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page 1 Issue: 11 March 2009 In this issue: • March is Nutrition Month • Food for thought • What’s the deal with extra protein? • Understanding the elusive Vegan • Healthy eating on the run • What’s Cooking • Upcoming Events We all know how important good nutrition is for optimal physical and mental health. It can be clearly realized after consuming a high fat, low nutrient meal and attempting to successfully engage in physical activity or mental concentration. We regularly promote healthy eating to patients, but often neglect our own health! Although we may know what we should eat, many factors can affect what we actually eat. Some common reasons for not making healthy food choices include: knowledge, attitudes, food preparation skills, time, cost, cultural values, traditions, advertising and the type of food available in grocery stores, workplaces, schools and community settings. Quote of the month “The wise man should consider that health is the greatest of human blessings. Let food be your medicine.” ~ Hippocrates The good news is that although these obstacles are real and can be challenging to overcome, it can be done! Healthy eating can be quick and easy. March is National Nutrition Month and the perfect time to aim for healthier food choices. Nutrition Month® is a campaign from Dietitians of Canada. This year’s theme is “Stay Active. Eat Like a Champion”. It promotes eating well in order to fuel our bodies for an active lifestyle of at least 30-60 minutes of activity 3 days a week. This newsletter includes articles with tips, ideas and suggestions for incorporating healthy food choices in your day to day life. It also includes perspectives from your fellow classmates on nutrition related topics. I hope you enjoy this newsletter and find some practical tips to include healthy foods in your everyday lives! Lesley Burgess, guest editor of this month’s issue, is a Regional Nutritionist with the Health Promotion Division of Eastern Health. She is also Chair of Dietitians of Newfoundland and Labrador, Newfoundland and Labrador College of Dietitians and the MUN Med Wellness Nutrition Sub-committee. Stay Active. Eat Like a Champion. Holly Grant, R.D. and Lesley Burgess, R.D, MSc Canada’s Food Guide recommends building 30-60 minutes of moderate physical activity into your life EVERYDAY! Nutrition Month™ is brought to you by Dietitians of Canada and thousands of dietitians across the country in collaboration with the campaign sponsors. The official sponsors of the 2009 Nutrition Month Campaign are: --EurestChartwellsMorrison - ESS Members of Compass Group Canada --Dairy Farmers of Canada and --General Mills Canada Corporation In order to have the energy to meet these recommendations you must eat a well balanced diet. A common misconception amongst exercisers is that you need expensive supplements to get the most out of your workouts, but choosing wholesome foods from the Canada’s Food Guide is a sure way to get all the nutrients, vitamins and minerals that you need. Timing is the key! To have energy for exercise you should supply your body with carbohydrates before any activity since they are the muscles preferred fuel source. Carbohydrates can be found in fruits, vegetables, grains, and dairy products. Muscles will store the energy from these foods and have it ready to use when you start moving! The key is to give the food enough time to break down in your stomach and travel to the muscles for storage. Therefore you should try to consume a snack a couple of hours before exercise. Healthy snacks include such things as: a peanut butter sandwich, glass of milk, and a banana. What should I eat after I exercise? After your workout it is important to provide your body with nutrients to repair any damage to muscle and to replace the carbohydrates in those muscles that were used during exercise. It is tempting to purchase protein supplements but they are just an expensive form of protein that can be found in our food. Your body is meant to process natural foods, rather than supplements. Protein found in meats, nuts, legumes, and dairy, will provide you with all the amino acids you need to repair your muscles. A great post-exercise snack could be a glass of chocolate milk (protein) and a piece of fruit (carbohydrates). Where can I go to find more information? Check out www.dietitians.ca/eatwell for lots of great tips that you can use to make wise food choices to support your active lifestyle! Holly Grant R.D. graduated with a Bachelor of Science from Memorial University and completed her Dietetic internship with Eastern Health. She is currently enrolled in the International Olympic Committee’s Sports Nutrition Diploma program. Holly competes in marathons and triathlons and experiences first hand the positive impact that healthy nutrition has on physical activity Lesley Burgess, R.D., MSc is a Regional Nutritionist with Eastern Health. Recipe Analyzer Food for thought Janine Woodrow, R.D. Food is political. We all eat, so we all have opinions about grub. Unlike smoking, which has been undoubtedly proven to be bad for your health, food can fit a whole range of categories all at once from healthy to ‘not-so-great’ depending on your individual health status and on the nutritional composition of the particular item (e.g. fat, fibre, sodium, sugar, etc). Given the complexity of today’s food industry and our high-speed lives, it’s hard not to be mechanically swayed by the ever-so-convenient packaging, flashy targeted advertising, and the trend de jour when it comes to dieting (the latest being the trickery of the 100 kcal packaging, which are often portion controlled sugar and saturated fat with little fibre or other nutrients!) A line from the latest Killers song comes to mind when it comes to our ever changing eating patterns “are we human or are we dancers?”… I recall the not-so-distant past being a full-time graduate student navigating though the cafeteria looking for a late lunch at 3 pm or sailing past a peculiar and alarming amount of what Canada’s Food Guide classifies as’ limit’ foods (cakes, cookies, potato chips and candy) in the gift shop on the hunt for some nuts, a granola bar or carton of milk to recharge the biological battery. My philosophy has always been ‘keep it simple’ … if it cannot be categorized in one of the four food groups of the Canada Food Guide then it’s probably not offering much in the line of nutrition … and therefore will likely not help you to persist through pages of scientific journal articles or hours of dissertation writing. Health Canada released its revised food guide in 2007. The prior revision was in 1992 and a whole lot of research has happened since that time to inform the content of the new version. It has been my experience as a Registered Dietitian that nearly everyone recognizes Canada’s Food Guide, but many people do not understand how to practically use it on a daily basis for planning meals and snacks. The new food guide breaks down the recommended number of servings from each food group according to gender and age. For example, if you are a 25 year old woman you should aim to have the following each day: • 7- 8 vegetables and fruit (fresh, frozen or canned) • 6 -7 grain products (whole grains more often) • 2 milk and alternatives (low fat milk and yogurt) • 2 meats and alternatives (only about the size of a deck of cards each!!) • 30 - 45 mL (2 to 3 Tbsp) of unsaturated oils and fats (think canola and olive oil) • A multivitamin that includes folic acid and iron Do you meet the new recommendations? • choosing vegetables and fruit over juice, • eating at least one dark green and one orange vegetable each day, • drinking plain water for thirst, • eating fish at least two times per week and • taking 10 μg (400 IU) of vitamin D each day if you are over the age of 50. Detailed lists of foods and the recommended serving sizes can be found on the Health Canada website www.healthcanada.gc.ca/foodguide. So, the next time you are navigating your way through your local supermarket, restaurant menu, or corner store try to stick to the basics of the food guide. Also keep in mind … children don’t need a ‘special menu’ of battered and fried foods in friendly shapes. Go for a reduced potion of the same food the family is enjoying. Bon appetite! Janine Woodrow, Registered Dietitian and currently works with the Health Promotion and Wellness Division, Government of Newfoundland and Labrador. In January, 2009, she defended her PhD within the Faculty of Medicine. Dietitians of Canada offers a tool to help Canadians make healthy eating choices. The recipe analyzer is a unique interactive on-line tool that offers consumers a quick and easy way to assess the nutritional value of their favourite recipes. To use the tool, simply visit the Dietitians of Canada website: www.dietitians. ca/eatwell and click on Recipe Analyzer. What’s the Deal with Extra Protein? Curtis Budden Each year Canadians spend millions of dollars on protein supplementation in hopes that it will have some effect on one’s physical fitness or overall health. Have you ever wondered if taking extra protein will actually do all that it promises? There is no doubt that protein intake is essential for physical health, however, how much protein is needed and does extra protein help with weight loss or muscle building? How much protein do we need? The current recommendation for protein intake is 0.8 g/kg of body weight. Therefore a 150 lbs person would require 54.5 g of protein each day. Food Sources of protein Amount consumed Protein contained 1 cup 9g Milk and Alternatives Cow’s Milk Yogurt 175 g Soybeans 250 ml Tuna 125 ml Almonds 125 ml Meat and Alternatives Chicken Salmon Egg Source: Nutrient Value of Common Foods 7-9 g 30 g 75 g 24.5 g 75 g 19 g 1 egg 20 g 12 g 6g A well balanced diet according to Canada’s Food Guide for an adult female includes 2 servings of Milk and Alternatives (such as 2 cups of milk) and 2 servings of Meat and Alternatives (75 g of chicken and 125 ml of tuna). This would provide over 60 grams of protein, which is actually more protein than the recommended amount. In fact, major nutritional organizations say that the average Canadian consumes above and beyond what is needed. If this is the case, then a logical question to ask is: Why buy protein supplements in the first place? The answer to this question is multifaceted and has been the quest of many researchers around the world. Are there times when additional protein could be useful? There is a wealth of information regarding the use of protein to enhance both weight loss and muscle recovery. A study conducted in the Netherlands showed that after a month long lowenergy diet, people who consumed 18% protein in their diet regained 50% less weight than did those on a lower-protein diet (15% total energy) after 3 months. This increased protein was taken in the form of a meal replacement, much like the ones pictured. Interestingly, the people with a higher protein intake reported a greater feeling of ‘fullness’ and the weight that they did regain was fat free mass. A more long-term study in the US followed people on a high-protein diet for 12 months and compared them to people with relatively lower protein intake (although it was within the acceptable Dietary Reference Intake, DRI, for protein intake and was isocaloric with the other diet). After 4 months, both groups of people lost the same amount of weight however, the group on the higher protein diet actually lost more body fat. After 12 months a similar trend was seen. There was a greater compliance to the high protein diet, which may also suggest a benefit for weight maintenance. These studies examine protein use to promote weight changes but protein is also marketed as a muscle-boosting tool used by men and women of all ages. Protein consumption in excess of that normally in the diet is touted as being a necessity for muscle building, but is this actually true? A study conducted in Texas compared the effect of protein supplementation on strength and body composition after 10 weeks of strength training. It was found that strength improved in all people, even those consuming a carbohydrate placebo. Researchers noted however that a combination of whey and casein protein promoted a higher increase in fat-free mass. Another study conducted in Denmark found that protein supplementation before and after leg exercise resulted in an increase in quadriceps muscle size. They also noted a significant functional change in people consuming protein supplements versus those consuming a sugar control. Currently, Dietitians of Canada states that protein intake greater than the RDA may be needed for strength athletes (in the range of 1.2-1.7 g/kg of body weight). They also state however that since protein supplementation has not been strongly shown to enhance performance, extra protein is aimed at maximizing results for training and minimizing the rest needed post-workout. Overall, increasing protein intake while still adhering to the acceptable macronutrient distribution range (protein should account for 10-35% of total calories) may allow you to feel full for a longer period of time and aid in losing more body fat than by cutting protein and replacing it with carbohydrates. The recommendation for protein is 0.8g/kg body weight and may vary slightly if you participate in regular endurance or strength training exercises. Protein, like the other nutrients that constitute our diets is essential but it can be consumed in healthy quantities by eating foods such as meats, poultry, lentils and nuts. If you are considering running off to the nearest GNC store to buy a 5 lbs tub of protein powder stop and determine the amount of protein you are consuming each day. Bottom line: Chances are you are already meeting the RDA for protein and by eating a few more nuts or having an extra glass of milk you will save your money and benefit from the extra nutrients found in eating whole foods. Curtis Budden is a first year medical student who has an honours degree in Biochemistry(Nutrition). Active in sport, he has a strong interest in proper nutrition to enhance athletic performance What is a Dietitian? The titles “Registered Dietitian”, “Professional Dietitian”, and “Dietitian” are protected by law -through provincial legislation -- so that only qualified practitioners who have met education qualifications can use that title. A dietitian is a health professional who has a Bachelor’s degree, specializing in foods and nutrition, as well as a period of practical training in a hospital or community setting. Dietitians are members of a provincially regulated profession that has Public Protection as their mandate. Dietitians are held accountable for their conduct and the care they provide. Understanding the elusive Vegan Janelle Taylor In my short time as a vegan I have come across my fair share of blank and confused faces. In an effort to clarify the mysterious ways of the vegan I have decided to share a sample of some of the questions I get asked on a regular basis. “Vegan? Is that the same as vegetarian?” Actually they are quite different. While vegetarians refrain from eating the flesh of animals (this may or may not include fish), vegan diets are free from all animal sources. No consumption of meat, poultry, fish, dairy products, or eggs. “How do you get your protein?” Despite what the meat, egg, and milk industry might tell you there are a multitude of sources that can provide you with more than enough protein to sustain a healthy, active lifestyle. Tofu (don’t grimace!) is a delicious, easy, and inexpensive way to help obtain your protein requirements and with so many ways to prepare it you’ll find endless recipes to keep your meals interesting! Other great protein rich foods essential to sustaining a healthy vegan diet include lentils, beans, nuts, seeds, soy products, and whole grains. A study by the American Dietetic Association has shown that meat based diets actually contain protein levels far beyond the daily requirements and are consistently rising along with the prevalence of heart disease, obesity, diabetes, and osteoporosis. Vegan sources of protein do not contain any of the saturated fat or cholesterol that animal products do and thus supply your body with the necessary amount of protein without clogging arteries! “Aren’t you worried about osteoporosis?” “Nothing will benefit human health and increase the chances for survival of life on Earth as much as the evolution to a vegetarian diet.” ~ Albert Einstein (1879-1955) Milk industries have made a fortune pushing the “Got Milk?” commercials, scaring people to death about bone health and osteoporosis, and Western society has been eating it up or gulping it down to be more precise. With all this milk being consumed how is it that the prevalence of osteoporosis is so high in Western milk loving countries while barely an issue in areas where adults rarely, if ever, drink milk? There is serious debate about this issue and I am not going to pretend to be an expert on it but think about it before reverting back to the imprinted “milk does the body good!” response. High animal based protein diets have been shown to leach calcium from the body, significantly depleting calcium stores, this can lead to decreased bone density and osteoporosis. There are plenty of ways to get calcium without milk and without expensive dietary supplements including soymilk, green vegetables such as broccoli, turnip greens, or kale, tofu, nuts, seeds, beans, oats and grains. “Your iron must be so low!” This was a big concern for me when first making this transition since iron levels can be a problem for many women vegan or otherwise. The main thing is to be vigilant about reading the nutrition facts labels and ingredient lists (personally I think everyone should be doing this regardless of lifestyle because it’s the only true way to know what you are actually eating!). Iron rich foods do include red meat, fish, and poultry but they also include oatmeal, whole grain cereals, dark green leafy vegetables, dried fruit, lentils, and beans. Also it is important to note that iron absorption can be significantly lower then the amount of iron in food and that even if you are consuming adequate amounts your body may not be absorbing enough. Drinking tea or coffee too close to an iron rich meal decreases iron absorption while eating vitamin C rich foods directly before or with an iron rich meal significantly increases absorption. My iron is actually better now then it ever was when I ate meat because I am more attentive to what I put in my body. To keep my iron levels high I eat things like oatmeal with fruit, chili with bell peppers and tomatoes, or strawberries in a spinach salad. “But WHAT do you eat?” I think people picture vegans living on nothing but salad and raw carrots, which technically would be vegan friendly, but where’s the fun in that! I transitioned from eating meat to vegetarian to vegan in very small baby steps but I never saw myself being able to handle cutting out all animal products from my diet. When I ate meat I would say I could never be vegetarian because I couldn’t live without chicken, once I became vegetarian I said I could never imagine being vegan-I could never give up egg white omelets! The truth is I eat more exciting and delicious foods now then I ever did when I ate meat. I have to put more thought and effort into my meals because I can’t fill half my plate with meat anymore! Supermarkets here in the metro area offer a fairly good selection of fake meats, cheese, milk, and yogurt all made with cholesterol free soy and full of protein, calcium, iron and a ton of flavor! It takes a bit of experimenting but once you find the brands you like it’s easy to make your favorite omnivore dishes into vegan friendly delights! I have really learned to embrace my inner Martha and love for cooking and I have no choice, as I am the only person in my house that does not eat meat. If do not cook, I do not eat! So to get back to the original question- what do I eat? For the most part any non-vegan dish can be made vegan with some simple alterations. My favorite foods include sloppy joes, lasagna, quesadillas, pizza, and chocolate pudding – all vegan friendly if made with the right ingredients- and all foods that my carnivore friends have enjoyed in disbelief about the lack of meat, cheese, or cream included. I hope that this article has helped explain some of the more confusing misconceptions about vegan nutrition. Properly adhering to a vegan diet can do wonders for your health and well being, however I highly encourage anyone considering making the switch to thoroughly research this subject in order to avoid compromising their health. I realize this article is not going to make everyone stop eating animal products and that was not my intention I assure you. I just wanted to open some people up to the idea that vegan food is nothing to be afraid of and that it can be a healthy and delicious way of life! Janelle Taylor has a Bachelors degree in Biochemistry from Memorial and is currently in her first year of medical school. In addition to her passion for nutrition and health she is a sports and fitness enthusiast and loves taking part in a wide range of physical activities. Healthy Eating on the Run! Lesley Burgess, RD, MSc With a busy study and work schedule it can be easy to put healthy eating on the back burner. Convenience foods are readily available and often cheap. However, healthy eating may be even more important for those with a hectic lifestyle to keep energy levels up and the brain working at full capacity! We have all heard about what foods are healthy such as vegetables and fruit, whole grains, low fat milk products, lean meats and plant-based protein sources (nuts, seeds and beans). However when eating on the run, these choices are not always available or the choices offered are prepared with tons of added fat, sugar and salt. The first key to making healthy eating a possibility is to have healthy foods at your finger tips. Many people enjoy healthy foods, but do not always think to eat them if they are not on hand. Stock up on the some healthy basics when you do find time to shop: • • • • • • • • • • • For great healthy, time saving recipes and nutrition information, why not check out: whole fruit or fruit cups packed in water or 100% juice whole grain crackers or granola bars with little added sugar and fat low fat yogurt trail mix or mixed nuts canned or bottled tomato based pasta sauces frozen or canned vegetables frozen or canned fruit bagged salad greens canned tuna or salmon canned beans or lentils lean meats, poultry and fish In order to get the recommended servings of vegetables and fruit per day, you should include vegetables and/or fruit at each meal and snack. Vegetables and fruit are naturally low in fat, salt and added sugar and provide nutrients that will help our body perform at its best. When you don’t choose vegetables and fruits at meals and snacks what choices do you make? Student Health 101 Did you know that students at MUN have free on-line access to the publication: Student Health 101? And, what’s more…. in every issue there is a chance to win great prizes such as an IPOD or Spring Break Trips! This month’s issue has an article about “cooking healthy in college” and one about eating disorders. Here is the link to the issue: Apples, popcorn and yogurt, which have fewer calories, and no fat will help keep your energy levels up much more than the empty calories in chips, chocolate bars and candy offered in many vending machines. If you really can not find the time to pack a healthy lunch use the following tips when eating out: a Steer away from deep fried foods a Choose healthier side dishes such as salad a Skip high fat dessert and go for fruit or yogurt a Keep portion sizes under control. Order kid-sized meals or share with a friend! a Ask for dressing, sauces and other condiments on the side. Just one tablespoon of mayonnaise adds 100 calories and 11 grams of fat! a Stick to water rather than fruit drinks, specialty coffees and soda. A 591 ml bottle of pop has about 260 calories and more than 10 teaspoons of sugar! Of course preparing your own meals and snacks gives you much more control over added fat, sugar and salt, which often leads to healthier end product. When you do find the time to cook, make double! Freeze stir-fries, casseroles, chili, soup and pastas. Then you will have a freezer full of homemade microwave dinners rather than having to buy the highly processed convenience dinners that are often loaded with salt! Cooking twice the chicken, ground turkey or lean beef you need can leave you with extras for chicken salad, enchiladas, chili or spaghetti sauce the next day. Hopefully you now realize that eating well on the run can be accomplished! It may take a little prioritizing of time, but the results of looking and feeling your best and the increased mental and physical energy are well worth it! Student Health 101 (March 2009) Click to see issue. What’s Cooking? Vietnamese Green Apple Salad Carolyn Power This recipe is based on a green papaya salad prevalent in the cuisines of Southeast Asia. Of course papaya is often unavailable here so the apple makes a great substitution. This salad goes great with grilled pork or chicken, especially if they have been marinated in lime juice Dressing ¼ cup rice vinegar 2 limes, juice & zest ¼ cup fish sauce* 1 clove garlic, smashed 1” piece of ginger, finely grated 1 tbsp brown sugar 1 tbsp chile paste Combine all ingredients. Set aside. * Fish sauce is a seasoning like soy sauce that is used in Thai and Vietnamese cooking. It is made from anchovy extract (mostly) and water. It can be found at The Asian Variety on Water St and Magic Wok grocery on Duckworth. Some brands have MSG so it’s good to read the label. The chile paste can also be found there. Salad 2 Granny Smith Apples 1 red pepper 1 yellow or orange pepper ½ red onion ½ bunch cilantro, finely chopped ½ bunch mint, finely chopped Julienne apples, peppers, onions and toss together with the dressing in a bowl. Add the chopped fresh herbs. Salad can be served immediately, or be refrigerated, covered, for later use. Carolyn Power is the chef and co-owner of the Epicurean Restaurant on Cookstown Road in St. John’s. Carolyn’s passion for cooking led her to a culinary school on Vancouver Island, British Columbia, where she was exposed to a variety of cooking styles. Her enthusiasm grew to new heights as she began to work with local and often organic products to create spectacular dishes. Then an opportunity to cultivate this enthusiasm in others came when she began teaching Professional Cooking at college in Nova Scotia. The Epicurean Kitchen is a combination of her love of teaching and her desire to create using local ingredients, offering a venue to share her culinary knowledge and enthusiasm with St. John’s. To learn more about the Epicurean Kitchen visit the website at: http://ekitchen.ca/ Upcoming Events Memorial Community Wellness Fair (on MUN Campus) Live well. Be active. Connect. Step into spring with the Memorial Community Wellness Fair. Displays and activities will include: glucose and cholesterol testing, BMI height weight measurement, meditation, foot care, nutrition and much more! Healthy refreshments will be served and prizes can be won! Date/Time: Location: Contacts: Wednesday, March 18, 2009, 10:00 am – 2:30 pm Inco Innovation Centre, MUN Laura Chapman, Worklife Programs Coordinator & Kelly Neville, Wellness Coordinator/Counsellor Price: Free! Student Wellness Lunch and Learn: Bringing fitness into your busy lifestyle Date/Time: Location: Facilitated by: Tuesday, April 28, 2009, 12 noon Theatre B, Faculty of Medicine Carl George Carl George is a strong supporter of preventative medicine and a holistic approach to health and wellness. He has been very successful in helping people reach their personal wellness goals. In this session, Carl will provide advice and tips on how to incorporate fitness and wellness activities into busy lifestyles. Lunch and Learn sessions are hosted by the Student Wellness Committee in the Faculty of Medicine and are open to all students in the Faculty. Price: The Lunch and Learns are free to students in the Faculty. Tickets must be picked up in the Office of Student Affairs and are available on a first come, first served basis. Tickets for this event must be picked up by noon on Friday, April 24, 2009. Wellness Challenge 2009! Students in the Faculty of Medicine (undergraduate, post graduate and graduate) are invited to participate in a 30 day Wellness Challenge. The Challenge will begin on Mnday, April 13 and end on Canada Health Day, May 12. There are prizes to be won (thanks to MedCareers – Dr. June Harris and Physician Recruitment – Scarlett Hann)! The challenges are simple and fun. The primary objective is to motivate you to think about and enhance your wellness. Details about this event will soon be posted on the Student Wellness website. Stay tuned! Closing Special thanks to Lesley Burgess, guest editor, and the Nutrition Subcommittee of the Student Wellness Committee for preparing this issue of the newsletter. They have done a stellar job putting together articles and information with healthy ideas for nutritious food to fortify active lifestyles! There will be no newsletter published in April but we are pleased to announce that the Wellness Committee will, once again, be sponsoring a Wellness Challenge. Stay tuned for more information. We will also be hosting a Lunch & Learn with guest speaker, Carl George. Carl comes highly recommended as an exceptional motivational speaker on the topic of wellness. We are already working on an exciting issue for May-June. The focus of this issue will be on balancing professional and personal life. The Wellness Committee is actively seeking ideas for articles and contributors for this issue. If you are a parent trying to juggle studies in medicine with family life, have tips for keeping relationships alive during medical school or have some other perspective on balancing professional and personal life, we would love to hear from you! Drop by! Sincerely, Michele Neary, Ph. D. Student Wellness Consultant