“A spoonful of medicine helps my risk factors go down”

“A spoonful of medicine helps my risk factors go down”

Having been in the field of nutrition nearly 30 years, I know what nutrition can and cannot do for the body. I read research studies about fiber and gut health and potassium and blood pressure. I recognize that hydration may aid with reducing constipation and that too much caffeine causes insomnia. I know more than the average bear as this is what I do. Nutrition is my bread and butter, my meat and potatoes. Puns intended.

I’ve had rheumatoid arthritis for close to 25 years. While gluten-free and other restrictive diets have worked for some people, I have tried them with moderate success, but still require chronic medication to keep me feeling somewhat normal. This is something I have accepted and have no issue doing. I am so thankful for insurance coverage to pay for my medication. Without it, I’d be in pretty bad shape.

I am a healthcare professional in a wellness field. I weigh 130 lbs and exercise regularly.  I don’t look ill. But you can’t judge a book by its cover. Having 2 parents with diabetes put me at high risk for diabetes and at the age of 50, I was diagnosed with pre-diabetes. My doctor told me I could try no medication for 6 months, but with my weight being normal and exercise being regular, there was not much wiggle room. My blood sugar is in good control with diet, exercise AND meds. I need medication and I am not ashamed to admit it, yet when I tell people my situation, they are in shock. Why?

Why do people feel defeated when they need medication? Do they feel like a failure if they get a sinus infection and need antibiotics? Do they get angry for having a migraine and needing medication to help it? It’s as if it’s their fault that they got arthritis, high blood pressure or high cholesterol. And again, while diet therapy can help control these chronic issues, medication has its place and thank God we have it.

This month, I had blood drawn for my annual physical. I’ll admit, I had cookies over the holidays and my share of cheese but did not go overboard. In fact, my weight did not change and neither did my exercise level. But, you can’t outrun your heredity. My cholesterol is close to 240 and LDL (“lousy”) cholesterol is nearly 150. With a chronic inflammatory illness and family history of heart disease, my risk for heart disease is higher than most.

So, guess what? My doctor practically insisted that I start medicine to lower my cholesterol. Am I happy about it? No. But do I want to have a heart attack or need bypass surgery in the next 10 years? Definitely not. I will continue to eat a healthy diet to help reduce my risk of getting diabetes and heart disease. I will continue to exercise to maintain decent joint function and keep my weight in check. Dietitians are not super humans. We are people with chronic diseases just like the clients we help. We recognize that diet therapy can only do so much. And that is OK.

Planetary Diet announced

Planetary Diet announced

Have you seen the headlines today for the latest “diet”? I think it’s pretty exciting that researchers were not only looking at nutrition, but environmental sustainability. I (unlike some people who shall remain nameless), believe that global warming is REAL.

I am all for less sugar and less red meat and more fruit, veggies, nuts and whole grains. Cheese and other dairy still allowed? Win win. I suppose my only concern is the 2500 calorie mark. This (to me) is likely too high for women and anyone trying to lose weight (unless you’re a big person or super active). What are your thoughts? Article below.

https://www.thisisinsider.com/planetary-health-diet-could-transform-planet-save-millions-of-lives-a-year-scientists-2019-1

Handling Hangover

Handling Hangover

Did you know that 23% of people that drink alcohol never experience hangovers? That leaves over 75% of people that do experience the consequences of too much wine, beer or spirits including nausea, fatigue and headache. I feel sick thinking about it! How can you prevent feeling like death the day after a party? Here are a few simple tips:

 

  1. Be moderate. Alcohol creates acetylaldehyde when metabolized, a toxin that’s linked with several types of cancer. Moderate alcohol intake for men is 2 drinks per day and for women, 1 drink/day. You know why? Men are typically bigger than us and have more body surface area to absorb alcohol. Binge drinking increases risk of several types of cancer, especially breast cancer in women, so limit to 3 drinks PER WEEK if your risk is high. Bottom line, the smaller you, the more susceptible you are to the effects of alcohol.
  2. Eat before you drink. Drinking on an empty stomach is a recipe for hangover. Alcohol gets absorbed much faster when you’ve got no vittles in your belly. Include some carbs from whole grain bread, pasta or crackers as well as protein from beans, lean meat, eggs or other source. Foods containing fat (such as cheese, nuts or oil) may also help slow the absorption of alcohol.
  3. Have a mocktail instead. Years ago when my friends and I were having babies but it was too early to let everyone in on the secret (those 12 weeks of the first trimester when some women miscarry), we’d have mocktails to fool our friends. There are loads of delightful seltzer and flavored waters out there to choose from that you can enjoy if you’re the designated driver or just taking a night off from drinking.
  4. Limit dark alcohol. Whiskey, bourbon, cognac and red wine contain substances called congeners, which are created when alcohol is fermented. Congeners slow alcohol metabolism, which means it sticks around in your system longer. This is why you may not feel as bad after drinking vodka or gin VS whiskey. The amount still matters, so continue to be moderate.
  5. Drink water before, during and after you’ve been drinking. Alcohol dehydrates you, which can lead to headaches, fatigue and nausea. Drink at least a liter of fluid (four, 8 oz cups) before you go out for the night and have a glass of water between cocktails to slow your intake down and stay hydrated.
  6. Keep peppermint on hand. This time of year, you may have some candy canes left over or peppermint tea in your pantry. Peppermint oil relaxes the stomach lining, which may help reduce nausea.
  7. Try gingerale or non-alcoholic ginger beer. Ginger has been used for centuries in pregnant women to reduce morning sickness and for travelers to reduce motion sickness. The combo of ginger and carbonation may help lessen nausea when you’ve had a few too many.
  8. Take a B complex vitamin before drinking. Your body loses B vitamins when you drink because alcohol is a diuetic. While there isn’t much research to support taking vitamins to prevent hangovers, they certainly can’t hurt. Chronic drinkers are commonly deficient in thiamine, folic acid and vitamin B 12. Others I’ve spoken with use Emergent C, an effervescent vitamin C tablet used to prevent colds.
  9. Consider not drinking. A clear head, less holiday weight gain, less money spent, and no risk for DUI are a few perks! Perhaps you’re the life of the party without the booze? Whatever you decide, be smart this holiday season.
Facing failure

Facing failure

Have you ever heard someone say, “There’s no such thing as bad cake”? My husband would beg to differ. A perfectionist by nature, he must follow a recipe to a tee for fear of failure. Yesterday was a perfect example. He baked a two-layer cake for my birthday, but when he removed them from the oven, he quickly realized he’d forgotten baking soda. In a panic, he whipped up two more layers for my cake before our friends showed up to celebrate. How sweet is that? Doubly sweet!

We all make mistakes. We write down the wrong appointment. time. We miss answers to test questions. We forget ingredients. Perhaps we’re trying to follow a perfect eating plan and we “screw up” and have a cookie? Should that stop us from continuing to eat healthy again? I sure hope not.

When you find yourself in a self-depreciating mode of “mistakes”, try to have grace and forgive yourself. If you’ve upset someone close to you, would you stop spending time with them? If you made a mistake at your job, would you quit? Probably not.

Take the same approach to your eating habits. Rather than beating yourself up over a “forbidden” food eaten, remember that FOOD IS FOR EATING. It’s to be shared, enjoyed, savored. it’s not meant to leave you with feelings of guilt or shame. I’m not sure when we will eat the “cake failure” in the freezer, but it will serve as a reminder that no one and no diet is perfect. And that, is perfectly OK.

Gluten & Diabetes Risk- not what you think

Gluten & Diabetes Risk- not what you think

Got gluten?  You should.  A recent study suggests that going “gluten-free” may raise your risk for Type 2 diabetes.  The diet, meant for a small population of individuals who have Celiac disease or gluten intolerance, became popular despite lack of evidence that it was healthy for most people.  Gluten is a protein found in wheat, rye and barley that gives baked goods their texture.  A small percentage of people with celiac disease may also need to avoid oats due to a protein sensitivity.

According to Dr. Geng Zong from the Harvard University Dept. of Nutrition T.H. Chan School of Public Health, gluten-free foods are often less nutritious because they lack dietary fiber as well as vitamins and minerals. They tend to be more expensive.  His study looked at health effects of a gluten-free diet on subjects that did not medically need to follow one. In a long term longitudinal study, scientists observed that most subjects consumed 12 grams of gluten or less per day.  In those that consumed higher amounts of gluten, the risk of type 2 diabetes over a 30-year span, was lower.  Cereal fiber intake was lower in subjects on a gluten-free diet, which is important to note as it is a protective component for development of type 2 diabetes.  After accounting for the effect of cereal fiber, those in the highest 20% of gluten ingestion experienced a 13% lower risk of diabetes development than those with the lowest intake of gluten (< 4 grams).

In three other large, long term Nurse’s Health studies (NHS and NHS II) and the Health Professionals follow up study, gluten intake was gathered using food frequency questionnaires.  The average gluten intake was between 5.8 to 7.1 grams per day, which came primarily from pretzels, bread, pizza, muffins, cereal and pasta.  Data was observational as subjects self-reported their gluten intake.  In over 4.24 million person years of follow up over 1984-1990 to 2010-2013, 15,947 cases of Type 2 diabetes were identified.  Gluten-free diets were not popular at the time, so information on gluten abstainers was not available.

The bottom line is that if you don’t need a gluten-free diet, don’t follow it.  Include gluten-containing, high fiber, whole grains in your diet daily.  The US Dietary Guidelines advise 20-25 grams of dietary fiber per day for women and 35-38 grams per day for men.  Below is a list of whole grains and their fiber content:

Barley (1/2 cup cooked): 3.1 grams

Bran cereal (3/4 cup): 5.9 grams

Brown rice (1/2 cup cooked): 2 grams

Bulgur (1/2 cup cooked): 4.1 grams

Oatmeal (1/2 cup cooked): 4.1 grams

Rye bread (1 slice): 1.5 grams

Quinoa (1/2 cup cooked): 2.75 grams

Whole wheat bread (1 slice): 3 grams

Whole grain pasta (1/2 cup cooked): 5-6 grams

Reference:

Geng Zong, Ph.D., research fellow, department of nutrition, Harvard T.H. Chan School of Public Health, Boston; Lauri Wright, Ph.D., R.D.N., spokesperson, Academy of Nutrition and Dietetics, and director, doctorate in clinical nutrition program, University of North Florida, Jacksonville; March 9, 2017 presentation, American Heart Association Epidemiology and Prevention/Lifestyle and Cardiometabolic Health 2017 Scientific Sessions, Portland, Ore.

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