Heartfelt Eating

Great explanation of how stress can contribute to heart disease from one of my favorite Fredericksburg cardiologists, Dr. Bob Vranian.

THE MILK AISLE is crowded with so many options it can be hard to know which kind is best for you. Should you go the organic route, or is conventional milk just as nutritious? Should you pick whole or skim? And what about milks made from soy, rice and almonds?

Along with choice overload, there’s the issue of whether people should be allowed to drink raw milk—which some folks around the country are lobbying for, while others say it’s not safe.

My preference is actually for pastured milk, which comes from cows that graze on grass, rather than being fed grain. While some organic milk comes from grass-fed cows, not all of it does; you have to check labels carefully and do a little research.

Milk is such a core part of so many people’s diets. It’s amazing how controversial milk choices have become.

IS RAW OK?

In the U.S., most milk is pasteurized, meaning it’s heated to high temperatures to kill bacteria. Before pasteurization became common, some people caught infections from milk.

Brucellosis was one infection that caused fevers and pain in the joints, spine and testicles. A form of tuberculosis was also present in some raw milk.

Proponents of raw milk say that on modern farms, the risk of infection is minuscule. They also say that enzymes in raw milk make it easier to digest.

From a nutrition standpoint, pasteurizing milk does not change the amount of protein, fat, carbohydrates or vitamins in the milk. Based on conventional science, there is no drawback to pasteurized milk.

Pasteurization is here to stay, by law. Some states do allow sales of raw milk, too.

If you’re interested in trying raw milk, you have to be comfortable with the potential risks. I don’t know any local farmers who sell it, so I have not tried it so far myself.

PASTURED MILK

As a dietitian who’s interested in nourishing our bodies and the planet, I think we are losing perspective. Instead of debating about pasteurized milk, I think we should be encouraging consumption of pasture-fed milk.

There’s evidence that pastured cows—those that graze on grass—are less likely to have E. coli and other infections than cows that are confined indoors and fed corn and soybeans, which are not foods that cows historically ate.

There’s also evidence that pastured cows have in their milk more of a healthier fat called CLA, as well as more heart-healthy omega-3 fats. This is a subtle change that doesn’t show up on nutrition labels, but it is important.

Grazing is also good for the environment. Cows that graze outside can make use of hilly land that’s not otherwise suitable for farming. Plus, they don’t depend on processed feed trucked across the country, so there is less use of foreign oil and gasoline.

FAMILY FARMS

When possible, I try to support small, family farms that don’t use hormones or antibiotics on their cows, whether or not the farm is certified organic.

The term “organic” can be confusing when it comes to milk and foods. Many farms follow organic practices—not using hormones, antibiotics or pesticides—but don’t want to pay the thousands in fees it takes to be certified organic by the U.S. Department of Agriculture. So, I don’t think a farm has to be certified organic to be environmentally friendly.

At the same time, some large organic farms have given cows only limited access to pasture, so the organic label doesn’t always mean you’re getting milk from grass-fed cows. (A new USDA rule, taking effect in June, will require that cows get at least 30 percent of their feed from grazing to be considered organic.)

There is no standard way to label whether milk is pastured or not. However, many farmers take pride in pasturing their cows and do include this information on the label.

While I look for pastured milk, I also drink conventional, non-organic milk. It’s still a refreshing source of calcium and protein.

COW’S MILK VS. NONDAIRY

Besides cow’s milk, there are plenty of other kinds out there: goat’s milk, and milk made from soy, rice and even almonds. They have important nutritional differences.

Cow’s milk comes in four varieties: whole, 2 percent, 1 percent (low-fat) and skim or nonfat. Whole milk is richest, at 150 calories 5 grams of saturated fat per cup. Nonfat milk has only 90 calories and traces of fat. Two percent and 1 percent are in between.

All cow’s milk has about 8 grams of protein, 12 grams of carbohydrates, and 30 percent of your calcium needs per 8-ounce serving.

You also can buy lactose-free varieties of all those milks.

As for other kinds of milk: Powdered milk is made from fat-free milk. Goat’s milk is slightly higher in calories and fat than whole milk. Unsweetened soy milk is comparable to skim milk, with equal amounts of calories and protein, and fortified with calcium and vitamin D. Almond and rice milks are often lower in protein.

There are a variety of reasons to choose alternative milks. People with lactose intolerance may want a lactose-free version of cow’s milk. People with milk allergies or strong feelings about animal rights may prefer milk made from plant sources.

SWEETENED MILKS

Most flavored milks, such as vanilla or chocolate milks, are higher in calories and sugar.

You can make healthier flavored milk at home simply by combining fruit and milk in your blender. It’s higher in vitamins and fiber and lower in added sugar than most artificially flavored milk.

The strawberry smoothie recipe below is a refreshing source of calcium, protein and vitamin C, whether you use regular or organic, pastured milk or even soy milk.

Jennifer Motl welcomes reader questions via her Web site, brighteating.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.

Strawberry smoothie

1 cup frozen strawberries

1 cup 1 percent low-fat milk

Makes 1 serving

Directions: Use frozen berries for a thick, creamy drink. Combine ingredients in blender, and puree until smooth. Pour into a tall glass and enjoy.

Nutritional information per serving: 210 calories, 9 g protein, 3 g fat, (1.5 g saturated fat), 40 g carbohydrate, 3 g fiber, 311 mg calcium, 155 mg sodium, 64 mg vitamin C.

Jennifer Motl is a registered dietitian. Formerly of Fredericksburg, she now lives in Wisconsin. She welcomes reader questions via a form on her Web site, brighteating.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.

Jennifer’s column appeared in The Free Lance-Star newspaper, a daily in Fredericksburg, Va., near Washington D.C., on April 18, 2010.

Feel free to ask me questions or submit info. Thanks!

“The current focus on fighting obesity does a disservice to everyone, fat and thin. What we need is a public policy campaign focused on health and behaviors rather than on weight.” Read this great New York Times article by Harriet Brown. 

Feel free to ask me questions or submit info. Thanks!

Feel free to ask me questions or submit info. Thanks!

NEVER FEAR: Eggs probably won’t affect your cholesterol or your heart.

In the 1960s and 1970s, scientists warned people to avoid eggs. The cholesterol-rich yolks were believed to increase blood cholesterol and thus the risk of heart attacks and strokes. But the advice—although it sounded logical—didn’t hold up. One Harvard study of nearly 108,000 people showed no difference in heart disease risk between folks who ate eggs daily and those who avoided them.

Ironically, it turns out that eating cholesterol-rich foods does not affect blood cholesterol as much as eating saturated fat. That’s because our bodies produce cholesterol to ferry saturated fat through the bloodstream. If you eat more saturated fat, your liver makes more cholesterol.

A small number of people inherit a gene that makes them very sensitive—their bodies overproduce cholesterol most of the time. But for most people, eating eggs does not affect cholesterol much. (Diabetics seem to be an exception—read on to learn more.)

Nowadays, the American Heart Association’s guidelines don’t even mention cholesterol. The association’s latest plan, released in January, advises limiting saturated fat to less than 7 percent of total calories. For the average person—who needs about 2,000 calories a day—that works out to 16 grams of saturated fat. An egg yolk has 1.6 grams of saturated fat. Saturated fat is also found in meats, poultry and dairy products. In moderation, eggs can be part of a heart-healthy diet.

EGGS CAN FIT

The American Heart Association recommends the following eating plan for the average adult:

• Fruits and vegetables—at least 4.5 cups per day
• Fish—at least two servings per week (preferably oily fish)
• Fiber-rich whole grains —at least three ounces a day
• Sodium—less than 1,500 milligrams daily for most adults; less than 2,300 milligrams for young or physically active people
• Sugar-sweetened beverages—less than 450 calories (or 36 ounces) per week
• Nuts, legumes, and seeds—at least four servings per week
• Processed meats—zero to two servings per week
• Saturated fat—less than 7 percent of total energy intake
• Avoid trans fats.

If you’re going to follow this heart-healthy plan, it would be better to eat your eggs with fruit salad or veggies rather than bacon.

Another thing to consider is that just because you can eat eggs every day doesn’t mean you must. Eating eggs daily for six weeks had no effect on cholesterol or blood pressure levels in a Yale Prevention Research Center study. But, substituting oatmeal for eggs reduced total cholesterol from 204 to 194. Oatmeal also reduced “lousy” LDL cholesterol from 125 to 117. So, while eggs are not bad, oatmeal may be better if you need to lower your cholesterol level.

DIFFERENT FOR DIABETICS

People with diabetes might react differently to eggs. Scientists at the Harvard School of Public Health found that diabetic men who ate eggs daily had double the risk of heart disease as egg-avoiders. In diabetic women, those who ate eggs daily had a nearly 50 percent higher risk of heart disease. A more recent study found a higher risk for developing diabetes, too. Daily egg consumption was linked with a 68 percent to 77 percent higher risk of new diabetes, Harvard scientists said.

The link is mysterious, because eating eggs does not raise blood sugar levels. Eating eggs less frequently, a few times a week, did not appear to raise the risk of diabetes or heart disease.

BENEFITS OF EGGS

Compared to meat, poultry and fish, eggs are a relatively inexpensive source of protein and iron.

Eggs are also a good source of choline, a lesser-known nutrient. You need choline for muscle control, memory, and liver function. Choline also works with folate and vitamin B-12 to reduce homocysteine. High homocysteine has been linked to heart disease, cancer, memory problems and fractures.

Women who are pregnant or nursing need extra choline, too, as it’s important for babies’ brain development. Women who get the least choline are twice as likely to give birth to babies with defects such as spina bifida.

Most adults need 425 to 550 milligrams of choline per day, the U.S. Institute of Medicine says. But most Americans fall short, according to a study at Morehouse School of Medicine. One egg has about 145 milligrams of choline. Only organ meats like liver and giblets have more choline than eggs, but many people don’t enjoy organ meats. Smaller amounts of choline are found in wheat germ, meats, fish, seafood, milk and some vegetables.

CHOOSING EGGS

The grocery aisle is full of different types of eggs. No matter whether the shell is white or brown, most eggs contain roughly the same amount of protein and fat. The type of fat depends on what the hens eat. Hens that are fed vegetarian diets or are allowed to range free in pastures lay eggs containing more heart-healthy omega-3 fats, according to some research. 

Springtime Egg-Salad Sandwiches

• 4 large hard-boiled eggs (preferably vegetarian, pastured, organic)
• 3 tablespoons nonfat plain yogurt
• 1 tablespoon grainy mustard
• 1/2 cup minced celery 8 Romaine lettuce leaves freshly ground pepper, to taste
• 1/2 cup grated radishes (or substitute grated carrots)
• 8 slices pumpernickel or rye bread

1. Put eggs in a pot and cover with 1 inch of cold water. Over medium-high heat, bring to a boil. Immediately turn off heat. Let eggs stand for 15 minutes. (Don’t overcook or you’ll get that greenish-gray coating on the yolk.)
2. Pour off hot water and rinse in cold or icy water. Peel.
3. Chop eggs and mix in a bowl with yogurt, mustard, pepper, radishes, and celery.
4. Lay out 4 slices of bread. Put a piece of lettuce on top of each slice. Put half of the egg salad on each slice. Add another piece of lettuce to each. Top with the remaining bread. Serves 4.

Nutrient analysis per sandwich: 199 calories, 9 grams protein, 3.5 grams fat, 34 grams carbohydrate, 5 grams fiber, 108 milligrams calcium, 2.5 milligrams iron, 543 milligrams sodium, 622 units vitamin A, 1.6 grams saturated fat

Jennifer Motl is a registered dietitian. Formerly of Fredericksburg, she now lives in Wisconsin. She welcomes reader questions via a form on her Web site, brighteating.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.

Jennifer’s column appeared in The Free Lance-Star newspaper, a daily in Fredericksburg, Va., near Washington D.C., on April 4, 2010.

Lake Effect Executive Producer Mitch Teich interviewed me about the ongoing controversy. The interview aired on March 25, 2010, on radio station WUWM, Milwaukee’s NPR affiliate. Listen online by visiting Lake Effect’s site and clicking on Raw Milk.

Check out some of the other great topics on Lake Effect, too. For example, I enjoyed a recent interview with an organic farmer, Dave Kozlowski, co-owner of Pinehold Gardens Farm. He makes an evidence-based case for locally grown food.

      Save the date! On the night of Wednesday, April 21, 2010, consider hosting a potluck and screening party for the PBS broadcast of the Oscar-nominated movie Food, Inc.

If you can’t wait until April, you can watch the movie sooner—it’s already out on DVD. (Since we watched it last week, my husband has been surprisingly keen on changing how we eat!) Also, from April 22nd to April 29th, the film will be streaming online.

Americans have plenty of affordable food, compared to the rest of the world. But this inside look at industrial feed lots, chicken shacks and hog farms shows some hidden costs.

Footage of meatpacking operations secretly shot by workers was a real eye-opener, as was testimony from a woman whose toddler died after eating tainted beef.

The film also showed some profitable producers of organic foods and even some free-range fast food.

The film also had a lot of positive ideas for things that everyday people can afford to do to help make our food supply safer and more sustainable. We can protect our health and the planet!

Jennifer Motl is a registered dietitan. E-mail her at brighteating.com or chat on Twitter.

“Tucked neatly inside the health reform legislation headed to the Oval Office for a presidential signature is language that will require calorie labeling on chain restaurant menus, menu boards, and drive-through displays, as well as on vending machines.”

Read the whole story at the Center for Science in the Public Interest’s site.

YOU MAY HAVE heard of “locavores,” a word coined recently to describe people who eat locally grown foods when-ever possible. Eating foods grown close to home has become a movement: It’s thrifty, healthy and eco-friendly.

One way to eat more locally grown foods is to shop at a nearby farmers market. Another way is to join a CSA, or community-supported agriculture. This time of year, early spring, is the time to subscribe to a CSA if you’re interested.

My family joined one recently. We paid a local farmer upfront, and from mid-May to late October, she’ll deliver weekly bags of fresh veggies and fruits to our neighborhood. Some farms also have options for meat, eggs, milk and even flowers. And most CSAs are small, family farms that use organic or eco-friendly farming methods.

Our farm’s basket will have everything from asparagus to zucchini, depending on the season. We’ll also get free newsletters with recipes and invitations to events on the farm, such as potlucks and pick-your-own strawberries, snap peas and pumpkins.

If you haven’t heard of them before, CSAs have been around in the U.S. since the mid-1980s, a good idea imported from Europe. Now, there are probably more than a thousand CSAs in the states, including one in the Fredericksburg area.

SMART SHOPPING

Prices vary by farm. Most farms allow you to buy a full share, which is a weekly market basket of produce large enough for a family of four, or a half-share, suitable for singles or couples. Prices depend on the foods included and the length of the harvest.

This year, my husband and I chose a CSA half-share that cost $378 for 26 weeks; it also includes you-pick strawberries and sugar snap peas. It works out to about $14.50 a week, or about $1 a day per person for chemical-free produce. And when you add in the organic strawberries, it’s an even more budget-friendly deal.

WHERE THE MONEY GOES

We’re not the only people who benefit from buying locally—it helps our neighbors, too. Money spent on local businesses tends to help the local economy, while profits earned by national chains tend to be spent out-of-state on corporate executives and the like.

For example, for every $100 spent at a Borders bookstore, only $13 was returned to the local economy; when the same $100 was spent at a locally owned bookstore, about $45 returned to the local economy, according to an economic impact report for Austin, Texas.

Although the report mentions books, the same is likely true for food. Buying from CSAs supports local family farms rather than big corporations, such as those profiled in the Oscar-nominated movie, “Food Inc.” (foodincmovie.com).

BEYOND DOLLARS

My family’s choice of a CSA was about more than money. I like knowing that food grown on the CSA farm won’t be contaminated with chemicals, nor will it pollute streams and lakes. In the long run, I hope to leave the world a little cleaner for my children and grandchildren.

Plus, locally grown food doesn’t need to be transported far. That’s a contrast to average supermarket foods, which are trucked 1,500 miles. When you buy local foods, you’re reducing dependence on foreign oil.

LIP-SMACKING GOOD

The best reason to buy from a CSA is that the food tastes so delicious.

Unlike food shipped from afar, CSA produce is often picked the same day you get it. It’s hard to beat fresh sweet corn and watermelon slices so ripe that the juices run down your chin.

SEASONAL RHYTHMS

The only challenge that comes with CSAs is actually a good one. You don’t get to pick what produce you receive—you get what is ripe on the farm that day.

In early spring there are a lot of greens—asparagus, spinach, radishes, and some rhubarb and strawberries. By late summer, different veggies are ripe—tomatoes, sweet peppers, eggplant and basil.

If not for Fredericksburg’s CSA, I would never have learned to use up those late-summer ingredients in ratatouille, which is now one of my husband’s favorite dishes.

If you’d like to try the Fredericksburg Area CSA Project, you can learn more about it at localharvest.org/farms/M409.

Also, you can find lists of CSAs nationwide in the U.S. Department of Agriculture’s national farm databases at nal.usda.gov/afsic/pubs/csa/csa.shtml.

CSAs aren’t the only way to eat local. Check out the National Sustainable Agriculture Information Service at attra.ncat.org/attra-pub/localfood_dir.php for a list of farmers markets, too.

Joining a CSA or shopping at a farmers market is a great way to eat more fruits and veggies, which we know reduces the risk of strokes, diabetes and cancer. Beyond your own health, it can benefit your entire community.

Jennifer Motl is a registered dietitian. Formerly of Fredericksburg, she now lives in Wisconsin. She welcomes reader questions via her Web site, brighteating.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.

Jennifer’s column appeared in The Free Lance-Star newspaper, a daily in Fredericksburg, Va., near Washington D.C., on March 21, 2010.

THE RIGHT foods can help you feel good now and reduce risks of cancer in the future.

Fruits, vegetables, beans and whole grains are all anti-cancer foods. The American Institute for Cancer Research recommends filling at least two-thirds of your plate with those foods at every meal.

“Choose mostly plant foods, limit red meat and avoid processed meat,” says the AICR.

Here are my top 10 choices for nutrient-rich foods that are high in natural cancer-fighting phytochemicals:

1. Beans. They’re a magical fruit. Women who ate the most beans had a 40 percent lower risk of breast cancer, according to one study.

Any kind of beans will do: black beans, kidney beans, pinto beans, navy beans, etc. Consider adding beans to chili, to minestrone soup and as a topping for salads.

Soybeans also fall into this category—so enjoy soy milk, veggie burgers, soy nuts, edamame, tofu and tempeh. Soy has been shown to reduce risk of hormonal cancers such as breast cancer, and a Chinese study released in February showed soy foods don’t interfere with chemotherapy—soy seems safe for breast cancer survivors, too.

Soy foods were linked to 30 percent to 40 percent lower rates of ovarian and endometrial cancers in a Korean study.

Eating more soy reduced prostate cancer growth in a small study in California.

2. Berries. They’re rich in vitamin C and fiber, both of which reduce cancer risks. Strawberries are especially rich in ellagic acid, while blueberries contain anthocyanosides, and red grapes have resveratrol, all powerful antioxidants.

3. Cruciferous vegetables. These vegetables—including broccoli, cauliflower, cabbage, Brussels sprouts, bok choy and kale—are also linked to lower cancer rates.

Along with having fiber and vitamin C, these veggies contain cancer-fighting isothiocyanates.

One study showed yellow vegetables and cruciferous veggies were linked to longer survival for women who had ovarian cancer. Other studies suggest benefits for preventing lung cancer and stomach cancer. Cabbage eaters had a 50 percent lower risk of colon cancer in an Indian study.

4. Dark-green leafy vegetables. These vegetables, including spinach, lettuce and other greens, are packed with heart-healthy potassium and magnesium. They’re also rich in cancer-fighting agents such fiber, folate, lutein and zeaxanthin.

Women who ate more of these veggies had 50 percent lower rates of cervical cancer than women who ate few greens.

When it comes to colon cancer, some people may be genetically susceptible, especially when they eat meat. Luckily, those same folks seem less likely to develop cancer if they eat lots of carotenes (found in orange and dark green veggies) and natural vitamin E, found in nuts, seeds, olive oil and other oils, according to British researchers.

5. Fish. Fresh fish is associated with a 40 percent to 70 percent lower risk of colon cancer, according to Indian researchers. It’s also linked to reduced risks of prostate and breast cancer.

6. Garlic. Stinky but healthy, allium vegetables such as garlic, onions, scallions, leeks and chives are linked to lower rates of stomach and colon cancer. Plus, these veggies enhance the flavor of other foods.

7. Green Tea. This kind of tea contains more cancer-fighting catechins than black tea.

8. Mushrooms.Cooked mushrooms have compounds that help stimulate the immune system. Chinese women who consumed the most cooked mushrooms had a 64 percent lower risk of breast cancer.

9. Tomatoes. Tomatoes contain lycopene, which may reduce the risk of prostate cancer. Women who ate more lycopene-rich foods had half the risk of cervical cancer in one study.

10. Turmeric. Turmeric, the spice that makes curry powder yellow, is a powerful antioxidant and is being studied for cancer-fighting properties.

IT’S ALL GOOD

Don’t worry if your favorite fruits and veggies aren’t on the list. All fruits and vegetables, and the fiber they contain, have shown anti-cancer links in multiple studies.

For example, women who ate the most fiber had a 40 percent lower risk of endometrial cancer and a 70 percent lower risk of breast cancer.

And men and women who ate the most foods with quercetin—an antioxidant found in apples and many other fruits and vegetables—had 50 percent lower rates of colon cancer, according to Scottish scientists.

AVOID THESE FOODS

Eating red meat, especially cured and processed meats like bacon and sausage, was associated with shorter survival time in Illinois women with ovarian cancer, in a study released this month. And eating meat was associated with a 250 percent higher risk of colon cancer in an Indian study.

Saturated fat was linked to pancreatic cancer risk by Minnesota researchers.

Excessive alcohol is associated with risks of several cancers, so try to limit alcohol to one drink per day—if you drink at all.

Excessive calories and high blood sugar are also linked to increased cancer risk, so try to eat in moderation.

Eating well now can help you live long into the future.

Jenny’s Super Curry Salad

Makes 12 -cup servings

Cook’s note: This salad combines several cancer-fighting foods—broccoli, garlic, raisins and curry—into a delicious dish that can be served warm or cold.

You can make variations by substituting cauliflower for broccoli and using dried cranberries instead of raisins, or a chopped scallion instead of garlic powder.

5 cups broccoli, chopped cup water cup low-fat plain yogurt teaspoon garlic powder teaspoon curry powder (more if you like) cup raisins cup almonds, chopped

Directions:

1. Steam broccoli in 1 cup water.

2. In a separate bowl, whisk together yogurt, garlic powder and curry powder.

3. Toss broccoli with dressing.

4. Top with raisins and almonds, and serve.

Nutrient analysis per serving:

96 calories, 4 grams protein, 6 grams fat, less than 1 gram saturated fat, no cholesterol, 12 grams carbohydrate, 2 grams fiber, 64 milligrams calcium, 1 milligram iron, 19 milligrams sodium, 276 milligrams potassium, 572 units vitamin A, 35 milligrams vitamin C.

Jennifer Motl is a registered dietitian. Formerly of Fredericksburg, she now lives in Wisconsin and welcomes reader questions via her Web site, brighteating.com, or mailed to: Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.

This story appeared in The Free Lance-Star newspaper on March 7, 2010.