Nutritionality

Our Nutritionist:

Mary (Howley) Ryan, MS, RD from Beyond Broccoli 

Mary Ryan is a Registered Dietitian with a Master of Science degree in Foods & Nutrition and the founder of Beyond Broccoli Nutrition Counseling formerly based in Jackson Hole, Wyoming and now in the process of re-settling in Seattle, Washington.  She has turned her passion for healthy, whole foods towards helping people understand and use nutrition to achieve and maintain good health.

The Salty Truth

Salt is the latest nutrient under fire. Health advocates are clamoring for regulations to address public health issues and the food industry is balking due to the challenges associated with making processed foods taste good with less (or no) salt. Despite the fact that we’ve known for more than 30 years about the link between excess sodium intake (salt is 40% sodium and 60% chloride) and high blood pressure (a risk factor for heart disease and stroke), little has been done to reduce the amount of salt in processed foods found both in restaurants and on grocery shelves.

One problem is that processed food doesn’t taste or look as good without salt. In addition to preserving food, salt provides and enhances natural flavors, covers up bitter and other unpleasant flavors that may be present in foods, and contributes to both the texture and color of many processed foods. As we have increased the amount of restaurant, packaged, and other processed foods we eat over the past few decades we have acquired quite a taste for the salty stuff. (By the way – this tidbit of info is important. We have acquired a taste for excessive amounts of salt…we aren’t born with this hankering.)

 A recent NY Times article gave a fascinating account of the food industry’s struggles with the whole salt issue, past and present. (It’s a good read if you have a few minutes and an interest in the subject.) But what I found most interesting about the latest industry response is that they claim the only way to reduce the salt in many processed foods without sacrificing flavor (and in many cases texture and color) is to use more expensive ingredients. Of course this would dip into industry profits and probably still raise the price of these foods for us consumers. But wouldn’t that make all of the highly engineered and processed foods that have been tempting people away from healthier foods more in line with the “true cost” of such foods?

  These hidden costs of processed foods include both health and environmental impacts. All of that processing requires energy and wide range of resources. Unfortunately, when we draw attention to the fact that our food supply needs a lift in terms of quality and it may be time to pay the “true cost” of such foods the elitism accusations start flying. It is a disturbing reality that many of our country’s poorest people do not have access to fresh foods or cannot afford them even when available. This situation is criminal and though it’s currently being addressed in some places, this problem definitely needs more attention.

 In the meantime, for those of us who have access to whole or minimally processed foods (like the incredible selection at the Jackson Whole Grocer!) the salt issue provides added incentive to make changes. The food industry is making some effort to lower the sodium content of some processed foods so if we choose these options when we do buy packaged and processed foods we will spur their efforts along. Now that the growing season is upon us in the mountains (or close anyway) we can re-train our palates to enjoy the inherently flavorful fresh foods from gardens, farmers markets (including the in-store farmer’s market at the JWG), CSAs, grocery stores, and restaurants that feature these foods. Because the industry representatives are right about one thing – higher quality ingredients is what makes food taste good!

  

 

 

 

Make Beans Taste Good

You’ve heard it before – beans are good for you. (I use “beans” here to describe legumes or dried beans, peas and lentils.) Beans are high in fiber, plant protein, vitamins and minerals…help lower cholesterol, balance blood sugar, fill you up with fewer calories than many animal foods, keep you “regular,” blah, blah, blah. Add to the list that beans are cheap and the question becomes “why not eat beans?”  I often hear in response “but I don’t like beans” or “I like beans but they don’t like me – if you know what I mean” or “beans are so boring.”

So, here is the secret: make beans taste good and learn how to make them easier to digest.

First: digestibility. Humans do not naturally produce the enzymes needed to break down certain sugars in beans. The bacteria in our digestive tract are left to this task – a process that can cause flatulence when beans are not consumed regularly or are eaten in large amounts. Some natural foods that can help you digest beans include the sea vegetable kombu, and the spices cumin, anise and coriander. Soaking dried beans prior to cooking and using fresh water to cook the pre-soaked beans can also reduce the level of indigestible starches in the cooked beans.

Sprouting is another way to increase the digestibility of some beans – especially lentils, mung beans and garbanzo beans (or chick peas). Soak beans (1 cup dry: 3 cups water) overnight or at least 8 hours. (Variety and age of beans affects time required for soaking and sprouting.) After soak, rinse beans thoroughly and place in a jar with holes in the lid or spread on a baking sheet covered with cheesecloth. Allow to sprout for 3-4 days. Beans will be crunchy but not hard and have small white “tails.”

Second: taste. If you have an adventurous palate then look to ethnic cuisine to help you learn how to make beans taste delicious. Indian, Mexican, Thai, Japanese, Chinese, Middle-eastern, Mediterranean, Cuban, and many other cultures use beans as staples in many dishes. If you eat at ethnic restaurants order bean dishes so you can try different flavors and get ideas. Peruse ethnic cookbooks or cooking websites to find recipes that use beans.

Another way to introduce beans is to replace half (or all) of the meat in your favorite recipes with some kind of bean. White beans are great in pasta dishes and chicken soup; black beans in tacos, burritos or mixed into salsa; edamame (green soybeans) are delicious in stir fry or mashed with some lemon juice and salt as a spread for crackers. There are many varieties of hummus (traditionally made with garbanzo beans or chick peas) that make great dips for veggies or sandwich spreads. One of my easy summer go-to meals is grilled fish or burgers with baked beans and salad.

For the record, eating more dietary fiber in any form can cause digestive distress (fruits, veggies, whole grains, and beans) but beans tend to get the bad rap for these effects. If you decide to dramatically up your intake of plant foods, drink more water and eat more cooked than raw foods until your body adjusts. The time it takes to adjust to a high fiber diet varies quite a bit from person to person so listen to your body – but don’t give up, it’s worth the effort!

Pitfalls for Parents of Active Kids

The June issue of the Jackson Whole Grocer Newsletter includes an article about keeping healthy carbs on the menu to support active summer lifestyles. Here I’d like to draw attention more specifically to active kids. “Active” means child or teen athletes in organized sports, dance, martial arts, or the plethora of outdoor activities in our mountain community. In an attempt to keep kids healthy some parents either consciously or subconsciously restrict calories in general and carbohydrates in particular. Here are some common examples:

• Parents refuse to give kids a sports drink because it has “too much sugar.”

There is no question many kids and adults eat and drink way too much added sugar. The problem here is that “sugar” is the whole point of a sports drink. Sugar is easily converted for energy during physical activity. While a sports drink may not be necessary if the activity lasts less than 60-90 minutes, during the summer months the heat, altitude (when playing up in the mountains), and dryness all add to your kids’ fluid needs.

Sports drinks can be an easy way to help kids fuel their activity, replace the stored carbohydrate (also called glycogen) used in activities, along with some electrolytes and fluid lost in sweat. There is no magic in these drinks but they are also not the worst thing your kids can have – especially when they are active. There are many recipes online to make your own version of a sports drink if you prefer to use honey or pure maple syrup in place of the white sugar or High Fructose Corn Syrup found in many commercial products (this will save you money too).

• Parents feed the whole family a low carb diet.

Many adults choose to restrict carbohydrates as a way to lose weight. Though this approach can work and there are many nutritious versions of low-carb meals, this is not appropriate for active kids – even if they are overweight. Certainly choosing healthier carb foods like fruits, starchy vegetables prepared with their skin (and not deep fried!), whole grains, and legumes is a good strategy for overall health. But feeding your active kids a hunk of protein and green salad for dinner after an active day of sport or other activities does not allow them to replenish carb stores (glycogen). This is especially important when they are consistently active and can affect their energy levels, irritability, and mood the following day.

For active kids there are situations when more refined carbs like bagels, crackers, and chocolate milk may be better for quick energy before or after a sports event, or between multiple events (soccer tournament). Meals or snacks made up of foods high in fiber, fat or protein take longer to digest – even if they are “healthy” foods.  Think of the healthier, nutrient-dense foods as your kids’ nutritional foundation and the more refined foods (and beverages) that digest quickly as fuel for activity.

• Health or weight conscious parents unknowingly restrict calories of active kids.

Active kids need calories to grow and to fuel their activities. If they aren’t getting enough calories they are not getting enough of other important nutrients like carbohydrates, proteins, fats, vitamins, minerals, and phyto (plant) nutrients they need to grow, build bone, and play hard. While it is easier to make changes in the whole family’s diet for foods like low or nonfat milk and yogurt or not buying certain snack and dessert foods, active kids may need more calories than other members of the family. Additional access to healthy foods for between meal snacks like fruit and veggies, whole grain crackers or bread and nut butters can help active kids get enough fuel.

• Too big of a gap between meals.

This is a problem for many adults too but for kids it can be especially difficult. During the school year this is particularly challenging for active middle and high school kids who don’t have scheduled snacks and lunch time may be several hours after breakfast or before after school activities. During the summer months this can be challenging due to less structure during the day. As a general guideline, active kids probably need something to eat every 3-4 hours. (This is also a strategy that can help adults trying to lose weight or maintain a healthy weight.) Crabby moods or sudden fatigue are a couple of signs your child or teen may need a snack or a drink.

Annoying Anti-Organic Food Headlines

As I scanned the nutrition headlines this week I was annoyed by a Reuters Health article: “No Evidence Organic Foods Benefit Health: Study.”The article reports on a recent review published in the American Journal of Clinical Nutrition by a team of British researchers. The researchers pored through all of the scientific articles published in the past 50 years related to organic food and health. Apparently they found nothing to suggest organic is “healthier” and in the final evaluation only 12 of the 162 articles met their criteria as acceptable studies.

The part about this article that annoys me is that headlines like this take our attention away from some really important issues related to organic foods and overall health. In fact, the final two paragraphs of the article are probably the most important information and didn’t make headlines. This is where the researchers point out that both people and the environment may benefit from organic foods because these foods are made without the use of conventional pesticides, synthetic fertilizers, antibiotics or hormones. The current study did not look at the possible health benefits of “reduced exposure to those substances.” This begs the question – why are we giving so much attention to studies that aren’t investigating the most important questions?

There are studies that compare organic versus conventional foods and find higher levels of specific nutrients and beneficial plant compounds in the organic foods. But now that organic foods have gone main stream there is likely a difference in the nutrient content of organic foods that come from large scale production and have a long journey to your table, compared to the produce you get from your local organic farmer. In fact even local conventional produce will likely have higher levels of these nutrients than its jet-setting counterparts. However, the comparison of specific nutrients still misses some key points in the “organic vs. conventional for best health” discussion.

First, we are slowly learning about some individual chemical compounds that may cause or contribute to the development of cancer, interrupt the work of important hormones, or mess with our immune cells. We don’t know the long term health impacts of the chemical cocktail we are currently exposed to from combined food, air, and water, and frankly we may never know. Think about it. How would you begin to design a study that looks at what each of us gets from all of these areas? (Not to mention confounding factors like exposure to nasty off-gassing from carpeting, new car upholstery, passing traffic on our daily lunchtime walk,…it is overwhelming to think about!)

I have observed that many people who are concerned about the health of humans and the planet shift towards eating more organic foods. Lately the trend has expanded to include more locally produced food when it’s available and this food may or may not be USDA-certified organic. Movies like Food, Inc. and books by popular authors like Michael Pollan, Barbara Kingsolver, Marion Nestle and Alice Waters have raised the general consciousness related to our industrialized food system. Though “organic food” no longer solely represents the radical minority of counter culture hippies and tree-huggers it still represents change.

When you buy organic, especially in a depressed economy, you need to really think about your food choices because it is generally more expensive to buy these foods. The upside to this switch from a nutritionist’s perspective is that spending more money on organic foods can leave less money for the junk food that truly endangers our health. Sure there is organic junk food too but even those purchases may help behavior if the added cost of choosing organic chips or cookies means you eat fewer of them or eat them less often. These are observations I’ve made based on both clients in my practice and customers I’ve spoken with at the Grocer – there is no research to back me up on these benefits but to dismiss the possibility is a mistake.

Finally, we really need to break away from our nutrient focus when it comes to food. Yes, Medical Nutrition Therapy used to manage specific diseases or conditions does evaluate nutrients to make sure people get enough of some and not too much of others. But in general, as Michael Pollan and others so eloquently point out, we eat food not nutrients. We need to think about the quality of the food we eat and how it is grown or raised. We need to think about where it comes from and the resources needed to get it from farm to fork. Our health depends on a much broader view of nutrition than inflammatory headlines like the one that started this rant depict.

The good news is that there are a lot of people who aren’t waiting for the double-blind, placebo-controlled clinical studies to tell them what to eat. They are choosing food based on this broader notion of collective health for humans and the environment. Choosing organic foods does not guarantee we will be healthier but it certainly demonstrates that we are at least thinking more about what we eat.

Lactose Intolerance Isn’t All or Nothing

As part of this month’s “milk alternative” theme at the Grocer I decided to delve into some research about lactose intolerance since this is a common reason many people choose to avoid or limit dairy.  There is a lot of confusion about what lactose intolerance is and how to deal with it.

People with lactose intolerance do not make enough of the enzyme lactase needed to fully digest lactose, the natural milk sugar in dairy. Lactose intolerance shows up as a collection of symptoms including diarrhea, abdominal pain, flatulence, and/or bloating that occurs after eating or drinking lactose. The symptoms usually appear within 30 minutes to a couple of hours after eating (or drinking) the dairy.

Lactose intolerance symptoms vary individually and are influenced by several factors; the amount of lactose in the food or drink, whether the dairy is part of a meal or eaten on an empty stomach, the degree of enzyme deficiency, and other factors related to digestion. Yogurt and kefir are often tolerated because the “good bacteria” used to make these foods produces lactase enzymes to help with digestion. High fat dairy foods, especially when made in traditional ways using fermentation and aging, are also tolerated well since they have little to no lactose in the final product. Unfortunately modern manufacturing practices often add milk solids that increase the amount of lactose in various dairy products, including some yogurts and cheeses. Also, lower fat or fat free dairy foods have a higher percentage of lactose, even without added milk solids.

Healthy babies worldwide from every ethnic and racial group produce lactase and can digest the lactose in human milk or infant formula. At some point after weaning most children produce less of the necessary lactase enzyme and experience some level of lactose malabsorption. In fact, the ability to digest lactose as an adult is thought to be a genetic mutation that developed roughly 6,000 – 7,500 years ago in Europe and certain parts of Asia and Africa by nomadic tribes who relied upon animal milk for nutrition.

According to Wikipedia the Greek physician Hippocrates (460-370 BC) first described “gastrointestinal upset and skin problems in some who consumed milk” though it wasn’t until the 1950s when international famine relief organizations began their efforts outside of Europe that lactose intolerance was recognized more widely. Roughly 75% of adults worldwide are thought to show some lactose malabsorption with much higher percentages in some African and Asian countries. The estimated percentage of lactose intolerance is also  high among many Pacific Islander and Native American populations and lowest among northern Europeans.

There is apparently debate about exactly when the genetic mutation that enabled many adults to tolerate dairy occurred and it is likely this happened at different times throughout different parts of the world. I have often thought that the Traditional Chinese Medicine recommendations to avoid dairy stem from the high prevalence of lactose intolerance in many parts of China and Japan.

A recent NIH conference on “Lactose Intolerance and Health” looked at the current research to determine the prevalence of lactose intolerance here in the U.S. and its affect on health. The official consensus from this conference is that we don’t really know much about either of these issues based on the research that met their criteria as acceptable. Some people self-diagnose lactose intolerance but may not be according to medical tests (and of course not everyone likes all of the tests used for diagnosing LI) so deciding who really is lactose intolerant and who isn’t, is apparently tricky.

Current research shows even those with lactose intolerance can take in at least 12 grams of lactose at a time (the amount in 1 cup or 8 oz. of milk) with minor or no ill effects. So, of those people “properly diagnosed” with LI, many still consume some dairy and we may not need to worry about deficiencies of key nutrients found in dairy.

Many dairy foods, such as cow milk, are excellent sources of calcium, protein, magnesium, potassium, riboflavin and often fortified with vitamin D (that helps calcium absorption). The main health concern is that younger people with lactose intolerance, especially teens and young adults still developing bone mass to last the rest of their lives, may not get enough of these nutrients essential for bone health without dairy.

The NIH panel does say there is no evidence to support a decrease in dairy consumption is a problem right now and all of the nutrients in milk are available in other foods. I think it’s also important to recognize that many of the countries that don’t consume dairy are perfectly healthy (assuming they aren’t suffering from malnutrition of course, due to a lack of food). The traditional Okinawans of Japan come to mind, a culture that has been studied extensively because of their renowned longevity and excellent health.

Milk without Cows

Years ago I put together a class called “Calcium without Cows” in response to the many people I met who either could not or preferred not to eat or drink dairy. Since much of the mainstream nutrition education material is sponsored by the Dairy Council it is difficult to find lists of non-dairy food sources of calcium. While it is true that many dairy products, especially milk, have quite a bit of calcium per serving compared to say spinach or almonds, it is also true that we absorb small amounts of calcium more efficiently and that we need many nutrients in addition to calcium for healthy bones.

The trend away from dairy has led to a plethora of alternative “milk” options made from nuts (almond, cashew, coconut), seeds (hemp), legumes (soy), and grains (rice, oats) boasting a variety of nutrients, textures and flavors. For those accustomed to traditional cow or even goat milk these substitutes can be an acquired taste. Some of these milks are fine poured over cereal or blended into a smoothie but are less appealing naked in a glass. Others are almost dessert-like and the perfect companion to a PBJ lunch or afternoon snack.

I find people are very animated about their alternative milk choices – some vehemently eschew anything with soy or evangelically embrace coconut and hempseed. To some extent we are all subject to the biases of health professionals, books, websites or nutritional approaches that resonate with us, combined with what tastes good (or is at least acceptable while we “acquire” the taste!). The truth is there are many reasons people choose to avoid dairy and either enjoy or avoid certain alternatives that may not be backed by research (or even basic biochemistry and physiology) and that’s fine. There are plenty of populations that live very well with and without every one of the “milk” options – including dairy.

The bottom line is: if you choose to avoid dairy and still want to drink milk you have many choices. Experiment and find what tastes good and fits with your nutritional beliefs (some of this may also be tied to politics and the environment – avoiding GMO crops, choosing organic ingredients). Many places that offer alternative milks for smoothies or lattes are happy to let you sample the options. Also remember that if you are concerned about your bones regular doses of sunshine and exercise are just as important as what you eat!

The Not-So-‘Sweet’ Update on Agave Nectar

When agave syrup or nectar first hit the health food store shelves it seemed like the perfect answer to our sugar woes. Health conscious consumers fed up with refined sugar and High Fructose Corn Syrup (HFCS) in just about everything, welcomed this new “natural” sweetener that boasts a low Glycemic Index (GI) and is considerably sweeter than table sugar (theoretically this means we can use less of it). Agave marketing painted a lovely picture of tapping the agave plant (a cactus-like succulent), similar to the maple syrup extraction process, and sharing an “ancient secret” to sweeten everything from tea to baked goods. Unfortunately the real agave nectar story is not so ‘sweet.’

First, the idyllic maple syrup scenario does not appear to match commercial production of this “natural” sweetener and these processes (much like HFCS production) are not easily duplicated in a home kitchen. There are different methods used to extract what becomes the syrup of agave depending on the variety of agave used. While I suspect there was a “traditional” more simple method of collecting juice from the agave plant and boiling it to make syrup, modern production involves a complex process that uses enzymes and heat (or a “raw” method using enzymes from a particular mold).

In addition to the not-so-natural industrial processing of agave, the high content of fructose in the final product is perhaps most troublesome. Estimates of the amount of fructose in agave syrup varies but is anywhere from 56% to 92%, compared to 55% in HFCS commonly used in beverages. Problems linked to excessive fructose intake include high tryclycerides (blood fats) and uric acid formation (associated with gout) as well as high insulin levels and decreased glucose tolerance, issues in metabolic syndrome and diabetes. (I suspect the HFCS industry is celebrating the news about agave nectar’s high levels of fructose after battling bad publicity over the fructose in its products for several years now!)

Another potential problem with agave products is that some species of agave contain natural steroid compounds (anordin and dinordin) with contraceptive and anti-fertility effects. Though the real risk of these effects is not known due to various species and processes used to make agave syrup, this is certainly something consumers may not want to risk given there may be no real benefits to eating agave nectar after all.

Finally, while the Glycemic Index of agave syrup is low, some agave nectar products are mixed with HFCS, maple syrup or other substances that can alter its glycemic effects. Low GI foods cause less of an insulin spike after eating them (with MANY caveats – but that’s a story for another blog), so a sweetener that doesn’t wreak havoc on blood sugar levels is a plus. Unfortunately not all of the agave nectar research related to people with diabetes (who theoretically stand to benefit most from such a product) is positive, and one lab that initially gave a “diabetic friendly” seal of approval to agave syrup has since rescinded its support. And for the record, while a sweet food that doesn’t spike blood sugar may be helpful it takes more than that to make a food healthful.

So, as one of the “health-conscious consumers” who thought I’d found a new alternative to refined sugar or HFCS, I do feel duped. I wasn’t in search of a magic bullet for my sweet tooth and am not obsessed with my sugar intake but deceptive marketing is a pet peeve of mine. Despite the speculation about the dangers of agave syrup there is not much research to back up the claims at this point so while I don’t recommend it, nor do I condemn it, yet.  I happen to like the taste of agave nectar and have found uses for it where pure maple syrup or raw honey aren’t so easily used (like stirring it into iced tea), but I don’t think I’ll replace the bottle in my fridge when it’s gone.