Thursday, May 29, 2008

Are you eating at home more?

After reading these reason why people are eating at home more, I would respond to this survey by saying "All of the Above!" Additionally, I can eat more food that is locally grown, organic, and sustainably raised, plus I always eat a wider variety and larger portions of vegetables at home.

Three very recent happenings in restaurants:
(1) I was recently in a restaurant where my younger son asked the waitress if the salmon was farm-raised or wild-caught Alaskan. The blank look on her face and non-answer led my son to the likely answer to his question.

(2) To this same restaurant's credit, they did serve their fish on a large bed of fresh kale. Even my nieces and nephews know that I love kale and eat the kale that is placed on the plate for decoration. However, one of them told me that he wonders if it has actually been washed since it not intended to be consumed. Oh, how sad is that. :-( Golly, I sure hope the kale has been washed, but then again, it certainly would be washed and intended to be eaten if I were serving it at home.

(3) I ordered lentil soup (yea - a vegetarian soup in a restauant!) that was a huge disappointment, as I could actually taste the added salt, which is a obvious clue that too much has been added to the recipe. In fact, most restaurant food has a very high salt content even though it is difficult to actually taste. Because of the damage my heart has sustained from various cancer therapies, I need to limit my salt intake to prevent fluid retention and thus extra work for my heart. So rather than fuss or throw this soup away, I did take it home and use it in a future recipe (will post at a later date).

Are you eating at home more these days? What reasons have led to this change? Are you enjoying trying new foods, eating more leisurely, cooking more? I hope you take the time to get down to your local Farmers' Markets to meet your farmers and purchase their fresh produce to eat at home.

I do hope people take a minute to think about and give thanks for their food, the rain and sun, and the farmers who grow it, when eating away from home as well as at their own table. A blessing for our meals, whether we are eating at home or away from home:

Let us give thanks for the food we are about to eat.
May there be food for all,
Abundant and healthful.
Let us have the wisdom to choose to eat only that
Which enhances our precious energy
And sustains us through our labors and rest.

~~Adapted from An Haggadah of Liberation

Diana Dyer, MS, RD

Wednesday, May 21, 2008

More Michigan Spring Produce!

Did you know that Michigan is the "Asparagus Capital of the World"? I'm sure it is grown elsewhere, too, but if you have not grown your own or cannot find some locally grown at your Farmer's Market, look for some to buy in your local grocery store that was Michigan-grown.

This photo shows the first harvest of the year from the small asparagus patch in our backyard. I cooked these spears for just a few minutes in a scant 1/2 inch of lightly boiling water in a wide frying pan (so I did not have to cut any of the stalks) with the lid on. Do not overcook! They were still bright green, tender all the way through, and incredibly delicious in their simplicity. No sauces, no seasonings, no butter or olive oil, no soup ingredients needed! When I get an abundance of asparagus, yes, I will make soup, but until then my husband and I will savor these springtime treasures, plain and simple. (In the meantime, I'm saving all the water from cooking the asparagus to add to our soups.)

We talked about experimenting with freezing some asparagus to enjoy during the winter months (I have never eaten canned asparagus that was worth the effort). However, I admit to enjoying "the wait", the anticipation of waiting until the ground has warmed up the roots enough to send up this most unusual vegetable. After all, we waited the two years as recommended after planting and nurturing the roots before harvesting our own crop.

One of the ways that I got myself through chemotherapy both times was planning and looking forward to various activities, again, enjoying the anticipation of the delight after the waiting, rather than complaining or wringing my hands over the necessity of "the wait". So maybe we won't bother with freezing any asparagus, but just enjoy (even pig-out) while we have it in abundance during the all too short spring in Michigan.

Asparagus is one of the foods that are considered excellent sources of folate, one of the water-soluble B vitamins so necessary to overall good health. Enjoy the freshness of springtime in every delectable bite!

I'll end with this beautiful prayer in praise of plant roots and the life-sustaining foods they produce:

I inform thee that I intend to eat thee.
Mayest thou always keep me to ascend,
So that I may always be able to reach
The tops of mountains,
and may I never be clumsy!
I ask this of thee, Sunflower-Root.
Thou are the greatest of all in mystery.
~~Thompson River Indian prayer
(First Nations people of Salish tribal ethnicity who inhabit the Thompson River area in British Columbia0

Diana Dyer, MS, RD

Tuesday, May 20, 2008

Recipe: Lupini Beans

I always look at the dried beans available when I grocery shop. Last week I saw a variety I had not noticed before called Lupini Beans by Ziyad. In fact they were even marked at a 50% discount. Well, I'll usually try anything once, so into my basket they went.

The directions on the back of the package say to keep changing the water until the bitterness disappears. Hmmmm, good thing I read the directions, and even then went to the internet to find out more info, before just cooking them up like other beans.

I learned that lupini beans are commonly consumed in Mediterranean and Middle Eastern countries, often eaten like popcorn at bars or movie theatres. I also learned that they contain bitter molecules called alkaloids that do need to be removed by repeated soakings before eating (both from a taste perspective but also from a health perspective as these molecules can lead to a variety of unwanted side effects). After all this reading, I finally noticed that the bag I picked up said it was "small sweet" variety, which means it has been bred to have lower amount of these alkaloids that need removing.

So I did the soaking, cooking for an hour, then soaking, soaking, soaking, soaking, yes soaking and throwing away the water for 5 days. No way was I going to accidentally poison myself or guests. :-)

After all this soaking, they can be served drizzled with olive oil and freshly ground pepper. I served them last Saturday night along with pasta and a spring greens salad. They are not soft like other cooked beans but have a little heft to them. The skins are a little tough, they can be slipped off, but they are edible.

Lupini beans do have a high protein content (almost as high as soybeans) so they are great to serve as an appetizer or side dish when the meal does not have a major protein source. The internet info says that they last a long time kept refrigerated in a brine solution. I cooked up the entire 1# bag, which made about 4 cups of cooked and soaked beans. I have some still in my refrigerator, but I have actually frozen the remaining beans to use at a later time.

We did have guests for dinner. Here is the blessing we used. It seemed appropriate for this boisterous group!

I sent out invitations
To summon guests.
I collected together all my friends
Loud talk
And ample feasting;
Discussion of philosophy,
Investigation of subtleties.
Tongues loosened
And minds at one.
Hearts refreshed
By discharge of emotion!
~~ Ch'eng-kung Sui (died AD 273)

Good food and good friends do lead to refreshed hearts!

Diana Dyer, MS, RD

Thursday, May 15, 2008

Recipe: Spring time is Rhubarb time!

Remember my earlier posting that showed the rhubarb plant in our backyard garden just barely peeking through the dirt? What a difference a month makes! Rhubarb just bolts out of the ground once it the dirt warms up a bit. Here is the same plant a month later, all ready to harvest. Rhubarb is very very hardy. The plant in the picture came from my sister-in-law, who got a start from the original plant from her father, who got it from his mother approximately 50 years ago. I wonder how old this rhubarb plant really is. :-)

In fact, we have harvested those gorgeous red and pink stalks a couple of times now to make easy stewed rhubarb, which we eat all by itself, served over oatmeal, plain unflavored yogurt (my husband makes this), granola, or with ice cream as a very special treat.

Stewed Rhubarb can be made on the stove-top or in the microwave.

Wash the rhubarb stalks. Cut off the little bit of white at the root end (if any) and cut off all of the leaves (do not eat any part of the leaves).
Cut stalks into 1-inch pieces until you have 2-3 cups.
Put into 1 quart saucepan.
Add ~1 Tbsp. water to pan.
Heat on medium heat ~10-15 minutes until rhubarb gives up its own juice and is easily mashed (or breaks apart on its own).
Add 1/4 cup sugar (or I used 1/3 cup honey)
Heat another 5 minutes or so.

Serve and eat: While most of what we make we do eat plain or on cereal, this sauce is unbelievably scrumptious served hot over cold vanilla ice cream. Save that for a very special treat. :-)

My husband and I froze bags and bags of cut up rhubarb plus canned many pints of stewed rhubarb last year, as we have 2 rhubarb plants in our community garden also that produce in abundance!! I admit that stewed rhubarb is a favorite food of mine because of the wonderful memories it brings back. My Gramma Helen always made her own and served it for breakfast in little glass custard cups when we visited her each summer in northern Wisconsin. So each time I eat it, I am transported back to those wonderful summer childhood days. :-)

I just did a quick check in the PubMed database of articles published in medical journals, looking for published studies evaluating rhubarb's anti-cancer activity. There are only 26 articles using the search terms rhubarb + cancer, but each one is showing significant promise as the various molecules are being evaluated. There are even well-designed human studies showing various benefits from consuming a rhubarb extract resulting in decreased lung toxicity associated with pulmonary radiation and shorter healing time after surgery for gastric cancer.

So don't wait for more studies to be done. Simply enjoy one of the first foods that announce the beginning of the outdoor growing season in those areas that have cold winters. If you're not lucky enough to have your own rhubarb plant, head down to your local farmers' market to pick up some locally grown. Know that you are eating a healthy and delicious food! If you want to make a rhubarb pie, go for it. However, easy is also great, so make the rhubarb sauce for a win-win-win enjoyment!

I thank my sister-in-law and my Gramma for sharing a part of their heritage with me. I'll end with this short and lovely blessing that also emphasizes sharing of food.

O God, you have formed heaven and earth;
You have given me all the goods
that the earth bears!
Here is your part, my God.
Take it!
~~ Pygmy prayer

Diana Dyer, MS, RD

Tuesday, May 13, 2008

Word games - What is a "diet"?

One of my blog readers made the comment that she does not like the word "diet", although she likes the foods I recommend. I agree, I agree!!

Unfortunately, our society has morphed the word diet into a huge money-making industry based on disordered eating. How sad is that. There is even a Garfield cartoon showing him prostate before his food bowl, holding up a piece of lettuce and saying "Diet is die with a t". That is not how I like to think of the word diet or my life!

I prefer to go back to the early definitions of the word diet, which are:
(1) A day's journey
(2) A way of living or thinking. 

Ahhh, what a more normal and comfortable use of the word, so enlarged and all-encompassing, not so narrow and restricted and leaving one feeling deprived. These uses of the word diet lead to health and wellness, including both the body and soul. 

So what I eat, what I think, what I do (exercise, stress reduction, work, play, cook, express thanks and gratitude, care for others, etc, etc) each and every day is all included in how I care for myself and all ingredients of my daily diet for a healthy life of cancer survivorship, and in fact, it a recipe for a healthy life, period, with or without a cancer diagnosis. I try to emphasize this message in my book and during my presentations. :-)

I'll end with a soothing quotation I recently read:

"Take care of yourself,
you never know when the world will need you."
~~ Rabbi Hillel

Diana Dyer, MS, RD

Monday, May 12, 2008

Eat More Kale!

Anyone who has been reading my blog for a while has come to realize that I am just crazy about eating kale. We do have our kale already planted in the garden, hoping for a early summer crop before it gets too hot. In addition, we have one small kale plant that we apparently didn't see to pick last November and was hardy enough to winter over, even during our long, cold, and snowy winter this year. (Ann Arbor just finished its snowiest winter on record, including setting a record for the most snow in March!). That one small plant is being "babied" along (meaning being careful about keeping our dog from stepping on it when she is in the garden with us as we are planting and weeding), as I have read that those are the plants that will quickly go to seed, thus giving us "free seed" for our fall planting - yea!

Well, surprise, surprise when the mail was delivered today, I received a large envelope that was squishy. There was no return address, but it was postmarked in Montpelier, VT. Although I have heard Montpelier is a great place to live, to my knowledge I don't know anyone who lives there. The envelope contained a T-shirt that said "Eat More Kale" and a few of the cute green stickers shown above. That's all, no note, etc!

It only took a few seconds to find the likely source of my new T-shirt. Check out the web site called by Bo, the Eat More Kale Guy. What fun!! I do love people who also love kale, but maybe even more importantly, I love the fact that Bo has found an outlet for combining his thoughts and creative talents. He obviously loves what he does, and obviously many many other people love what he does, too!

I'm not sure who sent it to me, but I extend my heartfelt thanks. Hopefully I'll hear soon. Meanwhile, I'll have fun wearing my new T-shirt. It's sure to be a conversation starter! :-)

In celebration of spring, I'll end with this blessing by Saint Francis of Assisi (1181-1226):

Praised be my Lord for our Mother the Earth,
which sustains us and keeps us and brings forth diverse
And flowers of many colors -- and grass.

Yes, spring has sprung. We have finally cut our grass.

Diana Dyer, MS, RD

Saturday, May 10, 2008

Do Cancer Survivors Make Suggested Lifestyle Changes?

A recent article published showed the results of a survey conducted by The American Cancer Society that asked cancer survivors about lifestyle changes done after their cancer diagnosis. Here are the findings:
* Only 14–19% of cancer survivors were eating five servings per day of fruit and vegetables.
* Physical activity recommendations were met by 29–47% of cancer survivors.
* Smoking cessation was met by 82–91% of cancer survivors.
* 12.5% were meeting none of the recommended changes
* <10% of the survivors were meeting two of the recommended changes in any of the different cancer diagoses
* Overall, only 5% of survivors met all three of the recommendations.

Hmmm, these data are really good to have documented. However, a higher percentage of diet and lifestyle changes in cancer survivors is not a surprise to me. Yes, a cancer diagnosis is a "teachable moment", but so are other diagnoses or events. Yet, would anyone really expect a person who has just been diagnosed with diabetes or has had an MI or by-pass surgery
to find, sort through, prioritize, and make all the necessary diet and lifestyle changes completely on their own to optimize the disease process and quality of life from that point forward?

I know how hard it was to first physically recover from cancer surgery
and treatments and then both figure out and then make major
meaningful changes myself to my diet and lifestyle. When left on my
own after my cancer therapies were completed, I essentially created my own individual and personal "oncology rehab program" similar to a cardiac rehab program or an intensive diabetes management education program. No only do I know how hard this was to do by myself, even as an RD, I know how hard it is to stick to these changes every single day of the year, year after year after year. (I thank my lucky stars that I did not need to quit smoking, in addition to diet and exercises changes.)

It is beyond my intellectual capacity to understand how the oncology
community expects most cancer survivors to "do this on their own"
without the professional and group education and support that the
cardiac community provides for continuity of care for their patients.
Granted many cancer survivors are "health seekers" and will find their
way to reliable information and find the individual drive and
motivation to make changes, but if that only ends up being 5%, well I
guess 5% is better than 0%. (can you hear me sighing.........?)

Simplifying the goals to eating 5 servings of fruits and vegetables
per day and exercising 30 minutes per day for each day of the week
sounds simple enough, but the point is people are not doing that
before the diagnosis for multiple reasons. With so much else weighing on you, distracting you, and/or needing immediate attention (like figuring out how to sort through the medical insurance info - if you're lucky enough to have insurance - and figure out how to pay for everything else not covered by insurance, just for starters!!), I think it is abundantly clear that cancer survivors are not going to jump on the health bandwagon quickly or easily, and it is unreasonable to expect them to "stop smoking, eat right, and exercise" completely on their own.

I don't know what it's going to take to move oncology to the point
that nutrition and other lifestyle changes are fully incorporated
pro-actively into comprehensive cancer care. Cancer patients need "oncology rehab" as much as people with cardiac disease and diabetes do (and I sure I could add other diagnoses here, too).

As a cancer survivor, I'm glad I'm in the 5% group but as a health
care professional, I'm not proud of the 5% figure. Somehow we have to
figure out a way to do better, much better, and sooner rather than
later. Maybe implementing the use of the upcoming nutrition survival care plans will help increase these figures. (Sounds like a research project to me for some center/RD to do.)

I'd love to hear others' reactions and thoughts to the results of this
survey, and I always love hearing ideas for how RDs can be (and are!!) involved with improving health and quality of life after cancer. I will add that for those of you who moving the curve forward by providing nutrition information and support for cancer survivor, I first say "Thank you!" and then add that I hope some type of outcome data are being collected since "lack of research" always seems to be a reason given for why nutrition is not included in comprehensive cancer care. (I admit to getting weary of hearing that there is not yet enough research; granted, I know I am an impatient person!)

Diana Dyer, MS, RD

Saturday, May 3, 2008

Does Food Choice Trump Food Miles?

An upcoming article to be published in Environmental Science & Technology Journal will present data that show the choice of food eaten can significantly reduce or increase a family's household impact on climate change. Carnegie Mellon researchers Christopher L. Weber and H. Scott Matthews article expands the perspective of the question asking if reducing "food miles", i.e., consuming locally grown foods versus those transported in from afar, decreases greenhouse gas emissions and thus reduces an individual's and/or family's food-related contributions to global warming.

Their analysis shows that the transportation involved with the distance that food travels produces only around 11% of the average American household's food-related greenhouse gas emissions. They do agree that fruit, vegetables, meat and milk produced closer to home require fewer petroleum-based transport miles than foods brought cross country (or from the other side of the world!) to your table, however, their analysis demonstrates that the large amount of greenhouse gas emissions involved with producing the food matters more than the distance traveled.

The authors also agree with other reports that eating less red meat and/or dairy products will lower food-related climate impacts. They give some examples to put these recommendations into perspective by estimating that a shift to eating an entirely locally grown diet would reduce the equivalent greenhouse gas emissions as much as reducing your driving by 1,000 miles per year, while changing only one day per week's meat and dairy-based calories to chicken, fish, or vegetables would have about the same impact. However, shifting entirely from an average American diet to a vegetable-based one would reduce the same emissions the equivalent of driving 8,000 fewer miles per year. (Wow, I no longer feel like I need to purchase a hybrid car to significantly reduce my personal impact on climate change.)

"Where you get your food from (i.e., where it is grown) is a relevant factor in family food decisions, but what you are eating - and the greenhouse gas emitting processes needed to grow it - is much more important from a climate change perspective,'' said Matthews, associate professor of civil and environmental engineering and engineering and public policy at Carnegie Mellon.

My recommendations would be to buy locally grown and organic food when possible and eat a plant-based diet every day of the week with no more than 2 ounces of meat per day (or equivalent animal protein - see my previous posting for examples). Making a commitment to these food choices (1) supports our local small farmers, local economy, and community, (2) reduces our impact on climate change, and (3) optimizes both our stewardship of the planet and personal health. This sounds like a win-win-win (or more!) situation to me. :-)

The beautiful graphic I used here came from the blog called A Veggie Venture, which has compiled a seemingly endless number of delicious and exciting vegetable recipes (yes, I really do get excited looking at and eating beautiful vegetables!).

One more final thought to consider. A colleague recently reminded me of this Japanese phrase concerning both healthy eating habits and lifestyle.

"Hara hachi bu",

It means to eat until only 80% full to allow space in one's life.

Hmmmmm, I like thinking about the space in my life image. :-) Is this more physical space, i.e., in my stomach or getting those closets and rooms finally cleaned out, space within each day (i.e. time), more days in my life span, or what? What does more space in your life mean to you?

Diana Dyer, MS, RD