Don't be burned but heartburn meds

If you’re someone who takes medicine daily, any medicine, it’s important to step back and consider whether you still need to be taking it. I’d also brush up on the side effects. While I’d love doctors to focus on getting patients off unnecessary meds, let’s face it medicine is a business. But if you, or someone close to you, are one of the 15 million Americans who take a certain type of acid blockers, there are some serious side effects.

There is a class of acid blocking (“heartburn”) meds called PPIs. Examples of PPI’s are Prevacid, Nexium and Prilosec. The concerns about taking these meds long-term have been out there; however, almost daily I have a client in my office who feels they’re totally safe.

Whenever I see one of these meds in a new client’s chart I ask a few questions.

How long have you been taking this medication?

Have you tried going off of it?

What modifications do you make in your diet for your reflux or heartburn?

The answers are quite similar. Most clients have been on their acid blockers for a while- usually years. They haven’t tried to discontinue them and they “can eat anything on these meds so there’s no need to change their diets.” Sigh. It’s so backward. The meds are like pain killers; they aren’t improving the condition. And just because you “can eat anything” doesn’t mean you should.

Stomach acid has important functions. We need an acidic environment for maximum vitamin and mineral absorption. On PPIs you see more bone fractures because calcium absorption is compromised. There have been cardiac side effects researched as well. There is an increased heart attack risk on PPIs. There’s also less gut diversity or less “good” bacteria when there’s less acid. Our gut flora is connected to mood and food cravings. Stomach acid helps digestion and prevents infection.

These meds should be used short term or occasionally. If you are interested in going off of your PPIs, you need to wean yourself gradually you can have rebound symptoms. As you decrease your dose, address your diet. For starters, try decreasing alcohol, sugar and caffeine. You can try a spoonful of apple cider vinegar diluted with water before meals. I also like a probiotic, vitamin D and glutamine supplement to restore your gut health.

While I only focused on these acid-blocking medications, talk to your physician if you are interested in discontinuing a particular drug. And yes, there are certain cases where you absolutely need a particular med, even the acid blockers. More often than not, this isn’t the case.

Paula Deen: from Burgers and Butter to Diabetes and Drugs

Did y'all hear? Soon I'll sell the pills with my cookbooks- no need to change a thing.

Paula Deen, the queen of fried everything, has diabetes and a lot of people are fired up about it. Janet Helm, on her Nutrition Unplugged site, wrote that the size of Paula's following comes with a certain responsibility. Initially I disagreed. Though Paula takes unhealthy to new heights, that’s her shtick. I don’t necessarily feel chefs have a responsibility to cook the way I do. And whether it’s Paula Deen, Mario Batali or Ina Garten (who loves olive oil as much as Paula loves butter) I often adapt recipes keeping the flavor profile and cutting the calories. I don’t think Paula is any more responsible than the cupcake shop on my corner for my health.

I wouldn’t wish diabetes on anyone but, if anything, this reminds me of the 80’s Partnership for a Drug Free America commercial with the fried egg (this is your brain, this is your brain on drugs). If Paula was previously this smiley sugary chef now she’s the “this is what happens when you cook (and eat) like this.” The Paula Deen diabetes headlines will do more for people rethinking her cuisine then any adapted recipe ever could.

Many feel Paula has withheld this news. She has had diabetes for three years but hasn’t shared it publicly. On Today she told Al Roker “I wanted to wait until she had something to bring to the table.” What she meant is, she wanted to wait until she could announce her relationship with Novo Nordisk (her diabetes drug).  Oh yes, there’s a website too “diabetes in a new light” but let’s be clear the lifestyle filler is on the drug company’s site and they are paying her as their spokesperson.  When asked about her style of cooking Paula downplayed the food connection and said it’s “part of the puzzle” and then talked up genetics and stress as cofactors. This could’ve been spun so well. Paula could’ve said,  “I cooked like this for years and now I’m making some changes.” Instead, it’s I’ve cooked like this and now I’m taking a drug. I don’t know if I’ll be able to make my favorite Bobby’s Baked Chicken with Dijon and Lime (using Greek yogurt instead of mayonnaise) ever again.

What do you think of the Paula Deen news? Have you ever made her recipes? Isn't a chef working for drug company like a distillery teaming up with a liver transplant unit? 

Birth Control or Weight Control?

What in this purse may affect your weight? 

Many clients come to see me for the first time when their doctors inform them their cholesterol or blood sugar is elevated. They want to improve their diet in order to avoid going on medication. I totally get this; after all why take something pharmacological if you don’t have to? Every medication can have side effects. What I don’t understand is why millions of young (and not that young) women take birth control pills without a second thought. Whether it’s a pill, injection, patch or “ring”  we should think clearly about this before taking something hormonal every day for years and years.

Then there’s the question of weight gain and certain birth control methods. Many doctors will tell you that the Pill and weight gain is a myth. Katherine O’Connell MD, of Columbia University was quoted saying, “women seem to learn early to blame a lot of side effects on their birth control. But, when women were given placebo (fake) birth control pills in recent studies, they reported the same physical complaints – including weight gain – as women who were popping the real hormone-rich Pill” Many studies echo these conclusions.  There trouble with this research is that it’s hard to determine causal relationships when many women in their 20’s (college aged) and 30’s (childbearing, aging) gain weight anyway.

Doctors also emphasize that the pills of today are innocuous compared to the early versions of birth control. The older generation of pills contained significantly more estrogen and physicians admit these were capable of causing weight gain. I have an issue with this threshold reasoning. You see it often with food ingredient research “at these levels there is no cause for concern.” Concern is concern and my thought is that today’s pills range in their hormone content and who’s to say what dose produces what effects in certain people. The reason studies may not tease out obvious trends is that everyone’s system reacts differently.  A Mayo Clinic piece mentions that estrogen can make adipose cells larger but not more numerous. Larger fat cells = weight gain.

If there’s one form of birth control that clearly produces weight gain it’s Depo Provera a progesterone-only shot (Depo-Provera contains a synthetic form of progesterone called progestin). This was touted for its convenience since it’s needed once every three months and almost foolproof when it comes to pregnancy. However, would you trade convenience for going up a couple of clothing sizes? In a study in the American Journal of Obstetrics and Gynecology in March 2009, 700 women were allowed to choose among various contraceptive methods and then were followed for three years to measure their gain in weight and body fat. Those who chose the Depo shot gained an average of 11 pounds over three years. An interesting theory is that the progestin only birth control (Mirena IUD is progestin only as well as are “mini pills”) may decrease insulin sensitivity which would increase the likelihood of fat storage.

In my work with clients, many women have symptoms when starting a pill that often dissipate at about the 3-month mark. For others, you can tell a pill does not agree with them,  hormonal symptoms do not resolve and their weight continues to rise or not drop despite eating well and exercising. A WebMD article I read stated, “weight gain is an uncommon and temporary side effect to the pill, if you happen to be one of those few women who put on pounds, talk to your doctor. Your doctor may suggest a different type of birth control pill. Why? Because all pills are not the same.” While there are many reasons and motivations to take the pill, there is another option and that’s no pill at all.
Do you take the Pill? Ever had a pill that didn't agree with you? Any concerns about the safely of birth control pills or side effects?

10 Sneaky Sources of Salt

We all have a friend or family member who, like my husband, often reaches for the saltshaker even before tasting their food. Perhaps this person is chided for their overzealous shaking; perhaps not. But the truth is that even the most serious salt-lover isn’t in danger of approaching the recommended one-teaspoon-a-day of salt from that habit. Instead, have you ever considered criticizing the amount of spaghetti sauce someone uses? Maybe you should.” Here are ten sneaky salt sources lurking in your food from a post I wrote for Blisstree.

 Chicken Breast

And I’m not talking about fried chicken or chicken tenders, either. Most supermarket chicken breasts are injected with a sodium solution. One serving of that can contain 400 mg of sodium (raw!), while less than 100 mg of sodium are naturally found in chicken. I first learned about this from Janet Helm’s Nutrition Unplugged post and have been disturbed ever since.

Medications

You have PMS, so you pop an NSAID (non-steroidal anti-inflammatory drug) to help relieve your cramps. But many NSAIDS (like ibuprofen) are high in sodium, which is a concern for those with high blood pressure or high “bloat.” A salt pill won’t likely help improve your moodiness once you realize that.

Baked Goods

Muffin with your salt? A Starbucks low-fat red raspberry muffin contains 500 mg of sodium, but at least that’s 400 mg less than the 900 mg in its egg white, spinach, and feta wrap. Either way, go easy on the baked goods.

Tomato Sauce
You may obsess about the carbs loaded in your bowl of pasta, but have you contemplated the sauce? Tomatoes are full of lycopene, a powerful antioxidant; tomato sauce also contains lycopene – and a lot of salt. A cup of tomato sauce (no meatballs) contains almost 1,500 mg of sodium. For less salt, make the sauce yourself using fresh tomatoes (yes, less convenient).

Deli Sandwiches

It’s no surprise that processed meats are salty. However, at delis, the meat, bread, and “extras” also contribute salt. A 6” Subway turkey breast sandwich has 910 mg of sodium. American cheese adds 200 mg and pickles another 125 mg, for a grand (or not so grand) total of 1,235 mg of sodium. How’s Jared’s blood pressure doing?

Canned Beans

You’ve probably considered the serious salt in canned soups, but what about your beans? Those that come from a can will run you more than 700 mg of sodium per cup (or 1/3 of your daily allowance). If you eat beans at home, give them a rinse in a colander or buy low-sodium beans. Better yet: Soak and cook your own.

Raisin Bran Cereal

You know that fiber is a good-for-you whole grain, and we all need more of it in our diets. Problem is, salt and sugar are often added to processed whole grains to spice them up. One culprit is raisin bran cereal, with 342 mg sodium per cup (plus a whole lot of sugar).

Bottled Salad Dressing

Just two tablespoons of bottled Italian salad dressing contain almost 500 mg of sodium. (And two tablespoons is not a lot.) Pair that with the aforementioned beans, plus some olives or roasted peppers and now you know why you feel bloated after hitting the salad bar. Foodtrainers’ favorite dressing olive oil and lemon juice.

Cottage Cheese

When you mention “diet” foods, many people’s heads fill with images of cottage cheese, Melba toast, and Kellogg’s Special K cereal. But cottage cheese is certainly not a low-sodium diet food. Just one cup contains 900 mg of sodium, so you may want to rethink breakfast (just not with raisin bran).

Ketchup

Those cute little packets look so harmless, especially compared to the fries next to them. But just one tablespoon of this adorable condiment means 190 mg of sodium. Add the fries, and you’re well over 500 mg.

The moral of the story is to read labels and check out the sodium. You don’t want your day’s food composed of many serious sodium sources, the same can be said for your children’s food. Which of these items was the biggest surprise? Do you consider yourself salt sensitive? Any strategies, other than making yourself to cut salt?