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.