Vegan – a Path to Better Health?

Every vegetarian and vegan I know strongly defends their choice to abstain from eating meat and meat byproducts. And, with good reason, they obviously chose this lifestyle because they believe doing so will improve their health. Here’s the rundown on the pluses and minuses of becoming a vegan:

Benefits:
Higher intake of fiber, folic acid, vitamins C & E, potassium, magnesium and many phytochemicals (plant based healthy compounds).
Less saturated fat and cholesterol (beneficial? For some, possibly)
Vegans tend to be thinner, have lower total cholesterol and lower blood pressure reducing their risk of heart disease.
In general, vegetarians typically have lower rates of cardiovascular disease, obesity, type 2 diabetes and some types of cancer.

Drawbacks:
Vegan diets increase the risk of some nutrient deficiencies including vitamins B-12 and D, calcium, omega 3 fatty acids.
Iron and zinc status may be compromised because of the limited bioavailability of these minerals in a vegan diet (compounds in grains, seeds and legumes as well as some other foods and beverages interfere with the absorption of iron and zinc).

Recommendations
Consume B-12 fortified foods such as rice and soy milk and breakfast cereals (check out the Nutrition Facts panel).

Consume calcium-fortified plant foods such as breakfast cereals, fortified beverages, in addition to natural sources such as green leafy vegetables, tofu and tahini.

Consume vitamin D fortified foods.

Eat omega 3 rich vegetarian foods (which contain the omega 3 fat ALA) including flaxseeds, walnuts, canola oil, soy products, hemp seed beverages. Also, consider taking EPA and DHA supplements or eating foods and consuming beverages fortified with these two omega 3 fatty acids.

Click here for references.

Do Supplements Work?

Friday night, while looking at the Dali exhibit in the High Museum, my friend’s cousin asked me “do multivitamins work?” Startled I responded, “wow that’s one loaded question. Work for what? What result are you looking for?”

Neither supplements or the entire broad topic of nutrition for that matter, are cut and dry like an algebra problem. For x + y = z in your body, you must take the right form of the supplement, take it at the right time (with or without food; noting attention to specific types of foods that may help or hinder your supplement’s absorption) and look at how much you are taking at a time. In addition, to notice a benefit, many supplements need to be taken for a period of time, not just a one stop, pop it and bam! you feel amazingly better. Because of all of these factors, part of the responsibility of taking supplements falls on you, the consumer. But, here’s a quick cheat sheet for some common nutrition supplements.

In addition, I encourage people to follow this train of thought when considering a dietary supplement:

McDonald’s Happy Meals, Buy One Now, Eat it 6 Months Later

In a horrific display of food preservation, Sally Davies, a photographer and vegetarian, posted her McDonald’s science experiment on Facebook. She took a Happy Meal home six months ago and took pictures of it over time to see if it molded or changed the way we expect food to go rotten. Click here to see pictures.



First off, I have a difficult time believing this story since I’ve seen the changes in a McDonald’s hamburger bun after my 6 year old niece, Sticky Fingers (because she sneaks her fingers in icing when I’m decorating cakes), left part of her unfinished meal on the table for hours. It didn’t mold but it did start to get hard like fresh bread will if left out. Secondly, I’m wondering why the McDonald’s hatred? I don’t work for McDonald’s, I can’t recall the last time I ate there but, I can tell you their McCafé drinks are darn good, their portion sizes for anything not supersized haven’t morphed into linebacker-sized meals and there’s no study to date showing a direct correlation between fast food and the obesity epidemic.

Now I know what you are thinking, what is a dietitian doing defending McDonald’s? Here’s my take on nutrition: I take people where they are and help them make positive changes based on their lifestyle and goals. If I get a client who eats fast food daily because they work, have kids and are going to school and don’t have time to cook, we’ll look at the options available and explore better fast food choices. Though it sounds good on paper, it is completely unrealistic to think that everyone has the time, motivation or desire to buy all organic, local produce and grass-fed beef and make fresh meals every single day. And asking someone to do something they won’t do just sets them up for failure and frustration. Instead, I can direct them to better choices at home, in the grocery store and even at fast food chains (gasp!). Most fast food places have salads, Chick-Fil-A has delicious wraps loaded with vegetables, Wendy’s has the new “Pick 2”.



The choice is yours. You can get a McDonald’s hamburger for cheap, on the fly and just 250 calories while getting some protein and meeting 10% of your calcium needs and 15% of your iron needs. Or, you can go to a “fine” restaurant and blow a good part of your daily calorie budget on a thick, juicy burger and sides. Fast food isn’t making anyone fat but their choices at fast food restaurants, choices in the grocery store and lack of activity are likely to blame.

Beat Breast Cancer

This month is the 25th anniversary of Breast Cancer Awareness Month and though this is the 2nd leading cause of cancer in women, there are several things you can do to help decrease your risk:

1) Eat a diet loaded with colorful fruits and vegetables. According to the National Cancer Institute, fruits and vegetables are our best dietary bet for reducing our risk of this disease. Produce is loaded with antioxidants that may help us decrease the risk of some types of cancer. Aim for ½ - 2/3 of your plate from plant based foods.

2) Bone up on calcium and vitamin D. Some studies show that those with a higher intake of calcium and vitamin D from their diet, have a reduced risk of developing breast cancer.

3) Drink tea. Black, white, green and oolong tea are loaded with antioxidant polyphenols that may decrease our risk of some types of cancer. Add a slice of lemon, lime or an orange to further enhance your absorption of these disease fighting compounds.

4) Maintain a healthy weight and exercise. Overweight and obesity increases one’s risk of breast cancer, breast cancer recurrence and a poorer prognosis.

5) Aim for omega 3s. Omega 3s from fatty fish like salmon, mackerel, herring, halibut, sardines, anchovies and lake trout decrease inflammation and keep our cell membranes fluid in structure (this is important so insulin can bind to it’s receptor site on cell membranes and because rigid membranes hold estrogen in the receptor for a longer period of time).

6) Support the Susan G Komen foundation by buying products with the pink ribbon on them or running the Race for the Cure.

Vegetarian? Make Sure You Eat these Key Nutrients!

Vegetarianism is a healthy way of life for many. Some research shows vegetarians live longer, are leaner and their diets include more fiber and disease fighting antioxidants. There are four main categories of vegetarians and a fourth one for those who just don’t want to go all the way: Flexitarians. Here’s a brief description of all of these categories in descending order of how completely they follow a vegetarian diet in addition to what nutrients they need to be especially cognizant of consuming:

Flexitarian – a Flexitarian is someone who is a semi-Vegetarian. They choose vegetarian meals the majority of the time but sometimes fit in poultry or turkey. Most Flexitarians avoid red meat completely. Flexitarians are not really considered vegetarians but, their diet still consists mainly of plant-based foods. For more information, check out this book on the Flexitarian diet.


Pesco-vegetarian – this diet includes fish, eggs and dairy but excludes all meat and poultry. The main nutrient of concern for a pesco-vegetarian is iron. However, if you eat fish, opt for oysters and clams for your heme iron (the most well absorbed type of iron).

Lacto-ovo vegetarian – this person excludes meat, fish and poultry but eats eggs and dairy products. With good planning (and by including eggs and dairy) the lacto-over vegetarian can easily meet most of their nutrient needs (though they may fall short on iron, copper and zinc).

Lacto-vegetarian – meat, poultry, fish and eggs are excluded but milk and milk products (butter, cheese, yogurt) are allowed.

Vegan – this is the most strict type of vegetarian. Vegans exclude all animal flesh as well as eggs and dairy.

The top vegetarian sources of commonly missing nutrients:

Iron – vegetarians who avoid fish need about twice the amount of iron as non-vegetarians. Why? Vegetarian source of iron (non-heme iron) are poorly absorbed so you need more. Choose from fortified cereals, instant oatmeal, soybeans, lentils, beans (kidney, navy, lima, pinto), tofu, spinach, and black-eyed peas. Consume your iron rich foods with a source of vitamin C such as tomatoes and citrus fruits to enhance the absorption of non-iron. You can also cook in an iron skillet (add foods rich in vitamin C to your skillet meal).

Iodine – this forgotten nutrient is found in iodized salt. If you avoid salt, eat kelp.

Calcium & Vitamin D – dairy is your best bet. If you avoid dairy, choose calcium and vitamin D fortified soy or rice milk. Vitamin D insufficiency and deficiency is emerging as a huge issue in all people, vegetarian or not.

Vitamin B 12 – is found in animal flesh and animal products. Therefore, vegans are very likely to fall short on this crucial vitamin and should therefore focus on consuming fortified cereals (check for B12) and fortified tofu or, talk to your physician about taking a supplement.

Zinc – is found mostly in some types of seafood and meat. For vegans, opt for fortified breakfast cereals, cashews, almonds, kidney beans and peas.

Copper – sesame seeds, cashews, crimini mushrooms, cooked soybeans, cooked barley, sunflower seeds, cooked tempeh, garbanzo beans, navy beans.

Omega-3 fats – are mainly found in fatty fish. If you avoid fish, opt for walnuts, soybean oil, flaxseeds, hemp seeds, dark green leafy vegetables and canola oil. These contain the omega-3 fatty acid alpha linolenic acid.

In general, the more you cut out of your diet, the more diligent you must be to ensure an adequate nutrient intake. It can be done, though sometimes not through food alone and therefore supplements are necessary. Vegans, in particular, should consider supplementing with a B complex (which includes B12), iodine rich foods, vitamin D and calcium or consider a multivitamin which will help make up for dietary shortfalls.

What's the Point of a Raw Food Diet?

Every once in a while I pick up US Magazine, People or a similar publication while waiting in line at the grocery store (I know I know, I’m the only person around who isn't glued to facebook mobile). And, I always turn to the sensational (i.e. crazy) stories about how stars got their celebrity bodies. What they report about their diet is pure entertainment for me. Like the actress who said she didn't eat carbohydrates and then listed her daily diet which consisted of, among other things.....fruits and vegetables - both of which are otherwise known as forms of... *gasp* carbohydrate!

But when it came to Raw Food Diets, I pretty much ignored the stories. And then one day, while doing something random (probably driving) I sat there thinking and thinking trying to figure out why someone would take the deep plunge into a raw food diet.

Here are some of the benefits as I see it:
• Enzymes - that doesn't really jive though as our body has the enzymes it needs to break down food during digestion. Next...
• No Acrylamides. Acrylamides are formed during high temperature cooking and may be carcinogenic (cancer-causing) in high doses.
• No heterocyclic amines, carcinogenic compounds formed by cooking meat at high temperatures.
• Loads of fresh fruits and vegetables
• Little prep time

Drawbacks:
• Boring!
• Where’s the protein? If you can load up on fish (including oysters), you’ll get the protein and minerals you are missing if you cut out meat and poultry (zinc, iron, copper). If you don’t eat fish, good luck with many missing nutrients since fortified cereal is… cooked! PS, you need that fish for EPA and DHA (omega 3s) too so, enjoy your sushi!
• No dairy (and therefore little to no calcium or vitamin D – unless you want to eat 10 cups of leafy greens a day to get your calcium and bake in the sun for your vitamin D).

The raw food diet has some perks but some serious drawbacks as well. If a person is doing it solely for health reasons I think it should be a short-term thing. Otherwise, I just don't see the point of living without ever eating a nice chocolate dessert.

It's Time for a Diet Overhaul

You’ve heard about shopping the perimeter of the store. And by now you probably also know that creating a list and sticking to it (regardless of what is on sale) will help you save money by preventing you from buying food you either won’t use or probably shouldn’t be eating. But, have you ever considered taking a close look at your diet and considering if you need a overhaul? Here are some keys to a healthy diet as well as some food groups you should include in your diet (or supplement somehow).

1) Variety – eating a variety of foods increase the likelihood that you will obtain a wide variety of nutrients (vitamin, minerals) and antioxidants.

2) Consider the staples:

a. Dairy – got milk? Or yogurt or cheese? If not, try a calcium fortified soy milk, cheese or yogurt or, consider
supplementing with calcium + D (D especially in the winter in states north of Atlanta, GA).

b. Fruit – are loaded in vitamins, minerals and antioxidants to keep you healthy and functioning in tip-top shape. Most
adults need 2 cups of fruits per day. If you aren’t getting that now, consider adding fresh or frozen fruit to your dishes.

c. Vegetables – like fruit, vegetables pack a nutrient-rich punch. Think variety and different methods of cooking and
preparation. You can choose salads or opt for steamed veggies. Top your pizza with veggies or load your sandwiches,
soups and stews to get the recommended 2.5 cups per day.

*There really is no substitute for not eating fruits and vegetables. So, find ones you enjoy eating and load up (you can eat
more than the recommendations, especially for vegetables).

d. Lean meats & poultry – are your best bet for iron, zinc and ……How much you need really depends on what your
individual needs are but, every single adult should aim for 25-30 grams of protein per meal (yes, that includes
breakfast).

e. Fatty fish – salmon, mackerel, herring, halibut, sardines and anchovies are packed with EPA and DHA, the two fatty acids
that are best for preventing certain risk factors for cardiovascular disease as well as potentially decreasing the risk for
depression in some individuals – notably women and the elderly). How much do you need? I use the American Heart
Association’s recommendations: eat at least
two 3.5 ounce servings of fatty fish every week (after all, cardiovascular disease is the number one cause of death
in men and women in the U.S. as well as many other countries). If you don’t consume fatty fish, add walnuts, flaxseeds
and flaxseed oil to your diet or, talk to your physician about omega 3 supplements.

When you add any of these foods that are missing to your diet, you will force out some of the not so healthy foods that you are eating while adding a variety of nutrients you need for optimal health.

Low Calorie Diet Concerns

Low calorie diets have their place – they can help morbidly obese persons shed weight rapidly thereby modifying their disease risk factors and enhancing their quality of life. But, for the person who needs to lose 20 lbs or so, low calorie diets are not my favorite option unless they use them for a short period of time (2 weeks or so) or alternate low calorie days with higher calorie days (this takes diligence and commitment).

Why the distain for very low or low calorie diets? According to research out of Baylor University, conducted on Curves participants, a low calorie diet can quickly drop metabolism which means you are burning fewer calories at rest (in this particular study, they put women on a 1,200 calorie diet for 2 weeks). And that counteracts exactly what you are trying to do.

Secondly, low calorie diets can make you feel fatigued (especially if you aren’t eating the right foods). And when you are lethargic, all you want to do is sit on the couch – not exactly a good prescription for weight loss.

And lastly, low calorie diets often make it tough to get all the nutrients we need everyday. You have no calories to spare when you aren’t eating much, which means every single food must be packed with nutrition value. And, even then, you won’t meet your nutrient needs making a multivitamin and possibly supplemental vitamins or minerals (in addition to the multivitamin), very important. Some of the most obvious nutrient deficiencies and the foods you must eat to obtain enough of each nutrient include:

- Omega 3s ~ fatty fish
- Vitamin D ~ salmon, mackerel, fortified milk, some yogurts, some mushrooms, sunlight
- Calcium ~ dairy
- Iron ~ red meat, dark turkey meat, chicken
- Magnesium ~ halibut, mixed nuts, cereal

If you want to try a low calorie diet, do so only under the care of a Registered Dietitian and/or a physician who specializes in bariatrics (few physicians are versed on diet and nutrition but bariatrics is the study of obesity).

Micronutrient Smackdown: The Best Time to Take Your Vitamins and Minerals

When I meet with people for nutrition coaching, I always ask about their medicine and supplement intake in addition to what they are eating. Why? Because I can quickly spot gaps in their diet and want to be sure they are filling those gaps with supplements. Especially if they don't plan on adding food sources of the missing nutrients in the near future. And, I want to be certain they are taking their supplements the right way because many people were never told by their physician (or the supplement bottle doesn’t mention this) how to take a particular mineral.

You see, like sorority girls, minerals are finicky. There are many forms for each one (calcium carbonate, calcium citrate, calcium phosphate for example) and some just don’t like each other (calcium interferes with iron absorption) or certain medications (calcium decreases the absorption of some antibiotics) and others have formed a team and help one another (magnesium and calcium for example). So, how do you know what to take when? Here’s a quick rundown of some of the common ones people need and how to take them:

Multivitamin – take with food and preferably food with a little fat (to enhance the absorption of fat soluble vitamins you need fat in your gut).

Calcium – take up to 600 mg at a time. If your physician told you to take 1,200 total mg/day, take them in two separate doses of 600 mg, spaced apart. Your body only absorbs up to 500-600 mg at a time.

Calcium carbonate – take with food to enhance absorption.
Calcium citrate can be taken at any time of the day.

Magnesium – no single pill multivitamin contains 100% of your magnesium needs per day (it is a very big mineral) and according to population based data, many people don’t consume enough magnesium through their food intake. Diuretics and antibiotics can contribute to magnesium depletion. Magnesium can decrease the absorption of tetracycline (an antibiotic); so take it at a different time of the day. Many antacids and laxatives contain magnesium –be careful consuming these due to the potential for elevated blood magnesium levels. Enteric coating of magnesium supplements can decrease their absorption.

Iron – there are two types of supplements.
Non-heme iron is the most popular (all over the counter kinds of iron unless it says it contains heme iron) and should be taken with vitamin C rich foods, a heme iron source (meat) and not taken close in proximity to calcium containing foods or supplements. In addition, it’s best not to take this with leafy greens or bread as each has compounds that decrease the absorption of non-heme iron.

Heme iron – easy, take anytime of the day. You don’t need to worry about what you take it with or without.

Zinc – taking an iron supplement with large quantities of iron may decrease zinc absorption. According to NIH, taking iron between meals will help (see note above about iron). High intakes of iron can impair absorption of copper.

Potassium – found in very minor amounts in multivitamins. Don’t take extra potassium unless your physician tells you to do so. Having too much or too little potassium can be very serious.

Given that so minerals are picky and like to be treated a certain way, you are probably wondering why you should even bother taking a multivitamin mineral supplement. However, I do believe in multis and take one myself and I supplement with minerals as needed. After all, I try to eat a wide variety of foods but, I realize that there are probably vitamins and minerals I am missing out on.