Joanne Donovan is a registered dietitian and a private practice nutritionist with over 20 years of invaluable experience helping people of all ages incorporate protective eating into their lives. She is the author of this newsletter’s key article on phytochemicals, protective plant nutrients.
For those who seek a more personalized approach to protective eating, Joanne is available for private nutrition consultations in our office. She specializes in designing nutrition programs for healthy eating, weight control, optimal nutrition for pregnancy, cholesterol or lipid lowering, blood sugar and blood pressure management.
In addition, Joanne enjoys speaking for groups on the topic of “Protective Eating” and the necessary nutrition needed to live a long, healthy and happy life.
Prior to developing her private practice, she worked in Cardiac rehabilitation as well as medical nutrition therapy at U.C. San Francisco Medical Center.
We have seen Joanne work wonders with a number of our patients. If you would like to schedule an appointment with her, you can call 650-988-0235.
Congratulations, El Camino nurses!
El Camino Hospital was recently honored with a Magnet designation. This is the top honor a hospital can receive in nursing and is nationally accepted as the gold standard in nursing excellence. El Camino Hospital is the first hospital in the Bay Area to receive this designation and only one of seven in California. Less than three percent of the nation’s hospitals have qualified for this designation.
Independently sponsored research shows that Magnet Facilities have positive out-comes for patients, nurses, and their facilities. Specifically, patients experience lower mortality rates, shorter lengths of stay and increased satisfaction. Nurses also experience increased job satisfaction and better retention and recruitment rates.
Thanks for keeping El Camino Hospital # 1 in the Bay Area!
What’s In Your Diet?
STOP: Take a minute and record what you have eaten in the past 24 hours…
CONTINUE: Now it’s time to assess your record. How many servings of fruits, vegetables, WHOLE grains and legumes did you eat in the past 24 hours? For a quick assessment of your diet, consider one serving as the following:
One Fruit serving equals: 1 cup of fruit or one small piece of fruit such as a banana, peach, pear, nectarine or orange. One serving of dried fruit is equal to 8 apricot halves; 3 tablespoons of raisins, dried cranberries, berries or cherries; 3 medium prunes, dates or figs; 2 halves of dried peaches or pears.
One Vegetable serving equals: 1 cup of raw or cooked vegetables or vegetable juice, or 2 cups of raw leafy greens.
One Whole Grain serving equals: 1 slice bread, 1 small tortilla, roll or chapati; Ѕ small bagel, English muffin, hamburger bun; Ѕ cup pasta, noodles, hot cereal, rice; ѕ cup ready to eat cereal; 5 whole grains crackers or 3 cups popcorn. (Remember we are looking for WHOLE GRAINS. A whole grain will have “whole grain” or “whole wheat” as the first ingredient on the label.)
One Legume serving equals: approximately 1/3 cup of the following: cooked dry beans (such as black, kidney, pinto, or white beans), cooked dry peas (such as chickpeas, lentils, or split peas), baked beans, refried beans, tofu, roasted soybeans, hummus, tempeh, bean, pea or lentil soup, soy milk, or 1 soy patty.
What do these foods have in common? Fruits, vegetables, whole grains and legumes have phytochemicals or “plant” chemicals which are highly protective nutrients occurring naturally within plant foods. Research is showing that phytochemicals may help to prevent many chronic diseases. Phytochemicals can interfere with the various stages of cancer and lower the risk of cardiovascular disease. Some phytochemicals within our four plant food groups serve as powerful antioxidants giving our bodies added protection from oxidative damage that occurs from normal metabolism and exposure to sunlight and environmental pollutants. The key to high levels of protection from phytochemicals is to focus on eating a variety of the foods within our four plant groups. For optimal protective eating, think in “threes” aiming for three servings of fruits, three cups of vegetables and three whole grains daily. In addition, add a minimum of 1/3 cup of legumes three times per week. Statistically, your total plant food intake is more associated with reduced disease risk than any individual food or supplement, so think volume and variety when it comes to eating the four plant food groups.
Fruits Fruits contain a host of phytochemicals serving as potent anti-cancer agents. Fruits also have water-soluble fibers which lower cholesterol. How can three fruits per day easily be added into the diet? Start the day with an orange or Ѕ grapefruit. Enhance breakfast cereal with fresh berries, banana or peaches or add a combination of dried fruits such as blueberries, cherries or cranberries.
Munch on a mixture of raisins and nuts for a mid-morning snack. Eat an apple in mid-afternoon with a natural almond or peanut butter from Trader Joe’s. For an evening treat bake an apple or pear in the microwave with a dribble of molasses and cinnamon. In the winter when fresh berries aren’t in season, try microwaving the Trader Joe’s frozen mix of blueberries, blackberries and raspberries. When the berries are steaming hot add a single scoop of light ice cream. It’s not berry pie, but it comes darn close!
Vegetables Vegetables are SUPERSTARS when it comes to being loaded with highly protective phytochemicals. Again, think variety and focus on a range of colors from yellow to purple. How can we up the veggies to three cups daily and include them in at least two meals or snacks per day? Focus on vegetables in the main entrйe. Veggie salads, slaws, soups, omelets or frittatas can easily become main entrees with additional protein sources added. If you are concerned about cholesterol, use egg substitute in omelets and frittatas. Burritos, quesadillas, wraps or pita pockets can be filled with a wide variety of vegetables and beans to become a main entrйe. Add veggies to whole grain pastas or brown rice and top with low fat grated cheese or a mix of fat free sour cream and salsa.
Keep a “veggie box” in the frig. Twice a week fill a Tupperware-type container with raw, cut-up vegetables and keep it at eye level in the frig. My favorites include grape tomatoes, precut carrots, English cucumber, red bell pepper and celery. Why are they my favorites? To be honest, it’s because I can prepare them in less than five minutes! Having a veggie box makes snacking on veggies easy and keeping the box at eye level in the frig encourages snacking. Veggies in the bottom crisper of the frig are very easy to forget, especially at the end of the day when the convenience of the crackers and cheese or other snack foods is tempting.
Include a green leafy salad at lunch, pre-dinner or dinner. Romaine is great, but rotate with the Spring Mix, which includes baby lettuces, greens, spinach and radicchio. Macular Degeneration is the leading cause of irreversible blindness in folks over age 65. Two phytochemicals, lutein and zeaxanthin found in spinach, romaine, parsley, chard, kale, collard, beet, mustard and turnip greens, appear to be the best defense against macular degeneration. These phytochemicals filter out damaging sunlight and squelch harmful free radicals in the eye. These protective chemicals provide us with a perfect example of how phytochemicals within plant foods can have a significant effect in specific cells of our bodies and help to prevent a debilitating, untreatable and age-related condition.
Lycopene is a phytochemical found in cooked tomato products. The cooking process ruptures the plant cell wall and releases the lycopene. Lycopene is a potent antioxidant and suppresses cancer cell growth especially lung, prostate, stomach, cervical, breast and colon cancers. In an ongoing Harvard study of more than 28,000 women, those with the highest lycopene levels were about half as likely to develop heart disease. How do we include lycopene in our diets? Don’t be afraid of whole grain pasta with tomato sauce. If you are carb conscious, limit the pasta portion and go heavy on the sauce. Because lycopene is fat-soluble, don’t forget the olive oil and a sprinkling of Parmesan.
Cruciferous vegetables should also be center stage in our diets at least three or four times per week. Cruciferous veggies include cabbage, broccoli, cauliflower, Brussel sprouts, radishes, kohlrabi, kale, turnips, collards, mustard greens and rutabagas. These vegetables are loaded with indoles and isothiocyanates, phytochemicals that are highly effective against cancer. They help convert estradiol, the most potent estrogen in our bodies, into benign forms, potentially protecting against estrogen-related cancers such as breast cancer. As Californians, we may commonly include broccoli, cauliflower and Brussels sprouts in our diets. One of my favorite ways to include cabbage is by preparing “Mock Chinese Chicken Salad.” Try tossing Three Color Cole Slaw mix and Girard’s Chinese Chicken Salad Dressing, both available at Safeway. Add Trader Joe’s unsalted dry toasted almonds along with Chicken strips if desired. The result is an easy and delicious salad loaded with phytochemicals.
Whole Grains Phytic acid predominant in whole grains is another phytochemical protecting us against cancer. Fibers in whole grains are also important for lowering cholesterol and prevention of constipation, hemorrhoids and diverticulitis. Two separate studies in the ongoing Nurses Health Study at Harvard Medical School found some dramatic results in those consuming three whole grains per day: a 40% lower risk of coronary heart disease, 43% lower risk of stroke and a 30% reduction in risk for Type II Diabetes. Look for “whole grain” or “whole wheat” as the first ingredient on food labels. Protect yourself with a minimum of three whole grains per day. If the grain has been cracked, crushed, rolled or cooked but retains the bran and germ part of the grain, it will deliver the same nutrients found in the whole grain seed. Whole grain options include wheat, brown rice, corn, barley, oats, bulgur, millet, rye, quinoa, spelt, kamut, or buckwheat groats (kasha). Options for uses of the whole grains include breads, cereals, muffins, bagels, pastas, tortillas, wraps, rolls, buns, popcorn, pancakes, waffles or crackers.
Legumes Our last plant food group is the legumes, which includes beans, lentils and soy. The phytochemicals, genistein and daidzein clean up free radicals known to contribute to cancer. Saponins and protease inhibitors in legumes also inhibit cancer cell growth. Legumes lower cholesterol and are loaded with blood pressure lowering potassium. Options for legumes in the diet might include soups, bean salads, beans in salads, chili beans, baked beans, hummus, refried beans, dhal, bean burritos and wraps. Options for soy in the diet include tofu, edamame, soy nuts, soymilk and soy veggie burgers. Make it a habit to include a small serving of one of these foods at least three times per week.
Appetite Suppression & Calorie Control
Besides being loaded with phytochemicals, our four food groups are bulky and excellent sources of fiber. Grehlin is a hormone made in our stomach in response to emptiness or hunger. Research is showing us that grehlin is a powerful appetite stimulant. Bulky, high fiber foods like fruits, vegetables, whole grains and legumes help to prevent elevations of grehlin and thus serve as an appetite suppressant. Volume in our tummies is one of the key factors in weight control!
Adding 3 fruits, 3 cups of vegetables, 3 whole grains and 1/3 cup of legumes per day adds up to only 600 calories per day – only 1/3 of the estimated maintenance calories for an average woman. With only 600 calories a day accounted for, there’s still plenty of room in the diet for healthy proteins, nuts, fats, dairy products, a glass of wine, or the treats which we occasionally all need (e.g. chocolate!) If desired, we can also have additional servings of our four plant food groups.
A Few Words of Caution
Individuals with glucose intolerance, high triglycerides or metabolic syndrome can eat the foods discussed in this article. However, individual tolerance and medical conditions should always be reviewed with a registered dietitian to address portions, spacing and combinations of foods. If your gastrointestinal tract is not accustomed to a higher fiber intake, avoid gas and bloating by introducing the four plant food groups gradually and in small amounts.
I doubt if any of us would
drive anywhere without the protective benefit of a seatbelt. Think of your
daily dose of fruits, vegetables, whole grains and legumes as putting on your
“seatbelt” to avoid an early collision with a chronic disease or premature
aging. Nutrition experts are now even going so far as to say that cancer, heart
disease and other diseases may actually be in part the result of nutritional
deficiencies and not at all part of the normal aging process. The
phytochemicals in fruits, vegetables, whole grains and legumes help us to
prevent nutritional deficiencies. We have clearly learned the safety message
“buckle up.” Our 24-hour food intake recall may suggest that we may need to
incorporate the protective message “eat ‘em up!”
Overexposure to the sun's invisible rays - ultraviolet A (UVA) and ultraviolet B (UVB) - can cause skin damage. The damage can be immediate and long-term, with effects ranging from sunburn, rashes, and cell and tissue damage to premature wrinkling and skin cancer. Indeed, many skin changes that often are identified with aging actually result from damage by too much sun.
Any tan is a sign of skin damage. Tanning occurs when the skin produces additional pigment (coloring) to protect itself against sunburn from ultraviolet rays. Indoor tanning devices also give off ultraviolet rays that can be as harmful as those from the sun.
To help reduce your risk of
skin damage from sunlight, try to minimize your exposure to the sun between 10
a.m. and 3 p.m., when the sun's rays are strongest. Even casual exposure to
sunlight - driving a car, walking to the store, taking an outdoor lunch break -
contributes to cumulative lifetime exposure. If you're out during the peak
hours, wear a hat and tightly-woven clothing that covers your body, and use
maximum protection sunscreens.
Most people benefit from sunscreens with sun protection factor (SPF) numbers of 15 or more. The SPF number gives you some idea of how long you can stay in the sun without burning. For example, if you burn in 10 minutes without sunscreen and you apply a liberal dose with a SPF number of 15, you should be protected from sunburn for 150 minutes. Sunscreens with SPF numbers higher than 15 may work better for people who are fair-skinned, live at high altitudes, work or play outdoors much of the day, or perspire heavily. Swimming and perspiration reduce the actual SPF value of many sunscreens - even those that are water-resistant - so you have to reapply the product often.
Although sunscreens with identical SPF numbers give you equivalent sunburn protection from UVB rays, no sunscreen product screens out all UVA rays. Some may advertise UVA protection, but there is no system to rate UVA protection yet.
Many sunscreens - even those with the same SPF numbers - have different ingredients or different combinations of the same ingredients. Because some people experience allergic reactions to various sunscreen ingredients, it's a good idea to test a product first by applying a small amount to a limited area of your skin. To get the maximum protection from your sunscreen, apply at least one large handful about 30 minutes before you go outside, and reapply after swimming, toweling dry or participating in any vigorous activity that causes heavy perspiration.
If you're taking medication,
ask your doctor or pharmacist if your medications will make your skin sensitive
to the sun or aggravate sunburn or rashes. Certain antibiotics, birth control
pills, diuretics, antihistamines, and antidepressants are among the commonly
used drugs that can
Sun-protective clothing offers another way to protect skin from the harmful effects of the sun. Sun-protective fabrics differ from typical summer fabrics in several ways: they typically have a tighter weave or knit and are usually darker in color. Sun-protective clothes have a label listing the garment's Ultraviolet Protection Factor (UPF) value, that is, the level of protection the garment provides from the sun's ultraviolet (UV) rays. The higher the UPF, the higher the protection from the sun's UV rays.
The UPF rating indicates how much of the sun's UV radiation is absorbed by the fabric. For example, a fabric with a UPF rating of 20 only allows 1/20th of the sun's UV radiation to pass through it. This means that this fabric will reduce your skin's UV radiation exposure by 20 times where it's protected by the fabricEverything above UPF 50 may be labeled UPF 50+; however, these garments may not offer substantially more protection than those with a UPF of 50. Also, a garment shouldn't be labeled "sun-protective" or "UV-protective" if its UPF is less than 15. Sun-protective clothing may lose its effectiveness if it's too tight or stretched out, damp or wet, and if it has been washed or worn repeatedly.
Special Precautions For Children
Experts estimate that a significant percentage of our exposure to sun occurs by age 18. That's why it's especially important to apply sunscreens with a minimum SPF of 15 to children's skin about 30 minutes before they go outdoors. Reapply sunscreens after they swim, towel off or play hard. Talk with teachers, child care providers and camp counselors about scheduling outdoor activities to reduce children's exposure to the midday sun, when the sun's rays are most harmful.
Infants six months and younger should be kept out of direct sunlight altogether. Sunscreens may irritate baby skin, and infants' developing eyes are particularly vulnerable to sunlight.
Information on this website is for educational and reference purposes only and should not be interpreted as specific medical advice.
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Women Physicians Gyn Medical Group