When a Pharmacist Talks With a Registered Dietitian/Nutritionist….

Dr. Jessica Nouhavandi, PharmD, co-founder and co-CEO of Culver City-based Honeybee Health, asked me recently what it’s like to think like a registered dietitian/nutritionist, and a little about my approach to nutrition, food, and eating.  

When did you first start working as a registered dietician (RD)? 

I have been an RD since 1980, so I’m now 40 years in! I was in graduate school back then, working on my doctorate and working part-time as a “relief” dietitian, so I’d fill in on weekends and when they needed someone during the week. It was great because, as a relief, I’d be experiencing all the different hospital units: oncology, cardiac ICU, pediatrics, the works.  

What inspired you to become an RD? 

Nutrition science was my undergraduate degree. I always enjoyed learning how the body worked, and the more I learned about how truly complex it is, the more fascinated I became.  Plus, in a nutrition curriculum, you also learn about food science, not just nutrition. Food science focuses on food before you eat it. Nutrition is what happens once you put it into your mouth.  

How would you say your approach differs from other RDs? 

My approach has definitely evolved over the years, because I keep learning, but also because nutrition is such an evolving science. I came up in a health care setting where the patient was the focus, not the statistics. My kids and families aren’t often “typical,” or they wouldn’t be in our clinic. I always felt I had to dig a little deeper with my patients and their family lives, to see what might be contributing to the child’s nutrition issues. 

There is the “cut-and-dry” approach that focuses mostly on educating people about what to eat and what a balanced diet is. However, just focusing on education doesn’t cut it any longer. It’s about motivating people to make changes. The combination of education WITH motivation can have much more of an impact than education alone.

You have a strong background in pediatrics, including working with children with special needs. Could you please elaborate on your “meet them where they live” approach to working with these children and their caregivers on nutritional issues?

When it comes to changing diets and eating behaviors, you have to remember you’re treating the child AND the caregiver. Caregivers need to know they don’t have to make huge food and eating changes all at once. I also tell them how long they should expect things to take. For a child with autism who eats 5 foods, parents need to know that he may never eat the same way as everyone else, but if he can accept at least two or three foods in each group, that’s enough.  Even that may take a year, and the only thing they need to really do is be patient and be consistent. It’s about baby steps towards improving, not big leaps to perfection. It’s about helping meet the child’s nutrient needs and also helping the caregiver feel he/she is doing their best.

What other chronic illnesses can benefit from particular diets? Can you please elaborate on one example? 

Many kids with ADHD are on medication to help them focus at school and do their best academically. When medication is prescribed, it’s often quite helpful, but there are side effects, the most common being a poor appetite. For these kids, it’s so important to get a solid breakfast into them every day. It might be the only thing they eat until dinner, so it must do double duty if possible, with calories, protein, and micronutrients. Most importantly, I stress that, once it becomes routine, it’s much easier—it’s a learning process. 

You talk about myth-busting when it comes to nutrition. The spread of misinformation has been a big issue with COVID-19 as well. What changes would you like to see to the way health information is shared online? 

One very popular online thing is “immune boosters.” Foods and supplements may “support” the immune system, but only a vaccine will actually boost immunity. That’s what it’s designed to do.  All nutrients “support” immunity, but support is such a vague term that it’s almost meaningless.

There is so much “junk science” online that credible sources get diluted or even lost. Please, follow your doctor’s or medical professional’s advice. It’s easy to get sucked in by celebrities, sports players, or others with high profiles, who talk about what they do, but it’s a huge risk.  Hydroxychloroquine is a perfect example. People are desperate for a COVID-19 cure and this just won’t do it. And anything described as a “miracle” food or supplement should be passed by.  Period.  

Can you please “cut to the chase” and give us your top 5 pieces of advice for anyone struggling to live a healthier lifestyle during these tumultuous times?

Comfort food is perfectly understandable for the short term, but we’re in this for the long haul and we need to get back on track.  Here are some great ways to get started:

  • Protein matters! It comes in plant and animal forms, and unless you’re a vegan, get it from both animal and plant sources. Every meal, every day. 
  • MOVE! It’s absolutely safe to go outside and walk or be otherwise physically active. In fact, you should if you can as long as you wear a mask and keep your distance from others. If the benefits of physical activity were derived from a drug, it would be the most demanded drug ever. It’s not in pharmacies though, it’s in your shoes. Use them.
  • Best diet? Maybe it’s a screen diet. Cut it off at least an hour before bedtime and give yourself permission to do nothing. The world will spin without you and still be there in the morning. You’ll have missed nothing and improved your chance for better sleep.
  • Sleep is medicine, in my book, so for most people, no eating at least 2 hours before bedtime. You’ll have a better quality, deeper sleep when your digestive system isn’t working so hard breaking down food.  
  • Yes, fruit and vegetables are critically important, and there’s no substitute for them nutritionally. Frozen and canned are fine (canned beans should be in every pantry) and they last, but include fresh when you can, too. Summer fruit is unbeatable. Aim for at least 2 cups a day, total, but the more the better.

Anything else you’d like to add?

One thing people ask me about is if I’m a vegetarian or vegan. I’m neither. I eat everything and I don’t like wasting food. That said, people think you have to be strict about being vegan or vegetarian but you don’t. That’s a self-imposed thing, but being a “flexitarian” is perfectly fine.  Or just being an omnivore who sometimes eats vegan or vegetarian meals. It doesn’t have to be either/or. And I’m just glad dark chocolate fits all the above eating styles.

Dr. Jessica Nouhavandi, PharmD is the co-founder and co-CEO of Culver City-based Honeybee Health. Dr. Nouhavandi combines ethics, patient care and passion to create the ultimate patient experience. She earned her bachelor’s degree in bioethics and became a Doctor in Pharmacy from Western University of Health Sciences in 2011. Dr. Nouhavandi left her traditional retail pharmacy to start her own accredited online pharmacy, Honeybee Health, once she realized she could dramatically reduce medication costs for patients by cutting out industry middlemen such as insurance companies and pharmacy benefit managers. Honeybee Health now provides direct access to affordable, high-quality prescription medications to patients—without the need for insurance or coupons. You can read more about her and her company at www.honeybeehealth.com.

And The Survey Says: COVID-19 Changed How We See, Eat, & View Food

During “This Challenging Time” may people’s usual food concerns gave way to more immediate priorities: stocking up on staples like proteins, milk, canned goods and the like.  (Count me in – I bake our bread and I’m one of those who found it hard to find yeast and flour.)   Right after sheltering-in-place (SIP) began, our attention went towards all things comfort: in our food, our home, our down time, everything.

The International Food Information Council (IFIC) conducted their 2020 Food & Health Survey of adults, ages 18-80, in mid-April, during the pandemic.  More than 8 out of 10 of us changed how we ate and prepared food in response to COVID-19.  People under 35 made the most changes – but not all changes were good ones.

Here are other survey highlights about how we see food and health right now:

We’re eating better – or not

More than 1 in 5 say they’re eating healthier, but there’s another group, about 1 in 7, who felt they were making less healthy choices.

We’re cookin’!

About 3 in 5, were doing more cooking at home.  Not a surprise, since most restaurants were closed.  Grocery stores continued selling their prepared foods at a pretty good clip, however, so cooking at home still was still able to be avoided by some.

You can bet that people working from home and now forced to produce 3 meals a day, probably relied more on help from the prepared foods section of the supermarkets.  Supermarket sales in almost all sections of the store were way up.

Got kids?  You got snacking!

More than 3 in 5 (41%) parents with minor children were snacking more than they normally did, vs less than 3 in 10 parents with grown children.  With more kids at home all day, it figures that there will be more snacking going on, and parents serving snacks are probably more likely to join them. Even so, about 1 in 4 said they were now snacking multiple times each day.

What worries us more about food now? 

  • More than half had concerns about eating food away from home or eating food prepared outside the home. Roughly half of survey respondents were at least somewhat concerned about either eating away from home or food prepared away from home (take-out, restaurant deliveries, etc.).  This was somewhat more so for African-American and Hispanic consumers than for whites.
  • Put into simple language, people want to know if the person/persons who made this dish I brought home were careful about proper food safety when they made it.
  • “Food handling/food preparation related to risk of COVID-19” had never been asked in this annual survey, but it became the number 1 concern for consumers, knocking off the top 4 food safety concerns of 2019. On the home front, we’re also washing our fruits and vegetables more.

What worries us less?

  • Food-borne illnesses from bacteria.
  • Chemicals, carcinogens, and pesticides in food.

These were still concerns, but issues related to COVID-19 knocked them off most people’s “top concern” list.  It’s consistent with the huge increase in purchases of items like canned and frozen vegetables – foods that people know are safe and have a long shelf life.

Health vs. Weight: Which Matters to People More?

Health mattered a little more than weight but not much.  Most participants valued both equally, but women and overweight persons put slightly more priority on weight.

More “style” in our eating!

A consistent trend the past few years is following some form of eating style.  Nearly 3 in 5 persons reported trying some type of diet or eating style.  Top reason: to try and lose weight.

Top eating style for 2020?  Intermittent fasting.  It bumped last year’s “clean eating” from first place.  Keto/high fat dieting was third.

The survey offered hope, though. “Nearly 6 in 10 place more emphasis on their overall health now in comparison to how they made decisions a decade ago.”  Healthier weight will follow – another “two-fer”!

Cut-To-The-Chase Takeaway

We CAN and DO make changes to how we eat – if we’re motivated.  Let’s not lose sight of that.  Instead of our motivation coming from fear, let it be wanting to feel better. And knowing we deserve that.

From 9 Top Nutritionists: Positive Take-Aways From COVID-19

In a very short time period, COVID-19 turned how we live upside down.  We’re suddenly living, eating, and shopping differently than perhaps ever before. Has all this impact been negative?  I spoke with 8 nationally-known registered dietitian-nutritionists to get their take on what they think are the POSITIVES that might come out of the current pandemic, what they’ve learned, and a few noted what they’d like to keep from the whole pandemic experience.

Newfound Respect for Some Pantry Standbys

Amy Myrdal Miller hopes people “appreciate the benefits of canned fruits, vegetables, and beans and frozen fruits and vegetables. For too long people have believed ‘fresh is best.’  This points out the reality that canned and frozen foods offer nutrition benefits and convenience.”  If the increased demand for canned and frozen foods is any indication, this appears to be happening.

Neva Cochran agreed, noting that consumers returned to these foods as well as beans, beef, pasta, and others, “that are often mis-characterized as not being healthy or nutritious.”  Since the onset of the pandemic, she continued, “Concerns about buying organic, meat-free, non-GMO, all-natural, no added hormones, antibiotic-free and gluten-free have taken a back seat when people are concerned that there may not be enough food.”

Gratitude was also expressed.  “I’ve never been more grateful for all these non-perishable options – and the farmers who bring them to my table,” said Nicole Rodriguez.  “Whether it’s a simple box of raisins with my daughter during ‘home school’ snack time, cottage cheese topped with a pre-portioned serving of cling peaches, or frozen berries heated up as a makeshift jam,” she said she has a deeper appreciation for fruits in all forms.  As do I, including fresh fruit!  (See my Cut-To-The-Chase Take-Away below for more!)

Isolation – The Good Part

Photo credit: Andrea Piacuadio, pexels.com

Some found appreciations that had nothing to do with food or nutrition.  Chris Mohr’s normal schedule has him on the road constantly.  Being grounded (literally!) has been an unexpectedly positive experience for him, his wife and their two daughters.  “I love the increased level of connection among us.  We’ve each grown closer because we’re not socializing, traveling for work or anything else.  And I will work really hard to keep that up once we are ‘released’ from our homes”.  Probably something we all might focus on.

Having a less structured schedule during isolation has allowed Karen Ansel some freedom.  She’s found that she can do things “at times of day that mimic my body’s natural energy flow instead of when I’m “supposed” to do them.  I’ve been spending a lot of time spinning my wheels trying to be productive at the wrong times of day.” While she realizes all this may change when isolation is relaxed, “normal” life resumes, she does want to maintain take some of this new-realization.  “I do plan to really try to follow my body’s internal energy cues as much as possible.” 

Teachable Moments

If your kids show an interest in cooking, all the at-home time is great for getting into the kitchen with them to practice.   Toby Amidor, author of numerous cookbooks, has found it’s allowed her to, “Cook with my kids in the kitchen and actually see how my girls can cook without me in the kitchen.”  She sees how much they’ve learned from their mom, adding, “Now we are focused on further developing their cooking skills into more complex dishes they want to learn to cook.”  Sounds like “teacher” and her students have both learned something.

Rosanne Rust loves that people are sharing more time with their families in general, but including in the kitchen. “Teaching the kids how to bake, or working together at home, is a win-win for both the parents and the children. Even if at times it seems stressful.”  Good point.  If you’re new to teaching your kids cooking skills, start with goof-proof, entry-level skills: boiling an egg, baking a potato, steaming a vegetable.  Baby steps here!

As a retail dietitian (as in supermarket), Leah McGrath thinks many have gained a new appreciation for how hard supermarkets and restaurants work to make sure there is food available to us.  “Perhaps we won’t forget to take a moment when we’re shopping for groceries or eating out to remember that with a kind word, a smile or, when appropriate, a generous tip.”  Active on social media (@InglesDietitian), she’s using the #QuarantineKitchen hashtag.  “I think many have surprised themselves with their culinary creativity and ingenious substitutions to make meals for themselves and their families.  Necessity is the mother of invention!”

Beyond teaching cooking skills, food has always been part of family culture, too.  Notably, our isolation has occurred during Easter and Passover periods.  Christine Rosenbloom sees this isolation as, “An opportunity for kids and families to learn to cook and bake.  Teaching kids family heritage through foods and sharing treasured recipes,” is something she recommends during all the enforced down time.

I hear that.  Growing up, we celebrated what we called “regular” Easter (the one recognized nationally) and “Greek” Easter (the Eastern Orthodox one, which usually falls on a different Sunday).  This year, I did my part by making this braided Easter bread, like my Greek grandmother made, pictured here. (I hope she’s lenient – I reduced the amount of anise seeds by half and added some nuts – personal preference!)   

Cut -To-The-Chase Take-Away:

I join my colleagues in valuing all those pantry staples people have forgotten or dismissed.  They are – and always were – safe and nutritious to eat.  BUT…SO IS FRESH PRODUCE! 

Moreover, farmers need your help!  Many are plowing under or discarding perfectly good crops because of lower demand by consumers too afraid to handle and purchase fresh fruits and vegetables. 

You CANNOT get COVID-19 from food.  Why?  I explain it to you backed by facts!) in a previous post here.  So, when you do shop, buy fresh, too.  Remember – farmers aren’t “first responders”, they’re CONSTANT responders, through all.

News Flash: Fresh Produce Is Safe To Eat!!!

When I hit the supermarket these days, I’m seeing canned and frozen vegetables and fruits flying off the shelves.  All good, because they’re shelf-stable and many folks are minimizing trips anywhere, including to the supermarket.  Yet the fresh produce section, loaded with colorful, delicious fresh fruits and vegetables, isn’t feeling the love. 

That’s a problem.  There seem to be concerns about buying and eating produce these days, especially if it’s sold in bulk, since other consumers might have handled it.  

Feel Good About Eating Fresh Produce

No reason in the least to avoid eating fresh fruits and vegetables.  Yes, you need to wash it.  You’ve ALWAYS needed to wash it.  You DON’T need to wash it with anything special.  Here are 7 terrific tips, straight from the FDA website, for washing fruits and vegetables so you can eat them with confidence, :

  • Wash your hands for 20 seconds with warm water and soap before and after preparing fresh produce.
  • If damage or bruising occurs before eating or handling, cut away the damaged or bruised areas before preparing or eating.
  • Rinse produce BEFORE you peel it, so dirt and bacteria aren’t transferred from the knife onto the fruit or vegetable.
  • Gently rub produce while holding under plain running water. There’s no need to use soap or a produce wash.
  • Use a clean vegetable brush to scrub firm produce, such as melons and cucumbers.
  • Dry produce with a clean cloth or paper towel to further reduce bacteria that may be present.
  • Remove the outermost leaves of a head of lettuce or cabbage.

COVID-19 note: Your risk of getting it from food is slim to none.  Check This graphic from the University of Georgia Extension.  I love it because it tells you how you WON’T get COVID-19, and you won’t get it from food. 

Your stomach acid HATES this virus as much as you do.  It’s part of our body’s protective barrier.  Stomach acid has a very low pH (meaning it’s a strong acid) and the virus can’t survive that.  Plus, the virus needs to get to you through your respiratory tract, not your GI tract.  The tips on washing your produce however, still holds.  Consider it part of “best practices” on the home front.

 

Long before COVID-19, I wanted to be prudent and remove whatever dirt and such that might have accumulated on the skin.  In our home, we’re eating lots of root vegetables like carrots, beets, and potatoes, especially now, because that’s what’s left in the farmers’ market, and since these veggies grow in the ground, it makes sense to give them a good scrubbing.  (Note, in the photo below there’s also kohlrabi and celery root on the left and right, respectively — other root veggies definitely worth trying!) I do the same for oranges and apples, too, though.  Food safety is not just a farmer’s responsibility, it’s mine and all of ours as well. 

Biggest Pandemic: 9 Out of 10 STILL Don’t Eat Enough Fruits & Veggies!

The latest from the 2020 US Dietary Guidelines Advisory Committee established that average COMBINED intake of fruits and vegetables is just under 2½ cups a day, and that includes 100% fruit juice.  Specifically, average consumption of fruit is 0.9 cups a day of fruit and 1.4 cups of vegetables.  This accounts for all of it – including your 100% juice and the lettuce on your sandwich.  This is about what it’s been for the past 20 years.  Not much progress.

I’m not going to bother you with the Mt. Everest of research about the bennies of eating 5 cups a day of fruits and vegetables.  Unless you’ve been licving under a rock for the past 50 or so years, you know how beneficial eating fruits and vegetables can be for your health – and your taste buds.   I’m just going to say we can do better.

Cut To The Chase Nutrition take-away: I don’t’ split hairs here.  While 2½ cups of vegetables and 1½ cups of fruit are the recommended minimums, don’t obsess.  If your consumption adds up to at least 4 cups a day, in any combo, and regardless of whether they’re fresh, canned, frozen or dried, take a bow.  Keep the juice to a max of 1 cup though, and the dried fruit to 1/4 cup or so if you’re watching calories. 

Otherwise eat up.   

COVID-19: 5 Steps To Make Some Lemonade Of It ALL!

Amid a pandemic like COVID-19, the hysteria seems to build and change by the hour.  Businesses are shut, so are many workplaces and offices.  Gyms, malls, anything even slightly optional, not happening.  We don’t know when things will return to normal but the world isn’t ending either.  In fact, there are some real positives for our lifestyle and our health that can come from all this disruption.

Positives?  From COVID-19?  Yes.  The disruptions are forced upon us, but everyone’s at the same place.  Let’s work it.  Here’s where I see the lemonade from “sheltering in place”:

Everyone. Slows. Down.

Less pressure to get all the errands done and on time.  Indeed, none of us can “do it all,” because so much of “it” has been cancelled!  There is also no rushed commute, no traffic snarls, no morning scramble to get kids to school, no mad dash after work to meet friends or get home to make dinner, and fewer errands to run.

Avoid Going Nuts & Enjoy The Extra Time 

It’s time to get to things you’ve been putting off – especially the “me” things that help clear our heads and bust our anxiety.  Some options to consider: 

  • Move it!   No marathons, just get out and walk.  It’s still OK, even if you’re under “shelter-in-place” orders.  You’re not under house arrest, so get on your sneakers and walk as briskly as you can, staying at least 6 feet from others.  About 100 steps a minute – done outside or inside – is considered a “brisk” pace and that’ll get you a mile for every 20 minutes of walking.  Or ride a bike, dance to a video, or do online yoga!  Exercise is well-known as a great mood lifter. It clears your head, gives you a mental boost, and makes life more manageable.  Make it part of your “me” time.  About that marathon though, check out this story of a guy in France who ran the distance of a marathon on his 23-foot balcony!
  • Give yourself a 30-minute “organizing” task. The task may take longer, but spend 30 minutes a day doing it.  That might be de-cluttering your home office desk (the bane of my existence), cleaning out a closet, gathering clothes and knick-knacks to donate, or going through the pantry to throw out expired condiments and food.  You can do it at a leisurely pace and end up with so much extra room!
  • Do fun stuff. Got a hobby you never seem to have time to do?  It’s time, and make it a priority.  Aim for an hour a day here, too.  I hope you make it a habit you’ll continue, even after this all passes.
  • Family meals are back!  Make these a priority, too, and make them last at least 30 minutes.  No technology at the table, just re-acquaint with conversation and socializing.  Some of the best memories of my childhood were sitting around the dinner table with parents and grandparents.  We’d talk about everything: the meal, friends, goals, you name it, and everyone was welcome to participate.  To me, it’s what a family meal should be, but make your own family meal style you’ll enjoy.
  • Rediscover the joy of cooking!  It’s WAY more enjoyable when you’re not pressured.  You can finally get to making those recipes you’ve collected but never got around to trying.  No cookbooks? No problem.  There are tons of great sites online.  Try www.beefitswhatsfordinner for starters.  It’s my go-to resource for all things beef, and their recipes are excellent and don’t require a degree from Le Cordon Bleu.    Check out Dr. Keith’s Pot Roast recipe.  I’d never cooked one before and adapted a NY Times recipe.  Turned out to be lean and the best pot roast I’d ever eaten!  The prep doesn’t take very long, you just have to be home for a few hours.  And since you’re home anyway, enjoy the aroma and eat the reward – and it stretches for more than one meal!

Big Apple Diversity: More Here Than Meets The Eye

Four apples that look alike, but they’re four different varieties – and they taste different.

When people say “I don’t really like apples” my reaction is that there are dozens of varieties, how many have they really tried?

The four varieties here – Evercrisp, Koru, Ruby Frost, and Snap Dragon, are all grown in New York State.  Disclosure: These apples were provided by Yes! Apples. They did not ask me to write this and I’m wearing both my food-critic/foodie hat and my nutritionist hat, so here goes.

Since they looked pretty similar, I expected them to taste fairly similar.  Au contraire.  The only commonality: crispness.  Nothing mushy here. 

Overall, these were four outstanding apple varieties, none of which I’d tasted before.  Quick review of each:

Evercrisp: More like “supercrisp”—solid, firm and with an intense, flavor, almost like apple extract had been added to it.  To be fair, the Evercrisp I tasted also had a “sugar core” — that almost clear, icy-looking appearance in the flesh that signifies a concentration of natural sweetness.  Any apple can have this, and I was the lucky taster here.

Koru: I’ve written about this apple before – when I first tasted it at the New York Produce Show.  Sweet, tart but not astringent, and the smaller core gives you a little more edible portion – and less to waste.  All good by me.

Ruby Frost: A good snap when biting into it, this one seemed to have more wine notes to it.  I’m no wine connoisseur, but I’d say it was more Riesling than burgundy, perhaps due to the sweetness.  I see this one as a sophisticated apple, if you can imagine such a thing. 

Snap Dragon:  This one was sweet and tart and almost like it was injected with extra apple flavor.  Take apple juice and heat it like you’re reducing it just a bit to concentrate the flavor.    

For me, the Evercrisp wins by a hair, but I’d eat each one of these again in a heartbeat.  I don’t like all apples.  Give me a Rome apple and it’ll sit there until I die.  They’re just not an eating apple.  Both Red and Golden delicious are OK, but apples that are crisp, tart and sweet win me over.  On the other hand, if I see any of the four varieties noted above in my local market, I’m grabbing them, and don’t get in my way.

An Apple A Day? Make It 2 & Lower Your Cholesterol

Speaking of heartbeats, there’s a new study out on the bennies of eating 2 apples a day.  All subjects were borderline overweight, with BMIs just over 25, and had mildly elevated cholesterol levels.  Two groups, eating either two whole apples a day (about 12 ounces of edible apple, with skin but without the core) or a control group drinking the same number of calories as apple juice, for 8 weeks.  Then there was a 4-week “washout period” and each group traded interventions.  That is, the apple eaters now got the juice and the hjuice drinkers now had the apples.

When the whole apples were eaten, total cholesterol and LDL-cholesterol (the “bad” one) declined significantly, not a huge drop, but about 5 percent each.  That’s ain’t shabby, for just eating more fruit. 

It’s not clear if the difference happened because of the apples’ high content of pro-anthocyanidins (antioxidant compounds in the skins of apples) or because the whole apple also has loads of good prebiotic fiber, or some combination of those two factors.  That’s for the scientists to figure out in additional research.  Consumers (and those of us who eat) just need to know that eating apples may help steer your health in a good direction. 

Wearing my registered dietitian-nutritionist hat, I also like that eating apples — or any fruit — more often, is likely to squeeze out some of the less nutritious foods you might otherwise have eaten.  It’s not just about eating a great food, it’s about using it to replace a not-so-great food.

A few caveats here: Most people don’t want to commit to eating two apples a day forever.  I wouldn’t either.  And this study used a single variety of apple, called “Renetta Canada”, like those pictured here, so the proanthocyanidin content could be consistent.  That said, most apples are good sources of these compounds, whether you eat them with the skin (personal favorite) or without. 

Cut-To-The-Chase Take-away

Most people need to eat more fruits and veggies anyway, so just count this latest study as more ammunition in favor of doing so.  Eat whatever fruits you like but eat them DAILY!  And mix it up whenever possible – they all have their diverse benefits – and flavors!

7 Nutrition Myths These Dietitians Are Busting

When people learn I’m a registered dietitian/nutritionist (RDN), they almost immediately start venting their frustrations about food issues. “Every day it’s another thing you can’t do or eat.  One day a food is good for you, the next day it’s bad for you.”  Since confused consumers make no changes, I always try to bust their myths and misinformation.

While consumers may be confused about food fads, RDNs are not.  They’re fed up with them.  They’re trained to spot hype, fads, and myths around a blind corner and it annoys them to no end. I asked some RDNs who have particularly good communications skills to tell me which popular nutrition fads really grind at them.  Here’s what they said:

Carbo-phobia!

Mindy Hermann, MBA, RDN, said straight up, “I wish people would stop thinking carbs are the devil.”  She’s had it with a near universal demonizing of these essential macros. 

Sure, most people eat too much added sugar, but she’s right that all carbs seem to be lumped together, whether it’s whole wheat bread or soda.  “Today it’s keto, yesterday it was Paleo, so many others before,” she said.  “I’m tired of all the iterations of high-protein, restricted carbs.”

Plant “Milk” Deserves No Halo

Nutritionally, plant-based diary alternatives just can’t hold a candle to the nutrition in real milk, according to Salge Blake, EdD, RDN, FADN, professor of nutrition at Boston University and the host of the hit health and wellness podcast, SpotOn! In addition to being a dynamite protein source, “Cow’s milk is chock full of vitamin D, calcium, and potassium, three nutrients that many Americans are falling short of in their diets.”  Dairy alternatives only have these nutrients if they’re added, and they often aren’t.  Unfortunately, says Salge Blake, “plant-based milks may also contain added sugars, adding calories and no additional nutrition to your glass.” 

Salge Blake also sees the affordability of real milk as a win-win.  “When it comes to your wallet, plant-based milks can be at least twice the price of cow’s milk.  For the nutrients and the money per gulp, you can’t beat low fat or skim dairy milk.”  If you’re allergic or vegan, soy is the closest alternative.  Be prepared to pay though.

Stop Kicking The Canned Foods!

Shari Steinbach, MS, RDN, spent years working directly with consumers as a retail dietitian in supermarkets, is fed up with canned foods getting dissed when they offer so many advantages:

  • Sustainability: “90% of cans are recycled and they can be recycled indefinitely.” Linings are safe, with 90% containing none of the controversial BPA.
  • Convenience: They have a long shelf life and that helps prevent wasted food and wasted food dollars.
  • Nutrition: “You can cut 40% of the sodium in canned beans and veggies just by rinsing and draining them,” Steinbach says. Since 9 in 10 people don’t eat enough vegetables, “Canned beans and tomatoes count,” towards scoring enough of this critical food group, and are a, “convenient, nutritious way to balance your diet.”

Want her recipe for quick, veggie-loaded, chili using canned ingredients?  “Here’s a favorite simple chili recipe that I made this week”:

  1. Brown 1 pound of lean ground beef;
  2. Drain and add 2 cans of chili-seasoned beans and 2 cans of undrained diced tomatoes.
  3. Season to taste with cumin or chili powder. “Serve with a green salad and whole grain crackers. Enjoy!”

Don’t Panic If It’s Not Organic

That’s advice from Leslie Bonci, MS, RDN Owner of Active Eating Advice, who is fed up with food elitism.  I see her point.  I spent decades working with low-income families who will never be able to afford organic food.  They shouldn’t worry.  They can still put delicious, nutritious food on the table. 

“What do we even mean when we say clean?” Bonci says, because “clean eating” has no definition.  That leaves every definition up to whomever is spewing it and that’s a perfect recipe for consumer confusion, fear, and doubt.  Instead, Bonci favors creating “an enabled table where foods of all price points have a place.”

White Foods Are Bright Foods!

Liz Ward, MS, RDN, Author of Better is the New Perfect is bugged by all the attention given to putting “only the most colorful fruits and vegetables on your plate.”  Forget colors, she says.  “Instead of worrying about what types of produce are “best,” simply include the types you like, no matter how pale,” Ward advises.  Besides, white, brown, and tan produce, such as mushrooms, cauliflower, potatoes, and bananas, are just as worthy as their brighter counterparts,” are loaded with nutrition.

“And while we’re at it, can we stop shaming starchy vegetables, such as corn, potatoes and peas? They are packed with nutrition and starch is a form of energy.”  It’s true, these foods are hugely important to so many food cultures and have sustained people for thousands of years.  Empty calories they most certainly are not. 

One Diet DOESN’T For Everyone?  Seriously?

“The nutrition belief that I hope goes to its final resting place in 2020 is that a single diet plan, or way of eating, is right for everyone,” declares food anthropologist and nutrition communications consultant Robyn Flipse, MS, MA, RDN.  Looking ahead, Flipse feels personalized nutrition, not fad dieting, holds the most promise in the years ahead.  

Leah McGrath, MS, RDN, corporate dietitian for Ingles Supermarkets, couldn’t agree more.  “It seems like every year we have a new ‘hot’ diet,” she says.  “However, just like our fingerprints,  we should want to and  deserve to individualize our eating plans.” 

Flipse continued, “The one thing we’ve learned from the decades of fad diet trends we’ve endured is that none of them have delivered on what they promised because they have all overlooked our metabolic differences.”  They also tend to be extreme, which is probably why people burn out on them. 

Flipse admits that we still lack the scientific tools to allow us to tailor nutrition to each person’s needs.  Unfortunately, when consumer demand gets ahead of the science, charlatans see an opportunity to market all kinds of pseudo-scientific gimmicks.

Plant-Based Doesn’t Mean Plants-ONLY

This one is mine.  I’ve written about it before and everyone in 2019 seemed to be jumping on this bandwagon.  Thing is, there’s no universal definition of “plant-based!” 

What it DOESN’T mean is vegan.  Eating a plant-based diet doesn’t automatically guarantee your diet is balanced or healthful, either.  Living on soda and chips is a fully “plant-based”, vegan diet.  And it ain’t balanced.  A huge salad with 10 different veggies, some nuts, and crumbled feta or parmesan cheese or a couple of ounces of beef or salmon is not vegan – but it IS plant-based.  Flipse put it best, “I tell people if 50% or more of what they eat is plants, then they have a ‘plant-based’ diet.”

Holidays, Eating, & Why Everyone Needs This “Drug”!

NO ONE wants to hear about health stuff this month.  Save that for January!  We want our “once-a-year-foods”, so stay out of the way or we’ll squash you like a grape!  And why not?  Food that’s around once a year should be eaten and enjoyed.  I’ll even join you.

But holidays can be challenging.  There are always more things to do than time in which to do them: buying gifts, heading to social occasions, hosting them, cooking foods you have only once a year (how did I cook that last year?), and on.  All on top of the usual stuff called “life.” 

Your “Dream Drug”

If you could invent a drug for this time of year, you’d probably want it to:

  • Burn excess calories
  • Act like a statin to lower your cholesterol
  • Improve your heart’s health
  • Lower your fasting blood glucose
  • Help you cut stress
  • Give you a “mood lift”
  • Improve your sleep
  • Add some lean muscle
  • Help you think more clearly

If you could patent this drug and market it, you’d be richer than Jeff Bezos, who would be begging you to sell it on Amazon.

This “drug” isn’t in a bottle.  It’s in your shoes: physical activity.  It does ALL the things listed above and you can get all those benefits.

Registered dietitian nutritionist, Leslie Bonci, should know, as the owner/founder of www.activeeatingadvice.com, she says, “Exercise is the gift that gives your body the lift it needs during the holidays.”  This isn’t just an opinion, either.  Read on.

Hot Off the Research Press: Thinking Won’t Help You Exercise, But Exercise Helps You Think

This study, just out, looked at the cognitive outcomes of four older adult groups: those who did moderate physical activity three days a week (walking or biking), ate a DASH diet (Dietary Approaches to Stop Hypertension), those who did both and a control group that received only dietary education.

Best neurocognitive improvement at 1 year?  The group that did BOTH aerobic activity and the DASH eating style.  Second best was the aerobics-only group.  No surprise to Bonci.  “Getting moving helps to circulate blood to the brain,” she says.  

Why I Love This Study

  • The participants were at least 55 years old. If these folks can do it, it can be done by most people. 
  • The activity wasn’t extreme. No marathons, no sweating until exhaustion, just walking or stationary biking for 35 minutes, thrice weekly. Just move, then move on. 
  • DASH eating style? Also easy-peasy: It’s 2½ cups of fruits and veggies and two servings of dairy foods – what we should be doing anyway!   

Starting Moving

Baby steps here.  Registered dietitian Liz Ward’s philosophy says it all. “My mantra is that any movement is better than none to relieve tension and help you sleep better.”  Even her website is called “BetterIsTheNewPerfect

No time to do that walk?  Try doing it for half your lunch hour, so it doesn’t use any valuable “off” time.  FYI: a “brisk walk” is about 100 steps a minute.

This time of year, Ward admits her workouts may be shorter or even less frequent, but she knows the benefits go way beyond calorie-burning.  “I try to exercise as much as my schedule allows because physical activity is a huge stress-buster for me.”

Start “DASH-ing” 

Getting those 2½ cups (total) of fruits and veggies and two servings of dairy is easier than you think.  No specific fruits or vegetables here, and it’s cooked or raw, so choices are up to you.  For dairy, even some cheese is fine (an ounce per serving), but mix it up.  Examples:

  • Dairy: a cup of REAL milk on your cereal
  • Greek yogurt at breakfast, lunch, or for a snack or even dessert (with some of that fruit!).
  • Fill a pint plastic container (the kind that holds the won-ton soup form Chinese take-out) with any combo of fruits and veggies – that’s 4 servings right there – so you’re almost done for the day.

Cut to the Chase Bonus: Start now and you’re (literally) miles ahead of everyone else come New Years! 

15 Tips: Prevent G.E.R.D. From Being “Thanksgiving’s Revenge”

“National G.E.R.D. Awareness Week” is November 18-24 this year — a week BEFORE Thanksgiving, but maybe that’s good.  Being aware of this annoying condition can help you avoid it.

What’s “GERD”? It stands for “gastro-esophageal reflux disease”.  Back in the day, it was commonly known as “heartburn.”   It happens when the acid from your stomach backs up into your esophagus and it burns the hell out of it.  Your stomach is well-equipped to handle the stomach acids it produces to aid digestion, but the esophagus is much more sensitive.  When stomach acid gurgles up into the esophagus, it’s painful. 

A big Thanksgiving meal can trigger GERD even if you rarely experience heartburn.  Why?  Your stomach is only so big.  When you eat more than the stomach can handle, the sphincter muscle between the stomach and the esophagus may not close completely (see the graphic).  When stomach acid is released to start digestion in the stomach, some of that acid bubbles up and you feel a burning sensation. 

How to prevent GERD and Enjoy Your Thanksgiving Meal

The International Foundation for Gastrointestinal Disorders (IFFGD) put out this great graphic with 15 tips for avoiding GERD.  I’ll explain each one:

  1. Eat the meal earlier. It gives you more time to digest your food.  Having a big dinner in the the evening is a sure-fire way to get heartburn. 
  2. Serve (and eat) light appetizers. The Thanksgiving meal is an important tradition.  Save valuable tummy space and spend calories on the meal, instead of on typical nibbles.  A couple of bites of something and leave it at that.
  3. Stay active! Keeping moving helps your stomach empty itself a little sooner.  No marathons or vigorous exercise here, but any movement more than sitting down is a good idea.
  4. Don’t smoke. Add “heartburn irritant” to the list of reasons to avoid smoking.  Enough said.
  5. Nix the juice. The acid in fruit juice is much tamer than stomach acid, but can still bother the esophagus. Fruit nectar fares better, but if you must have juice, dilute it at least 1:1 with water.
  6. Limit the drinks. Alcohol is a known trigger for reflux.  It relaxes the esophageal sphincter, allowing stomach contents to back its way into the esophagus, but it can aggravate tender tissue on the way down, too.  Another trigger drink: regular coffee.  Keep it to decaf.
  7. Season lightly. This is individual, but some known irritants are things like chili peppers, tabasco, and hot sauces like salsa. They may not like you as much as you like them.
  8. Pass on deep-frying your turkey. I’d add, “and anything else.”  Fried foods trigger GERD symptoms in many folks, so be warned.  If you must eat them, think “taste” or a bite instead of a portion.
  9. Use smaller plates. It’s amazing how well this works.  If you’re int the habit of having seconds, try using a salad plate.  Then a second helping doesn’t have to mean overeating.
  10. Trade the soda for water. Bubbly stuff creates gas.  Gas puts upward pressure on that sphincter again and risks blowing acidic stomach contents into the esophagus. 
  11. Watch the desserts. Two reasons: 1) They’re heavy, just at the time your stomach is probably already full.  2) They’re usually really fatty (pie crust especially, but cake as well).  Best bet? Eat the filling in a small portion of pumpkin pie.  Hold the whipped cream and the a-la-mode.
  12. Skip the after-dinner mint. Peppermint oil – the flavoring – isn’t a “spice” but it’s just as irritating to the stomach and the esophagus.  It’s NOT a “digestive”. 
  13. SLOW DOWN! Make that salad plate-sized portion last at least 20 minutes – the amount of time it takes for your brain to register fullness, so don’t get there before the brain does!  Then ask yourself if you even want any more.  And remember, this is a time to get social.  Try and say something to everyone at the table.
  14. Stay awake. And upright.  People can feel comatose after a big meal (another reason to eat less).  Laying down after eating just makes it easier for stomach contents to back its way up into your esophagus and give you GERD symptoms.  Empty stomachs are better sleep companions.
  15. Talk to your doctor. Get relief!  There are medications available if you suffer from GERD symptoms frequently. 

Above all, may you enjoy the day, remember to be thankful.  My very best to you and your family.

No, I Don’t Care If Kids Eat Candy on Halloween

Letting kids loose on Halloween doesn’t have to mean all hell breaks loose afterwards.

Halloween is a once-a-year occasion.  I’m focused on what kids do the other 364 days of the year.  If they’re eating well on those other days, then there’s absolutely nothing wrong with letting them enjoy Halloween!

Every year around this time I get a ton of questions from parents about what to “allow” kids to eat on Halloween, how much candy to let them collect and keep, and what kind of candy is “best” to give out on Halloween.

Sugar Shakedown

No, sugar won’t make them hyperactive.  They might have a burst of energy, but the whole “sugar-gives-them-a-buzz” thing has been completely dismissed.  The rigorous science just doesn’t show anything.  Actually, a high-sugar snack has even been shown to help keep you on-task.  I’m NOT encouraging more sugar.  It’s not angel food, but not devil’s food, and it’s not a new food, either.  Just keep it real.

Your Homework: Laying the Groundwork

Planning ahead is everything here.  Kids (and adults) don’t like sudden, unexpected changes, especially to their eating habits.  Here are a few tips to help things go smoothly on the big day:

  • Be real about how much you buy. You know how many kids typically visit you, so get enough for THEM.  Buy with an eye to having as few leftovers as possible.
  • If you’ve already bought the candy, let the kids know ahead of time about the plan for leftovers: share with neighbors, you’re bringing them into work for co-workers, making up a bag for a child who couldn’t Trick-or-Treat (a nice thing to do for a child who is ill), and so on.
  • Buy only the smallest portions of candy! No full-sized bars, just the little mini things.  That way even with leftover stuff, the treat is reduced to a bite, not a commitment.

Tricks Before Treats

The idea to reinforce to kids is to “take care of business” first, by spending calories on the foods we need.  If there’s anything left, have a treat and enjoy it.  That’s the eating style I want kids to have 364 days a year.

  • Keep only the “top 10%” – their absolute fave candies. The rest gets donated or shared with others.  Quickly – like, get it out of the house the next day. (Note: For me, candy corn got tossed first thing!  Never could stand the stuff, even as a kid!)
  • Make it social! Halloween is also about dressing up, hanging with friends, and walking the neighborhood. This applies to all holidays or occasions.  It helps them see food and eating in perspective.
  • Never make candy a “reward” for good behavior (save that for training the dog), but see it as a teachable moment. Candy is an “extra”, it provides mostly empty “discretionary calories” so treat it that way.  It’s something to have in a small amount AFTER the rest of needs are met.

“What Does the Research Say”?

Yes, someone actually did a study on whether seeing Michelle Obama’s face (versus other political women’s faces) might influence them to choose a box of raisins or a small name-brand candy bar.  Connecticut home.  Three years of Halloween.  Kids were directed randomly to either of two sides of the porch – one with Michelle Obama’s pic, the other side pics of other political women (Hillary, Ann Romney, or no photo) and asked if they wanted a box of raisins or a small candy bar.  Authors described the community as politically liberal.

Result: The kids on the Obama side were 19% more likely to choose the box of raisins than the candy.

Great, but there was no info on whether the kids then ATE the fruit.  After all, no food can be nutritious until you EAT it.  Ironically, the box of raisins is about the same calories as the small candy.

Cut-To-The-Chase-Nutrition Take-Away

Halloween can be a blast.  It should be.  It’s also over in a day so enjoy it fully.  On other days, it’s about getting what you need first: the fruits, veggies, whole grains and dairy foods FIRST.  Be active, FIRST.  Those are the tricks, before the treats.