Can Red Meat be as Heart-Healthy as Chicken or Fish? Diet and Diabetes Eating for the Holidays Importance of a Diet Containing Carbohydrate, Protein, and Fat Truth Regarding Low-Carb Diets and how it will affect my Lipid Panel To Be or Not to Be Vegetarian? Using the Non-Diet Approach for Treating Binge Eating Disorder (BED)

Can Red Meat be as Heart-Healthy as Chicken or Fish? When a recently published study regarding red meat announced that consumption can be as effective in reducing blood cholesterol (as much as a diet consuming chicken or fish), the media projected people eating hamburgers. It must be made clear that research was comparing lean red meat to poultry and fish, as well as the portion size (6 oz.) compared to a super sized burger, or thick sirloin steak.  Beef provides one of the most concentrated forms of several nutrients including zinc, iron and B vitamins.  To consume the same level of zinc, iron and B vitamins found in just one 3 oz cooked serving of beef, as adult would have to consume seven chicken breasts and eight chicken breasts respectively.   Beef also contains its concentration of conjugated linoleic acid (CLA), which may have a variety of advantages including cancer protection, and selenium, a potentially powerful antioxidant.    CLA is a unique fatty acid found in beef that exhibits powerful anticarcinogenic effects at relatively low dietary levels in animal studies.  Studies have found that CLA can inhibit malignant melanoma, colorectal, lung, breast, ovarian, and liver cancers.  The lowest cuts of beef and pork will often have “loin” or “round” in their names.  For ground beef, choose a package that’s 90% or 95% lean. 3 ounces cooked meat calories total fat (grams) saturated fat (grams) 90% lean ground beef 169 9 4 Beef eye of round 143 4 2 Beef top loin 176 8 3 Pork tenderloin 139 4 1 Pork loin chop 172 7 3 Veal loin 149 6 2 Veal leg 128 3 1 Skinless chicken breast 140 3 1 Skinless chicken leg 162 7 2 Skinless chicken thigh 178 9 3 Flounder 62 1 0 Halibut 119 3 0 Remember that having variety, taste and food quality, we should follow a diet that is heart healthy.

Diet and Diabetes Diabetes and diet are always a topic of discussion, since most of us are acquainted with guidelines to avoid sugar.  We experience the fear of the foods that may have to be given up.  Understanding the NEW Guidelines is that not one food is restricted.  Our bodies do not care about the source of carbohydrate, rather than the total amount (in grams).  Carbohydrates are a category of food that includes sugars and starches.  Understanding the various forms is important in seeing why one’s body tolerates some forms better than others do.  Glucose is also known as a single sugar.  This is the form that all of our food will be broken into at some point.  Fructose is also a single sugar and is better known as fruit sugar.  Sucrose is a double sugar.  Glucose and fructose molecules hooked together make sucrose.  This is also known as table sugar.  Lactose which is also a double sugar, is made up of two simple sugars, glucose and galactose.  This is also known as milk sugar.  Finally there is starch which is hundreds of glucose molecules linked together.  Common sources of starch are wheat (pasta, bagels, bread), corn and potatoes. Upon food being broken down into glucose (the body’s main fuel), glucose enters the bloodstream and the level of glucose in your blood begins to rise.  When an increase in glucose is sensed, the body sends a signal to your pancreas.  The pancreas then makes insulin and sends it into the bloodstream.  Insulin is like a key that allows blood glucose to cross from the bloodstream into the body’s cells.  When the glucose is inside the cell, your body converts the glucose into energy.  Therefore, insulin effectively lowers the level of blood glucose by letting glucose leave the bloodstream and go into the cells.    In people with diabetes, this system doesn’t work.  This is why diet is very important in understanding how to better control the blood sugar.  Having any source of carbohydrate that contains fiber will sustain blood sugar longer (fruit with skin, whole grains) compared to white flour refined starches.  Also understanding the effects of the different fats in our diet can helpful, because our blood sugar can be better sustained with the right types of fats.  Finally seeing how lean protein options can also benefit the control of blood sugar is important to understand.  People who have poor control of blood sugar can eventually cause damage to small blood vessels and complications in the heart, kidneys, eyes and nerves.  This also increases the risk for heart disease two to four times and more than doubles the risk of a stroke.    Robyn is available in our office Tuesdays and Wednesdays, to teach you more specifically how your diet can be tailored to the appropriate amount of carbohydrates, proteins and fats, while utilizing the new carbohydrate counting system.

Eating for the Holidays Are you uncertain what to eat over the holidays, since you have been successful losing weight? Or are you unclear how to prepare tasty meals that won’t increase your cholesterol? Healthy eating includes, healthy cooking. Included in this article are tips to decrease the overall caloric and fat content in meals. Planning creamy sauces and dips can be done the skinny way by using nonfat dairy products or using extra firm lite tofu. Tofu has the consistency that be implemented in desserts, puddings, whipped toppings, frostings, dips, dressings, and creamed sauces. Also soymilk and rice milk can be used in place of full fat or reduced fat dairy products. De-fatting the turkey and stuffing are key components in serving lean poultry. While the bird is resting after being cooked, put the pan drippings in the freezer for 20 minutes and then remove the fat. Bake the stuffing in a casserole dish instead of in the turkey where it absorbs animal fat. Baste the turkey with broth instead of fatty drippings. Finally when preparing Matzo ball soup keeps removing the top layer of chicken fat from the broth. Roasting your vegetables can enhance the flavor because it concentrates the natural sugars. Cut your veggies into wedges or strips, and sprinkle with fresh herbs and olive oil and bake at 400 degrees for 40 to 50 minutes. Remember that using canola oil instead of margarine, or extra-virgin olive oil for salad dressing would be heart healthy alternatives. It is important to keep in mind that using too much of a good thing can still contribute to the waistline. When cooking meals, this can be a tempting time to sample meals that may lead to overeating. A key idea when preparing meals is to not begin when hungry. This will likely lead to over sampling of food. Keeping raw vegetables on hand is a handy alternative to curbing one’s appetite. Dessert is always a hot topic over the holidays. Pies are commonly seen at various events. But why not try to be different this year and serve a fresh fruit cobbler!! Most of the fat and calories in the pie are in the crust, or the added butter mixed with the fruit. A fresh fruit cobbler is satisfying to your sweet tooth and healthy too. Planning the appetizers for your party can be challenging. Some ideas include hummus (chick pea spread) with pita triangles, or a reduced fat cracker with your favorite low-fat spread. One can be extra creative by fooling their guests with soy cheese and crackers, or soy-veggie dogs wrapped. The traditional fruit kabobs with pineapple chunks, mango, strawberries and melon balls are always a hit. Modify your traditional holiday menus and recipes to reduce fat, cholesterol and calories. For example: Original Menu Leaner Menu 3 ounces roast duck 3 ounces roast turkey breast ½ c stuffing ½ c rice pilaf ½ c broccoli with hollandaise sauce ½ c broccoli with lemon juice ½ c jellied cranberry sauce ½ c fresh cranberry relish 1 medium crescent roll 1 fresh roll 1 slice pecan pie 1 slice pumpkin pie     Total Calories=1205 Total Calories= 730 Total Fat=55 grams Total Fat= 21 grams Some additional recipes for your use over the holidays, that are low-fat, and low sodium but quite tasty. Green Bean Casserole 3 packages (10 ounces each) frozen French-cut beans, thawed and drained 1 can (10 ¾ ounces) condensed low-fat cream of mushroom soup ½ cup nonfat sour cream ¼ teaspoon ground black pepper 1 ½ medium onions, thinly sliced and separated into rings 4 tablespoons grated nonfat or reduced-fat Parmesan cheese 2 tablespoons Italian bread crumbs 1. In a large bowl, combine the green beans, mushroom soup sour cream, and pepper, and toss gently to mix. 2. Coat 2-quart casserole dishes with nonstick cooking spray, place the green bean mixture in the dish, and arrange the onion rings over the top. Combine the Parmesan cheese and breadcrumbs in a small bowl, and sprinkle over the onions. 3. Bake at 350 degrees for 50 minutes, or until the green bean mixture is bubbly and the top is lightly browned. Serve hot. NUTRITIONAL FACTS (PER ½ CUP SERVING) Calories:51 Fat: 0.6gm Protein:2.8gm Pork Tenderloins with Pineapple Stuffing 3 pork tenderloins, 1 pound each PINEAPPLE STUFFING 6 slices multigrain bread ½ cup crushed pineapple in juice, drained ½ cup chopped water chestnuts ½ cup finely chopped onion ½ cup finely chopped celery ¾ teaspoon dried sage ½ teaspoon poultry seasoning 2 egg whites, lightly beaten BASTING SAUCE 3 tablespoons unsweetened pineapple juice 3 tablespoons brown sugar 1 tablespoon spicy mustard 1. To make the stuffing, tear 4 of the 6 slices of bread into pieces. Place the piece in a food processor or blender, and process into coarse crumbs. Measure the crumbs. There should be 2 cups. (Adjust the amount if necessary.) Cut the remaining bread into ½-inch cubes, and measure the cubes. There should be 2 cups. (Adjust the amount if necessary.) 2. Place the breadcrumbs and cubes in a medium-sized bowl, and add the crushed pineapple, water chestnuts, onion, celery, and seasonings. Toss to mix well. Add the egg whites, and toss to mix well. Set aside. 3. Combine all of the basting sauce ingredients in a small bowl, and stir to mix well. Set aside. 4. Trim the tenderloins of any visible fat and membranes. Rinse with cool water, and pat dry with paper towels. Split each of the tenderloins lengthwise, cutting not quite all the way through, so that each tenderloin can be spread open like a book. Spread 1/3 of the stuffing mixture over half of each tenderloin, extending the stuffing all the way to the outer edges of the meat. Fold the facing half of each tenderloin over the stuffing spread half, and use a heavy string to tie the meat together at 2 ½-inch intervals. 5. Coat 13*16-inch roasting pan with nonstick cooking spray, and lay the tenderloins in the pan, spacing them about 2 inches apart. Bake at 350 degrees for about 50 minutes, or until the meat is no longer pink inside, occasionally basting with the prepared sauce. 6. Remove the pan from the oven, cover loosely with aluminum foil, and let sit for 5 to 10 minutes before slicing ½ inch thick. Serve immediately. NUTRITIONAL FACTS (PER 4-OUNCE SERVING) Calories: 196 Fat: 4.7 gm Protein:26gm Old-Fashioned Rice Pudding ½ cup plus tablespoons uncooked short grain rice ¾ cup pear of apricot nectar ½ cup water 1 quart skim milk ½ cup sugar ½ cup nonfat dry milk powder 1 cup egg substitute 2 teaspoons vanilla extract ½ cup raisins ½ teaspoon ground nutmeg 1. Combine the rice, nectar, and water in a 4-quart pot, and bring the mixture to a boil over high heat. Reduce the heat to low, stir once, and cover. Simmer for 15 minutes, or until the rice is almost tender and most of the liquid has been absorbed. 2. Add the milk, sugar and nonfat dry milk to the rice mixture, and cook over medium heat, stirring constantly, until the mixture just begins to boil. Reduce the heat to low. Stir ½ cup of the hot rice mixture into the egg substitute. Then return the mixture to the pot. Cook and stir for 2 to 3 minutes, or until the pudding thickens slightly. (Do not let it boil). Remove the pot from the heat, and stir in the vanilla extract and raising. 3. Coat a 2-½ quart casserole dish with nonstick cooking spray, and pour the pudding into the dish. Sprinkle the nutmeg over the top and place the dish in a pan filled with 1 inch of hot water. 4. Bake at 350 degrees for 1 hour and 10 minutes, or until a sharp knife inserted midway between the rim of the dish and the center comes out clean. Cool to room temperature. Cover and chill for several hours or overnight before serving. Nutritional Facts (per ¾-cup serving) Calories:178 Fat: 0.3 gm Protein: 8.4 gm

Importance of a Diet Containing Carbohydrate, Protein, and Fat Are you confused by the recommended quantities of Carbohydrate, Protein and fat that one should consume in their diet? This article will explain the specific requirements of each, the function and their sources. CARBOHYDRATES Carbohydrates are the main source of fuel in the body and are broken down to glucose for energy to the brain and all other cells in the body. They provide 4 kcal/gm, and aid in the metabolism of fat. They contain fiber, which aids in elimination, intestinal health, promotes a sense of fullness, and can regulate cholesterol and blood sugar. They are broken down and digested in one to three hours of consumption. American Heart Association recommends that one consumes 50 to 65% of their total caloric intake from carbohydrates, but newer recommendations include 45-60% of meals. If one were on the more active side, then the higher percentage would be consumed. Carbohydrates contain B vitamins, Vitamin E, Fiber and minerals such as chromium and Selenium. Excellent sources include: Whole grains, breads, cereals, pastas, rice’s, fruits, vegetables, *nonfat or low fat milk products, and *legumes. * contains carbohydrates and protein. PROTEIN Protein is also known as the building blocks of amino acids, which are needed for growth and repair of every cell in the body. Protein is needed to create antibodies (for immunity), hormones, red and white blood cells and enzymes as well as help maintain fluid balance in various parts of the body. Protein also provides essential amino acids that the body can’t manufacture on its own and is broken down within three to four hours of consumption. They also provide 4 kcal/gm. Recommendations had previously been 12-20% of the total caloric intake, but newer recommendations are 20-30% of meals. Protein provides B-6, B-12, Iron, Chromium, Selenium, Zinc and Copper. Lean sources include: skinless boneless poultry, fish, pork tenderloin, lean cuts of beef (eye round, top round, round tip, top sirloin, tenderloin), soy, egg whites. FAT Fat is our friend, not the enemy that it’s been portrayed out to be. Fat is the primary carrier of flavors in food, provide and store fat-soluble vitamins, A, D, E, and K, and is necessary for DNA synthesis. Fat is needed for temperature regulation, and supplies essential fatty acids necessary for healthy skin, hair and nails. Fat triggers us to feel full and stop eating. Fat provides 9 kcal/gm and recommendations are 20-30% of the total caloric intake. The three types include Saturated, Monounsaturated, and polyunsaturated fats. Saturated fat is the “bad” fat, solid at room temperature, and is animal based which can elevate one’s lipid panel. Butter, lard, cream cheese, creamy salad dressings, fat in poultry, meat and cheese and hydrogenated fats are ones to avoid. Mono- and Polyunsaturated fats are the “good” fats which are plant based and liquid at room temp. Examples include olive oil, canola oil, avocado, peanut butter, and cashews. The above key nutrients are important for one to consume for optimal health, satisfaction with meals, and adequate intakes of vitamins and minerals. In a society that is obsessed with diets and dieting it is a struggle for the consumer to know which nutritional information is accurate.

Truth Regarding Low-Carb Diets and how it will affect my Lipid Panel An estimated 50-70 million Americans go on diets each year. Many of these same people will go on a diet the next year. And again the year after that. For many, this represents a cyclical pattern of yo-yo dieting that does our physical and emotional health little good. The lowdown on carbohydrate-restricting diets has a rationale something like this: Eating carbohydrates increases blood sugar, which increases insulin secretion that causes excess insulin in bloodstream. This causes an increase in hunger, making you eat more, and increases the conversion of carbohydrates into fat. This then increases body fat. Some parts of this rationale are fact, while others are fiction. FACT: Consuming carbohydrates will increase your blood sugar level, temporarily. This is a normal response to eating. An elevation in blood sugar will cause your pancreas to release more insulin into your blood stream. This too is normal. The insulin will help to bring blood sugar back into a normal range. In some instances, blood sugar and insulin will increase to abnormally high levels. Foods with a high-glycemic index will result in an exaggerated increase in blood sugar, and as a result, a higher than usual increase in insulin. People who are insulin resistant generally also will have an increased insulin response, regardless of blood sugar level. FICTION: The exaggerated insulin response does not result in a significant conversion of carbohydrates into fat. Although, many animals- pigs and cattle, for example-fatten up quite easily on carbohydrates, humans have a very poor capacity for turning carbohydrates into fat. It is not primarily carbohydrates in your meals that get converted into body fat. The carbohydrates that you eat are, for the most part, either burned as fuel or stored in your muscles and liver for later use. It is the fat in your meal that gets converted into body fat. Researchers at George Washington University Medical center and the National Institutes of Health placed 24 overweight men and women on the Atkins diet for eight weeks. Body weight was measured before and after, and blood samples were drawn and analyzed for cholesterol, free fatty acids, and uric acid. Conclusions of the Atkins diet may elevate total and LDL (bad) cholesterol, particularly in women. The diet also lowered HDL (good) cholesterol in women, as well as increase the ratio of bad to good cholesterol, especially in women. The nearly 50 percent increase in LDL/HDL cannot possibly be considered a good thing- regardless of weight loss. The Atkins diet also increased blood free fatty acid levels, which increases the risk of irregular heartbeat and diabetes. Furthermore, the increase of blood uric acid levels may be hazardous to joints and kidney function. This diet may result in weight loss over the course of a least eight weeks if strictly followed. What should be considered is the actual amount of fat and protein consumed during the diet did not change all that much from their usual diet. In fact, total fat intake actually decreased a bit. The only major difference was that carbohydrates were virtually eliminated from the diet. So, one possible conclusion from this study is that the unfavorable cholesterol changes were due not to the relatively high-fat nature of the Atkins diet, but rather to the fact that the diet is low in carbohydrates. The study indicated an important role for dietary carbohydrates in cholesterol control.

To Be or Not to Be Vegetarian? Much controversy has developed since the Dean Ornish Study that was published in the Journal of the American Medical Association (1998;280:2001-2007). People are confused with what they should eat if they have coronary artery disease. “Should I eat a high carbohydrate diet?” “A vegetarian diet?” or “maybe a high protein diet?” The first thing that needs to be evaluated is that a lifestyle change needs to occur. No fad diet is the answer to resolving your lipid problem or heart disease. According to the American Heart Association guidelines, one can begin with a Step I or Step II diet. The Step II diet is the more stricter of the two and consists of no more than 30% calories from fat and no more than 7% of those calories from saturated fat. Realistically, most people will not make radical changes in their diet to become a vegetarian. People will be more likely to eat vegetarian meals and increase their overall intake of vegetables and fish. But according to a response from the Ornish study, “if people make moderate changes they are likely to get worse. If they are willing to make bigger changes, they are likely to get better and better”. I believe decreasing your intake of saturated fats, and including more monounsaturated fats and polyunsaturated fats in moderation will decrease many weight and cholesterol levels and in opening blocked arteries. Method of food preparation is of high importance as well. Heart healthy methods such as baked, broiled, grilled, roasted, BBQ, and steamed are ways that we can acquire good tasting food, while cutting the fat.

Using the Non-Diet Approach for Treating Binge Eating Disorder (BED) Many of us are familiar with the terms Anorexia Nervosa, and Bulimia, but the eating disorder, which is in the younger stages, is called Binge Eating Disorder (BED). This article will discuss the diagnostic features of BED and treatment using the non-diet approach. Binge-Eating Disorder is classified as having binge episodes occur, usually among the overweight population on average a minimum of twice per week for a period of six months. The symptoms do not occur concurrently with Anorexia Nervosa or Bulimia. BED is more prevalent among women compared to men, and one may have self-esteem issues relating to their body, relationships with others, with their job, and positive feelings about themselves. Some may have prevalence with Major Depressive Disorder, Personality Disorders, and Substance-Related Disorders. Many individuals with this form of disordered eating have gone various routes with losing weight. These may include fad diets, pills, and feel they have tried everything except identifying their behavior. The non-diet approach teaches physical hunger vs. mouth hunger and does not focus on the result of weight loss. It focuses on improvements of self-concept and body image, and not classifying foods as good or bad (AKA: forbidden foods). Learning how to work on internal vs. external hunger cues and body dissatisfaction is a key part of the non-diet approach. Also being able to understand that it is the non-hunger eating that one is engaging in, NOT eating “bad” or (ineffective) foods that cause weight gain. As one progresses towards this approach learning how to focus on eating in response to physical hunger and normalizing feelings about food are key areas. Also size acceptance is an area that one needs to identify with and having their goals be realistic per their bone structure. Also, each approach is very individualized, so one must work with a Registered Dietitian, who can tailor this approach per each specific lifestyle. Long-term outcomes show that traditional weight-loss diet programs have not been successful because of psychiatric disorders. Cognitive behavior therapy (CBT), interpersonal psychotherapy (IPT) and antidepressant medications have been the routes most commonly used. By using the non-diet approach in conjunction with therapy, long-term results will be more promising than going the route of the “quick fix” to temporary weight reduction.