Sharing an article which I wrote for “Practical Nutrition”:

http://practicalnutritionbydietitian.com/2010/06/28/the-bottom-line-on-artificial-sweeteners/

Have a happy & healthy week!

Angie

I spoke to the “Circle of Hope” mother’s group here in Elizabeth City this morning.  I compiled a list of helpful resources for parents of young children and just wanted to share…. 

Nutrition Resources for Parents of Toddlers & Preschoolers

Books for Parents:

“Child of Mine: Feeding with Love and Good Sense”, Ellyn Satter MS, RD, LCSW, BCD. Bull Publishing Company; 3rd edition, 2000.

“Just Two More Bites!: Helping Picky Eaters Say Yes to Food”, Linda Piette, MS, RD. Three Rivers Press, 2006.

“Feed Your Family Right” by Elisa Zeid, MS, RD, CDN. Wiley, 2007.

“Baby Bites: Everything You Need to Know about Feeding Babies and Toddlers in One Handy Book” by Bridget Swinney, MS, RD. Meadowbrook, 2007.

Helpful Websites:

http://www.dinnertogether.com

My Pyramid: www.mypyramid.gov

Nutrition Pair, LLC: www.nutritionpair.com   http://www.facebook.com/NutritionPair

Super Kids Nutrition: www.superkidsnutrition.com

Books for Children:

“Eating the Alphabet” by Lois Ehlert. HMH Books, 1996.

“Bread and Jam for Francis” by Russel Hoban. Harper Collins, 1964.

“Eat Your Peas” by Kes Gray & Nick Sharratt”. Harry N. Arams, Inc, 2006.

“The Carrot Seed” by Ruth Krauss. HarperCollins, 2004.

“I Will Never NOT EVER Eat a Tomato” by L. Child. Orchard Books, London, 2000.

“Muncha, Muncha, Muncha” by Candace Fleming. G. Brian Karas Atheneum Books for Young Readers, New York, 2002.

It’s Your Health.  It’s Your Life.  Make That Change!!!

~ Angie

It’s Farmer’s Market season.  Local open air markets are a great opportunity to do something good for your health.  As we have said numerous times before, increasing our fruit and vegetable intake is one of the best things we can do for our bodies.  Fruits and vegetables are low in calories but enormously high in nutrition. 

Local or home-grown fruits and vegetables are usually highest in nutrition.  They are freshly picked and have not been traveling long distance on a truck or sitting in a warehouse.  They do not have to travel far to their destination—your table! 

Another great and fun advantage is that you get to meet the people who have grown your food.  You can ask them how to prepare the particular fruit or vegetable.  Farmers really enjoy sharing their knowledge about their produce and providing you with recipes and/or preparation tips.

Additionally, you are helping to stimulate your local economy as well as keep your local farmers in business.  Want to eat “organic”?   Many local farmers practice organic farming.  Just ask them about it. 

Want to find markets in your local area?  Check out this site   http://www.localharvest.org/. Just plug in your zip code and it will find farmer’s markets in your local area.

In Elizabeth City, NC, we have the Downtown Waterfront Market every Saturday from 9am until 1pm through October 30 this year.  Visit www.downtownwaterfrontmarket.com for more information. 

So, make plans to visit a local farmer’s market this weekend.  Enjoy the sights, sounds, and fresh air.  Pick up a fruit or vegetable that you have never eaten.  You may discover a new summertime favorite!

It’s your Health!  It’s Your Life!  Make That Change!

~ Angie

Happy Valentine’s Day! I wanted to take this day to discuss a subject that is near and dear to my heart. I am a Registered Dietitian and, yes, nutrition is a love of mine. However, I would have to say that my true passion lies in helping those who have diabetes live healthier and happier lives.

Chances are that you have a family member, friend or at least know of someone who has the diabetes. In the past 25 years, the rate of diabetes in the United States has more than tripled. Currently, 21 million, or seven percent of the U.S. population has this chronic disease (Source: NIDDK).

People who happen to have diabetes should not be called “diabetic”. In contrast, they should be referred to as “having diabetes”. It really makes me cringe when I hear an individual being identified as “the diabetic”. I hear it in both the lay as well as health care settings. It is especially displeasing when I hear it used in the medical community. Coming from a professional perspective, this is awful. People with diabetes are people. They are people who just happen to have diabetes.

It’s not about being politically correct. It’s about semantics. We need to consider the person. They are much more than their disease. As the wife of someone who has diabetes, it makes me even more upset. John is not a “diabetic”. John is a person — a wonderful person who lives a healthy, full life and has many different interests and hobbies. He just happens to have diabetes. John says it does not bother him to be called “diabetic”. “That’s what I am”, he will say. But, he does think it’s peculiar and amusing to call an object “diabetic” such as “diabetic yogurt”, “diabetic socks” or “diabetic shoes”. “The shoes don’t have diabetes”, he will say jokingly.

The term “diabetic diet” is even no longer used. The American Diabetes Association (ADA) eliminated the use of the terms “Diabetic Diet” and “ADA Diet” over ten years ago. They stated that there is no one diet for people with diabetes and that meal plans need to be individualized.

In that same sense, people with diabetes are individuals — individuals who happen to have diabetes. Please call them by their names and not a disease.

It’s Your Health. It’s Your Life. Make that change!

~ Angie

There was an interesting study which was released earlier this month. The study looked at the Nutrition Facts from selected restaurant and packaged food products.  They compared what was listed versus what was actually found in the foods when tested in a laboratory.  Check out original release here.  Unfortunately, the findings of the study showed that most restaurants and some of the packaged food product companies significantly underestimated the amount of total calories contained in their products.  It appears that one of the reasons for the discrepancies comes from portion size served versus the portion size estimate.  The study focused on calories only. 

Let’s take this a step further. Calories do not tell the whole story. We are all aware of Subway and their ‘healthier’ choices and lower fat options.  McDonald’s also promotes healthy options.  KFC, formerly, Kentucky FRIED Chicken and now even Taco Bell have ‘healthy’ fare.  Heck, Taco Bell is trying to steal some of Subway’s promo action by pushing their own ‘Drive Thru Diet’ plan with “Christine” as their “Jared”.  What I find interesting in this whole exchange is that nobody is pushing fresh fruits & vegetables AND nobody seems to be concerned that the ‘healthy’ options can be very high in sodium. 

Should we be concerned about sodium?  Well, if you have High Blood Pressure, Chronic Kidney Disease, Congestive Heart Failure, take diuretics (fluid pills), or have a problem with fluid retention, then the answer is a resounding “YES!”  Sodium can increase fluid retention which can cause an increase in blood pressure.  Americans tend to get too much sodium from our foods. We only need about 500-1,000 mg a day to sustain life.  But recent estimates place the average daily intake at about 4,000-5,000 mg a day. (For a point of reference, a teaspoon of salt contains about 2,300 mg of sodium).  Most health organizations today are encouraging people to keep sodium intake to no more than 2,400 mg a day. Angie & I encourage our clients to limit intake to no more than 2,000 mg a day.

What we must increase our awareness of is that the sodium intake in our diets comes predominantly from our food choices NOT the salt shaker.  Processed foods, restaurant food, fast foods, snack foods and canned products all contain significant amounts of added sodium.  As we tend to prepare less foods at home and eat fewer fresh fruits and vegetables, the sodium levels in our diets will continue to rise.  The problem with our increasing intake of sodium is that the salt flavor is an accquired taste.  The more we get, the more we want.  Long-term, high sodium intakes can increase your risk of developing high blood pressure and heart disease.  Because it takes time for the cumulative effects to add up, we don’t pay as close attention to our food choices. Sodium in your diet can sneak up on you.

Let’s turn our focus back to those fast food companies and their push to get us to look for lower fat  & calorie options: Links to the companies web site for nutriton facts are provided:

• Subway’s 8 choices of subs with 6 grams of fat or less.  Only one option has a sodium content of less than 500 mg. The 6″ Black Forest Ham Sub has 1200 mg of sodium.  If you add a bag of chips, that adds at least another 200 mg!
• McDonald’s Premium salads sodium content varies. Without chicken, the salads range from 150-300 mg of sodium.  Add chicken to the salad and you increase the sodium 600-800 mg.  Throw in a bag of Croutons and add another 140 mg. Pour on salad dressing and you have to add another 340-730 mg of sodium. The side salad is listed as having only 10 mg of sodium.
• The Taco Bell Drive Thru Diet Fresco Menu has 7 items with less than 9 grams of fat. However, the lowest sodium choice, the Fresco Crunchy Taco has 350 mg of sodium. By itself that is acceptable.  The other choices from the Fresco Menu have anywhere from 600 to 1410 mg of sodium.
• KFC’s Grilled Chicken options have been getting a lot of attention. While they are lower in fat, you must still think about the sodium content. They do have a lower sodium content than many of the other examples we’ve been talking about.  However, most orders also include sides.  The sodium content of the grilled chicken choices range from 230 to 550 mg. The grilled chicken breast comes in at the highest with 550 mg but it also provides you with the largest amount of food. Add a side of green beans and you add 380 mg of sodium.  Complete your meal with a side of mashed potatoes without gravy and the sodium increase another 350 mg.  A meal with a grilled whole wing, side of green beans and side of mashed potatoes without gravy would give you over 900 mg of sodium!

Keep in mind the total daily intake of sodium we are recommending–around 2000 mg  a day. That equates to about 600-700 mg per meal.  Eating out makes it difficult to hit those goals.  I’m not saying you should stay away from fast foods or never go out to eat but I want you to be aware of what you are getting.  Don’t just look at the fat and calories.  Look at the whole picture. You can make better choices by leaving off dresings, gravies, sauces, cheeses and mayonaisse. Resist the french fries, onion rings, tater tots & biscuits and you’ll save more in the way of calories, fats and sodium.  I encourage our clients to take a piece of fruit with them if they are going out to eat.  Have that at the end of your meal in place of a dessert and you will definitely come out ahead.  As we always say, prepare more foods at home and concentrate on trying to eat more fruits and vegetables!

~It’s Your Health. It’s Your Life. Make That Change!

~John

Fall is our busiest season.  School is back in the session, the children are busy with fall sports and we are traveling to college football games. However, I would have to say that it is my favorite.  I love making gingerbread with the kids and the awesome smell that carries through the house. I love relaxing at the end of a busy day to George Winston’s “Autumn”. I love the crisp coolness and excitement in the air at college football games. But, one of my all-time favorite things to do in the fall is to run.  There is something about a run in the fall that is different from any other time of the year.  It is a treat for the senses.  The sound of the crackling leaves under your feet, the smell of the wood fires burning in the chimneys, the feel of the cool air, the look of the vibrant colors in the changing leaves and coral sunrises. The bugs are gone and the humidity is down. Madison, our ten year old Lab, feels it too as she is finally willing to leave from below the shaded tree and join me for the cool down. 

Running, just like any exercise, makes you feel good.  When you exercise aerobically, you release endorphins. Those endorphins reduce stress and improve your mood.  Whenever I feel tense, exercise always makes me feel more relaxed.  The more hectic life gets, the more exercise seems to help me cope.  If I have tough decisions to make, it seems gives me a clear head in which to think. 

Many people know about how exercise can help you physicato lose or maintain weight, control blood sugar levels and improve overall fitness. But, one very important aspect of exercise that is often overlooked is how it can improve your mood.

So, get out and enjoy the good things that both fall and exercise offer.  If you are not a runner, go for a walk.  You will be surprised at how good it will make you feel, both physically and emotionally! 

 ~ Angie

It’s Your Health. It’s Your Life. Make that change!

November is National Diabetes Awareness Month. This is an opportunity to recognize this widespread disease that can result in serious and debilitating complications, such as heart disease, stroke, kidney disease, blindness, and amputation. In the United States, 24 million people or 7% of the population have diabetes. Another 57 million Americans, or 29% of the population, have pre-diabetes. The incidence of diabetes in North Carolina is especially high as North Carolina ranks tenth in the nation.

Diabetes is an expensive disease. One out of every five U.S. health care dollars is spent caring for individuals with diabetes. The total annual economic cost of diabetes in 2007 was estimated to be $174 billion. In fact, over the past five years, the cost has risen more than $8 billion each year.

The prevalence of diabetes in the U.S. is also rising. It has more than tripled over the past 25 years. The CDC estimates that every 21 seconds, someone in the US is diagnosed with diabetes. If things continue at this rate, 1 in 3 children born today will develop diabetes within their lifetime. Research has shown that obesity is the main reason for this increase.

Besides obesity, additional risk factors for diabetes include:

• Sedentary lifestyle
• Unhealthy eating habits
• Age over 45 years
• Family history of diabetes
• African American, Latina, Native American, Asian American, Pacific  Island ethnicity
• Women who have delivered babies nine pounds or more at birth.

The good news in all this is that diabetes is a controllable disease. We can’t control our genetics, ethnicity or age, but we can control unhealthy eating habits and a sedentary lifestyle. Complications are decreased when blood sugar control is managed through health eating and physical activity. Research has shown that for every 1% reduction in Hemoglobin A1C (A1c), the risk of developing eye, kidney, and nerve disease is reduced by 40%. The A1c is an estimate of average blood sugar over the previous three months.  What this means is that if your average blood sugar is lowered by just 30 points, your chance of any potential complications is almost cut in half.

If you have diabetes, pre-diabetes or are even at high risk of developing diabetes, find a Registered Dietitian, preferably one who is a Certified Diabetes Educators (CDE). A CDE is a health care professional that teaches people with diabetes to manage their condition. Formal education, years of practical experience, and a Board Examination are required prior to becoming a CDE. RD/CDE’s will help you to learn the tools, skills and emotional support necessary to control blood sugar and decrease the risk of long term complications.

It’s Your Health. It’s Your Life. Make That change!

~ Angie

I usually do not title a Nutrition Blog with a political quote but this one fits….From JFKs inaugural address, January 20th, 1961, “…ask not what your country can do for you -  ask what you can do for your country.”

We are hearing everyday how our country needs health care reform.  We are being told that we are in a health care crisis. Democrats & Republicans alike have thoughts on what reform should be or look like.  I’m not here to debate the issue of reform.  There is no question we need changes in many things.  From prescription drug costs to health care costs, we pay dearly for ways to bring us good health. But, are we healthier?  In the debating of the reform process, there has been some talk of increasing reimbursement for preventative care.  That is a nice start.  However, the major disappointment I feel stems from the fact that there has not been a call for increasing personal responsibility. We all want somebody to shoulder the costs of health care reform.  We complain about the cost of prescription medications, the high co-pay fees and health insurance.  Where we need to start, though, is with ourselves. Our lifestyles lead us to increasingly bad health. Sure, you can make the argument that you have the right to choose how you live. I am all for  that. But what happens when you get sick?  Many research studies have looked at the impact that lifestyle plays on our health.  Do we need studies telling us that fast foods are not healthy, that high sodium diets can cause high blood pressure, that diets low in fruits & vegetables can lead to a variety of illnesses?  For confirmation of that, we don’t need to look much further than the current increase of Type 2 diabetes in our youth. Twenty years ago, that was unheard of.  Today, as our children become more overweight and obese, it has become common place.

The time has come for each of us to take health care reform into our own hands. Each of us hold the keys to better health.  We don’t need government sponsored plans to set a healthier path. Look around and seriously assess your lifestyle choices.  From foods to alcohol to smoking to physical activity.  Are you choosing habits that will help or harm you in the long run?

People often tell us that it is too expensive to eat healthy.  Sometimes it may be more costly to eat healthier.  But think of that cost as an investment in your future.  The cost of getting sick is much more than the cost of eating healthy!  It’s funny that people have no problem spending money on the latest gadgets, HD TVs, cars, hair styles,….yet fail to look at what they eat, or how physically active they are.  Unfortunately, I can not promise you a longer life or total freedom from sicknesses if you make those changes.  But, I can offer you a better chance to beat those sicknesses and the opportunity to lead a more active , and possibly, productive life. 

“And so, my fellow Americans: ask not what your country can do for your health – ask yourself what you can change to improve it!” 

Like we say at Nutrition Pair, “It’s Your Health.  It’s Your Life.  Make That Change!”  We believe that each of us have the potential to lead healthier lives.  Don’t wait for the government to make a change.  Start it yourself. Challenge yourself to eat an extra piece of fruit everyday, dine out less often, prepare more foods at home, eat more broccoli or other vegetables, or walk an extra 15 minutes.  Challenge yourself to learn more, do more and get healthier.  Remember……

“It’s Your Health.  It’s Your Life.  Make that Change!”

~John

This article was written by John and myself and was featured in the “Guest Columnist” section of the August 22, 2009 edition of The Daily Advance. 

We read Robert Kelly Goss’s article, “I am Not a Foodie”, from the August 5, 2009 Daily Advance with some interest. However, we found his assertions disconcerting. His claim, “it is now a known fact that it (milk) is laden with chemical growth hormones and antibiotics that leaches into your child’s body, changing your child’s chemistry and not for the best” is a concern. While he may enjoy organic milk, making unsubstantiated claims like that are in poor judgment. This type of sensationalism is what fuels the fears and misconceptions many people have about nutrition and our food supply.

As “Foodies”, or more correctly, Registered Dietitians, we have been trained with both B. S. and M. S. Degrees in Nutrition with courses including Anatomy & Physiology, Human Metabolism, Chemistry, Biology as well as Food Science. When claims such as Mr. Kelly-Goss’s are allowed to float with no response, it adds to the “fictional” sciences that some people follow. While I am sure you can find support for any position on the internet, we would hope that Mr. Kelly-Goss would have done more in-depth research on this topic, or at least spoken with a Registered/Licensed Nutrition Expert before sharing his fringe ideas with our community.

We have no problems with people choosing organics over conventional food. This is certainly a personal choice. However, we question the reasons for doing so. For example, there is no difference in the nutrient value of organic and conventional milk. Keep in mind, companies promoting organic consumption DO prosper when claims targeting conventional foods play on our fears. Unfortunately, the onus of proving or disproving such a claim seems to always fall on the conventional line of thinking. Look at the billions of dollars still being spent by consumers on “natural” supplements. Many tend to not question the claims they make for curing a multitude of illnesses yet question the validity or safety of our food supply. However, the claims made by many supplement manufacturers fail when held to a peer – reviewed research study.

A former college professor lived and taught by his mantra to, “think critically and analytically” when assessing ideas. That line of thinking would help many people find the true answers they are looking for when trying to improve their health. Unfortunately, critical thought and analysis were missing from the claims made in that article.

All milk, even organic milk, contains hormones. One main point that should be brought out from a physiological standpoint regarding the hormones is that the majority of these are amino acids, or proteins. If taken by the mouth, they are subjected to the contents in our gut. More specifically, they are digested by hydrochloric acid. Thus, these proteins are denatured by the power of hydrochloric acids that our stomachs produce. This denaturing will render the hormones ineffective in our bodies. A great example is that of insulin. Insulin is a growth hormone used to help regulate your blood sugar levels. In the body, insulin is created in the pancreas and delivered directly to the bloodstream. For people with diabetes that require insulin to control their blood sugars, it must be injected. Insulin taken by the mouth will become ineffective once it hits the acids in the stomach.

Another protection we have from the hormones given to cows is that many of them will be eliminated during pasteurization BEFORE reaching our milk supply. Pasteurization is an extremely effective means of killing bacteria and protecting our food supply.

It is a shame that we continue to look for magic bullets instead of taking simple steps to improve our health. Simply eating more fruits and vegetables would be a great start. Before you start to complain about the potential pesticide residue on your fruits, washing your fruits and vegetables with water will eliminate almost all of them. If you’re still not sure, add a little soap to the water and wash them like you would your hands!

Base your nutrition information on scientific evidence, which includes peer-reviewed articles and research studies. Use caution if getting nutrition information via the internet. The internet is full of scare tactics, speculations and pseudoscientific claims. Think critically and analytically about the sensationalized claims you may hear or read about. If you want to get educated about nutrition, look to Registered Dietitians. They are your source for the most reliable and science-based food and nutrition information.

It’s Your Health.  It’s Your Life.  Make That Change!

~ Angie & John

John and I are huge proponents of breastfeeding.  As parents, we have seen the wonderful outcomes and rewards that breastfeeding has provided in our own children.  As Registered Dietitians, we know that breastmilk is nature’s most perfect food.  Besides the ideal balance of carbohydrate, protein, fat and micronutrients, it contains antibodies specifically obtained from the mother to destroy viruses and harmful bacteria.  The benefits of breastmilk extend well into an infant’s adult years and will reduce their risk of ever developing obesity, diabetes or cancer. 

August is World Breastfeeding Month and a time to “celebrate” breastfeeding.  I participated in the University at Albany School of Public Health’s  Breastfeeding Grand Rounds earlier this month.  This year’s theme is ”Breastfeeding: A Vital Emergency Response”.   This is certainly an appropriate theme, especially as we are entering into peak hurricane season here on the east coast and the threat of upcoming H1N1 pandemic flu.  What I will remember most from this webinar was the story told by a breastfeeding mother who was displaced during Hurricane Katrina.  She spoke of how difficult it was for formula feeding mothers to find formula as well as uncontaminated water or supplies.  Also, she spoke of the breastfeeding “heroes” that she witnessed–mothers who stepped in and fed the babies of mothers did not have formula or supplies.   

With breastfeeding mothers, there are no worries about formula supplies, storage or contamination.   The milk is readily available.  Plus, breastmilk protects against diarrhea–which is a huge problem in disaster settings.   

With the H1N1 threat, the Centers for Disease Control and Prevention (CDC)  is stressing the importance of breastfeeding for protection against the H1N1 (swine) flu.  The CDC states, “Flu can be very serious in young babies.  Babies who are not breastfed get sick from infections like the flu more often and more severely than babies who are breastfed.”   They are urging new mothers to initiate breastfeeding early (within the first hour of birth) and to feed frequently.  Mothers who are breastfeeding should continue, even if they become ill.  Formula should be avoided or minimized and breastfeeding maximized.  

The Academy of Breastfeeding Medicine is also recommending for mothers to continue breastfeeding if they have the virus.  If an infant is suspected to have H1N1, the infant should continue breastfeeding.   They state, “Breastfeeding is generally beneficial in limiting the severity of respiratory infections in infants but information specific to this influenza is currently unavailable. During typical influenza outbreaks, often the infant has been exposed to the virus prior to the mother’s awareness that she has an infection. It is believed that the spread of this particular virus may occur 24 to 48 hours prior to the onset of symptoms. Exclusive breastfeeding up to 6 months of age provides optimal protection.  The mother who is mixed-feeding  (breastmilk plus other liquids or foods) may wish to attempt to increase the amount of breastmilk provided to her infant. If the infant has difficulty with direct breastfeeding, pumped or expressed milk can be provided.”

I know this from my personal experience nursing my daughter.  Over Christmas 2003, John, Jonathan and I all contracted influenza.  At the time, I was exclusivlely breastfeeding Bayleigh, who was two months old.  I was so worried that she would get sick, but continued to nurse her throughout my illness.  She stayed healthy and happy while the rest of us were bedbound for days! 

Here in Elizabeth City, Jessica Williams, LPN & Certified Lactation Specialist, states:  “the unique thing about breastmilk is that every component is used by the infant in some way. It’s the ultimate recipe for a new baby and a new mom. The immunity and vitamins and minerals provided just in the first few days after delivery alone by breastmilk are remarkable!  Breastmilk was designed to nuture a baby just as a mother’s womb  has the previous 9 months prior to being born”.  Jessica teaches breastfeeding classes for expectant mothers and states that  just educating moms about the wonderful components of breastmilk sometimes is all they need to get past the “fear of the unknown”.

Jill Overton is an Occupational Therapist and a new mother to a seven week old baby girl.  Jill says,  ”I breastfed my son for a full year and feel that it contributed to him having little to no stomach or bowel upset, severe illness or allergies during that first year of his life.  He was as healthy and as strong as could be!”.  Breastfeeding is also calming to new mothers, “it allows me a wonderful opportunity to bond and snuggle with my baby during an otherwise chaotic day.”

I think this quote from James Grant, the Executive Director for Unicef from 1980-1995 sums it all up:  “Imagine that the World had created a new ‘dream product’ to feed and immunize everyone born on earth.  Imagine also that it was available everywhere, required no storage or delivery and helped mothers to plan their families and reduce the risk of cancer.  Then imagine that the world refused to use it”.

It’s Your Life.  It’s Your Health.  Make That Change!

~ Angie