Going Gluten-Free

from HealthyWomen’s e-newsletter, HealthyWomen Take 10

What’s up with gluten? You might not have even heard of gluten until recently when foods without this grain protein started being promoted on store shelves.

People with celiac disease, an autoimmune disorder, suffer difficult gastrointestinal symptoms that are triggered by gluten. Those individuals must avoid eating or drinking any gluten, which isn’t easy.

Gluten is found in wheat, barley, rye and spelt. (Never heard of spelt either? It’s a grain from ancient times that’s highly nutritious.) Gluten occurs in a wide range of foods. Some of these you might expect, such as baked goods and pizza, and some you might not, like ice cream (gluten is commonly used as a thickening ingredient). Food labels now must state if a product contains gluten or was made in a facility that processes wheat.

In addition to those with celiac disease—which is being diagnosed more frequently as doctors become more aware of the condition—others don’t have celiac but do have a heightened sensitivity to digesting gluten. They, too, are helped by avoiding gluten foods.

Fortunately, there are many naturally gluten-free foods, such as fruits, vegetables, poultry, eggs and more. Grains and starches that can be eaten on a gluten-free diet include corn, amaranth, flax, buckwheat (not a wheat), rice, quinoa, potatoes, soy and teff (an Ethiopian grain used for flour).

When eating gluten-free, it’s helpful to consult a registered dietitian to achieve a good nutritional balance in your food selections. Your healthcare provider or a local hospital’s nutrition counseling department should be able to refer you.

For more on nutrition, visit: www.healthywomen.org/ages-and-stages/healthy-living/diet-and-nutrition

References

Harvard Medical School . “Getting Out the Gluten.” Harvard Health Letter. http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2009/June/Getting-out-the-gluten.

American Dietetic Association. “Do I Need to Follow a Gluten-Free Diet for Life?” http://www.eatright.org/Public/content.aspx?id=10594&terms=gluten. Accessed April 20, 2010.

American Dietetic Association. “Celiac Disease.” http://www.eatright.org/Public/content.aspx?id=5542&terms=celiac. Accessed April 21, 2010.

American Dietetic Association. “If You Have Celiac Disease: Grains and Plant Foods to Include on Your Grocery List.” http://www.eatright.org/Public/content.aspx?id=4294967395. Accessed April 21, 2010.

© 2010 HealthyWomen All rights reserved. Reprinted with permission from HealthyWomen. 1-877-986-9472 (toll-free). On the Web at: www.HealthyWomen.org.

Whole Grains May Help Control Blood Pressure

 Previous research has shown that women who eat more whole grains are less likely to develop high blood pressure.  But the impact of whole grains on men’s blood pressure was unknown. 

 A recent study published in the American Journal of Clinical Nutrition (September 2009) followed over 31, 000 men for 18 years.  Men with the highest daily whole grain consumption were 19% less likely to develop high blood pressure versus men who ate the least amount of whole grains.  The lower blood pressures were found regardless of weight, physical activity, fruit and vegetable intake.

 So whole grains can help control blood pressure in both women and men.  The current dietary guidelines recommend that adults eat at least 3 ounces or 85 grams of whole grains daily.  Whole grains are richer in nutrients because they retain their bran and germ unlike refined grains.

 “Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their blood pressure, cholesterol and other risk factors to prevent a heart attack, stroke and diabetes. “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009. For more info visit www.heart-strong.com

Heart Healthy Vitamins and Supplements (Part 2)

Lower Your Cholesterol with Heart Healthy Choices

from the Living Well Center

For many Americans working toward better heart health, an important first step is getting cholesterol to a healthy level. Diet and exercise are important steps to reduce high cholesterol. However, many people may find that with diet and exercise alone, cholesterol numbers are not where they should be.

More than one hundred million Americans have high cholesterol, an important risk factor for heart disease. Though diet is very important, many people don’t realize that cholesterol is also produced in the body based upon heredity.

Learning about your family health history is important—we recommend talking to your family about their health and creating a family health tree (a sample is available on our Web site). Bringing this information to your next doctor visit will help you discuss your family history regarding cholesterol and other hereditary health concerns.

Understanding Cholesterol

What you eat affects your health, by raising or lowering the blood fats (cholesterol, triglycerides) that circulate through your body. Some foods increase your levels of total cholesterol, LDL or “bad” cholesterol and triglycerides. Over the years, excess cholesterol and fat are deposited in the inner walls of the arteries that supply blood to your heart. Eventually, these deposits can make your arteries narrower and less flexible, a condition known as atherosclerosis. Left unchecked, this buildup can lead to heart attack, stroke and death.

Additionally, because of your family health history, your body may be genetically predisposed to make more cholesterol than you may need, in addition to the cholesterol from your food intake.

Know your numbers!

Each one of us has a cholesterol goal level, based upon our individual risk factors and our risk for heart disease. The National Cholesterol Education Program (NCEP) recommends that everyone age 20 and over have a blood cholesterol test every five years to check their cholesterol levels. To learn more about your goal, visit www.nhlbi.nih.gov/chd for the National Cholesterol Education Program’s Live Healthier, Live Longer Web site.

If your cholesterol levels are mildly to moderately higher than your goal, making a few dietary changes may be all you need to get back on track.

According to current NCEP recommendations, people with coronary heart disease or others considered to be at high risk for coronary heart disease generally have an LDL cholesterol goal of less than 100 mg/dL. An LDL cholesterol goal of less than 70 mg/dL is a therapeutic option for people considered to be at very high risk. Work with your doctor to develop a plan to help reduce your LDL cholesterol number to goal.

Here are guidelines for your cholesterol and triglyceride levels according to NCEP guidelines (new guidelines will be released in 2010):

Total blood cholesterol levels
less than 200 mg/dL	Desirable
200 to 239 mg/dL	Borderline high
240 mg/dL or above	High

LDL blood cholesterol levels
less than 100 mg/dL	Optimal
100 to 129 mg/dL	Near optimal/above optimal
130 to 159 mg/dL	Borderline high
160 to 189 mg/dL	High
190 mg/dL and above	Very High

HDL blood cholesterol levels
above 60 mg/dL. Levels above 60 mg/dL are considered especially beneficial and can offset risk factors for heart disease, according to NHLBI. The higher the level, the healthier it is.	Optimal
50 to 60 mg/dL for women; 40 to 50 mg/dL for men	Average
less than 50 mg/dL for women; less than 40 mg/dL for men. Below these levels is considered a major risk factor for heart disease.	Low

Triglyceride levels
less than 150 mg/dL	Normal
150 to 199 mg/dL	Borderline High
200 to 499 mg/dL	High
500 mg/dL or higher	Very high

It is important to remember that these recommendations are for healthy individuals, not for women with existing risk factors for heart disease, such as diabetes, kidney disease, being overweight, smoking or having a family history of heart disease. If you are at risk for heart disease, your target goals likely will be lower.

Fighting Back

There are things that you can do now to help you gain a better understanding of your risk factors and perhaps lower your chances of high cholesterol and heart disease. For starters, it’s important that you eat right, get plenty of exercise, as recommended by your physician, and begin to understand your family health history. A healthy diet may help reduce total cholesterol. In general, you want to get “good” cholesterol higher and “bad” cholesterol lower.

You can still enjoy a wide variety of foods by making healthful dietary choices and changes.

If elevated cholesterol is part of your family genetics, or you have other conditions such as heart disease or diabetes, you may need medication in addition to eating a heart-healthy diet. But whether you have normal cholesterol, high levels, or are currently taking a cholesterol-lowering drug, eating a healthy diet is important for everyone.

Good fats/bad fats

Fats can be good for you and your heart, when they’re the right kind and consumed in limited amounts; but even good fat is packed with calories.

Those include monounsaturated and polyunsaturated fats, which decrease “bad” cholesterol, and omega-3 fatty acids, which lower triglycerides.

• Unsaturated fats are liquid at room temperature.
• Monounsaturated fats include olive oil, canola oil and peanut oil.
• Polyunsaturated fats include corn oil, safflower oil and soybean oil.

Saturated fats are the bad guys that may endanger your heart. They increase LDL or “bad” cholesterol more than anything else in your diet.

• Saturated fats, found mostly in animal products, are hard at room temperature or in the refrigerator. Think butter, shortening, fat on and in meat and poultry skin. Whole milk or two-percent milk products, half-and-half and cream all have a lot of saturated fat.
• Tropical oils—coconut, palm and palm kernel oils—also contain a lot of saturated fats. These oils are used in commercially baked crackers, cookies and non-dairy creamers.
• Foods containing saturated fats often also contain high amounts of cholesterol, which is only found in animal products.

Trans fats are another culprit to watch out for.

• Trans fats raise “bad” cholesterol.
• Trans fats are found in foods made with hydrogenated or partially hydrogenated oils—stick margarine and some store-bought cookies and cakes, fast-food French fries, potato chips and other snacks.
• Read your food labels before purchasing. If there are .5 grams or less of trans fats in an item, the company can claim 0 trans fats on the label, so check the ingredient list for hydrogenated oils.

Heart-Healthy Choices

1. Switch your dairy

• Make the change from whole or two-percent milk to one-percent and then to skim, for drinking and in recipes. Or try almond milk or rice milk for a nondairy alternative.
• Use low-fat or nonfat sour cream, yogurt, cream cheese and ice cream.

2. Choose lean cuts

• Beef tenderloin, sirloin, eye of round, ground beef with 10 percent or less fat and pork tenderloin are good choices.
• Other alternatives include white meat chicken or turkey.
• Remove the skin before cooking any poultry.

3. Cook with monounsaturated or polyunsaturated Oils

• These include olive, canola, peanut, safflower, sunflower, sesame and soybean oils.

4. Use more plant-based proteins instead of animal products

• These include beans and peas—black beans, kidney beans, pinto beans, chickpeas, lentils—and tofu or soy. Try veggie burgers (soy-based or grain-based) for an alternative to beef.

5. Boost your intake of foods that are high in soluble fiber

• This type of fiber binds to cholesterol in the digestive tract and helps remove it from your body. Good sources include oatmeal, oatmeal bread, oat bran cereal, beans and peas, apples, bananas and citrus fruits.

6. Increase whole grains in your diet

• Choose bread with at least 3 grams of dietary fiber per slice, whole-grain pastas and brown rice.

7. Use products containing plant sterol and stanol esters

• These components help keep your body from absorbing cholesterol.
• Consuming two to three grams a day decreases LDL cholesterol by 6 percent to 15 percent.
• Food products that have added cholesterol-lowering sterols and stanols include margarines, orange juice and yogurt.

8. Eat fatty fish twice a week

• Choose wild salmon over farm-raised to reduce possible toxin exposure.
• Pregnant or nursing women and children should limit tuna intake to 6 ounces a week and avoid swordfish, due to concerns about methyl mercury levels.

9. Increase the amounts of fruits and vegetables you eat

• Most women should have 1-1/2 cups of fruit and 2 to 2-1/2 cups of vegetables (without cheese sauce!) every day, according to new guidelines.
• Adding more of these to your diet fills you up, adds fiber and important nutrients and helps replace foods with saturated fats.
• For details on the new dietary recommendations, visit www.mypyramid.gov.

10. Keep an eye on dietary cholesterol

• Dietary cholesterol, such as is found in eggs, dairy products and some other foods, may raise cholesterol in the blood slightly, but newer studies find that consumption of dietary cholesterol is unlikely to substantially increase risk of coronary heart disease or stroke among healthy men and women. If you have other existing health conditions or risk factors for heart disease, such as diabetes, kidney disease, being overweight, smoking or having a family history of heart disease, you may need to monitor dietary cholesterol more closely.
• Egg yolks are filled with dietary cholesterol—213 milligrams in each. If you have elevated cholesterol, the National Cholesterol Education Program recommends you keep your consumption under 200 milligrams per day.
• Egg whites are cholesterol-free, so use two for each whole egg in recipes, or use cholesterol-free egg substitute, which works well in baking and omelettes.

Heart-Healthy Tips for Eating Away from Home

Here’s how to eat out and have a terrific meal without taking in too much fat and cholesterol:

 

1. Preparation counts. Order your food fresh, sautéed, grilled/broiled, or poached. If sautéed or broiled, ask for it to be cooked with olive oil or without fat. Have sauces served on the side, so you add only what you need.
2. Divide and conquer. Resist the pitfalls of inflated portions by eating only half of what you order. Take the rest home for an easy lunch or dinner the next day. Ask if you and your dining partner can share an entrée, with each of you ordering individual salads.
3. Balance. Have the nachos if you really want them, but order a healthy entrée. Dessert isn’t a no-no—pick fresh fruit or sorbet. Enjoy the bread or rolls, just skip the butter and drizzle on olive oil.
4. Sip slowly. Wine may raise HDL “good” cholesterol a bit, but there’s also evidence it can boost your triglyceride levels.
5. Fast food stops are OK. Most fast-food restaurants now offer healthier items than a bacon double cheeseburger. Depending upon which chain you visit, you may find salads (ask for nonfat or olive oil dressings), grilled chicken, yogurt, baked potatoes and fresh fruit cups.
6. Look for a heart-healthy symbol. Some restaurants put a heart or other sign next to healthful menu items. Choose from those.

For More Heart Healthy Info visit www.heart-strong.com

References

Lichtenstein, A.H. Dietary fat and cardiovascular risk: quantity or quality? Journal of Women’s Health. 2003 Mar.;12(2):109-14.

Mozaffarian, D., Rimm, E.B., King, I.B., Lawler, R.L., McDonald, G.B., Levy, W.C. Trans fatty acids ad systemic inflammation in heart failure. American Journal of Clinical Nutrition. 2004 Dec.;80(6):1521-5.

Thompson, G.R., Grundy, S.M. History and development of plant sterol and stanol esters for cholesterol-lowering purposes. American Journal of Cardiology. 2005 July 4;96(1 Suppl):3-9.

Associated Press. “U.S. Government Discards One-Size-Fits-All Food Pyramid.” 2005 Apr. 19.

© 2009 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (tollfree). On the Web at: www.healthywomen.org.

Heart Healthy Vitamins and Supplements

7 Quick Healthy Diet Tips

Small changes can make a BIG difference over time.  If you are trying to lose weight or just trying to eat healthier here are a couple of suggestions to gradually make some dietary changes.

1)      Replace white bread with whole grain bread
2)      Avoid candy instead try some dried fruit (raisins, dates, apricots)
3)      Eat brown rice or wild rice instead of white rice (increases your fiber intake)
4)      Instead of potato chips have baked tortilla chips or whole wheat pretzels
5)      Pick up some fruit you can eat on the run (banana, grapes, apple, pear)
6)      Have nonfat frozen yogurt instead of ice cream
7)      When ordering pizza request extra tomato sauce, oregano, basil, add some veggies (limit or cut back on the amount of cheese)

Change is hard, so try to make gradual changes whenever possible (even one a week or one a month).  A study published in the Journal of the American Medical Association found that men who ate fish JUST ONCE A MONTH reduced their stroke risk.

For more healthy dietary tips visit  www.heart-strong.com

The Power of Cinnamon

 

Not only does cinnamon taste good, it has some great health benefits for diabetic patients (and for non-diabetics too).  Several small studies and a few anecdotal reports show that cinnamon may help decrease blood sugar levels.  Researchers are not exactly sure how the cinnamon helps improve blood sugar levels, but one thought is that it may slow the digestion rate from the stomach, which improves insulin sensitivity.  Several small studies also report reductions in cholesterol levels with daily cinnamon intake. The studies that showed the positive health benefits used ground cinnamon, not cinnamon pills.  There was one small study that stated there was no change in blood sugar levels in post-menopausal women using cinnamon pills.

So, we recommend a daily intake of 1-2 teaspoons of ground cinnamon daily.  Sprinkle it in your coffee, cereal, oatmeal, and yogurt or on an apple (to make it taste like apple pie).  Enjoy the health benefits of this tasty spice!

 For more heart healthy info visit www.heart-strong.com

Fruit Drinks Increase Your Risk for Diabetes

 

Fruit drinks oftentimes are considered a healthier choice that soft drinks but they may actually be more likely to lead to weight gain and diabetes.

 A recent report from the Black Women’s Health Study (published in the Archives of Internal Medicine) which included over 2,700 women found that the higher the intake of sweetened fruit drinks the greater the likelihood of developing diabetes.  Women who consumed two or more sweetened beverages a day were much more likely to develop diabetes than women who consumed fewer than one per month.  The incidence of diabetes is dramatically higher among black women compared to white women and this study points out the importance of avoiding sweetened fruit drinks especially among black women.

 Believe it or not – Fruit drinks often have more calories than sweetened soft drinks.  It’s important to read those food labels!! (Fruit drinks in this study included powdered fruit flavored beverages, fruit flavored beverages, fortified fruit drinks and juices other than orange and grapefruit juice)

 For more heart healthy info visit www.heart-strong.com

Learn More From Our New Book “Take Charge: A Woman’s Guide to a Healthier Heart” available at www.heart-strong.com

A Fresh Look at Organic Produce

A Fresh Look at Organic Produce from the National Women’s Health Resource Center’s e-newsletter, HealthyWomen Take 10

 Which is better for you-an organic tomato or one that’s grown through conventional methods? The answer might not be as obvious as it seems.

 There’s certainly a benefit to eating foods that don’t contain pesticides, especially if you’re pregnant or nursing or feeding the foods to young children. Yet data from about 87,000 tests analyzed by the Environmental Working Group, a food watchdog organization, discovered that more than half of conventionally grown tomatoes had no detectable pesticide residue on them.

 The same was true for broccoli, eggplant, cabbage and sweet peas. More than 90 percent of the samples of conventionally grown asparagus, sweet corn and onions also had no detectable pesticides.

 In addition, a 2008 Italian study found that organically grown tomatoes contained less vitamin C and lycopene-important nutritional components-than did conventional tomatoes. The organic tomatoes did have more salicylic acid, another beneficial nutrient. Yet, other studies have shown more nutritional benefits in some organically grown produce, such as blueberries.

 So how do you choose what to buy? Organic produce contains little or no pesticide residue and organic growing methods tend to support land and water ecology. If you buy conventionally grown vegetables and fruits, some of them contain high levels of residue. Be especially cautious about buying the “dirty dozen” (see list below), which includes peaches, apples, bell peppers and celery.

 Rinsing conventionally grown produce will help remove some pesticide residue, but not all of it. You can peel fruits and vegetables to avoid a lot of the residue, but that also results in losing nutrients.

 On the practical side, organic produce is often more expensive and harder to find, with fewer items available. You may get fresher, less expensive produce from local growers (even nonorganic ones), who use less gasoline getting their fruits and vegetables to your market than do organic farmers located at greater distances.

 To help find your way through the confusion in the produce aisle, the Environmental Working Group created a list of which conventionally grown vegetables and fruits retain the most pesticide residue and which have the lowest levels. You can use these lists to guide your decision making when wondering whether to buy organic or not:

 Highest levels of pesticide residue (highest first)
Peach
Apple
Bell pepper
Celery
Nectarine
Strawberries
Cherries
Kale
Lettuce
Grapes (imported)
Carrot
Pear

 Lowest levels of pesticide residue (lowest first)
Onion
Avocado
Sweet corn
Pineapple
Mango
Asparagus
Sweet peas
Kiwi
Cabbage
Eggplant
Papaya
Watermelon
Broccoli
Tomato
Sweet potato

 Whichever type of produce you decide to buy, be sure to eat plenty of fruits and veggies (fresh or frozen) every day. For women who get less than 30 minutes of physical activity daily, the U.S. Department of Agriculture recommends:

 Vegetables: Women under 50, 2-1/2 cups per day; women 50 and over, 2 cups per day

• Fruits: Women under 30, 2 cups per day; women 30 and over, 1-1/2 cups per day

 More active women may increase their consumption from those daily levels.

 References

Environmental Working Group. “Shopper’s Guide to Pesticides.” http://www.foodnews.org/methodology.php. Accessed April 14, 2009.

 Rossi F, Godani F, Bertuzzi T, et al. “Health-Promoting Substances and Heavy Metal Content in Tomatoes Grown With Different Farming Techniques.” European Journal of Nutrition. 2008;47(5):266-272.

Environmental Working Group. “Shopper’s Guide to Pesticides.” http://www.foodnews.org/walletguide.php. Accessed April 14, 2009.

 Wang SY, Chen CT, Sciarappa W, et al. “Fruit Quality, Antioxidant Capacity, and Flavanoid Content of Organically and Conventionally Grown Blueberries.” Journal of Agricultural Food Chemistry. 2008;56(14):5788-5794.

 For information on recommended daily food consumption, go to http://www.mypyramid.gov.

 © 2009 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (toll-free).

Can Coconuts Protect Us From Heart Disease?

Heart disease is the leading cause of death in the United States and many European countries.  In the Pacific Islands it appears that heart disease is a rarity.  Many medical studies have demonstrated that an unhealthy diet and lifestyle can lead to the development of heart disease.   So why are Pacific Islanders almost immune to heart disease?  Several prior studies have shown that coconut-eating populations around the world have lower cholesterol levels and an immunity to heart problems. 

A recent study was conducted on people living on two remote islands in the Pacific (Pukapuka and Tokelau).  The foods and lifestyles were carefully evaluated.  Coconut was their primary source of food and was eaten in some form at every meal.  No evidence of coronary artery disease, diabetes or cancer was found.   Despite the high amount of saturated fat in their diets (from coconuts) their cholesterol levels were lower than expected. 

Coconuts contain medium chain fatty acids and are used immediately as a source of energy, which is unlike other oils.  Vegetable, sunflower and safflower oils are comprised of long chain fats which are deposited in blood vessels as cholesterol or stored around the waist as fat.

This is some interesting data which needs to be evaluated further to determine if there really is a benefit to eating coconuts?  But right now this data suggests that adding coconuts “in moderation” to your diet may be heart healthy.