How to Treat Blood Pressure with Food

Blood Pressure: What's food got to do with it? 

Is the most recent interview I've done with Harvard Men's Health Watch.  

This article gives some first steps to use either the DASH (Dietary Approach to Stop Hypertension) or Mediterranean Diet to help lower your blood pressure.

I was happy to see the New England Journal of Medicine article published online 2 days ago which showed that the Mediterranean diet reduces the number of cardiovascular events (ie. heart attack and stroke) by 1/3.  The study lends more proof to something I've been espousing for a long time - in my opinion, the Mediterranean diet is the healthiest - and tastiest - option out there.  It is rich in fruits, vegetables, whole grains, olive oil, nuts, and fish.  Moderate wine consumption (up to 1 five-ounce glass per day for women and up to 2 for men) is also part of the picture for those who partake.  Foods that are eaten rarely or in small quantities include dairy, meat and meat products.

The DASH diet has been shown through studies to lower blood pressure as well as one blood pressure medication.  Diets rich in olive oil, like the Mediterranean diet, have been shown to reduce the amount of blood pressure medication needed by as much as half in those treated for high blood pressure.

Using either diet in combination with exercise and weight loss could be the difference between a life consigned to a bottle of blood pressure medication or not.  What are you waiting for?

Photo credit makeitnaked.com

12 Superfoods You Should Be Eating

What should I eat?

If I had a dollar for every time someone asked me that question...The answer is a diet varied in colors, flavors, textures, nutrients and generally recognizable as how the food comes from its original or whole state.  As Michael Pollan famously wrote, "Eat food. Not too much.  Mostly plants."

With collaborators at Harvard Women's Health Watch, we've put together a list of 12 "superfoods" and details about what makes them so healthy.

Check out:  12 Superfoods You Should Be Eating

*Photo credit: 78superfoods.com

Calcium and Heart Disease - Are Supplements Dangerous?

There has been a lot of press lately about a potential link between calcium supplements and heart disease.  

Harvard Health Blog interviewed me for today's post on the topic: 

High calcium intake from supplements linked to heart disease in men

POSTED FEBRUARY 06, 2013, 3:36 PM

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.

An extensive list of the calcium content of hundreds of foods is available for free from the U.S. Department of Agriculture’s website.

Take time for 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.

New Years Resolution - Eat Your Way to a Healthy Heart

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.

Please follow the link to read for yourself:

Resolution: eat your way to a healthy heart

Harvard Heart Letter, volume 23, number 5, pages 1 and 7.

Quick Tip - Instant Brown Rice (that doesn't taste like it!)

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.

Pancakes - making them healthier without making them taste healthy

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.

© Chef Michelle Hauser, MD, MPA

Really Delicious Roasted Cauliflower

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

3 tablespoons olive oil

1-1/2 tablespoons lemon juice

1 tablespoon sliced garlic (about 5 cloves)

2 tablespoons spice mix (curry powder, ras-el-hanout, etc.)

Directions:

1. Preheat oven to 500 degrees Fahrenheit.

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.

What cauliflower looks like when it's finished

© Chef Michelle Hauser, MD, MPA