Pioneer Valley Nutrition

Introducing Samuel Baker Normand

2012-04-14T09:17:00.012-04:00

Sam was born punctually on his due date, March 29th. 7 pounds 12 ounces. 22 inches long. Mom and baby are doing very well and couldn't be happier.

First bath. First walk.

Two days old. First look outside.

Stay tuned for details on when I'll return to work and thank you all for your well wishes.
-Polly

CLOSED DURING MATERNITY LEAVE

2012-03-14T16:33:00.002-04:00

Pioneer Valley Nutrition will be closed for roughly 3 months (late March through late June) while Polly is on maternity leave. Please check back for details about when she will begin booking patients again. If you are an existing patient and have a matter that is urgent in nature, please contact your physician. We will not be checking voicemail or email messages during this period.

See you this summer!

Genetic testing for weight loss

2012-02-27T13:51:00.008-05:00

Lately I have been getting more inquiries about the genetic testing for weight management. There is already a bunch of information on our website under the link "weight management gene test" in the upper right-hand side of the screen, but here is a bit more information that summarizes what you will learn from the test ...

In brief, the gene test for weight management tells you if you would do better on a low-fat diet, a low-carb diet, or if it doesn't matter.

Researchers have been studying various diets for weight loss for years and years. For example, they will put subjects into random groups and assign a variety of different diets, one for each group (Atkins, Mediterranean, South Beach, Low-fat, etc.). Then, they analyze which seemed to be most effective. In the end, they always conclude that different people lose weight at different rates, but that no particular diet is better than another. The conclusion seems to always be that body weight is a result of calories burned and calories consumed.

Recently, some researchers at Stanford University discovered that there are certain gene markers that can predict how people burn various macronutrients (fat, protein, and carbohydrate - the only nutrients that have energy or calories). They discovered that some people actually store more calories from fat than others, while some store more calories from carbohydrate than others, and in the minority of human beings, they burn both fat and carbohydrate equally. The researchers contacted some old subjects from previous studies and asked them to participate in a new study in which they tested their genes and put them on a "gene appropriate" diet. Turns out that the subjects who had shown poor weight loss results in the previous study lost significantly more weight once they were on a diet that was in line with their genetic makeup. For example, if you put someone who was "carb sensitive" (meaning that they stored more calories from carbohydrate than fat or protein) on a low-fat diet, they would not see nearly as good of a result as if you put them on "The Zone" diet, which restricts carbohydrate intake to 40% of your caloric intake. Another example ... if you ate 1600 calories a day and were losing 1 pound a week on a low-carb diet, found out you were actually fat-sensitive and began eating more carbohydrate and less fat, yet still 1600 calories, you would lose more weight.

The gene test will tell you if you are carb sensitive (50-55% chance), fat sensitive (25-30% chance), or sensitive to neither (10-15% chance). In each case, there are specific dietary guidelines that can help you lose more weight or more easily maintain an optimal body composition. This does not mean that you ever need to eliminate or severely limit your fat or carbohydrate intake. We will discuss how much fat or carbohydrate is optimal for you in detail once your results are in.

When to eat around your workouts

2012-01-02T12:18:00.003-05:00

Perhaps you have made a New Year's Resolution to begin exercising or start working out more. Maybe you've just always wondered, "when is the best time to eat? Should I eat before I work out? Should I eat after? Both?"

Well, it depends!
The three main variables are:

Your comfort level
Your exercise goals, and
The timing of your work out

When you eat, more blood moves to your digestion system to help absorb and process your meal. Some people experience cramping, nausea, and/or discomfort if they eat before they exercise. If this is you, it is likely best to work out in the morning BEFORE eating. Let your body focus on your heart, lungs, and muscles while you are active. If you feel more comfortable and better fueled for your workout if you eat before, go for it.

If you are exercising to try to lose weight, the timing of your meals doesn't really matter. Do what feels best so that you have strength for your workout and feel comfortable doing it. If you are trying to gain weight/gain muscle, you should try to eat right after you workout. Immediately after is best. The sooner you eat after a workout, the more glycogen you store. By maximizing the amount of glycogen you have stored in your muscles, you increase your endurance for your next workout. Same rule applies if you are an athlete. Eat asap after practice or a game. Keep bars or dried fruit and nuts with you if you can't get to a kitchen right away.

Transitioning into fall

2011-08-31T13:57:00.004-04:00

With summer coming to an end, you may find your schedule changing. If you are a parent or a teacher, it's for certain. For many others, the shorter days and end of the vacation season mark a change in your daily routine as well.
Why not begin this fall with the best routine possible?

Try to implement the following tips into your day in order to optimize your health and feel your best:

Commit to going to bed at a specific time and getting up at a specific time. Most people need 7-9 hours of sleep nightly. Catching up on the weekend and changing your sleeping pattern has been shown to negatively affect food choices.
Eat breakfast, or at least something within 2 hours of waking up. If you're not a big breakfast person, at least have a snack to get your body going and then follow it up with another snack a few hours later.
Pack your lunch. Food you bring from home tends to have less calories, be more balanced, and be more affordable than meals you buy out.
Plan ahead to avoid getting too hungry or too full. Try to eat something at least every 4 hours. For example, if your lunch was a reasonable size and you ate it at noon, you will probably be hungry again by 4:00, so have a snack ready.
Keep food at work or bring balanced snacks. Depending on when you eat meals, you may need an additional 1-3 snacks during the work day.
Incorporate a high-protein food into your meals and snacks. Foods that are high in protein include yogurt, milk, eggs, cheese, nuts, nut butters, soy products like veggie burgers, beans, meat, seafood, and poultry.
Eats lots of vegetables. They are low in calories, high in fiber, and packed with vitamins and minerals. Strive to eat a variety of different colors.
Limit sugar. Sugar can spike and drop your blood sugar causing spikes and drops in energy, prematurely age you, and make you crave more food when you don't need it.
Drink plenty of fluid, preferably water. Try to stay hydrated by drinking throughout the day. Shoot for drinking half of your body weight in pounds. If you weigh 150#, that's 75 oz or about 9 cups (4 2/3 pints) a day.
Take steps to destress. Whether it's meditating, reading, journaling, yoga, knitting, or going for a walk, incorporate time to wind down daily.

For help planning a new eating routine, call 584-2200 to set up an appointment with one of our Registered Dietitians to customize a plan just for you. We will help you brainstorm meals and snacks and reach your health goals. We accept most health insurances, yet coverage varies depending on your specific plan.

Let's not be so hard on red meat!

2011-04-28T07:04:00.016-04:00

The sun is shining. The world is turning green. You leave work and can't wait to get outdoors. Shortly after you step outside you smell it ... your neighbor grilling burgers (hamburgers, that is). You think "Mmmmm, that smells delicious," but there is a part of you that thinks that you should have a veggie or turkey burger instead because it would be healthier.

Stop feeling guilty! There is nothing wrong with enjoying a hamburger on occasion if you are tempted. (For those of you who are vegetarians for humane or environmental reasons, I commend you.)

Red meat is notorious for being bad for your health. I don't think it deserves this bad reputation. The main debate is that it is higher in saturated fat than other meats like poultry and diets high in saturated fat have been shown to raise your bad cholesterol levels which in turn can increase your risk of having a heart attack or stroke. However, so does cheese, but you don't see us coming down as hard on it. Most of the research linking the consumption of red meat to an increased risk of heart disease looks for a correlation between the diet, sleep habits, activity levels, genetics, etc. of the individuals examined and tries to find common denominators for those that develop heart disease. This type of study does not prove a direct correlation between red meat and an increased risk. Many of the people who eat diets high in red meat choose to also be sedentary, eat more processed foods, and make other choices that could be the ones responsible for increasing their risk. It is unfortunate that the interpretation of this research has translated into a common association that red meat is bad for us.

Some GOOD things about red meat:

It is very high in protein.

It is high in iron, specifically heme iron, which is more readily absorbed by the body.

It is high in many B Vitamins such as B12 which supports metabolic and cellular health and Choline which has been shown to support healthy fetal neurological development.

It is high in the mineral Zinc which supports your immune system.

It is a great source of CLA (conjugated linoleic acid) which may have anti-carcinogenic properties.

It is a whole food! Well, if you choose to buy it in that form (which I would recommend) - steaks or fresh ground beef. Local meat produced without the bad stuff (hormones, antibiotics, etc.) from animals that are grass-fed is ideal.

You can select red meats that are lower in saturated fat such as leaner ground beef or a steak with less marbling. One ounce of cheese has 50% more saturated fat than a 4 oz. piece of filet mignon. You can certainly limit your saturated fat intake without eliminating red meat.

Saturated fat content in select foods:
4 oz. 95% lean ground beef = 2.5 gm
4 oz. 80% lean ground beef = 8.7 gm
4 oz beef tenderloin = 3.8 gm
4 oz. pork tenderloin (trimmed) = 0.76 gm
1 oz. cheddar cheese = 6 gm
1 large egg = 1.5 gm

Choose how you want to spend your saturated fat allowance and don't feel guilty about including some red meat if it is a food you enjoy!

3-Day weight loss jump start

2011-03-28T17:14:00.007-04:00

They are coming. The first warm days of the year. When it's time to get out your tee shirts, tank tops, shorts, and of course, swim suits. Many Americans (particularly in New England), put on weight in the winter because we tend to be less active and cook (therefore eat) richer foods. If you have been thinking about summer lately and how you really want to trim down, what are you waiting for?

I find that many of my patients know that they want to lose weight and think about it quite often, yet they can't seem to give up their sweets, or get into an exercise routine. Long days at work can be draining and may make it seem impossible to find the motivation to get to the gym. High-calorie comfort foods can seem like the perfect reward for a hard day, but SNAP OUT OF IT! What's really more important to you? Lying on the couch, watching TV, and eating junk food, or getting into a healthy routine and losing weight? If you have ever lost weight in the past, you know that once you get into the swing of things, it gets easier and you FEEL BETTER. So stop the cycle and just get back on track ...

If you are having a tough time getting on track, try my 3 day weight loss jump start challenge:

Pick 3 days that you can be prepared with groceries, truly commit yourself to proper meal planning, and don't have any dinner plans or tempting food situations on the calendar.

Avoid sugar, avoid alcohol, limit processed foods, and limit white flour for those 3 days.

Choose whole foods, whole grains, and try to have a high-protein food with every meal and snack (milk, yogurt, cheese, eggs, legumes, meat, poultry, seafood, nuts, nut butters, protein bars, protein shakes, or soy products).

Plan out all of your meals and snacks. Yes, all of them. Try not to go over 4 hours without eating (but eat more often if need be), try to eat something within 2 hours of getting up, and try not to eat anything within 2 hours of going to bed. Keep these two things in mind when making food choices: protein and amount. Be sure that one of the foods in your meal or snack is high in protein and be sure that you plan to eat enough food (enough calories) to last until you eat again, but not much so that you aren't hungry for your next meal or snack. Just try to imagine how many hours it will last you.

Go grocery shopping with a list and your meal plan in mind.

Declare your plan to your family, friends, and/or coworkers if any of them tend to sabotage your efforts.

Try your best to get enough sleep during this time period.

Drink half your body weight in pounds of water. For example, if you weigh 128#, drink 64 oz. of water a day, if you weigh 200#, drink 100 oz. of water a day, if you weigh over 250#, try to get in at least 1 gallon of water per day.

Follow through and keep reminding yourself that you can do anything for 3 days.

If you actually implement this for 3 days, I promise that you will feel more motivated on the 4th day and hopefully, you will stick with it!
If you need help planning, that's our specialty. Most health insurances will cover our services if you are overweight or have another health concern, and Health New England typically covers 4 visits per year for any reason. In addition, the genetic weight management testing we started a few months ago has been a huge success (see my December 22nd post for more info). The test is $169 and your insurance will likely cover all of the consults associated with it.
Email pioneervalleynutrition@gmail.com or call (413) 584-2200 to set up an appointment today.

Food Addiction

2011-01-26T08:25:00.005-05:00

Although you have had this kind of pizza dozens of times and will probably eat it on many more occasions, you consume it like you will never have the chance to taste it again. Whether there is one more slice or 4 more slices, you would want to eat them all. You unbutton your pants because you start to feel full and bloated, but you have one more slice anyway. Then the guilt sets in and you regret having eaten that much. You want to lose weight and know that overeating will only cause you to gain weight, yet the food is overpowering. You know you have had enough, yet you keep eating. If this sounds familiar, perhaps you or a loved one are addicted to food.

Food addiction is just as real as drug addiction. Merriam Webster's online dictionary defines "addiction" as "persistent compulsive use of a substance known by the user to be harmful." In fact, an estimated 15% of Americans struggle with "hypereating," a condition former FDA Commissioner, Dr. David Kessler, describes as "characterized by a cluster of symptoms such as obsessive thoughts about food or overeating despite a conscious desire not to." In a 2008 Princeton University study, researchers concluded that binging on sugar and then subsequently being deprived of sugar mimics the behavioral and neurological craving, binging, and withdrawal of drug abuse. In another study published this year in The Journal of Psychoactive Drugs, researchers found that an effective treatment for compulsive eating is to restrict all highly palatable foods (which may require constant supervision) until the cravings subside. This method is similar to the detoxification process recommended as treatment for drug abuse.

With drug abuse, you can simply commit to giving up drugs and seek treatment to help you. However, with food abuse, you cannot commit to giving up eating. We have to eat to survive. I find that my patients who struggle with food addiction can conquer it with the right help, but you have to be willing to do the work. If this does sound like you or someone you care about and you are interested in getting help, I would suggest working with a Dietitian and Psychologist who have experience with disordered eating and weight management.

It is important to:

determine which emotions are most likely to trigger you to overeat
create a plan to manage those feelings
have a realistic meal plan established by an experienced nutrition professional tailored for you
plan ahead accordingly (grocery shopping, cooking, traveling) in order to implement your meal plan
establish a support system so that you can be held accountable (online forums, sponsor, health practitioners)
don't be too hard on yourself and work on letting go of guilt

A simple exercise I give my patients to help with emotional eating:

If you have a craving or want to overeat yet know that you shouldn't be physically hungry, determine what you are feeling ... stress? overwhelmed? bored? tired?
Think of the opposite of that feeling. For example, the opposite of "overwhelmed" is "in control."
Do something that makes you feel that way. For example, making a to do list may help you feel more in control.

To set up a confidential appointment with me, call 584-2200 or email pioneervalleynutrition@gmail.com.

The best New Year's diet advice EVER!

2010-12-22T08:43:00.009-05:00

South Beach, Weight Watchers, Jenny Craig, Medifast, Biggest Loser, Skinny Bitch, The Zone, FullBar, Atkins, low fat, low carb, high protein, more milk?!?! There are SO many diet plans out there! With the holidays upon us and the New Year approaching, many Americans are beginning to think about a diet plan for 2011. How do you pick which one is right for you?

I have helped thousands of people lose weight and know that taking in less energy (less calories) than you burn up is how to do it. Over the years, I have noticed that some people lose weight more quickly than others depending on the percentages of macronutrients (fat, protein, and carbohydrate) they eat. However, there seemed to be no rhyme or reason to which percentages work best . . . until now!

Researchers have looked at numerous studies to review weight loss success based on both caloric intake and percentage of fat, carbohydrate, and protein eaten and concluded that there is no formula for weight loss beyond calories in/calories out. They have always determined that carb, fat, and protein intake don't directly affect weight management. Recently, researchers from Stanford University contacted participants from these older studies and asked for permission to test their genes. It turns out that there are specific genes which determine who tends to burn more dietary fat, who tends to store more carbohydrate, who burns more fat with intense exercise, who burns more fat with moderate exercise, and more! This discovery is truly revolutionary!

Local Registered Dietitian, Nancy Dell, has maintained her weight for 20 years. She took the genetic test in order to test this theory. Her genes showed that she should eat more fat. She increased her dietary fat intake and has lost 9 pounds eating the same amount of calories as she has for the past two decades! You can view her news clip on NBC by following this link: http://www.wwlp.com/dpp/health/dietitian/nancy-dell-genetic-test-weight-loss

We are now offering this genetic testing at our office in Northampton. It costs $399, which includes an initial consultation for the gene test and a body composition analysis, a follow up consult to interpret the test results and develop a personalized eating plan, and a third consult to answer questions and check your progress. Most health insurance plans will reimburse for the medical nutrition therapy consultations which will significantly lower the cost.

Call 413-584-2200 to schedule your test today!

How we gain weight over the Holidays

2010-11-21T14:23:00.021-05:00

You think, “oh, but I can only get Stollen once a year,” or “if I am going to make Latkes, I might as well make extra.” Perhaps you love all of the goodies that seem to move into your office once the cold weather really hits. I look forward to my mother-in-law’s pumpkin pie. Whatever your holiday temptations are, be aware that your indulgences may result in tight pants come New Year’s.

If your clothes tend to fit well again shortly after January 1^st, GOOD FOR YOU! But, if you tend to hold onto your holiday weight gain, please, read on . . .

Most unintentional weight gain is unwelcome. There is no good data on how much weight the average American gains over the holidays. In a regularly cited, 10-year old study published in the New England Journal of Medicine, the researchers found that only 10% of participants gained over 5 pounds during the holiday period. However, the study only included 165 subjects. Assuming that this was a good reflection of American’s weight patterns during November and December, it still indicates that 10% (or roughly 30,000,000 people) will gain over 5 pounds during the holidays!

If you gain 5 pounds, it means that you consumed an extra 17,500 calories. Sounds like a lot, right?! Well, it's really not that difficult. Let me show you how 17,500 calories can add up over the holiday season . . .

Beginning on Thursday, November 25^th, you eat Thanksgiving dinner from 2:00 to 4:00pm. You have some cheese and crackers to start, a few veggies with dip, a total of 2 ½ glasses of red wine, dinner of turkey, gravy, stuffing, potatoes, squash, turnip, green bean casserole, and bread with butter, followed by a piece of pumpkin pie and ½ piece of apple pie and then a bit more turkey and stuffing later on. TOTAL CALORIES 2705 – 1000 (usual calories for lunch and dinner) = NET EXTRA of 1705

On Friday, November 26^th, you go shopping and go out to lunch (which you normally don’t do on Fridays). You have a grilled chicken Caesar salad and a Diet Coke. TOTAL CALORIES 1100 – 400 (usual calories for lunch) = NET EXTRA of 700

Beginning the week of November 29^th, the office goodies really start rolling in. A package from this client, cookies from that one, not to mention the treats your coworkers are bringing in from home. Over the next 4 weeks you average one serving of these goodies a day. Perhaps two small cookies, one brownie, or 3 Lindt balls. TOTAL CALORIES 6000 – 1200 (calories in usual indulgences over 1 month) = NET EXTRA of 4800

You attend 3 holiday parties where you consume 1200 extra calories at each party (those drinks really add up!) = NET EXTRA of 3600

You bake cookies on December 4^th and give most of them away, yet have 7 of them over the course of the day you made them. = NET EXTRA of 1050

If you celebrate Christmas, let’s pretend you have an 1800-calorie dinner (and appetizers) on Christmas Eve (normally you eat 500-600 calories) and consume an extra 1600 calories of food on Christmas Day. = NET EXTRA of 2800

You indulge in one more piece of pumpkin pie on the 27^th = NET EXTRA of 400

On December 28^th, you get together with friends from out of town and consume 1700 calories at dinner (nearly 400 of them from your 2 glasses of red wine) = NET EXTRA of 1200

On New Year’s Eve, you attend a party and eat a good amount of appetizers, but only 600 more calories than usual. However, you end up drinking 4 glasses of champagne by night’s end and consume = NET EXTRA of 1320

And there you have it. 17,575 extra calories = 5 pounds. It can happen so easily . . .

Calories to remember:

1 thumb-sized piece of chocolate has roughly 70

1 slice of cheesecake has 600-1200

1 slice of fruitcake has about 400

2 Lindt chocolate balls have 140

1 cup egg nog has 300-600

1 TBSP of oil (any kind) 120

1 TBSP of butter 100

8 oz. of red wine 192

6 oz. of white wine 144

12 oz. light beer 100

1 ½ oz. hard alcohol 96

Be sure to ask yourself, “is it worth it?”

My Food Experiment - Day 10

2010-11-06T08:48:00.010-04:00

It has been one week since I last reported on my donuts, burgers, and bread, and I am calling it … the 14 year-old McDonald’s hamburger must have been kept in a controlled environment.

All of the bread and buns are completely dried out and hard as well as the Atkins donut. The Dunkin Donut is still a bit squishy to the touch despite the incredibly dry weather we’ve been having. The rest of the loaf of Wonder Bread (living in it’s bag) is still squishy and mold-free, while the bagged loaf of Bakery Normand bread is growing green and white mold. The Local burger is growing more white mold on the lettuce and tomato and there are a few specs of mold of the McDonald’s burger’s onions. The veggie burger has green mold growing on the bottom of it (where it was touching the plate and still holding in some moisture), yet the rest is dried up.

What have we learned here?

In the natural environment of dry fall in New England, both fast food and that which is homegrown will mummify if it is not a moisture-rich food, and will grow mold if it is a food that contains more water. In response to those who have played with food before me and proposed that "food which rots slowly or not at all must be bad for your health" . . . I think we have provided evidence which suggests that this is a poor theory. A McDonald's hamburger can change over time and the rate of decomposition varies greatly on the environment it is kept in.

Where does that 1996 burger reside?!

My Food Experiment - Day 4

2010-10-31T12:23:00.005-04:00

So as of Saturday the 30th, "Day 4," the food seems to be simply drying out.

I have been storing it in our guest room with the window open and door closed.

Both the Wonder Bread and the Bakery Normand bread are dried out and hard, yet otherwise look the same. The blueberry cake Dunkin' Donut is still moist (probably due to it's glaze), but the Atkins donut is dry and hard. I went with the blueberry cake donut from Dunkin' Donuts because I thought that the consistency would be most similar to the cider donut from Atkins Farm, yet in retrospect, the glaze verses sugar-coating really makes a difference.

All three burgers are drying out as well and the buns are getting hard. The tomato on the local burger has white dots all over it (since the tomato is still moist, I assume this is mold?). While the McDonald's burger looks like it has mold on it in the picture as well, it is really just part of the bun that stuck to the ketchup. I have stored the burgers with their buns on.

Sorry, those who have saved and monitored food before me, the McDonald's burger is already beginning to change, but please stay tuned ...

Fast Food Experiment Photos - Day One

2010-10-27T19:27:00.017-04:00

As I follow up to my October 21st post from last week, I have bought and photographed all of the food I had planned on buying.

Here are the "Day 1" pictures ...

Grass-Fed Local Burger and McDonald's Hamburger

The burgers side-by-side and a Boca Vegan Soy Burger

A whole loaf of Wonder bread and a single slice

A whole "French Loaf" from Bakery Normand and a single slice

A blueberry cake donut from Dunkin' Donuts and a cider donut from Atkins Farm

Feel free to email me with your predictions and I will keep you posted!

My Fast Food Experiment

2010-10-21T20:02:00.003-04:00

Perhaps you didn’t have time to pack your lunch for work, or maybe you were on the highway and it was the only obvious place to get something to eat . . . McDonald’s, Burger King, Wendy’s, KFC, they’re everywhere! I get it. You drive up, order, pay a small price, and get a meal in a couple of minutes without even having to get out of your car. I’m a busy person. I think we all are these days. But, I can honestly say, that I can only recall eating fast food twice in the past 13 years, since college. Once was at an airport when I had absolutely no other options and truly didn’t think I would get the opportunity to eat again that day, and the second was at a conference in the middle of nowhere that didn’t supply any food and the only option was McDonald’s. Fast food just never appealed to me, although I recognize that many people enjoy it.

So . . . is fast food so bad? What’s wrong with it? Fast food tends to have more calories than food you make at home, but surprisingly, not any less than restaurant food elsewhere. If you are aware of the calories in the fast food you order, it may not be that terrible for your weight.

But, your HEALTH is another story. Most fast food is high in the stuff that is bad for you, like saturated fat that can clog up your arteries, and low in the stuff that is good for you, like fiber and antioxidants, (not to mention all of the additives and preservatives).

I heard a piece on NPR last week about someone who had kept a McDonald’s hamburger for 6 months and reported that, “the food feels plastic and looks shiny but still no mold.” Looking further, I found a blogger who has kept a McDonald’s burger since 1996 and IT still looks the same! Check it out http://bestofmotherearth.com/2008/09/24/1996-mcdonalds-hamburger.html.

Anyway, it got me thinking, what would a burger from somewhere else do? What about comparing other fast foods to their fresher counterparts?

So, next week (when I have the chance), I am going to buy, photograph, and monitor:

1. a McDonald’s Hamburger, a hamburger from “Local” on Main Street in Northampton, and a veggie burger from the grocery store.

2. a loaf of Wonderbread and a loaf of bread from my favorite local bakery (Bakery Normand, of course) and …

3. a donut from Atkins Farm in South Amherst and a donut from Dunkin’ Donuts.

I have my predictions, but we’ll see what happens . . .

Please stay tuned!

Can you prevent kidney stones?

2010-09-29T18:26:00.012-04:00

Perhaps you or a loved one has gone through the pain of passing a kidney stone. In order to avoid this dreadful experience again, step one is find out what kind of stone it was. If you or anyone you know ever passes a stone in the future, SAVE IT!

There are four possibilities:

About 80% of kidney stones are Calcium Oxalate stones.
Roughly 10-15 % are Struvite Stones.
About 5-10% are Uric Acid Stones.
And finally, it could be a Cystine Stone, yet they are rare.

Ask your doctor which one he or she suspects you had, but most-likely it was a calcium oxalate stone.

If so:

Try to comsume less than 80 mg of oxalate per day. Visit http://www.ohf.org/diet.html for a chart of the oxalate content in foods.
Avoid foods that are very high in oxalate: almonds, beets, miso, tahini, chocolate soy milk, rhubarb, sesame, and dark leafy greens.
There shouldn't be a need to limit foods that contain calcium, although calcium supplements are not recommended.
Limit your sodium intake to 2000 mg per day or less.

For all types of kidney stones, it is important that you drink plenty of water. Shoot for 3-4 quarts. Yep, that's 96 to 128 ounces! Keep water with you: in your car, at the office, and right next to you when you are hanging out at home. Yes, you should get to know where the best restrooms are if you are on the road a lot, but what's worse . . . having to take a lot of bathroom breaks, or passing another stone?! Once you get used to it, it will be easy.

So drink up!

You might think, "That's nuts!"

2010-08-31T21:18:00.016-04:00

One of my earliest memories of childhood is the smell of peanut butter. I remember wondering how all of the other kids at my nursery school could love this gooey food so much, yet it repulsed me more than anything I had ever encountered in my few years on Earth. The scent alone made me want to run away. I distinctly remember one day when all of the other young students were munching away on PB and crackers and I was just sitting there holding my breath. My teacher came over and said, "Polly, eat your snack." I told her I didn't like it. She said I HAD to TRY it. The conversation continued to escalate, yet I wouldn't give in. When my mother came to pick me up that day she was told about how stubborn and uncooperative I was at school. The year was 1980. Oh, how times have changed! My own mother didn't even think to connect that whenever I was being a brat about trying a certain food as a child, IT HAD NUTS IN IT AND I WAS ALLERGIC! Nut allergies just weren't that common then.

Now they are common. I keep hearing more and more about schools and work places banning foods that contain nuts. My nut allergy is pretty severe, yet I can be in the same room with nuts and nut butters. I don't enjoy it, but it is tolerable. I have patients who truly cannot even be around nuts, as airborne nut particles can result in an anaphylactic allergic reaction for them. Not only do I feel awful for those that have to be so careful, ALL THE TIME, yet the worst part of their allergy is sometimes the lack of sensitivity from others. An anaphylactic allergy is uncontrollable. The only way to treat it is to avoid the allergen. If an anaphylactic reaction goes untreated, it can continue to worsen and even result in death.

Many people I know need clarification about food allergies versus food intolerances. A food allergy occurs when one's body mistakes the food for a harmful substance and makes antibodies to fight it. These antibodies stay in your system and the next time you eat the food, your immune system fights it by releasing histamine which causes an allergic reaction. Typically symptoms include hives, swelling, and trouble breathing. Nut allergies are the number one cause of fatality from food allergy. Yes, FATALITY, death! A food intolerance involves difficulty digesting a food, often due to a lack of the enzyme to digest it such as a lactose intolerance when someone lacks the enzyme lactase that digests lactose (milk sugar). Finally, some people avoid dairy because it may congest them or onions because they don't digest them well, yet this type of avoidance is NOT a food ALLERGY.

It is challenging to manage food allergies and intolerances. While a lactose intolerance or avoiding certain foods because one has irritable bowel syndrome are legitimate reasons to be picky, I believe that the staggering increase in people watching what they eat has resulted in irritation from some people who can eat whatever they want. It is absurd that we, as human beings, cannot all eat the same things, however this is the reality.

If you have a food allergy, please be sure to always ASK before you eat. In restaurants never settle for simply telling your server and getting their word about whether or not a menu item is nut-free, insist that they check with the chef. If you are parent, be aware of the signs and symptoms of a food allergy. If you don't have any kids with allergies and can eat anything you want, please understand that the nut-free-school thing is not just a stunt for schools to battle any legal drama. It can save a kid's life!

There is one part of some schools' nut policy that I disagree with and am looking for feedback from parents about . . .

I have never seen or heard of a child with a nut allergy having an airborne allergic reaction to a product that does not list nuts in the ingredients, yet says, "this product was manufactured in a facility that also processes nuts." Some area schools have banned these products as well. SO MANY foods list that disclaimer on their products nowadays that it does severely limit what parents can pack for lunch and snacks. Not only does this limitation put stress on parents to pack appropriate lunches and teachers to check that they are following through, it limits many healthy snack options. I believe that children with nut allergies should be educated about avoiding those products and that other kids should be allowed to bring them to school. If you know of a child who has had an airborne reaction, (meaning that they didn't eat the food, they were just near it) to a food that does not contain nuts, yet lists that disclaimer, please let me know! pioneervalleynutrition@gmail.com

My final tip, is to watch out for the top five foods that I (one with a nut allergy) ask about and then discover that there were hidden nuts:

chocolate (usually even something that appears to use plain chocolate yet there are hidden ground hazelnuts in it)
pesto (it typically contains pine nuts, or sometimes walnuts)
green salad
pasta salad
baked goods

Artificial Sweeteners and Your Body Weight

2010-07-11T08:55:00.014-04:00

You may have heard it before and now I seem to be hearing it from my patients again lately . . . they ask, "Should I stop drinking diet soda? Should I avoid using artificial sweeteners? I heard they can make me gain weight?"

Most people drink artificially sweetened beverages and eat artificially sweetened foods because they are trying to watch their weight or have Diabetes. Foods and drinks that are made with artificial sweeteners tend to have a lot less calories than products that are naturally sweetened.

The answer to these questions is complicated because the research is conflicting. Most studies look at the potential for artificial sweeteners to increase one's appetite. In the early 90's, several American studies found a correlation between consuming artificially sweetened beverages and increased appetite. A German study published this January found that "artificial sweeteners create hunger," (although I couldn't read the specifics because they were in German). Despite these findings, other studies have shown no relation between diet products and appetite. In 2009, a review study (one that examines and reviews all previous research) published in the American Journal of Clinical Nutrition, determined that artificial sweeteners "may increase appetite," yet if consumed with other foods, they do not. It sounds like the jury is still out on this one.

My opinion? If you are trying to lose weight and you really miss sweet foods or drinks, some diet soda or artificially sweetened food is alright, but make it a temporary thing while you work on losing weight, then just watch your calories from sugar in the future. Many of my patients who are actively losing weight consume artificially sweetened products and still lose weight. If you are Diabetic, watch your total carbohydrate in one sitting and have artificially sweetened products as "treats." Many of my patients with Diabetes do not consume artificial sweeteners, yet still indulge their sweet tooth and control their blood sugars. While most research suggests that aspartame and sucralose are safe, I'm suspicious. I think that we should strive to eat as many whole foods as possible and avoid or limit consuming anything artificial. If your goal is weight maintenance, I suggest avoiding artificial sweeteners on a regular basis, yet some here and there are likely alright.

Buying produce . . . organic or not?

2010-06-06T11:28:00.006-04:00

Standing in the grocery store, you hold a container of organic strawberries and one that is not organic. The organic quart is $4.99 and the other is $2.00 (two for $4). You are on a budget, yet begin to imagine your 4 year-old daughter eating the strawberries on her cereal and throw the non-organic quart back.

Many of us debate about whether or not to buy organic produce. It can be much more expensive and really add up. Organic produce is grown without using chemicals to control pests, insects, or weeds, or to fertilize crops. Organic fruits and vegetables cannot be genetically modified either. Many studies have shown a link between chemical pesticides and a number of diseases including cancer, ADHD, birth defects, and Parkinson’s disease.

Research has shown that many pesticides cannot be washed off. In order to protect you and your family from these harmful chemicals, you should try to limit your consumption as much as possible. An organization called The Environmental Working Group tested produce and found that the following fruits and vegetables had the greatest amount of pesticides of those not organically grown . . .

Try to buy organic:

strawberries
apples
peaches
celery
blueberries
nectarines
bell peppers
spinach
kale
potatoes
cherries
imported grapes

The following fruits and vegetables were found to be the safest of non-organically grown produce:

onions
avocados
sweet corn
pineapple
mango
sweet peas
asparagus
kiwi
cabbage
eggplant
cantaloupe
watermelon
grapefruit
sweet potato
honeydew melon

When shopping for organic produce, don’t forget about local farmer’s markets. While some vendors may not have certified organic produce, they may not use pesticides and simply did not get officially certified as an organic farm. Visit www.localharvest.org to find a Farmer’s Market near you.

Be social and lose weight

2010-05-12T11:31:00.004-04:00

You are going out for dinner tonight, have plans to go out again on Friday, have a party on Saturday, a wedding next weekend, are out of town for business next week, and then have your grandparents’ 60^th wedding anniversary the following weekend. The list of engagements goes on and on and there is no shortage of good food at any of them. How are you going to lose the winter weight in time for summer?

Try following these guidelines . . .

1. Avoid getting hungry. Try not to go to dinner, a party, or any event with food hungry. Being hungry (especially too hungry) affects your ability to stay in control. If you are trying to lose weight, it’s all about control. When we get too hungry, we are more likely to make bad choices, order too much, and overeat. Plan ahead so that you are just beginning to feel hungry when you are able to eat. Be sure to think about when you will actually have access to food. If you are meeting for dinner at 7:00, you probably won’t eat anything until 7:30 or 7:45. So think, “how much do I need to eat before I go to last me until 7:45?” Then have a snack.

2. Choose wisely. Try to eat at least one high-protein food (cheese, meat, poultry, seafood, eggs, legumes, hummus, or nuts), load up on vegetables, and avoid the high-fat choices. Some fat is good because it helps to fill you up. Chances are, if you eat very little or no fat, you will be hungry again soon. Balance.

3. Avoid grazing. Make a plate of food, sit down with it, and enjoy it. Try to acknowledge the food while you are eating it and be mindful of the fact that you just ate. You know when you are driving down the road sometimes and while you are paying attention and driving safely, you forget what you just drove by? That means that you were not being mindful of driving. Try to be mindful of eating.

4. Ask yourself, “Is it worth it?” While tempura fried vegetables with yuzu ponzu dipping sauce, mascarpone cheesecake with strawberry balsamic drizzle, and truffle fries may sound appealing, you need to exercise proper judgment and determine if you will be happy with your choice the next day. Would you rather get closer to fitting into your shorts, or have 3 bites of cheesecake for 300 calories? You decide, just be sure to ask yourself this question FIRST.

5. Avoid multiple courses. They are never a good idea. If you followed rule #1 and aren’t that hungry, you can hold off for the main course which should be PLENTY of food. If you feel left out, order a salad (vegetables only) and go light on the dressing.

6. Limit alcohol. It should definitely go in the “is it worth it” category. Just remember that there are 3,500 calories in one pound of fat. If you want to lose 10 pounds, you have to pass up 35,000 calories . . . (that’s 625 calories less per day for 8 weeks). A half bottle of wine has 336 calories. A light beer has about 100 calories. A draft microbrew has about 220 calories. It adds up fast!

7. Keep food with you. If you are traveling, it can be tough to know where and when your next meal or snack will happen, not to mention what it will be. Put bars and small packs of almonds in your purse, bring some oatmeal for breakfast at your hotel, and buy your own food to keep in your room. If you are at a conference and close to your room, buy some fruit and/or yogurt at a store close by, empty out the mini-fridge, and put your own food in there.

8. Drink lots of water. If you’re thirsty, you could mistakenly think you’re hungry, so drink up! Water has no calories and some studies have shown that people who drink more water lose weight faster.

So, go be social AND lose weight! Summer will be here in no time . . .

Safe and Sound Seafood

2010-04-07T09:34:00.011-04:00

You have probably heard discussions about how healthy seafood is for you. I've written about the extensive health benefits of EPA and DHA fatty acids found in fish (see 11/16/09 post), but what about the safety and availability of seafood?

The Monterey Bay Aquarium puts out a "Seafood Watch" guide once a year. It is short and sweet and includes lists of the best choices, good alternatives, and seafood to avoid. The focus is on maintaining fish populations and supporting environmentally friendly fishing practices.

Best choices:

Pacific Halibut
Wild Alaskan Salmon
Albacore Tuna (troll/pole) from the U.S. or British Columbia

Avoid:

Chilean Seabass
Blue and Striped Marlin
Orange Roughy
Farmed Salmon
Imported Swordfish
Shark
Longline Tuna
Bluefine Tuna (except Albacore and Skipjack)

Visit www.montereybayaquarium.org to learn more and download a pocket guide for your area.

Eating to age well

2010-03-12T16:16:00.007-05:00

Have you ever thought about or talked about wanting to "eat healthy?" What does that mean? I believe that eating healthy means eating to age well; to prevent disease, optimize energy, and maintain physical and emotional health. Seeing as I am celebrating a birthday today, here are my tips for eating healthy to age well:

Try your best to choose whole foods. Limit processed foods as much as possible.
Eat a balance of the 3 macronutrients: protein, fat, and carbohydrate.
Choose organic foods as much as possible. Avoid eating animals that are given hormones and/or antibiotics, dairy products made from those animals, and produce sprayed with chemicals.
Eat a diet high in fiber from fruits, vegetables, legumes, and whole grains.
Drink plenty of water and mainly water.
Limit alcohol.
Chew well and eat slowly.
Plan for meals and snacks, keep food with you, and stay on top of groceries.
Avoid getting too hungry or too full.
Try to cook as much as possible and avoid eating out often.
Eat a variety of different foods and be creative.
Avoid trans fats (hydrogenated oils).
Limit sugar.
Eat fish and/or take a fish oil supplement.
Eat plenty of different colored fruits and vegetables.

What to eat to boost your immune system

2010-02-23T09:14:00.006-05:00

You may wash your hands before eating, bring your own pen to the bank, avoid touching any public bathroom door knob, and turn off sinks with a shield of paper towels. What else can you do to avoid catching a cold or flu? Here are some tips on what to eat to boost your immune system . . .

Try to incorporate the following:

Vitamin C – it is known to increase the production of white blood cells that fight infection and increase interferon levels which protect cells from being infected with a virus. Try to get Vitamin C from fruits and vegetables and spread your intake out throughout the day. Foods that are high in Vitamin C include: oranges, grapefruit, broccoli, peppers, cantaloupe, strawberries, butternut squash, and bok choy.

Vitamin E – it works to increase the production of cells that kill germs. Find it in almonds, sunflower seeds, fortified cereal, tomato sauce, avocado, wheat germ, and sardines.

Selenium – it works alongside Vitamin E to fight germs. It is found in higher quantities in protein sources such as tuna, cod, beef, turkey, chicken, eggs, and brazil nuts, yet also found in smaller amounts in asparagus, lima beans, and mushrooms. Amounts of selenium in produce vary depending on how much was present in the soil they were grown in. If animals were fed plants that were grown in soil high in selenium, they will have higher levels as well

Zinc - works with Selenium and Vitamins C and E to help your white blood cells and killer cells do their jobs. Find it in oysters, fortified cereals, beef, crab, and beans.

Beta-glucan – it is a glucose polymer, a polysaccharide, that has been shown to stimulate the immune system. Find it in oatmeal, barley, mushrooms, and nutritional yeast.

Omega-3 Fatty Acids – here they are again. Research has shown that Omega-3’s increase killer cell activity, help your cells absorb nutrients, and get rid of toxins. The Omega-3’s in fish, EPA and DHA, are most beneficial. See my November 9th post for more information on EPA and DHA fatty acids.

Other helpful hints . . . stay hydrated and maintain a healthy body weight.

How much should my child eat?

2010-02-14T11:20:00.010-05:00

I get this question a lot . . . “How much should my kids eat?” The answer to this question varies quite a bit, but the bottom line is that they should take in enough energy to fuel their bodies based on their activity level and body composition. By “enough energy” I mean enough calories. Calories are the measurement we use to calculate the energy in food, just like your height is measured in inches, or your weight is measured in pounds.

Consider the following:
· How much do they weigh? The more they weigh, the more energy they need to support their weight.
· How much are they growing? If they have been going through a “growth spurt,” they will need more energy.
· Are they overweight and would you or your doctor like them to maintain or lose weight while they continue to grow? If so, they should cut back on calories, but still eat frequently throughout the day.
· Are they underweight and you or your doctor would like them to gain weight? You should try to incorporate more calories into their diets.
· How active are they? The more active your child is, the more energy they need to fuel their activities.
· How much time do they spend sitting? If your child sits a lot (at school, watching TV, studying, in front of the computer), they may need less energy than other kids.
· What size were you (their parents) when you were their age? Sometimes, especially before puberty, kids gain a bit of weight, but if they are active and eat well, they will grow taller and their weight will stay roughly the same. Sometimes, kids can appear very thin even though they seemingly eat a lot of food. If you feel that they are eating the right amount of energy, think back about your size when you were their age. It may just be in their genes to be a larger or smaller child.
· How much muscle do they have? Children with more muscle have faster metabolisms and need to eat more energy than those that are less muscular.
· Are you thinking about your son or daughter? Boys need more energy than girls because they have more muscle.

Kids should eat at their first signs of hunger and stop when they are no longer hungry, not full. In order to ensure that this happens correctly, it is helpful to be aware of your answers to the above questions. You should also try to be well prepared. Keep snacks with you just in case. Nuts, dried fruit, and granola bars are good stand-bys. Most kids need an afterschool snack. To determine how much is enough, think of how much time has elapsed since they ate last and think about how long it will be until they eat again. For example, if your child eats lunch at 12:00, gets home from school at 3:00, and dinner is usually at 5:30, then their lunch should be enough calories to last 3 hours until their snack. Their snack should be enough to last them 2 and ½ hours until dinner at 5:30. Make sense? Another example . . . If they do not have a morning snack at school and eat breakfast at 6:45am, then it should be enough to last them 5 hours and 15 minutes - until lunch at 12:00. Sometimes, kids who do not eat enough during the day get too hungry at night and evening snacking becomes habit. Try to gradually increase their intake during the day and decrease their intake at night. If they go to bed at 9:00pm and have a snack at 7:30, it should be a “ 1 ½ hour” snack. If your child is resistant to eating more during the day and less at night, consider setting up an appointment with a Registered Dietitian to help change their habits . . .

High-protein, high-fiber meals for when you need one fast!

2010-02-08T09:35:00.008-05:00

I have had a really busy week. You know those weeks when you already have a ton of stuff to do and are concerned with how you will get it all done then more and more things keep piling up? These weeks happen and you still need to eat. Here are some of my favorite quick, high protein, high fiber dinners for one (or more) . . .

Rice and beans with egg, cheese, and salsa.

Alright, I know this sounds weird, but anyone I have recommended it to who likes the individual ingredients thinks it’s good. You can use leftover rice or that quick, instant kind with no additives that you microwave in the bag. I use canned black beans and rinse them. Dice up some onion and use olive oil spray or olive oil to cook it until almost translucent (the onion is optional). Then put it off to the side of the pan and cook an egg (I like it still a bit runny), then add the rice and beans, mix with the onion and heat. While the egg is cooking and the rice and beans are heating up, shred some sharp cheddar cheese. Put the rice, beans, and onion in a shallow bowl, place the cheese on top, then add the egg. Top with salsa and voila! Using the following portions, this dish has only has 420 calories.

½ cup black beans

½ cup cooked rice

1 egg

1/8 cup salsa

1 oz. cheddar cheese

Few tablespoons of onion

Salad with Chicken

Buy some bagged, prewashed greens, chicken breast, goat cheese, and keep almonds and dried fruit around (you can use them as snacks when running around this week too). Cook the chicken with olive or canola oil or spray in a saute pan (slice the breast through the middle to cook faster). Toss the greens in olive oil and vinegar, add goat cheese, almonds, and dried cranberries then top with the chicken. Using the following portions, this salad has only 435 calories.

½ bag salad greens (use as much as you want)

4 oz. chicken breast

1 oz. goat cheese

15 almonds

3 TBSP dried cranberries

½ TBSP olive oil

TBSP vinegar

Lean pork chop with grilled apple and onion

Pork chops, a lean meat when you trim the fat, are cheap and you can usually pick up just one from the deli. Macoun apples are great for cooking. Wash and cut one through the middle into ½ inch slices. Pick up a yellow onion and slice it as well. You may want to pick up another vegetable for a side (such as broccoli). Spray a pan or griddle with olive oil spray and cook the pork chop, apple, and onion together (flipping as necessary). They should all take roughly the same amount of time to cook and go really well together. Steam some broccoli on the side and have a small roll or slice of bread. All together, it has 435 calories.

4 oz. pork chop, trimmed

1 Macoun apple

½ yellow onion

3 oz. broccoli

Small roll (1 ½ oz.) with tsp butter

Alright. Gotta go! Have a good week . . .

Checking Your Blood Sugars

2010-02-01T13:26:00.003-05:00

If you are Diabetic and your doctor tells you that your blood sugars are still too high, you should be checking them. If your doctor tells you that your blood sugars are getting higher, that you are on the road to getting Diabetes, or that you are "Prediabetic," you can learn a lot by checking your blood sugar. If you have a loved one who is concerned with their blood sugars, share this post with them and help them to prevent or postpone Diabetes. Also, check out my December 1st post, "What Exactly is Diabetes?"

First, get set up with the right meter and supplies . . .

If you need a meter, you can likely get one for free from your physician, or if you are in the area, stop by my office and we will give you one. If you have a meter, how old is it? Do you have strips and lancets? Are they expired? If so, refill your prescription or call your doctor to get a new one. There are several different meters available. Some have larger number displays for those of us who don't have the best vision. Some meters use lancets that are easy to load and larger strips for those of us with arthritic fingers. Be sure to speak up about what you prefer so that you get the best meter for you. Also, you may want to check with your health insurance company to make sure that the strips are covered under your plan and to find out what the copayment is.

Next, gather data . . .

You should get a sense of what your blood sugar is running at the following times:
• First thing in the morning (fasting)
• Before bed
• Postprandial (2 hours after your first bite of a meal)

If you haven’t been checking lately and aren’t too keen on starting, you may want to begin by choosing two checks a day and varying them. Morning and after lunch, breakfast and before bed, morning and after dinner, etc. Get a sense of what your blood sugar is at different times of day and after eating different foods.

Finally, look at the data and share it with your Diabetes Educator and Doctor . . .

This is the key to better control . . . recognize and acknowledge which foods tend to spike your sugar and in what portions. If you are just starting out or resuming checking, you may want to keep a food record with your blood sugars in it. That way, you can compare what you ate to what your blood sugar was afterward. If you are having a tough time limiting certain foods or your portion size, it may be better to take some or more medicine or insulin in order to keep your blood sugars from spiking. You MUST discuss this with your doctor. Tell him or her when it is too high so they can help you dose your medication properly and keep your blood sugars down. Most meters store your readings so that your doctor and/or diabetes educator can just go through your meter and see what they have been. Some healthcare practitioners will upload the data to their computer.

It is incredibly important for you to control your blood sugars if you have Diabetes. Think of high blood sugars as creeping into the wrong places over time (like you kidneys, eyeballs, and toes). If you have not yet been diagnosed but told to be careful, START MAKING CHANGES NOW! You and your health practitioner can work together to prevent complications and keep your blood sugar levels healthy . . . the sooner the better!