Citicoline and Brain Health

My husband is concerned about his brain. He exercises, is lean, and eats right, but increasingly he says he has a hard time remembering the right word or clearly articulating his thoughts. So, when I attended a lecture by Drs. Deborah Yurgelun-Todd and Perry Renshaw from The Brain Institute of the University of Utah on the brain health benefits of the dietary supplement, CognizinÒ citicoline, I was intrigued. (The session was sponsored by Kyowa Hakko, USA (http://kyowa-usa.com/), a global manufacturer of compounds used in dietary supplements and CognizinÒ brand citicoline).

After the conference I did some research by starting with Natural Medicines and then doing a literature search through Pub Med (http://www.ncbi.nlm.nih.gov/pubmed) to learn more about citicoline. I also contacted Dr. Yurgelun-Todd about her research on citicoline, as she has been studying it for over a decade. I found that citicoline was originally used as a treatment for individuals who had a stroke.  It is estimated that 2 million brain cells die every minute after a stroke so early treatment is essential to preserve the brain and maintain normal function. In a recent review of citicoline used in stroke patients, it was found that citicoline was safe to use and had beneficial effects on recovery, especially in older patients (>70 yrs) who had no other treatments. One study found that when citicoline was given to stroke patients within 3 hours, they were more likely to have complete recovery compared to those who got a placebo. Not all studies find such great results, but overall the evidence of a positive improvement in brain function after a stroke is well founded.

Food is not a good source of citicoline; only a small amount is found in organ meats. When citicoline is taken orally (in a pill) it is broken down into a B-vitamin, choline, and cytidine which is further metabolized into a compound called uridine. Both choline and uridine can cross the blood brain barrier and once in the brain, they can be converted back to citicoline, sometimes referred to as CDP-choline. Within the brain citicoline has several actions. First, it helps stimulate the production of cell membranes. Second, citicoline increases the production of the neurotransmitters which have been shown to increase attention, focus and memory.

Research on citicoline for other disorders where cognitive abilities are affected is scant, but promising. Researchers can’t yet say that citicoline will improve memory or cognition in individuals with Alzheimer’s disease, Bipolar disorder, Parkinson’s disease or traumatic brain injury, but stay tuned as more research is conducted in these areas.

I asked Dr. Yurgelun-Todd what she would say about healthy 50+ adults taking citicoline and she said that there is some good evidence to support the use of the supplement on improved focus and sustained attention. Her studies have used doses ranging from 250-4000 mg/day but she says a dose of 250-500 mg/day is effective and well-tolerated.

What about my husband? He has been taking citicoline for a couple of months (250 mg twice a day) and notices an improvement in word finding and clarity in conversations. He said he sometimes had to “think in pictures” when telling a story, but now he thinks he has better mental clarity. Of course, this is anecdotal. As for his memory, well, he still leaves the house without his wallet and phone and can’t find the milk in the refrigerator, but he feels it has helped him and that is a good thing.

 

Guilt-free snacks?

The email caught my eye..."guilt-free snacks for healthy habits." Sounded like something I would be interested in and it had all of the buzz words for today's consumer: "pure, natural, real, organic, gluten-free, and straight from nature."  Well, that last one is a lie because no processed snack food comes "straight from nature." I've never seen a chocolate hazelnut brownie coconut butter tree or a dark chocolate Brazil nut bush.

Never mind that, snacking is big business and many of us graze all day long, forgoing meals for snacks. So, how did these 3 "guilt-free" snacks fare on closer look? Spoiler alert....not so good.

For those of us 50+ adults, snacks should be nutrient-rich but not calorie-rich. Even for the most active among us, calories count and I've seen many older adults sabotage their weight and fitness goals by consuming too many "healthy" snacks. Snacks have calories and to avoid the weight creep of aging we have to be mindful of calories from all snacks. Let's take a closer look at these so-called "guilt-free snacks."

• Dark chocolate Brazil nuts. A 4-oz bag sells for $6.00 with 5 servings/bag. Each serving has 230 calories, 18 g fat, 7 g saturated fat, 12 g sugar, and 3 g protein. Let's face it, how many of you can stop at one serving? A pretty pricey snack, loaded with calories, fat and sugar and not much protein to promote satiety...that feeling of fullness that keeps you from eating more a few hours later.
• Chocolate hazelnut brownie coconut butter. This one costs $13.33 for a 12-oz jar. Two tablespoons comes with 220 calories, 20g fat and 3 g protein. Coconut butter is all the rage and we can debate the health aspects of it another time, but as a snack it packs a calorie and fat wallop.
• Crunch cluster almonds. A one-oz serving will set you back 160 calories and 13 g fat with only 5 g protein. And, a 9-oz bag costs $6.32.

To me, a guilt-free snack is affordable and delivers on nutrition and taste. Snacks that are much (much!) less expensive and more (more!) nutrient-rich include plain Greek yogurt (100 calories and 18 g protein) mixed with your favorite seasonal fruit or try cottage cheese (1/2 cup has 90 calories and 13 g protein) with a few whole grain crackers. If you like a creamy, cheesy snack, try a portion-controlled wedge (like The Laughing Cow spreadable cheese wedges with only 35 calories per wedge) on crisp apple slices.

Don't be fooled by the health-halo surrounding "guilt-free" snacks. Eat nourishing, healthy snacks without the high price tag. I'll bet you have some in your fridge right now!










Is Sugar the New Fat?

After a morning aerobics class at the local YMCA, I was catching my breath in the locker room and chatting to two women from the class. They know I am a registered dietitian nutritionist so the conversation turned from our hard workout to what else....food. One of the women asked me about calcium and what were the best sources. She said she gave up drinking milk because it had too much sugar....11 grams of sugar in a cup of milk and didn't I think that was outrageous?!  Before I could answer the other woman chimed in and started talking about the World Health Organization's (WHO) recommendation that sugar intake should be halved to 5% of total calories or about 6 teaspoons or 25 grams a day for an average person.


So, back to the calcium question. I suggested a glass of 100% orange juice fortified with calcium as a good way to start the day. Fortified orange juice contains needed nutrients (130% of the daily value for vitamin C, 25% of the daily value for vitamin D, and 35% (or 350 milligrams) of the calcium daily value); that goes a long way in helping women meet the 1200 milligrams of calcium recommended for women of our age. Both women were surprised (shocked?) that a dietitian would suggest drinking fruit juice. "What about all that sugar?" was the reply. I wish I had my carton of OJ to show them that 1 cup of 100% orange juice has 22 grams of sugar and that the sugar is naturally occurring in fruit and fruit juice. These are same women who were sipping on post-exercise recovery drinks that were "all natural." One had a Snapple Cranberry Raspberry (16 ounces = 51 grams of sugar) and Odwalla Mango Tango (16 ounces= 44 grams of sugar).


Sugar is becoming the new fat. Remember when we abhorred fat and removed fat from our favorite foods? That brought us such interesting foods as fat-free cookies (loaded with sugar and refined carbohydrates), fat-free cheese (scary stuff that tasted like plastic), and fat-free coffee cakes (remember Entenmann's? Fat-free goodies but often with more calories than the original coffee cake). Now, sugar has taken fat's placed as the new nutrient to be vilified.


Yes, we can all afford to decrease our sugar intake, but why eliminate healthy foods, like orange juice or pineapple juice or milk or yogurt that contain naturally occurring sugars? I work with athletes who are trying to gain weight and I recommended low-fat chocolate milk and 100% fruit juices like grape and orange and apple to boost calories while getting needed nutrients. I think it is better to get real foods with real nutrients than taking protein powdered drinks.


The WHO recommendation is meant to help curb obesity and reduce dental cavities but there are unintended consequences when we demonize one nutrient and try to find a replacement for it. The woman who questioned the sugar in low-fat milk said she read online that almond milk was lower in sugar. True, but did she also notice that almond milk is lower in protein? A cup of almond milk has 1-2 grams of protein yet a glass of low-fat milk has 8 grams of protein. We need the protein in the low-fat milk more than we need fewer sugar calories in almond milk.


So, if you want to reduce sugar intake (and, we all should), start reading labels and look for the hidden sugars in your favorite foods. Check out your brand of peanut butter, catsup, soup, and pasta sauce and see how much sugar is lurking in those foods. Find alternatives (take your reading glasses to the grocery store) but don't give up healthy, nutritious foods just because there is some naturally-occurring sugars in them. I am not giving up my OJ despite the WHO recommendation.

Tomaotes...in winter?

 

I had the good fortune to be an invited guest at The Culinary Institute of America's yearly conference, World of Healthy Flavors in January. World of Healthy Flavors is a collaboration between the CIA and Harvard School of Public Health. It brings chefs, food service operators, growers, and suppliers together to marry nutrition science with delicious food. From quick service restaurants to campus dining, innovations in food preparation and flavor is the outcome of this conference, now in it's 10th year.

 

After the conference, there is a day added to celebrate "Produce First." This is where the real fun begins. Teams are established that include chefs, nutritionists, and produce representatives to come up with several dishes showcasing one produce ingredient. I was on the "Tomato" team, sponsored by NatureSweet tomatoes. (Disclosure, I have no financial relationship to the company to promote the product.) We had three types of tomatoes from NatureSweet...."Glorys" (cherry tomatoes, )"Cherubs" (grape tomatoes), and "SunBursts" (yellow tomatoes). All of these fully vine-ripened tomatoes are produced in greenhouses under controlled environmental conditions; everything from the seeds to soil to water is controlled. The result is a delicious, juicy tomato that tastes good all year long. When I first discovered NatureSweet tomatoes at my local discount shopping club, I was excited because, (1) they taste great and I love them as a snack with only 27 calories per cup, (2) they are great roasted and used to top fish, chicken, or pasta. To roast, heat the oven to 450 degrees F. and drizzle olive oil on a baking sheet. Add a carton or two of tomatoes, swirl them around the pan to coat in olive oil and sprinkle with salt and pepper. Roast in oven for 15 minutes and then turn them. Continue roasting for another 10 to 15 minutes until they begin to split open. I use them on pasta for a much tastier and nutrient-rich topping than jarred marinara sauce, or over grilled fish or chicken breast for a quick dinner.

 

Tomatoes, raw or cooked, are a tasty, healthy food. Tomatoes are anti-inflammatory foods and are loaded with anti-oxidants of the carotenoid family. One carotenoid that has gotten a lot of media attend for it's role in prostate health is lycopene. This compound in tomatoes is associated with lower risk of prostate cancer and stroke. Cooking the tomatoes breaks down the cells, releasing the lycopene making it more readily absorbed. Lycopene is also fat-soluble so eating tomatoes with some fat will also help it be better absorbed. Eighty percent of lycopene in the U.S. diet comes from tomatoes, so start roasting tomatoes in a bit of olive oil to get even more health benefits.

 

Back to my "team." The creative chefs came up with many dishes but the highlight was our "Tomato Cod with Smoked Roasted eggplant, Fried Citrus Rind, and Pickled Roasted Tomatoes." A dish that begins and ends with tomatoes...what could be better?

 

 

For more recipes, check out www.naturesweet.com

 

 

362 Exhibitors and So Little Time!

Every year I attend the Food and Nutrition Conference & Expo of the Academy of Nutrition and Dietetics and like a kid in a video game store, I love the exhibit hall. This year 362 exhibitors were doling out food and beverage samples in Houston and as I walked through the aisles of vendors I thought about what might appeal to the 50+ audience. So, here are some of my favorites that can help improve your health and taste great at the same time. (I have no financial interest nor have I done any consulting with these companies or products.)

The Mushroom Council, representing fresh mushroom producers or importers, was preparing samples of turkey-mushroom burgers. The smell drew me in but the taste made me a true believer. Paring mushrooms and meat to make healthier burgers, meatballs, tacos...or any recipe that calls for ground beef or turkey... can reduce the fat, sodium and calories of a dish while increasing vitamins, minerals and fiber. And, let's not forget the cost. One study showed a 27% reduction in cost when using mushrooms for part of the ground meat. Recently, research sponsored by the Mushroom Council was highlighted on NPR at http://www.npr.org/blogs/thesalt/2013/11/05/243218136/make-room-for-mushrooms-fungi-compete-with-meat-in-burgers. So, next time you are using ground meat in a favorite dish, finely chop mushrooms and mix into the meat and be prepared to be surprised at the flavor punch.

The Almond Board of California was handing out a dietitian's favorite snack...a tin filled with natural whole almonds. The tin holds the "perfect portion" of 1-ounce or 23 almonds. Almonds make a great a snack for those of us 50+ as a serving has 6 grams of protein, 3.5 grams of fiber, and 35% of the daily value for vitamin E. A 2013 study from Purdue University with 137 participants who were given 1.5 ounces of almonds (about 35 whole almonds) every day for a snack showed that hunger levels were decreased, vitamin E and "good" fats were increased without weight gain. So, when the mid-morning or afternoon hunger hits, grab a handful of nutrient-rich almonds.

The Cherry Marketing Institute was serving refreshing tart cherry juice. While I don't like the term "super food," cherries are making a pitch for that title. Some studies using tart cherry juice (about 10-ounces a day) have shown anti-inflammatory effects in those with arthritis and gout. Athletes are getting in the cherry juice cheering section, too, as a recovery drink. Some college and professional athletes are drinking cherry juice after a hard workout or during injury rehab to reduce inflammation and promote healing. Cherry juice is a nutritious beverage that might be worth a try for active older adults who experience muscle soreness after a tough workout.

The Canola Info/Canola of Canada booth caught my eye because in Georgia I've noticed the beautiful fields of canola plants in the early spring. Fields of yellow flowering canola plants are quite a sight to see. Canola oil has the least saturated fat of all the oils (even olive oil) and it also contains alpha-linolenic acid, an omega-3-fat, associated with fatty fish or flaxseed. It is about 60% oleic acid (the kind of fat in olive oil) and 21% polyunsaturated fat. All of those numbers give canola oil a heart healthy profile for those who want the lowest saturated fat oil and don't always like the taste of olive oil.

Last, I was happy to see Flatout at the expo. I've been using these flatbreads as a bread substitute for about a year because they are higher in protein and fiber with half the calories of sliced bread. This Chicago-based company was sampling a new product, a rosemary and olive oil "fold it" flatbread. Great taste for 100 calories and I bought a package when I got home (found in the deli/bakery section of most grocery stores) and it will be a staple in my house. The flatbreads are also great for quick pizzas on a busy night...top with mushrooms, of course!

Can't wait for next year's expo to see what else I can taste...and enjoy!

What is junk food?

Last week a study in Pediatrics (Athlete Endorsements in Food Marketing, October 7, 2013) made headlines. Almost without fail the headlines used the word "junk" food to describe athletes' endorsements and one headline went so far to say, "Yes, Peyton Manning is making you fat."

When I read the study, it got me thinking about what is a "junk" food and who defines the parameters of what is and is not considered a "junk" food. As a registered dietitian nutritionist, I am not so sure what a "junk" food is....is it a side of pork belly or a soft drink or cheese puffs?  Usually, a junk food describes one that is calorie-rich without providing nutrients. Does a sports drink fit that definition? Some would say yes, and athletes have been endorsing sports drinks for decades. While a sports drink might be a junk food to a sedentary person who never breaks a sweat, to an athlete a sports drink is a proven hydration beverage. The joint position paper of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine states that "beverages containing 6-8% carbohydrate are recommended for exercise events lasting longer than 1 hour." The Evidence Analysis Library of the Academy of Nutrition and Dietetics goes on to say that " current research supports the benefit of carbohydrate consumption in amounts typically found in sport drinks (6-8%) to endurance performance in events lasting 1 hour or more."  Anyone who watches Peyton Manning or Serena Williams or LeBron James (all called out in the media reports for endorsing "junk" foods) knows they perform at a high intensity and duration and can benefit from the carbs and electrolytes in sports drinks. So, to a competitive athlete a sports drink is not a "junk" food so why shouldn't football, basketball or tennis players endorse sports drinks?

Quick service restaurants were also on the hook for "junk" food and athletes' endorsements. McDonald's is often picked on as a provider of  "junk" food but did you know that 80% of McDonald's menu items are under 400 calories? And, that in 2012 the default in the new happy meal is a side of fruit, a kid's size fry, and a fat-free milk? McDonald's has served 530 million packs of apple slices to kids in a one year period from 2012-2013. Of course, there are high calorie and high fat and high sodium items in any restaurant, but we often forget that there are healthy choices in every restaurant if one chooses to look for them.

And, of course we mustn't forget the fry...a real junk food that is making us all fat, right? On average, Americans get about 1.5% of their calories from French fries. Potatoes are an excellent source of potassium, a nutrient identified by the 2010 Dietary Guidelines Advisory Committee as a shortfall nutrient. Only 2-3% of Americans had adequate intakes of this important mineral. And, frying of potatoes does not destroy the potassium as some people believe.

A further look at the Pediatrics article showed that famous athletes endorse more sports goods and apparel than foods and beverages. Yet, I didn't hear anyone complain about sneakers made in less than desirable conditions in developing countries and sold for a tidy profit by U.S. companies.

I would like to see the media stop demonizing foods and instead help people enjoy their favorite foods in moderation (another word some people don't like), but I like it just fine.

Should you avoid white vegetables?

Last Saturday I was at a rural Georgia Farm Festival and I bought a bag of potatoes from a local farmer (photo of my purchase to the left). As I carried the 5-pound bag to my car, a stranger approached me wagging her finger at me. She said, "You shouldn't eat those. I stopped eating potatoes years ago because white vegetables are horrible and you might as well pour sugar down your throat."  I was stunned by her comment on many levels. First, when did it become acceptable for a stranger to give out nutrition advice? Second, she was just plain wrong.

A recent paper (executive summary available for free at http://advances.nutrition.org/content/4/3/318S.full.pdf) published a roundtable discussion convened on the campus of Purdue with leading nutrition experts. The topic of the roundtable and the summary was, "White vegetables: A forgotten sources of nutrients."  As nutritionists, we often tell our clients to choose a colorful diet but maybe we should have emphasized that white vegetables are healthy, too, and certainly are not devoid of nutrients. One of the experts cited in the paper reminded us that white vegetables contain important nutrients like vitamins C and D, potassium, calcium, and dietary fiber, and color is not an accurate indicator of these nutrients. In addition to potatoes, other white vegetables include onions, cauliflower, mushrooms, and turnips and if we only used color as a guide to choosing our veggies we would miss some key nutrients.

Only 2-3% of Americans get the recommended intake of potassium and potatoes are one of our best sources of this important mineral. Higher potassium intakes are associated with lower blood pressure and the DASH diet, a meal plan designed to lower blood pressure, contains many potassium-rich foods, including potatoes. Potatoes are naturally low in sodium and high in potassium; a healthy combination.

Potatoes are also a good source of dietary fiber and not just in the skin. The flesh of the potato has soluble fiber, the kind of fiber that helps to lower blood cholesterol levels.

As for the comment that potatoes=sugar, well, that is a reference to the glycemic index; a measure of how a fixed amount of a carbohydrate in a food affects blood sugar. Potatoes have a higher glycemic index than other vegetables but that doesn't mean they are the same as eating sugar. Most of use eat potatoes as part of a meal and the other foods in the meal can alter or lower the glycemic response of a single food.

I am going to prepare my potatoes by roasting them with a drizzle of olive oil and dried rosemary for a delicious side dish. Oh, and by the way, I saw the woman who admonished me later on at the festival eating hot dogs and, you guessed it, a bag of potato chips!

Spice it up

Lately, I've been in a food rut; going back to the same recipes time and time again. Then I read an article in the summer issue of the American Institute for Cancer Research (available at aicr.org under publications tab Science Now) called The Spices of Cancer Protection. Herbs and spices have long been known to have plant compounds called phytochemicals similar to those found in fruits and vegetables. Scientists have been trying to unlock the cancer protective effects of phytochemicals and they are discovering that certain spices have potent anti-cancer effects; well, at least in the lab. It is too early to swallow tablespoons of  the stuff out of your spice rack, but it is never too early to learn how to use these spices in cooking for many reasons. Using spices can help you replace sodium, impart flavor without fat, and wake up your palate to new flavors.

The spices being studied for cancer protection include allspice, cinnamon, cumin, turmeric, and black pepper. Garlic, although not a spice, is also included as we tend to use garlic as a seasoning (unless you trying to ward off vampires and then it becomes costume jewelry.)  The ways in which spices fight cancer are many and range from repairing DNA, reducing inflammation, regulating hormones, and altering cancer cell metabolism. Not all spices have the same effects so for now it is a good idea to include a wide variety of spices in your diet.

But, getting back to my food rut...how to overcome it? That is where a cool online tool from McCormick comes in (I have no relationship with the company and learned about it at a presentation at The Culinary Institute of America). McCormick has launched "Flavor Print" (accessed from McCormick website at mccormick.com/flavor print) an online tool based on sensory science that "reads your palate" to discover your personal flavor print. I started by rating foods that I liked; a thumbs up or thumbs down task. I rated everything from my like or dislike of hoppy beer (dislike), arugula (like), and pfeffernuse cookies (dislike). After rating a bunch of foods, my flavor print appeared. Turns out, I'm cheesey, garlic and onionish, and coffee and chocolatey. Next, I rated by cooking preferences (I've never deep-fried but I love to grill) and went to the recipe section to find matches to my flavor print. Based on my palate, I found several mouth- watering recipes like Slow Cooker Italian Beef (89% match), Almond and Date Bulgar Salad with Sofrito (88% match), and Grilled Chicken and Blueberry Pasta Salad (88% match). Fair warning, this online exercise will make your hungry!

I think this tool could break me out of my food rut and help me include more cancer-fighting spices in my diet. My 80-something year old mother-in-law will be spending some time with me and as many seniors do, she complains she has little appetite. I think the first thing we'll do is her Flavor Print and then head to the grocery store!

Resvertrol: Longevity Miracle?

Last month a small study of 27 men in their 60s got national attention. The author of the study, a doctoral student, gave some of the men 250 milligrams of a resveratrol supplement and the other half got a placebo. The men were all healthy but not physically active. The men were put through a rigorous exercise program for 8 weeks. At the end of the study all the men showed improvements in physical fitness but the men not getting the resveratrol supplement showed greater improvement in fitness and blood lipid levels. The media reported that resveratrol "negated" exercise benefits and started the worried well wondering if they should toss their expensive resveratrol supplements in the trash and stop drinking red wine.

Resveratrol is a polyphenolic compound found in the skin of red grapes, berries, grape juice, pistachios and peanuts. The compound has antioxidant properties, reduces inflammation, initiates programmed cell death (a good thing in cancer prevention), improves nerve function and improves insulin sensitivity. All of these changes are good for human health but the problem is that most of the studies on resveratrol were done in animals or test tubes; very few studies were conducted in humans and no long term studies have been done for benefits or safety. For example, mice got anywhere from 22-400 milligrams of resveratrol per kilogram of body weight....far more than we would get in supplement form. And red wine, has about 1-2 milligrams PER BOTTLE of wine, according to ConsumerLab.com

So, even though evidence is slim for the benefits of resveratrol supplements on human health that hasn't stopped the flood of supplements marketed to seniors. Dr. Oz has even blessed resveratrol as one of the "4 supplements for a longer life." So, now, based on one small study, resveratrol is bad?

Not so fast, resveratrol is found in many healthy foods and we should all be consuming berries, grapes, and nuts as part of a healthy diet. Red wine, in moderation, and consumed with a meal, has heart health benefits beyond resveratrol. But, that small study did remind us that supplements are not thoroughly evaluated by the Food and Drug Administration for effectiveness or safety....let the buyer beware! Don't believe the Internet supplement sales hype and stay healthy the old fashioned way....exercise and eat well. And, enjoy a glass of red wine if you drink alcohol without worry that you will get "too much" resveratrol.

Peanuts and Baseball

"Take me out to the ballgame....buy me some peanuts...."

Baseball and peanuts are a natural combination and with baseball season right around the corner it got me thinking about peanuts (that, and the fact that I live in Georgia!) But, peanuts don't seem to get the love like the tree nuts almonds, walnuts, pecans and pistachios. I love all of the tree nuts, but the humble legume, the peanut, should also be celebrated for its nutritional content and health benefits. So, here are all the reasons you should eat peanuts:

• Peanuts are a protein powerhouse with 7 grams of protein per 1-ounce serving (that is about 40 pieces from a jar of peanuts) and that is the same amount of protein found in one egg. Peanuts are rich in the amino acid arginine which is a precursor to a potent compound that relaxes blood vessels to help keep the blood flowing and lower blood pressure.
• Peanuts are not high in sodium contrary to what you might think. Roasted unsalted peanuts have only 5 milligrams of sodium per ounce and roasted salted nuts have 230 mg so a serving of salted nuts can easily fit into a diet with a heart healthy 2300 mg of sodium per day.
• Research has shown that frequent nut eaters have lower lipid levels than those who don't eat nuts. Eating peanuts lowers your risk of heart disease. Peanuts also reduce inflammation; a condition that can set the stage for heart disease and other chronic diseases.
• Peanuts are high in the mineral magnesium; a nutrient in short supply for many Americans.
• Peanuts are also high in two plant nutrients (phytonutrients) beta-sitosterol and resveratrol and both are tied to reducing cancer risk.
• Lastly, peanuts have a low glycemic index (GI) helping to keep your blood sugar level in a healthy range.

Peanuts, like all nuts, are high in calories and fat. The fats in peanuts are "good" kinds of fat (monounsaturated and polyunsaturated) but all fats have 9 calories/gram so keep your portion sizes in check. Share your bag of peanuts at the baseball with your family and friends!

Enjoy baseball and enjoy peanuts this season.

National Almond Day

Happy National Almond Day! Active people are always asking me about healthy snacking options and with February 16 as National Almond Day it is the perfect time to talk about the benefits of one of my favorite foods. I am proud to be teaming up with the Almond Board of California to host a giveaway celebrating the healthfulness of almonds to one of my readers.

Just post a comment on the ways you enjoy almonds and a winner will be selected to receive an almond cookbook and almonds in several forms for snacking or making heart healthy almond appetizers, entrees, salads and desserts.

I've had the good fortune to visit almond orchards during the harvest and you can see from my photo that not only do almonds look heart healthy, they are! The American Heart Association recommends eating nuts, legumes and seeds at least four times a week as part of a heart healthy diet. Almonds pack a nutrition punch with nutrients that are good for your heart. One serving (1 ounce or about 23 whole almonds) contains 35% of the antioxidant vitamin E and that is more than any other tree nut. Almonds are also a rich source of fiber and monounsaturated fats; all recommended for reducing your risk of heart disease.

For active people, almonds have other great benefits. One serving contains 6 grams of protein and 75 milligrams of calcium to support muscle and bone health. Many of you are exercising to lose or maintain your weight but don't fear the calories in almonds. Research from the USDA shows that almonds contain about 20% fewer calories than what is stated on the label. So, your 100-calorie snack pack of almonds only provides 80 calories. When we eat nuts, especially hard nuts like almonds, the cell walls are not completely broken down and the fat contained inside the cells does not get absorbed so you get fewer calories but will all the great taste and nutrition.

If you are looking for satisfying snack that is:

• a good source of protein
• rich in vitamin E
• high in fiver
• calcium-rich
• gluten-free
• tasty
• crunchy
• and, delicious, almonds check all the boxes.

For more information and great recipes visit the Almond Board of California at www.almondboard.com. Tell me your favorite way to snack on almonds before February 16 to be eligible for a cool giveaway. (Disclaimer: I was not paid to write this post but the Almond Board sent me the almond bundle to enjoy and that you can also enjoy!)

Good Food News of 2012

 

 

Nutrition headlines seem to shout the "worst" food news...from "everything causes cancer" to "no health benefits found" by consuming your favorite food. So, let's take a moment as 2012 comes to a close to celebrate those nutrition stories that you may have overlooked in all of the noise. The following nutrition stories were good news stories and should be embraced in 2013.



1. A healthy diet (one high in the usual suspects...fruits, vegetables, whole grains, nuts and fish) is additive to the protective effects of medications used to treat heart disease. In a study of over 31,000 patients from 40 countries, researchers found that those who ate a healthy diet along with taking prescription meds reduced their risk of cardiovascular disease by 35%, stroke by 19%, heart attack by 14%, and congestive heart failure by 28%. This study looked at secondary prevention....that is preventing another disease after one disease has been diagnosed and treated. Paying attention to diet...and not just relying on medication to treat our most common diseases has a better outcome than just popping pills.

2. Speaking of nuts...did you see the study from researchers at the United States Department of Agriculture who found hat calories on the label are too high for our of the most heart healthy foods....almonds (check out my photo above to see that almonds even look heart healthy!) Researchers found that almonds contain 20% fewer calories as stated on the label; so that means your 100-calorie snack pack of almonds provides only 80 calories to your body. When we eat nuts, especially hard nuts like almonds, the cell walls are not completely broken down and the fat content inside of the cells does not get absorbed. Voila...fewer calories but all of the great taste and nutrition.

3. For the 2.9 million breast cancer survivors in the U.S. there is good news on eating soy. For years, those of use who have had breast cancer have been frightened to eat soy because of reports that the isoflavones in soy exert an estrogenic effect on breast tissue. Recently, the American Institute for Cancer Research reported that "six recent human studies and one major meta-analysis have found that consuming moderate amounts of soy foods does not increase a breast cancer survivor's risk of recurrence or death." A moderate serving of soy is defined as one or two servings of soy a day; a serving is 1 cup of soy milk, 1/2 cup of edamame, 3-ounces of tofu, or a soy-based veggie burger.

4. Lastly, one of my good food news stories comes from McDonald's...yes, McDonald's. In September they announced that they will voluntarily post calorie counts on menu boards and I applaud any quick service restaurant that provides nutrition information to the public. And, if you haven't tried some of their healthier options like the strawberry banana real fruit smoothie, Southwest salad with grilled chicken, or the new Egg White Delight McMuffin, try one in 2013 and be prepared to be surprised.



Healing Foods

Although I was in denial for about 6 years the truth is I needed a total hip replacement. For me, an old high school injury + 25 years of running + age = osteoarthritis. I tried physical therapy, cortisone injections, glucosamine, chondroitin, oral meds, and even acupuncture, and while everything helped for a little while, the reality was that the cartilage cushion in my hip just wasn't coming back. I was sure I was too young for such a big surgery, although my surgeon's PA assured me I was a year over the average age of patients getting hip replacements (thanks for reminding me of my age). I learned from the American Academy of Orthopaedic Surgeons website that hip replacement "is one of the most successful operations in all of medicine," with more than 285,000 performed each year in the U.S.

So, I had a total hip replacement five weeks ago today. The first 2 and half weeks were rough but then I got my strength back (thanks to home physical therapy) and am walking 2 miles a day without pain and without a limp...no more swaying when I walk!

In all the preparation leading up to the surgery no one talked about the importance of nutrition in recovering from surgery, so here is my advice to anyone having major surgery.

1. Eat high quality protein foods before and after surgery. Foods that contain all of the essential amino acids are need to keep your immune system strong (the last thing you want is to get sick before surgery). After surgery protein-rich foods help wound healing and to make blood cells to replace blood losses from surgery. Expect a poor appetite after surgery (my appetite was depressed for about 2-3 weeks after surgery) so eat small portion of protein several times a day. For example, eat a hard cooked or a scrambled egg for breakfast, a piece of string cheese mid-morning, Greek yogurt for lunch (regular yogurt is OK, but Greek yogurt is higher in protein), shredded chicken in chicken soup for dinner and a handful of almonds in the evening to get protein at every meal and snack. As your appetite picks up, add cereal and milk, peanut butter toast, turkey on a bagel, grilled cheese, a small lean steak, or a tofu noodle bowl.

2. Vitamin C-rich foods are needed to make the protein collagen that provides strength to the surgical wound. In the old days when vitamin C deficiency led to scurvy (it was prevalent in those undergoing long sea voyages with little access to fruits or vegetables) it was common for wound dehiscence or the opening up of old wounds.We don't have to worry about scurvy today and it is easier for us to get vitamin C by eating citrus fruits or drinking orange juice. I snacked on my favorite seasonal fruit, Clementine tangerines, every afternoon. If your appetite is not good, try a supplement of vitamin C or a vitamin C adult gummy.

3. Zinc is a mineral found in meat, fish, poultry and dairy foods, with smaller amounts found in whole grains, legumes and nuts. Zinc is needed to repair cells and keep a healthy immune system. Get zinc from foods rather than supplements...too much zinc can cause nausea and vomiting.

4. Tart cherry juice is a potent source of anti-oxidants and many athletes use it to reduce muscle soreness and inflammation after exercise. And, tart cherries also contain melatonin which might help improve sleep quality. Tart cherries aren't the same as the sweet cherries that you eat for a snack; so, it you want to try it look for tart cherry juice. One 10.5 ounce bottle contains the equivalent of about 45 tart cherries which is enough to reduce inflammation and pain.

5. Fiber may not seem to fit with the "healing" foods theme of this article, but after surgery including high fiber foods in your diet (along with plenty of water) can alleviate constipation. Prescription pain meds are well known to cause constipation so stock up on prune juice or dried prunes. Drink about 4-5 ounces of prune juice or eat 2-4 dried prunes each day to keep things moving without having to resort to harsh chemical laxatives.

No one wants to have surgery, but if it happens, use foods to help you heal and bounce back to be better than the old you!

Cancer Resource for Prevention, Treatment and Survivors

September marks 7 years since I was diagnosed with breast cancer so that means I join 11 million cancer survivors in the U.S. Many of you are also cancer survivors and what we eat and how much we exercise has a big impact on cancer prevention and recurrence, as well as our quality of life.

I am often asked about "super" foods or supplements and which, if any, I recommend. My "super" food is, well, food. Eating plenty of fruits and veggies (as pictured at left from a summer cookout) along with whole grains, lean meat and fish in small portions, and nuts is a great way to eat for everyone. The only supplement I take is fish oil because I'm just not the crazy about fatty fish so I use a high quality, USP approved, "burpless" fish oil supplement. But, no special South American berries, antioxidants, or trendy food-of-the-month...just real food that tastes real good.

When first diagnosed with cancer, I was so focused on the treatment that I didn't think much about the aftermath. Once treatment was over, I was more apprehensive because cancer lurks in the mind....every new   pain or change in body function is viewed as the cancer returning. I am thankful to have understanding doctors who assured me that an upset stomach might be due to a mild food borne illness...not stage III colon cancer as I diagnosed. Or that hip pain is osteoarthritis, not bone cancer.

That is why I was so glad to see the new publication, Cancer Resource: Living with Cancer from the American Institute for Cancer Research. For a flip book of the publication, check out this link
http://preventcancer.aicr.org/new/flipbooks/CancerResource/index.html#/i/

In one quick resource, you can learn about all stages of cancer, help in formulating questions to ask your health care providers, and learn about delicious eating and the importance of exercise. This resource can help you learn to fight cancer with more than drugs, surgery and radiation....the power of food and exercise is something in your control and should be an integral part of any cancer prevention and treatment plan.

Here is looking forward to many more years as a cancer survivor!

Hydration Tips for Active Older Adults

As the temperatures soar, active 50+ exercisers (myself included!) need to pay special attention to hydration. There are some who say that thirst should be your only guide for hydration, but that advice could be dangerous as we age. When older adults exercise, especially in hot and humid climates, they have a diminished sensation of thirst. And we know that "normal" thirst kicks in after you are already thirsty so waiting for thirst may lead to heat illnesses.

Aging also brings about other changes in normal physiology that contribute to dehydration. Our sweat rate changes, our kidneys change the way they handle fluids and electrolytes, like sodium and potassium, and there is an altered blood flow response. All of these normal age changes mean that we need to be aware of hydration and adopt strategies to keep us hydrated during the physiological stress of exercise.

In addition, many 50+ take medications that contribute to loss of body water. Chief among the drugs are common blood pressure medications that act as diuretics which can increase water loss. When you add in other common drugs, caffeine and alcohol, both which are mild diuretics, hydration becomes even more important.

How do you know if you are dehydrated? This question is of great interest to researchers and unfortunately there is no single, easy test to assess hydration. Until there is an easy reliable and valid test, the best strategy is to weigh yourself before and after exercise. For every pound loss, drink 16-24 ounces for every pound loss during exercise. If you gain weight after exercise that means you are most likely overhydrated, but a loss of 1 pound or less means you are doing pretty well at hydrating. Another way to assess hydration is by monitoring urine volume and color. A dark colored urine usually means you are dehydrated (although some dietary supplements like vitamins with a high concentration of riboflavin can cause a bright colored urine) as well as infrequent urination.

Here are some tips to keep you hydrated:

• Monitor body weight before and after exercise to gauge fluid loss
• Monitor urine volume and color
• Drink fluids before activity and during activity when exercising in hot, humid environments
• Replace fluids after exercise
• Eat foods with high water content (fruits and vegetables)
• Consume fluids with meal
• Use sport drinks if you are a heavy sweater and/or a salty sweater; if watching calories, try the "light" verisons that provide some carbohydrate but with the same electrolyte content as the regular sport drinks.

I liked this article on 13 health buzzwords we're sick of....
http://www.rd.com/health/13-health-food-buzzwords-were-sick-of/

Because I am sick of them, too, and throw in the word "artisan" to that list because all of these words have been overused in marketing and don't always mean what a consumer thinks they mean.

But, it got me to thinking about a couple of words that you might think are bad when associated with foods, but both of these words are good words when used with a few nutrients that those of us 50+ need for good health.

The first is "irradiated."  We don't want our food irradiated (it smacks of radiation, but it isn't the same thing). Researchers have found that mushrooms can be exposed to ultraviolet light and, voila, the irradiated mushrooms are bursting with vitamin D. Why is this a good thing for older adults? We are part of the "at risk" group for vitamin D deficiency because as we age our skin is less efficient at making vitamin D from exposure to sunlight. We need 600 IU of vitamin D a day (those over 70 years need 800 IU) but data from the National Health and Examination Survey (NHANES) found that for women aged 51-70 the average intake of vitamin D from foods was 156 IU/day and was bumped up to 404 IU/day when supplements were added to their intake...but, still short of the daily recommendation.

Vitamin D does not occur naturally in too many foods. Salmon, tuna, and some other fatty fish, as well as eggs (but the vitamin D is in the yolk) contain vitamin D so some foods producers add or fortify foods with vitamin D. Milk and dairy foods, and some (but not all) yogurt has vitamin D but you need to read the labels to find out how much.

So, I was surprised when I bought some mushrooms to toss in a stir-fry and the label said "100% Vitamin D" in a 3-ounce serving. Not all mushrooms have been irradiated to boost vitamin D so look for labels that tout the added vitamin if you want to increase your vitamin D intake with a tasty, healthy food.

The second word is "synthetic" when followed by vitamin B12. I know what you are thinking, isn't natural always better? Not when it comes vitamin B12 and those of us over 50.Vitamin B12 is needed for red blood cell formation, DNA synthesis, and neurological function and is found predominantly in animal foods. The vitamin is tightly bound to the protein in foods and it takes stomach acid to separate the vitamin from the protein before it can be absorbed. Therein lies the problem...10-30% of those of us over 50 have decreased secretion of stomach acid. In fact, the Institute of Medicine recommends synthetic vitamin B12 (synthetic vitamin B12 is used in supplements and fortified foods) for everyone over 50 because the synthetic vitamin doesn't need stomach acid for absorption.

So, just as some words have been used to get us buy foods, some words might turn us off from buying a food or supplement that is actually good for us.

There is Good News on Beef

Americans love beef but some media headlines have frightened consumers into thinking that only "white" meat is healthful. A new study from Penn State University researchers shows that lean beef when part of a heart healthy diet can lower total and low density lipoproteins (LDL or "bad" cholesterol) and even lower markers of inflammation. The key is choosing the leanest cuts of beef, paying attention to preparation in the kitchen and watching portion size. And that is good news for all of us who love beef.

The BOLD study (Beef in an Optimal Lean Diet) was conducted with adult men and women with elevated total cholesterol and LDL-cholesterol (LDL levels ranged from 110 to 177 milligrams) with different diets prepared in a test kitchen (that means it was a well-controlled diet study). None of the study participants were on cholesterol-lowering medications. The diets studied included the DASH (Dietary Approaches to Stopping Hypertension) which contained only 1 ounce of beef a day and the BOLD and BOLD plus diets contained 4 and 5 ounces of lean beef, respectively.

Weight remained constant during the study (losing weight in itself can lower blood lipid levels so monitoring weight was a positive aspect of this study) and researchers found about a 5% reduction in LDL-cholesterol when the BOLD and BOLD plus diets were consumed, similar to the DASH diet. Researchers also noted that a marker of inflammation (CRP) was lower in those who had the highest levels of blood cholesterol and LDL-cholesterol.

The take away from this study is that lean beef can be part of a heart-healthy diet. While there are 29 cuts of lean beef that meet the criteria for lean meat, the study authors note that most grocery stores carry top loin and top round steak, top sirloin bottom round roast and 95% lean ground beef.

There is another good reason to include lean beef in your diet...a 4-ounce serving is an excellent source of the nutrients that are often low in the diets of the 50+ population: protein, B-vitamins niacin, B6 and B12 and minerals zinc and selenium. It is also a good source of choline, phosphorus, and iron. Beef is nutrient rich and many cuts of beef are 20% leaner than 15 years ago, according to the USDA.

It is important to keep portions moderate (4-5 ounces). Good ways to incorporate lean beef in your diet is by making kabobs with plenty of veggies, slicing lean grilled meat over a salad, and whipping up a stir-fry dish. Lean ground beef can be used as patties, meatloaf, and meatballs or as pizza topping or in pasta sauces. To further reduce the fat in ground beef, check out these tips at http://www.beefnutrition.org/cmdocs/beefnutrition/reducingfatincookedgroundbeef.pdf

Will zinc help you get over your winter cold?

I've managed to avoid the dreaded winter common cold; when I was teaching I almost always got a cold at the beginning of the semester when students brought those nasty cold viruses into the classroom.

There about a billion colds in the U.S. each year, according to the CDC, but the good news for those of us in the 50+ age group is that we get less colds probably because our lifetime exposure to viruses gives us a leg up in the immunity department.

But, if you do get the scratchy throat and other cold symptoms, will zinc be the answer to preventing the cold or at least reducing the severity? Zinc is an essential nutrient that is found in every cell of our body, acting as an anti-oxidant and critical nutrient in a healthy immune system. Zinc has the potential to inhibit the rhinovirus (the virus that causes most colds) to sticking and replicating in the nose and throat. It can also stop inflammation that contributes the symptoms of a cold...runny nose and stuffy head.

While there are many zinc preparations in the cold and flu aisle of your local drug or grocery store, should you use them? The research results are mixed, of course, they often are, but the latest review from the Cochrane Collaboration (a group that reviews medical topics by reviewing many studies on a particular topic) found that when zinc is taken at the first sign of a cold the length of the illness is reduced by about one day. Underwhelming or is it worth reducing your cold by about 24 hours?

If you want to try it, here are some tips and some personal advice...more on that later. Some considerations if you decide to use zinc lozenges (most provide between 5-10 milligrams of zinc):

• timing and dose is important, try one zinc lozenge at the first sign of a cold and take it every 4 hours
• more isn't better, in fact, in can make things worse; nausea and vomiting can occur and it can leave a metal taste in the mouth
• avoid zinc nasal sprays...the Food and Drug Administration warned consumers that zinc sprays can lead to changes in the sense of smell and sometimes permanent changes
• zinc can interfere with some prescription medications, like antibiotics and blood thinners, so always consider potential drug interactions

My personal advice comes from a bad (and stupid) reaction to zinc, even though I should have known better. Several years ago I was on my way to professional meeting in France when I started to get a sore throat..always my first cold symptom. During the flight a colleague's spouse gave me a bag of zinc lozenges and I popped them like candy for the 9-hour flight. When I arrived at the hotel I was so sick to my stomach I couldn't even make to the bathroom before vomiting. A great first impression to the conference hosts and hotel staff! And, to add insult to injury I still got sick.

So, my advice is to be careful when using zinc and I won't touch the stuff after my experience. Instead, I 'll stick to chicken soup. In 2000 some physicians actually studied chicken soup and found that it does have anti-inflammatory properties that inhibit a white blood cell that produces mucus. Mom was right about so many things!

Food Trends for 2012: Marketing Foods to 50+

Marketers have set their sites on those of us in the 50+ demographic for 2012. Retiring baby boomers want to stay healthy and fit and many new products will be introduced promising better brains, healthier joints, and happier hearts. Leatherhead Food Research notes that glucosamine-fortified foods and beverages for joint health will become increasing available in 2012. The food research group also says to expect more omega-3-fats in foods for cardiovascular and brain health. And, the popular trend of adding the word "natural" to foods and beverages will continue in the New Year.

Sounds great, doesn't it....but is it really? For years food processors have been adding needed nutrients to food to protect the public health; for example, adding (called fortifying in the food and nutrition world) vitamin D to milk makes sense because (1) milk does not naturally contain vitamin D (even breast feeding mothers have to give infants supplemental vitamin D), and (2) vitamin D is crucial for absorbing the calcium in milk. A more recent example of good, "makes sense" fortification is the addition of calcium to orange juice to increase dietary calcium intake.

However, when it comes to adding glucosamine and chondroitin or omega-3-fatty acids to foods, my response is why? Don't get me wrong...I think glucosamine is useful for some people with osteoarthritis and omega-3-fatty acids are important for good health, but when added to foods there is usually not enough of the good stuff in the food to justify the cost.

Glucosamine and chondroitin may help rebuild cartilage in damaged joints, especially in the early stages of the disease, and some people report it relieves pain. Here is the catch....you need a lot of the stuff to achieve therapeutic levels and it is very unlikely you will get it in a fortified food. When people ask me about glucosamine and chondroitin as dietary supplements, I suggest they take 1500 milligrams of glucosamine and 1200 milligrams of chondroitin in a divided dose (i.e., 750 milligrams of glucosamine and 600 milligrams of chondroitin twice a day) for about 3 months. If in 3 months there is no improvement of symptoms then it is unlikely that it will work for you.

Same thing goes for omega-3-fatty acids....1000 milligrams (1 gram) may lower heart disease risk but therapeutic doses for triglyceride lowering may be much higher, up to 6 grams per day. And, omega-3 is a general term for a type of fat. What you really want is DHA and EPA and not omega-3s from other sources, like flax seed.

And don't even get me started on the word "natural." What is natural is real food; a baked potato is natural, potato chips are not. And no hot dog is ever "natural." Did you know that the Food and Drug Administration does not approve of the claims natural, all-natural, or pure on a food label.

If you want to stay healthy and active, eating whole foods, cooking your own meals, and choosing a wide variety of whole grains, fruit, vegetables, lean protein, nuts and seeds is the best way to go. If you want to try glucosamine and chondroitin or omega-3-fats, look for high quality supplements (more on that topic in an upcoming article) or naturally occurring omega-3 foods, like salmon and tuna.

Athletes and the Beige Food Diet

Athletes, especially female athletes, eat what I call the "beige food diet." A typical recall from a female distance runner? Oatmeal, boneless skinless chicken breasts, soy milk, yogurt, bananas, granola bars, wheat bread, peanut butter, and maybe some beige sweets, like vanilla wafers. These athletes are not vegetarian but they fear red meat...specifically beef.

For those athletes who are not vegetarian (and I don't really see many who are), I encourage them to eat lean beef a couple of times a week. Many female distance runners have poor iron stores, and according to the Office of Dietary Supplements, female athletes and distance runners have the highest risk for iron depletion and iron deficiency. Athletes with iron depletion usually have normal hemoglobin and hematocrit levels but low levels of ferritn or storage iron. Often the first thing they ask me about is taking iron supplements but I take a "food first" approach and encourage iron-rich foods, like lean beef. 3-ounces of lean beef provides 14% of the daily value for iron or 2.5 milligrams of iron compared to only 1.7 milligrams in boneless chicken breast. Beef also provides quality protein, zinc and vitamin B12 needed by athletes. The iron in beef is in the heme form and 15-35% is absorbed and is unaffected by other food components; by comparison non-heme iron found in cereals, grains or beans is poorly absorbed and can be affected by food components like fiber and phytate.

I encourage female athletes to learn about the 29 lean cuts of beef (downloadable wallet card from the beef website makes it easy to choose lean meat when grocery shopping.

http://www.beefitswhatsfordinner.com/leanbeef.aspx

I also explain that ground beef can be lean but the label information is tricky (fat is expressed as percent lean to fat so while 80% lean sounds good, it can have 13 grams of fat per serving). Choosing 95% lean gives all of the nutrient benefits of beef with only 6 grams of fat per serving. And, by comparison 85% ground turkey has 13 grams of fat with less iron than lean beef.

I suggest that when traveling and eating with the team, that they choose lean beef like a petite filet at a steak house or beef and broccoli at an Asian restaurant as healthy options to provide good quality protein for recovery while boosting intakes of iron and zinc.

When athletes ask about iron supplements I explain that iron is a pro-oxidant and should never be taken in high doses without a blood test to determine the need for supplements. It is important to be monitored when taking iron as it can be toxic in large doses without proper monitoring. Another plus for food...no need for a blood test and monitoring when eating healthy foods that nourish the body and fuel muscles for sport.