Thursday, March 31, 2011

Food Trends: Artificial Food Dyes- what’s the verdict?

How about all that chatter this week regarding artificial food dyes?  Not only was this in the news, blog posts, all over my facebook but it was also a big story on Good Morning America.  The FDA’s advisory panel was to finally attend a “colorthon” for two days this week to discuss a hypothesized correlation between food dyes and hyperactivity.

Some studies have linked food dyes to hyperactivity in children and even suggest it could predispose to different Cancers.  After reviewing this evidence, the British government mandated manufacturers to display government warnings on all foods containing food dyes.  Guess what happened?  Suddenly companies were substituting beet extract in place of the red dye #40.  Fooducate ™ alerted me to the fact that Kellogg’s changed the red dye #40 in their Nutrigrain Bars to beet extract in Britain but no changes have been made in the United States. 

Although the FDA labeled food dyes such as red dye #40 and yellow #5 as generally recommended as safe (GRAS) many parents and some clinician’s recommend to stay as far away from food dyes as possible.

I myself have some personal experience with sensitivity to dyes. My three year old displayed a delayed onset allergy to red dye #3 this winter.  The onset of hives and difficulty breathing were scary for me, as I have lived with severe allergies and asthma since I can remember.  I felt I was very lucky to be a dietitian as I believe I quickly found the culprit but there really is no certain way to know if this was the issue because there is no test for a specific dye allergy.

Either way, I decided to remove all red dye from my house the day my son was put on prednisone and have not looked back.  It is worth mentioning, however, how upset I was when the pharmacy handed me a generic form of prednisone that was red. Thankfully, I asked the pharmacist to check if this was natural.  Guess what? Yes, you guessed it red dye #40.  The very nice pharmacist switched this right out for me and since then we have been hive free in this household.

Thankfully I had always chosen dye free products for my children prior to this event, , but looking through everything else was a horrifying experience.  The toothpaste, bubble bath, most flavored yogurts, Jell-o, macaroni and cheese, Tylenols, Benadryl, and most vitamins. It was a big job!

So, what came about the “colorthon?”  Well, the LA Times just published that the meeting is over and the FDA is not convinced there is enough evidence to link food dyes to hyperactivity.  They suggest further studies. As far as Cancers and food allergies, they feel the same. We need more research.

In the meantime, with my Mom hat on, I say go with your gut.  Fresh foods are always your best bets.  When looking at ingredient lists avoid any of the food colorings listed as well as annatto and tartrazine (yellow dye) and carmine (red dye).  It’s also worth avoiding anything that’s honey flavored or lists artificial coloring.  Are your children sensitive to food colorings?  I’d love to hear your story.  Be well!

Monday, March 28, 2011

Common Challenges: The Vicious Cycle of eating too little

Everybody has an individual resting metabolic rate (RMR). This is the minimum amount of calories it takes for your body to function, including breathing, absorption and digestion.  An activity factor is added to your RMR that configures how many additional calories are needed to function on a daily basis.  The more activity you engage in, the more calories your body needs to function.  Once you add the activity level to the RMR you have your total energy expenditure (TEE) or estimated amount of energy it takes to perform all activities in a day.  When your body is not getting enough of the minimal amount of calories it needs to function, your body will think its starving.  Every time your body thinks its starving it breaks down stored protein and fat to provide energy to ‘get things done.’  If this becomes a consistent event, the next times you eat your body will store all nutrients as fat to prepare itself for the next fast.  In addition, your metabolism stalls and learns how to use fewer calories to function. 

So there we have the vicious cycle.  You eat too little, your body reacts and stores your food as fat to prevent a fast, it then lowers your resting metabolic rate. You go out on Friday night to have a couple beers, eat out Saturday night and Sunday and before you know it you ate or drank three hundred additional calories each night.  This total of nine hundred calories contributes to .25 pounds a week which you might not even detect on your scale. That leads to one pound a month and twelve pounds a year.  Sound familiar?

I have many clients who have come to me ready to restrict further or exercise more to lose weight.  After we sit down and discuss daily intake and exercise habits, they are absolutely shocked when I tell them the issue is that they actually have to eat more.   When I ask most if they are hungry they usually reply no. Did you know anorexia is a side effect of starvation?

Other symptoms of eating too little are low blood pressure, gallstones, heart arrhythmias, nutrient deficiencies, hair loss, brittle fingernails, dizziness, anemia, or depression.  A dietitian is the only clinician who can recommend a calorie level to an individual. He or she is licensed and registered to do so and is trained specifically on human metabolism. Everybody’s ‘number’ is different and depends on age, weight, height, activity levels and co morbidities.

Are you skeptical? Kindred Nutrition is always welcoming newcomers into our community. It’s worth the assessment if you have any of the symptoms above, have a plateau with your weight, or just need a kick start.  Good luck and be well.

Thursday, March 24, 2011

Common Challenges: Blood pressure - What’s salt got to do with it?

High blood pressure, otherwise known as hypertension, can be a silent, chronic disease.  Blood pressure readings explain the pressure that is built upon the wall of your arteries.  The higher the reading, the more pressure you have against the wall of your arteries and the harder it is for your arteries to pump blood which puts stress on your organs.  Hypertension is a risk factor for stroke, heart attacks, heart failure, and is the leading cause for kidney failure.

Mild to moderate hypertension can go without symptoms. Since most of us only check our blood pressure at our annual physicals, many can go without a diagnosis for years.  Once the hypertension is advanced symptoms include headache, drowsiness, confusion, nosebleeds, nausea, and vomiting.  A diagnosis for hypertension is usually given once three separate readings of blood pressure are high.  It is recommended to get all readings at least a week apart along with a complete medical exam. Normal blood pressure reading is 120/80 mmHG or less.

If you’ve been diagnosed with hypertension or know someone who has hypertension there has most likely been an instruction for a low sodium diet, a very general instruction that can be hard to follow and initiate a lot of questions.  Does a low sodium diet include salt?  What’s the difference between sodium and salt? Am I supposed to watch both? I’m so confused!

Salt or sodium chloride is made up of 60% chlorine and 40% sodium.  A teaspoon of salt consists of 2400 mg of sodium.  So when you look at the food labels and you read the sodium level this also contains the amount of salt in the item.  In addition, it means that when the American Heart Association is recommending to aim for a daily intake of 1500 mg of sodium or less, they are talking about a little over a half teaspoon of salt a day.   How’s that for a visual and why are they recommending such a low intake?  Well, the more salt you eat, the more water your body retains and as your body works to excrete the excess salt from your body, your blood pressure can rise.

Here’s some quick ways you can decrease your salt consumption:
·   Add less salt when cooking
·   Avoid adding salt at the table
·   Utilize salt replacements like Mrs. Dash or Pleasonings Seasonings
·   Buy fresh or plain frozen vegetables, instead of canned vegetables
·   Use fresh poultry, fish, and lean meat, rather than canned or processed varieties
·   Buy low- or reduced-sodium or no-salt-added versions of foods
·   Limit smoked, cured, or processed beef, pork, poultry, and fish

The following foods are generally high in sodium:
Canned foods                                     Salted popcorn                        Smoked meats
Frozen dinners and meals                   Snack mixes                            Tomato sauce
Ready-to-eat breakfast cereals            Vegetable juice                       Potato Chips
Cheese                                                 Bacon fat                                Pretzels
Cured and processed meats                Salt pork                                  Nuts
Ham hock                                            Ketchup                      Mustard
Prepared salad dressings                     Soy Sauce                   Canned gravies and sauce
Canned gravies and sauces                 Barbecue Sauce           Dried gravy mixes

Now that you are familiar with a decreased sodium and salt diet, let’s talk lifestyle change. You guessed it, in addition to focusing on your affair with salt and sodium, losing weight is key. Research proves that a 5% weight loss can bring early stage hypertension back to normal range.  That is only nine pounds for someone who weighs 180. 

If you or someone you know has hypertension, it’s worth it to work with a registered dietitian.  He or she can estimate your sodium and salt intake per day and also assess if weight loss should be a priority.  Don’t wait too late; this precursor is silent and destructive.  Be well!

Tuesday, March 22, 2011

Family Nutrition: When your child is ‘failing to thrive’

There’s so much information about child obesity out in the press and media, but what if you are dealing with the opposite end?  It can be very scary as a parent to watch your little one fail to gain weight.  As you travel back and forth to the doctors waiting for the dots to appear on the growth chart a million things can go through your head.  You sit and wait and then finally get the ‘diagnosis’ failure to thrive.  What do you do next?

Failure to thrive is more of a descriptive diagnosis that is the result of an underlying condition or situation.  It’s loosely defined as the inability to gain weight for approximately three consistent months.  

What should you do with this diagnosis?  The first suggestion is to insure your infant or toddler gets a full medical exam.  You want to rule out any metabolic disorders, malabsorption disorders, or food intolerances or allergies.  Believe it or not, something such as GERD (gastroesophageal reflux disorder) can contribute to a lack of weight gain.  Infants and toddlers are smart cookies and if it’s painful to eat, they will withdraw to avoid being uncomfortable.  I also suggest asking for a referral to a dietitian or working directly with the dietitian in the office as he or she can complete a calorie account and compare to recommended needs.  Dietitian’s are the specialists for food and nutrition and are the only clinicians licensed to evaluate nutritional status and provide suggestions to nurture nutrition related conditions.

It’s also imperative to think of any changes that could correlate with a weight stability or loss.  Did your infant or toddler just start daycare?  It’s possible that they aren’t getting the attention they need at mealtime.  Are they an early crawler or walker?  They could be burning more calories than you expect and you may need to increase nutrients.   Have you recently introduced new foods?  If so could your infant or toddler have an intolerance that is causing some pain?  Speak up, all of the above are very important for your physician or dietitian to know.

A thorough medical exam and the help of a dietitian can help get to the bottom of the cause.  Failure to thrive can usually be turned around once the cause is detected but its imperative to use your resources.  Have any questions? I’d love to help provide you with an answer.  Be well.   

Thursday, March 17, 2011

Food Trends: Hooray for the FDA

I was so pleased to just read the consumer update Beware of Fraudulent Weight-Loss ‘Dietary Supplements’ posted by the FDA two days ago.  Since I’ve become a dietitian, the magic bullet supplement or diet pill industry has been a thorn in my side.  I’ve had many clients and patients over the years describe their habitual visits to GNC, the Vitamin Shoppe, or lately the internet purchasing hundreds of dollars of items that are supposed to help with weight loss, melt the fat off, or expedite the burn.  Now the FDA is speaking out and I’m thrilled. 

Not only was I happy to see this consumer update, but I learned something as well.  Did you know that federal regulators have evidence that some dietary supplements contain hidden prescription drugs that haven’t been adequately studied on humans?  The FDA also found that some weight- loss drugs still contained sibutramine, which was taken off the market in 2010 because it caused strokes and heart problems.  “We’ve found other weight-loss products marketed as supplements that contain dangerous concoctions of hidden ingredients including seizure medications, blood pressure medications, and other drugs not approved in the U.S,” quotes Michael Levy, director of the FDA.

I always remind my clients that dietary supplements are not regulated by the FDA and do not need to get any approval prior to selling products.  As suggested by the FDA, before you start taking any dietary supplement or weight loss product check with your healthcare provider or registered dietitian. 

I’ll leave you with this. “We have seen deaths associated with these weight-loss products,” adds Levy. “Make no mistake—they can kill you.”  Is it that worth it? Take a look at the full update at this link. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm246742.htm

Tuesday, March 15, 2011

Common Challenges: Pre Diabetes

In the health field arena we hear this term quite a bit as the obesity epidemic continues to soar and I was shocked to find out that the American Diabetes Association estimates that as many as fifty seven million Americans suffer from this disease, most undiagnosed.

What in the world is pre Diabetes you say?  Well it is when your blood glucose is higher than normal but not high enough to be diagnosed as Diabetes.  There are two tests that determine this, the oral glucose tolerance test and the fasting plasma glucose test.  Any of us who have been pregnant remember the oral glucose tolerance test, a challenge where you drink glucose and test blood sugar levels at different intervals up to two hours post.  Normal is considered under 140 mg/dL two hours post food. If your oral glucose tolerance test is between 140 mg/dL and 200 mg/dL you are considered pre Diabetic.  Your fasting plasma glucose is a blood test that is collected in the a.m. after fasting.  Ideally this should be under 100 mg/dL and if it is between 100 mg/dL and 126 mg/dL, you guessed it, you are considered pre Diabetic.

Research shows that without intervention pre Diabetes can turn into Type 2 Diabetes in as little as ten years.  It is also thought that circulatory and heart damage begins in early stages of pre Diabetes.  Those at highest risk are the obese population, African American, Latino, North American, Asian American, Pacific Islander, the aging population, and woman diagnosed with polycystic ovarian syndrome (PCOS).

The prominent causes of pre Diabetes are obesity and insulin resistance.  Insulin is a hormone produced to assist with glucose metabolism.  When the pancreas is unable to produce the required insulin to metabolize glucose, your blood glucose rises contributing to an increase in blood glucose.  This particular pathway is considered insulin resistance.

The good news about pre Diabetes is that the Diabetes Prevention Program Study proved that thirty minutes of physical activity a day and a weight loss of five to ten percent produced a 58% reduction in Diabetes. 

If you are overweight, have a family history of Diabetes, or have symptoms of increased thirst, increased hunger, sudden weight loss or weight gain it is worth getting your levels checked.  It is never too late to start a physical activity and weight loss regimen. Have questions? Good luck and be well.

Friday, March 11, 2011

Food Trends: The Value of NuVal ™


I learned about NuVal on Facebook.  Laugh as you may but Facebook has really become a great community for Kindred Nutrition.  I find the greatest resources here and I am always delighted to share with colleagues, clients, and friends. 

For those of you who may have not heard of NuVal yet, it is a nutritional scoring system on individual foods.  The system was developed by nutrition and medical experts and simply provides a number score for all foods in your grocery store.  The scale is 1-100 and the higher the score the better the nutrition.

In my experience, teaching and learning nutrition labels is always challenging.  I have always craved an easier method and I believe this is the answer.  Let’s look at some of the examples shall we?  Many of our pantries may be lined with Sunshine Cheeze Its which have a NuVal score of 20. Would it surprise you that Old Fashioned Kettle- Cooked Cape Cod Chips 40% Reduced Fat has a NuVal score of 31?  How about breads?  Arnold Natural Flax and Fiber bread has a NuVal score of 48 verses Sara Lee Honey Wheat Bread Sandwich who has a NuVal score of 23.

At this point, the NuVal system is active in some chain grocery stores such as Price Chopper, Food City, United Supermarkets, and some others.  It does not look like it has hit the Maryland or DC Metro areas yet but there is an option to go to the site and suggest a store or chain.  Just go to www.nuval.com/Location/suggestions.  While you are there take a look at your site.  If you like it go to Facebook and make sure to like it as there are always great tips that come up on a daily basis.

For all my relatives and friends in the New York area, check it out at Price Chopper and let me know what you think.  Be well!

Wednesday, March 9, 2011

Family Nutrition: Brinner

Isn’t serving breakfast for dinner magnificent?  Last night was one of those nights where I forgot to take ingredients out of the freezer.  I was travelling all day from client to client and my kids had long days at school followed by shots at the doctors.  They were a little grouchy to say the least and I was losing my mind.  As my hunger pains kept getting louder and louder, the last thing I wanted to do was order out.  What to do, what to do? That’s when my husband suggested using the awesome farm fresh eggs.

As you can see, my husband whipped up a quite the breakfast burrito.  A serving of each had two farm fresh eggs, an ounce of milk, two ounces of cheddar cheese, and a vegetable medley of asparagus, mushrooms, and tomato.  Boy was it good!  I topped it off with Frank’s original Red Hot and my husband topped it off with salsa.  We also had one cup of fresh strawberries as a side which was perfect to the palate.  All in all I estimate this dinner to contain about 410 calories, 360 for the burrito and 50 for one cup of strawberries.  Not only are the calories reasonable but you are getting a great source of protein and vitamin D from the eggs as well as fiber from the whole wheat wrap (This Santa Fe wrap had 7 grams in one serving) and vegetables.  Add a glass of skim milk for an additional 80 calories and you are gaining more protein, vitamin D and Calcium.
                                                                                                       
This concoction is great for your kiddos too.  I suggest giving your toddlers a half of a burrito and sneaking as many vegetables in as you possibly can.  Go ahead and try this recipe on your family and let me know how you like it. Good luck and be well.

Monday, March 7, 2011

Common Challenges: Quick ideas for 500 calorie dinner meals

Ideas for 500 Calorie Dinner Meals

Every evening at dinner time I feel hungry, rushed, and discombobulated.  Frankly, I’m a complete mess.  The day is unwinding, my children are tired and starving, and I keep going through the list in my head that I didn’t get completely finished.  Most of my clients voice that they feel the same way with the addition of the considerations of likes and dislikes of the family they are cooking for or eating with.

I always think a great rule of thumb is to keep a meal less than five hundred calories with snacks fewer than two hundred.  Here are some examples of some five hundred calorie dinners I put together.  Take a look and try them out.  Are you surprised by the amount of food? Do you think you’d be able to feel satisfied with these?  Good luck and be well.
Day 1  Calories
5 oz baked chicken breast
125
K.C Masterpiece Honey Terriyaki Marinade 1.5 T50
1/2 cup brown rice

160
1 1/2 cup green salad
50
1 T Italian Dressing

45
1 T  sunflower seeds (on salad)
50



0










Total480
 
Day 2  Calories
5 oz Baked Salmon
227
Dill Herb Seasoning 3/4 tsp10
1 tsp butter on fish
45
1/4 cup cous cous
40
1 cup sauteed spinach50
1 tsp olive extra virgin olive oil45
1/8 cup sliced almonds (sauteed with spinach)85
Salt to taste
0



0


Total502
 
Day 3  Calories
1 cup whole wheat cooked spaghetti160
1/2 cup generic spaghetti sauce80
3 ounces of 95% Lean Ground Beef150
2 tsp Parmesean Cheese
30
1 1/2 cup green salad
50
1 T Italian Dressing

45












  Total515
 
Day 4  Calories
5 oz Generic Turkey Meatloaf225
1 T ketchup
15
1cup steamed fresh green beans50
1 tsp butter
45
1/2 cup Mashed Potatoes80
8 oz skim milk
85












  Total500
 
Day 5  Calories
2 C Low fat Turkey Chili
200
1/2 T Daisy Sour Cream
15
1/4  2 % shredded cheddar cheese80
1 1/2 c green salad

50
1 T Ranch Dressing

80
1/4 Avacado (on salad)
75




  Total500
 
Day 6  Calories
4 oz london broil
200
1 Tablespoon Italian dressing (marinade for above)45
1 1/2 green salad
50
2 T blue cheese crumbles70
1 T Balsamic Vinegar45
1/4 avacado
75




  Total485
 
Day 7  Calories
5 oz pork tenderloin

150
1/4 cup cream of mushroom (on pork)50
1 cup brocolli

50
1 tsp Parmesean Cheese (on brocolli)15
Medium Baked Potato
110
1 tsp butter

45
8 ounces of skim milk
85








  Total505

Thursday, March 3, 2011

Food Trends: Say Heck No to HCG

It is my opinion that the topic of nutrition is like politics.  Everyone thinks they know a lot about it, and for the most part people do know the basics, but when it comes down to the need to make individual change, there’s a lot of talk and little visible action.  This is why for the most part when strangers, friends, and even family speak of nutrition; I keep my mouth shut unless it’s worth discussing.  It is not my desire to come off as a no it all even though the amount of organic chemistry, biochemistry, and anatomy I’ve ingrained in my head far outweighs most of the general public or that my years of experience proves results with many clients.  I am mostly happy that people are interested in the subject and always very interested in what’s out there.  Still, at the end of the day 65% of the United States is still overweight with one third being OBESE. 

So it is not unusual, that I have been relatively quiet on the HCG ‘diet’ except for a couple of conversations with my dietitian colleagues and friends.  I have to say though, I’ve had enough and my usual unbiased opinion has been left at the door today.  This ‘diet’ is in the newspapers, on the news, we have a wellness center in the DC Metro area that has been featured in Groupon promoting this diet, and I just can’t be silent anymore.

I will always stand by my statement that if a diet, lifestyle plan, what have you looks like a pill, is advertised as easy or the answer, or is mega bucks, it’s a Fad diet and that my friends, is exactly what this diet is all about.  Not only is this diet a Fad diet but it is dangerous and my recommendation is to avoid it at all costs.

The diets name hCG stands for human chorionic gonadotropin hormone which is made by a developing embryo after conception.  It basically helps protect and nourish the womb during pregnancy.  It is used clinically to induce ovulation in the ovaries, testosterone in the testis, and has even been suggested that some levels can be the culprit inducing morning sickness in pregnancy.  Clients either take injections or topical creams of hCG or combine it with a very low calorie diet mostly 500 calories a day, sometimes 800 calories a day.

Let’s remove the hormone from the equation and talk about the 500-800 calories. This is extremely low and will result in a constant vicious cycle of your body feeling starved for energy.  Your body will breakdown every single nutrient it can to provide the energy it needs just to survive, including the very important muscles your organs need to function properly. 

I am appalled that Dr. Oz mentioned he thinks it’s worth a try under physician supervision for people who don’t have another option.  Why would a physician ever recommend something this dangerous over something that is approved by the FDA or provides positive research with proven results?  To this day hCG has not been approved from the FDA for dietary usage and has described as fraudulent and illegal.  The FDA also bans direct-to-consumer-sale but since hCG is on the market for other therapies, it is still being prescribed for ‘off label’ uses.

At the end of the day, I suggest avoiding this diet at all costs.  Losing weight is hard work.  It first takes a commitment, then a specific plan with measurable goals, and requires a lot of support, but if you do it the right way the rewards outweigh the hard work you endure.  Do you know anyone who has tried this diet?  What are your thoughts?  Be well!

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