If fairy tales kept abreast of modern trends, poor Peter Cottontail would be too fat to do much hopping…he’d be sprawled on the sofa watching TV and snacking on junk food. I don’t want to paint with too broad a brush here but, unless you’ve been on Gilligan’s island for the last twenty years, you’re as aware as I that children’s weights are increasing at an alarming rate, as are the numbers of children who are packing on excess body fat.
With spring in the air my mind goes back to when I was little and how excited my friends and I were about our new Easter outfits. As I think back I recall that in those days (early fifties) there was only one little girl in our school who could be described as obese. She wasn’t the subject of ridicule, just accepted for who she was and, since all her family was overweight, her condition was simply chalked up to family trait. I have a picture of five of us little girls in our Easter best and there she is, just as proud and happy as the rest of us.
How times have changed. Today a school of similar size would probably have twenty obese little girls (there were no boys in our school!) and many more who could be described as overweight. While exercise is not my area of expertise, one doesn’t need to be an exercise physiologist to understand that reduced activity has a major part to play in the fattening of North American children. I’m sure you’ve read about or discussed the nature of the problem before, but to recap, here’s a synopsis of the situation:
The School Bus: Unless a child lives next door to the school, most are either driven by their parents or take the bus. I won’t pretend there’s an easy solution here, but we need to acknowledge that the simple act of walking has been reduced to a foreign concept for many kids and “in my day” walking was the main activity that kept us in shape.
Television: What to say? The number of hours that the average child is plunked in front of the TV is staggering. I’ve heard of a number of arrangements that attempt to address the problem…one Mom lets her child watch television as long as she’s walking on the treadmill while viewing. Another has a similar arrangement for an exercise bike. Some parents simply limit TV time but that doesn’t insure that they’re otherwise being active. Even reading is a sedentary pastime. GET OUTSIDE AND PLAY!
Computers: There’s no getting around it, technology has revolutionized our lives and computers and computer games have changed the way in which kids amuse themselves. Hide-and-seek just can’t compete with the adrenalin rush of star-wars type games. Limiting time spent on these games is about the only reasonable approach.
Diet. OK…on to an area where I’m on more comfortable ground. What is the major dietary difference between today and when I was a child, and even when my sons were children? Pop! In the fifties pop was something you had at a birthday party and very special occasions. It wasn’t part of the weekly grocery list and it certainly wasn’t consumed as part of a meal. Even when my children were little, pop was special although I will admit to letting the boys have pop with their pizzas on Friday nights.
But are the calories that come with a can of pop sufficient to account for the upswing in kids’ weight? No. But, of course, some children have more than one glass of pop a day. Still the question has more to do with what the pop is replacing and in a word, the replaced food is milk. But, you might argue, a glass of milk has roughly the same amount of calories as a glass of pop. True enough, but in nutrition nothing is ever quite as simple as it might seem at first blush. Turns out that calcium, of which milk is a major supplier, plays an important role in breaking down fat and leading to less fat deposits. Studies have confirmed that kids who drink milk instead of pop are way less likely to have a weight problem. As milk consumption has gone down and pop-drinking has gone up, so has the average weight of children.
Snacks: Sure, we’d all like to see kids snacking on carrot sticks instead of chips, but unless the parent is in control of the larder, it ain’t gonna happen. Parents still buy the groceries and it takes tough love to make sure that greasy snack foods are available only rarely. Seeing that healthful snacks are at hand is the parent’s job and from the looks of things, some are falling down on the job. Moms and Dads who wouldn’t dream of letting their offspring go unbelted in the family sedan, would never let them play with matches, or be within a mile of cigarette smoke somehow fail to see the long-term consequences of a poor diet. I certainly don’t pretend to have all the answers, heck, maybe even none of the answers, but this I do know: something must be done and that something begins with small improvements, one at a time. Family walks, sports participation, pantry make-overs. If shortening or hydrogenated vegetable oil is on the ingredient list, throw it out; fresh fruit available for quick snacking; cakes, pies and pastries for special occasions only.
It’s do-able, but it takes effort. Come on people, let’s put this weight problem behind us…or at least further behind than it currently is!
Friday, April 30, 2010
Thursday, April 29, 2010
vitamin D...the sunshine of your life
A couple of years ago I had a skin cancer diagnosed on my nose. I commented hopefully to the dermatologist that I had the best kind of skin cancer you could have and with a withering look she replied that there were no good kinds, but at least mine wasn’t the worst. True enough. She then went on to recommend that I cover myself completely every day with a # 60 sun screen. When I asked what she told her patients about vitamin D after warning them to completely avoid the sun and wear sun-screen, she replied that she told them nothing. “What’s the big deal?” was her attitude.
Well, it’s a very big deal. While I’m unaware of any dermatologist ever being held liable for telling a patient to totally avoid the sun and not recommending vitamin D supplements, I bet it won’t be long before such a case comes to light in our neighbour to the south. Vitamin D deficiency is widespread, and not just in people who are being treated for skin cancer. It’s been estimated that roughly two-thirds of the Canadian population has a vitamin D deficiency.
For a long time it was thought that the only real upshot of inadequate vitamin D would be rickets in children. Fortification of milk with the vitamin pretty well put an end to that, but lately, for a variety of reasons, rickets has been reappearing. Northern First Nations children were among the first to be seen in this resurgence of the condition, but now there is also evidence of the vitamin D deficiency disease called osteomalacia in adults as well. Particularly vulnerable are those women who immigrate to Canada from countries where fluid milk is not routinely consumed and whose religion or culture requires them to be covered from head to foot. And, osteoporosis is not just the result of inadequate dietary calcium; poor vitamin D status plays a role as well. A favourite aunt of mine was confined to a nursing home thanks to complications from diabetes and the subsequent amputation of one of her legs. Though I kept nagging them to give her vitamin D supplements they neglected to do so. One day I received a call saying that she had rolled over in bed and broken her remaining leg. The next day she was dead from complications of the break.
Unfortunately it’s not just the bones that pay a price for insufficient vitamin D. There is now pretty persuasive evidence that an inadequate intake of this vitamin plays a role in the development of hypertension, heart disease, certain cancers, diabetes and autoimmune illnesses.
This naturally enough leads to the question as to why so many people have inadequate vitamin D and what are the natural sources of it. The industrial revolution is partly to blame for this sad state of affairs…that and the fact that nature didn’t think we’d move to places like Edmonton (she figured we’d stay in the Garden of Eden wearing only a fig leaf and getting plenty of sunshine). But the move to cities and the development of polluting industries coupled with the need to wear clothes and the invention of sun-screen did us in. Don’t get me wrong: I’m not suggesting that we shouldn’t use sun0screen, I’m simply pointing out that it pretty much does away with the skin’s production of vitamin D. Because of Canada’s geographical setting little or no vitamin D is made in the skin between October and April (not to mention the fact that we’re all bundled up during those months). And as for food, don’t count on it. Milk is fortified with vitamin D but still only gives 100 IU’s per 250 mL. Not enough. Contrary to popular belief, most other dairy products have none. Unless you’re eating very large quantities of oily fish, your diet is highly unlikely to provide you with all the vitamin D you need.
So then, what to do? You may know that dietitians are usually reluctant to recommend supplements since for most nutrients food is the best source. But for vitamin D we must make an exception. I would suggest that for most people a supplement of 1000 IU of vitamin D3 (cholecalciferol) per day would be appropriate. You might be tempted to take cod liver oil but I think that’s a bad idea since a tablespoon of the stuff will also give you about 14,000 IU of vitamin A…way too much. I would opt for a capsule that contains only vitamin D.
Can you get too much? Yes. Toxicity can occur since the vitamin is fat-soluble and can be stored over time. Most evidence indicates that you’d need 20,000 IU a day over a long time to have problems, but to err on the side of caution I think you should not exceed the 2000 IU level. Are there people who shouldn’t take vitamin D? Yes: Those with a condition called sarcoidosis (or any other granulomatous disease), cancer (especially lymphoma) or hyperparathyroidism.
The bottom line here is that most of us are not getting enough vitamin D and the result can be serious.
Well, it’s a very big deal. While I’m unaware of any dermatologist ever being held liable for telling a patient to totally avoid the sun and not recommending vitamin D supplements, I bet it won’t be long before such a case comes to light in our neighbour to the south. Vitamin D deficiency is widespread, and not just in people who are being treated for skin cancer. It’s been estimated that roughly two-thirds of the Canadian population has a vitamin D deficiency.
For a long time it was thought that the only real upshot of inadequate vitamin D would be rickets in children. Fortification of milk with the vitamin pretty well put an end to that, but lately, for a variety of reasons, rickets has been reappearing. Northern First Nations children were among the first to be seen in this resurgence of the condition, but now there is also evidence of the vitamin D deficiency disease called osteomalacia in adults as well. Particularly vulnerable are those women who immigrate to Canada from countries where fluid milk is not routinely consumed and whose religion or culture requires them to be covered from head to foot. And, osteoporosis is not just the result of inadequate dietary calcium; poor vitamin D status plays a role as well. A favourite aunt of mine was confined to a nursing home thanks to complications from diabetes and the subsequent amputation of one of her legs. Though I kept nagging them to give her vitamin D supplements they neglected to do so. One day I received a call saying that she had rolled over in bed and broken her remaining leg. The next day she was dead from complications of the break.
Unfortunately it’s not just the bones that pay a price for insufficient vitamin D. There is now pretty persuasive evidence that an inadequate intake of this vitamin plays a role in the development of hypertension, heart disease, certain cancers, diabetes and autoimmune illnesses.
This naturally enough leads to the question as to why so many people have inadequate vitamin D and what are the natural sources of it. The industrial revolution is partly to blame for this sad state of affairs…that and the fact that nature didn’t think we’d move to places like Edmonton (she figured we’d stay in the Garden of Eden wearing only a fig leaf and getting plenty of sunshine). But the move to cities and the development of polluting industries coupled with the need to wear clothes and the invention of sun-screen did us in. Don’t get me wrong: I’m not suggesting that we shouldn’t use sun0screen, I’m simply pointing out that it pretty much does away with the skin’s production of vitamin D. Because of Canada’s geographical setting little or no vitamin D is made in the skin between October and April (not to mention the fact that we’re all bundled up during those months). And as for food, don’t count on it. Milk is fortified with vitamin D but still only gives 100 IU’s per 250 mL. Not enough. Contrary to popular belief, most other dairy products have none. Unless you’re eating very large quantities of oily fish, your diet is highly unlikely to provide you with all the vitamin D you need.
So then, what to do? You may know that dietitians are usually reluctant to recommend supplements since for most nutrients food is the best source. But for vitamin D we must make an exception. I would suggest that for most people a supplement of 1000 IU of vitamin D3 (cholecalciferol) per day would be appropriate. You might be tempted to take cod liver oil but I think that’s a bad idea since a tablespoon of the stuff will also give you about 14,000 IU of vitamin A…way too much. I would opt for a capsule that contains only vitamin D.
Can you get too much? Yes. Toxicity can occur since the vitamin is fat-soluble and can be stored over time. Most evidence indicates that you’d need 20,000 IU a day over a long time to have problems, but to err on the side of caution I think you should not exceed the 2000 IU level. Are there people who shouldn’t take vitamin D? Yes: Those with a condition called sarcoidosis (or any other granulomatous disease), cancer (especially lymphoma) or hyperparathyroidism.
The bottom line here is that most of us are not getting enough vitamin D and the result can be serious.
Wednesday, April 28, 2010
Lentils: the caviar of the pulse world
I've been absent for a while due to hand surgery, but I'm back at it and raring to go!
There are two problematic words in the above headline: lentils and pulses. As a dietitian I’m familiar with both the nutritional value and mealtime uses for both of these items, but as a mother and housewife, I have to admit that both make infrequent appearances on my menus. Beans, yes…lentils and pulses no. And therein lies some of the confusion. While rural folks may be completely aware that beans are in fact pulses, city slickers are often oblivious to the fact. They don’t actually know what a pulse is and what they do know about lentils is simple: they don’t like them.
The Food and Agriculture Organization (FAO) of the U.N. defines pulses as annual, leguminous crops that are harvested solely for the dry grain. That is, it excludes green (or yellow) beans, green peas, and also excludes crops grown for oil extraction like soybeans and peanuts. What it does include are beans like kidney, lima, broad beans, chickpeas, garbanzos and, of course, lentils.
The younger generation is quite “into” lentils, so I thought today we’d do a bit of generational and inter-community bridge building and have a fresh look at this under-appreciated staple in the diets of many of the world’s cultures.
To begin with, lentils are very nutritious, especially in terms of protein, fibre, folic acid and potassium. Because of their high protein content they are sometimes referred to as “poor man’s meat”. The protein content, however, comes with some qualifications. Because lentils are lacking an essential amino acid (in this case, methionine) they are what nutritionists call an “incomplete” protein. They’re rich in protein, but unlike the protein found in meat, milk, cheese and eggs, the protein itself cannot sustain and promote growth and life. In order to complete the protein, lentils are consumed along with a grain that will contribute the missing methionine but is itself missing another essential amino acid, like lysine. Still with me? Interesting that without the help of a dietitian cultures were able to figure this out thousands of years ago and ate lentils along with other foodstuffs like rice and wheat. A cup (250 ml) of lentils will give you about 20 grams of protein, as will a three ounce (80 g) hamburger patty…the protein just isn’t as “complete”.
The main problem facing lentils is their image. While they may not be in such dire need of an image makeover as, say, Brittney Spears, they could definitely use a little help. Lentils suffer from the double stigma of a) being thought of as watery and mushy and b) the misconception that, like their bean cousins, they have to be soaked before cooking. Not true. Lentils also aren’t thought of as very sexy. A restaurant menu that boasted “stewed lentils” would have a lot of leftover lentils on its hands. If, on the other hand, they were called “French caviar beluga lentils”, well, that’s a horse of a different color. Nowadays Canadian cooks have access to a wide variety of lentils that can result in quick-to-prepare but tasty dishes that bear little resemblance to the soggy, dish-water brown lentils of the past.
Orange-coloured lentils are perhaps the more common, and certainly a popular form of that particular pulse, but the French du Puy lentils are increasingly used in homes and restaurants. They are the ones often referred to as “caviar” lentils owing to their small firm greenish-dark blue appearance which does indeed give them the look of fish eggs. They’re best served “al dente”, sort of like the ideal way to serve pasta…soft enough to bite into, but not mushy. And speaking of pasta, that’s a great way to introduce the family to this new treat: cooked to the proper stage of doneness and added to whichever pasta you choose. It adds interest to the pasta dish and a goodly amount of protein and fibre.
The basic method for preparing lentils involves boiling them with large chunks of onion, celery and carrots (some garlic wouldn’t hurt either) along with a bit of olive oil and maybe even some wine if you’re feeling adventurous. When they’ve reached the desired stage of doneness, you then have a variety of ways to serve the finished product. You might reduce the liquid and add some Italian sausage and tomatoes to make a stew; or you can drain the lentils (saving the rest of the contents for a soup) and dress them up for a salad. The beauty of lentils is that they lend themselves to so many possibilities.
In the West we tend to cook so as to preserve the shape and integrity of each lentil. In India, however, where the average family has lentils as part of every meal, it is more common to cook them until they’re very soft and puree them until creamy. You might be familiar with the term “dal” which is the Hindi word for dried lentils, but can also refer to other dried peas and beans. Indian cookbooks have an incredible number of ways to use lentils and I encourage you to give some of them a try. Lentils are also a popular dish in many North African countries and throughout the Mediterranean. We’ve definitely got some catching up to do.
I’m not suggesting that we should give up on meat; the minerals that meat provides are hard to come by in dishes made up only of lentils. But as an occasional dish by itself or as a side dish to meat, pasta or in a stew, lentils have a lot to offer. Accompanied by a salad, a glass of milk or dish of yogurt, and some fruit for dessert, lentils can pack a nutritional wallop that’s hard to beat.
There are two problematic words in the above headline: lentils and pulses. As a dietitian I’m familiar with both the nutritional value and mealtime uses for both of these items, but as a mother and housewife, I have to admit that both make infrequent appearances on my menus. Beans, yes…lentils and pulses no. And therein lies some of the confusion. While rural folks may be completely aware that beans are in fact pulses, city slickers are often oblivious to the fact. They don’t actually know what a pulse is and what they do know about lentils is simple: they don’t like them.
The Food and Agriculture Organization (FAO) of the U.N. defines pulses as annual, leguminous crops that are harvested solely for the dry grain. That is, it excludes green (or yellow) beans, green peas, and also excludes crops grown for oil extraction like soybeans and peanuts. What it does include are beans like kidney, lima, broad beans, chickpeas, garbanzos and, of course, lentils.
The younger generation is quite “into” lentils, so I thought today we’d do a bit of generational and inter-community bridge building and have a fresh look at this under-appreciated staple in the diets of many of the world’s cultures.
To begin with, lentils are very nutritious, especially in terms of protein, fibre, folic acid and potassium. Because of their high protein content they are sometimes referred to as “poor man’s meat”. The protein content, however, comes with some qualifications. Because lentils are lacking an essential amino acid (in this case, methionine) they are what nutritionists call an “incomplete” protein. They’re rich in protein, but unlike the protein found in meat, milk, cheese and eggs, the protein itself cannot sustain and promote growth and life. In order to complete the protein, lentils are consumed along with a grain that will contribute the missing methionine but is itself missing another essential amino acid, like lysine. Still with me? Interesting that without the help of a dietitian cultures were able to figure this out thousands of years ago and ate lentils along with other foodstuffs like rice and wheat. A cup (250 ml) of lentils will give you about 20 grams of protein, as will a three ounce (80 g) hamburger patty…the protein just isn’t as “complete”.
The main problem facing lentils is their image. While they may not be in such dire need of an image makeover as, say, Brittney Spears, they could definitely use a little help. Lentils suffer from the double stigma of a) being thought of as watery and mushy and b) the misconception that, like their bean cousins, they have to be soaked before cooking. Not true. Lentils also aren’t thought of as very sexy. A restaurant menu that boasted “stewed lentils” would have a lot of leftover lentils on its hands. If, on the other hand, they were called “French caviar beluga lentils”, well, that’s a horse of a different color. Nowadays Canadian cooks have access to a wide variety of lentils that can result in quick-to-prepare but tasty dishes that bear little resemblance to the soggy, dish-water brown lentils of the past.
Orange-coloured lentils are perhaps the more common, and certainly a popular form of that particular pulse, but the French du Puy lentils are increasingly used in homes and restaurants. They are the ones often referred to as “caviar” lentils owing to their small firm greenish-dark blue appearance which does indeed give them the look of fish eggs. They’re best served “al dente”, sort of like the ideal way to serve pasta…soft enough to bite into, but not mushy. And speaking of pasta, that’s a great way to introduce the family to this new treat: cooked to the proper stage of doneness and added to whichever pasta you choose. It adds interest to the pasta dish and a goodly amount of protein and fibre.
The basic method for preparing lentils involves boiling them with large chunks of onion, celery and carrots (some garlic wouldn’t hurt either) along with a bit of olive oil and maybe even some wine if you’re feeling adventurous. When they’ve reached the desired stage of doneness, you then have a variety of ways to serve the finished product. You might reduce the liquid and add some Italian sausage and tomatoes to make a stew; or you can drain the lentils (saving the rest of the contents for a soup) and dress them up for a salad. The beauty of lentils is that they lend themselves to so many possibilities.
In the West we tend to cook so as to preserve the shape and integrity of each lentil. In India, however, where the average family has lentils as part of every meal, it is more common to cook them until they’re very soft and puree them until creamy. You might be familiar with the term “dal” which is the Hindi word for dried lentils, but can also refer to other dried peas and beans. Indian cookbooks have an incredible number of ways to use lentils and I encourage you to give some of them a try. Lentils are also a popular dish in many North African countries and throughout the Mediterranean. We’ve definitely got some catching up to do.
I’m not suggesting that we should give up on meat; the minerals that meat provides are hard to come by in dishes made up only of lentils. But as an occasional dish by itself or as a side dish to meat, pasta or in a stew, lentils have a lot to offer. Accompanied by a salad, a glass of milk or dish of yogurt, and some fruit for dessert, lentils can pack a nutritional wallop that’s hard to beat.
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