WISE PROTEIN CHOICES: AIM FOR VARIETY AND AVOID UNHEALTHY FATS

Foods containing protein include both animal (meat, poultry, seafood, eggs, dairy) and plant (beans, lentils, soy products, nuts) food sources. We all need protein.  It is an essential for the body to maintain and repair all body tissues including your organs, muscles, skin, hair, nails, bones, and hormones.

Try to include a protein source at every meal.  Consuming adequate protein is an important part of a healthy diet.  Sufficient protein intake is especially important when trying to lose weight.  Eating adequate protein while limiting the total calories (energy) of the food you take in allows your body to preserve your muscle and body proteins and burn stored fat for energy.  Without enough protein, the body will break down body tissues for energy and less fat will be lost.  Consuming adequate protein is also helpful when trying to lose weight because protein is more filling than fats and carbohydrates (i.e. grains, starches, sweets). Therefore adequate protein intake helps to keep you full on less food.  Contrary to what many think, consuming extra protein does not make muscles bigger.  If you consume too much food whether from protein, fat, or carbohydrates, the body will store the extra energy as fat.

When choosing protein food sources, opt for a variety of lean sources.  The fat in meat, chicken skin, cheese, and other full-fat dairy products increases blood cholesterol and clogs arteries.  To support heart health, opt for fish, skinless poultry, eggwhites, beans, and nonfat dairy more often.  Limit your red meat intake and when you do have meat, choose extra-lean cuts.  Nut and seed sources of protein are rich in healthy kinds of fat.  Still, all fats are high in energy, so it is important not to overdo even the healthy fats.  To control calories, portion control your nuts servings to ¼ cup or less.  Unlike animal proteins, plant sources of proteins such as nuts and beans are high in fiber that can help to lower blood cholesterol. 

Tips for Making Healthy Protein Food Selections:

1.  Vary your protein food choices –Consume a variety of protein sources. Experiment with main dishes made with beans, soy, or eggs/eggwhites.  Lowfat/nonfat yogurt and cottage cheese are convenient lean sources of protein.

2.  Choose fish twice a week or more - Eat fish and seafood in place of meat or poultry at least twice a week. Select a variety of seafood—include some that are higher in heart healthy natural fish oils such as tuna, salmon, trout and herring.

3.  Make meat and poultry low fat - Choose lean or low-fat cuts of meat like round or sirloin and ground beef that is at least 90% lean. Trim or drain fat from meat and remove poultry skin. 

4.  Have an egg - One egg a day, on average, does not appear to increase risk for heart disease, so make eggs part of your weekly choices. Only the egg yolk contains cholesterol and saturated fat, so egg whites are a great, naturally fat-free protein source.  Consider having one whole egg along with egg whites in a scramble or omelet.  Try egg salad with mostly whites and just one yoke or part of a yoke.

5.  Emphasize plant-based protein options - Try beans and peas (kidney, pinto, black, or whitebeans; split peas; lentils; chickpeas & hummus), soy products (tofu, soy milk, veggie burgers, edamame), nuts, and seeds. They are naturally low in saturated fat and high in fiber.

6.  Choose lean dairy – Like meat, the fat in dairy is high in artery clogging fats.  Cheese, while rich in protein is especially high in fat. Even “part-skim” and “reduced fat” cheese can still contain significant unhealthy saturated fat.  Use cheese sparingly or opt for lowfat or nonfat options.  Lowfat/nonfat milk, yogurt, cottage cheese, and whey protein isolate are good choices for protein.  The thicker, Greek-style of yogurt has 2-3 times as much protein as the regular yogurt. 

7.  Cook without added oil - Instead of frying, try grilling, broiling, roasting, stewing, braising, or baking—they don’t add extra fat. Some lean meats need slow, moist cooking to be tender—try using these in stews or cooking them with a slow cooker. Watch out for items cooked in butter or with cream sauces.

8.  Make a healthy sandwich or salad - Choose grilled chicken, turkey, roast beef, canned tuna or salmon, hard-boiled egg/eggwhites, or cottage cheese for salads and sandwiches. Many deli meats, such as regular bologna or salami, are high in fat and sodium—make them occasional treats only. Use cheese as an accent rather than the main protein source in a dish.  For example, instead of a grilled cheese sandwich, use one thin slice of cheese along with another protein source such as turkey.

9.  Think small when it comes to meat portions - Get the flavor you crave but in a smaller portion. Make or order a smaller burger (consider “Jr.” options) or a “petite” size steak.

10.  Watch the sodium & saturated fat - Check the Nutrition Facts label to limit saturated fat and sodium (salt). Deli meats, for example vary greatly in their saturated fat and salt content.  Salt is added to many canned foods—including beans, fish, and meats.  Processed meats—such as ham, sausage, and hot dogs and most cheese are especially high in sodium. Choose unsalted nuts or seeds.

VITAMIN B12 ENERGIZER SHOTS? UNNECESSARY EXCEPT IN CASES OF DEFICIENCY

Although vitamin B12 injections have a reputation for being a magic antidote for weight loss and fatigue, there is little creditable evidence to support this.  B12 injections can improve energy levels in persons who are B12 deficient but deficiency is relatively uncommon.  According to the 2001-2004 National Health and Nutrition Examination Survey, 3.2% of those over the age of 50 have B12 deficiency. And, there is no evidence that vitamin B12 impacts weight loss.

B12 is an essential vitamin that plays an important role in DNA synthesis, red blood cell development, peripheral nerve integrity, and cognitive function.  When deficient in B12, persons can develop pernicious anemia characterized by fatigue. 

All animal proteins including eggs, meat, fish, and poultry are rich in B12.  Additionally, most wheat is fortified with B12.   In order to for the body to digest the B12 found in foods, first the B12 in foods must be exposed to the stomach’s acids and then it must be linked with a protein made in the stomach called intrinsic factor. 

While rates of deficiency are low, some persons are at greater risk.  As we age, our stomach’s acidity decreases so persons over 60 are more likely to have B12 deficiency.  Also, persons taking medicine for gastroesophageal reflux disease (heartburn) have reduced stomach acidity.  Additionally, a common medicine used to treat diabetes, metformin, is associated with greater risk of B12 deficiency.  Persons who have very limited intake of food sources of B12 such as those who do not consume dairy or animal-based foods as well as persons who have digestive dysfunction such as those with inflammatory bowel disease are also at increased risk for B12 deficiency. 

What to do:  Consume a diet rich in sources of B12 including lean animal proteins such as lowfat dairy, fish, chicken, and lean meat.  If you believe you may be low in B12, consider taking an oral B12 supplement or ask your doctor to assess the B12 level in your blood.  If you are deficient, shots of B12 can be very helpful but, be aware, most B12 shots are not administered to persons who will actually benefit from the supplement.  As long as you have adequate levels, mega-supplementation has no benefit and can be quite expensive. 

Information adapted from article by Consumers Union of United States Inc. for Washington Post found at http://www.washingtonpost.com/national/health-science/vitamin-b12s-reputation-as-an-energizer-exceeds-evidence-deficiency-rate-is-low/2012/04/02/gIQAhxyHrS_story.html

VARICOSE VEINS CAN BE A SIGN OF SERIOUS VASCULAR PROBLEMS

Varicose veins and their precursors, spider veins can signal serious vascular problems.  Full-blown varicose veins appear as twisted, enlarged veins close to the surface of the skin while milder varicose spider veins appear as sunbursts of small blue or red vessels near the surface of the skin.  Spider and varicose veins are often misunderstood as merely a cosmetic problem.  However, if left untreated, spider and varicose veins can progress to a more serious form of vein disease called chronic venous insufficiency (CVI). 

Veins are the vessels that return blood to the heart from the body.  To keep the blood flowing up from extremities, and not back down, the veins contain one-way valves. Failure of  leg veins’ valves to hold blood against gravity leads to swelling in the lower legs and ankles, aching or tiredness in the legs, new varicose veins, leathery-looking skin on the legs, and/or flaking , itching, or ulceration on the skin of the legs or feet.

Varicose veins and vein valve damage is more likely among women, persons over 50, and persons with a personal or family history of leg clots (known as deep vein thrombosis).  Obesity, smoking, sedentary lifestyle, and sitting or standing for long periods have also been found to increase the risk of varicose veins and vein disease.  To prevent and reduce the progression of venous diseases try to maintain a healthy weight, avoid smoking or quit if you already smoke, exercise regularly, and avoid long periods of standing or sitting.  Elevating your legs to the level of your heart when sitting or lying down as well as wearing compression stockings can also support  venous blood flow in the lower extremities.

It is estimated that more than 40 million Americans suffer from vein disease but less than 3% get treated.  Because varicose veins are a potential risk factor for vein disease, persons with varicose veins, should have their risk for CVI assessed and be treated when indicated.  A vascular ultrasound can examine the blood circulation in the legs.  Non-surgical treatments for existing varicose veins and spider veins include sclerotherapy in which an injection into the veins causes them to collapse and disappear and endovenous thermal ablation in which laser or high-frequency radio waves create intense local heat in the affected vein causing it to close.  For more severe cases, surgical venous stripping or ligation may be necessary.

What to do:  To maintain healthy veins in the legs aim for good cardiovascular health by not smoking, maintaining a healthy weight, and exercising regularly.  Also, try to avoid long periods of sitting or standing.   If you are traveling or will be sitting for a long time, flex and extend your legs, feet, and ankles about 10 times every 30 minutes to keep the blood flowing in the leg veins. If you need to stand for long periods of time, take frequent breaks to sit down and elevate your feet.  If you are experiencing varicose veins or other symptoms of leg vein disease, discuss assessment and treatment options with your provider. 

Sources:  “Chronic venous insufficiency.” Vascular Web. Society for Vascular Surgery, Jan. 2011. Web. http://www.vascularweb.org/vascularhealth/Pages/chronic-venous-insufficiency.aspx and Gloviczki P, Comerota A, Dalsing M, Eklof B, Gillespie D, Gloviczki, M, et al.  The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011 May; 53(5 Suppl): 2S-48S.

RESEARCHERS PINPOINT HOW A LACK OF VITAMIN D MAY INCREASE THE RISK OF ALZHEIMER'S AND VASCULAR DEMENTIA

Researchers have found that low blood levels of vitamin D are associated with an increased risk for a host of health problems ranging from cardiovascular disease, susceptibility to infections, and diabetes, to osteoporosis, dental cavities and periodontal disease.  Vitamin D deficiency is also known to be linked to an increased risk of Alzheimer’s and vascular dementia.   For example, recently, a study from the large Third National Health and Nutrition Survey (NHANES III) in the U.S. showed a marked association between vitamin D deficiency and risk of dementia.   According to the latest estimates, 5.3 million Americans have Alzheimer's disease and it is the seventh-leading cause of death in the U.S

In 2009 it was reported that vitamin D3 appears to stimulate the immune system to clear harmful amyloid beta proteins, the main component of plaques associated with Alzheimer's disease.  But, the researchers didn't know how it worked.  Now researchers have identified the cellular mechanisms regulated by vitamin D3 that help the body clear the brain of amyloid proteins.

For the study, scientists drew blood samples from Alzheimer's patients and healthy controls and then isolated critical immune cells from the blood called macrophages, which are responsible for gobbling up amyloid beta and other waste products in the brain and body.  The team incubated the immune cells overnight with amyloid beta. An active form of vitamin D3 which is made in the body was added to some of the cells to gauge the effect it had on amyloid beta absorption.  They found that vitamin D3 activates key genes and cellular signaling networks to help stimulate the immune system to clear the amyloid protein. 

To determine whether vitamin D supplementation may help to treat dementia, clinical trials are still needed.  It is too early to know whether supplementation with vitamin D can reverse or slow the course of dementia.

What to do:  To reduce your risk of inflammatory diseases such as Alzheimer’s and heart disease, aim to maintain a healthy weight and lifestyle as well as adequate vitamin D.  For vitamin D, consume food sources rich in vitamin D such as lowfat/nonfat milk and oily fish such as salmon.  Also, next time you get blood work with your regular doctor, you can request your vitamin D level be checked.   This way you can know if you are deficient or not and how much to supplement with.  Vitamin D3 is widely available in supplements.  To maximize uptake of vitamin D, it is best to take it along with calcium.  Persons with some conditions should not supplement with vitamin D so check with your doctor before starting supplementation.  

Adapted from content in:   Journal of Alzheimer's Disease, 2009 17:1 & 2012;29:51-62, Science Daily at http://www.sciencedaily.com/releases/2009/05/090526140747.htm and Medscape at  http://www.medscape.com/viewarticle/760305.

EVEN IN THE ABSENCE OF WEIGHT GAIN, SUGAR-SWEETENED DRINKS INCREASE HEART HEALTH & DIABETES RISK FACTORS

Drinking two or more sugar-sweetened beverages a day boosts a woman's risk for developing heart disease and diabetes -- even if this habit isn't causing her to pack on extra pounds, a new study says.

Sugary sodas and other sweetened beverages are frequent targets in the war on obesity as their consumption often leads to increases in caloric intake and weight gain. Now it appears that even when the consumption of sweetened drinks does not result in weight gain, they may still be detrimental to heart health. 

For the study, researchers at the University of Oklahoma assessed the drinking habits of nearly 4,200 women aged 45 to 84 from various ethnic groups via questionnaires. The researchers measured weight gain, waist circumference, cholesterol levels, triglycerides and glucose (blood sugar) during three follow-up exams conducted over a five-year span.

Researchers found that compared to women who drank one or less sugar-sweetened beverage, those who drank two or more sugary beverages a day were four times as likely to have high levels of unhealthy blood fats called triglycerides and elevated fasting blood sugar levels (known as "prediabetes').  What's more, among women of similar weight, those who drank two or more sweetened drinks had more belly fat than those who drank one or less each day.  Unfortunately, belly fat has been found to be the fat that is most detrimental to health. 

What to do:  Aim to avoid consumption of sweetened drinks including soda, sweet ice tea, and juice.  These are high in calories and tend not to be filling.  Opt for water, seltzer, and tea instead. 

 

Adapted from articles available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_118658.html and http://newsroom.heart.org/pr/aha/sugar-sweetened-beverages-may-217750.aspx

TIPS TO CUT BACK ON SODIUM

It’s clear that Americans have a taste for salt, but a diet high in salt (sodium chloride) contributes to water retention, high blood pressure, stroke, and kidney disease. The average American consumes about three to four times the recommended amount of sodium. For health, everyone, including kids, should reduce their sodium intake to less than 2,300 mg of sodium a day (about 1 teaspoon of salt). If you have heart health risk factors, aim to consume less than 1500 mg of sodium each day.  This means getting less than 2/3 of a teaspoon of salt from all dietary sources. 

Even if you do not add salt while cooking or do not use the salt shaker at the table, you are probably eating too much sodium. That is because we eat packaged foods, like deli meats, frozen dinners, boxed noodle and rice dishes, canned soups, canned vegetables, bottled dressings & sauces, breakfast cereals, bread, and snack foods. Approximately 75% of our intake of sodium is derived from salt added by manufacturers to food products long before they appear on our tables. Even some foods that do not taste salty are high in sodium.  For example, bread is the leading source of salt in most American’s diets but you don’t necessarily taste all that sodium because it’s “baked in” rather than on the surface of the food like with chips where the salty taste is more distinct. 

10 Tips to Cut Back on Sodium in Your Diet:

·         Think fresh - Most of the sodium Americans eat is found in processed foods. Choose highly processed foods less often and in smaller portions—especially cheesy foods, such as pizza; cured meats, such as bacon, sausage, hot dogs, and deli/luncheon meats; and ready-to-eat foods, like canned chili, ravioli, and soups. Fresh foods usually have little or no added sodium, allowing you to better regulate sodium intake.

·         Enjoy home-prepared foods - Cook more often at home—where you are in control of what’s in your food. Foods prepared in restaurants and fast food locations are often very high in sodium with many dishes having more than a day’s worth of sodium!

·         Fill up on veggies and fruits—they are naturally low in sodium - Eat plenty of vegetables and fruits—fresh or frozen or canned with no sodium added.  Aim to eat a vegetable or fruit at every meal.  Fresh fruits and vegetables are high in potassium which helps to somewhat counteract the increases in blood pressure caused by sodium.

·         Choose dairy and protein foods that are lower in sodium - Choose more fat-free or low-fat milk and yogurt in place of cheese, which is higher in sodium. Choose fresh beef, pork, poultry, and seafood, rather than those with salt added. Deli or luncheon meats, sausages, and canned products like corned beef and fish like sardines are high in sodium.  Look for canned tuna without added sodium. Choose unsalted nuts, seeds, and nut butters like peanut butter.

·         Adjust your taste buds - Cut back on salt little by little—and pay attention to the natural tastes of various foods. Your taste for salt will lessen over time.

·         Skip the salt shaker - Skip adding salt when cooking. Keep salt off the kitchen counter and the dinner table. Use spices, herbs, garlic, vinegar, and lemon juice to season foods or use no-salt seasoning mixes. Try black or red pepper, basil, curry, ginger, rosemary, dill, and many others to add flavor to dishes.

·         Read the label - Read the Nutrition Facts label to find packaged and canned foods lower in sodium. These list the amount of sodium in one serving of the food.  The % Daily Value (%DV) is the percentage of the daily sodium limit in one serving of the food.  If the %DV is less than 10% than the food is not so high in sodium but if it is 25% or more, try to choose a lower sodium option.

·         Ask for low-sodium foods when you eat out – Restaurants’ foods are usually loaded with sodium but often they can prepare dishes with less added sodium at your request and will serve sauces and salad dressings on the side so you can use less.

·         Pay attention to condiments - Foods like soy sauce, ketchup, pickles, olives, salad dressings, and seasoning packets are high in sodium. Choose low-sodium soy sauce and ketchup. Have carrot or celery sticks instead of olives or pickles, or if you are using these for salads replace them with low-sodium options such as unsalted roasted red peppers, unsalted sun-dried tomatoes, horseradish, and more lemon/vinegar.  Mix up dressings at home or dilute store bought ones with added lemon/vinegar to control the sodium.  Use only a sprinkling of flavoring packets instead of the entire packet.

·         Boost your potassium intake - Choose foods rich potassium, by emphasizing fruits, vegetables, nuts, beans, whole grains, and low-fat/non-fat dairy in your diet.  Intake of foods rich in potassium can help to counteract the effect that sodium has on blood pressure. Some of the fruits and vegetables highest in potassium include oranges, melons, bananas, kiwis, potatoes, yams, tomatoes, spinach, beans, and artichokes.

BPA EXPOSURE MAY RAISE RISK OF HEART DISEASE

A new study has found that exposure to bisphenol A (BPA), a controversial chemical commonly used to make plastics, increases a person's risk of developing heart disease later in life.

BPA is a building block of plastic that is in the epoxy resin used to line most cans, some plastic bottles that have a #7 recycling code as well as other hard plastic containers, older dental sealants, receipts, and receipts. There are concerns that BPA mimics estrogen in the body interfering with endocrine function and fetal development.  Animal studies have found that exposure to BPA early in life may alter behavior and may increase the risk of cancer, diabetes, and heart disease.

For this study, which found an association between BPA exposure and heart disease, researchers gathered urinary BPA levels of healthy adults at the start of a large long-term population study in the U.K.  After 10 years, 758 people developed heart disease. The study found that the subjects who developed heart disease had significantly higher levels of BPA in their urine at the start of the study than those who did not develop the disease.

The findings of another recent study emphasize just how much consumption of products that have been in contact with BPA can increase urinary BPA levels.  Here, researchers fed 12 ounces of fresh or canned (Progresso) vegetarian soup to 75 people at lunch every day for five days.  They found that several hours after lunch, compared to those who had fresh soup, those who consumed the canned soups had urinary BPA levels that were 12 times higher.

What to do:  Scientists don’t yet know is BPA is truly harmful. In the meantime, to play it safe it may be wise to try to avoid BPA as much as possible, particularly among persons who are pregnant, breastfeeding, or under age 18.   To minimize exposure avoid #7 plastics and use glass or stainless steel to store foods.  Avoid freezing, microwaving, or dish washing plastics with BPA as these degrade the plastic allowing more BPA to leach into your foods.  Choose drinks packaged in glass and instead of canned items, look for these products packaged in cartons, pouches, or as frozen items.  There are also now some cans such as those used by Eden Organic that are made BPA free.  Also, when possible, discard of receipts and try not to mix them in with groceries.

Adapted from article at: http://www.nlm.nih.gov/medlineplus/news/fullstory_122396.html, report by  Nutrition Action Healthletter Jan/Feb. 2012, and Peninsula College of Medicine and Dentistry, news release, Feb. 23, 2012.