RADNUT

Hello all, just writing to update you that Health 411 has now become RADNUT, Robin Arora-Desilet Nutrition. Connect with us at http://www.radnut.ca/ for more up to date evidence based health information. In addition to health information, you will finally gain access to my personal recipes that I have tweeting about for years. We've also added Nikolas Desilet, resident internal medicine physician to the RADNUT team. We welcome you to join us at RADNUT and thank you so much for following Health 411.

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Updates, Changes, Moving Forward & Fake it Till You Become It

Hello and happy holidays to any and all of you that check out Health 411. Just dropping by to let you know some exciting things are in the works for Health 411; so no, I've not forgotten about this resource, in fact, I'm working on developing and expanding Health 411, so stay tuned in the new year for access to my recipes, updated nutrition information and much more!

As for what I've been up to over the last 2 months, I've been teaching a wonderful course called craving change. The course helps us take a very close look into our personal relationships with food and why it can be challenging to make healthy choices and changes. When it comes to leading a group of people, I can become nervous at times. On one of my typical TED talk nights (I love TED talks), I stumbled upon a talk by Amy Cuddy discussing the power of body language and how it shapes who we are. Before each workshop I kept this talk in mind and it helped me remain confident in myself. Her suggestions are simple and easy to follow. Try it out and let me know how it goes!

Decrease Your Dementia Risk

Being in preventative health care, us dietitians are always thinking about how to prevent diabetes, heart diseases, stroke.. and today dementia was on my mind. My husband and I have joked about being 85+ years old together and dealing with inevitable dementia that comes with age. When I consider this seriously, it’s not a joke at all. To have impaired memory, mood fluctuations, possible hallucinations, tremors, dis-inhibition, personality change, and/or language difficulties sounds like an emotional, confusing, heart-wrenching process. There are many types of dementia; not every person with dementia will experience all of the symptoms listed above since certain symptoms correlate with certain types of dementia.

Curious about how to decrease your risk or delay the development of dementia? Take a look at some of the research below:

• Challenge your brain. Education may protect you against dementia later in life. Some theories suggest that those with higher levels of education create more complex connections and efficient networks in the brain which can compensate for dementia-relate damage. Others say that those with higher education have higher socioeconomic status and can afford a healthier lifestyle, are exposed to less toxins, and have greater access to healthcare. While some say “use it or lose it” and that lifelong brain activity may be needed to prevent cognitive decline.
• Get support to deal with depression. Those with depression may have increased risks of dementia later in life. Speak with your doctor to see what type of support is available to you.
• Stop Smoking. It damages blood vessels, increases heart disease risk, decreases life expectancy. Yes it is an addiction. Yes it will take many tries to quit. So don't forget to utilize your healthcare team and government funded smoking cessation programs for the public.
• Watch those drinks: alcohol abuse has a deleterious effect on the brain as it damages neurons and decreases cerebral volume. It also leads to liver tissue death and increases risk of heart disease and certain cancers. Alcohol in moderation e.g. 1-2 drinks/ day may have some health benefit in lowering heart disease and Alzheimer dementia risk, but further research is needed.
• Physical activity improves blood flow through large and small blood vessels to the brain, can help decrease blood pressure, decrease insulin resistance and improve blood sugars, increase HDL (cholesterol that protects the heart), increases neurogenesis (formation of neurons in brain), and can reduce the loss of neurons in certain parts of the brain. Some studies suggest that high physical activity may decrease Alzheimers and vascular dementia risks by 40%. 
• A Mediterranean style diet high in whole grains, fruits, fish, legumes, nuts & seeds, and vegetables, has been associated with reduced risk of heart disease, type 2 diabetes, some forms of cancer and overall death. When people are deficient in Vitamin B12 or folate, homocysteine levels rise. High homocysteine levels could be related to nerve cell death and may increase risks of brain injury. It is unclear if Vitamin B supplementation decreases risk of dementia but it may be beneficial in those patients who are deficient. 
• Manage your high blood pressure (hypertension). Studies show that high blood pressure is related to lower brain volume. It can lead to cell damage in the brain as well as an accumulation of protein which could lead to Alzheimers dementia. Hypertension in midlife, is associated with an increased risk of any late-life dementia. Manage your high blood pressure through dealing with stress, not smoking, limiting alcohol intake, physical activity and assessing your sodium intake.
• Having diabetes later in life is associated with increased risks of all types of dementia, especially vascular dementia. Learning how to keep your blood sugars in target ranges using high fiber foods, lean protein, physical activity and stress management may save you from more than just common complications of diabetes.

There you have it, an array of ideas on how to decrease your dementia risk. Now it's up to you to decide which one you start with!

Information Source:
http://www.alz.co.uk/research/WorldAlzheimerReport2014.pdf

Why We Procrastinate

Have you had a busy summer like me? Have you kept up with your day to day or weekly self-education? Or is there a project you began a few months ago that doesn't seem to be moving forward? We have all been there, that feeling where you know you have to or should do a certain thing, but you just put it off.
This summer my form of procrastination has been with keeping Heath 411 updated. I like to have at least 1 post per month, but a whirlwind of summer weddings, road trips, cooking and cleaning have given me reason to stay away from my laptop! This got me thinking about, why do we procrastinate?
Procrastinating involves postponing, delaying, or putting off an intended course of action. It is wide-spread and has been reported for thousands of years.
Studies on college students show that they spend over one third of their time procrastinating by sleeping, playing or watching TV. Some suggest that there is an involvement of irrationality and self regulatory failure because the task is often delayed despite expecting to be worse off with the delay. Depression has been linked to procrastination due to low energy levels, and lack of interest in previously enjoyable activities. Additionally, it has been suggested that perfectionism, fear of failure, lack of self confidence, lack of certainty of success, or low self-efficacy could be probable causes of procrastination. Decreasing the value of the task also can increase procrastination, especially if we consider it to be boring or attempt the task when energy levels are low.

Ways to decrease procrastination may involve:

• Taking time to understanding reasons, habits, and thoughts that lead to your procrastination. If you're wanting to change these thoughts, practicing positive self-talk may be helpful
• Consider acquiring or improving skills related to the task may help increase self-confidence
• Increasing task difficulty to make the task challenging but achievable may reduce boredom
• Sometimes simply starting the task can create motivation to complete it, instead of expecting to feel motivated in order to begin the task
• Setting short-term, realistic, goals or breaking big tasks down to little ones can increase personal satisfaction each time we achieve a goal
• Take time to identify and write down personal reasons for wanting to reach your goals or complete tasks. These reasons need to be related to what you want for yourself, not what others want for you

For more information on procrastination take a look at Cal Poly's Procrastination Resource for Students and the links below. Now lets go and get some things done!

Information Sources:
http://www.ncbi.nlm.nih.gov/pubmed/17201571
http://sas.calpoly.edu/asc/ssl/procrastination.html

http://success.oregonstate.edu/six-reasons-people-procrastinate

http://www.princeton.edu/mcgraw/library/for-students/avoiding-procrastination/

Curious About Coconut Oil?

I'm sure you've heard all about the potential benefits of coconut oil, but do you know which types are available, which one may be better for your health, and which type you're using?

Let's start with the main types of coconut oil:

• Unrefined or Virgin: extracted from the fruit of fresh mature coconuts without using high temperatures or chemicals. Unrefined coconut oil has phenolic compounds which have been associated with antioxidant and anti-inflammatory properties. It has a light, sweet-nutty coconut flavor and aroma and is ideal for baking or sautéing up to 350°F.
• Refined: made from dried coconut meat that’s often chemically bleached and deodorized. This oil is tasteless and can be used for baking or for medium-high heat sautéing, up to about 425°F.
• Partially Hydrogenated: further processed by manufacturers and often found in commercial baked goods. Hydrogenating the oil transforms some unsaturated fats to trans fats which can increase our LDL ("bad" cholesterol) and decrease HDL ("good" cholesterol). 

One small study looked at obese adults who were on a low calorie diet and were supplemented with 30mL coconut oil daily. Results showed decrease in waist circumference but no statistical change in weight or fat mass. In another observational study, participants with normal cholesterol levels who reported ~30mL intake of coconut oil daily showed increased HDL ("good") cholesterol, but also had an increased in LDL ("bad") cholesterol. Consumption of unsaturated vegetable oils such as olive or canola did not show a similar increase in LDL cholesterol when compared to coconut oil. High LDL has been linked to increased risks of heart disease, however this link is currently being re-analyzed by many in the medical community.

It has been suggested by some that the short and medium chain saturated fats in coconut oil may have health benefits because they can be metabolized quickly, used for energy rapidly, and may play a role in immune function/ infections/ viral conditions. At this time, there is insufficient evidence to support weather or not these health claims are true. Additionally, it is unclear if the lauric acid in coconut oil which raises HDL results in a cardiovascular protective effect or if the raised LDL is harmful to our hearts.

Overall, small amounts of unrefined coconut oil could be part of a healthy diet. It is important to remember that it's rarely just one thing that "causes heart diseases" or rarely do we find a magical oil or pill that cures all that ails us. It's about your lifestyle, your fiber intake, your activity levels, your mood, your sleep and many other things that work together to decrease or increase our risks of heart disease!

Information Sources:
http://www.eatright.org/Public/content.aspx?id=6442477202
http://www.eatrightontario.ca/en/Articles/Fat/I-ve-heard-that-coconut-oil-is-the-best-oil-to-use.aspx#.U7NUX_ldV-h
http://www.ncbi.nlm.nih.gov/pubmed/23674795
http://www.healthcastle.com/nutrition-faceoff-coconut-oil-vs-olive-oil
http://advances.nutrition.org/content/4/3/294.long
http://www.pennutrition.com.ezproxy.library.ubc.ca/KnowledgePathway.aspx?kpid=2878&pqcatid=146&pqid=2946

Snack Attack: 10 Satisfying Snack Ideas You've Got to Try!

Are you skipping meals? No time to eat in the day so you end up snacking or over-eating at night? The best way to prevent over-eating or unhealthy/ uncontrollable snacking at night is to eat at regular intervals throughout the day. If you don't have time to prepare a lunch, why not take some of these fiber and protein packed snacks that won't leave you searching for more food an hour later. Be sure to add these ingredients onto your next grocery list so that you're refrigerator is well stocked!

• Apple, nut butter sandwich. Sprinkle with pumpkin or sunflower seeds for added crunch. If you have a sweet tooth, add raisins, cranberries and cinnamon
• 3/4 cup of plain greek yogurt and frozen berries. Top with your favorite high fiber granola or cereal (4 grams fiber or more per serving) or nuts
• 3-4 Ryita crackers with almond or peanut butter. Add sliced banana, chia or hemp seeds for more flavor and crunch 
• Cherry tomatoes, snap peas, & bell peppers dipped into 2 heaping tablespoons of hummus or home made greek yogurt tzatziki
• Home-made trail mix: 1/4 cup unsalted nuts, 1 tbsp pumpkin seeds, mixed with 1/4 cup dried fruit (e.g. apricots, dried cranberries, cherries, raisins). You can even prepare larger quantities and divide into small bags or containers for the week.
• 1/4 Cup unsalted nuts like almonds, walnuts, or pistachios with your favorite fruit 
• Smoothie with banana, frozen fruit, plain greek yogurt, & 1% or skim milk, water, or 1/4 cup juice. For more fiber and antioxidants blend in a handful of kale or spinach. For more protein and healthy unsaturated fats, blend in a closed handful of nuts, or 1 tbsp of chia, flax, or hemp seeds 
• 4 Ryvita crackers or a whole wheat wrap with salmon, tuna, or egg salad 
• 1/4 Cup cottage cheese with fruit such as orange slices or vegetables like celery 
• 1 Whole wheat pita with mashed pinto or black beans, guacamole and/ or hummus
  
  There you have it, my top 10, protein and fiber filled, dietitian approved snacks that promise to keep your belly full and hopefully limit cravings and over-eating later in the day. Happy snacking!

What About MSG?

Have you ever thought "what is the deal with MSG?" Many of my patients, colleagues and even I try choose foods without MSG, but do you know why you're avoiding it and what it is? If you're a curious soul like me, read on to get some facts about MSG.

Monosodium glutamate is a salt formed from the amino acid glutamate, sodium, and water. It originally was extracted from seaweed kelp by Japanese chemist Ikeda Kikunae.  It is used in our food industry to enhance natural flavors and is often found in soups, crackers, potato chips, casseroles, meat, seafood, prepared pastas, Chinese food, broths, spices/ seasonings, gravy and sauce mixes. Glutamate is used in our bodies to make protein and also naturally occurs in dairy, meats, tomatoes, mushrooms, potatoes, grapes, peas, corn, and cheeses such as Parmesan and Roquefort.

The FDA states that MSG is “generally recognized as safe” (GRAS). However, some people identify themselves as sensitive to MSG and report symptoms of headache/ migraine, facial pressure, burning/ tingling, nausea, flushing, chest pain/ palpitations that appear ~20 minutes after consumption and resolve within 2 hours. If this reaction consistently occurs after MSG ingestion, the best treatment is to read ingredient labels and avoid MSG.

A study conducted in 2008 on 752 healthy Chinese participants looked at MSG intake and body mass index (BMI). The population was from rural China and 82% of participants used MSG powder as seasoning in their cooking. Participants were asked to shake out the amount of MSG they added to their daily cooking onto a scale; weighed amounts were recorded. MSG in soy sauce and restaurant foods were also accounted for. Results showed that those who used greater MSG had higher BMI and were more likely to be overweight than non-MSG users.
A 2014 study that looked at specific DIAR newborn mice who were treated with MSG and without. The BMI and blood sugar levels of MSG treated mice was found to be higher. The MSG mice also showed cholesterol accumulation in the liver. However it is important to remember that injecting MSG into neonatal mice is different than a human consuming small amounts of MSG orally within the food supply.

Alternatively, a 2010 study looked at 1282 participants; MSG intake and body weight were assessed in 2002 and then in 2007. When other food items and dietary patterns were accounted for within statistical analysis, no association between MSG and weight gain was found in the study.

Due to conflicting evidence, it is still difficult to clearly determine if MSG leads to weight gain, liver toxicity, increased blood sugar and/ or allergic reactions. A simplified question to ask could be does the use of flavor enhancers lead to more frequent over-eating in our population? If so, how does this affects our choices, health, blood sugar, cholesterol, and weight?

Information Sources:
http://www.hc-sc.gc.ca/fn-an/securit/addit/msg_qa-qr-eng.php
http://www.eatrightontario.ca/en/Articles/Food-allergies-intolerances/The-Truth-about-MSG.aspx#.U4OxP_ldV-g
http://www.fda.gov/food/ingredientspackaginglabeling/foodadditivesingredients/ucm328728.htm
http://www.healthcastle.com/msg.shtml
http://www-ncbi-nlm-nih-gov.ezproxy.library.ubc.ca/pubmed/?term=intermap+study+monosodium+glutamate
http://www-ncbi-nlm-nih-gov.ezproxy.library.ubc.ca/pubmed/20370941
http://www-ncbi-nlm-nih-gov.ezproxy.library.ubc.ca/pubmed/24730643

Green Tea Extract for Weight Loss? Let's Get Some Facts!

Another recent weight loss regime I've been asked about are green tea extract pills. Widely known as a protective antioxidant, over the last few years it has been suggested that green tea (from the Camellia sinensis plant) contains polyphenols called catechins which may play a role in promoting weight loss, decreasing LDL or "bad" cholesterol, preventing inflammation, and preventing heart disease.

In a 2010 study that lasted 8 weeks, 35 obese participants were divided into 3 groups: those who drank 4 cups water/day, those who drank 4 cups green tea/day and those who took 2 capsules of green tea extract daily. Patients who drank green tea or supplemented with green tea extract showed greater weight loss than the group who had water only. Additionally, a 2005 study with Japanese participants who drank oolong tea high in catechins (from green tea extract) showed reduced weight and body fat after 12 weeks when compared to those who drank tea low in catechins. Adversely, a 2014 study which assessed the affect of a weight loss beverage containing green tea extract showed no benefit or additional weight loss in participants who drank the beverage. This study found that participants who were involved in an online 12 week behavior modification course experienced greater weight loss results. The 2013 study by Liu et al., combined the data of 17 studies and found that green tea could reduce fasting blood glucose and hemoglobin A1C levels (average blood glucose over a 3 month span), which may have implications in diabetes management. However it is unclear if these results were related to green tea or green tea extract, which populations would most benefit from the intervention, and what dose would be most effective. It is additionally important to note that some studies have linked supplements containing green tea extract to incidents of hepatotoxicity (toxicity to the liver); These concentrated supplements have not been proven to be safe.

If you're still interested in trying this idea out, I'd recommend the safest source of catechins in their diluted form of a warm, soothing cup of green tea! Don't forget that your daily food choices, activities, family/ friends, and healthcare team can always be utilized to support your weight management goals.

Information Sources:
http://www.ncbi.nlm.nih.gov/pubmed/18691042
http://www.ncbi.nlm.nih.gov/pubmed/20595643
http://ajcn.nutrition.org/content/81/1/122.full
http://www.ncbi.nlm.nih.gov/pubmed/23920353
http://www.ncbi.nlm.nih.gov/pubmed/23803878
http://www.ncbi.nlm.nih.gov/pubmed/23121117
http://www.nlm.nih.gov/medlineplus/druginfo/natural/960.html
http://www.eatright.org/Public/content.aspx?id=6442473527