A Toast to American Heart Month?

February is American Heart Month, so I've been thinking about some of the confusing recommendations about keeping your ticker ticking.  Do you drink?  Do you drink because it's healthy?  Are all alcoholic drinks healthy?  How much is a drink anyway?  This month, I've tried to abstain from alcohol as much as possible, book club nights and date nights being the exceptions.  The American Heart Association does a great job explaining why the relationship between alcohol and heart health is so complex.

For some people, drinking is not a healthy choice.  A few examples:  if you have a personal or family history of addiction, already have high triglycerides, liver disease, or are taking medications that do not mix well with alcohol, please don't drink.  If you are generally healthy with normal weight, blood pressure, cholesterol, and triglycerides, the American Heart Association suggests that up to one drink per day for women and up to two drinks per day for men might be protective of your heart.  Does this mean that you should have 14 glasses of wine a week?  Does this mean you can drink a case of beer all by yourself on the weekend? 

As a proud alumna of a Big Ten university, I can tell you from personal experience that saving all your drinks for one night, either at a particularly juicy book club or at a too-long happy hour, is a twisted interpretation of the American Heart Association's recommendations.  You know the saying, "Too much of a good thing is good for nothing"? 

I was all ready to post this lesson on how much alcohol is considered a serving.  I had pictures of wine in different glasses and a mini lesson on how glass size and shape affect one's perception of quantity when I woke up on Monday to this:

This week, the nutrition and health world is abuzz about the news that the Mediterranean diet, with its liberal inclusion of alcohol, especially wine, is being hailed as effectively preventing heart disease in people at risk.  I took the "How Mediterranean is Your Diet?" quiz, thinking I would score pretty highly.  My diet is only moderately Mediterranean because I don't drink enough wine!  Who do you believe:  the American Heart Association or a 7500-person prospective study published in the well-regarded New England Journal of Medicine?  First, read the article for yourself.  It's well written and not too jargon-y. 

If you don't want to read the article, keep these points in mind:  The researchers gave Spanish people, who are already following a Mediterranean-ish diet, even more olive oil and nuts than they usually consume.  They did not give them more wine.  The researchers think it is these healthy fats and fiber which might be responsible for the differences in risk of heart attack or stroke in people who were already at high risk for such major cardiovascular events.  The researchers also point out that they lost more people to follow-up in the control group, which was supposed to follow a low-fat diet.  The people in the control group were given less support, education, and intervention than the people in the Mediterranean diet groups.  Maybe the difference in quantity and quality of education affected not only their adherence to the low-fat diet but also their desire to stay in the study.  People from the control group who dropped out also tended to have the worst health at baseline, so they might have benefited more from intensive nutrition education and intervention, even if it was for a low-fat diet.  The Mediterranean diet group was also asked to limited their intake of commercially prepared sweets, processed meats, and dairy products.  The health benefits might have come from eating fewer cakes, cookies, hot dogs, ice cream, and cheese, not necessarily from the fruits, vegetables, sea food, legumes, and wine.  

Also, researchers don't know what exactly about the Mediterranean diet makes it so healthy because it comprises so many healthy components.  It's plant-based and therefore high in not only fiber but other phytochemicals that can be anti-inflammatory or cardioprotective in and of themselves.  The diet is rich in omega-3 fatty acids from both fish and nuts, which are also beneficial, and low in red meat, which is high in the not-so-good kinds of fats.  It could be that all of these components are synergistic in the body in protecting older people with multiple risk factors for heart disease from having a stroke or heart attack. 

Back to the question of whether alcohol is good for you, I guess my professional answer remains that it depends.  It depends on what the rest of your diet is like, what risk factors you have, your family history, level of activity, medications, and how you incorporate alcohol into your diet.  Binge drinking is never good, and drinking your calories instead of eating them -- even if you're a healthy weight -- will leave you malnourished.  After reading the study, I'm not convinced that I need to add more wine to my life, but I will try to include more seafood and nuts.

Meatless Mondays: Onions

Picture from http://www.epicurious.com/articlesguides/seasonalcooking/farmtotable/visualguideoniongarlic

Can you think of any savory recipes that don't begin with "Saute your chopped onions in some olive oil or butter..."?  Cuisines all around the world rely on this bulb to bring a rich, sweet depth of flavor when cooked or a sharp pungency when used raw.  Food historians and archaeologists do not agree on where cultivated onions originated, possibly Asia, possibly Iran or western Pakistan, but onions have been cultivated for at least 5000 years.  Ancient Egyptians believed that onions symbolized eternity because of their structure:  circles within circles.  Onions were buried with the pharaohs, perhaps because of their antiseptic properties or the belief that onions' strong smell would revive the dead. 

For the living, onions can promote good health.  Onions are low in calories and fat, and high in carbohydrates and fiber.  They are also a good source of the B vitamin folate and vitamin C.  Scallions have moderate amounts of vitamin A and high amounts of vitamin K.  Onions have a long history of being used for medicinal purposes, and research is revealing the benefits of the plant's many phytochemicals.  For example, onions are a good source of chromium, a mineral that helps to regulate insulin response and might help to control blood sugar levels.  The soluble fiber in onions helps to lower levels of the LDL or "bad" cholesterol.  The compounds responsible for onions' smell, allium and allyl disulphide, further promote cardiovascular health by reducing cholesterol levels and decreasing the stiffness of blood vessels, which can reduce blood pressure.

Do you always cry when you cut onions?  I've tried nearly every remedy I've heard of, but nothing has worked for me.  The tears are caused when propanethial-S-oxide is released from the cell walls by your knife, turns into sulfuric acid, and mixes with your tears.  You can try slicing onions under running water, which dilutes the compound, or chill the onions for an hour or so in order to slow down the molecules of the propanethial-S-oxide.  Or you can dispense with vanity and get those onion goggles that prevent the water-soluble propanethial-S-oxide from even reaching your delicate eyes.  I haven't tried the goggles.

When I have a lazy weekend, I love to prepare a big batch of caramelized onions.  The onion's sulfuric compounds turn into sugars when heated, and the amino acids plus sugar undergo the Maillard reaction, which most people know as caramelizing.  Slice up as many onions as you can find.  Heat a big skillet over medium-low heat, add some olive oil, and your sliced onions.  Stir occasionally, coating each onion in the oil.  Don't turn up the heat; low heat and occasional tossing are all that's required.  After 45-60 minutes, your pile of onions will have transformed into a luscious brown jelly-like mass, which can be stirred into eggs, eaten with toast, tossed with pasta, served with cheese, or used as an accompaniment for roasted chicken or fish.

Free February: mid-month check-in

Picture from blog.foodnetwork.com

Is anyone else doing Free February?  I've been practically wheat-free all month.  I went to The Meatball Shop with a friend for lunch yesterday, where I suspect there were breadcrumbs in the delicious meatballs.  Last night I felt achy and tired.  Coincidence?  Possibly.  Otherwise, I've resisted pizza, pasta, and bread.  At the restaurant yesterday, I could have had my meatballs with pasta, but the polenta and risotto options actually sounded more appealing.  I wasn't even tempted to eat the slice of focaccia that came on the side.  Progress?  Yes!

What's been hardest is when I need a snack at work or even when I'm out with the kids.  So many of the shops and delis sell only bread products.  Our go-to snacks with the kids are 75% flour-based.  Think goldfish crackers, pretzels, animal crackers, even most of the cereal bars.  My usual favorite snack, a pretzel and peanut butter bar from Clif, is made with pretzels, which are made with....wheat.  Even Sun Chips, which is my usual vacation treat, is made with wheat! 

I've been a little less successful on the alcohol challenge.  For some crazy reason, I'm in 3 book clubs.  The most recently-joined club was scheduled to meet this week.  Only the organizer and I showed up, so we had a glass of wine to commiserate/celebrate/discuss/try to figure out why no one else is coming.  I think we deserved and enjoyed that wine.  And of course, it's just wrong to go to a restaurant like Aureole without having a carefully selected wine from a carefully selected wine list to go with spectacular food! 

I'm not sure if I'm feeling any benefits yet.  I had a great run tonight with a friend, but that could just be my one great run for the month.  A co-worker told me it looked like I was losing weight, but that could just have been my magic pants that are so flattering they could make anyone look better (Banana Republic denim trousers in case you're curious).  My tummy is still grumbly and I still have the occasional red spots on my face.  It could be that I'm not being as careful with my label-reading as I should be.  I'll do a longer post on what to look for when going gluten-free later this month, if anyone's interested.

What about you?  How are you doing?  Do you feel any better?  My brother-in-law has lost 11 pounds by not eating bread, desserts, eating 1/3 fewer calories overall and getting 7 hours of sleep a night.  Maybe I should be working on getting more sleep, too.

How Fat is your Fat Tuesday?

Photo from https://www.facebook.com/buschs

Somehow, I spent 18 years in Michigan, home to a large Polish population, and never consumed a single Pączki.  Now that I live in Brooklyn, which also has a sizable Polish community, I still haven’t tried them.  I keep forgetting to travel to Williamsburg to seek them out because Mardi Gras always sneaks up on me.  Have you had your Pączki yet today?   Pączki, for the uninitiated like me, are essentially donuts filled with fruit or sweet cheese.  They are eaten in Eastern Europe and places with lots of eastern Europeans to celebrate Shrove Tuesday or Mardi Gras before the austerity of Lent begins.  An article on Huffington Post reports that paczki were created to clear out all of the “bad” foods from pantries like lard and sugar before Lent.  This article also reports that one can now find lower-calorie versions, gluten-free paczki, and a baked-not-fried version:  http://www.huffingtonpost.com/2013/02/11/paczki-day-2013-polish-doughnut-diet_n_2662549.html 

Frankly, the low-fat and low-calorie paczki sound ridiculous and defeat the entire purpose.  Pączki are meant to be eaten once a year, and indulging in some greasy sugar bombs before Lent won’t make your cholesterol, blood sugar, or weight shoot up overnight.  Of course, it’s wise to know exactly how much you’re going to indulge.  Nutrition information for pączki varies greatly from brand to brand.  Calorie counts range from 320 to more than 500 per donut, fat from 9 to 38 grams, and anywhere from 25 to 75 grams of carbohydrates.  I wouldn’t recommend having more than one, but enjoy each and every sticky bite!

 

Meatless Mondays: Potatoes

4 different kinds of potatoes from the farmers' market

Do you remember the Atkins days when potatoes were beyond passé?  “Too starchy!”  “Carb bombs!”  Poor, maligned potatoes.  Like everything, potatoes can be very good for you in moderation.  Did you know that potatoes have a moderate amount of protein and vitamin C?  Spanish colonizers noticed that the soldiers who ate potatoes were less likely to develop scurvy than those who didn’t because of the vitamin C in the potatoes.  It is also a decent source of folic acid and very high in potassium.  With the skin, a medium potato (about 6 ounces) has 4 grams of fiber.  Potatoes are virtually sodium- and fat-free and will only set you back 168 calories.  Waxy potatoes have a little bit less starch and calories, but are still rich in potassium and fiber.  Compare that to 2 slices of ciabatta, which has 260 calories, a lot of salt, and hardly any fiber or one cup of cooked white rice, which has 205 calories and negligible fiber. 

Did you know that potatoes are in the same botanical family as tomatoes and eggplants?  The nightshade family is so named because these plants can produce neurotoxins.  Potatoes’ neurotoxin is called solanine, which is made in the green parts of the plant and any green spots on the potato itself.  Light exposure hastens solanine production, which is why most guides tell you to store your potatoes in a cool, dark place.  All potatoes make solanine, but the government regulates how much is allowed to be present in potatoes for sale.  In order to feel any effects of the solanine, you’d have to eat 3 pounds of potatoes or 2.4 pounds of the skins.  A child would feel the solanine by eating 1.5 pounds of potatoes of 1.4 pounds of the skins.[1]  Just to be on the safe side, throw away sprouted potatoes or ones that are all green. 

Have you looked at the varieties of potatoes out there to buy?  Potatoes originate in South America, where they have been cultivated since at least 500 B.C.  Check out this website for more history of the potato:  http://whatscookingamerica.net/History/PotatoHistory.htm  Or read this Smithsonian article about the role of the potato in creating today’s civilization:  http://www.smithsonianmag.com/history-archaeology/How-the-Potato-Changed-the-World.html.  Or look at the National Geographic photo feature of some of the more unusual potatoes one can buy in South America:  http://ngm.nationalgeographic.com/2011/07/food-ark/potato-variety#/1.  My favorite is “Makes the Daughter-in-Law Cry.”  In New York, Cornell University certifies 70 different kinds of potatoes.  At my farmers’ market, I’ve seen about 20 of them. 

We usually roast potatoes with olive oil, salt, pepper, and maybe some rosemary, so our preferred potatoes are the waxy type.  If I were to mash potatoes, I would select Russets or Idahos.  The picture above is of Adirondack Blues, Carolas, Red Sunsets, and another pink one whose name I’ve forgotten.  I’ve also liked German Butterballs and La Rattes.  Every once in a blue moon, I’ll make mashed potatoes with regular red potatoes, boiling them with their skins and with a clove or two of garlic.  I like my mashed potatoes pretty rustic, with lots of butter and salt.  Even though I'm from Michigan, I'm not much of a potato salad person.  However, I've been told that waxy or medium-waxy is the way to go for a non-mushy potato salad.  Tomorrow, I’m making curried red lentils with potato and chicken in my slow cooker using starchy russets. I'll let you know how it turns out and if my kids will deign to consume it. How do you use potatoes?  What’s your favorite kind?  Have you found a way to tell whether a potato is starchy or waxy just by looking at it in the store?

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[1] Rinzler, Carol Ann.  The New Complete Book of Food:  A Nutritional, Medical, and Culinary Guide., 2 ed.  New York, NY:  Checkmark Books; 2009.

Scooped by the New York Times

I was researching and preparing a post about gluten sensitivity and celiac disease, but today's New York Times has a great article that says just about everything I was going to say.  Check it out at http://well.blogs.nytimes.com/2013/02/04/gluten-free-whether-you-need-it-or-not/?hpw. 

At the last two big dietitian conferences I've been to, there have been hundreds of companies marketing gluten-free this and gluten-free that.  Celiac disease diagnoses are on the rise, and everyone knows someone who is gluten-free either because of celiac or autism spectrum disorder or any number of other reasons.  Knowing people who have true wheat and gluten allergies, this proliferation of gluten-free products definitely makes their lives easier, but it's not necessary for everyone.  I appreciate that the journalist makes clear that a gluten-free diet is not necessarily healthier, especially if you don't have a gluten-sensitivity or celiac disease.  The journalist also highlights research that makes a pretty compelling case for a true gluten sensitivity.  It isn't all in my head. 

As for my own gluten-free experiment, I confess to having half of a grilled cheese sandwich on Saturday (and a small glass of wine -- oops!), so it's only been 3 days of "clean" living for me so far.  I haven't noticed any changes yet.  February is a pretty hard month to give up wheat and alcohol.  I was probably the only person in American not drinking beer while watching Beyonce and that little football game on Sunday.  Then there are the Oscars drinking games.  Valentines Day.  Holiday weekend away with friends.  You get the idea.  I haven't figured out what to do about my youngest daughter's birthday, which is at the end of the  month, either.  She'll want a cake of course. I've made wheat-free cookies, but I don't feel ready to tackle a wheat-free birthday cake.  She's old enough now to be more discriminating in her treats, so she'll not be happy with a substandard substitute.

What do you think about the gluten-free movement?  Is it a trend?  Or is it another example of activists being ahead of science?  Any good gluten-free birthday cake recipes to share?

Meatless Mondays: oranges

Have you gotten tired of oranges yet?  This time of year, it seems like the only fresh fruit available in the dead of winter that doesn't cost as much as a year's college tuition are mealy apples, hard pears, and citrus.  When I first moved to New York, I was obsessed with clementines, which are a sweet, seedless, easy-to-peel cousin of the tangerine.  I probably would have fallen hard for them even if they weren't introduced to me by my boss at the time, a woman I idolized and at whose swank Chelsea (the neighborhood in Manhattan, not the town where I grew up) apartment I was thrilled to finally see.  Fifteen years ago, these five-pound boxes of sunshine were an absurdly priced $10 per box, but I bought them even when I couldn't really afford them because they were just. that. good.  They seem to be more widely available these days, and they come from all over the world now.  Back in the day, the best clementines were from Spain.  I've seen them lately from California and Morocco, but I think the Spanish ones are the most reliably sweet. 

My current citrus obsession is blood oranges.  I first had these when I was an exchange student in France, and I couldn't believe that a citrus fruit could be so gorgeous and have such a complex flavor.  Unlike the naval oranges I grew up with, blood oranges aren't pure sugar; they can be just a little bit bitter.  The peel is sometimes bruised with burgundy, sometimes it's all orange.  The flesh looks like the Vermilion Cliffs in northern Arizona:  orange, pink, wine, and, of course, blood red variations make everything else seem dull by comparison.  Blood orange juice makes the prettiest cocktails because the juice is more rose-colored than orange. 

Most people think of oranges as being a great source of vitamin C, but it's also rich in folate and potassium.  Vitamin C supports your immune system and helps to build collagen, which supports your skin.  Folic acid is essential for proper cell division and growth, and potassium can help to regulate blood pressure.  Oranges are also high in soluble fiber, which can help lower cholesterol and fills up your belly to keep you full for longer.  As with most fruits, it's better to eat the whole fruit than to drink the juice if you're watching your weight or your blood sugar.  One eight-ounce glass of juice can be equivalent to 3-6 whole oranges.  A medium-sized orange has 62 calories plus 3 grams of fiber compared to a cup of orange juice, which has 110 calories and no fiber. 

My favorite way to eat oranges is just peeled and popped into the mouth, but I sometimes get fancy and slice them up into salads.  My husband is anti-fruit in savory dishes, so I haven't explored other ways of eating them.  Cooking will destroy the vitamin C, but there are some classic recipes that call for cooked oranges.  I'm thinking crepes suzette, duck a l'orange, etc.  I've also had some cooked citrus in Asian food.  How do you eat oranges?  Or are you ready to never see another orange again and dying for the first strawberries of spring?

No Fun February

Welcome to Free February!  Because it is the shortest day of the month and so many people have slowly relinquished their New Years resolutions by now, February seems like a good time to buckle down and focus on reinforcing healthy habits.  For probably the first time, my brother-in-law has inspired me.  Every February, he eschews alcohol, meat, and other vices, in order to correct the excesses of the holiday season.  I don't feel like I really have any excesses to compensate for, but I do like the idea of challenging myself for a discrete time period.  A blog I used to read did something similar, calling the experience "No Fun February."  I'd like to think of these forthcoming 28 days as something other than "no fun."  That's hardly inspiring or optimistic, and I'm framing this experiment as a challenge feel better, lighter, and maybe even richer.

Because we all know that making your intentions public is a great way to ensure accountability, I hereby endeavor to free myself from a reliance on the following for the next 28 days:

• alcohol
• white bread, pasta, and crackers
• Amazon

OK, so Amazon isn't really a bad food habit, but it's kind of scary how easy it is to one-click your way to a big credit card bill while justifying it as "education" or "research." As to the other "free-froms," I'm thinking of February as being a mini cleanse and coining my own term:  Free February. 

There is a place in a balanced diet for wine, beer, and cocktails, but I'm finally realizing that I just don't need the extra calories.  I'm going to try to follow my own advice to my patients to eat my calories rather than drink them.  A five-ounce glass of wine has 125 calories, but I think my glass holds more than 5 ounces.  ;-) A four-ounce cocktail, such as a cosmo, has 213 calories.  My unwinding-after-work drink of choice, a manhattan, is a little bit better at 130 calories, but it's usually followed by a glass of wine or beer with dinner.  This after-work or dinner drink has become a part of my daily dinner/evening routine.  It probably isn't all that good for me, so I want to see if I can do without it and feel better.

My favorite cocktail, the Manhattan.  I'll miss you!

Bread, pasta, and crackers are not in and of themselves bad for you, but my family has been eating a lot of cheese with that bread, pasta, and crackers.   These simple starches are great sources of energy to fuel my long runs, but they offer little else nutritionally besides calories.

I also suspect that I might have a bit of a gluten intolerance.  Please don't think that I'm jumping on the gluten-free bandwagon, but I want to do an experiment whereby I eliminate gluten as much as possible from my diet to see if it makes my tummy feel better.  As any student of the scientific method knows, one cannot manipulate more than one variable if one wants to determine an effect.  That's why I'm only going gluten-free and not also dairy- or casein-free, meat-free, or--horrors!--caffeine-free this moth, too.

A pediatrician I used to work with believes that it takes four months to clear the gluten antibodies from the body.  Celiac disease support group sites report instant relief to 3-4 weeks to feel better.  I'm going to try for the four weeks of February to see if it changes anything.  Do you know how prevalent gluten is?  I'll devote an entire post to the challenges of gluten-free eating later.      

I've recruited at least one friend to join me in freeing ourselves from greediness.  We run together, so we'll be able to check in and commiserate over the lack of wine in our lives for a measly month.  Earlier this week, as we enjoyed bread, triple cream cheese, and a bottle of wine, then rehashed the horror that was our half marathon last Sunday, she told me she was actually looking forward to Free February.  Do you want to join us in Free February?  What do you think you could do without for four weeks?