Something to Chew On

A Guide to Eating Right and Living Well


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Guest Blogger : Belly Fat and Your Risk of Chronic Disease

Watch Your WaistDo you have more than an inch to pinch? When you look down, have the tips of your toes disappeared? If so, you might want to measure your belly fat, which can increase your risk for chronic disease.

According to an article by Mayo Clinic staff; it is common for “belly fat,” also known as visceral fat, to appear after menopause due to low levels of estrogen. It is estrogen that influences where we store fat in our body. So let’s measure our risk! Determine your waist circumference by locating the top of your hip bones. Use a measuring tape from this point to pull snug, but not so much to compress your skin. Run the tape around your middle; take your final measurement when you exhale.

Now that we’ve measured our “belly fat,” let’s discuss why it may not “just be a cosmetic concern.” You should know that “belly fat” can increase inflammation and produce hormones that raise blood pressure, negatively change the balance of good (HDL) to bad (LDL) cholesterol and promote insulin resistance, a risk factor for developing diabetes.

As a registered dietitian, I encourage people to improve their health through good nutrition and physical activity. Shed those extra pounds to avoid complications associated with “belly fat” and the “bad stuff” it creates. Eat foods that help you feel full, such as whole grains and high fiber foods like peas, dried beans and lentils. To expand your antioxidant arsenal without adding extra calories from fat, enjoy fruit and non-starchy vegetables. Great choices are berries, cherries, apples, carrots, tomatoes and dark green, leafy vegetables!

We all need to consider the effect chronic disease has on our body, but people with a genetic risk for diabetes also need to worry about the damage high blood sugars can cause to the eyes, kidneys and feet. A decrease in “belly fat” may help to reduce these effects.Woman on Exercise Machine

Other concerns for those with diabetes
In addition to a healthy diet, be as physically active as possible. In general most of us should be at least moderately active. Moderate activity is defined as being physically active at least 150 minutes per week. This level of activity could be met by walking 30 minutes, 5 days a week.

Talk to your physician about the importance of maintaining adequate vitamin D levels. Low vitamin D is associated with a 30% to 50% increased risk for breast cancer. Remember, some of our best defense can be found in “super foods” such as broccoli, cauliflower, cabbage, cranberries and green tea. You could also add ground flaxseed to your cereal or have a moderate amount (1-2 servings a day) of soy or tofu. Did you know certain brands of mushrooms are a great source for vitamin D?

Please know, current literature is still mixed about the impact of plant estrogens in people with hormonally sensitive cancer of the breast, ovaries or prostate. Speak with your physician about this topic and practice caution with the use of phytoestrogen supplements, soy powders and capsules, as they could be linked to recurrence of cancer. As with all medical nutrition recommendations, individualization is essential. Speak with a registered dietitian today if you have more questions about healthy eating for disease prevention.

Schleder, Missy RD

Melissa S. Schleder
Registered Dietitian, Springfield Clinic Endocrinology
Resources:
http://www.nutritioncaremanual.org ; http://www.mayoclinic.com ;
http://www.aicr.org; http://www.aicr.org/foods-that-fight-cancer ; http://www.uptodate.com


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Cholesterol Month – Part 3

heartexerciseThe final two factors of cholesterol: physical activity and weight.

Physical Activity

  • Daily physical activity helps reduce the risk of heart disease and can also help with weight management. It can help lower the bad cholesterol (LDL) and additionally boost your good cholesterol levels (HDL). Exercise helps speed up the rate that LDL molecules are sent back to the liver to be turned into bile salts or excreted. Aim for at least 30 minutes of physical activity on most, if not all days. Additional physical activity may be needed for weight loss/weight management. Any exercise is better than no exercise; however, research indicates that exercise performed at higher intensities may be more effective at lowering LDL cholesterol levels and additionally raising the good HDL levels.
  • Find an activity that you love, or even several activities so you can vary up your routine. A combination of strength-training and cardio exercises has shown to be very beneficial for reducing risk factors for heart disease (weight loss, lowering blood pressure and lowering cholesterol levels).
  • Exercise alone cannot guarantee one will not have high cholesterol. Diet and genetics also play very strong roles in determining one’s cholesterol levels. However, additional benefits observed from being physically active include bone strength, mood improvement, stress management and can decrease the risk of diabetes, cancer and stroke.  heartplate

Weight

  • Being overweight/obese is an additional risk factor for heart disease. Weight gain also tends to increase cholesterol levels. Losing weight can help decrease LDL, triglycerides and total cholesterol levels and help increase HDL levels.
  • Losing just 5-10% of body weight can show improvements in cholesterol levels. Consuming 500 less calories every day can help you lose 1 pound per week. You can even combine this with exercise by consuming 250 less calories every day additionally to burning 250 calories from exercise. Easy ways to cut down on calories include:
    • Eliminating soda, sweet tea, juice or other sugary-sweetened beverages.
    • Using one slice of bread instead of two.
    • Limiting cheese consumption.
    • Avoid snacking while at the computer/watching TV.
    • Swap your potato chips or pretzels for carrots, bell pepper slices and celery sticks.
    • Choosing a side salad instead of a side of pasta or potatoes.

Sometimes, diet and lifestyle are not enough to lower your cholesterol levels to a safe range. Your doctor may prescribe a cholesterol-lowering medication. Always take these medications as prescribed. Additionally, consult with appleheartfruityour physician if you are considering taking an herbal supplement to decrease your cholesterol levels. In many cases, the safety of these supplements has not been proven since their dosage amounts are unregulated.

Click here to see parts 1 & 2 of this blog series.


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Cholesterol Month – Part 2

Diet:

  • Limit saturated and trans fats.
    • Saturated and trans fats are found in fatty or fried meats such as: bacon, sausage, hotdogs, bologna, pepperoni, salami, poultry skin, fried chicken, fried pork tenderloin and fried fish.salmonheart
    • They are also found in whole milk products, high-fat cheese, ice cream, butter, cream, margarine and lard.
    • Foods made with hydrogenated oils (pizza and other packaged food items), candy bars, crackers, chips, pastries, doughnuts and muffins are additional ways these bad fats can be found in our diets.
    • Take Away Message: Try to avoid/limit red meat, fried foods, processed pastry/bakery items and dairy products made with whole milk.
  • Limit total amount of fat that you eat (good and bad) to 25%-35% of the total calories you eat.
    • Even if you’re not a calorie-counting whiz, the simplest way to accomplish this is to stick to heart-healthy fat sources such as: fish, nuts, seeds, peanut butter, avocados and olive oil and limit/avoid the sources of unhealthy fats.
    • A small popcorn from the movie theater contains 42 grams of fat, which would be 25% of total calories for a person following a 1500 calorie diet. Here’s an example of a healthier way to incorporate fat into the diet: Try adding ½ medium avocado (15 g) with breakfast, 1 Tbsp of peanut butter (8.5 g) with a snack and 4 oz of salmon (12 g) with dinner to create nutritious, well-balanced meals.
    • Become more familiar with reading food labels  and utilizing online resources for finding fat content of foods. A great website is www.calorieking.com for finding nutritional information on foods and menu items. This is very useful when dining out or ordering in! Pizza is a very common source of unhealthy fats in our diet. Two slices of pepperoni pizza plus garlic dipping sauce contains 37 grams of fat.
  • Increase Omega-3 fatty acid intake.
    • This recommendation goes right along with choosing healthier sources of fats in one’s diet. The benefits of omega-3 fats go well beyond heart health. They can also help with reducing inflammation and supporting eye and brain health.
    • Omega-3 fats, specifically Alpha-linolenic acid (ALA) are found in canola, soybean and flaxseed oil.
    • The most potent sources of omega-3 fats include salmon, albacore tuna, mackerel and sardines (EPA and DHA sources).
    • Ground flaxseed and walnuts (ALA) are two wonderful ways to incorporate omega-3 fats into your diet, especially if you are not a fan of fish.
    • The American Heart Association recommends that people with heart disease get 1 gm of omega-3 fatty acids from a combination of EPA and DHA per day. Consult with your physician before adding a fish oil supplement into your regimen as this may have possible interactions with other medications.
  • Increase dietary fiber intake to at least 20-30 grams per day.
    • Fiber is Mother Nature’s cholesterol lowering medication. While total fiber is very important, try to include sources of soluble fiber into your daily intake.
    • Soluble fiber is found in oats, oat bran, kidney beans, broccoli, ground flaxseed, apples, bananas and potatoes with the skin. It is also added in fortified fiber products such as Fiber One and Fiber Plus cereals and snack bars.
    • Fiber is only found in plant-based foods; fruits, vegetables, nuts/seeds, beans/legumes and whole grains. When choosing a grain (pasta, bread, cereal), make sure it is made with 100% whole wheat or whole grain. Barley, quinoa and brown rice make great choices too. Focus on filling ½ your plate with fruits and/or vegetables. Add nuts/seeds to salads, cereals or simply enjoy them by themselves.

Patients often ask me, “But Amanda, I don’t eat fried foods and I never eat red meat; why do I have high cholesterol?” In many cases, it’s not a matter of consuming too much of the bad stuff, it’s that you may not be consuming enough of the good stuff, specifically the omega-3 fatty acids and enough fiber.

Read part one of Cholesterol Month here!cholesterol colors


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When In Rome: The Mediterranean Diet

While skipping off to the coasts of Greece and Italy may seem like a fantastic idea, a less expensive option may be to bring the Mediterranean style of eating into your home. Research consistently shows that following the Mediterranean diet can help reduce one’s risk for developing heart disease, diabetes and possibly degenerative cognitive disorders like Alzheimer’s disease.med pyramid

Principles of the Mediterranean diet include:

  • Consumption of fruits and vegetables, whole grains, fish, chicken and eggs, beans and nuts, olive oil and small amounts of dairy.
  • Regular daily physical activity.
  • Family meal times.
  • Focus on plant foods and minimal consumption of red meat and processed foods and beverages.
  • Increased use of herbs and spices, not condiments to flavor foods.
  • Diet low in saturated fat with olive oil as the main fat source.

Foods to include on your next grocery list:

Vegetables

  • Tomatoes
  • Broccoli
  • Spinach
  • Artichokes
  • Red/green peppers
  • Mushrooms
  • Fresh green beans
  • Eggplant
  • Zucchini
  • Mustard/collard greens
  • Squash
  • Olives
  • Onions
  • Sweet potatoes

Fruits

  • Apples
  • Bananas
  • Melons
  • Blueberries
  • Strawberries
  • Raspberries
  • Pomegranate
  • Peaches
  • Plums
  • Oranges
  • Kiwi

Fish/Poultry/Dairy

  • Salmon
  • Shrimp
  • Scallops
  • Tuna
  • Tilapia
  • Chicken
  • Eggs
  • Greek yogurt

Beans

  • Chickpeas
  • Hummus
  • White, Black, Pinto Beans
  • Lentils

Nuts/Seeds

  • Walnuts
  • Almonds
  • Cashews
  • Ground Flaxseed
  • Pine Nuts

Grains

  • Oatmeal
  • Quinoa
  • Bulgur
  • Barley
  • Wild/Jasmine/Brown Rice
  • Couscous
  • Whole Wheat Pasta

Healthy Oils/Fats

  • Olive oil
  • Avocados

Herbs/Spices

  • Garlic
  • Basil
  • Oregano
  • Cilantro
  • Parsley
  • Mint
  • Coriander
  • Cumin

While this is not an all-inclusive lists of foods found in the Mediterranean diet, it can be a great place to start.

What are the pros for following the Mediterranean diet?

  • Increased consumption of omega-3 fatty acids. Healthy fats containing omega-3 fatty acids have been shown to help reduce LDL (the bad) cholesterol levels, help prevent degenerative eye disorders and possibly reduce inflammation.
  • Increased fruit and vegetable consumption. Most people miss the mark for consuming 5 servings of fruits and vegetables daily. Incorporating Mediterranean recipes into your meals can help you easily reach that goal.
  • Limited red meat consumption and dairy consumption. Red meat and high-fat dairy products are some of the highest sources of saturated fats. Diets high in saturated fats have been linked to an increased risk of heart disease.
  • Family meal times. Research shows that families who eat together consume more fiber, calcium, iron and Vitamins B6, B12, C and E and consume less sodium and added sugars. Children and adolescents who share family meal times are more likely to be in a normal weight range and have healthier eating patterns.

The potential cons?

  • Meal planning. Most recipes require fresh ingredients that take to time to be chopped, cooked and prepared. However, planning ahead can help you utilize preparation and cooking time more efficiently.
  • Cost. Some items such as salmon, seafood and nuts can be more costly compared to other proteins.
  • Kid-friendliness. Consuming more natural flavors may take time to adjust to for young kids. Keep in mind that many children with unhealthy BMIs often consume too many processed food items and sugary-sweetened beverages.

Whether you take the Mediterranean diet on full-storm or simply incorporate a few Mediterranean-style meals into your week, consuming minimally processed foods is a great habit for a healthy lifestyle.


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High-Fiving Fiber

It was the spring semester of my junior year in college. I was engaging in conversations with my classmates as we were being handed back the results of our cholesterol screenings. I glanced down at the sheet that had been deposited on my desk and quickly went to my professor because I clearly had someone else’s results. She replied, “No, those results are yours, Amanda, and you have high cholesterol.” I thought this can’t be! I’m 21 years old, I run, teach group fitness classes, watch what I eat; how could I have high cholesterol???

This was a major scare to me, especially since heart disease runs in both sides of my family. After coming to terms with the news, I had a good hard look into how much fiber I was consuming in my diet.

Fiber has been referred to as many different things: bulk, roughage, even cardboard. Essentially, fiber is the indigestible part of plant products. It is found in whole grains, fruits, vegetables, beans, legumes, nuts and seeds. The average American needs at least 20-30 grams of fiber daily, but, unfortunately, most people miss this mark…by a lot. This is due largely to our high consumption of refined carbohydrate sources and processed food items, in addition to a poor intake of fruits and vegetables. But fiber has many benefits.

  • Fiber has shown to help keep you fuller longer between meals, aiding in weight management.
  • Choosing foods that are higher in fiber has shown to benefit blood glucose control.
  • A diet high in fiber can decrease one’s risk for diverticulosis/diverticulitis. Fiber can play a role in treating both constipation and diarrhea.
  • Increased fiber can help children’s constipation problems (check out this article for tips), as well as those of adults.
  • Another great thing a high fiber intake can do (and the focus of this blog) is help lower one’s cholesterol and, therefore, reduce the risk for heart disease.

Fiber is split into two categories: soluble and insoluble, and most fiber-containing products have both. Insoluble fiber can aid as a laxative by moving intestinal contents more rapidly. Soluble fiber forms a gel-like product when entering the digestive system. Soluble fiber absorbs bile salts in the intestines, which are important for digesting and absorbing fat. In order to keep our pool of bile salts at a proper level, the body utilizes cholesterol, specifically LDL found in the blood stream, to manufacture more bile salts. The National Cholesterol Education Program’s Therapeutic Lifestyle Changes recommends consuming at least 5-10 grams of soluble fiber per day to reduce LDL cholesterol by 5%. Check out the complete list of recommendations.

Good sources of soluble fiber:

Broccoli and Walnut Salad

Broccoli and Walnut Salad

  • Kidney beans
  • Oatmeal
  • Orange
  • Oat bran
  • Broccoli
  • Ground flaxseed
  • Apple
  • Banana

Other sources of fiber:

  • Blueberries/raspberries/blackberries
  • All beans/legume varieties
  • Brussel sprouts
  • Artichokes
  • Almonds
  • Shredded wheat cereal
  • Pears
  • Prunes
  • Sweet potatoes
  • Strawberries
  • Whole wheat bread/pasta

Assorted fruitIn addition to consuming more fiber, there are other diet recommendations for reducing one’s cholesterol level. This includes limiting trans and saturated fats from the diet (fatty red meats, fried foods, whole fat dairy products, snack crackers, chips, candy, cookies). It is encouraged to replace saturated fats with omega 3 and unsaturated fats from sources like salmon, walnuts and ground flaxseed. Fat intake should be limited to no more than 35% of total calories. Plant foods are recommended more often. Engaging in physical activity can also be very beneficial, as recommended by one’s physician.

How does my high cholesterol story end, you ask? I first began with choosing foods higher in fiber. I replaced my regular granola bars with high-fiber bars, consumed more vegetables, snacked on nuts more often, added fruit as part of my breakfast routine and chose cereals, English muffins and bread with higher fiber contents. In six months, I dropped my cholesterol level down from 216 mg/dL to 167 mg/dL. Today, I am still going strong with my fiber intake, omega-3 fatty acid intake and consuming low amounts of saturated and trans fats. Physical activity is a priority every day, and I am constantly finding new ways to challenge my body. My most recent cholesterol level taken was 151 mg/dL and I couldn’t be happier.

When increasing fiber in one’s diet, it is recommended to make sure you consume an adequate amount of water. Although it is rare with mixed diets, too much fiber can also be a problem causing poor absorption of calcium, iron, zinc and magnesium. Always consult with your physician or dietitian before making changes to your diet.


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Let’s Get the Flax Facts!

When hearing the word omega-3 fatty acids, most people think of salmon, or maybe walnuts. Today, I wanted to introduce you to another heart-healthy food that contains omega-3 fatty acids—flaxseed. I know what you’re thinking: what is flaxseed, and how do I eat it?

Flaxseed is one of many nutritional powerhouse foods, meaning it is full of healthy nutrients, including fiber, antioxidants, protein and omega-3 fatty acids (specifically alpha-linolenic acid or ALA). ALA is a polyunsaturated fat that is needed in our diets. Replacing bad fats (saturated and trans-fats) with the good fats (mono- and poly-unsaturated fats) can help lower the risk for chronic diseases like heart disease, stroke and cancer, as well as lower the LDL (bad) cholesterol. Flax is a source of lignans which are antioxidants that may reduce the activity of cell-damaging free radicals. One tablespoon of milled flax contains about 3 grams of fiber (both soluble and insoluble). Fiber from flax can help one feel fuller longer, help reduce cholesterol and improve colon and digestive health. Flax is also a great source of nutrients for vegetarians and a great way to obtain omega-3 fatty acids for people with fish allergies.

You can find flaxseed at your local grocery store. I have found it in the cereal aisle, next to the oatmeal or in the gluten-free section. Remember to refrigerate the flaxseed once opened.  Aim for an intake of 1-2 tablespoons of flaxseed per day. The best way to buy it is “milled”. We cannot absorb all the healthy nutrients flax has to offer unless it’s in the ground/milled form. You can grind whole flax seeds on your own using a coffee grinder, food processor or blender.

Here are some ideas for adding flax into your diet. Consuming it with other foods adds a light nutty flavor to your dishes:

  • Mix flax in with your yogurt
  • Add it to breakfast cereal or oatmeal
  • Mix in with fruit smoothies
  • Sprinkle into soups/stews/sauces

Try these other flax-friendly recipes!

For kids:

  • Add to applesauce
  • Sprinkle a thin layer between peanut butter and jelly sandwiches
  • Add to beans/chili after cooking
  • Mix in with mashed potatoes (or mashed cauliflower) after cooking

How do you add flax into your diet?

For more ideas, recipes and information about flax please visit: www.healthyflax.com.

Eat right, move more and live life to the flax!

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