricultural experts came to realize that the chemicals that were being used in the treatment and production of food products were having a seriously negative effect on both the environment and on people’s health. At that point in time, according to the documented history of organic food/agriculture, a sound movement began whereby a growing number of people the world over began to recognize the benefits of eating organic food.”[2]

In 1990, the USDA created the Organic Foods Production Act that established the principles of the USDA Organic Standards.  The certified organic seal tells you many things about the food according the standards and these standards are divided into four categories.

Contents of Organic Ingredients	Certified Organic Seal on Label	Label Statement Permitted
100%	Yes	“100% Organic”
95-99%	Yes	“Organic”
74-94%	No	“Made with organic ingredients (can list up to 3 such ingredients on front)
73% or less	No	Can list organic ingredients only on information panel

 

As you may have noticed many of our local grocery stores will carry organic produce; however, you can pick out the “certified organic” items by locating the PLU (product look-up) codes, which are those tiny stickers glued to the skin or peel of the fruit or vegetable.  The PLU codes on organic foods all start with a number 9 in front of the next four numbers. 

By choosing organic foods, you can reap the health benefits of fruits and vegetables without exposing yourself to potentially harmful chemicals.  However, this choice may also come with a higher cost for your food budget because some organic foods may be priced higher than their conventional counterparts.  The Environmental Working Group (EWG) has created a list of the fruits and vegetable, known as the “dirty dozen,” that are most likely to contain high pesticide residues.   Whenever possible you can try and budget your resources to buy these particular foods as organic and stick with conventional produce for your other staples. 

 

Peaches	Apples
Bell Peppers	Celery
Nectarines	Strawberries
Cherries	Kale
Lettuce	Grapes (imported)
Carrots	Pears

 

Of course, the best (and least expensive) way to get organic foods is to grow your own!   Try this Spring to begin growing a small vegetable garden.  Pick two or three fruits or vegetables that are easy to grow and that you enjoy eating.  Get your children involved in the process, they will develop a connection with the earth and they will proudly participate in reaping the benefits of good nutrition. 

 

 

For more information about organic food visit:
http://www.thedailygreen.com/healthy-eating/eat-safe/Dirty-Dozen-Foods
http://www.ewg.org/
http://www.ams.usda.gov/AMSv1.0/nop

December - National Hand Washing Awareness Week
November - American Diabetes Awareness Month

November is American Diabetes Awareness Month.   According to the American Diabetes Association “nearly 24 million children and adults (7.8% of the population) in the United States (are) living with diabetes, and an additional 57 million Americans (are) at risk.”   There are two major types of diabetes.  Type I, also known as insulin dependent diabetes, occurs when the body does not produce insulin.  This type only affects 5-10% of the American population and results from an autoimmune destruction of the insulin producing cells in the pancreas.  Type II diabetes also known as insulin-independent diabetes or insulin resistant diabetes is a condition in which although the body produces insulin, it fails to use it properly.  When our body becomes insensitive to the effects of insulin, a dangerous accumulation of sugar occurs in our blood leading to damage to small blood vessels and organ dysfunction.  Keeping a tighter lid on the cookie jar may be a good start to reducing sugar consumption and your risk of developing diabetes. 

 

What exactly is Diabetes?

When a person has diabetes it means that his or her body is not properly absorbing glucose, a type of simple sugar.  Our cells need and utilize glucose for energy.  Over time, however, too much glucose circulating in the blood can be toxic and lead problems such as kidney failure, blindness, and loss of sensation.  An easy way to understand the insulin-glucose connection is to think about the role of our mailman.  The mailman carries and delivers our mail to each house every day, rain or shine.   Insulin performs a similar role to the mailman’s because it carries and delivers glucose into our cells.   When a person develops Type II diabetes, it is if the mailmen have set up a strike and refuse to deliver the mail until more suitable conditions exist.  When this happens the mail just collects at the post office, we can’t pay our bills, and we are left in a financial crisis!   If insulin doesn’t work, glucose accumulates in our blood and our body goes into a state of sugar turmoil.   By maintaining a steady insulin-glucose balance, we can avoid these insulin meltdowns and protect the body from experience toxic sugar overloads.  Choosing complex carbohydrates, eating more smaller meals throughout the day, and watching proportion size are steps you can take to keep insulin and glucose in metabolic harmony.  

 

 

Unfortunately, type II diabetes is not considered an adult disease anymore, and in fact, more and more older children and adolescents are being diagnosed.  This is a very disturbing state and reflects the obesity epidemic that our country is experiencing.  The good news is that eliminating weight, especially abdominal fat, decreases the risk of developing insulin resistance and the progression to Type II diabetes.  Lifestyle therapies such as eliminating weight, engaging in consistent moderate exercise and maintaining a healthy, low-fat diet filled with complex carbohydrates (whole grains and fiber rich foods) will set you on the right foot toward good health.   Try snacking on sliced apples dipped in peanut butter, strawberries drizzled with coconut flakes, or bananas sprinkled with ground flax seed.   Make fruit snacks fun dessert options by coming up with creative ways of dipping or adding toppings to them (minus chocolate sprinkles and caramel sauces!).  Also, offer your children a brisk after-dinner/ after-lunch walk.  This is a great time to not only lighten up after a full meal, but a walk also provides an intimate time to engage in special parent-child moments.  This can become a unique ritual shared and look forward to each week.  Play an active role in disease prevention and you will be providing one of the most important tools your child will carry throughout life – the recipe for good health. 

Take a Bite Out of Your Apple Shape!

 

Body Mass Index v.s. Abdominal Obesity

 

Being overweight is a very strong risk factor for the development of many chronic diseases such as diabetes, heart disease and certain forms of cancer.  Assessment of body weight involves two key measures:  body mass index and waist circumference.   The body mass index or BMI is a calculation that was developed to determine the amount of body fat based on a person’s height and weight.   Once calculated, a person may be defined as underweight if BMI < 18.5, normal weight if BMI is equal to 18.5-24.9, overweight if BMI is equal to 25-29.9 or obese (BMI > 30).   (Quickly calculate your BMI at http://www.nhlbisupport.com/bmi/).  There are some limitations when calculating one’s BMI.  First, athletes and others who have larger muscle mass may have an overestimated BMI because the weight of these individuals is disproportionate to their height due to the increased amount of muscle.  The opposite is true of older individuals who have decreased muscle mass.  These individuals may have an underestimated BMI and may have more total body fat then calculated.  Because the body mass index calculation has its drawbacks, a more important tool in evaluating body weight is measuring the abdominal or waist circumference measurement (WCM).  When measuring one’s waist circumference, you are essentially measuring abdominal fat, which is a stronger predictor of developing risk factors for heart disease and diabetes.  It seems that the distribution of fat stores, especially abdominal fat, is more important in determining risk factors than the total amount of fat. In fact, it has been documented that individuals who suffer from diabetes or heart disease tend to have “apple-shaped” figures storing excess body fat around the abdomen.  To measure your waist circumference, place a measuring tape snugly around your waistline right above your belly button. Waist measurements over 40 inches in men and over 35 inches in women are considered above normal.  A cluster of risk factors has shown to promote the risk of developing Diabetes and Heart Disease and of all the risk factors, abdominal obesity has the strongest association with insulin resistance.   In fact, the concept of a cluster of metabolic abnormalities, including abdominal obesity, hypertension, impaired fasting glucose, and hyperlipidemia (high blood lipid levels), leading to the development of insulin resistance, diabetes, and heart disease has been understood for the past sixty years and was originally referred to as Syndrome X or the Deadly Quartet.  In 1998, the official name, Metabolic Syndrome was coined by the World Health Organization.  The Mayo Clinic defines Metabolic Syndrome as “a cluster of conditions that occur together, increasing your risk of heart disease, stroke and diabetes.” In 2002, the American Association of Clinical Endocrinologists (AACE), designed the criteria for diagnosing Metabolic Syndrome involves having three of more of the following components:

Impaired fasting glucose (100 -126 mg/dl) or 2-h post oral glucose (= 140 mg/dl)

• Blood pressure = 130/85 mmHg
• Abdominal obesity (waist circumference >102 cm (men) or 88 cm (women)
• HDL-cholesterol < 40 mg/dl (men) or < 50 mg/dl (women)
• Body mass index = 25 kg/m2
• Other risk factors: family history of type 2 diabetes, hypertension or cardiovascular disease; PCOS, aging, physical inactivity, ethnic susceptibility to type 2 diabetes or cardiovascular disease

 

 

 The good news is that most of the risk factors are modifiable and by managing your risk through lifestyle therapies, you may reduce the major risk factors for Diabetes and Heart Disease.  Lifestyle interventions include weight loss, increased physical activity and healthy eating habits. 

Know Your Sugar Score Card

Get a bit cranky before lunch time and feel like taking a snooze after it?  These food swings are due to the sugar waves your body experiences in between meals.  Controlling the affects of sugar can be difficult but by understanding why they happen and how to prevent those ups and downs may help eliminate the blood sugar yo-yo effect.  Glycemic Index, abbreviated GI, is a measurement of how rapidly a certain carbohydrate-rich food metabolizes into the simple sugar, glucose.  Knowing which foods have a low versus high GI (scored from 0 to 100) may help you maintain proper blood sugar and insulin balance and prevent sugar spikes which over time can lead to insulin resistance and diabetes.  For instance, a boiled, white potato has a very high GI (78) compared to a raw apple (36).   Learning which foods are quickly metabolized into glucose can help you achieve better sugar control especially for individuals (including children) with sugar sensitivities, who are prediabetic, or are suffering from diabetes.  Although the Glycemic Index is a good starting point for understanding basic sugar-insulin response, it doesn’t provide the total picture.  First, the GI of a food may change based on how the food is prepared.  For instance, by decreasing the cooking time for pasta, known as cooking it “al dente”, the GI is actually reduced leading to a more sugar stable pasta form compared to the softer, overcooked variation.   Secondly, the GI doesn’t account for the amount of sugars per serving.  Therefore, another numerical system called the Glycemic Load, GL, was created which calculates the amount of sugar per serving of food calculated as GI/100 x Net Carbohydrates.   The glycemic load not only accounts for the types of sugar but also the quantity of sugar in a food.  For example, apple juice has a GI of 40.  However, the GL of apple juice changes depending on the serving size.  Increasing the amount of apple juice from one ounce to one cup increases the GL from 1 to 3 because more sugar is available in a larger volume of juice.  A food that has a GI of 55 or less is considered low and a food that has a GL or 10 or less is considered low.  One last consideration is that a low GI or GL does not translate into a calorically lower food.   For instance, a medium sized apple weighing 130 grams has a GL of 16 whereas as 4-oz package of peanuts has a GL of 2; however, the apple only has 72 calories whereas the package of peanuts contains more than 400 calories!  To put it simply, the GI or GL measurement does not ensure weight loss; however, it is a good predicator for regulating blood sugar patterns and making better carbohydrate choices.    Also remember, that sugar fluctuations not only affect our pancreas and hunger cravings, but also affect our minds and leads to mood swings, problems with concentration, and aggressiveness.  (Sound like anybody you know?!)  Keeping sugar levels at a steady balance, protects a person from feeling the emotional “highs and lows” associated with sugar euphoria and sugar crashing.   In general, a basic rule of thumb to keep in mind when choosing a sugar safe diet is to choose whole grain and high fiber foods, and stay away from refined sugar and white flour.  Use GI and GL measurements as a general method of predicting safer carbohydrate choices in order to avoid the disruptive sugar swings. 

 

Additional information on glycemic index can be found at

http://www.glycemicindex.com/ ,  http://www.nutricoach.net/low_gi_foods.html, and http://www.diabetesnet.com/diabetes_food_diet/glycemic_index.php

 

 

Artichokes are great example of a low glycemic food with a GL score of 2 for every 84 grams, or ½ cup of artichokes hearts.  Artichokes are versatile with their unique, nutty flavor and can be eaten alone as an appetizer with a dipping sauce or prepared with other vegetables in a dish as a main course.   They are a great source of folate and phosphorous.  Kids really enjoy eating artichokes because you get to eat them with their fingers!  The following recipe was taken from the California Artichoke Advisory Board.  Enjoy with lots of napkins! 

 

4 Large California Artichokes

 Selection of Dips (recipes follow)

   Wash artichokes under cold running water. Cut off stems at base and remove small bottom leaves. Cut away ¼ inch off the top of each leaf to remove thorns.  Stand artichokes upright in deep saucepan large enough to hold snugly. Add 1 teaspoon salt and two to three inches boiling water. (Lemon juice, herbs, garlic powder or onion powder may be added, if desired.) Cover and boil gently 35 to 45 minutes or until base can be pierced easily with fork. (Add a little more boiling water, if needed.) Turn artichokes upside down to drain. Cool completely; cover and refrigerate to chill. Makes 4 artichokes.

Combine all ingredients; mix well. Makes ¾ cup.

Variation: For "Oriental Dip," omit peanut butter

Combine all ingredients; mix well. Makes about 3/4 cup.

 

 

Protection by Early Detection

 

October is National Breast Cancer Awareness Month. Breast cancer is the most common cause of cancer, other than skin cancer, in women in the U.S. In addition to mammography, annual breast exams are one of the most important tools in regard to early cancer detection. All women over age 20 should perform monthly breast self-examinations. The following link from the American Cancer Association contains intructions and demonstrates the proper way to perform a breast self-exam.
http://www.cancer.org/docroot/cri/content/cri_2_6x_how_to_perform_a_breast_self_exam_5.asp

In addition to self-exams, the American Cancer Society (ACS) recommends a baseline mammogram for all women by age 40. Locally, in St. Louis you can get your "mammogram to go" by making an appointment to visit one of Barnes-Jewish Hospital’s Mammography Vans, which brings quality mammography services to women in St. Louis and surrounding areas (Funded mammograms available for those without health insurance).

http://www.barnesjewish.org/cancer/default.asp?NavID=3253

If you live in other parts of the United States, you can perform a search through the American College of Radiology to identify a mammography center closest to you.

http://www.acr.org/accreditation/accreditedFacilitySearch.aspx

Or you can also try calling your local hospital to find out if there are any promotional mammography testing normally offered during this time of the year. Make early detection your best protection for good health and wellness.

 

 

The Skinny on Fats and Breast Cancer

 

A considerable amount of research has been linked to high fat diets and the risk of breast cancer.  In response to these findings, dietary recommendations have evolved directing women to maintain a “low-fat” diet to help reduce the chances of developing this frightening disease that effects 1 out of every 10 women.  Although we have been given explicit instructions to lower fat intake, it is important to understand what is low and which types of fats actually propose the most risk.   Generally, to maintain a “low-fat” diet the American Heart Association recommends to eat no more than 25% of total calories as fat, and that less than 1/3 of this twenty-five percent should come from saturated fats.  That means based on an average 2000-calorie diet, a woman should not consume more than 500 calories in fat or 56 grams of fat per day.  However, only 16 grams or 144 calories of fat can come from the saturated form.  For example, one cup of 2% milk contains 3 grams of saturated fat, but substituting low-fat milk to skim milk reduces your saturated fat intake to zero!  For the most part, large amounts of saturated fats are found in animal based products such as eggs, milk, cheese, and red meat.  Certain vegetable oils also have saturated fats; however, their ratios of saturated fats to the healthier variety of mono or polyunsaturated fats are very different then in animal based counterparts.  For instance, take a look at the following table that shows the breakdown of types of fats in different types of foods. 

 

BREAKDOWN OF FATS

 

Food –           1 tablespoon	Saturated Fat in grams	% Saturated Fat	% Monounsaturated Fat	% Polyunsaturated Fat
Butter	8	70	5	25
Olive Oil	2	14	78	8
Canola Oil	1	7	62	31

 

 

Although studies have shown a positive correlation between saturated fats and breast cancer, the consumption of mono and polyunsaturated fats such as oleic acid (a major constituent of olive oil) as well as omega-three fatty acids (found in fish oil) have actually reduced the risk of breast cancer.  There are many ways to transition into a low-fat diet and following website gives 10 easy ways to get started.

http://lowfatcooking.about.com/od/lowfatbasics/a/tensteps05.htm.

In addition to lowering saturated fats and increasing the amount of “healthy fats”, there are a couple of “Super Foods” that have a protective effect toward the developing of breast cancer including:  walnuts, decaffeinated green tea, fiber, Vitamin D, Folic Acid, and Soy.   The following recipe taken from Mark Reinfield’s fantastic new cookbook coauthored with Jennifer Murray titled “Vegan in 30 Minutes” is a perfect example of cancer-protective meal, combining the proper proportion of  “healthy fats” with some of the suggested “Superfoods”.   The spinach really packs a punch in this salad and provides the fiber (2 grams per serving) and folic acid (58.2 mcg per serving).  The walnuts and olive oil provide the proper proportion of healthy fats into your diet.

  Warm Spinach Salad

              

(Serves 4)

 

8 cups of prewashed spinach, lightly packed

4 Cremini mushrooms

¾ cup thinly sliced red onion

2 Roma tomatoes, thinly sliced into whole circles

1 ½ tablespoon of red wine vinegar

1 teaspoon of agave nectar

1 ½ tablespoons Dijon mustard

2 tablespoons water

½ teaspoon sea salt, or to taste

¼ teaspoon black pepper, or to taste

½ cup chopped walnuts

3 tablespoons of olive oil

 

1.)   Place the spinach in a large mixing bowl with the mushrooms, onion and tomatoes

2.)   Place the vinegar, agave nectar, mustard, water, salt, and pepper in a small bowl and whisk well

3.)   Place the walnuts in a small sauté pan over medium heat and dry-roast for 2 minutes, stirring frequently.  Add the olive oil and cook for 2 minutes, stirring frequently.  Add to the bowl with the liquids and mix well.  Pour this into the large bowl with the spinach and gently toss well. 

Variations:  You can sauté the mushrooms before adding to the salad.  Add them to the pan after adding the olive oil and cook for 3 minutes, stirring frequently.

 

 

Make Strides Against Breast Cancer

 

The positive role of physical activity on the risk of breast cancer has been demonstrated by many evidence-based studies.  A recent article written by the Division of Epidemiology and Prevention in Nagoya, Japan found that the benefits of exercise are experienced by women who engage in consistent, moderate physical activity of two hours, or more per week.   Physiologically, physical activity has a direct action on the metabolism of estrogen, insulin and fat, which are all three important factors in the development of breast cancer.  Moderate walking exercise is translated into 100 steps per minute, or 3,000 steps in 30 minutes.  To help calibrate the intensity of a workout, use a simple pedometer and a wristwatch to gage your activity level.  To build-up to moderate exercise levels, start with trying to walk 1,000 steps in 10 minutes.  Researcher Simon J. Marshall, PhD, of the School of Exercise and Nutritional Sciences at San Diego State University, discussed in a news release that “because health benefits can be achieved with bouts of exercise lasting at least 10 minutes, a useful starting point is to try and accumulate 1,000 steps in 10 minutes, before building up to 3,000 steps in 30 minutes.”  Begin making strides toward your health by engaging in moderate exercise at least three times a week to prevent disease and optimize your health and wellbeing.