Movember

Movember – Trying to Change the Face of Men’s Health

They’re sprouting up everywhere, moustaches on men’s faces, around the world!  During the month of November, “Movember” uses the power of the Mo (slang for moustache).  Movember helps raise money and awareness to help combat men’s health issues: prostate and testicular cancer, poor mental health, and physical activity.  Getting the right screening test at the right time is one of the most important things a man can do for his health.  Screenings find diseases early, before you have symptoms, when they’re easier to treat.  The tests you need are based on your age and your risk factors.  Take control of your health and look after yourself.

Prostate Cancer

Prostate cancer is the second most commonly diagnosed cancer in American men (after skin cancer).  1 in 7 men will be diagnosed with prostate cancer in their lifetime.  In 2015, an estimated 220,800 American men will be diagnosed with prostate cancer.  It tends to be a slow-growing cancer, but there are also aggressive, fast-growing types of prostate cancer.  Screening tests can find the disease early, sometimes even before symptoms develop, when the treatments can be more effective. 

Know the Risk Factors in developing the disease:

Family History – A man with a father or a brother who developed prostate cancer will be twice as likely to develop the disease.

Ethnicity – There is an increased occurrence in black African and Afro-Caribbean males.

Symptoms, Testing, and Treating –

There are not always symptoms associated with prostate cancer.  In fact, many times it is first detected at routine check-ups.  However, here are some symptoms that might indicate the presence of prostate cancer: 

·         A need to urinate frequently, especially at night

·         Difficulty starting urination or holding back urine

·         Weak or interrupted flow of urine

·         Painful or burning urination

·         Difficulty in having an erection

·         Painful ejaculation

·         Blood in urine or semen

·         Frequent pain or stiffness in the lower back, hips, or upper thighs

If you are experiencing any of these symptoms, it is important for you to contact your doctor.  The following tests are recommended to detect prostate cancer early on (before the disease progresses):

·       The Digital Rectal Exam (DRE) – The DRE involves the doctor inserting a gloved finger in the anus, where it is possible to feel part of the surface of the prostate.

·       The PSA blood test (PSA) – The PSA blood test looks for the presence of a protein in the blood that is produced specifically by prostate cells.

Depending on the results of these tests you may be referred to a specialist for a biopsy – the only way to determine if cancer is present.

Testicular Cancer

This uncommon cancer develops in a man’s testicles, the reproductive glands that produce sperm.  Most cases occur between ages 20 and 54.  The American Cancer Society recommends that all men have a testicular exam when they see a doctor for a routine physical (even if you feel fine, it is still important to see your health care provider to check for potential problems).  Men at higher risk (a family history or an undescended testicle) should talk with a doctor about additional screening. 

Symptoms, Testing, and Treatment – Men may experience few or no symptoms of testicular cancer.  Here are some important symptoms to be on the lookout for:

·         Swelling or a lump in either testicle (usually painless)

·         A feeling of heaviness in the scrotum

·         Change in the size and shape of the testicles

·         Aches or pain in the lower abdomen or groin

·         A sudden build-up of fluid in the scrotum

·         Pain or discomfort in a testicle or in the scrotum

·         Enlargement of tenderness of the breast tissue

Regular self-examination of the testicles is important for young men.  Just like women are recommended to self-examine their breasts for breast cancer, doctors advise regular self-exams in men, gently feeling for hard lumps, smooth bumps, or changes in size or shape of the testes.  Self-examination can help find any changes in the testes EARLY on. 

Colorectal Cancer

Colorectal cancer is the second most common cause of death from cancer.  Men have a slightly higher risk of developing it than women.  The majority of colon cancers slowly develop from colon polyps: growths on the inner surface of the colon.  After cancer develops it can invade or spread to other parts of the body.  The way to prevent colon cancer is to find and remove colon polyps before they turn cancerous. 

Tests for Colon Cancer -

Screening begins at age 50 in average-risk adults.  A colonoscopy is a common test for detecting polyps and colorectal cancer.  A doctor views the entire colon using a flexible tube and a camera.  Polyps can be removed at the time of the test.  A similar alternative is a flexible sigmoidoscopy that examines only the lower part of the colon.  Some patients opt for a virtual colonoscopy – a CT scan – or double contrast barium enema – a special X-ray – although if polyps are detected, an actual colonoscopy is needed to remove them.

Skin Cancer

The most dangerous form of skin cancer is melanoma.  It begins in specialized cells called melanocytes that produce skin color.  Older men are twice as likely to develop melanoma as women of the same age.  Men are also 2-3 times more likely to get non-melanoma basal cell and squamous cell skin cancers than women are.  Your risk increases as lifetime exposure to sun and/or tanning accumulates; sunburns accelerate risk.

Screening for Skin Cancer

The American Cancer Society and the American Academy of Dermatology recommend regular skin self-exams to check for any changes in marks on your skin including shape, color, and size.  A skin exam by a dermatologist or other health professional should be part of a routine cancer check-up.  Treatments for skin cancer are more effective and less disfiguring when it’s found early.

High Blood Pressure (Hypertension)

Your risk for high blood pressure increases with age.  It’s also related to your weight and lifestyle.  High blood pressure can lead to severe complications without any prior symptoms, including an aneurysm – dangerous ballooning of an artery.  But it can be treated.  When it is, you may reduce your risk for heart disease, stroke, and kidney failure.  The bottom line:  Know your blood pressure.

Screening for High Blood Pressure

Blood pressure readings are two numbers.  The first (systolic) is the pressure in your arteries when the heart beats.  The second (diastolic) is the pressure between beats.  Normal blood pressure is less than 120/80.  High blood pressure is 140/90 or higher, and in between those two is prehypertension.  How often blood pressure should be checked depends on how high it is and what other risk factors you have.

Cholesterol Levels

A high level of LDL cholesterol in the blood causes sticky plaque to build up in the walls of your arteries.  This increases your risk of heart disease.  Atherosclerosis – hardening and narrowing of the arteries – can progress without symptoms for many years.  Over time it can lead to heart attack and stroke.  Lifestyle changes and medications can reduce this “bad” cholesterol and lower your risk of cardiovascular disease.

Determining Cholesterol Levels

The fasting blood lipid panel is a blood test that tells you your levels of total cholesterol, LDL “lousy” cholesterol, HDL “healthy” cholesterol, and triglycerides (blood fat).  The results tell you and your doctor a lot about what you need to do to reduce your risk of heart disease, stroke, and diabetes.  Men 20 years and older should have a new panel done at least every five years.  Starting at 35, men need regular cholesterol testing.

Type 2 Diabetes

One-third of Americans with diabetes don’t know they have it.  Uncontrolled diabetes can lead to heart disease and stroke, kidney disease, blindness from damage to the blood vessels of the retina, nerve damage, and impotence.  This doesn’t have to happen.  When found early, diabetes can be controlled and complications can be avoided with diet, exercise, weight loss, and medications.

Screening for Type 2 Diabetes

A fasting plasma glucose test is most often used to screen for diabetes.  More and more doctors are turning to the A₁C test, which tells how well your body has controlled blood sugar over time.  Healthy adults should have the test every three years starting at age 45.  If you have a higher risk, including high cholesterol or blood pressure or a family history, you may start testing earlier and more frequently.

Poor Mental Health

3 out of 4 deaths by suicide are men.  Anyone can be affected by poor mental health.  Many men might find it difficult to share their problems and feelings with others.  Many men might try to remain ‘strong and silent’ rather than get the support that they need.  It’s important to be proactive about your mental health and be aware of the risk factors and symptoms:

·         Family history of mental health problems

·         Drug and alcohol use

·         Serious medical illness

·         Isolation or loneliness

·         Unemployment, homelessness, conflict, or other stressful life situation

If someone that you know is at risk, encourage them to contact their doctor, a mental health professional or access support.   Take action, stay connected, and look after your mental health. 

Physical Inactivity: is the fourth leading risk factor for global mortality.  Sitting is the new smoking.  It’s killing us.  Being active is essential to prevent and reduce risks of many diseases and improve both physical and mental health.  Make time and MOVE more!!

The bottom line

Stop avoiding the doctor.  Routine physicals are meant to screen for diseases and assess the risk of future medical problems.  Take action to reduce your risks.  Start with healthy lifestyle choices – eat a healthy diet, stay physically active and quit smoking.  The impact of the changes now will be greater than you’ll ever know. 

Movember’s vision:  “have an everlasting impact on the face of men’s health.”

 

November is American Diabetes Month®

Diabetes – Fact versus Fiction

November is American Diabetes Month®.  The vision of the American Diabetes Association is a “life free of diabetes and all of its burdens.  Raising awareness of this ever growing disease is one of the main efforts behind the mission of the Association.” 

Here are a few of the most recent statistics:

• Nearly 30 million children and adults in the United States have diabetes.
• Another 86 million Americans have prediabetes and are at risk of developing Type 2 diabetes.
• The American Diabetes Association estimates that the total national cost of diagnosed diabetes in the United States is $245 billion.

Nearly one in 10 Americans has diabetes.  There are many myths that still remain.  I hear them in my office all the time.  Let’s set a few of these myths to rest and get the facts.

Myth:  Everyone who is overweight develops diabetes.

Fact:  Type 2 diabetes (which accounts for 90-95% of the cases) is much more common in people who are overweight.  Excess weight IS the strongest known risk factor.   Being overweight increases the chances of developing type 2 diabetes seven fold.  Losing 7 to 10 percent of your current weight can cut your chances of developing type 2 diabetes in half.  Losing any excess weight – and keeping it off – is the best defense against diabetes.  However, keep in mind that other factors play a role as well:  genetics, inactivity, age, and ethnicity.  The key is to know your numbers and know your risk – prevention is key! (With type 1 diabetes, the body’s immune system attacks part of its own pancreas.  Scientists are not sure why – more on Type 1 in a separate blog post).

 

Myth:  If your fasting blood sugar is 100 to 125 (called prediabetes), you will develop type 2 diabetes.

Fact:  Having prediabetes does not mean that you will develop diabetes.  The risk is there and the key is to make lifestyle changes in order to prevent or delay it from progressing to diabetes.  The scary fact is that many people come into my office with prediabetes and don’t know they have prediabetes.  There are three reasons this could be the case.  The first I call the “Charlie Brown” syndrome – it’s possible their doctor did tell them and all they heard was, “wah waaah wah wah”.  The second reason is that their doctor told them they have prediabetes and they’re in denial and last but not least is the patient was never told by their doctor.  86 million people have prediabetes.  This CAN be prevented or delayed from progressing to diabetes.  Know your numbers.

 

Myth:  People with diabetes need to eat special food.

Fact:  The irony is that everyone should eat healthy food.  It’s no different than what I recommend to anyone, diabetic or not.  As people are faced with a diagnosis of diabetes they’re simply more pressed to make immediate changes.    Healthy eating means having variety, balance, and moderation.  I teach people to limit their intake of sodium, saturated (and trans) fat, added sugars and refined grains.  I also teach people to place an emphasis on nutrient-dense foods, to increase their fiber intake, and begin to look at more whole foods and less processed (chemical enhanced) foods.  The key is to implement one change at a time and then move on to the next.  Healthy eating is a way of life, it’s not just a quick fix for a short period of time.

Myth:  Eating sweets is off-limits for people with diabetes.

Fact:  Variety, balance, and moderation.  EVERYONE should limit their intake of sweets, not just people with diabetes.  Indulging in too many sweets makes it more difficult for anyone to keep off unwanted pounds and leaves less room for the nutrient-rich foods the body needs.  This is what I tell my patients:  you know yourself, are you the kind of person who can have a piece of chocolate or are you the type of person that will have the whole chocolate bar?  Having sweets lying around the house can only set you up to fail if you’re the type to eat the whole chocolate bar.  The key is to allow for some of those moments with sweets and desserts, otherwise you’ll go overboard when you do see the desserts.  In people with diabetes I always try and explain that it’s important to have good blood sugar control.  Including these sugar-containing treats is possible with portion control and knowing their blood sugar levels – it’s called managing your diabetes.  I teach them that desserts are a part of life (especially as the holidays are approaching), however, desserts are not the fuel source your body needs to operate at full-strength capacity.  Always aim for the best fuel and keep the desserts in check.

Myth:  Fruit is a healthy food.  Therefore, it is okay to eat as much of it as you wish.

Fact:  Yes fruit is a healthy food, but NO you cannot each as much of it as you wish.  Fruit does contain fiber and lots of vitamins and minerals.  However, fruit contains carbohydrates and therefore needs to be included as part of your meal plan, in a controlled amount.  Since beginning work at the Diabetes Research Institute, this is one change I’ve made – I’ve decreased the amount of fruit I eat and started to increase the amount of non-starchy vegetables I’m consuming.  Tough?  Yes.  Healthier for me?  Absolutely!  (p.s. Juicing, smoothie, and smoothie bowls as a trend needs to stop – the fiber is there but not functional and it tends to be a load of carbohydrates – EAT and CHEW your food.)

I’m always telling my patients to “know their numbers”  Here’s a chart to help explain your numbers:

 

If you have your fasting blood sugar checked routinely for your doctor visits, the fasting blood sugar should be less than 100 mg/dL.  If it is above 100 mg/dL this will be an indicator to have your A1c checked.  The A1c is a blood test that runs an average over the last three months of your blood sugar level – so while your fasting blood sugar could’ve been high it doesn’t necessarily indicate your overall control.  The A1c is the best test for verification.  An A1c between 5.7-6.4% indicates prediabetes and an A1c at 6.5% and over is diabetes.  This November, have yours tested so you can know your numbers.  Knowing if the first part of prevention.  Here are a few other tips to help reduce your risk:

Exercise moderately.  Aim for 150 minutes of exercise/week.  Inactivity promotes type 2 diabetes.  Working your muscles more often and making them work harder improves their ability to use insulin and absorb glucose.  This puts less stress on your insulin-making cells.  Long hours of hot, sweaty exercise aren’t necessary to reap this benefit.  Walking briskly for a half hour every day reduces the risk of developing type 2 diabetes by 30 percent.  Limit the time you spend sitting at work, at home, or in between.

Tune Up Your Diet  - Making a few dietary changes can have a big impact on the risk of type 2 diabetes.       

1. Choose whole grains and whole grain products over highly processed carbohydrates.   Whole grains don’t have a magical nutrient that fights diabetes and improves health.  It’s the entire package – elements intact and working together – that’s important.  The bran and fiber in whole grains make it more difficult for digestive enzymes to break down the starches into glucose.  This leads to lower, slower increases in blood sugar and insulin, and a lower glycemic index.  As a result, they stress the body’s insulin-making machinery less, and may help prevent type 2 diabetes.  Whole grains are also rich in essential vitamins, minerals, and phytochemicals that may help reduce the risk of diabetes.
2. Skip the sugary drinks and choose water.  water.                                                                       When it comes to diabetes, sweet beverages seem to be a double-whammy.  Their high-fructose corn syrup and other sugars increase the demand for insulin and have a high glycemic load.  The sugar you sip may add flab more than the sugar you chew.  Liquid calories don’t seem to lead to satiety and the reduction in subsequent food intake that you might have with solid calories.  It’s easy to take in a large amount so easily.  Think your drink.
3. Include heart-healthy plant-based fats.                                                                                              The types of fats in your diet can also affect the development of diabetes.  Healthy  fats, such as the polyunsaturated fats found in liquid vegetable oils, nuts, and seeds can help ward off type 2 diabetes.  Trans fats do just the opposite.  These unhealthy fats are found in many margarines, packaged baked goods, fried foods in fast-food restaurants, and any product that lists “partially hydrogenated vegetable oil” on the label. 

If You Smoke, Try to Quit.                                                                                                                                        Smokers are roughly 50 percent more likely to develop diabetes than nonsmokers, and heavy smokers have an even higher risk.

Alcohol Now and Then May Help.                                                                                                                         A growing body of evidence links moderate alcohol consumption with reduced risk of heart disease.  The same may be true for type 2 diabetes.  Moderate amounts of alcohol – up to a drink a day for women, up to two drinks a day for men – increases the efficiency of insulin at getting glucose inside cells.  If you already drink alcohol, the key is to keep your consumption in the moderate range, as higher amounts of alcohol could increase diabetes risk.  If you don’t drink alcohol, there’s no need to start – you can get the same benefits by losing weight, exercising, and changing your eating patterns.

The bottom line to prevent type 2 diabetes:  Keep your weight – and especially your waist – under control, and spend more time on your feet than on your seat.

The Toll of Sitting All Day

 

The Toll of Sitting All Day

Think about it for just one minute.  How many minutes a day do you sit? At work?  At home?  The drive for your commute?  Things that make you go hmmmm.  Well, more and more research is coming out to say that sitting is harmful to our health.  I wrote about this topic just last January.   Ned Levine termed the phrase, “Sitting is the new Smoking”.  He even wrote a book called, “Get Up” – a tale of how he came to the scientific conclusion that our chairs are killing us and what needs to be done in order to stop this threat.  He also happens to be the inventor of the treadmill desk – clever if I do say so myself.  And then just this week an article in the Wall Street Journal brought attention to this very same theme – the toll that sitting all day is having on our health – once again.  More and more people are talking about it and more and more research is studying the negative health effects of sedentary behavior.   There have been at least 35 diseases identified that if you spend all day sitting, are at an increased risk of developing:   diabetes, osteoporosis, cancer. 

 

 

Here are some general guidelines to help you avoid sitting too long:  For every half-hour working in an office, people should sit for 20 minutes, stand for eight minutes and then move around and stretch for two minutes, says Alan Hedge, a professor of ergonomics at Cornell University.  This is what I say to you Alan – it ain’t happening.  I have my patients scheduled for every hour.  If all my patients come in a day that’s seven hours of sitting, not to mention the charting that has to take place (ICD-10 should’ve merged better with ICD-9 codes, but that’s a different gripe for another day).  I’m pretty sure it’d look quite odd for me to stand during my session with my patients.  The only time I get to move around is when I’m teaching class.  So, it seems there is a bit of a predicament.  My only reprieve is if a patient doesn’t show.  I’m constantly getting up and moving around.  But to put his recommendations into practice is almost impossible and hence why we have such a problem on our hands.  Another way he terms it is this:  “People should get a combined two to four hours of standing and light activity spread throughout the workday.  The research also shows that aiming to stand for two minutes 16 times a day while at work could be an effective strategy for maintaining bone and muscle density.   Again, I won’t be able to get the two to four hours of standing, but this getting up for two minutes at a time, might be possible.  The bottom line:  break up your activity throughout the day. 

“Regular exercise doesn’t seem to compensate for the negative effect from sitting too much during the day”.  The article goes on to say that sitting causes physiological changes in the body, and may trigger some genetic factors that are linked to inflammation and chronic conditions such as diabetes and cardiovascular disease.  Whereas when one stands, it activates the muscles.  One area where this is of benefit is with glucose, if you stand and go for a walk the excess glucose doesn’t hang around in the bloodstream and instead will actually be absorbed in the muscles.  I tell my patients this all the time, “go for a walk after you eat lunch.  Get moving, get outside.  The change in environment does you good not only for better utilization of your glucose, but also because it’s been proven to help you to be more productive!”  Sitting at your desk and eating lunch is one of the worst things you can do! 

While the research is showing the negative effects that sitting has on our health, they are also looking at ways of how to get people to sit less.  The key is educating people and making sure they’re aware of the harmful effects.  Another strategy that worked was setting an alarm/reminder for when it was time to stand.   A few other helpful hints:  if you’re having a meeting with just one or two people, have the meeting on the go.  So instead of cooping yourself up in a stuffy conference room, make your next meeting a walking one.  Another helpful hint to parents with kids:  use the time that you’re at an athletic event to be on your feet instead of on your seat.  While it’s okay for you to watch some of their game, move around and use that time as possibly your exercise time – whatever you do, don’t sit for their whole practice. 

I used to have a 150 mile daily commute, 75 miles each way.  My work day was 6:30-6:30, 3 hours driving and then more sitting when in the office.  Sure my new job does require a lot of sitting, especially when all the patients come for the day, along with the charting.  But my commute is MUCH shorter than before and if I want to go out for a walk at lunch I can and often do.  While I’d love to say that I’ll be able to get a treadmill desk, the odds are that’s not happening.  I’m in the same predicament many of you are:  sitting is harming our health.   While the research keeps coming out to prove it, it makes all the sense in the world.  No need to scare us with the stats. 

This is where I challenge you to be mindful of your movements during the day.  Each day is different and no one knows what the day will hold.  When it comes to your work place environment if you know your job is more sedentary than others’ jobs, get up and get moving, as much as you can.  Many patients have told me that they just start working and “get in a groove” and don’t pay attention to the clock.  While I’m not asking that you break your concentration in the middle of a productive session, I am asking that you get up periodically and get the blood flowing.  Be mindful and move more.  I have a Fitbit.  When I first got it I thought I was going to use it primarily for my running.  I’d be able to track my pace, my distance, etc.  Where it’s really been the most helpful?  Tracking my day to day steps.  I challenge myself to get a certain amount of steps by a certain time of the day.  There have been times where I’ve been known to do a little jogging in place in my office in between patients.  You gotta do what you gotta do J  I’m able to tell by lunchtime if I’ve been up and moving as much as possible.  I take full advantage of the times when people don’t show for their appointments – I get up and walk around as much as possible.  And at least twice a week I go for a walk at lunch – I aim for more, but it’s recently been quite rainy here in the MIA.  Moving more and being mindful about your movements, that’s my challenge for you.

Beyond the Buzz II

Beyond the Buzz.  Is what you’ve heard true…or just new?

With so much information – and misinformation – out there, it’s hard to know what to believe.  Nutrition information is passed along through the media, from friends, the internet, and even some health professionals.  What is true or what is based on flawed data?  What is exploited by the food industry (they are trying to make a profit let’s not forget).  Here’s the truth about some of the foods that you eat. 

Can Sugar Harm Your Heart?

The U.S. government recently came out with new dietary guidelines to withdraw longstanding warnings about cholesterol.  There was much news about the “incredible edible egg” and I can’t tell you how times this question was asked in my nutrition classes, “So really, how many eggs can I eat in a day?” What people seem to forget is that the warnings weren’t dropped from foods such as meat, butter, and other foods that raise cholesterol.  The warnings were not about foods, like eggs, that contain cholesterol.  The actual news headlines were missed in fact.  Everyone was so worried about eggs. 

The actual report concluded that added sugars are linked to a higher risk not just of obesity, type 2 diabetes, and tooth decay, but of heart disease and stroke.  Whoa.  Why aren’t we talking about this more then?? There is a gentleman who did a film called, “The Sugar Film” who is talking about this (I need to see this movie!) 

The research does suggest that over a lifetime the typical amounts of added sugar do increase your risk of cardiovascular disease and cardiovascular death.  This evidence has been building for a while now.  And there were two studies just recently that helped provide the proof.  In a study by Kimber Stanhope at the University of California, Davis, there is  direct evidence that added sugars increase risk factors for cardiovascular disease.  The participants in the study drank a sugary drink with breakfast, lunch, and dinner.  The drinks were made with a dose of high-fructose corn syrup equal to 0, 10, 17 ½ or 25 percent of their daily requirement.  What were the results you ask??  The higher the dose, the higher the participants’ LDL “lousy” cholesterol and post-meal triglycerides.  Just to put this into perspective the 10% group had the equivalence of half a can of regular soda with each meal and this was enough to raise risk factors for cardiovascular disease.  ½ can of soda?  Let’s be real.  Sodas no longer come in cans.  We’re talking 20-ounce bottles in this day and age.  Remember only ½ can of soda at each meal was found to raise LDL cholesterol.

So how do sugars raise LDL and triglycerides?  It’s the fructose half of table sugar, high-fructose corn syrup, and other added sugars that seem to be the culprit.  “Fructose is nearly exclusively metabolized in the liver, so it doesn’t get to the rest of the body.  When the liver gets overloaded, it turns some of the fructose in to fat.  Some of that fat ends up in the bloodstream as triglycerides, and that eventually leads to a rise in LDL cholesterol,” explains Stanhope. 

Bottom Line:  Follow the recommendations from the American Heart Association’s guidelines:  limit added sugars to no more than 6 teaspoons (100 calories’ worth) for women and 9 teaspoons (150 calories) for men.  Eat whole, real food and stay away from packaged products. Oh yeah, and know all the hidden names for sugar.   

 

Is drinking fruit and vegetables as healthy as eating them?

Last week at work I had a professional program and I was teaching ~50 adults.  I might have burst everybody’s bubble with this one.  This trend of juicing and smoothies (and let’s not forget the now popular smoothie bowl) is one of the worst trends ever!!  Many companies tailor their advertising to show that even if you don’t have time to eat your veggies be sure to drink them during the day (and their product can help you accomplish this goal.) 

In the study conducted, for every three servings of whole fruit eaten, the risk of type 2 diabetes dropped by nearly 20%.  And for each serving of green leafy vegetables eaten, the risk was linked to roughly a 10% drop in diabetes risk.  And then in contrast, for each daily serving of fruit juice consumed, there was an 18% higher risk of type 2 diabetes – that being for just an 8-ounce juice.  The theory is that at times people aren’t always compensating for the calories later on.  It’s the same thing that happens with sugar-sweetened beverages.  You have the calories at your meal and don’t pay attention to the calories in your beverage.  They have to be considered as a part of the total calories for the day. 

Fruit juice provides a heavy sugar load in a liquid form, therefore it has a faster absorption.  With this rapid absorption it increases the insulin required to get the sugar out of your bloodstream and into your muscles.  And if you are having that insulin spike regularly it might cause problems with your ability to produce enough insulin – your pancreas is on overdrive.  It gets tired from repeatedly having to compensate and that’s when we begin to see problems arise.  And while we are talking here about juice, please remember that smoothies are just as harmful.  When you have the blade destroying the fiber, which is the benefit of chewing the fruit whole, the blade destroys the insoluble fiber of the fruit.  As Robert Ludwig describes it, “the cellulose is torn to smithereens.”  Yes, you still get some soluble fiber, which will help move food through the intestine faster, “but it doesn’t have the “latticework” from the insoluble fiber to help form an intestinal barrier – the sugar in the fruit will be absorbed just as fast as if the juice were strained with no fiber at all.  You need both types of fiber to derive the beneficial effects.” So now you see the problem with this trend??  I know you don’t want to hear it but it’s the truth. 

The Bottom Line:  Eat, don’t drink, your fruits and vegetables.  Even if they did just open up a juice bar across the street from your work place.

Do beans cut cholesterol?

Many companies promote their products to contain whole grains and will then in turn lower cholesterol.  But what about beans? Why isn’t there more discussion on their benefits?  (Yes, I know the answer to this:  no $$ to promote healthy foods).  And can they lower cholesterol?  (Currently the only bean that has promoted this to be a benefit is the soybean). 

The study took place in 2011 and people were randomly assigned to eat either legumes or an alternative food.  On average, LDL “lousy” cholesterol levels were 8 points lower when they ate legumes.  The serving size was just ½ cup per day!  Beans are high in soluble fiber, the fiber that dissolves in water.  As digestion is occurring, soluble fiber binds the bile acids in the gut which in turn keeps them from being reabsorbed into the bloodstream.  The liver makes up for this loss by taking cholesterol out of the blood to make more bile acids – that lowers your LDL cholesterol.  Thank you beans and soluble fiber.   In most of the studies conducted the serving size again was right around ½ cup in size.  That’s a lot of bang for your buck!  Beans not only have soluble fiber, but they’re a good source of complex carbohydrates and protein, all of which helps in maintaining a better blood sugar level. 

The bottom line:  Been told to lower your LDL cholesterol level?  Add beans to your daily intake – as a side dish, in a soup or salad, or even as your main dish – Meatless Monday anyone?

Does green tea prevent cancer?

This is what is quoted out there – whether it is through WebMD or Doctor Oz or Andrew Weil:  “In many laboratory studies they’ve been examining green tea’s potential role in lowering risks of cancers:  ovarian, breast, bladder, esophageal, and prostate cancers.  More studies are needed, however, the research so far is promising.  “Green tea’s high EGCG content also makes it an effective cancer fighter.”  The actual truth:  Many studies hunting for a lower risk of cancer in tea drinkers have come up EMPTY. 

Breast:  There was no lower risk in those who drank tea in regards to breast cancer.  Some of the studies looked at those who drank black tea, however, there were studies with Japanese women who do drink a high quantity of green tea and there were no benefits.

Colon:  In the study conducted, green tea was linked to a lower risk of colorectal cancer in Chinese women and a higher risk in Chinese men.

Prostate:  The studies were conflicting.  In one study there was a lower risk in Japanese men who drank 5 cups a day, however, in another study there was no link of a benefit.

There was a review of over 20 studies on various cancers (bladder, colon, esophagus, lunch, pancreas, prostate, stomach, and other organs), the conclusion:  “there is insufficient and conflicting evidence to give any firm recommendations regarding green tea consumption for cancer prevention.”

The Bottom Line:  Drink green tea if you like it, just not to lower your risk of cancer.  And of course make sure that there’s no added sugar. 

 

Is fiber the key to staying regular?

How many times a day do YOU use the restroom?  No need to answer out loud, just something to think about J  If you are having a problem in that department, fiber can help.  I always tell people to go for the WHOLE food version – you can’t always believe what’s on a label – there are just TOO many added sources of fiber and the full extent of their benefit is not yet known.  Fiber helps with regularity but processing can disrupt it’s natural structure – for example use wheat bran, not ground up wheat bran.  Insoluble fiber  is thought to be more helpful for laxation than soluble, however, some studies show that oat bran and psyllium (soluble fiber) are very effective as well in helping laxation.  So soluble versus insoluble isn’t always a good predictor. 

The average intake of fiber for most Americans is less than half of what’s recommended.  For women 50 and under the recommendation is 25 grams of fiber (over 50, it’s 21 grams).  If you’re a man under 50 you’ll need 38 grams of fiber (over 50, 30 grams).  People often underestimate the amount of fiber that they’re taking in – I always tell people, log your food for a day or two – you might be surprised to see what you find. 

As for all these “fiber-enhanced” products on the market?  There are too few studies to have actually looked at their benefits.  But many of the easily added fibers, polydextrose, inulin, and resistant starches – have minimal effects on stool weight.  They may add just 1 or 2 grams of fecal matter for every gram of fiber consumed.  The fiber in oats, probably produces 3 grams of fecal matter for every gram you eat.  That’s right, I went there.  As a marketing technique, sure I’d want to buy a product with that much fiber in it, however, when you get down to the nitty gritty, it’s not natural and doesn’t provide the benefit.  And who knows how much added sugar is in some of those products, i.e. Fiber One?? 

The Bottom Line:  Eat whole foods to receive REAL fiber.  Don’t rely on packaged products enhanced with fiber to get your daily intake. 

Nutrition is a science that is always evolving.  Sorting out the research and separating food fact from fiction can be difficult – not to mention that new studies can always change the picture.  Pay attention to reputable sources of information.  And remember, if it sounds too good to be true, it probably is. 

That's A "Keeper"!

It’s my Saturday morning ritual.  Long run, breakfast with my running buddy, and then planning my groceries for the week.  Yesterday I came home and began to sort through ALL the recipes I have.  I have a stack and I mean a stack of recipes just waiting to try.  I scroll through Instagram, Facebook, and now Twitter.  Yes, Twitter.  There are SO many resources to find recipes.  I’m starting to get a little overwhelmed with all of the recipes I want to try.  I try to be selective and think ahead as to what really will be a “keeper” and weed out ones that won’t make the cut.  Maybe they just sounded good the first time around but at the second look I know I must’ve been hungry at the time that recipe made the cut. J  I also got the America’s Test Kitchen Cookbook – The Complete Vegetarian Cookbook – a couple of months ago.  Talk about overwhelming.  I know ALL their recipes will turn out!   They tested them for pete’s sake!  The only problem again with their book is there are TOO many to try!   The other premise for picking out some recipes is whether or not I’ll be able to make it.  I am not a cook by any means.  And if any of you all know me, accidents find me.  Yesterday when I was making homemade waffles I was opening the seltzer water and sure enough it exploded.  I don’t buy carbonated beverages and definitely wasn’t prepared for that!!  Who does that happen to?  Moi.  I need a hidden camera in my kitchen so that people would believe the chaos in the kitchen J 

“Keeper” – a recipe that I’ve tried that’s a definite success and makes it into my “keeper” recipe book, ultimately a possible repeat recipe.  The key word being repeat – I haven’t repeated any in quite a few months, but I know I have my tried and true recipes when and if they’re needed.  Here are a few of the latest rounds of keeper recipes. 

Breakfast: Cinnamon Oatmeal Pancakes

I was in the grocery store the other day and noticed all of the frozen breakfast products.  Frozen waffles, pancakes, breakfast sandwiches, and even frozen oatmeal for you.  Packaged and convenient, all you need to do is warm it up.   It actually grossed me out.  I know I’ve had this conversation before and convenience is a really big issue, but cooking healthy will require a little bit of planning and time spent toward the cooking.  Sorry not sorry.  These pancakes are a prime example where you can make a lot ahead of time and freeze them.  They freeze amazingly!!  I am not the best at flipping pancakes so instead of crowding the griddle I do less at a time and use two spatulas for the flipping.   Mine may have not turned out as pretty but they sure did taste delish.  I always add protein in for the breakfast with nut butter on top of the pancakes.  Breakfast is typically high carbohydrate and not enough protein and then you’re hungry right away.  Always add the protein – it will keep you satiated for longer.  I rotate through the nut butters:  peanut, almond, and cashew – to help provide some variety and flavor.  I also add some hemp seed on top as well.  More about hemp seed later.  Make these pancakes, you won’t regret it.

http://www.twopeasandtheirpod.com/cinnamon-oatmeal-pancakes/

 

Breakfast: Overnight Oats

I can’t tell you how many recipes for overnight oats I have tried.  I have felt bad in throwing the oats out (but couldn’t stomach eating them so I had to waste them).   I almost gave up in trying the overnight oats trend.  Until this recipe came along.   I’m not sure if it has to do with the quantity being individual sizes or what but this recipe comes out delish!  I was a little bit doubtful when she said it could be eaten cold.  The first morning I made it and forgot I had made it the night before.  The 2^nd day I was determined to remember to eat them and was in a rush.  I had to grab the oatmeal on the run (so there was no time to heat it up).  Cold it was.  Surprisingly it was good even cold!  Now don’t get me wrong, heating it up just a bit allows the nut butter to melt and I do prefer it warmed just a tad.  But in a pinch, cold will work!  I am such a believer in this recipe that I made these overnight oats for a program of 12 people at work.  There I was the night before prepping each individual Mason jar (with love).  I did alter the recipe and used regular cow’s milk, just ½ tablespoon of maple syrup, and did a mix of peanut butter or almond butter.  I knew the exact carbohydrate count for the participants (Type 1 DM where they inject insulin based on the carbohydrate count) and I wanted to show them how eating on the run/go could be easy.  10 of the 12 participants liked the recipe.  The two that didn’t said, “It was too healthy tasting”.  Okay maybe they need the full tablespoon of maple syrup.  I think the odds are good for liking these overnight oats.  Make them, just don’t forget to eat them the next day – the chia seeds do swell and it will get too thick to eat if left too long.  (this picture is the minimalist baker's - it's a double portion of the recipe!)

http://minimalistbaker.com/peanut-butter-overnight-oats/

 

 

 

 Main Dish:  Tacos

Can every night be Taco Tuesday night? And why isn’t there a taco emoji yet?  I’m always telling patients to plan their monthly meals ahead of time (at least weekly).  Tacos can be part of the weekly meal rotation.  They’re easy to throw together and can taste completely different from the taco from the week before, so it won’t feel like it’s a repeat.  Which is important when it comes to making dinner for the family (in the hopes that all will like what’s being prepared).  Here are two, both vegetarian (you can always add some grilled chicken or steak), one that takes a little more preparation time and one that takes virtually no time at all.

Brussels Sprout Tacos with Caramelized Shallot Salsa – If you think you don’t like onions (shallots) think again.  These tacos will take some time due to roasting the tomatoes and Brussel sprouts and caramelizing the shallots, but it is SO worth it.  This lady, Jessica Merchant, has a talent for pairing together the right flavors.   Sometimes I’ll read her blog and think, no that can’t be.   I have learned never to doubt her.   Her flavor combinations are on point all the time.   My only gripe?  She needs more vegetarian recipes J  These tacos are quite delicious and they do warm up well (if you’re only making for one, like me!)

http://www.howsweeteats.com/2014/01/brussels-sprouts-tacos-with-caramelized-shallot-salsa/

 

 

 

Quinoa Black Bean Tacos – Super easy and quite delicious!  Two thumbs up also because ALL her recipes are vegetarian!  This is another blog, Cookie and Kate (her dog) that I have been using a lot of lately.  Her recipes are vegetarian and are simple to make.  For being so simple and having so much flavor is a plus for me.  I love using quinoa as part of the combination here.  Quinoa is a grain that is a complete protein – having all the amino acids, essential and nonessential.  Not to mention quinoa has more protein than other grains.  For me as a vegetarian the key is making sure to balance my protein with my carbohydrates.  It’s very easy as a vegetarian to eat high carbohydrate meals (as the protein might be lacking from an animal source).  While it is harder to get a sufficient amount of plant protein it is possible.  As a dietitian I am always constantly aware of this and am striving to make sure that I get the sufficient amount of protein that I need.  This helps stave off cravings that may occur because I didn’t give my body what it adequately needs.

http://cookieandkate.com/2015/quinoa-black-bean-tacos-recipe/

 

 

 

Vegan Jalapeño Sauce – I found this gem of a sauce on another taco night.  This vegan sauce has the base of cashews.  Think of a cool ranch kind of flavor.  That’s THIS sauce.  The best part (besides it helping to give me more protein at every meal?) it’s versatile!  Yes it was great as a sauce for my tacos, but it worked well the next day as a salad dressing – a sauce that can “blend once” and eat more times kind of sauce – as the author/maker of this sauce states, and it’s the truth!   I love a variety of nuts to help obtain my protein, but cashews hands down are the most versatile.  You can make them into a savory type sauce or into something sweet, it’s kind of hard to believe they can do that!  I’ve made them before in a vegan cheesecake.  They really can be both savory and sweet. 

 

http://www.loveandlemons.com/2015/08/26/portobello-tacos-vegan-jalapeno-sauce/

Snack – Nutty Jumbles

These are absolutely SO easy to make.  I buy the Planter’s Mixed Nuts (50% fewer peanuts unsalted) mix so I have a variety of nuts and don’t have to worry about measuring each nut out individually.  Yes, there is some sugar added in along with the egg white, but after you bake them this is what helps them bind together.   The percentage of carbohydrate to protein is a perfect balance and isn’t skewed to have too much of one or the other – perfect snack in my book.  I eat nuts every day to help obtain my protein for the day.  Every now and then I need to spruce them up and make them taste a little different than just your average nut.  I’ve used nuts to make “taco meat”, the cashew sauce as above, and even blended them up to make a fake parmesan cheese.  These nutty jumbles bring the natural flavor of the nuts out when they roast in the oven.  Simple and delicious, what’s not to love?

 

http://www.williams-sonoma.com/recipe/nutty-jumbles.html

 

 

 

Snack – Almond Butter Cookies

I’m all for experimenting.  This recipe did just that for me.  A cookie without an egg you say?  Let’s go.  You mix flaxseed meal along with some water and let it sit for a few minutes.  This acts as the binder in the recipe (similar to what an egg does) and is used quite often in vegetarian/vegan baking recipes.  These cookies are so delicious and proved me to be a believer when using the “flax-egg”.  Many have bombed and none stood the test of time.  These do.  I haven’t made them with another nut butter, but I can tell you now, they didn’t last long at all and need to be made again. Picture by the Simple Veganista.

 

http://www.simple-veganista.com/2014/05/almond-butter-lace-cookies-4-ingredients.html

 

 

My new go to add it to everything item:  Hemp seeds.   I’ve been doing this for a while now and I’m not sure why I haven’t shared this idea before.   I throw hemp seeds in my salad dressing (so they don’t sink to the bottom of my salad), I throw hemp seeds in those overnight oats, I throw it on top of my nut butter toasts – anywhere and everywhere I can add it I do.   These little seeds give you the nutritional power of hemp with a blend of omega-3 and omega-6 fats and high fiber content.  There are 10 grams of protein per 3 tablespoons.  They are also a good source of magnesium, a mineral that helps with relaxation, blood sugar control, blood pressure, and potentially osteoporosis.    Yes they are calorically dense, but they are NUTRIENT dense as well.  So easy to add in the day to my meals and help me obtain a sufficient amount of protein to help balance my carbohydrate intake.  Hemp seeds have a rich nutty flavor that makes everything just taste better.  Try it.

 

 

So there you have it – a few more recipes that have recently made it into my “keepers”.  I hope you see a recipe or two that you might like to try.  Why struggle to find a new recipe if you’re not sure that’ll turn out?  Start your own “keeper” cookbook.  You’ll be glad you did.