Daniel Pendick, Executive Editor, Harvard Men's Health Watch
Getting extra calcium from supplements is supposed to be good for your bones. The latest in a string of studies heightens concern that this simple practice could end up being bad for your heart. The results support growing recommendations to get calcium from food, not pills.
The new evidence comes from the NIH-AARP Diet and Health Study, which has followed the health of nearly 400,000 men and women since 1995. At the study’s start, the participants were asked how much supplemental calcium they took. From diet surveys, the researchers also assessed the likely amounts the participants were getting from food. Over 12 years of follow-up, men who took more than 1,000 milligrams (mg) of daily supplemental calcium were 20% more likely to succumb to heart disease than those who didn’t take calcium supplements. There was no connection between calcium supplements and heart disease in women (which has beenseen in earlier studies), and no connection with calcium from food. The results were published yesterday in JAMA Internal Medicine.
This one study isn’t enough to find calcium guilty of heart disease in the first degree. It wasn’t a randomized trial, the gold standard of medical research, so it’s possible that other unmeasured factors could account for, or at least contribute to, the link between calcium supplements and heart disease.
But it’s not the only research to point the accusing finger. “This is another study looking at high calcium supplements and their effect on heart disease, and it’s starting to get concerning,” says Dr. David Slovik, an osteoporosis expert, endocrinologist, and associate professor of medicine at Harvard Medical School.
Calcium for health
Everyone needs calcium to keep bones strong. It’s especially important for older folks, in whom the mineral can leach from bones. Losing calcium weakens bones and leaves them more prone to breaking. Vitamin D is the helpmate to calcium, allowing the body to absorb more of the mineral during digestion.
Recommended daily intakes of
calcium and vitamin D
Calcium
Vitamin D
Women ages 19 to 50
1,000 mg
600 IU
Women ages 51 to 70
1,200 mg
600 IU
Women ages 71+
1,200 mg
800 IU
Men ages 19 to 50
1,000 mg
600 IU
Men ages 51 to 70
1,000 mg
600 IU
Men over ages 71+
1,200 mg
800 IU
Many people don’t obtain enough calcium or vitamin D from natural sources—food in the case of calcium and sunlight in the case of vitamin D. They make up shortfalls by taking daily supplements.
Until the calcium–heart disease issue is worked out, it’s best to get as much calcium as possible from food. The menu options go beyond milk and cheese. “There are a lot of common foods that people don’t realize have calcium,” says Dr. Michelle Hauser, a clinical fellow in medicine at Harvard Medical School and a certified chef and nutrition educator.
The go-to foods for calcium have traditionally been milk (an 8-ounce glass contains 300 mg of calcium) and other dairy foods. But dairy foods often come with saturated fat and plenty of calories, which limits their use for delivering calcium.
Dr. Hauser points out that a number of common foods besides milk, cheese, and dairy foods can deliver comparable amounts of calcium.
An 8-ounce portion of off-the-shelf orange juice contains about 300 mg of calcium. The calcium in fortified soy milk also compares favorably to whole milk.
Breakfast cereals (which are also fortified) contain substantial amounts of calcium, especially when combined with low-fat milk.
A portion of oatmeal on its own contains just 100 mg of calcium. “But if you cut up some dried figs and add it to a bowl of oatmeal with milk, you easily get about half of what you need without having any supplements,” Dr. Hauser says.
Lunch and dinner afford opportunities to boost calcium. Start with salads with leafy greens like kale, turnip greens, and Swiss chard. “A large salad would contain about as much calcium as a glass of milk,” Dr. Hauser says. But go easy on the spinach—it is high in iron, which tends to block absorption of calcium.
If you enjoy sardines and other canned fish with bones included, you are in luck: they are unusually high in calcium. One 3-ounce serving of sardines provides about 325 mg of calcium.
Since the NIH-AARP participants were surveyed in 1995-1996, efforts have intensified to prevent osteoporosis not just with calcium supplements but also with a nutritious diet and, perhaps most important, regular weight-bearing exercise. “I think we should be a little more cautious about calcium from supplements,” Dr. Slovik says. “I tell my patients they should get as much as possible of the recommended amount from food.” Drs. Slovik and Hauser also emphasize the importance of getting enough vitamin D.
It might seem that popping a calcium supplement is an easy answer to maintaining bone health. But it comes with an uncertain risk of heart problems, and denies you the nutrients that hitchhike along with calcium in whole foods.
I recently worked with Harvard Heart Letter to put together New Years resolutions - one for each month of 2013 - to help you eat your way to a healthy heart.
Now that brown rice is becoming more mainstream, I hear fewer complaints from people about brown rice tasting different than white rice. These complaints are often replaced by comments like, "I would eat brown rice, but it takes so long to cook!" Having been in a time crunch myself for more years than I can count at this point, I came up with a solution that allows me to have great-tasting instant brown rice for most meals. For other meals, I have a fun project for kids (or the kid-at-heart).
Affectionately called "rice castles" or "rice cubes" - ready to go into the freezer
1) First, choose a night when you'll be in the house for 45 minutes or so whether or not you plan to eat brown rice that night.
2) Rinse several cups of rice (enough for multiple meals) in a mesh strainer or swish in a bowl full of water. Repeat until water is clear and drain well.
3) For each cup of brown rice you measured out and rinsed, add 1.75 cups water to a pot along with the rice.* Add a pinch or two of salt (optional).
4) Bring to a boil, stir well, immediately turn to lowest possible heat and cover. Set a timer for 35-40 minutes.
5) When timer goes off, remove pan from heat but DON'T UNCOVER. Allow to sit at least 10 minutes before eating. Rice continues to cook after removing it from heat.
6) After resting, rice can be eaten. Allow leftover rice (or all of the rice if not eating that day) to cool to a temperature you're comfortable handling it at.
7) Take a measuring cup the size of your usual serving of rice for 1 person (anywhere from 1/2-1 cup) and pack rice into in, then overturn measuring cup and tap the edge on a sheet pan to get your very own rice "sandcastle" to pop out. Repeat with remaining rice until you run out.
8) Place the sheet pan with all of your rice "castles" on it into the freezer and allow to freeze overnight. The following day, overturn sheet pan onto kitchen counter and rice "castles" will come off. Put them into ziplock bags and store in the freezer for later use. I can fit about 8 into a gallon ziplock bag.
9) For instant rice on another day, take one rice "castle" or "rice cube," as I'm fond of calling them, out of the ziplock bag. Put it into a bowl, sprinkle a few drops of tap water over it, cover with a plate and heat in the microwave for 1-2 minutes. The rice is ready and tastes freshly cooked. This is MUCH better than that terrible instant rice you buy at the store either in the pantry or freezer sections. (That stuff tastes truly awful to me!)
*NOTE: the amount of water listed here is less than it says on the bag/box of rice you purchased because most of us actually don't end up draining the rice very well and a lot of water clings to in. In my experience making hundreds of batches of rice this way, the amount listed here will be more accurate if you rinse rice before cooking. Rinsing rice before cooking helps produce cooked rice that doesn't turn into a mushy, sticky, pasty mess.
It was my first day off at the end of my first week as Internal Medicine Wards Resident. I had a fiancé headed out of town on a business trip later in the day. It had been WAY too long since we'd shared a lazy Sunday morning. Pancakes seemed like the perfect breakfast food.
The recipe below is what I created in an effort to make a pancake that was fluffy and exactly what you'd expect from a delicious pancake. Unfortunately for me, delicious pancakes usually have buttermilk in them. As someone with whom dairy is not a friend, I created this version. My intention actually wasn't to create a healthier version of the classic buttermilk pancake that didn't taste healthy, but that is exactly what happened.
Blueberry Pancakes with Maple Syrup
Breaking it down:
1) Sneaking in whole grains - as a baker and pastry chef, I've had a lot of time to experiment. I find that up to half of all-purpose white flour can be replace by whole wheat pastry flour without anyone noticing.
2) Cholesterol-free - this recipe has no eggs and instead uses baking powder and the combination of baking soda and vinegar to make the pancakes rise to fluffy perfection.
3) Saturated fat-free - canola or other vegetable oil is used instead of butter or shortening in this recipe.
4) Reduced fat - only 1 tablespoon of oil is used in this recipe. This is 63% less fat than the standard recipe.
5) Healthy flavors - to boost flavor and interest, cinnamon is added to the batter and white sugar is replaced by dark brown sugar. Frozen berries are added to the pancakes and used as a topping to cut down on the amount of maple syrup and butter needed to moisten and add flavor after cooking. Other healthy flavor options are to use dark chocolate chips instead of berries and top the pancakes with peanut or almond butter instead of syrup. A household favorite is to make chocolate chip pancakes, top with peanut butter and drizzle a little maple syrup over the top. While the nut butter adds calories, it also add protein and decreases the glycemic load of the final dish. (Don't worry, most people don't know what glycemic load is - more on that later.)
6) Dairy-free - buttermilk is replaced with vinegar and soymilk in this recipe. Depending on your perspective on healthy foods, dairy may or may not be on your "good list." For the majority of the people the in world, it's just not very digestible. If you eat dairy products, feel free to replace the soymilk and vinegar with buttermilk in this recipe.
Fluffy Pancakes
Ingredients:
1 Tablespoon apple
cider vinegar
1-1/4 cups
unsweetened soymilk
1 Tablespoon oil
¾ cup unbleached
all-purpose flour
½ cup whole wheat
pastry flour
2 tablespoons packed
dark brown sugar
1 1/4 teaspoons
baking powder
2/3 scant teaspoon
baking soda
1/2 teaspoon salt
½ teaspoon ground
cinnamon
2-4 Tablespoons
water, as needed
Toppings (optional):
chocolate chips, frozen or fresh berries, real maple syrup, etc.
Directions:
1. In a liquid measuring cup, add vinegar and then fill to
the 1-1/4 cup mark with soymilk. Stir to
thoroughly mix (it will get chunky).
2. Add oil to liquid measuring up without stirring in.
3. In mixing bowl, whisk together flours, sugar, baking
powder, baking soda, salt and cinnamon.
4. Preheat griddle to medium-high heat.
5. Add liquid mixture to dry mixture and stir just to
combine. Avoid over-stirring as this
will make pancakes tough and chewy.
6. Thin with 2-4
Tablespoons water. The batter will still
be thick after this. Do not make it as
thin as traditional pancake batter.
7. To cook, lightly oil griddle and scoop ¼-1/2 cup pancake
batter onto griddle then use the back of a spoon or spatula to spread out the
batter into a thin layer (about 1/4 –inch thick). If using any toppings like berries or dark
chocolate chips, immediately scatter these over the top of the pancake. Cook cake until the edges start to appear
slightly dry and like the batter is begin to set, then flip once and cook for
another minute. Pancakes should be
lightly browned on both side.
8. Serve with your favorite toppings. I generally use Earth Balance (non-dairy “butter)
and good drizzle of real maple syrup.
A previous post featured a recipe for a spice mix foreign to most Americans - Ras-el-hanout. On the accompanying video, I mentioned a few ways to use the mix. One of these was on roasted cauliflower or Brussel sprouts. Since it's officially fall, I figured it was time to share my recipe for roasted cauliflower. It is the most delicious cauliflower I've ever had - hands' down. You can use the same recipe to roast Brussel sprouts and lots of other fall and winter veggies. You can also leave out the spice mix and just season with salt and pepper for a more basic dish. Enjoy!
Dinner tonight: Red Quinoa, Ras-el-hanout Roasted Cauliflower and Edamame with Sun-dried Tomato and Red Pepper Spreads
Really Delicious Roasted Cauliflower
Ingredients:
1 large head
cauliflower broken up into 1-2 inch florets
2. Spread cauliflower out in a single layer in a roasting
pan. Drizzle with olive oil and sprinkle
with lemon juice and spice mix.
3. Scatter garlic over the cauliflower and then toss or
still well to coat cauliflower with all of the ingredients.
Ready for the oven
4. Roast for approximately 20 minutes or until cauliflower
is staring to brown and there are crunchy bits on the bottom of the pan. Stir a few times during cooking to ensure
even cooking and prevent garlic from burning to the bottom of the pan.
Here are the recipes and video from the On Call with Dr. Darriaepisode that aired September 4, 2012.
Here's the link to her blog post about the episode http://doctorgillespie.wordpress.com. Check out her other posts and helpful tips about all your medical questions!
We’ve all become accustomed to foods flavored and preserved with a lot of salt, sugar, chemical additives, MSG, hydrogenated oil sources, et cetera. When it comes to delicious food, however, healthy-fresh flavors win out.
For this episode of On Call with Dr. Darria, I walked to my local Farmer’s Market to find what was in season and combined those fruits, vegetables and herbs with dried spices and a few items from the pantry to show viewers how to make the following sauces, condiments and spice mixes that are sure to add fresh, healthy flavors from around the world to your late summer table. Many of the recipes can be made, or stored for use, at any time of the year as well.
I also show how to properly store herbs and lettuces. One comment I hear often from people is “I don’t buy herbs or lettuce because they only last a couple days and always go bad before I can use them.” Tune in for tips to keep your herbs and lettuce fresh for up to 2+ weeks!
Seasoning Mixes
Definitions
The following recipes use the words “spice” and “herb” a lot. They are not the same thing!
Spice: any dried part of a plant, other than the leaves, used for seasoning and flavoring. This includes bark, seeds, roots, twigs, berries, etc.
Herb: leaves of a plant used for seasoning and flavoring.
Tip for making delicious spice mixes: the best flavor comes from toasting whole spices in a dry skillet and then grinding the spices. It’s still delicious when made with pre-ground spices, just not the same.
Example recipe – Dry spice mix or rub:
Ras-El-Hanout
This Moroccan spice mix is excellent on fish, chicken, vegetables, couscous, scrambled eggs, rice, tofu, lentils, lamb and potatoes. Like any dry spice mix, the best flavor comes from toasting whole spices in a dry skillet and then grinding the spices. It’s still delicious when made with pre-ground spices, just not the same. Make extra and store in an airtight container in a cool, dark, dry place for use later. Lasts for months.
½ teaspoon ground cloves (or approx. ¾ teaspoon whole cloves)
½ teaspoon ground cardamom (or ½ teaspoon whole cardamom seeds)
1 teaspoon black pepper* (or 1-1/4 teaspoon whole peppercorns)
2 teaspoons ground ginger
2 teaspoons salt, optional
1 teaspoon ground cinnamon
1 teaspoon cayenne*
1 teaspoon turmeric
1 teaspoon paprika
1 teaspoon garlic powder, optional
Directions
-Option 1: stir all ingredients together.
-Option 2: heat sauté pan over medium heat and add whole cumin seeds, coriander seeds, whole allspice, whole cloves and whole cardamom seeds. Shake pan until spices are fragrant. Transfer to mortar and pestle or dedicated coffee-grinder (never use the same one for spices and coffee – your coffee will taste terrible) along with peppercorns and pound or grind to a powder. Stir in ground ginger, salt, cinnamon, cayenne, turmeric, paprika and garlic powder.
Makes: just over ¼ cup spice mix.
*Halve these for less spicy mix.
Example recipe – Seasoning mix with ground nuts, seeds and spices:
Dukka
Pronounced “Da’a” or phonetically Dha-ah, is an Egyptian condiment made of a mixture of pounded herbs, nuts and spices. Versions vary a bit and generally contain salt, pepper and then one or more of the following: hazelnut or pistachio, mint, salt, pepper, cumin, caraway, sesame seed, cashew. I’ve even seen some with coconut (I’ve never tried this, though, because it sounds terrible to me!). It is REALLY addictive! Traditionally, it’s eaten with flat bread (about the thickness of a pita) dipped in olive oil and then dipped in dukka. It's also delicious to use as a crunchy coating for baked or roasted cauliflower or brussel sprouts and pork or poultry.
Ingredients
2/3 to 1 cup hazelnuts, pistachios, almonds or macadamia nuts, raw, unsalted*
1/2 cup sesame seeds, untoasted*
1/4 cup coriander seeds*
2 tablespoons cumin seeds*
1 teaspoon white sugar
2 teaspoons freshly ground black pepper
1 teaspoon flaked sea salt or kosher salt
Directions :
1. Preheat oven to 350 degrees F and place nuts on baking sheet. Grab a handful after 5 minutes to check for doneness. To do this, look for a slight darkening in the color, smell for a toasty aroma and make a fist around a couple of nuts. The should quickly heat up your palm if they are done. If not quite there, they will cool off within a few seconds in your closed fist. Continue to check every 2-3 minutes until done. Remove from oven and set aside to cool.
2. For nuts with skins that are flaking off a bit. Once cool, lie a kitchen towel out on the counter, pour the nuts onto it. Fold the towel over the nuts and roll around under your palms with gentle pressure to remove some of the excess skin. No need to try to get it all off.
3. In a medium sized dry sauté pan heated over medium heat, add the sesame seeds, shaking the pan occasionally until the seeds are popping and starting to turn golden. Keep a lid handy to prevent the seeds from popping out all over!
4. In the same pan, dry toast the coriander seeds and then the cumin seeds each until fragrant and starting to turn a slightly darker hue.
5. Allow all toasted seeds to cool.
6. In a food processor or mortar and pestle, pulse or grind all ingredients until finely ground. Beware, don’t grind too long or you will end up with nut and seed butter.
Makes: Approximately 1 cup, 16-1 tablespoons servings. Varies with exact Kosher salt, but each serving has approximately 100mg sodium and 65 calories per serving.
Store: in an airtight container for up to 1 month.
*Time saver: buy nuts already dry roasted (unsalted), sesame seeds toasted, and roasted ground cumin and coriander. This is much less tasty, but much faster and still delicious.
Example recipe – Seasoning mix using fresh herbs:
Gremolata -- OMITTED FROM FILM due to time constraints
This smells heavenly when sprinkled on anything hot just before serving. The heat releases the natural oils in the ingredients and fills the room with this enticing scent. Delicious on cooked fish, chicken, pork, potatoes or vegetables (like roasted asparagus or cauliflower). My favorite way to serve it is to sprinkle gremolata over any of the above, then drizzle with a good extra-virgin olive oil and then season with salt and freshly ground pepper. Gremolata can also be mixed with breadcrumbs to liven up any savory crumb topping.
Ingredients
Zest of 1 lemon (or orange), chopped finely
1/3 cup packed fresh parsley, tough stems removed, chopped very finely
2 garlic cloves, smashed and very finely minced
Directions
1. Chop all ingredients together or separately and then mix together.
Alternative version: substitute orange peel for lemon.
Note: Parsley must be VERY dry before using. If ingredients are damp, you will end up with a clumpy mess that is difficult to sprinkle.
Serve: As directed above. Use within 24 hours of making as flavors degrade after that.
Simple Sauces, Dips and Spreads
Hummus
As a vegetarian in the Midwest in the 1990s, I remember learning to make hummus and thinking I’d struck gold! Now, it is found EVERYWHERE in the U.S. However, those delicious eight-ounce containers that sell for $4.50 can be made at home for $2.00 using prepared ingredients and right around $1.00 if you cook your own chickpeas. Not to mention that making it at home allows you to be creative with your flavor additions and bean choices.
Ingredients
1 clove garlic, coarsely chopped
1-1/2 cups cooked chickpeas (One 14-1/2 oz. can)
2 Tablespoons Tahini, Roasted or Toasted (Do NOT use “Raw” Tahini)
2 Tablespoons Lemon Juice, or to taste
2 Tablespoon Olive Oil, plus extra for serving
¼- ½ teaspoon ground cumin
Pinch of cayenne pepper, optional
Salt, to taste
Water as needed
Directions
1. Place garlic in a food processor or blender to chop even more finely.
2. Add chickpeas, tahini, lemon juice, olive oil, cumin, cayenne and salt to food processor or blender. Process until as course or silky smooth as you want, thinning with water to desired consistency.
3. Taste for salt and acidity – there is a DRASTIC difference between the under-salted and correctly-salted version. Use additional lemon juice to increase acidity, if needed.
Makes: 2 cups
Serve: with fresh vegetables, pita bread, chips or use as a sandwich spread. For a traditional presentation, spread in a platter, drizzle with olive oil and sprinkle with smoked paprika or ground sumac.
Variations: Add a bit of chopped green onion, parsley, carrot, etc., at the end of processing without completely pureeing these additions. You can also use other types of beans and flavor themes to make a completely different style of hummus (i.e. white beans and sage or sundried tomatoes and basil, et cetera).
Pesto
Pesto comes from the Italian word, “pestare,” which means “to pound or crush.” This refers to the original preparation of pesto in a mortar and pestle. Now, many people save time (and the mess…trust me, herb infused olive oil splattered all over your clothes is difficult to get out!) by using a food processor to create a paste. Most people think of traditional Pesto Genovese when they think of pesto, so this is the recipe that I’ve included here. However, you can use the same proportions of other herbs and nuts, plus or minus cheeses, to make as many sauces as you can imagine.
Ingredients
3 cups packed fresh basil leaves
4 cloves garlic, roughly chopped
½ cup packed fresh parsley, tough stems removed, optional
½ cup olive oil
¼ cup pine nuts, toasted
¾ cup grated parmesan cheese (dairy-free and salt-free version: substitute 1/3 cup nutritional yeast and a couple dashes curry powder)
Food Processor Directions:
1. Place garlic, parsley and olive oil in the food processor and process until garlic is very finely chopped.
2. Add basil, pine nuts and parmesan (or alternative ingredients for dairy-free and salt-free version) and pulse until mixture resembles a paste of finely chopped, but not completely smooth, ingredients.
Mortar and Pestle Directions:
1. Pound garlic to a paste.
2. Add a handful of basil with a little of the olive oil and pound until reduced to a paste. Continue to add a handful of basil and a drizzle of olive oil until all basil has been used. Then do the same with the parsley if using.
3. Pound in pine nuts and parmesan (or alternative ingredients for dairy-free and salt-free version) until mixture resembles of not-quite-smooth paste.
Makes: Approximately 1-1/2 cups
Storage:
-To store for 1-2 weeks in the refrigerator, put pesto in an airtight container and cover with a small layer of olive oil to help prevent the browning of the basil.
-To store for longer, I like to fill an ice cube tray with pesto, freeze, then pop out the cubes and store them in an airtight bag or container in the freezer. Since the cubes are small, they can be stirred into any dish and thaw very quickly.
Note: Parsley is not traditional, but I use it to keep the sauce green since the basil has a tendency to turn brown.
Peach Salsa
If you have a food processor or blender, nothing could be easier than salsa! This time of year, when every ingredient is fresh and plentiful at the farmer’s market, there’s no reason to spend $5.00 on a pint of “fresh” salsa at the grocery store made with near-tasteless hot-house tomatoes. This recipe makes almost twice that much, is MUCH more flavorful and will cost about half as much by volume.
Ingredients
2 teaspoons apple cider vinegar
1 teaspoon lime juice
1 garlic clove, peeled and crushed
½ - 1 jalapeno, seeded and diced (use more for spicier or less for less spicy versions) [ how-to video - jalapeños ]
2 medium peaches, pitted and roughly chopped
1 large tomato, cut in half through the widest point at the middle, then seeded and roughly chopped
¼ medium yellow or white onion, roughly chopped
¼ cup packed fresh cilantro leaves
Couple pinches of salt, optional
Directions:
1. Place vinegar, lime juice, garlic and jalapeno in food processor or blender and pulse until finely chopped.
2. Add remaining ingredients and pulse until and smooth or chunky as you like your salsa.
Makes: 3 to 4 cups
Serve: great as a topping to a savory dish such as grilled fish or chicken (or vegetarian equivalents) or served with chips – basically anywhere you’d regularly find a traditional tomato salsa.
