Out with Vit C - In with Vit D!

A new study published in Archives of Internal Medicine reports that "higher levels of vitamin D may protect against the common flu and cold".

This study found that among 19,000 adults and adolescents, people who had the lowest blood levels of vitamin D were 40% more likely to have recently experienced a cold or flu. The authors of this study also noted that low levels of vitamin D were linked to even higher risk of respiratory complications in those who suffer from chronic respiratory disorders (asthma, emphysema, and chronic obstructive pulmonary disease).

http://archinte.ama-assn.org/cgi/content/abstract/169/4/384

Although further studies are needed to confirm this observation, it certainly contributes to the list of potential health benefits linked to this immune fighting vitamin!

Note to my friend with pneumonia: Another reason to take those vitamin D pills !!

Shocking salads!

Brace yourself for this rant...bad salads ! Yes, we know they exist, but seriously, did we know they were this bad ?
Some examples....

T.G.I. Fridays Pecan Crusted Chicken Salad = 1,360 calories (company does not provide the nutritional information on total fat, saturated fat, or sodium)

99 Restaurant Crispy Honey Mustard Salad = 1,160 calories, 74g total fat, 18 g saturated fat, 2110 mg of sodium. This is 114% the daily value (DV) for total fat, 90% for saturated fat, and 88% for sodium (based on 2,000 kcal intake).

Cheesecake Factory Lunch Caesar Salad = 860 calories, 10g saturated fat, 861 mg sodium. If you order the regular size salad you double these values.

I'm not suggesting you 'throw the baby out with the bathwater'!. When you order a salad, ask for the dressing on the side, skip cheese, bacon, croûtons and anything that's crunchy and not a vegetable. Sound less appetizing ? It is. An alternative suggestion, go with grilled fish or chicken, steamed vegetables, and rice or 1/2 baked potato (eat the skin, easy on the butter). Or as my husband likes to point out "Order what you want to eat because I'm not sharing". I have a tendency to order what I perceive to be healthier, and then I end up eating the food from my husbands plate. I admit, it is a very annoying habit. So now I order what I want to eat, and I try to eat only a third, or a half of what is on the plate. I find this degree of 'self control' very difficult because I grew up in a household where you had to eat everything on your plate (sorry, side tracking).

Back to the topic...

So why all the secrecy over what's in a meal ? Isn't it time for "full disclosure and transparency" ? Shouldn't customers be provided with the information they need to make informed choices about what they eat? Finally, change is on the way. Last week, a federal appeals court upheld the regulation in New York requiring that some chain restaurants post calories on menus and menu boards, saying the rule is a reasonable effort to curb obesity. Other states have passed similar bills (California and Philadelphia). Personally I fully and whole heartily support this regulation - curbing weight gain starts with knowing what is on the plate !

And for dieters trying to lose weight, keep this cartoon in mind and ask yourself "does it taste too good to be true?" http://www.cartoonstock.com/newscartoons/cartoonists/tbr/lowres/tbrn148l.jpg

Just think, one day we will be sharing this story with our children "when we would go out to dine in restaurants, we'd have absolutely no idea what we were eating ! Not a clue !!". Or at least I hope we will be sharing this story...

Take the Calcium Quiz

You can do this for your entire family, ask them to answer yes/no to a series of questions about what they ate yesterday. Its not an exact, valid screener of habitual calcium intake, but it will give you a good indication if you are even close to meeting your daily calcium needs.

It produces a nice graph that you can show your child. This will help you illustrate how they fair with respect to reaching their calcium needs. It also gives you some good ideas on how you can increase the calcium in your diet.

http://www.dairycouncilofca.org/Tools/CalciumQuiz/Default.aspx?action=quiz

Random Facts

Here are my 7 random facts of the week:

1. To burn off 250 calories from a 20-ounce bottle of coke, or a 250 calorie candy bar, a 135-pound woman would have to walk three miles in 45 minutes or play vigorous basketball for 40 minutes. Yikes ! Oh no, the same would go for those 2 glasses of wine !
   
2. Studies in older children have shown that eight to 15 repeat exposures to a new food are necessary to enhance acceptance of the food (Birch et al. 1995;Young Children;50:71-78; Skinner et al. 1998:30;17-22)
3. Eat a handful of almonds daily - they are an excellent source of vitamin E and magnesium, a good source of protein and fiber, and provide potassium, calcium, phosphorous, iron, and monounsaturated fat.
4. Cheerios is one of the better breakfast cereals on the market for children with only 1 gram of sugar and a healthful 3 grams of fiber per serving.
   
5. Check out MyPyramid for Preschoolers Web site (http://mypyramid.gov/preschoolers/). This gives advise to parents on how to make mealtimes stress-free for children by talking about fun things, encouraging children to try new foods without forcing them, and cooking together. I'll let you know if I can fit this into my crazy schedule! Mealtimes fun ?? I'm not a believer.
   
6. The Centers for Disease Control and Prevention (CDC) reported approximately 3 million U.S. children and teenagers under age 18 – or nearly 4 percent of that age group – had food allergies, compared to just over 2.3 million (3.3 percent) in 1997. This is an 18% increase. The CDC also found that children with food allergies were more likely to have asthma, eczema, and respiratory problems. Although not part of the study, the most common foods (that account for over 90% of allergic reactions in affected individuals) include milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. For more information go to www.cdc.gov/nchs/data/databriefs/db10.pdf
7. Afternoon cup of green tea anyone ? There are so many health benefits associated with drinking green tea that it will be its own posting on this blog in the near future. The secret of green tea lies in the fact it is rich in catechin polyphenols, particularly epigallocatechin gallate (EGCG) which is a powerful anti-oxidant (prevents or slow the oxidative damage to our body).

Calcium needs of children

Calcium is the most abundant mineral in the body. More than 99% of total body calcium is stored in the bones and teeth and the remaining 1% is found throughout the body in blood, muscle, and the fluid between cells.

Calcium has several important functions, for example

• It is vital in the construction, formation and maintenance of bone and teeth.
  
• It is an essential component in the production of enzymes and hormones that regulate digestion, energy, and fat metabolism.
• It maintains all cells and connective tissues in the body.
• It is a vital component in blood clotting systems, helps in wound healing and may prevent gum disease.
• It is involved in blood pressure control, nerve transmission, and release of neurotransmitters.
• It is essential for muscle contraction.

In the US, more than 60% of dietary calcium comes from milk and dairy products. Adequate dietary calcium intake during growing years is critical for the accretion of peak bone mass, which protects against osteoporosis later in life. The U.S. Department of Agriculture's Food Guide Pyramid (http://mypyramid.gov/) recommends that children two years and older eat 2-3 servings of dairy products per day. A serving is equal to:

1 cup (8 fl oz) of milk
8 oz of yogurt
1.5 oz of natural cheese (such as Cheddar)
2.0 oz of processed cheese (such as American)

Dairy products are the most concentrated food sources of calcium (e.g. one cup of milk contains approximately 271 mg of calcium). But what if your child/adolescent doesn't drink milk or is lactose intolerant, how do they meet their calcium needs ? In this case you need to consider other sources of calcium, for instance:

Calcium-fortified orange juice is a very good source of calcium, however because the calcium settles on the bottom of the carton, you need to ensure you shake it before pouring. Since most children require more vitamin D in their diet, choose an orange juice that is fortified with vitamin D as this will help improve calcium absorption. You may be inclined to think that giving your child several servings of juice is the solution to their calcium needs. As parents we need to keep in mind that excess juice intake may provide excess calories in the diet of our children. The American Academy of Pediatrics' recommendation is that children over the age of 7 years limit their juice consumption to 2 servings per day. So while calcium-fortified juice provides a useful alternative to dairy as a calcium source, drinking too much orange juice is not recommended.

Canned fish, such as salmon and sardines, are excellent sources of calcium. A single sardine contains 92 mg calcium, while a 3 ounces can of salmon (with the bones) contains 181 mg calcium. OK, this is great except I can't imagine too many children eat sardines. Perhaps we will have better luck with salmon, hmm.....not so sure they'll eat the bones !

Next idea...

Calcium fortified soy milk, (note, natural soy milk is not a good source of calcium, it needs to be calcium-fortified), is an alternative to dairy milk. Again, sedimentation of the calcium occurs so you need to make sure to shake the carton. One report (1) found that unshaken samples of soy beverages had only 31% of the expected calcium and there is some concern regarding whether the absorption of calcium in these products is the same as that of dairy milk. But it is a good alternative to dairy if your child does not drink milk.

Processed foods such as ready-to-eat breakfast cereals contain calcium. If the food label states the product contains 10% of calcium on the label - this is equivalent to approximately 100 mg of calcium.

Other foods that contain modest amounts of calcium include citrus fruit, dark-green leafy vegetables (chinese cabbage, kale, collard greens and broccoli), nuts/seeds and peanut butter.

If your child doesn't eat dairy products, will they have an adequate intake (AI) for calcium?"

First of all, lets review the AI for calcium:

500 mg for children aged 1 to 3 years
800 mg for children aged 4 to 8 years
1,300 mg for children aged 9 to 18 years.

One study (2) conducted in children aged 9 to 15 years found that an adequate intake (AI) of calcium could not be met if the child was eating a dairy-free diet and so they recommended that calcium-fortified foods should to be included in the diet. Ideally, calcium fortified juice or soy milk should not be a substitute for dairy milk. However, given that only 25% of boys and 10% of girls are getting enough calcium in their diet, its a welcomed solution for parents.

References:
(1) Heaney, R. (2006). Journal of the American Dietetic Association; 106 (11); 1753-1754.
(2) Gao et al. (2006) Journal of the American Dietetic Association; 106 (11); 1759-66.

A good point worth posting....

Because it's school vacation week I haven't had any opportunity to write, but I have been doing lots of reading in the evenings. It's sad, but true, that I've been reading a journal supplement entitled "Obesity: etiology, treatment, prevention and application in practice". I came across a statement by one of the experts in the field that I wanted to share with you. It's about obesity and how we assume that energy balance is a simple concept i.e. energy intake is what we eat, energy expenditure is what we burn through physical activity and just being alive and, if we do gain weight, it's because we are eating more than we burn off. This expert states:

"Another limitation of the concept of energy balance as the cause of obesity is the implication that if one is getting fatter; it is one's fault. One need only to control his or her energy intake and energy expenditure to control the problem. This implies that we should blame our children for their obesity. This seems grossly unfair. If obesity were easily controlled by moderating energy intake, the US military would not discharge up to 5,000 men or women yearly for failing to meet its weight standards. If loss of livelihood is not sufficient motivation to lose weight, then the problem must be more complex" (Bray & Campagne, 2005; ADA;105:S17-S23)

Like every other chronic disease, obesity is a complex condition. We need to consider genetics, the effect of drugs, intrauterine events, and disease conditions. In the US, dietary patterns have changed in the past 30 years - excess calories from dietary fat and high fructose corn syrup are major contributors to weight gain. As a society we are exercising less, working more and dare I say it, not taking 'time out' from our busy schedules like our ancestors. For most people, excess energy intake, or lack of physical activity, is the cause of weight gain, but health professionals should keep an open mind regarding the cause of weight gain in patients.

Cookin' with Google

I was so excited to come across this website:

http://www.researchbuzz.org/wp/tools/cookin-with-google/

Cookin' With Google allows you to find a recipe based on a list of ingredients that you may have in your fridge and cupboards. Ingenious!

I typed in "chicken, garlic, asparagus" and Google directed me to several cooking sites. Some of the suggested recipes included:

Penne with Chicken and Asparagus
Garlic Chicken With Asparagus and Mushrooms
Lemon-garlic Chicken Asparagus And Potatoes

It gets better! Vegetarian, diabetic, and gluten-free options are also available! I'm sure some of you are reading this and thinking "eh, welcome to the 21st century!"

This reminds me of a story. A couple of years ago, an older relative was sharing her thoughts with us on what to expect in the future. With an expression of certainty she announced, "one day you'll be able to work on your computer and it won't even need to be plugged in". I didn't have the heart to say "I'm sorry to tell you but that day is here". I guess sometimes everyone needs to feel they're ahead of the game, or at least still on the playing field, so please, don't bench me. I'm just so excited to find out that I can use what is in my fridge and come up with a meal plan.

Random Facts

I plan to make this a weekly feature - nutrition/health facts that are being published in popular magazines (NOT TABLOIDS!). I'm thinking more along the lines of Prevention, Shape, Self, Mens Health etc. What's my motivation ? It's what people read, some facts are true, others may be exaggerated, but the bottom line is these facts are more likely to influence peoples thoughts and behaviors that advice given by their Doctor!

My friend Kate (pointyuniverse.blogspot.com) wrote a great piece about how we change every 7 years, and this motivated her to come up with a "7 Songs of the Day" playlist. As Kate knows, I'd be lucky to come up with 7 songs in one year! I don't know the artists, or the words, and to the annoyance of my husband I make up words of songs and belt them out as if I'm auditioning for American Idol ! So Kate, the best I can do is come up with 7 random nutrition/health facts !

1. Consumer Magazines Digest interviewed 21,000 subscribers about their lifetime weight history and their eating, dieting and exercising habits. They found 6 behaviors were linked to a healthy weight. The most important - portion size. The others: limit fat, eat fruits and vegetables, chose whole grains over refined, eat at home and exercise, exercise, exercise (Feb, 2009).
2. In 1969, 50% of children walked to school. Today, only 15%. (Parenting,2007)
3. To calculate the number of teaspoons of sugar in a product, look at the sugar on the label and divide by 4 ( one teaspoon of sugar equals 4 grams).
4. Upsizing your fast food meal from a medium coke and fries to a large of both only costs 17% more but the increase in calories is 55% (Mens Health, 2007).
5. In a recent study, 27% of people who said they would opt for fruit over a sweet treat actually reached for the indulgence when given the choice a week later (Self Magazine, 2009).
6. The average serving of a bagel is a 5-inch, but one portion of grains is actually one half or a 3 inch bagel. So eating a bagel should count as 2 servings of grains.
   
7. Soda accounts for 33% of the added sugars in the American diet.

Please send along any facts you may come across while flicking through your favorite magazines !

Out of my comfort zone...

I dislike tabloid papers for obvious reasons but today I really hate them. Lets take this weeks poor victim - Jessica Simpson. On one hand I am outraged to read headlines like "Jessica Simpson and her fat pants" or "weighty issues for Jessica". And on the other hand, I'm concerned for teens reading this trash and believing that JS is fat! What effect does this have on teenage girls who are overweight? Or what about the girls who have distorted body images, how does this effect them? Jessica may have gained weight but she is a healthy weight. Do teenagers get this?

I asked one teenager, what do you drink at school? (back to the beverage issue!). Her response was "Arizona Iced Teas - about 3 a day". I could have told her all the reasons in the world why it would be better to drink water, but the bottom line is she likes these drinks. How do we talk to teens about making healthier choices ? On one blog I was asked about teens drinking coffee drinks and the effect of caffeine on their growth. I need to research this topic a little more, but I'm wondering, if we told our teens "drinking caffeine will stunt your growth" - would they care ?? I don't have answers to these questions.

As adults, we know that if we eat a lot of saturated fat for example, our cholesterol goes up and we may experience a heart attack sooner rather than later. The 'cause' and the 'effect' of eating unhealthy becomes clearer as we age. For most teens its about how they look, so talking to them about how they look, or how they think they look, and how this makes them feel is the important issue. If they are overweight, how do we help them ? As parents we need to take an active role in this step - provide healthy foods, prepare meals and work out with our teens. I am sure this is easier said than done !

I'm definitely out of my comfort zone when it comes to the mind of teenagers. I have no idea what they think about body weight and health issues. Any teenagers reading, or parents of teens, please share your thoughts !

Question Everything

This week I was asked the following question: "I am pregnant and I was wondering if you have any good suggestions on how I can increase my iron intake? I am allergic to salmon, I don't eat meat, and the multivitamins are making me sick"

First of all, congratulations on your pregnancy! Second of all, I suggest you check with your physician regarding the nausea you have experienced from taking your multivitamin. Perhaps he/she will have some suggestions on how you may be better able to tolerate the 'horse pills' (as I called them!).

With respect to iron, dietary iron exists in two different forms:
Heme iron which is found only in animal sources (beef, pork, poultry and fish) and non-heme iron which is found only in plant foods (fruits, cereals, legumes, nuts). Heme iron is more easily absorbed compared to non-heme iron. Absorption of iron is further complicated by the fact that some dietary factors help its absorption, while others hinder it. For example, coffee and tea are strong inhibitors, while vitamin C is a strong stimulator of iron absorption. And consider this fact, at most, only 30% of a foods iron content is absorbed by your body.

So assuming you don't eat meat or fish, what are good sources of non-heme iron ?

Lentils, chick peas, baked beans, dried figs & apricots, pumpkin seeds, tofu and fortified, ready-to-eat breakfast cereal. Check the label on the package for the percentage (RDA) of iron in a specific breakfast cereal. Also keep in mind that pasta, white rice, and most breads made from refined flours are enriched with iron, because iron is one of the nutrients lost in processing, however, these are not considered the riches sources of iron.

Iron is an essential nutrient because it is a central part of hemoglobin, which carries oxygen in the blood. Pregnant women require more iron to cope with the metabolic demands on pregnancy. Once you enter the third trimester your own iron stores begin to diminish and many women have difficulty maintaining their iron stores. For this reason the Centers for Disease Control and Prevention (CDC) recommends a routine low-dose iron supplement (30 mg per day) for all pregnant women. If you have a difficult time taking it at once, I suggest you cut the dose in half and take with a glass of orange juice twice a day. Orange juice boosts your absorption of iron! Good luck.

Don't Drink Your Calories! (Part 1)

This topic, "Don't Drink Your Calories" will be the first of many, because quite frankly I think most people are unaware of how many calories they can 'potentially' drink. Today, our supermarket aisles are packed with soda drinks, energy performance drinks, and vitamin enriched waters! And then we have the coffee drinks - the Caffè Lattes, the Coffee Coolattas, the Frappuccinos (with or without a twist, lite or not). Oh, and lets not forget the shakes!

This summer I asked my niece and her three teenage friends if I could get them something from an unnamed coffee establishment. I seriously had to ask the girls to repeat their coffee order 3 times ! This caused my anxiety level to increase, and by the time I ordered their drinks I mixed up the coffee part of the order, but I did remember the whipped cream! I recall thinking, these drinks are more like desserts. I did wonder how teenagers view them - as drinks or desserts?

I'm not saying that all drinks are equally bad and should be completely avoided from ones diet (I'll come back to this in other posts). I recognize that every individual is different, their caloric needs are different, their food preferences are different, and their body weight is different. I think making informed choices about what we drink and eat is a personal decision. But here is where I see the problem (please weigh in on this) - I think most people are clueless as to how many calories they actually consume daily from beverages or ice-cream based drinks. Let me give you an example.

If you were to guess how many calories are in a large Baskin-Robbins Chocolate Oreo shake (which by the way is 32 oz), what would you guess ? (I wasn't even close!)

2,600 calories.

And the saturated fat?
59 grams (and note, this is not total fat)

My husband brought this to my attention when he read about it in last weeks Boston Herald. http://www.bostonherald.com/business/general/view.bg?articleid=1148553

And lets be honest - it is shocking!

It raises questions.

If people drink their calories, do they displace other calories from their diet?(in this case avoid eating for the rest of the day!).

Does the average person know how many calories they are drinking?

If the nutrition information is posted - do they care?

Certainly some questions to ponder on ...

So why do I get all fired up about drinking calories? Some facts....

• The obesity epidemic exists across all age groups in the US - children, adolescents and adults.
• In 2006, 16% of children and adolescents, aged 2-19 years, were obese (i.e. at or above the 95th percentile on growth charts).
• In 2005-2006, 33% of adult men and 35% of adult women were obese.
• Both the portion size and the number of caloric beverages people consume has increased over the years.
• Excess calories from beverages leads to weight gain.
• The national costs attributed to both overweight and obesity are in the order of $90+ billion
• Approximately half of these costs were paid by Medicaid and Medicare.
• Obesity rates continue to rise in the US.
  

Topic to be continued...