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Should Salt Shakers Be Removed from the Table?

October 2, 2013 by  
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by Mommy MD Guide Ayala Laufer-Cahana, MD

Setting the table was my first contribution to the family food making effort as a little girl, and the first task my kids participated in in my own home (I hate calling it a chore – makes a job that can be delightful and creative sound so boring.) A basic set table to me has plates, glasses, cutlery, napkins, salt and pepper.

But now, many restaurants are omitting the salt shaker. The New York Times brought in chefs, health experts and others to debate this trend.

I suppose that most restaurants that do away with the salt shaker do so because they feel the food’s already properly seasoned, and that the chef is responsible for the final taste and deserves full control over the finished product. I don’t think hypertension is on their mind.

Chef Kevin Sbraga does not put salt on the table in his Philadelphia Sbraga. He thinks that the guests should expect to get the food properly salted, and he says, “Ultimately, it might be a control thing. I want to have as much say in our guest experience as possible, even when it comes down to the salt.”

Mary Sue Milliken of the Border Grill restaurants offers the same reasoning and doesn’t automatically provide salt at the table.

On the other hand, Marcus Samuelsson of Red Rooster Harlem thinks it’s not for him to force his salt preferences on his diners.

None of the chefs in this piece took the salt shaker off the table for health reasons. Indeed, Thomas Farley, New York City’s Health commissioner – who has waged a war on the salt excess in our diet and is a big proponent of salt reduction – is on good terms with the salt shaker: “The salt shaker is not the culprit. Only about 10 percent of the sodium in our diet comes from salt we add to food while cooking or eating. Most of the salt we consume is already in food when we buy it. In fact, foods that don’t even taste salty, like bread, are among the top sources of sodium in our diets.”

Salt to taste

Too much salt can have detrimental effects on blood pressure, especially in vulnerable populations, and there is no doubt that the American diet contains excess salt – added for a multitude of reasons some unrelated to taste – and salt clearly belongs on the ‘foods to reduce’ list.

Salt, on the other hand, is an amazing ingredient. It is an essential nutrient we can’t do without; it not only flavors food, it is also a taste enhancer and taste modifier, and a natural preservative that keeps foods from spoilage.

But how much salt is just enough salt for perfect flavor? To that — I beg to differ from the salt-controlling chefs — there is no right answer.

Salt sensitivity and preference varies from person to person, and depends on the foods we regularly eat. Evidence shows that we develop a preference to a certain level of saltiness through repeated exposure. Raise a kid on very little added salt, and his taste buds will sense just a few flakes; raise him on fast food and food will taste bland unless it’s generously salted. Evidence shows we are born liking some saltiness, but salt level preference depends on exposure.

So chef isn’t necessarily an authority on the perfect salt level. No one is.

I rarely add salt at the restaurant table, but when I want another grain of salt I hate having to ask – and wait – for it, and for me, a table is not set without it. Salt just belongs at the table, and has been part of how we welcome guests for a very long time. Please, do stop this saltless trend. And if I can, one more pet peeve: please don’t clear plates when other diners are still eating; it is rude, and interrupts the mood and the conversation.

Do you miss the salt shaker when it isn’t there?

Dr. Ayala is a pediatrician, mother, artist, serious home cook, and founder of Herbal Water Inc., in Wynnewood, PA. Dr. Ayala is known for her extensive knowledge of nutrition and food, as well as her practical approach to improving health and preventing obesity and disease.

Breakfast is the Most Important Meal of the Day

September 12, 2013 by  
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by Mommy MD Guide Sonali Ruder, DO

We’ve all heard the old adage, “Breakfast is the most important meal of the day,” but how many of us really follow it? On weekdays, I’m usually rushing out the door with only a cup of coffee to sustain me until lunchtime, by which time, I’m usually starving. Of course, I’ve always heard about how important eating a good breakfast is, but I never really thought it was a realistic goal for my lifestyle.
So why is it important to eat a nutritious breakfast? Studies show that people who eat a good breakfast end up eating fewer calories throughout the rest of the day. Eating a good breakfast keeps you feeling fuller longer so that you will avoid overeating later in the day. Although you may think that skipping breakfast will help you lose weight by cutting calories, it actually increases your risk of obesity. Eating breakfast boosts your metabolism, which makes you burn more calories throughout the morning rather than storing them.

Eating breakfast also helps boost your intake of important nutrients such as vitamins and minerals. People who eat breakfast are more likely to eat a healthier diet overall, including less fat and cholesterol, which is good for your heart and helps to maintain a healthy weight. Also, eating breakfast gives you more energy, which translates into increased concentration and productivity throughout the morning.
So what exactly constitutes a healthy breakfast? A good breakfast includes a balance of complex carbohydrates with protein, fiber, and just a small amount of fat. This combination will keep you feeling full for many hours as opposed to the high-carbohydrate breakfasts that we sometimes grab in a rush, such as muffins, bagels, and sugary cereals. These foods give you a short burst of energy, but in no time, you’ll be left feeling tired and hungry all over again. These are the components you want to include in your breakfast:

• Whole grains
• Lean proteins
• Low-fat dairy or soy products
• Fruits and vegetables

If you include foods from all of these categories in your meal, you will be eating a healthy, well-balanced breakfast. Need some examples? Here are some specific examples of healthy breakfast ideas that are quick and easy to prepare:

• Bowl of whole-grain cereal (watch the sugar content) with berries and skim or soy milk
• Whole-grain toast with peanut butter and sliced apples
• Whole-grain waffle topped with almond butter and sliced strawberries or banana
• Bowl of oatmeal with fresh or dried fruit and/or chopped nuts (apples, walnuts, and cinnamon are a great combination; another good combo is blueberries and almonds)
• Whole-grain toast with low-fat cottage cheese and sliced peaches or pineapple
• Parfait made with layers of fat-free Greek yogurt, fresh fruit, and chopped nuts or whole grain cereal
• Smoothie made with strawberries, blueberries, bananas, fat-free yogurt, and flaxseed
• Whole wheat pita topped with low-fat cottage cheese or part-skim ricotta cheese and sliced tomatoes; serve with fresh fruit or a glass of fruit juice on the side
• Whole-grain English muffin with lean ham or turkey, reduced-fat cheese, and sliced tomato
• Homemade breakfast burritos (see recipe below)

My Jump-Start Your Day Breakfast Burritos are a hearty and nutritious meal to jump-start your day and set you on the right path for healthy eating all day long. And the best part is that if you’re not a morning person, you can prepare a whole batch of them ahead of time and freeze them. Then when you want to eat one, you just unwrap, pop it in the microwave, and take it to go!

Jump-Start Your Day Breakfast Burritos
Makes 6 burritos
2 teaspoons olive oil
1 small yellow onion, chopped
1 red bell pepper, chopped
Kosher salt and black pepper
1 cup canned black beans, drained and rinsed
1 teaspoon chili powder
6 whole eggs plus 6 egg whites
½ cup shredded reduced fat Cheddar cheese
6 (9-inch) whole grain wraps (I used La Tortilla Factory Smart Delicious Whole Grain Soft Wraps)
¾ cup salsa
¼ cup sliced scallions
Hot sauce (optional)

Heat the oil in a large nonstick skillet over medium heat. Add the onion and pepper to the skillet and season them with salt and pepper. Cook, stirring occasionally, until softened, for 7 to 8 minutes. Stir in the beans and chili powder, and cook for 2 to 3 minutes until heated through. Pour the contents of the skillet into a bowl and set aside. Wipe the skillet clean.
Whisk the eggs and egg whites together in a large bowl along with ½ teaspoon salt and ¼ teaspoon black pepper. Spray the skillet with nonstick cooking spray and heat over medium heat. Add the eggs and cook them, stirring occasionally, until soft curds form. Stir in the cheese and cook 1 minute until melted. Remove from the heat.
Spread each tortilla with equal amounts of the veggie/bean mixture and top with the scrambled eggs. Spread 2 tablespoons salsa, some sliced scallions and hot sauce (if using) on top. Roll the tortillas up burrito style—fold the side closest to you over the filling, then fold both sides in toward the center and roll up. Serve alone or with reduced-fat sour cream, if desired.
If not eating right away, wrap each burrito in plastic wrap or aluminum foil and freeze. To reheat, unwrap and microwave until warm, about 2 minutes, turning over halfway through. For a crispier wrapping, heat in the microwave, then bake in a 450° oven for 5 to 10 minutes.

Dr. Ruder is a mom of a two-month-old daughter, an emergency physician at Coral Springs Medical Center near Fort Lauderdale, FL, and a recipe developer and blogger at TheFoodiePhysician.com.

Healthy Food Is on the Menu at School

September 4, 2013 by  
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by Mommy MD Guide Jennifer Gardner, MD
Happy New (School) Year!

The new school year is just that, a new year, so we think this is the perfect time to institute some new “school year” resolutions. One great place to start is in the school lunchroom. If your kids are attending school full time now, then they will be eating at least one meal away from home.

If your kids buy lunch from the school cafeteria, this may be the first time that they will get to choose their food without your direct input. But you can still exert some direct control over their meals if they brown bag their lunch (but recognize that they still might trade it). Each provides a great opportunity for you to teach your kids about healthy food choices and the importance of food. Below are some helpful guidelines for getting your kids to eat healthier at school.

Don’t Forget to Have Your Kids Eat Breakfast

Regardless of what you make for lunch or what the school is serving, please make sure that your kids have a nutritious breakfast before they leave the house in the morning. This will assure that they have the nutrition and calories they need to focus on their school tasks and to last until lunch. Breakfast really is the most important meal of the day!

Brown-Bag Lunch

Parents have many options for sending their kids off to school with a healthy lunch. It is all about balance and variety. Each lunch should include a healthy combination of lean protein, low-fat dairy, whole grains, and fruit and veggies. Whatever you choose, be sure to include your kids in the process of making the meal. Discuss with them the importance of nutritious and healthy meals and the right portion sizes, and have them help you pack the meal. This will help ensure they eat what you pack!

Classic sandwich choices include PB&J or PB & banana, chicken salad, tuna salad, egg salad, sliced chicken, or turkey. When sandwiches are on the menu, make sure that you use whole grain bread or pita, and mustard or low-fat mayonnaise when appropriate.

To vary things, you might want to try a pita packed with hummus and vegetables, sliced hard-boiled eggs, nut butter, avocado, or any other favorite protein. A whole grain tortilla loaded with beans, cheese, and favorite grilled veggies is another option. Sandwiches are an obvious way to add some veggies. Tomatoes, onions, lettuce, sprouts, cucumber, and sliced or shredded carrots are a great place to start.

You should also include one of the following in the bag: some whole or cut up fruit, dried fruit, a small salad, assorted veggie sticks, single serving applesauce, yogurt, nuts, seeds, or popcorn to round out the meal. And remember, once in a while, it is okay to send them with a small bag of potato chips, corn chips, or cheese puffs to avoid feelings of deprivation or envy!

Alternatively, you can pack a bento box full of food from home. Almost any leftover is a great option (meatloaf or meatballs for a sandwich, lasagna, omelets, quiches or frittatas, baked chicken nuggets, mac and cheese, BBQ or baked chicken, tacos, quesadillas, burritos, stir fries, sloppy Joes, salmon or crab cakes, pot pies). You can also include a salad, hummus, cut fruit, sliced veggies with dip or guacamole, cubed hard cheese, yogurt, trail mix, nuts, homemade pumpkin bread, or many other choices too numerous to list here. Kabobs are also fun in bentos and can be made from chicken, beef, or shrimp plus veggies. Or why not try fresh fruit or fresh veggie kabobs? Lastly, consider hearty soups, stews, and chilies (especially inviting when summer fades into a fall chill).

Avoid sending your kids off to school with prepackaged lunches such as Lunchables. Also limit the amount of highly processed deli meats (salami, bologna, ham, liverwurst, or deli “loaves”) by choosing whole roasted turkey, chicken, or roast beef. Processed deli meats are very high in salt, fat, sugar, additives, and preservatives. Plus, they are not cost effective. We also recommend that you avoid packing a dessert for most lunches. But of course, occasionally send them off with a cookie, pudding, or brownie!

Tips for Packaging a Safe Lunch

We want to pack healthy school lunches for our children, but we must also make sure that they are safe. Since your kids’ lunches usually remain at room temperature for several hours, you should take steps to minimize bacterial contamination and growth. Here are some steps you can take:

  • Seems obvious, but you should always wash your hands before preparing the meal.
  • Use insulated lunch containers over a brown bag if you’re serving perishable items (such as mayonnaise-based sandwiches or salads, dips, and dressings).
  • Use an icepack to keep food at a safe temperature.
  • Alternatively, you can put frozen juice or (preferably) water in the lunch bag. The drink will thaw by lunchtime, so this can be used in place of an ice pack. (You can also freeze a yogurt stick to use as an ice pack.)
  • Use a thermos to keep hot things (soups, stews, chilies, casseroles) hot and cold things cold.
  • Store the lunch bag in a cool area, away from sunny windows or heat vents. Use a refrigerator if available.
  • Keep all lunch boxes, bento boxes, bags, and thermoses clean. Wash with warm soap and water after each use and dry thoroughly.
  • Make sure your kids wash their hands before eating. Alcohol gels or wipes can be used in a pinch. (If you’re storing these in the lunch container, use wipes, not gels.)
  • Teach kids that they should not trade items in their lunch (and then keep your fingers crossed that they follow your instructions).

To compete with cafeteria lunch options, keep foods colorful and interesting (use cookie cutters to make sandwiches into fun shapes, leave lunch notes for little ones, pack in a favorite lunch box, or occasionally include an unexpected favorite breakfast food such as waffles with Nutella and bananas).

Cafeteria Lunch

When a homemade lunch is not an option, your kids can choose from the menu at school. Many schools now serve healthier items, such as grilled chicken and salads. But some choices still contain unhealthy amounts of fat, salt, or sugar.

Most schools also now post the weekly menu online or make it otherwise available to parents so they can see what is on the menu. Some even allow parents to check what the child has purchased!

If your school is among them, take advantage of this to discuss with kids the importance of healthy eating and nutritious foods. Ask which meals they particularly like or want to try. Make sure to point out what is the best choice, and once in a while, let your child pick out what he or she wants despite your input! Just let them know that the healthier foods will give them more energy for the rest of the school day and for after-school activities.

Counsel your kids to choose meals that contain fruits, vegetables, whole grains, and lean meats. Advise them to avoid fried foods (chicken fingers, french fries, fried chicken or fish) and heavily processed foods (hot dogs, lunch meats, processed cheeses, potato or corn chips, and commercial baked goods). They should also avoid sugary drinks, including fruit juices and sweet teas, and drink water or low-fat milk instead.

But at the same time, let them be kids too. Remember to allow them to make their own choices from time to time. Otherwise, they will feel stifled and rebel entirely against your efforts to help them build healthy eating habits!

Alternate bagged lunch days with cafeteria lunch days to maximize variety while still retaining significant control over what your kids eat. Done well, your kids will internalize the lessons they learn from you and from the choices they make on their own. This will help them be healthy for life.


Dr. Gardner is a mom of a three-year-old son, a pediatrician, and the founder of an online child wellness and weight management company, HealthyKidsCompany.com, in Washington, DC.


Would the Bloomberg Soda Ban Unfairly Target Poor People?

July 15, 2013 by  
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by Mommy MD Guide Ayala Laufer-Cahana, MD

Portion sizes have grown and so have we. Today’s kid-size soda at McDonalds (12 ounces, 110 calories) is 70 percent larger than the regular size (7 ounces) of the ’50s, and 32-ounce big gulps (310 calories) and food buckets wouldn’t have been fathomed several decades ago.

Are portion sizes to blame for our overeating? The obesity epidemic has multiple roots, but there’s very little doubt that when presented with larger portions, people tend to eat more, and that social norms affect what we perceive as acceptable behavior. So yes, most experts do see portion sizes and their attractive prices as culprits in the obesity crisis.

Last year, in an effort to shift the default portion size to something a little more logical, New York City proposed to cap the size of sugary drinks sold in food service to 16 ounces. It’s been a bumpy road for this proposed law, which was blocked this spring a day before it was supposed to take effect.

The free-choice and stay-out-of-my-business opposition to the proposed law is understandable, and I’m not going to get into it here. Will the cap reduce waistlines? If such a law ever passes, we’ll get to see if the predicted reductions in consumption play out.

The interesting question a new study set out to answer focuses on the argument that the so-called soda ban isn’t fair because it disproportionately affects low-income people.

Soda cap would target the overweight.

The new study in the American Journal of Clinical Nutrition from the Columbia University School of Health looked at the dietary records of almost 20,000 people, and found that about 60 percent of people consume sugary drinks on any given day, and of those, about 7.5 percent order a larger than 16-ounce cup. Two thirds of the large-size cups are bought at fast food restaurants.

The large-size purchases were more common in teens, young adults, and overweight and obese people. Although low-income people did buy more sugary drinks, they weren’t more likely to buy large ones.

This analysis suggests that capping soda at 16 ounces could disproportionately affect young people who are overweight or obese. The researchers calculated that if the cap led 80 percent of the people who order larger drinks to downsize to a 16 ounce, it would shave about 60 calories daily.

They, of course, don’t have to. Under the NYC proposal, anyone’s free to order as many 16-ounce drinks as they wish. The cap would just change the beverage landscape a little bit, and give people pause to consider whether the second 16 ounce is addressing thirst or habit.

Then, of course, even without the law in place, the endless debate and uproar against it is already doing that, so even without passage, the sugary drink cap is, I think, already a success.

Is There Scientific Basis for the Blood Type Diet?

June 14, 2013 by  
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by Mommy MD Guide Ayala Laufer-Cahana, MD

Why are so many of us struggling with our weight and suffering illness? According to naturopath Dr. Peter D’Adamo, knowing your blood type, and eating and exercising according to it, is the key to avoiding health and weight problems. His bestseller, Eat Right for Your Type, which was published in 1996, has been translated to more than 50 languages and has 7 million copies in print.

I know my blood type only too well. The Red Cross is extra excited with my O-negative donations (people with O-negative blood are considered universal donors), but as a pregnant woman, I had the pleasure of receiving plenty of shots to prevent hemolytic disease of the newborn.

So how should I be eating? “Type Os thrive on intense physical exercise and animal protein,” according to Eat Right for Your Type. Uh-oh! Although I exercise regularly, I’ve never run a marathon, and I’m a vegetarian; I eat lots of grains and legumes, which, according to Dr. D’Adamo, contribute to weight gain in my type. According to his diet, I should eat a lot of lean meat, which I don’t, and avoid gluten, oranges, mushrooms, cauliflower, coffee and tea, black pepper, all vinegars and beans, which I certainly don’t. I thought I was doing fine, but imagine how much better I could be feeling.

The science behind blood type diets

Blood types are perfectly scientific. There are about 30 different antigens than can be present or absent on the surface of a red blood cell. The ABO system for typing blood, which deals with just two of these antigens (A and B), is the most well known and useful, since ABO compatibility is the most important for blood transfusion—getting incompatible blood can be fatal. Most people have never heard of other blood types such as M, N, and Kell.

But do blood types really inform about our disease susceptibility and gastrointestinal fitness?

The book offers plenty of anecdotal “evidence” of people whose symptoms improved when they learned to eat for their blood type. Stories of success sound very convincing, and nothing makes as memorable an impression as personal testimony. But anecdotes are not proof.

A new study in the American Journal of Clinical Nutrition assessed the evidence for blood type diets in the scientific literature. The researchers looked for studies that grouped people according to blood type and studied whether adherence to a certain diet made a difference. Combing the entire life science and biomedical databases, the researchers could not find even one study showing an association between ABO blood type diets and health-related outcomes.

Not even one!

Is it possible that blood type affects susceptibility to disease and should predict your optimal diet? It is also perfectly possible that eye color and the curliness of hair could be associated with certain dietary outcomes, and that these traits are inherited together with traits that affect gastrointestinal differences. Much like the belief that blood type is predictive of personality, the notion that blood type affects metabolism and should determine your optimal diet is a belief, in this case, based on no facts whatsoever.

I have not given birth to any children of my blood type—a bit of good news. According to D’Adamo, my kids can thrive as vegetarians; so after proving I’m too lazy for “intense physical exercise,” you won’t be surprised that I’m also too lazy to cook separate, individual meals for my husband and three kids.

Growing Healthy Eaters

May 30, 2013 by  
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by Mommy MD Guide Stacey Weiland, MD

Getting our kids to eat right is no easy task. Our schedules are tight, and we are constantly driving from one activity to another. Poor food choices are readily available, and are often just easier to prepare. The last thing we as parents of today want to deal with is our child refusing to eat something we have put together.

We know what our kids are supposed to consume. According to the American Heart Association, children between the ages of 2 and 3 should have 2 cups of milk or dairy, 1 cup of fruit, 1 cup of vegetables, 3 ounces of grains, and 2 ounces of lean meat or beans daily. Fats should be limited to 30 to 35 percent of all calories.

Probably the most difficult food on the list is the vegetables, particularly the dark-green varieties. According to the 2004 Feeding Infants and Toddlers Study, children typically eat more fruits than vegetables, with 25 percent eating less than one vegetable per day.

Why is it so difficult for us to get enough vegetables into our children? Some hypothesize that our preference for sweet- over bitter-tasting foods is evolutionary in nature. Sweet flavors connote the presence of sugar, a quick form of energy, while bitter-tasting foods may harbor the presence of toxic substances or poisons. In fact, studies demonstrate that a person’s preference for bitter foods (e.g., dark-green vegetables) and beverages (e.g., coffee) are largely learned.

Putting our children on the path toward healthy eating may begin even before birth. A child’s prenatal exposure to certain food flavors have been shown to lead to greater acceptance and enjoyment of these foods during weaning. In a study by Mennella et al, published in the Journal of Pediatrics in 2001, infants whose mothers drank carrot juice during the last trimester of pregnancy were more likely to enjoy carrot-flavored cereals than those infants whose mothers did not drink carrot juice or eat carrots.

Food ingested by mothers who are breastfeeding also has an impact on a child’s later diet tendencies. A variety of food flavors are transmitted to human milk. Breastfed infants tend to be less picky, are more willing to try new foods, and tend to consume more fruits and vegetables compared with formula-fed infants.

Transitioning babies to solid foods is the first real opportunity that children have to taste these foods for themselves. It is generally recommended that babies be given yellow vegetables first, followed by green vegetables, and then fruits. One interesting study by Forestell et al, published in the Journal of Pediatrics in 2007, found that children who were fed peaches shortly after they were given green beans, during the first 8 days of exposure to green beans, tended to be more accepting of this dark-green vegetable later on. Associating the bitter food with sweetness appeared to make this food more palatable.

Repeated exposure and modeling are also very important. Children tend to be more accepting of foods if they are offered it on multiple occasions. Don’t forget that you as a parent need to eat healthy, too. Your child is constantly watching you. Good habits in eating are learned not just by what you say, but by what you do.

A Miracle Diet That Prevents Cancer?

April 25, 2013 by  
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by Mommy MD Guide Ayala Laufer-Cahana, MD

If you’re ready to believe the sensational titles and overhype in the mass media, miracle superfoods that decrease the risk of cancer are discovered every other week.

Except miracles are just that: something that rarely happens, and many of these reported “proven” food cures are based on flimsy findings, never again to be reproduced.

Nevertheless, health experts are unanimous about the effect our diet as a whole has on health, and on cancer risk. The World Health Organization estimates that 25 percent of death burden in developed countries is due to lifestyle risk factors, which are completely up to us.

Eight healthy habits

In 2007, a collaboration between the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) evaluated the evidence and produced consensus recommendations for reducing the risk of developing cancer and for promotion of general good health and well-being. The WCRF/AICR report is the largest study of its kind, and its conclusions are as definitive as the available evidence allows.

The report featured eight general diet and lifestyle recommendations for cancer prevention:

1. Body Fatness: Be as Lean as Possible within the Normal Range of Body Weight. Maintaining a healthy weight throughout life may be one of the most important ways to protect against cancer, and being overweight or obese increases the risk of some cancers.

2. Physical Activity: Be Physically Active as Part of Everyday Life.

3. Foods and Drinks That Promote Weight Gain: Limit the Consumption of Energy-Dense Foods and Avoid Sugary Drinks. Sugary drinks were targeted specifically in the report: “Such beverages appear to exert little influence on total daily self-selected energy intakes, and their habitual consumption can lead to rapid and sustained weight gain even in the face of restricted solid food intake.” Another recommendation under this heading is “Consume fast foods sparingly, if at all.”

4. Plant Foods: Eat Mostly Foods of Plant Origin. Diets that are protective against cancer are characterized by large intake of foods of plant origin and, indeed, several cancers are responsive to increased intakes of plant-based foods.

5. Animal Foods: Limit the Intake of Red Meat and Avoid Processed Meat.

6. Alcoholic Drinks: Limit Alcoholic Drinks. (Men to two per day; women to one per day).

7. Preservation, Processing, Preparation: Limit Consumption of Salt and Avoid Moldy Cereal Grains and Pulses (Legumes). Salt and salt-preserved foods probably contribute to stomach cancer risk, and foods contaminated with aflatoxins are a cause of liver cancer. Although salt is necessary for human health, typical levels of consumption are vastly excessive.

8. Dietary Supplements: Aim to Meet Nutritional Needs Through Diet Alone. Dietary supplements are not recommended for cancer prevention. According to the report, the greatest danger associated with the use of dietary supplements is the possibility that consumption of supplements is serving as an alternate to good nutrition, and supplements are taken as “magic bullets” to compensate for cancer-friendly dietary and lifestyle practices.

So, not as easy as popping a supplement or drinking acai juice, but does this recipe for cancer reduction and longevity actually work?

Not a shortcut, but it will get you there

A new study in the American Journal of Clinical Nutrition, including almost 400,000 people from nine European countries, scored participants’ compliance with the six first WCRF/AICR recommendations (there was insufficient data to assess recommendations 7 and 8). Women were also assessed for another WCRF/AICR recommendation specific to women: breastfeeding. The total possible score for a man was, therefore, six, and for a woman, seven. The group was followed for about 12 years, and during that time, almost 24,000 people died, 48 percent of them from cancer.

People with the highest WCRF/AICR score (five to six for men; six to seven for women) had almost 34 percent lower risk of dying than those who had the lowest scores (zero to two for men; zero to three for women). Each additional point in the WCRF/AICR score was associated with a 1.2 year increase in life expectancy, and a higher score was associated with lower risk of death from cancer, cardiovascular disease, and breathing problems. The recommendations regarding overweight and obesity, and eating plant food, were the most strongly associated with risk of dying.

We like things fast and now, and the WCRF/AICR recommendations aren’t a shortcut, but isn’t it nice to know that we do have some control over our heath trajectory?

Healthwashing with a Green Label

April 12, 2013 by  
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by Mommy MD Guide Ayala Laufer-Cahana, MD

Visual cues affect our decisions, and one of the strongest, most persuasive visual elements is color.

There’s a hot debate regarding the best way to present nutrition-at-a-glance on the front of the package. At this point, we don’t have a uniform labeling system, but food and beverage makers have, over the years, come up with several such schemes. (Smart Choices was widely criticized and abandoned; Facts Up Front is the latest voluntary industry-sponsored plan.)

While the debate goes on about front-of-package label content, a new study by Jonathon Schuldt in Health Communication looks at the label’s form, and more specifically, its color, and asks an important question: Does color affect perceptions of healthfulness?

What prompted this question is the Mars front-of-package nutrition label, called Guideline Daily Amounts (GDA). Mars’ “what’s inside” labels launched in 2010 and display the number of calories in the pack, as well as their percentage of daily value.

All well and good, and I do love chocolate and think the world’s a more pleasant place with some sweets.

But Mars’ GDA label is green, the color of traffic light “go” and the color adopted by the USDA organic seal, and Schuldt asks: Does green make us think it’s healthy?

Color coded food

To test color’s effect on health perception, Schuldt randomly divided 93 students into two groups. All students were asked to imagine that they were hungry, waiting in a grocery checkout lane, and see a candy bar with a calorie count on the wrapper.

At this point, the students saw an image of a candy bar with a calorie count of 260, 13 percent of daily value. Half the students saw a red calorie label, and the other half a green calorie label.

The students were then asked whether the candy bar they saw, compared with other candy bars, contained more or fewer calories, and how healthy it was.

The result: The green labeled candy was perceived as healthier than the red.

But does green say healthy, or does red say stop? To test that, Schuldt replaced the red label with a white one in an online experiment. The experiment was the same as before, but this time the 39 participants were also asked to what extent the healthiness of food is an important factor in their decision about which foods to buy and eat.

In this experiment, the more importance the participants placed on healthy eating, the more they perceived the white-labeled candy bar as less healthful. In other words, green “healthwashed” the calorie worries among those who care about such things.

Not a random choice

So is green an aesthetic choice, or one that carries persuasive value? Is green associated with natural, and does it provide a halo effect? This study gives some evidence that green labels shed some positive light on foods, and we shouldn’t be surprised. Other studies have shown that consumers view organic foods as lower in calories and see “low fat” as permission to overeat.

As the FDA and other government organizations continue to debate front-of-label systems, this study suggests that design and color deserve as much attention as the nutrition information itself if we are to really help consumers reach informed food choices.

Ingredient 911: Greek Yogurt

March 20, 2013 by  
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by Mommy MD Guides blogger Sonali Ruder, DO

You may have noticed that Greek yogurt is everywhere these days. Although it’s long been a favorite ingredient for chefs and foodies, it’s only recently become mainstream. Greek yogurt, which is a staple in other parts of the world such as Europe and the Middle East, is richer and creamier than traditional yogurt. Now its popularity has spread to the US, and sales of Greek yogurt have skyrocketed in this country. Multiple brands of Greek yogurt are popping up in grocery stores, and many major yogurt manufacturers are introducing lines of Greek yogurt to get in on the competition.

So why is Greek yogurt so popular? Is it really healthier than its traditional counterpart?

Both types of yogurt are made with milk that has had live bacterial cultures added to it, causing it to ferment. The fermentation process thickens the yogurt and gives it a tangy flavor. The yogurt is then strained to remove the liquid whey. The difference between the two types of yogurt is that Greek yogurt is strained much more extensively to remove most of its whey. Because it’s strained so much, it takes a lot more milk (up to four times as much) to make the same amount of Greek yogurt as regular yogurt. The result is a thicker, creamier texture similar to sour cream.

Here’s how Greek yogurt stacks up compared with regular yogurt:

Protein: Greek yogurt has more protein than regular yogurt—almost double the amount. The high protein content helps keep you feeling full longer. It’s a great option for breakfast to give you long-lasting energy throughout the morning. It can also be a good source of protein for vegetarians.

Carbohydrates: Greek yogurt has less (roughly half) carbohydrates than regular yogurt because a lot of it is lost during the extensive straining process. This makes it a great option for anyone watching their carbs, including diabetics. But be careful because the carbs can add up if you add a lot of sweeteners to your yogurt.

Fat: Greek yogurt actually has more saturated fat than traditional yogurt. Saturated fats in your diet should be limited because they raise cholesterol levels and increase your risk of heart disease. So if you’re going Greek, choose the fat-free or low-fat varieties instead of full-fat. The good news is that the lower-fat versions are so creamy and thick, you won’t miss the fat.

Sodium: Greek yogurt has less sodium than traditional yogurt because a lot of it is lost in the straining process. This makes it a great option for anyone watching their sodium intake.

Calcium: Greek yogurt has less calcium than regular yogurt because, once again, some of it is lost through the straining process. Although Greek yogurt still contains a good amount of calcium, if you’re worried about your calcium intake, make sure you get adequate amounts from other sources.

So what’s the final verdict? With more protein combined with less sugar and sodium, Greek yogurt does have a nutritional edge over regular yogurt—just be sure to choose fat-free or low-fat varieties. But with this said, keep in mind that both types of yogurt are good for you and provide probiotics that are beneficial for digestive health—just make sure the label states that it contains live, active bacterial cultures.

If you’re looking for an easy recipe using Greek yogurt, try my “Grilled Peaches with Greek Yogurt and Honey.” Grilling fruit caramelizes their sugars and brings out their natural sweetness. In this recipe, I top grilled peaches with a dollop of tangy Greek yogurt, a drizzle of honey for sweetness, a pinch of cinnamon, and some heart-healthy almonds for texture. This dish makes a great, light dessert or can even be served for breakfast.

Grilled Peaches with Greek Yogurt and Honey

Makes 4 servings

4 peaches, halved and pitted

1 1/2 teaspoons grapeseed oil

1/2 cup fat-free Greek yogurt

1/3 cup honey

1/4 cup sliced almonds

1/4 teaspoon cinnamon

Heat a grill pan over medium heat.

Brush the peaches with the oil. Place them on the grill, cut side down, and cook until grill marks develop, 5 to 6 minutes. Flip the peaches over and cook another 3 to 4 minutes on the second side.

To serve, place a tablespoon of yogurt on each peach half and drizzle with 2 teaspoons honey. Sprinkle the almonds and a pinch of cinnamon on top.

One serving: Calories, 190; Fat, 5 g (Sat. Fat, 0 g); Protein, 5 g; Carb, 35 g; Fiber, 2 g

Ingredient 911: Flaxseed—A Superfood

March 18, 2013 by  
Filed under Uncategorized

by Mommy MD Guides blogger Sonali Ruder, DO

Although flaxseed has been cultivated for centuries, it’s recently become extremely popular because of its numerous health benefits. This tiny seed packs a big nutritional punch! Although flaxseed has been touted to cure just about every disease from diabetes and heart disease to cancer, the full effects of flaxseed in the human body are still not completely known, and more studies are needed. What is known for sure is that flaxseed is rich in several important compounds, including omega-3 fatty acids, fiber, and phytochemicals, all of which have very important health benefits and should be included in a nutritious diet.

Flaxseed can be purchased at most natural foods stores or health food stores and comes whole, ground (milled), or as an oil. Whole flaxseed has a tough exterior, which makes it difficult to digest, so it tends to pass through the body without giving you much of its nutritional benefits. The ground form is absorbed better by the body and provides many more health benefits. Pre-ground flaxseed, however, has a short shelf life, so the best idea is to buy it whole and grind it up in a coffee or spice grinder as you need it. You can store unused flaxseed in a cool, dry place or in the refrigerator.

Flaxseed is high in protein and can be sprinkled on many foods such as yogurt or oatmeal. It also can be stirred into hot soups, stews, and pasta sauces. It can even be used in baking and can be incorporated into cakes, cookies, and muffins. It’s also a great addition to smoothies to add extra fiber and protein. To reap all of the health benefits of flaxseed, it’s recommended that you eat one to two tablespoons a day.

There are three main components that make flaxseed so good for you:

Fiber: Flaxseed is high in both soluble and insoluble fibers. A diet high in fiber has several health benefits, including helping to reduce cholesterol levels, regulate blood pressure, and promote heart health. Fiber also helps to regulate blood sugar levels. It’s also really important in maintaining bowel integrity and regularity. It may also play a role in preventing colorectal cancer, but the evidence is mixed.

Omega-3 Fatty Acids: Omega-3 fatty acids are essential compounds that our bodies need to function. However, because we don’t naturally produce omega-3s, we must get them from our diets. Flaxseed contains high levels of alpha linoleic acid (ALA), an omega-3 fatty acid that is partially converted to the omega-3 fatty acids EPA and DHA, which are mainly found in fatty fish such as salmon. Omega-3s have been shown to have incredible health benefits. They reduce the risk of death from cardiovascular disease by several different mechanisms, including lowering triglycerides and reducing blood clotting. They also are important for neurologic development, especially in fetal development and young children. They may help reduce the risk of dementia in the elderly, but more studies are needed. Because they work to reduce inflammation, omega-3s may improve symptoms in diseases such as arthritis and asthma.

Phytochemicals: Flaxseed is packed with phytochemicals, which are plant compounds that are beneficial to the body. They are an especially rich source of lignans, which are compounds that mimic the action of the estrogen hormone in our bodies. Lignans also have strong antioxidant properties. The lignans in flaxseed may provide some protection against cancers that are sensitive to hormones, such as breast cancer. Lignans also have an anti-inflammatory effect, which plays a role in preventing certain diseases such as asthma. Lignans help reduce the inflammation associated with plaque build-up in the arteries, thereby helping to prevent heart attacks and stroke.

If you’re looking for an easy way to incorporate flaxseed into your diet, try my “Blueberry Banana Flaxseed Smoothie.” It’s the perfect nutritious drink to get you going in the morning or any time of day.

Blueberry Banana Flaxseed Smoothie

Makes 2 servings

2 tablespoons whole flaxseed

1 ripe banana*

1 cup blueberries + additional for garnish

1/2 cup fat-free Greek yogurt

3/4 cup fat-free milk

1 tablespoon honey

1/4 teaspoon almond extract

6 ice cubes

Place the flaxseed in a blender and blend until it is ground. Add the banana, 1 cup blueberries, yogurt, milk, honey, almond extract, and ice, and blend until smooth. Garnish with the additional blueberries.

*For even better results, freeze the banana ahead of time.

One serving: Calories, 254; Fat, 6 g (Sat. Fat, 1 g); Protein, 12 g; Carbs, 43 g; Fiber, 7 g

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