Your Nutrition Prescription

As we get older, it seems the amount of prescribed medication goes up exponentially from year to year.  You start taking one medication, and because of the array of side effects from that medication, you are prescribed three more to help, and so it goes on.  As we get older, it is also more and more important to make sure we are eating a balanced and nutritious diet as well.  Wouldn't it be great if we could just get our doctors to write a nutrition prescription for us?  Well, guess what, now they do!

Doctors at select clinics accross the country are writing some obese patients "prescriptions" for fruits and vegetables.  The Fruit and Vegetable Prescription Program provides daily $1.00 subsidies to buy produce at local farmers markets.  The Program, also called FVRx, is funded through Wholesome Waves, a non-profit organization which operates from private donations.  Each member of a family gets the $1.00 prescription so, for example, a family of five would end up getting $35.00 per week to spend on fruits and vegetables.

So, how does this program work?  Can anyone just deem themselves unhealthy and ask for this FVRx prescription?  No.

First, a primary care provider needs to meet with you and enroll you based on your BMI, existing health conditions, and chronic disease risk factors.  Once enrolled, your primary care provider along with a nutritionist or Registered Dietitian meet with you and your family each month to reinforce the importance of healthy eating.  The primary care provider distributes the FVRx prescriptions during the visit and assess your fruit and vegetable consumption over the prior month, weight, height, blood pressure, and BMI.  A prescription represents one serving of produce per day for each participant and each family member, equal to $1.00 per day, as stated above.  The prescriptions can be redeemed weekly for fresh fruits and vegetables at participating farmers markets throughtout the 4 to 6 months program.  Participants return to their primary care provider and nutritionist or Registered Dietitian monthly to refill their FVRx prescription, set new self-management goals for healthy eating and have their health metrics recorded (these include fruit and vegetable consumption, weight, height, blood pressure, and BMI).

So, say you get enrolled in the FVRx program, will your family get the benefits too, even if they aren't technically qualified?  Or are you the only one with the monthly prescription?

Organizers say that a family-oriented approach is the best way to get this program to work.  Even if the whole family isn't considered obese, its not as beneficial if just one family member is eating fruits and vegetables from the farmer's market and the rest of the family is eating food that isn't as healthy.  That being said, if one member of the family is qualified and enrolled in the program, the entire family will get a prescription.  This also helps with the social support that is essential when trying to change a big thing like diet and lifestyle.

The program exists at twelve different sites in seven states and the District of Columbia.  It started in 2010 and has already helped over 1000 people buy healthier food.  The program targets areas where fresh produce may not be readily available or is too expensive for impoverished families. 

Organizers also believe this program ultimately produces a savings for the health care system because if people are more likely and have more opportunity to eat a more healthy diet, they are less likely to suffer from chronic conditions. Healthy food costs less in the long run than the medicine and treatment they would require in the future with a chronic condition.

So, if  you are one of the people who believe that all doctors want to do these days is prescribe yet another medication for your ailment, this might not be a bad option.  And the negative side effects are nonexistant!

If you would like more information on the FVRx program, visit their website at http://wholesomewave.org/fvrx/

Red Meat: Facing The Fa(c)ts

In the United States, there are many cultural norms that we follow on a day to day basis without much, if any, thought as to what we are doing.  Having our cell phone by our side at all times.  Cramming as many things as possible into a 24-hour period (do we really enjoy any of them when we can't take the time needed to enjoy them?).  Driving to work during rush hour, complaining about the traffic, but not even considering carpooling.  And my favorite: having red meat for each and every meal of every day (don't forget snacks, too).

But why is red meat so bad?  Why are there warnings out there telling us to cut down on our red meat consumption?  What is the big difference between using turkey or chicken instead of beef?  Is there any difference?  Maybe I can shed some light on the fat facts of red meat.

Every type of animal based protein will provide 7 grams of protein per ounce of meat.  This does not change whether you are consuming ground beef, steak, pork, chicken, turkey, lamb, veal, sausage and everything in between.  Also of note, one serving of meat is technically 4 ounces (the average American usually eats at least about 2 to 3 times that amount per meal), therefore the amount of protein per serving of meat is 28 grams, which is a good amount.  We know the target amount of protein the average healthy American should be consuming daily is 0.8 grams per kg of body weight.  Let's take a 150 lb woman: her body weight in kilograms would be 150 divided by 2.2, equaling about 68.18 kg.  If we multiply that by 0.8g, her target amount of protein needed per day equals about 55 grams.  One true 4 oz serving of meat would take care of about half her daily protein needs.

So, what is the big difference related to the types of meat we eat?  Answer: fat!  (Isn't that what it always comes down to?)

Red meat, specifically beef, has more fat per ounce than alternative meat options, such as chicken or turkey.  When choosing a meat, try to substitute turkey or chicken whenever possible to cut down on the amount of fat you are consuming.  Even some cuts of pork are leaner than beef.  If you absolutely love red meat and really want to indulge, try venison.  Venison is a red meat, but is a lot leaner than beef and has just as much flavor.  If beef is the only option for you and you just can't live without it, try to purchase the leanest cuts of steaks.  Additionally, when purchasing ground beef, take a look at the package.  All ground meat packages have a fraction somewhere on the front, for example: 85/15 or 95/5.  This fraction is the amount of lean meat to fat ratio in the package.  This means in a package of ground beef with a fraction of 85/15, the ground beef contains 85% lean meat and 15% fat.  Choosing the leanest varieties of ground meat will be the healthiest options.  That being said, you do want some fat in your cuts of meat, as the fat adds some flavor. 

What about those dedicated individuals who don't eat red meat?  Or are trying to cut down on the amount animal-based protein they consume?  Or those rare individuals, especially in our country, who don't LIKE meat period?  Are there options for them?  And how do those options compare?

Of course, there are a cournicopia of options for those individuals!  Meatless sources of protein can be tasty and just as satisfying as animal-based protein, and can pack in a much healthier punch (or serving) of protein. 

One of the best sources of meatless protein is quinoa.  Qunioa is a seed, that is prepared much like noodles or rice, boiled in water.  It is one of the only sources of meatless options that will provide all the essential amino acids your body needs (essential amino acids are ones that we need to get from our diet, unessential amino acids are ones that our body can synthesize on its own).  Quinoa is also an amazing source of fiber and an array of vitamins and minerals, without being high in calories or fat.

Beans and legumes are also great sources of meatless proteins.  There are many different types of beans to choose from, including black beans, red beans, white beans, edamame (soybeans), chickpeas, kidney beans, and many more.  Most beans are also pretty starchy, so a serving provides plenty of protein as well as carbohydrates, and little fat.  Using beans as a base for veggie dips and spreads are a great, healthy way to cut down on fat when dunking veggies and slathering on sandwich spreads.

Lastly, lets talk tofu!  Most people get a little scared when tofu is mentioned as part of their meal, because curdled soy isn't so appetizing to think about.  But the great thing about tofu is the fact that it is basically a clean canvas to add flavor to becuase tofu doesn't have much, if any flavor on its own.  I like to marinate tofu for at least 3 hours in the refrigerator to let the flavors meld and soak into the tofu, and then saute it with a little peanut oil on the stove top.  It doesn't take too long on a medium hot stove, maybe 5 to 10 minutes, and then top a salad with it or put it on a ciabatta roll with your favorite fixings.

Just for one day, each and every person should pay attention to how much red meat they eat, and I'm certain most people would be surprised to learn they consume 2, 3, or even 4 times the recommended daily allowance regularly.  Learning to pay attention to the amount of fat content in the cut of meat you choose is a great way to be a healthier red meat consumer.  Here are a couple great burger recipes that I love that incorporate alternative ground meat as opposed to ground beef.

Greek Turkey Burger:

2 cups fresh spinach, washed and cut (1 cup frozen spinach, drained)

¼ cup chopped red onion

1-2 garlic cloves, minced

1-2 tbsp olive oil

1/3 cup feta cheese, crumbled

¼ cup of fresh dill (1/8 cup dried dill)

Salt and pepper to taste

1 lb ground turkey 

1.)    Heat a shallow pan on the stove until it gets hot (this opens the pores of the pan), once hot, add your olive oil and let that heat up a bit.  Add the onion and garlic and sauté for ~5 mins.  Add the spinach and sauté until spinach is wilted, this won’t take more than 5 mins.  Let cool.

2.)    Combine the spinach mixture, ground turkey, feta, dill, and salt and pepper.  Make into about 6-8 patties, depending on how big you want them and grill!

3.)    I usually put a slice of cucumber and tomato on the bun with it.

Spicy South-Of-The-Border Burger

2 cups fresh arugula, washed and cut

¼ cup chopped red onion

1-2 garlic cloves, minced

1-2 tbsp olive oil

1/3 cup spicy cheese (like pepper jack or habanero jack) shredded

¼ cup fresh cilantro

1 jalapeño pepper, seeded and minced

Salt and pepper to taste

1-2 tsp chili garlic paste

1 lb ground venison

1.)    Heat a shallow pan on the stove until it gets hot (this opens the pores of the pan), once hot, add your olive oil and let that heat up a bit.  Add the onion and garlic and sauté for ~5 mins.  Add the arugula and sauté until arugula is wilted, this won’t take more than 5 mins.  Let cool.

2.)    Combine the arugula mixture, ground venison, spicy cheese, cilantro, jalapeño pepper, chili garlic paste, and salt and pepper.  Make into about 6-8 patties, depending on how big you want them and grill.

3.)    I put cucumber on my sandwich, or avocado, just to cool it down a bit.  I think a mango slice would be amazing as well.

Nutrition Knowlege: Look How Far We've Come!

Remember those Old Wives Tales your mom or grandmother used to tell you?  "Eating spicy foods can cause ulcers", "chocolate causes acne", "feed a fever, starve a cold", and there are so many more than just those.  Its amazing to see just how far we've come to know about nutrition and the science behind the connection between what we eat and how our body responds.

The first widely read nutrition study was published in 1872 in the British Medical Journal. Back then, researchers produced nutrition studies slowly, publishing fewer than five (and sometimes just one) a year. Today it’s a completely different story. In 2011, more than 16,000 nutrition studies were released in peer-reviewed scientific journals. It’s no wonder our understanding of nutrition is always expanding and shifting. In the last 10 years, we’ve seen new perspectives emerge regarding everything from fat to food sensitivities. Let's take a moment to look back at the top 10 revelations of the past decade:

1. Our genes and diet are related
The completion of the Human Genome Project in 2003 provided a blueprint of our DNA and helped give rise to nutrigenomics, the science of how the nutrients we consume impact our genes. “We now know that certain cancers, cardiovascular disease and other chronic diseases that accompany aging can be prevented or delayed by matching our diets to our individual genomes,” says Patrick J. Stover, Ph.D., professor and director of the Division of Nutritional Sciences at Cornell. For instance, roughly 58 percent of people with high blood pressure are genetically salt-sensitive, so simply limiting the amount of salt they eat can lower their blood pressure. But before you go running to your doctor or dietitian for a genetically prescribed diet, know that “there are still many challenges in classifying people by their genotype and designing a food system that can provide an individualized prescriptive diet,” says Stover.

2. Not all fat is bad fat
At the end of the 20th century, “low fat” seemed to be the ubiquitous mantra of health professionals, government organizations and countless food products, but today, research suggests that trimming fat to less than 25 percent of our calories isn’t a great idea. “Cutting too much fat out of your diet can raise triglycerides and decrease healthy HDL cholesterol, which are both risk factors for heart disease,” says Penny Kris-Etherton, Ph.D., R.D., F.A.H.A., a distinguished professor of nutrition at Pennsylvania State University. “When we replace fat with carbohydrates—refined carbohydrates in particular—our liver steps up its production of triglycerides.”

Low-fat diets get a failing grade for weight loss too. “For many people, low fat really translates to high carb, which prompts a big glucose (and insulin) spike, causing blood sugar to then drop quickly, ultimately resulting in hunger,” says Kris-Etherton. “Instead, aim for about 30 percent of calories from fat.”

The type of fat matters too. For optimal health, experts now recommend choosing mostly unsaturated fats (think: liquid vegetable oils, nuts, avocados) and limiting saturated fat because of its negative impact on cholesterol and heart health.

We’re also learning that the villainization of saturated fats might not be so black and white. What we call saturated fat is actually a mosaic of building blocks called saturated fatty acids, such as lauric, myristic, stearic and palmitic acids. Emerging research suggests that some of these may not be harmful. That’s good news if you like dark chocolate, a food plentiful in stearic acid, which has little impact on cholesterol. Then there’s lauric acid, the main fatty acid in coconut oil, which research suggests boosts beneficial HDL cholesterol (although it also raises unhealthful LDL). “Coconut oil is slightly less evil than other saturated-fat-rich foods like palm oil and shortening because of its impact on HDL,” says Kris-Etherton. “But it still isn’t good for you.” Until more is known, stick with foods rich in heart-smart unsaturated fats, olive and canola oils, rather than scrutinizing the individual fatty acids in food.

3. A calorie isn’t just a calorie
You’ve heard it a million times: to stay weight-stable, calories in must equal calories out. Now we’re learning that may not always be the case. In a 2010 Food & Nutrition Research study, researchers asked volunteers to eat either a sandwich made from multigrain bread and Cheddar cheese or a white bread and processed cheese sandwich. When the researchers measured how much energy it took to digest and absorb each of the sandwiches, they found the volunteers used nearly twice as many calories to break down the multigrain sandwich. The reason: our ­bodies handle processed and unprocessed carbohydrates differently. “When you use a machine to strip away the bran, husk and fiber from carbohydrates, that machine is essentially expending energy that your body would normally use to break down those food components,” says study co-author Jonathan Wright, Ph.D., a professor of biology at Pomona College.

4. Food sensitivities aren’t all in our head
Twenty years ago, if you told your doctor that eating foods like bread made you feel sick, he or she would likely have told you it was all in your head. Today we know roughly 1 percent of us suffer from celiac disease, an autoimmune reaction triggered by gluten in grains like wheat, barley and rye. And experts estimate that approximately 20 million Americans (6 percent) suffer from gluten sensitivity.

“We’re in the same place now with gluten sensitivity that we were with celiac disease 20 years ago,” says Alessio Fasano, M.D., director of the Center for Celiac Research at the University of Maryland School of Medicine. “Many of the symptoms of gluten sensitivity, such as abdominal bloating, difficulty concentrating and fatigue, are present in celiac disease. But by listening to patients, we’ve learned that many people who test negative for celiac disease still see their symptoms improve on a gluten-free diet. This led us to believe there was another condition, which we now call gluten sensitivity.”

5. We need more vitamin D than we thought
Thanks to our obsession with sunscreen, a short list of vitamin D-rich foods and hours spent indoors, three out of four Americans don’t get enough vitamin D. While we once thought vitamin D deficiency was only a problem for people living in northern latitudes, a 2010 Pediatrics study found that 56 percent of teens living in the sunny South were vitamin D-insufficient, meaning they didn’t soak up enough rays to produce the amount of D required for optimal health.

No wonder the Institute of Medicine (IOM) recently tripled its recommendation for the “sunshine vitamin” to 600 IU daily (800 if you’re over 71). The new quota is critical for strong bones, but many experts say you may need even more to lower risk of heart disease, type 2 diabetes, multiple sclerosis and many kinds of cancer (the upper limit is 4,000 IU). Moreover, it’s nearly impossible to get enough D from foods, especially when “vitamin D-fortified foods, such as milk and some orange juices, usually only have about 100 IU per serving,” says Michael F. Holick, Ph.D., M.D., director of the vitamin D, skin and bone laboratory at Boston University School of Medicine. The amount of vitamin D you make from sun exposure depends on several factors, such as the color of your skin, where you live and even how old you are. Because of that Holick recommends a three-pronged approach for everyone: eat D-rich foods (namely wild-caught salmon, which delivers more D than farmed salmon, UV-exposed mushrooms and fortified dairy and orange juice), get 10 to 15 minutes of sun on your arms and legs (and abdomen and back when possible) sans sunscreen three times a week during spring, summer and fall (when you can get enough UV rays to produce sufficient vitamin D) and take a supplement of 1,500 to 2,000 IU of vitamin D3 each day.

6. There’s one more reason to avoid BPA
The synthetic chemical bisphenol-A (BPA) has been used in the linings of metal food cans and in hard-plastic containers and bottles since the 1960s. It’s also found in everything from foodstorage containers to recycled paper, the receipt the cashier hands you at the cash register—even dental fillings and sealants. And BPA will persist in our food supply: in March, the FDA rejected a petition from environmentalists to ban the chemical from food and drink packaging.

Science has linked BPA to early puberty, reproductive irregularities and cardiovascular and neuro­logical damage. Now, a growing body of research suggests it may be making you heavier. In the late 1990s, studies revealed that BPA leads to developmental changes in the fat cells of unborn animals that cause those cells to multiply and soak up excess fat. Now experts say it’s a problem for humans, too—a serious concern, since nearly 93 percent of us harbor BPA in our bodies. A 2008 Journal of the American Medical Association study found that people who were obese had 30 to 77 percent more BPA in their urine than normal-weight adults. Experts suspect that BPA promotes weight gain by stimulating the pancreas to rev up its production of insulin, leading to increased blood sugar levels and decreased insulin sensitivity.

“BPA doesn’t just damage the development of one system: the more of it that’s in your body the more prone you are to obesity, diabetes and heart disease,” says Frederick Vom Saal, Ph.D., a professor of biological sciences at the University of Missouri.
The good news is we don’t store BPA in our bodies for long. Avoiding contact with it for just one week will flush it from your blood (it may still be stored in fat, and during pregnancy in the placenta or fetal tissue). While you may not be able to eliminate it entirely, try to buy fresh or frozen foods or foods in cans labeled BPA-free, store food in glass containers or plastic ones labeled BPA-free, and wash your hands after touching cash-register receipts and recycled paper.

7. How we get our nutrients matters
Even though more than half of all U.S. adults pop at least one dietary supplement a day, recent research reveals pills can’t match the disease-preventing power of food. “In their natural form, nutrients in food—like vitamins, minerals and phytochemicals—are present in specific, balanced concentrations and work together in a highly synergistic way,” says Manuel Villacorta, M.S., R.D., author of Eating Free (HCI Books, 2012). Consider avocados: they’re rich in heart-healthy fats as well as vitamin E, a nutrient that requires fat for absorption. While you could get vitamin E from a pill, you can’t absorb it without the fat that nature conveniently packaged in the avocado.

What’s more, some supplements taken in excess can be harmful. In the mid-1990s, a small body of research suggested that people whose diets were rich in vitamin E were less likely to develop heart disease. But a 2005 Journal of the American Medical Association study found that people who had vascular disease or diabetes and took 400 IU of supplemental vitamin E daily were 21 percent more likely to be hospitalized for heart failure. Similarly, studies show that smokers who take supplemental beta carotene are more likely to develop and die from lung cancer even though people who eat lots of beta-carotene-containing foods (carrots, watermelon) have a lower risk of cancer. The evidence is so strong that the IOM advises against beta-carotene supplements.

8. Dietary cholesterol isn’t so evil
Years ago, if you had a cholesterol problem you were under strict orders to avoid cholesterol-rich foods like eggs and shrimp. Today, we know these foods are fine to eat in moderation. The truth is our bodies need some cholesterol to make hormones, vitamin D, bile acids (compounds that help us digest fat) and the membranes that line our cells.

While some of the cholesterol in your bloodstream comes from the food you eat, your liver manufactures anywhere from two-and-a-half to five times that amount every day. When your liver senses incoming cholesterol from food, it simply produces less. What really trips it up is saturated fat from foods like cheese, butter and fatty cuts of red meat. When bombarded with too much saturated fat, our bodies respond by clearing less “bad” LDL cholesterol from our bloodstreams (the same thing happens if you’re genetically predisposed to high cholesterol). That means limiting saturated fat is far more important than axing all cholesterol from your diet. Keep your numbers in check by eating 7 percent or less of your calories from saturated fat (that’s 16 grams for a 2,000-calorie diet). And the American Heart Association (AHA) recommends limiting cholesterol from foods to 300 milligrams a day (that’s one and a half large eggs or, if you can believe it, 34 medium shrimp). If you have—or are at risk for—heart disease, cap cholesterol at 200 milligrams.

9. We’re eating too much sugar
In the past 40 years, the amount of added sugars in our diets has skyrocketed. Today, the average American eats about 420 calories (28 teaspoons) a day—essentially a meal—from added sugars. That’s a 12 percent increase from 25 teaspoons in 1970. All that sugar spells bad news for our waistlines. Although experts aren’t sure of the exact mechanism, sugar has also been linked to an increased risk of diabetes, high blood pressure, metabolic syndrome and heart disease. No wonder leading health organizations, such as the AHA, World Health Organization and USDA, have recently started urging us to slash the added sugar in our diets.

But if you think switching from white table sugar to a more natural sweetener, such as agave or honey, would be better for you, think again. Whether added sugars come in the form of white sugar, honey or high-fructose corn syrup, to our bodies they’re exactly the same, supplying empty calories that provide little or no nutrition.

The big picture isn’t the type of sugar we’re eating, it’s where we’re getting it. “About 75 percent of all consumer packaged foods and beverages contain added sugars,” says Barry Popkin, Ph.D., a distinguished professor of nutrition at the University of North Carolina. “But the major shift is the increase in sugar in beverages rather than foods.” Over 35 percent of the added sugar in our diets comes from soda, sweetened drinks and sports drinks. The easiest way to trim your added-sugars intake is to banish all sweetened drinks.

10. Our bodies don’t want us to lose weight for good
If you’ve ever lost weight only to gain it back again, you’ll be glad to know it might not necessarily be your willpower that’s the problem. “Your body is constantly striving for equilibrium,” says Villacorta. “When you do anything to disrupt that equilibrium, your body tries to tell you to eat more by altering production of hormones that control hunger.”

Losing weight wreaks havoc on your hunger hormones in two ways: it triggers a decrease in hormones that suppress appetite, such as leptin and cholecystokinin, and boosts production of hormones that tell you to eat, namely ghrelin and neuropeptide Y. A 2011 <3m>New England Journal of Medicine study of 50 dieters found that, even a full year after losing weight, the volunteers’ hunger hormones failed to return to pre-weight-loss levels.

The good news is you can eat to outsmart those hormones. “Skipping or delaying meals causes ghrelin, and your appetite, to increase,” says Villacorta. “Eating every three to four hours will help control your appetite.” At least that’s news we like to hear.

101 Nutrition Questions...Answered!

Every time I tell someone that I am studying to become a Registered Dietitian, I get asked some sort of interesting, burning, sometimes outlandish question that a person just HAS to know and has decided that I am the perfect person to answer them.  I have compiled a list of some of my favorites, along with links to additional information on each question.  Alright, its not quite 101 that I listed here, but it is as many as I could think of.  And maybe some of these were YOUR burning nutrition questions you just didn't get the chance to ask me.  Enjoy!

Is Goat's Milk Lower in Lactose than Cow's Milk?
There is slightly less lactose in goat's milk—9 grams per cup compared to 12 grams in cow's milk. If you are lactose intolerant and would like to try goat's milk, start with a small serving with meals.
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Does Grape Juice Have the Same Heart Benefits as Red Wine?
Recent studies suggest that red and purple grape juices may offer some of the same heart benefits of red wine.
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What Foods are Good Sources of Potassium other than Bananas and Orange Juice?
Fruits and vegetables are among the best sources of potassium, a mineral that helps normalize blood pressure.
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What is Quinoa?
Quinoa is a grain that cooks faster and is higher in protein than many other grains.
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Will Eating Lots of Sugar Cause Diabetes?
Just eating a lot of sugary foods does not cause diabetes.
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Is Popcorn a Whole Grain? What Other Foods are Whole Grains?
There are many options to choose from, including foods fortified with whole grains. The Dietary Guidelines recommend at least three servings of whole grains every day.
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What Does 'Organic' Mean on a Food Label?
The term organic has specific guidelines defined by the United States Department of Agriculture (USDA) National Organic Program.
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Is Flaxseed a Good Source of Fiber?
Yes, one tablespoon of whole flaxseed has three grams of fiber while the same amount of ground flaxseed has two grams of fiber.
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Is a Tomato a Vegetable or a Fruit?
This issue has a long history - it was even brought before the United States Supreme court in 1893.
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How Can I Get My Family to Be More Active?
As with healthy eating, kids are more likely to want to be active when other family members are active too. Here are some tips for getting family members together for physical activities.
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How Many Calories Do I Need a Day Now That I'm Over 50?
The number of calories you need each day depends on your age, gender and activity level. The estimated calorie needs for adults age 51 and older are listed.
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What is the Difference between a Plantain and a Banana?
Plantains belong to the banana family, but are starchy, low in sugar and contain more vitamin A and vitamin C than bananas.
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My Child Likes Fruit but Won’t Eat Vegetables. Is that Okay?
Each fruit and vegetable choice offers a unique combination of nutritients. Be sure to choose a variety.
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What is Pre-Diabetes?
Pre-diabetes is a condition in which blood sugar levels are higher than normal, but not high enough to be classified as diabetes. Pre-diabetes may be related to too little insulin being produced or decreased response to insulin by the body.
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How Can I Get Enough Calcium in My Diet if I Follow a Vegan Lifestyle?
Milk and dairy products are not the only calcium-rich foods. Low oxalate greens such as bok choy, broccoli and Chinese cabbage are good sources of calcium.
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I Have a Hard Time Getting my Child to Eat Meat. What Else Can I Feed Him for Protein?
There are plenty of options for high-protein foods. This food group includes not only meat but also legumes, eggs, nuts and seeds.
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Does Eating Breakfast Really Help with Weight Loss?
At this time, research has not demonstrated a consistent link between eating breakfast and body weight. Some studies show a relationship between skipping breakfast and a strong prevalence of obesity.
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Are Shrimp and Shellfish Still Considered Bad if You Have High Cholesterol?
A diet high in cholesterol can elevate blood cholesterol. The Dietary Guidelines suggest consuming less than 300 milligrams of cholesterol per day.
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I Am Supposed to Limit My Sodium Level. What Can I Do to Add Flavor to Foods?
An easy way to reduce sodium intake is to stop using the salt shaker at the table - instead, add flavor during food preparation with flavor-enhancing ingredients like:
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Why Does Yogurt Have So Much Sugar?
Yogurt has a high amount of sugar but it can still be a healthy choice for your nutrition goals. The "sugars" on the Nutrition Facts panel include both naturally-occurring and added sugars.
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What are the Best Bets on a Chinese Restaurant Menu?
There are plenty of healthy options at Chinese restaurants. Soups, such as wonton or hot-and-sour, are healthy and filling. Dishes that are heavy on the vegetables and include lean protein such as:
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Why Do Hard-Cooked Eggs Spoil Faster than Fresh Eggs?
When eggs are hard cooked, the protective coating is washed away, leaving bare the pores in the shell for bacteria to enter and contaminate it.
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Are Easter Eggs Safe to Eat?
Hunting for Easter eggs is a favorite pastime for many. But how are those eggs afterwards? Are they safe to eat?
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Does Chocolate Have a Lot of Caffeine?
Chocolate does contain caffeine, but not much. A 1-ounce milk chocolate bar or an 8-ounce glass of chocolate milk each contain about 5 milligrams of caffeine.
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Why Is the Inside of a Hard-Cooked Egg Green?
A green ring on a hard-cooked yolk is a result of overcooking. It’s caused by sulfur and iron compounds in the egg reacting on the yolk's surface.
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Is It Done Yet?
When cooking chicken and other poultry, use a food thermometer to measure the internal temperature and determine doneness; don't rely on visual cues.
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What Makes Hard-Cooked Eggs Hard to Peel?
The fresher the egg, the more difficult it is to peel after hard cooking.
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Is Lactose-Free Milk Real Milk?
Yes, lactose-free milk is real milk. The enzyme lactase has been added to break down the lactose, the natural sugar found in milk.
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Should I Worry About Moldy Food?
If you find foods in your refrigerator or pantry that have mold on them, there are some guidelines you should follow to handle the moldy foods properly.
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What is Trans-fat?
While there are some naturally occurring trans-fats in animal foods, most of the trans-fat in our food system is created through a process called hydrogenation.
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Any Tips on Packing Picnic Coolers?
When transporting food to another location, keep it cold to prevent growth of harmful bacteria. Use an insulated cooler with enough ice packs to keep the food at 40 degrees F. or below.
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Is Whole Milk Good For Toddlers?
Discuss the appropriate choice for your child with your pediatrician or registered dietitian.
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What Foods are Best for Backpacking?
If you are going for a day hike, just about anything will do as long as it can fit in your backpack and you can keep perishables cold – sandwiches, fried chicken, salads, cheeses – or choose non-perishables.
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How Do I Know When Grilled Meat or Chicken is Done?
Meat and chicken can brown quickly on the grill. Use a food thermometer to be sure the food has reached a safe minimum internal temperature to destroy harmful bacteria.
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Does Grilled Food Cause Cancer?
Some research has suggested eating grilled, fried or broiled meats may increase cancer risk. However, based on present research findings, eating moderate amounts of grilled meats cooked without charring and to a safe temperature does not pose a problem.
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Is All Bottled Water the Same?
Some bottled water can be classified by its origin, such as mineral, spring and well water, while other types may come from municipal water that is treated before its bottled.
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Is Fruit Juice Good For My Baby?
The Academy of Nutrition and Dietetics and the American Academy of Pediatrics agree that fruit juice offers no nutritional benefits to children younger than 6 months.
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Are Men Over 50 at Risk for Osteoporosis?
While the incidence of osteoporosis is higher among women, more than 2 million American men suffer from osteoporosis. One in four men age 50 and older will have an osteoporosis-related fracture in their lifetime.
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What Foods are High in Iron?
Iron-rich food sources include red meat, chicken, turkey, pork, fish, kale, spinach, beans, lentils and fortified breads and cereals.
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How Should I Select Canned Produce?
Fresh fruits and vegetables can sometimes be expensive or favorites hard to find. When using canned instead of fresh or frozen, consider the following tips to get the most out of your canned fruits and vegetables.
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What Is GERD and How Is It Managed?
"GERD" is gastric reflux disease which occurs when the contents of the stomach flow backward into the esophagus. Symptoms include heartburn, pain and difficulty swallowing.
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Why Is There No Nutrition Facts Panel on Some Food Labels?
In the National Labeling and Education Act, certain foods are exempt from nutrition labeling. These include ready-to-eat food that is not for immediate consumption and food that does not contain significant amounts of nutrients.
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Should I Eat Something before I Go to the Gym after Work?
Eating before exercise, as opposed to exercising on an empty stomach, has been shown to improve performance. A snack eaten before a workout provides fuel for your body to function at its best.
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Does Microwaving Food Destroy the Vitamins?
Whether you're zapping food in your microwave or cooking it on the stove, it's the amount of heat and cooking time that affects vitamin loss.
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What Do the Dates Stamped on Food Packages Mean?
The most common labels are sell-by, use-by and expiration date. Here's what they mean.
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Is Goat's Milk Lower in Lactose than Cow's Milk?
There is slightly less lactose in goat's milk—9 grams per cup compared to 12 grams in cow's milk. If you are lactose intolerant and would like to try goat's milk, start with a small serving with meals.
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What is the Source of Canola Oil?
The canola plant was developed from its close relation, the rapeseed plant, using traditional plant breeding methods. The oil extracted from canola seeds is very low in saturated fat and an excellent source of mono- and polyunsaturated fats.
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Are Simmering and Braising the Same Thing?
Recipes often use instructions like simmer or braise without any further explanation. Both culinary terms refer to moist-heating cooking methods that use water or water-based liquids such as broth to cook foods.
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What Does BMI Mean? Will It Tell Me My Ideal Body Weight?
BMI — Body Mass Index — is a measure of your weight in relation to your height.
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Does "Made with Whole Grains" Mean the Food is a Good Whole-Grain Source?
"Made with whole grains" means that the product has some whole grain in it, but the product is not 100 percent whole grain.
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What Can Reduce the "Fire" Caused by Eating Hot Chili Peppers?
Try dairy foods. Capsaicin in chili peppers stimulates pain receptors in your mouth. Casein, the main protein in milk, washes away the capsaicin that makes your mouth and throat burn.
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If I am Trying to Cut Back on Caffeine, Will Switching from Espresso to Coffee Help?
Actually, espresso has less caffeine than coffee! If you are trying to decrease your caffeine intake, consider changing to black or green tea.
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My Doctor Said I Need to Gain Weight. What Should I Eat That’s also Healthy?
For some people who are too thin, weight gain can be just as hard as weight loss. You need to eat more calories than you burn, but do this in a healthful way. Here are a few tips to get you started.
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I Need Some Ideas on How to Make Healthier Choices at a Sandwich Shop.
If you are looking to make healthy choices, remember it's okay to make requests. Here are a few tips for making healthy choices.
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Why Do Products Say They Have No Trans Fat, But I See Hydrogenated Oil Listed in the Ingredients?
Trans fats are mainly found in food prepared with partially hydrogenated oil. The FDA requires food labels to include the trans fat content per serving of the food, but a food label can read "0 grams" of trans fat if there is less than 0.5 grams per serving.
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Can I Follow a Vegetarian Diet if I’m Pregnant?
Well-planned vegetarian diets can be nutritionally adequate and provide many health benefits during all states of the lifecycle including pregnancy.
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Is Couscous a Grain?
Couscous may look like a grain but it’s actually a type of pasta made from ground semolina wheat.
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I've Heard That Low-calorie Sweeteners Can Increase Your Appetite. Is This Accurate?
A recent analysis of published research concluded that low-calorie sweeteners do not affect appetite in adults.
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How Much Exercise Do I Need to Lose Weight?
To lose weight, your goal should be one hour of moderate activity each day. This will burn about 2,000 calories per week, helping you achieve gradual, maintainable weight loss.
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Are Energy Drinks Better for Workouts?
For workout sessions that are of low to moderate intensity and will be lasting an hour or less, water is a good choice before, during and after exercise.
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Does Your Stomach Really Shrink When You Eat Less?
Your body doesn’t work that way. When you cut back on your portions, your stomach keeps its normal size even if your appetite isn’t as big.
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Is Coconut Water a Good Choice for a Sports Drink?
Coconut water contains electrolytes and minerals and is often marketed as a sports drink. It is a good source of fiber, potassium, magnesium and vitamin C.
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How Can I Spot a Fad Diet?
There are many popular diets you can choose from but fad diets have some things in common.
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What Is Meant by the Term 'Lean Cuts of Meat?'
When shopping for meat, words like round, loin or leg indicate cuts that are lean or lower in total fat and saturated fat. If you’re not sure of the cut, ask the butcher or check the label.
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Which Dishes Are the Healthiest At an Italian Restaurant?
If you enjoy Italian food, you can eat pasta and still follow a nutritious and healthy meal plan.
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What Foods Are Good Sources of Vitamin D?
Get the recommended amount of vitamin D by eating foods that are good sources of it — such as fatty fish and fortified dairy products.
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Is it True That Cinnamon Can Lower Blood Sugar in People Who Have Diabetes?
Although early studies suggested that cinnamon might be effective for lowering blood sugar (glucose) levels, recent studies show conflicting results.
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Can Certain Foods Help Prevent Macular Degeneration?
Research suggests that antioxidants may help prevent or slow the development of some age-related changes in the eyes such as macular degeneration.
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What is Basmati Rice?
Basmati rice is an aromatic, long-grain rice with a distinctive aroma and flavor much like that of popcorn or roasted nuts.
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What Are B-complex Vitamins?
The B-complex vitamins are a family of vitamins with related roles in promoting health. They are: thiamin (vitamin B1), niacin, vitamin B6, folate, vitamin B12, biotin and pantothenic acid.
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How Do I Cook Lentils?
Lentils are quick and easy to prepare without pre-soaking. Try adding them to soups, stews and salads.
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How Do You Eat a Pomegranate?
Pomegranates can be messy to prepare. Select one that has a deep color and is heavy for its size and try this 3-step process.
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Does Sugar Make Kids Hyperactive?
There's no scientific evidence to support any link between eating sugary foods and hyperactivity. Even so, many parents and other caregivers seem reluctant to give up this idea.
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How Can I Get My Kids to Eat Breakfast?
For kids and teens, a morning meal is especially important. Make breakfast fun by planning it with your child or trying non-traditional foods.
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Do Men Have Eating Disorders?
Yes, both men and women may develop an eating disorder; however some groups are more at risk than others.
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Is Anorexia the Only Kind of Eating Disorder?
Anorexia is just one category of eating disorders. Eating disorders are medical illnesses that involve extreme emotions, attitudes and behaviors focusing on weight and food issues.
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How Much Fluid Should You Drink When Breastfeeding?
During breastfeeding you need about 13 cups of fluids daily. Drink more if you're thirsty.
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How Do I Prepare the Fennel that I Bought at the Farmers Market?
Fennel has a broad, off-white base and light green, celery-like stems with bright green foliage. Fennel can be eaten raw or cooked like other vegetables by grilling, boiling or sautéing.
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What is the Morning Banana Diet?
The Morning Banana Diet which first gained popularity in Japan has now spread around the world. The basic rules of the diet are simple.
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If your burning nutrition question hasn't been answered, feel free to ask! 

Protect Your Picnic!

Summer is here and with it picnic season, a time to enjoy favorite summer dishes in the great outdoors. When you're relaxing with family and friends, it's easy to get caught up in the fun and accidentally cross-contaminate food, or forget to pack enough ice to keep your cooler cool. Unfortunately, one small error can sicken your whole crew, making you one unpopular host! One in six Americans gets sick every year from foodborne pathogens. Stay healthy by learning how to prevent these seven common picnic food slipups.

 Picnic Error: You Didn't Wash Your Hands
"The biggest mistake people make is not washing their hands at all, or often enough during food preparation," says Academy of Nutrition and Dietetics Spokesperson Melissa Joy Dobbins, MS, RD, LDN, CDE. "Nearly half of all foodborne illnesses could be eliminated if people would wash their hands more often when preparing food."

Wash your hands before cooking, after handling raw meat and before eating. Bring hand sanitizer if there is no running water at your picnic site, and rub it all over your hands, including between fingers and around nails.

 Picnic Error: You Didn't Start with a Clean Slate
Your hands aren't the only things you should keep clean. If you're not careful, juices from raw meat and poultry can drip into your cooler, creating a breeding ground for bacteria growth. Before you pack for your picnic, sanitize your cooler and wash reusable bags you'll use to transport food. Pack your food in clean, tightly sealed containers.

If you won't have access to running water at your picnic site, wash fruits and veggies at home first. Wash produce even if you plan on peeling it; bacteria can transfer from the knife or peeler to the edible portion.

 Picnic Error: You Cross-contaminated Plates
If you won't be able to wash plates, tongs and serving utensils at the picnic site, bring two sets: one for handling raw meats, and one for serving cooked meat. Accidentally serving cooked hamburgers on the same plate you used for the raw patties can lead to foodborne illness. Make sure you keep ready-to-eat food like buns, fruits, vegetables and side dishes away from contaminated serving utensils, too.



Picnic Error: Your Cooler Lost its Cool
Even an insulated cooler can't keep food cool enough on its own. Pack your cooler about three quarters of the way full of food, reserving one quarter of the space for ice packs. If possible, chill or freeze foods before packing them in your cooler. Pack cold and hot food separately.

Always pack a thermometer and keep an eye on it throughout the day. "Without a thermometer in the cooler, you can't be sure that the food is indeed at 40°F or below," says Dobbins. "Often the cooler is sitting in the sun or in a hot car so long that the temperature goes above 40 degrees."

Consider packing beverages in a separate cooler. You can keep the cooler with the perishable food closed while the beverage cooler is frequently opened and shut.
Picnic Error: You Repurposed Ice

If you're bringing ice to use in beverages, pack it in a separate sealed bag. Don't use loose ice used to keep food cold in beverages. This ice could have picked up odorless, invisible bacteria from leaking food.

 Picnic Error: You Let Food Sit Out
Keep perishable picnic food out of the danger zone – a temperature range between 40°F and 140°F. When food is in the danger zone, bacteria can double in number every 20 minutes. "Unfortunately, you cannot see, smell or taste if a food has harmful bacteria or toxins growing in it," says Dobbins. "This is very different from 'spoiled' food."

Don't let food sit out more than two hours. If the temperature outside is 90°F or above, food may only sit out for an hour. It's easy to lose track of time when you're relaxing outside. Bring a timer or set an alarm on your cell phone to remind you when it's time to put food away.

Remember – it's not just meat that can make you sick. All perishable food should be monitored closely, especially egg, potato and tuna salads made with mayonnaise, and anything dairy-based.



Picnic Error: You Didn't Bring a Food Thermometer
Meat needs to be cooked to certain temperatures to control harmful bacteria. Hamburgers should be cooked to an internal temperature of 160°F. Chicken breasts and legs must be cooked to 165°F.

There are right and wrong ways to take the temperature of meat. For example, you'll get a false reading if the food thermometer touches a bone when you're testing a chicken breast. Hamburgers should always be tested in the thickest section.

Remember these tips to help protect your picnic this summer.  Have a safe and happy Fourth of July!