Thursday, September 27, 2018

A Little Perspective

Fourth of July Lake (in the distance)
looking south from just a little west of Round Top Lake,
Carson Pass area, highway 88, CA

Are those mountains far away or closer than they look? Is that lake small or big? It depends on your perspective!

This post was to be about something else entirely but instead of what I was going to write about, I think I will share my experience from yesterday's visit to the doctor.

It's been 6 years since my bypass surgery (9/13/12).  Twice a year, I go for a visit with my cardiologist. In advance of that visit, I do some testing to see if my carotid arteries are still in good shape and I have my blood drawn in order to check my cholesterol levels and the functioning of my liver. When I see my cardiologist, I joke with him that I must be his most boring patient! With the exception of one thing, nothing has changed for me in the last 6 years. My cholesterol levels have remained constant, my overall cholesterol ratio is good, my blood pressure is low (good) and my liver is holding up nicely. The blockages in my carotid arteries have not advanced any further so that is always positive news as well. In addition to the above, my lifestyle choices don't pose much risk to my cardiovascular disease. I don't smoke or take drugs and I don't drink anymore. I haven't any extraneous conditions like diabetes or hypertension, I am not physically inactive or overweight. I am an (almost) older woman and I haven't a clue about my genetics, but all signs for continued good health look fine for now. I realize that health status is not a static thing, so as I get older, I will continue to monitor and change what I can. In the meantime though, I take my medications and thank my lucky stars.

As I left the office yesterday, I thought about how very fortunate I am. Not just in terms of our insurance coverage or the personal support that I receive, which all contribute to my sense of well being, but really in terms of what actually didn't happen to me. As of 2010, the leading cause of death for American women is heart disease (and this statistic is still true today). Over and above cancer, it is the number one killer of women. Women get it younger than you might think and the risk increases as we get older. Additionally, 23% of women will die within one year of a first recognized heart attack; 22-32% of women  heart attack survivors will die within five years. There are more statistics like this, taken from the website of The American College of Cardiology. Take a look at the link. It might scare the hell out of you like it does me. People may want to argue with the numbers but really, who cares? Any numbers are too high, in my opinion. 

I wrote above about what didn't happen to me. I did have some things happen of course. I got cancer when I was 30, was treated with chemotherapy and radiation which ultimately most likely caused the coronary artery disease and subsequent heart attack. I have received excellent medical care and I have the support of my husband, friends, and family. I have had setbacks and bad days. I have overlooked some other health issues. The scenario isn't perfect. It's pretty good though.

But back to those mountains and that lake. I went hiking with my friends on Tuesday. I had a hell of a time hauling myself up to one of the lakes on our route and then some more fun ensued as we went in search of the lookout point for the lake shown above. It was worth the extra mileage though to see that lake (Fourth of July Lake as mentioned above). Standing at the edge of the lookout point, the lake seemed bigger than I expected. The mountains felt closer than what I would have thought. It felt like we were right there with everything because really, we were in the middle of things, so to speak.  Both the lake and the mountains are far away, though. Not impossibly far from there (people hike to that lake) but far enough. It's all in your perspective, I think.

And that is what I wanted to say really. My health history might seem kind of bad at first glance just like those mountains and lake might seem far away. It is bad (and they are far) but if I just focused on that, well, I would be in trouble. So, I try to focus on my positive health status today and the fact that I didn't die, twice. It's a miracle to me; something I don't fully understand. As I walked out of my doctor's office yesterday, I thought to myself how very lucky I am to be here. There were people in his office that didn't look so great. People older than me, granted, (and my time will come) but for now, it looks good. Very good. As I wrote above, it's all in your perspective.

Thanks for reading, 

Sunday, September 23, 2018

My Ridiculous Love of Nutrition Labels

And I thought I was just buying a cookie. Wrong! 

A couple of days ago I was at the grocery store and the above cookie caught my eye. Normally, I would have given this a pass but I saw that it was vegan, I was hungry, and I guess that is all she wrote! Into the cart it went. I got home and ate it. The whole thing. And was immediately sort of sorry. Sort of. Once in awhile a little splurge is fine. 

The cookie though got me thinking because of course, prior to eating it, I examined the nutrition label. In depth and at length. It's what I do. I am an inveterate food label reader of long standing. Rich won't go with me to the store anymore unless I promise not to read the labels. I get irritated and because I am "that woman" now, I talk to myself out loud, airing my grievances in a quiet and muttering sort of way. Why is there sugar and salt in this can of tomatoes? Why is there added sodium in my frozen peas? (And why did these peas come from Austria???) Why is there sugar in a can of breadcrumbs? The list goes on.

Why do I read the labels anyway? I have read articles that indicate that food labels (and the system of counting calories in general) is flawed. (Article here.) Yet I still rely on this information to make some basic decisions. My sense is that the USDA guidelines on label reading (find them here and look at item 6 in particular for the % tool) is a good place for average consumers to start. I am that consumer.

So what information can be obtained by reading the nutrition label on a package of food? The above link gives a good primer on how to begin to understand the label's contents. I thought though that I might share what it is that I look for. These things are specific to my health situation and reflect my interests in three things: saturated fat, sodium and fiber. I also look closely at portion size, calories (for what that is worth, evidently) and ingredients. My hope is that this post will generate some interest in learning to read a food label and that it will prompt people to see how label reading can fit into a person's own way of being healthy.

Let's start with the simplest things first: serving size and calories. I tend to look at these items right away. They tell me where this food might fit into my diet, i.e. how much I might eat (portion size) and how many calories it will cost me. It makes a difference when I put this product into context with the rest of what I eat during the day. Food that doesn't have much nutritional value to me might squeeze out other foods that do have nutritional value, if I am watching the number of calories that I am consuming. So, I try to be mindful of needing to eat healthy foods and limiting those that won't benefit me much in the long run. 

As an example, let's look at the cookie above. That package of 1 cookie contains 2 servings. What? This means that one half of the cookie contains 230 calories and is 1 serving. When I see that and know that I am going to eat the entire cookie in one go, then I know I have to double everything. So the whole cookie (both halves) contains 460 calories. If I was following a 2000 calorie a day diet, that would be nearly 25% of my day's total calories. You can believe that I loved this cookie to death, ate every crumb, and licked the inside of the wrapper! It was a treat. And honestly, it was fine. I didn't sweat the rest of the day's food because overall, I am consistent with what I eat. Cookies are not normally on the menu.

Once I am done with portion size and calories, I continue on down the label to the parts that interest me. Aiding me in my search, is a "percentage" guideline supplied by the USDA and listed on their website mentioned above. Per their site, the USDA recommends that when looking at the overall % Daily Value (DV) column on a nutrition label, a person should apply the 5%/20% DV rule. That is, 5% is the low end of what you are consuming and 20% (or more) is the high end. (This is taken directly from their website-please see link above. Additionally, there are rules in place for regulating claims that companies can make about their food such as whether or not a food is "low in sodium" or "high in fiber." That is a discussion for another post.) 

As an example of this 5%/20% guideline, the above label states that the total DV% for saturated fat is 8% for a half of a cookie. (The serving size per package is 2 so that means one serving is one half of the cookie.) I ate the whole thing (2 servings) so that means that for the entire day, I ate 16% of my saturated fat allowance. (Based on a 2000 calorie diet-again taken from the label and the USDA's website.) Is that a lot? Well, figure that 16% is somewhere between 5% and 20%, leaning towards the high end of that range. For me personally, it means I was careful that day about the rest of my saturated fat intake. I use this tool in a general way and find it to be a good place to start. And again, it's something that the USDA has provided as a guideline only. 

Continuing to use the USDA's guideline as my tool, I look at the remaining nutritional components on the label that are of interest to me: sodium and fiber. The first item is sodium. Sodium is ubiquitous in the Western diet. I am not sure anyone could dispute that. It occurs naturally in some foods and is added to others to boost flavor, extend shelf life, etc. We tend to get too much sodium however, which by itself isn't good for heart health.  Because I have cardiovascular disease, I always take a look at sodium content and try for the lowest I can find. Again, I use the 5%/20% rule, knowing too that I eat beans and legumes and vegetables and fruits that may have a bit of sodium (and potassium, sodium's partner) in them naturally. I really do try to see where all of my choices fit with one another. I am likely at this point to forgo prepackaged snacks and instead spend my sodium allotment on things that will enhance my cooking, such as liquid aminos, reduced soy sauce, or other condiments like that.

The second item I check out is fiber.  (Remember that there are several ways to approach how much fiber each person needs so it's best to check with your doctor first. There is also a good basic article from WebMD here.) Personally, I go with what normal guidelines indicate for my age and sex which is 25 grams a day. I totally scan the label for this information! With the above cookie, of course there isn't much fiber (2 grams per servings or just 8% per serving). That isn't a lot and honestly, should you be getting the bulk of your fiber intake from a cookie? Probably not. I do look closely at prepackaged foods to see just how much fiber is present, and again, I apply that 5%/20% guideline. As a personal choice, I tend to get most of my fiber from beans, legumes, and grains. These are some of the heavy hitters in the plant world along with fruits and vegetables, of course! 

Apart from what I mentioned above, I tend to simply scan the other items (the ones prior to the ingredient list). I look briefly at cholesterol and carbohydrates, and also check for calcium, protein, and vitamin B-12. (All are unlikely to be present in great amounts but I look anyway.) 

Eventually, I get to the ingredients. I have read that the bulk of what is in a product is listed in the first several ingredients. With the above cookie as a guide, it contains what you would expect a cookie to contain: flour, sugar, peanut butter, water and oil. The rest of the ingredients? They have to do with making the cookie palatable, portable, and shelf stable. I don't necessarily fear a long ingredient list either though I know some would say to avoid this. As an example, I eat a pretty healthy bread every day for toast but it has a long list of ingredients, all healthy and of good quality. I tend to look more at content rather than quantity. If it's a bunch of chemicals and compounds to keep something stable, enhance taste and mouthfeel, or to do something else, I start to draw the line. I have put items back onto the shelf and looked up the ingredient on my phone right there in the store. (Technology does pay!) A person has to come to their own conclusions but reading the label first is a good start.

So, what do I get out of all of this label reading and why do I spend so much time doing it? First and foremost, I am the sort of person who likes to know things. And I try to be proactive with what I eat so that I can feel good. I feel lousy when I eat too much salt or too much sugar. That's a fact. Also, I can only eat so much food in the course of the day. I try to make that food be as nutritious and supportive of my health goals as possible. If I fill my calorie needs with junky food then there isn't room for much else. That's a fact too! And I am a vegan so it's especially important to me that any packaged food not contain any animal products. So, taking time to read labels with those things in mind is always my goal.

Is all of that energy and time spent reading ingredients and looking at percentages helpful to me in any way? Do I think I am going to live longer or enjoy a better health status because of my efforts? I don't honestly know. That is the truth. I do feel, however, that it doesn't hurt to hedge my bets, so to speak. I haven't read anything yet that says a bunch of sugar or salt is good for you or that excessive calories every day for the long term is going to help make a person feel good. Over time, I have simply developed a habit and an awareness. The habit is the label reading and the awareness is an attention to my health. Does that mean if a person doesn't do these things that they aren't doing something right? Absolutely not. The attention by me to those details is just part of my personality, my slightly neurotic persona. It's how I am, in other words. 

What is the final takeaway on my love of reading a nutrition label? I find the topic interesting. Nutrition label reading gets me a little outraged each time I do it which I think helps me to find and make better food choices overall. It also allows me to buy some convenience foods and to fit those into my overall dietary plan. Nutrition label reading fits my personality in several ways too. I am a person who likes some information, who likes some rules, and who appreciates things laid out in a fairly simple fashion. I like to know about my saturated fat, sodium, and fiber intake. I feel that monitoring those components in some way contributes to better overall cardiovascular health. I do recognize though that the approach isn't for everyone. And the USDA's information is not a one-size-fits-all deal. Variety is the spice of life isn't it? But for those of you reading who may be like me, I definitely advocate this approach in some form. Know that the label is there, know what it contains (and doesn't contain) and get educated about it. (I included some links above.) We are living in very confusing and changing times where nutrition information is fluid and evolving. For me, the nutrition label is a sensible raft to cling to.

Thanks for reading,

PS-As with all of my posts concerning nutrition, wellness and health, the reader should draw their own conclusions and do their own research. If the reader is seeking dietary advice of any kind, they should seek out a medical professional such as a Registered Dietitian or a Medical Doctor.

Tuesday, September 11, 2018

Cookbook Review-Part 4/4: Power Plates by Gena Hamshaw

*This blog post will appear in four parts, each part being a review of one specific book. Part 4 of 4  follows below:

Of the four books that I have reviewed, Power Plates: 100 Nutritionally Balanced, One-Dish Meals by Gena Hamshaw is my favoritte. It's the book that I turn to most often for inspiration and for recipes that I actually use regularly.

If you haven't yet "met" Gena, she is the author of The Full Helping Blog. Her credentials go beyond this though. She is a vegan food educator, cookbook author, and certified nutritionist who is currently working on her DI (dietetic internship). Gena writes with feeling and care about her recipes, her personal insights, and other information relevant to veganism, eating in general, health and well-being. I tune in every weekend to catch her Weekend Reading posts in which she provides links and commentary to all sorts of interesting health related articles. 

In this cookbook, Gena offers nutrionally balanced vegan recipes for breakfast, lunch and dinner. The uniqueness of the recipes and Gena's viewpoint lies in the idea that optimal nourishment can come from a healthy balance of the three macronutrients: fats, proteins, and carbohydrates. The book isn't meant as a kind of "diet" or weight loss book but offers more of a chance to incorporate all three of the above components into a regular and long term way of eating. Many of the recipes are quick and easy to put together while some take a little more time. Of the recipes that I have tried and have read about, all would be suitable for the beginning to intermediate home cook.

One of the features that I most like about this book involves its ease of use and content. The font is large enough and dark enough and clear enough not to give me any trouble. (I wear bifocals and don't see too well in dim lighting.) The recipes themselves offer step by step instructions that make sense. The ingredients for each dish are grouped together according to which component of the dish you are working with. For example, the roasted zucchini tacos contain two components: the preperation of the tofu and the preperation of the vegetables. Those ingredients are grouped together accordingly. This is a super helpful feature of the book. And in general, each recipe and its photo are side by side so it is easy to see what the finished dish could look like as you are working with the recipe. She offers variations and substituitions for some ingredients and provides a nice, personal intro. for each recipe. This is a friendly and encouraging book. The recipes (and Gena's "voice") are extremely approachable.

For those just starting their vegan journey (or maybe trying to expand on their current plant based way of eating), Gena provides information on ingredients. There is information on how to cook various types of grains and beans, as well as instructions on how to prepare tofu. She provides a list with explanations of common kitchen staples, such as nuts, plant based milks, and nutritional yeast. The book also offers examples of meal plans to give the reader an idea of how they might combine some of the recipes to suit their own needs for all three meals: breakfast, lunch and dinner. And lastly, the photography and food styling is just lovely. It makes the book a real joy to use.

The recipes that I have made so far, numbering about a dozen or so, have all turned out well and have suited my own tastes with regard to seasoning, etc. I don't like dishes that are too salty or sugary or oily. The dishes that I have tried seem to strike the right note between those three factors. I have added extra spices with some dishes here and there but overall, I have been very happy with my results. I can't say that the book is aimed at a particular age group but maybe would be most familiar to people who are already aquainted with one dish meals (bowls). The book would also suit people who are looking for creative salads and soups as well as dishes that can be prepared on the stovetop. 

In trying to end this review (and the group of reviews in their entirety), I don't actually have anything negative to present about this book. As mentioned above this is the cookbook that I most often turn to for inspiration and the one from which I cook the most. It's the one that I would recommend for a new vegan or anyone interested in expanding their existing plant based diet. 

The other books reviewed are all fine cookbooks and I hope that I have offered points about them that may entice people to seek those books out to try for themselves. Over the years I have come to view cookbooks as being highly personal things. I choose books that reflect where I am currently in my cooking and eating journey. Looking at my cookbook shelf, I can see how that journey has progressed. Because eating and cooking can be so personal, it's hard for me to suggest that one book is better than another. It's really up to the user to figure that out and to buy something according to where they are in their own eating and cooking journey. But, with that said, I do hope the information provided in these reviews is useful. It's my hope that anyone interested but still deciding about a plant based way of eating will hop off the fence and get going! Start with the above book and go from there. Happy cooking to you!

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