Esophageal Cancer Awareness

April is Esophageal Cancer Awareness month. Why is this important to a registered dietitian? With a focus on health and disease prevention, I frequently receive calls from individuals asking for diet/lifestyle tips to help manage their GI symptoms ranging from reflux/GERD, irritable bowel, gluten intolerance/Celiac Disease, etc. Most people have experienced reflux at one point in their life and know the unpleasant feeling. However, chronic reflux and GERD (Gastro-Esophageal Reflux Disease), especially when untreated, can lead to a condition called Barrett’s Esophagus which greatly increases the risk of developing esophageal cancer. For more information on Barrett’s, click here.

Luckily, I have the privilege to work with Dr. Fusco, a local surgeon who is skilled in treating Barrett’s Esophagus. Click here to learn more about Barrett’s/treatment options, and click here to learn more about Dr. Fusco and the Halo procedure to treat Barrett’s and significantly decrease your risk of developing esophageal cancer.

You can also visit Dr. Fusco’s website to learn more about the 2013 Esophageal Cancer Awareness Event which includes links to last year’s presentation slides, educational materials, and a patient testimonial/esophageal cancer survivor story.

If you have reflux/GERD, below are some of the most basic dietary guidelines to help manage and decrease symptoms:

  • Limit the following foods/common GI irritants:
     - Citrus fruits (orange/grapefruit, pineapple, lemon/lime)
     - Chocolate
     - Caffeine (soda, tea, coffee, caution with decaf varieties)
     - Fatty and fried foods
     - Rich foods heavy in butter/cream/whole milk/oils
     - Garlic and onions for some people
     - Spicy foods, hot sauce & hot peppers
     - Mint flavorings/peppermint
     - Tomato-based foods (ie. tomato juice, tomato sauces/pasta sauces,  salsa, chili, pizza, etc.)
  • Chew food well/eat slowly (focus on mindful eating & portion-control)
  • Eat smaller, frequent meals consistently throughout the day
  • Do not lay down for at least 2-3 hours after eating; limit late night snacks
  • Seek treatment/help for any emotional eating/disordered eating (including binge-eating disorder, bulimia nervosa, & anorexia nervosa)

In addition to dietary interventions, these lifestyle tips are equally important:

  • Maintain a healthy weight; even a 5-10% weight loss can help if you are overweight
  • Work on managing stress/prioritize time for relaxation
  • Try to stop smoking
  • Limit strenuous activity immediately after eating
  • Do not wear tight-fitting clothes/belts around your mid-section
  • Elevate the head of your bed 6-8 inches
  • Check with your doctor to make sure prescription/over-the-counter medications, vitamins/supplements are not making symptoms worse

According to the American Institute for Cancer Research (AICR), esophageal cancer is 2nd only to lung cancer in preventability. This starts with living a healthy lifestyle in addition to managing and treating reflux, GERD, and Barrett’s Esophagus if you have been diagnosed with any of these conditions. AICR experts estimate that maintaining a healthy weight, following a balanced diet, and limiting alcohol (1 drink/day or less for females & 2 drinks/day or less for males) could prevent 7 out of every 10 cases of esophageal cancer in the U.S. every year – that’s over 12,000 cases this year alone! For more information on the AICR, including recipes/etc., visit their website.

Kristine Van Workum, RD, CSSD, LDN

LifeShape Registered Dietitian & Owner of Brevard Nutrition (www.brevardnutrition.com)

Alcohol Awareness

alcohol image

Did you know April is National Alcohol Awareness Month? While there are several noted health benefits associated with moderate alcohol consumption, in particular with cardiovascular health, many Americans are unaware of what “moderate” intake refers to. Here are the official guidelines:

The definition of “1 drink” depends on the type of drink. According to the Academy of Nutrition and Dietetics, a standard drink is one that contains 0.6 fluid ounces of pure alcohol. One recommended serving is as follows:

  • 12 oz beer/wine cooler (keep in mind specialty beers with a higher alcohol content will have a smaller serving size)
  • 8 oz malt liquor
  • 5 oz table wine
  • 1.5 oz of 80-proof distilled spirits, such as gin/vodka/whiskey

Keep in mind also that the recommendations on alcohol intake differ between men and women. For men the guideline is up to 2 drinks per day & for women the guideline is up to 1 drink per day. Anything more than moderate drinking can be harmful to your health, including an increased risk for high blood pressure, liver disease and certain type of cancer. Check with your doctor to make sure drinking alcohol does not interfere with any medications or current health problems you may have.

And what about alcohol content and cooking? According to the Academy of Nutrition and Dietetics, if the food is uncooked, the alcohol content will remain the same. If the alcohol is added to boiling liquid at the end of cooking, ~85% of the alcohol may remain. For braised foods (foods cooked covered in liquid at temps below boiling in a covered pot) only ~5% of the alcohol remains after 2.5 hours of cooking. A flambé (flamed) dish may retain ~75% of its alcohol content.  

For more information and a toolkit sponsored by the National Council on Alcoholism and Drug Dependence, Inc., click here. Remember to make healthy and safe choices if you choose to drink alcohol, and do so in moderation!

Kristine Van Workum, RD, CSSD, LDN

LifeShape Registered Dietitian & Owner of Brevard Nutrition (www.brevardnutrition.com)

April 2014 Recipe: Taco Pizzas  -  * Great for celebrating Cinco de Mayo! *

Source: http://www.elliekrieger.com/taco-pizzas

Ingredients:

8 small corn tortillas (6 inches in diameter)

2 tablespoons canola oil

4 scallions

3 cloves garlic

1 tablespoon chili powder

½ teaspoon ground cumin

½ teaspoon dried oregano

½ teaspoon salt

¼ teaspoon cayenne pepper

¾ pound lean ground turkey

1 ear fresh corn or 2/3 cup corn kernels

½ cup no-salt-added tomato sauce

1 cup canned low-sodium pinto beans

¼ cup low-sodium chicken broth or water

3 ounces pepper Jack cheese (3/4 cup grated)

½ cup reduced-fat sour cream or plain Greek yogurt

Directions:

Preheat the oven to 425F

Brush the tortillas on both sides lightly with 1 tablespoon total of the oil. Place them on 2 baking sheets and bake until crisp, 5-7 minutes. Remove from the oven, leaving the tortillas on the trays.

Meanwhile, heat the remaining 1 tablespoon oil in a large skillet over medium-high heat. Thinly slice the scallions, keeping the dark greens separate, and mince the garlic. Add the scallion whites and light green parts to the skillet and cook until translucent, 2 minutes. Add the garlic, chili powder, cumin, oregano, salt, and cayenne and cook for 1 minute more.

Place half of the scallion-spice mixture in the bowl of a small food processor and set aside. Add the turkey to the remaining scallion-spice mixture in the skillet and cook, breaking the meat up with a wooden spoon, until it is cooked through, 4 to 5 minutes. Meanwhile, if using an ear of corn, cut the kernels off. Add the corn kernels and tomato sauce to the skillet with the browned turkey and cook until most of the liquid is absorbed, 2 to 3 minutes.

Drain and rinse the pinto beans and add them, along with the chicken broth, to the food processor. Pulse until smooth, scraping the sides once or twice if necessary. Grate the cheese.

Spread 2 tablespoons of the bean mixture on each tortilla and top with about ¼ cup of the turkey mixture. Sprinkle a heaping tablespoon of cheese on top and bake until the bean puree is warmed through and the cheese is melted, 3 to 4 minutes. Remove from oven and sprinkle with the scallion greens. Cut each pizza into quarters with a sharp knife or pizza cutter and serve each with a dollop of the sour cream.

Makes 4 servings; Per serving (2 pizzas): 510 calories; 22 g total fat (7 g sat fat); 65 mg cholesterol; 47 g carbohydrates; 36 g protein; 8 g fiber; 540 mg sodium

 

National Nutrition Month

The 2014 National Nutrition Month theme is “Enjoy the Taste of Eating Right.” What better way to enjoy the taste of your food than to focus on exploring the principles of mindful eating and experimenting with new foods/recipes? Make it a goal this month to try at least 1 new food or 1 new recipe per week. Try to focus on tasting & enjoying your food and eating slowly. I often give my clients the “homework” assignment or challenge to really taste the first 3 bites of everything you eat. This can be a difficult task, so even if you do it 30% of the time you eat, it’s a great start.

Remember to keep meal planning practical and simple. Cooking & eating healthy does not have to mean hours upon hours of slaving in the kitchen. Schedule cooking/shopping on your least busy days, search for crock pot recipes, and plan for leftovers so you do less cooking/meal prep when you are busiest.

One delicious way to experiment with flavor is by adding herbs & spices to your usual dishes. Click here for 30 simple ways to add spices to your diet.

Check out a variety of recipes posted on the Academy of Nutrition and Dietetics website, and don’t be afraid to try something new!

Kristine Van Workum, RD, CSSD, LDN

LifeShape Registered Dietitian & Owner of Brevard Nutrition (www.brevardnutrition.com)

Oven Roasted Asparagus

Source: http://www.eatright.org/Public/content.aspx?id=6442475677

Ingredients:

  • 1 1/4 pounds asparagus, with tough ends broken off
  • 2 tablespoons olive oil
  • Pepper, to taste
  • 1/3 cup low-fat plain yogurt
  • 1/3 cup reduced-fat mayonnaise
  • 2 tablespoons minced fresh tarragon or 2 teaspoons dried tarragon
  • 1 tablespoon minced shallots
  • 1 small garlic, minced
  • 2 teaspoons orange zest
  • 1 teaspoon Dijon mustard
  • 1/4 cup fresh orange juice
  • Tarragon sprigs, for garnish (optional)

Directions:

  • Preheat the oven to 425°F
  • Arrange the asparagus stalks in a single layer on an oven-proof baking dish. Drizzle olive oil over asparagus. Roast in the oven for 12 to 15 minutes until asparagus begins to brown, yet has cooked only until fork tender. When cooked, season to taste with pepper.
  • Meanwhile, make aioli by combining yogurt, mayonnaise, tarragon, shallots, garlic, orange zest and mustard in a small bowl. Mix in orange juice. Whisk to blend well. Season to taste.
  • Arrange the roasted asparagus spears on a serving dish. Spoon aioli over the top. Garnish with tarragon sprigs. Serve immediately.

Makes 4 servings; Per serving: 190 calories; 14 g total fat (2 g sat fat); 10 mg cholesterol; 14 g carbohydrates; 4 g protein; 3 g fiber; 180 mg sodium

Rosie O’Donnell Discloses Forty Pound Weight Loss after Weight Loss Surgery

 

Rosie O'Donnell undergoes weight loss surgery

Comedian Rosie O’Donnell recently disclosed that she has been able to lose 40 pounds after undergoing weight loss surgery. Approximately 8 months she underwent sleeve gastrectomy. She related that she had no success with numerous attempts at non-surgical weight loss over the years. Just as many of my patients, she decided to undergo the procedure after experiencing a serious health scare. In 2012, before the age of 50, she suffered a heart attack while coming to the aid of a women in the parking lot of a New Jersey mall. She subsequently underwent a cardiac stenting procedure. At the time she also had issues with high blood pressure, high cholesterol, and pre-diabetes. All these issues increase the risk of subsequent heart problems, and all are caused or made worse be having an unhealthy amount of extra weight. 

I congratulate Rosie O’Donnell on her weight loss and her decision to take control of her health. I would only add this piece of advice to others who might share many of Ms. O’Donnell’s issues:

Don’t wait until you have a heart attack to do something about your weight!

Not everyone survives their first heart attack. (or stroke, or sleep apnea episode, etc) The earlier you act the better. If you are overweight, start with a goal of not gaining any more weight. If you are more severely obese, again first stop gaining weight, then talk to your doctor or come to one of our free seminars to see if Lap-Band surgery or weight loss surgery might be right for you.

 

NEDAwarness Week is Feb 23 – Mar 1, 2014

I Had No Idea That Eating Disorders Can Destroy Lives

February 23 – March 1, 2014 is National Eating Disorders Awareness Week. The theme this year is “I Had No Idea” and the goal is to encourage others to “get in the know”about eating disorders and how destructive they can be.

Did you know:

  • eating disorders have the highest rate of death of any psychiatric disorder
  • nearly 4% of the US population suffers from an eating disorder
  • 1 in every 3-4 eating disorder cases affects males
  • binge eating disorder is the most common type of eating disorder (more common than both anorexia nervosa & bulimia nervosa combined)
  • more than 2/3 of youths with eating disorders have not received treatment, often due to lack of detection

Click here for simple-to-read definitions of eating disorders, as well as a few tips for how to help those who may be struggling.

For the past 12 years I have been working to help individuals fight their battles with various types of eating disorders through both group and individual nutrition counseling. Early intervention and treatment involving a qualified team of professionals who specialize in eating disorders (doctors, therapists, & dietitians, etc.) is essential in the recovery process. Recovery also requires a great deal of support from others as well as a tremendous amount of hard work and patience with one’s self throughout the process. However, recovery and self-acceptance IS possible. For more information and a confidential online screening tool, click here. Please do not be afraid to ask for help if you need it.

Kristine Van Workum, RD, CSSD, LDN

LifeShape Registered Dietitian & Owner of Brevard Nutrition (www.brevardnutrition.com)

Taco Pizzas

Source: http://www.elliekrieger.com/taco-pizzas

Ingredients:

  • 8 small corn tortillas (6 inches in diameter)
  • 2 tablespoons canola oil
  • 4 scallions
  • 3 cloves garlic
  • 1 tablespoon chili powder
  • ½ teaspoon ground cumin
  • ½ teaspoon dried oregano
  • ½ teaspoon salt
  • ¼ teaspoon cayenne pepper
  • ¾ pound lean ground turkey
  • 1 ear fresh corn or 2/3 cup corn kernels
  • ½ cup no-salt-added tomato sauce
  • 1 cup canned low-sodium pinto beans
  • ¼ cup low-sodium chicken broth or water
  • 3 ounces pepper Jack cheese (3/4 cup grated)
  • ½ cup reduced-fat sour cream

Directions:

  • Preheat the oven to 425F
  • Brush the tortillas on both sides lightly with 1 tablespoon total of the oil. Place them on 2 baking sheets and bake until crisp, 5-7 minutes. Remove from the oven, leaving the tortillas on the trays.
  • Meanwhile, heat the remaining 1 tablespoon oil in a large skillet over medium-high heat. Thinly slice the scallions, keeping the dark greens separate, and mince the garlic. Add the scallion whites and light green parts to the skillet and cook until translucent, 2 minutes. Add the garlic, chili powder, cumin, oregano, salt, and cayenne and cook for 1 minute more.
  • Place half of the scallion-spice mixture in the bowl of a small food processor and set aside. Add the turkey to the remaining scallion-spice mixture in the skillet and cook, breaking the meat up with a wooden spoon, until it is cooked through, 4 to 5 minutes. Meanwhile, if using an ear of corn, cut the kernels off. Add the corn kernels and tomato sauce to the skillet with the browned turkey and cook until most of the liquid is absorbed, 2 to 3 minutes.
  • Drain and rinse the pinto beans and add them, along with the chicken broth, to the food processor. Pulse until smooth, scraping the sides once or twice if necessary. Grate the cheese.
  • Spread 2 tablespoons of the bean mixture on each tortilla and top with about ¼ cup of the turkey mixture. Sprinkle a heaping tablespoon of cheese on top and bake until the bean puree is warmed through and the cheese is melted, 3 to 4 minutes. Remove from oven and sprinkle with the scallion greens. Cut each pizza into quarters with a sharp knife or pizza cutter and serve each with a dollop of the sour cream.

Makes 4 servings; Per serving (2 pizzas): 510 calories; 22 g total fat (7 g sat fat); 39 mg cholesterol; 47 g carbohydrates; 36 g protein; 8 g fiber; 540 mg sodium

Wear Red on February 7th!

go-red-for-women-logo

Focus on health and creating positive lifelong habits this year, rather than jumping into fad diets and deprivation. One way to focus on health is to plan for February 7, 2014 – it’s the 11th annual Wear Red Day! Since the first National Wear Red Day in 2003, research and education has helped to accomplish the following:

  • 34% fewer women now die from heart disease, saving 330 lives every day
  • Awareness is up: 23% more Americans now realize heart disease is the #1 killer of women
  • 15% have quit smoking, and high cholesterol has declined by 18%
  • Women no longer pay higher premiums than men for health coverage & 20 states have programs for low-income women to screen for heart disease/strokes through the CDC’s WISEWOMAN
  • Gender-specific medical guidelines & research is up, ensuring women receive the same level of treatment as men & recognizing gender differences in symptoms and responses to medications

Yet with all these successes, heart disease is still the No. 1 killer of women, killing almost 1,100 per day. It’s crucial we know the risk factors & warning signs, so read more below and focus on the ones we CAN control:

  • Smoking – If you smoke, resolve to quit. When you stop smoking, no matter how long or how much you’ve smoked, your risk of heart attack drops.
  • High Cholesterol – Know your numbers to know your risk; ask your doctor for a simple blood test.
  • High Blood Pressure – Have your blood pressure checked each time you visit your doctor.
  • Physical Inactivity – Get up and get moving. Nearly 38 percent of all women are sedentary. The American Heart Association recommends > 150 minutes of moderate exercise/week.
  • Obesity – Obesity isn’t an appearance issue, it’s a health issue. If you’re obese or overweight, you may have a higher risk of developing heart disease.
  • Diabetes – Have your glucose levels checked regularly, especially if diabetes runs in your family.

Warning Signs for Heart Disease & Stroke – Some heart attacks are sudden and intense, but most heart attacks start slowly, with mild pain or discomfort:

  • Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath with or without chest discomfort.
  • Other signs may include breaking out in a cold sweat, nausea or lightheadedness. As with men, the most common symptom for women is chest pain/discomfort. However, women are somewhat more likely than men to experience other common symptoms, such as shortness of breath, nausea/vomiting, and back/jaw pain. If you or someone you know has chest discomfort, especially with one or more of the other signs – call 911 ASAP!

Click here for more information on National Wear Red Day.

Kristine Van Workum, RD, CSSD, LDN

LifeShape Registered Dietitian & Owner of Brevard Nutrition (www.brevardnutrition.com)

Super Bowl Snack – Jalapeno Poppers (plan now for Feb. 2nd)

Source: http://www.eatingwell.com/recipes/jalapeno_poppers.html

Ingredients:

  • 12-18 whole fresh jalapeno (or mini sweet peppers)
  • 1 cup nonfat refried beans
  • 1 cup shredded Monterey Jack or extra-sharp Cheddar cheese
  • 1 scallion, sliced
  • 1 teaspoon salt, divided
  • 1/4 cup all-purpose flour
  • 2 large eggs
  • 1/2 cup fine cornmeal
  • Olive oil or canola oil cooking spray

Directions:

  1. Make a small slit on one side of each pepper & place peppers in a large microwave-safe dish. Cover and microwave on High until just softened, about 5 minutes.
  2. Meanwhile, combine refried beans, cheese, scallion and 1/2 teaspoon salt in a small bowl.
  3. When peppers have cooled, scrape out seeds with a small spoon; fill each pepper with ~1 Tbsp of bean filling, or until the pepper is full but not overstuffed. Close the pepper around the filling.
  4. Preheat oven to 450°F. Coat a large rimmed baking sheet with cooking spray.
  5. Place flour in a shallow dish. Lightly beat eggs in another shallow dish. Combine cornmeal and the remaining 1/2 teaspoon salt in a third shallow dish. Roll each stuffed pepper in flour, shaking off any excess. Dip in egg and let any excess drip off. Then roll in the cornmeal mixture. Place the peppers on the prepared baking sheet & generously coat all sides of peppers with cooking spray.
  6. Bake 5 minutes, turn each pepper over & bake ~5 minutes more or until hot & filling starts to ooze

Per popper: 87 calories; 4 g total fat (2 g sat fat); 39 mg cholesterol; 8 g carbohydrates; 5 g protein; 2 g fiber; 419 mg sodium

Click here for 25 additional healthy Super Bowl recipe ideas!