Slow day...post day...

You know work is slow when it's a double-post kinda day... : )

 Mari asked me a wonderful question about PCOS and what type of diet is best for women suffering from PCOS. Great question, Mari...I hope this is helpful!

Women with polycystic ovarian syndrome (PCOS) are at increased risk for heart disease and diabetes. Many women with PCOS have insulin resistance, causing the pancreas to secrete more and more insulin in order to transport glucose (sugar) out of the blood and into muscle, fat, and liver cells where it is converted to energy or stored as fat. Elevated insulin levels can cause polycystic ovaries, weight gain or difficult losing weight, increased risk of heart disease (elevated LDL-cholesterol and triglyceride levels and decreased HDL-cholesterol levels), and increased clotting factors. The risk of the developing diabetes in women with PCOS can be up to 40% by the age of 40. Most women (50-60%) with PCOS are obese (BMI greater than 30). Weight loss, even as little as 5% can lead to decreased insulin levels which is critical due to the fact that elevated insulin levels promote fat storage [1].

In researching how much carbohydrate a woman with PCOS should consume, I found varying recommendations. Before prescribing a standard 50-55% carbohydrate diet or a low (40% or less) carbohydrate diet, I would want to know a PCOS patient’s fasting blood sugar and HbA1c – a lab value indicating an average blood glucose reading representing 6-8 weeks. Agreeably, women with a higher BMI are statistically more likely to have insulin resistance, in which case a lower (less than 50-55%) carbohydrate diet is probably advisable.

I am of the opinion that to prevent diabetes, one should eat like a diabetic. For most women of normal to overweight size, this would include 30-45 grams of carbohydrates at meal times and 15-30 grams of carbohydrate + 1-2 ounces of protein before bedtime. Emphasis should be placed on complex, low-glycemic index carbohydrates, as well as a diet low in saturated (13 grams or less per day) and trans fat (none, preferably). For women with a BMI greater than 30, carbohydrate and energy needs go up – consult a Registered Dietitian for recommendations.

For example, a 180-pound (81.8 kilograms) female requires roughly 1230-1640 calories a day to lose weight (15-20 calories per kilogram of body weight. In order to find your weight in kilograms, divide your weight in pounds by 2.2). At minimum (30 grams of carbohydrate per meal with a 15-gram carbohydrate evening snack), carbohydrate comprises 26-34% of the daily intake. At maximum (45 grams of carbohydrate per meal with a 30-gram carbohydrate evening snack), carbohydrate comprises 40-54% of the daily energy intake. 

(Note: one gram of carbohydrate contains 4 calories – this is needed for calculations).

Other diet-related suggestions for women suffering from PCOS [1]:

-         Pair carbohydrate-rich foods and snacks with a lean protein or fat high in mono and/or polyunsaturated fatty acids.

-         Consume foods with a lower glycemic index – these foods are typically high in fiber

-         Space carbohydrates out throughout the day. Consuming consistent, moderate carbohydrate levels is best for blood sugar control

-         Consume plenty of decaffeinated, sugar-free beverages, especially water

-         Exercise on a regular basis -- aerobic and anerobic

-         Take a multi-vitamin mineral supplement daily

[1]. McKittrick, Martha. PCOS and Diet. OBGYN.net Publications.

The above information was provided by the above source. The author, Martha McKittrick is a Registered Dietitian and Certified Diabetes Educator. In other words, she is a wonderful resource!

Cookie Taste-Test Results!

The preferred cookie in yesterday's cookie taste testing was the Oatmeal Cranberry White Chocolate Chip Cookies. Hands down. There were only 2 votes NOT for the Oatmeal Cranberry White Chocolate Chip Cookies and they were for the Chocolate Peanut Butter Cookies and the Peppermint Cheesecake Brownies.

P.S. I had 2 late-comers who wanted in so the total participation was 18 employees!

Last night I made deer meat tacos for dinner!

My father-in-law is a bow hunter and provides us with deer meat. Yum!

I had 1 deer meat taco, a dollop of fat-free refried beans, and a bed of shredded lettuce with deer meat, salsa, corn, and homemade guacamole. Mmmm!

 Nutritional comparison of deer/venison vs. ground beef

(values represent a 1 ounce, raw portion)

- deer meat is 40 calories versus the 72 in ground beef*

- deer meat contains 0.8 grams of fat compared to 5.7 grams in ground beef*

- deer meat contains 7.6 grams of protein compared to 4.9 grams in ground beef

*this is standard 70-80% lean (does not specify)

Question: Have you tried deer meat? Did you like it? Did it taste "game-y" to you?

Diabetes, Cheerios, and Late Night Eating...

...you betcha, it's a smorgasbord today!

First up: a break-down of diabetes prevalence across the United States. Sorry the below map doesn't enlarge any bigger, but you can go here to see the enlarged version. Of course I found this interesting as I work with a largely diabetic population.

Among those 30 and older in the US, 13.7% of men and 11.9% of women have diabetes. A third of this estimated number are going undiagnosed. Colorado, Minnesota, and Vermont have the lowest rates of diabetes while the southeastern states have the highest rates -- Mississippi having the highest rates of all. Lead author and epidemiology research fellow, Goodarz Danaei at Harvard stated, "The Southern States have a very dangerous aggregation of risk factors for heard disease: obesity, high blood pressure, and diabetes [1]."

With more than 70,000 diabetes-related deaths each year, diabetes is the sixth leading cause of death [1]. You can clearly see that Oklahoma and Texas have much work to be done in diabetes prevention, especially among the men, compared to neighboring Arkansas, Missouri, Kansas, and New Mexico.

In other news, a federal court panel has ruled that five pending lawsuits against General Mills for claims touting the cholesterol-lowering benefit of Cheerios will be consolidated into one multi-district case. The FDA administered a warning to General Mills regarding their claims of Cheerios "lowering your cholesterol 4% in 6 weeks" and "clinically proven to lower cholesterol." A specific rate of risk reduction is not allowed, according to the FDA. Plantiffs states that General Mills made false claims which led them to eat the cereal as a way to lower cholesterol [2].

The FDA stated in May that eating Cheerios was "not generally recognized as safe and effective for use in preventing or treating hypercholesterolemia or coronary heart disease [2]. Shame, shame, Cheerios and General Mills!

Last up: light night eating produces weight gain. I found WebMD's take on evening eating and weight gain, which was in consensus with a post I made back in September. Similarly, recent research performed at Northwestern University found that eating at night led to twice as much weight gain, even when total calorie consumption was the same among mice. The science, however, is still unknown [3]s.

Kathleen Zelman, MPH, RD, and director of nutrition for WebMD recommends consuming regular meals, as well as consuming 90% of your daily caloric needs before 8 pm. Eating every three to four hours helps regular blood sugar and control hunger and cravings [3]. I concur, for what it's worth. :O ) 

And yesterday's diabetic diet...

Breakfast:

1/2 cup old-fashioned oats (2 carbs)

1 cup skim milk (1 carb)

1 tsp turbinado (1/2 carb)

1 tsp Splenda brown sugar (1/2 carb)

1/2 ounce pecans, chopped (0 carbs)

cappuccino with 2 Tbsp sugar-free International Delight

     Total: 4 carbs

1 cup whole wheat pasta (3 carbs)

4 ounce chicken breast (0 carbs)

3/4 cup marinara (1 carb)

1 ounce Parmesean cheese (0 carbs)

     Total: 4 carbs

Snack:

12 baby carrots (0 carbs)

small apple (1 carb)

     Total: 1 carb

Dinner:

1 cup mashed potatoes (2 carbs)

3 fingerlings of Biggest Loser "Fried Chicken" (2 carbs)

     Total: 4 carbs

Snack:

3 graham crackers (1 carb)

1 1/2 Tbsp peanut butter (0 carbs)

     Total: 1 carb

[1]. Bakalar, Nicholas. Diabetes: A State-by-States Breakdown. The New York Times. October 13, 2009.

[2]. Scott-Thomas, Caroline. Lawsuits Against Cheerios Cholesterol Claims Combined. Food Navigator. October 13, 2009.

[3]. Zelman, Kathleen M.  Is Late Night Eating More Likely to Pack on the Pounds? WebMD.

Omega-3 Show-Down!

Know that omega-3’s are good for you…but that’s about it? Bruce Watkins, Purdue University professor of nutrition and director of the International Omega-3 Learning and Education Consortium for Health and Medicine helped in developing a website devoted to teaching consumers about types of omega-3’s, benefits of omega-3’s, and where to find them in the diet. They created this site in the process. The site answers basic questions about omega-3 fatty acids. Also included for doctors, medical providers, and veterinarians is a fact sheet and patient handout [1] – check it out!

Additionally, the site includes a database of foods containing omega-3’s as well as the amounts. I know Gina and I have a discussion back about the feasibility of consuming adequate omega-3’s for cardio-protective benefits through the diet alone. There is also a chart showing how much and what types of omega-3’s men and women of varying ages and with differing health histories should consume [1]. Sign-up to receive their monthly newsletter, too! Jackpot!

Omega-3’s for asthma? Heart disease? Cancer? Maternal Health? Cognitive function? Transplantation? Mental health? Eye health? Diabetes? Go here!

The run-down (per 100 grams/~3.5 ounces):

Highest overall omega-3 content (fresh fish) = salmon, Atlantic, farm-raised (2507 mg omega-3’s)

Highest ALA content (fresh fish) = salmon, wild (295 mg ALA)

Highest EPA content (fresh fish) = salmon, Atlantic, farm-raised (862 mg EPA)

Highest DHA content (fresh fish) = salmon, wild (1115 mg DHA)

Okay…salmon takes the cake for the fresh fish. Other great options include: swordfish, trout, tuna (bluefin), whitefish, halibut, catfish, and anchovies.

Highest overall omega-3 content (shellfish) = shrimp (540-601 mg omega-3’s)

Highest ALA content (shellfish) = crayfish, wild (32 mg ALA)

Highest EPA content (shellfish) = shrimp (293 mg EPA)

Highest DHA content (shellfish) = squid (342 mg DHA)

So, shrimp are a GREAT option for omega-3's. Other shellfish sources of omega-3’s include: blue crab, Dungeness crab, queen crab, spiny lobster, mussels (yum!), and scallops!

And FYI: canola oil and flaxseed oil contain omega-3’s! Per 100 grams there are 9137 mg omega-3’s in canola oil and 53,300 mg omega-3’s in FLAXSEED OIL! I must ask, who knew that canola and flaxseed oils had so many omega-3’s!? You can boast your intelligence, it’s alright!

What do YOU need?

- If you have no documented coronary heart disease, eat a variety of fish at least twice a week. Try to focus on fattier fish such as salmon. Use other products such as flaxseed and canola oil, as well as flaxseeds and walnuts.

- If you HAVE documented coronary heart disease, consume about 1 gram of EPA + DHA per day, preferably from fatty fish. Supplementation may be recommended by a physician.

- If you have elevated triglycerides, take 2-4 grams of EPA+DHA per day through a supplement provided under a physician’s care.

As always, purchase and use supplements with caution. Supplements are not FDA-regulated and are not tested for purity or potency.

All the nutrition facts are provided by the US Department of Agriculture’s National Nutrient Database for Standard Reference, Release 21.

[1]. New Web Site Aims To Deepen Public Knowledge of Omega-3s. Purdue University. August 21, 2009.

Nutrition Hodgepodge

It's been a busy week. I attended a Conversation MAPS training by Merck for diabetes education on Tuesday night. I got my own set of 5 maps and I'm going to start facilitating sessions next month with my patients. These maps are AWESOME! Check out HealthyI for training sessions near you. If you work with a diabetic population, or just want an awesome set of educational tools free of cost, attend one of these sessions -- it was so rewarding!

Because there's so much I want to blog about today, consider this a hodgepodge of nutrition-related news. Here we go!

First up: cholesterol-lowering supplements [1]
Of course there's a TON of supplements on the market touting to be the ultimate cholesterol-lowering aid. Please note, supplements are meant to be used in addition to healthy diet and regular exercise regimens! Additionally, what works for one individual may not work for the next. Please consider the role an unconscious change in diet and/or a placebo affect can alter results of supplement-taking persons [1].

1. Artichoke leaf extract (also known as Cynara scolymus).

• The good: In 2000, a randomized, double-blind, placebo-controlled trial including 150 "high risk" adults (cholesterol > 280) was performed. The trial lasted 6 weeks and LDL-cholesterol (the bad) dropped 23% compared to the placebo group.
• The bad: The results are yet to be replicated. Similar studies show a decrease in cholesterol (-4%), but no major impacts on LDL or HDL have been found.
• The bottom line: Few studies conducted, mixed results, don't expect miracles.

2. Fenugreek.

• The good: Studies from the 1990's show a drop in total cholesterol and LDL, and in some cases, significant drops (as much as -38% in LDL). Fenugreek contains20-50% fiber and thus cholesterol-lowering effects may be attributable to this fact, if nothing else.
  
• The bad: The studies were small and poor quality questioning the validity of results noted above.
  
• The bottom line: Not enough evidence to support the cholesterol-lowering effects of this supplement.

3. Fiber (soluble - found in oats, barley, bran, peas, citrus fruits, and dietary supplements).

• The good: A 1999 meta-analysis performed by Harvard Medical School researchers contained nearly 70 clinical trials assessing the effectiveness of soluble fiber in cholesterol reduction. High soluble fiber intake was associated with reducing in both total and LDL cholesterol in 60-70% of the studies examined. For each gram of soluble fiber added to participant diets, and overall reduction in LDL was estimated at 2 points (in an average of 7 weeks).
• The bad: That's a lot of fiber. The current recommended guidelines state 25 grams of dietary fiber and the typical intake is comprised of a mere 20% soluble fiber. For example, 3 bowls of oatmeal will provide a measly 3 grams of soluble fiber. Supplements? Fine, but many experience GI upset and some prescription interferences.
• The bottom line: A diet high in soluble fiber can lower LDL-cholesterol, however, the drop in LDL will be relatively modest.

4. Fish oil (this is the one I was most interested in reading about!) - also known as omega-3's or EPA and DHA.

• The good: In clinical trials assessing dosing of 3 or more grams, fish oils have been shown to lower triglyceride levels by 10-30%.
  
• The bad: While fish oils do not lower LDL, they have been shown to sometimes cause the opposite: a small rise in LDL-cholesterol.
• The bottom line: Fish oils do lower triglycerides, especially in individuals with high triglycerides. The American Heart Association recommends those with high triglycerides consume 2-4 grams of fish oil a day. Those with heart disease should consume approximately 1 grams a day of EPA and DHA (combined), preferably through the diet and the consumption of fatty fish, such as salmon.

5. Garlic (oil, extract, pill, or natural state).

• The good: A 2000 report on garlic's impact on cardiovascular risk factors showed a small (but measurable) drop in LDL and total cholesterol.
• The bad: Studies to follow showed less encouraging results. A well-executed study performed in 2007 compared raw garlic and commercial garlic supplements over a 6 month period and found no measurable effects in total cholesterol, LDL, HDL, or triglycerides versus the placebo.
• The bottom line: Garlic may lower LDL temporarily but its meaningful effect on cholesterol long-term is questionable.

6. Red yeast rice - a fungus that grows on rice and contains a small amount of lovastatin (a type of statin found in prescription meds).

• The good: Compared to most supplements, evidence in support of red yeast rice is strong. Several high-quality trials have shown red yeast rice to lower LDL-cholesterol by 20-30%, comparable to a statin drug. A 2009 trial performed on patients discontinuing the use of statin drugs, red yeast rice showed a 15% and 21% decrease in total cholesterol and LDL, respectively. Cool.
• The bad: The amount of lovastatin in the supplements vary widely across brands.
• The bottom line: Red yeast rice is a potentially effective way to lower cholesterol, but its potency varies dramatically. Due to safety concerns with statin use, experts discourage the use of off-the-shelf red yeast rice.

The cliff notes version of the rest...

7. Ginseng

• The bottom line: There is not enough evidence to support the use of ginseng for lowering cholesterol.

8. Guggul

• The bottom line: More research is needed; there is not enough evidence to justify the cholesterol-lowering effects of guggul.

9. Niacin

• The bottom line: Niacin boosts HDL (the good), but you should NOT take it without consulting a doctor. Niacin should not be used in lieu of a prescription due to potentially serious side effects.

10. Soy protein

• The bottom line: Soy protein lowers LDL slightly.

Next up, mercury found in ALL fish caught in US streams (!) The government tested fish caught from 300 streams in the US. All the streams contained fish contaminated with mercury and thus the U.S. Geological Survey's research launches a comprehensive examination of mercury contamination [2]. Should this worry us? Maybe so. It was shown that 27% of the fish contaminated contained levels of mercury deemed unsafe by the Environmental Protection Agency for the average fish eater, consuming fish twice weekly. Mercury is a neurotoxin which is especially dangerous to neurological development in infants and fetuses [2]. The waters in urban areas, surprisingly, were less contaminated than those in costal plain streams fed by wetlands and forests, especially in North and South Carolina, Georgia, Florida, and Louisiana. The fish most highly contaminated included bass while the lowest levels of mercury were found in brown, rainbow-cutthroat trout and channel catfish [2]. To check for fish consumption advisories in your area, go here [2].

And up last, some reading material to leave you with. Is saturated fat being falsely accused? Read more!

I had planned to talk about myths surrounding egg consumption, but I'm out of time... it's off to the dog park. Hope Lily get some energy on the ride over! Have a wonderful weekend!

[1]. Hainer, Ryan. Cholesterol-Lowering Supplements: What Works, What Doesn't. CNN Health. August 20, 2009.
[2]. Weise, Elizabeth. Mercury Found In All Fish Caught in U.S.-Tested Streams. USA Today. August 22, 2009.

Omega-3's: How much?

Depends on the research.

A new analysis could lead to a heated debate on omega-3's having its own recommended daily intake levels. Heart-protective benefits of fish oil have been discussed for centuries, but how much do we need? Some cardiologists would like to see an established RDA for omega-3's. Dr. Carl Lavie, medical director of Cardiac Rehabilitation and Prevention at Ochsner Heart and Vascular Institute in New Orleans, advocates such. He recommends people consume at least 500 milligrams of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) daily. This recommendation was published in Monday's release of the Journal of the American College of Cardiology. Those with known cardiovascular disease should look to comsume 800-1,000 milligrams of EPA daily [1].

Dr. Steven Nissen, director of cardiovascular medicine at the Cleveland Clinic, says that Dr. Lavie's recommended may be premature and that wide-spread usage of omega-3's does not have compelling evidence in support.

Dr. Robert Bonow paves the way by recommending an increase in fish oil and deems this "good advice" while explaining that the strongest results from fish oil usage are seen in those with pre-established heart disease.

Lavie's recommendation is largely supported by recent research involving 40,000 participants ranging in health status, which revealed a number of potential advantages to omega-3's. For example, in men who had recently experienced a heart attack, those consuming omega-3's were 29% more likely to be alive in two years than their counterparts.

Dr. Rubenfire, director of preventative cardiology at the University of Michigan, explains that he would like to see a "trial in the modern era in patients on other evidence-based treatments such as aspirin, [blood pressure] control, statin and non smoking" to confirm benefits of omega-3's [1]. Fabulous suggestion, in my opinion.

MOST importantly, consumers MUST understand that supplements are not regulated. Therefore, a 1,000 milligram "fish oil" capsule can contain as little as 300 milligrams of EPA+DHA. Buy supplements that are 3rd party tested and approved for use by the U.S. Pharmacopeia (USP). These products may be hard to find, but they are available to consumers for purchase.

What does the boss say? Well, the American Heart Association is on board with omega-3's. The AHA's current recommendation includes 1,000 milligrams a day of combined DHA+EPA for those with confirmed coronary heart disease. For healthy adults, the AHA recommends consuming 500 milligrams a day, approximately the amount found in two servings of fatty fish a week [1]. Fatty fish include: salmon, mackerel, sardines, herring, lake trout, and albacore tuna.

[1]. Peck, P. and Childs, D. Recommended Daily Dose for Omega-3's May Be On the Way. ABC News. August 4, 2009.

Breakfast done right!

While an overwhelming 90% of Americans think breakfast is the most important meal of the day, fewer than half consume breakfast on a regular basis, according to the Food Information Council. Breakfast is not only important…but unique...it sets the tone for the entire day – be it for the better or the worse [1].

There’s no “perfect” meal, as everyone has different nutritional needs. However, a good breakfast starts with a “moderate meal of mixed foods,” says Richard Mattes, a professor of food and nutrition at Purdue University [1]. What does THAT mean? Keep reading.

WORST: No breakfast at all. Not hungry in the morning? This makes sense. Your body slows down its metabolism throughout the night due to the prolonged fast. If you’re sleeping 8-9 hours like we all should, your body is going a long while without food, especially since we typically don’t eat LAST thing at night and FIRST thing in the morning. Those who skip breakfast are more likely to be over-weight and eat more calories and fat throughout the day says Susan Biali, a physician specializing in dietetics. If you’re one of those people that claims eating breakfast makes you hungrier throughout the day, you’re probably starting off your day with too much sugar. If it’s a choice between nothing or something bad (i.e. a donut)…go with the donut and limit it to one [1].

BAD: Coffee or tea only. Hydration and caffeine – not enough. You’ll likely end up over-consuming at lunch when you’re famished [1]. A simple piece of fruit in the mornings would go great with your hot liquids, don’t you think?

(Pretty) BAD: Coffee/tea + a donut = quick, easy, and yummy. The 90-minute boost will leave you crashing into sleep-mode before mid-morning has even hit. Same goes for sugary cereals and bagels. Such foods high in “simple sugars” cause your blood sugar to both rise and fall too quickly, leaving you needing more. Think juice is a great option? Wrong. Physician John LaPuma says, “Think of juices as desserts because ‘their sugar content hypes up your insulin level and craving for a real, gut-filling food'” [1].

BETTER: A bowl of low-sugar, high-fiber cereal with non-fat or low-far milk, banana, and whole wheat toast with jam and coffee. Look for cereals containing at least 3 grams of fiber and 10 grams of sugar or less per serving. Cheerios, Kashi GoLean, All Bran, or Fiber One are great options. If your cereal has a mascot, leave it on the shelf at the stores. Tony the Tiger provides you nothing GRRRRRRRRRRRRRRRREAT!

BEST: A hard-boiled egg and a bowl of slow-cooking oatmeal topped with berries, walnuts, raisins, flax seeds or sunflower seeds with coffee or tea. THIS meal is a nutritional powerhouse and easy to do as you can prepare the oatmeal and egg ahead of time and have on-hand. The high-fiber / high-protein make-up of the meal help regulate blood sugar, and are much more satisfying during a long morning of work. The flax seed and walnuts provide heart-healthy omega-3’s which are shown to reduce LDL-cholesterol (the bad kind), and also reduce inflammation and the risk of heart disease. You can also add a slice of whole-grain toast with peanut butter or avocado for added healthy fats [1].

And how about Sunday brunch? Timothy Harlan, a professor of medicine at Tulane University School of Medicine says that a weekend "binge" isn’t likely going to have huge negative effects. He goes on to explain, “Eating healthy is all about balance. Sure, you can eat perfectly 21 meals a week and be healthier, but at what price? Having a large, friendly meal works for all of us on a social level that transcends the perfect diet. It’s the same with eating out.” Splurging on a meal every now and then is nothing to lose sleep over. Besides, the very term “brunch” translates into just 2 meals being consumed. Even if your brunch choices aren’t the best, you have one less meal contributing calories to your daily totals [1]. Sure sounds like Mr. Timothy is an "80-20" advocate in his own way, don't you think? ; )

Side note: I feel WAY better about the Sunday brunch Mark and I had with our friend Lena last weekend. It was DELICIOUS…and it did include a salad, for the record!

[1]. Deardorff, Julie. How To Eat Breakfast. Chicago Tribune. August 2, 2009.

Eat This, Not That: Mayo

I had a blog topic request from my amazing mommy. So, mom, here you go!

Her topic proposal: Mayo with olive oil. She said in an email, “I’ve seen it advertised and on the shelf today. Us consumers will need to know it it’s good because it touts the words olive oil. If it is indeed beneficial, how much?”

Simple answer: It’s a condiment that contains calories, fat, and in some cases cholesterol. It should be used in moderation.

Reality, however, is not omission from the diet. So, let’s discuss.

Between the choices offered by Hellmann’s, my recommendation in order of “dietary preference” would be:

1. Hellmann’s Canola Cholesterol-Free
2. Hellmann’s Low Fat
3. Hellmann’s Light
4. Hellmann’s with Olive Oil
5. Hellmann’s Real Mayonnaise

The logic?

The lowest option calorically is the low-fat Hellmann’s measuring in at 15 calories and 1 gram of fat per serving (1 tablespoon). The problem with it is the ingredients – water and modified cornstarch being the two main ingredients. Also, the sodium (while not high) is higher than any other Hellmann’s product. It is also the lowest in “good fat” – mono and polyunsaturated fatty acids (MUFAs and PUFAs).

Hellmann’s Canola Cholesterol-Free comes in as #1 in my book because it is 50% lower in calories than Hellmann’s Real Mayonnaise, contains no saturated fat, no cholesterol, and is lower sodium than the Hellmann’s made with olive oil. The olive oil product contains 5 more calories than the canola product and 5 milligrams of cholesterol, as well as 0.5 grams of saturated fat. Also, the olive oil product is not made of pure olive oil, but also contains soybean oil. Further, when you log-on to www.hellmanns.com, the olive oil product is asterisked and noted to not contain olive oil. If that’s confusing and unclear to a dietitian, it’s certainly unclear to consumers.

Canola oil is a heart-healthy oil and inexpensive. It offers similar MUFA and PUFA content as olive oil, and can be used diversely in cooking and baking.

Mom: Buy the Hellmann’s Canola Cholesterol-Free. Love you!

I'll take a pass, Dr. Atkins

The Physician’s Committee for Responsible Medicine (PCRM) reported a case study showing serious risks related to the Atkins diet [1]. For those that don’t know, the Atkins diet is the ultimate low-carbohydrate diet. WebMD explains the diet as being controversial…to say the least [2]. However, during the 1990’s, it was the diet craze…even for yours truly.

Sporting an excess 80lbs many years ago, I, too, gave the Atkins diet a shot. I vividly recall breakfasts consisting of bacon, eggs, cheese, and sausage. Um, hello cholesterol and saturated fat? It makes me ill even thinking about it today. Dr. Atkins, however, advocated for such: the ultimate low-carb diet, stating that it would improve health and memory function [2].

Let’s approach the science of the Atkins diet for just a second, because the diet does produce (temporary) weight loss. After a mere 2 ½ months, I was down 30-40 pounds. However, I’d bet just about anything that my lipid panel and blood pressure were up. Even at the ripe age of 14. The weight loss effects come from the lack of carbohydrates being consumed in the diet. The production of usable glucose: the source of energy for the body, particularly the brain, can cause serious strain on the body, especially organs such as the kidnies. Also, with carbohydrates unavailable, the body begins to breakdown it’s own fat stores, creating carbon fragments called ketones. This breakdown in the body puts oneself into a state of ketosis: the goal state for those following a low-carb diet seeking weight-loss. Ketogenic states tend to suppress the appetite which aid in producing weight loss. However, unpleasant side effects also pop-up when ketonic, such as unusual breath odor and constipation [2].

While fruits, vegetables, and whole grains are forbidden during the initial 2-week phase of the diet, they are gradually added back in. Effectively…supposedly. In my own experience, after maintaining a prolonged ketogenic state (albeit I surely didn’t know it was called that 10 years ago), the reintroduction of carbs into my diet caused major weight gain. Duh. Those 30-40 lbs were back in no time, and about 10 more joined in the following months. Please note, this was pre-nutrition education!

Low-and-behold, I got off easy post-Atkins. A case study published in the American Dietetic Association presented PCRM research on one man – a previously healthy 51-year-old now suffering from high cholesterol, atherosclerosis (hardening of the arteries), and erectile dysfunction after following the Atkins diet as discussed above. His poor wife…”unusual” breath odor and erectile dysfunction…

In one month’s time, the case study subject’s LDL (bad cholesterol) went from a health 85 mg/dl to an unsafe 154 mg/dl – a level most doctors would prescribe statins for. Eventually, the subject landed himself in the ER with symptoms of chest pain. The cause: a near total blockage of a coronary artery! For obvious reasons, the subject discontinued the low-carb diet and within 2 months had completely resolved his health problems.

If that’s not scary, I don’t know what is.

A shout-out to all the diabetics and weight-loss seekers out there: carbohydrates are an integral part of your diet – they are NOT the devil! Choose your carbohydrates wisely, however: whole grains, whole-wheat products such as rice and pasta, fruit, vegetables, and low-fat dairy.

[1]. Kraus, Peggy. Atkins Diet Blamed for One Man’s Chest Paid and Artery Blockage. Examiner, Tulsa. July 18, 2009.

[2]. The Atkins Diet. WebMD: Healthy Eating & Diet. Accessed July 21, 2009.

A glass a day keeps the doctor away?

Quite possibly.

Red wine contains a potent antioxidant called resveratrol. It is found in highest concentrations in the skin of the grape to protect the fruit from bacterial and fungal invaders. Resveratrol is also found in peanuts, blueberries, and cranberries, however the skin of the grape and long fermentation process of red wine produce the highest concentrations of resveratrol [1].

It was suggested by top Harvard biochemists that this antioxidant can extend life by activating the "longevity" gene (sirtuin), slowing the body's aging process and prolonging the development of chronic disease [2]. Research still in the works on those guys at Harvard...

Is red wine the ticket to eternal youth? I'm sure Dr. 90210 has something to say to the contrary. But, what does Mayo have to say?

Mayo Clinic supports the role of red wine in the reduction of LDL cholesterol (recall, this is the "bad" stuff), while protecting arterial walls of the heart. However, their stance on resveratrol's role on this matter remains up for dibs. There are studies out there suggestion resveratrol as the ingredient to thank, and others suggesting red wine providing no increased benefit to that of spirits or beer. Hmm...

Research confirms the role of alcohol (not just red wine) in the diet to 1) raise HDL cholesterol (the "good" kind), 2) lower LDL cholesterol (the "bad" kind), and 3) reduce the incidence of blood clots [1].

To keep things in perspective, research is performed on those with "moderate" alcohol consumption. "Moderate" consumption would be defined as 1 serving of alcohol a day for women, and 2 a day for men. Professionals do not encourage the intiation of alcohol in the diet if one abstains. Excessive alcohol intake can lead to hypertension, hyperlipidemia, diabetes, obesity, liver damage, increased risk of certain cancers, and accidents [1].

Additionally, resveratol studies have been performed on animals and the dose used to produce desired health benefits would require the consumption of 100 to 1,000 bottles of red wine to produce similar results. So, as you can imagine, resveratrol supplements were produced as to offer the public highly concentrated doses. Mayo Clinic stated in March 2009 that more research is needed to support the role and required dosing to confirm suspected health benefits of the antioxidant. But, they do state that the evidence looks good for red wine! [1]

What we know:

1. If you drink alcohol, consuming a "moderate" amoung each day may provide health benefits.
2. When you drink alcohol, red wine may be your best alternative health-wise.
3. If you don't drink, don't start for health reasons.

All good news here for this vino lover!

I suggest:
Ruffino Chianti (approx. $8-15/bottle)
Collazzi Chianti Classico ($20/bottle)
Banfi Chianti Classico Riserva ($16/bottle)

...Just for you, Mary! Salute!

1. http://mayoclinic.com/health/red-wine/HB00089/NSECTIONGROUP=2
2. http://www.cbsnews.com/stories/2009/01/25/60minutes/main4752082.shtml

“Breaded and baked is the new fried.”

...so says White House Assistant Chef, Sam Kass. And I concur.

We've all heard the term trans fat, right? That's definitely the bad stuff and has no place in any diet. The stuff is so bad there's been legal action suggesting the banning of trans fat. Not only does trans fat raise your LDL (low-density lipoprotein, i.e. the "bad cholesterol"), but also lowers your HDL (high-density lipoprotein, i.e. the "good cholesterol")! Bad deal.

Trans fats are not found in food, they're put into food through an industrial process which adds hydrogen to liquid vegetable oils to make them solid. Those french fries wouldn't taste the same without the trans fat, that's for sure. The chemistry doesn't much matter, but the danger of them is loud and clear: steer clear.

This RD loves a good french fry as much as anyone, but there's simple and enjoyable ways to enjoy the foods we love, without causing detriment to our health.

A favorite dinner in my house is "fried" chicken. Yep, that's right! My "fried" chicken is crunchy, baked, and great with BBQ sauce. While I can't take credit for the recipe, we can thank Bob Harper from the Biggest Loser for passing it along. Thanks, Bob!

Biggest Loser "Fried" Chicken

2 lbs chicken tenders
1 qt. low-fat buttermilk
2 cups whole wheat breadcrumbs
1 cup cornstarch
2 tsp. paprika
1 Tbsp + 1 tsp seasoning salt
1 Tbsp ground black pepper
1 large pinch Cayenne pepper
4 egg whites, beaten to soft peaks
Pam cooking spray

Directions:
Soak chicken tenders in buttermilk 6 hours, or overnight. Drain and blot chicken tenders to remove excess buttermilk.

Preheat oven to 325 F. Lay breadcrumbs on a baking sheet, stirring occasionally. Bake 40 minutes or until brown. This can be done ahead of time.

Increase oven temperature to 450 F. Combine cornstarch, paprika, seasoning salt, black pepper, and Cayenne pepper in a large Pyrex dish, mixing well.

Dredge chicken in seasoned starch. Next, coat dredged chicken thoroughly with egg whites. Last, dip the chicken into toasted breadcrumbs to fully coat.

Place chicken on a foil-lined, non-stick sprayed baking sheet. Lightly spray tops of chicken with Pam to add crunch. Lightly season with salt, if desired. Bake for 12-15 minutes or until outside is crispy and chicken is cooked and juicy.

Serves: 8
Per serving: 270 calories, 4 g. fat, 1 g. saturated fat, 65 mg. cholesterol, 210 mg. sodium, 27 g. carbohydrate, 2 g. dietary fiber, 4 g. sugar, 28 g. protein.

Enjoy!