New Flavored Drugs for Heavy Kids on Weight-Related Meds

Piggy-backing off the hoopla over cholesterol-lowering drugs to kids, the New York Times discusses a recent study demonstrating the pervasiveness of adult drugs being given to obese kids with multiple weight related health issues. It is so prevalent that meds are being created with new “kid friendly” flavors like bubblegum and grape. Several docs complain that these meds have not been tested in kids.

Of course kids need treatment, but until health care realizes that treatment begins with prevention and actually takes action on it, we’re going be stuck in this dizzying drug dilemma.

Read the article yourself, but here are a few doozies that worry me.

“You see elevated blood pressure, or elevated sugars, or elevated cholesterol and you try exercise and diet and you don’t see any improvement,” Dr. Rothman said. “I worry that some providers and some families are looking for the quick fix, and are going to want to start medication immediately.” Some pediatricians say they have been treating children with statins for several years.

I find it hard to believe that there is no improvement with diet and exercise in any of these areas. What was tried? Dietitian visits and group exercise? For how long? There are way too many people who do see improvement with diet and exercise. If you’ve watched one season of The Biggest Loser, you have seen first hand what lifestyle changes can do. I won’t argue that some people are looking for a quick fix, but drugs aren’t miracle workers either. Why make it sound like you have to give up one (diet and exercise) in lieu of the other (drugs).

Diet and exercise are tried first, but “lifestyle is really tough,” Dr. Kaufman said. Some of her patients live in neighborhoods without grocery stores and attend schools that do not offer physical education programs.

OK, I live in Takoma Park Washington, DC. We have a grocery store and community center with free swimming and kids camps. We have a farmers market every Sunday with fresh fruits and vegetables. People have to get food from somewhere so what are they choosing? Beans, rice, and tuna? There are even healthier choices at our vendor stand right outside metro. I often see high schoolers reaching for an orange soda and candy bar before school - not the bananas, which are turning brown.

People have a right to access fresh, healthy foods and it is a problem in the U.S., but surely it is not a problem for all the kid patients on all these drugs.

“They deserve to be treated,” Dr. Kaufman said. “I think the slant from most of the media is that pediatricians are jumping to put kids on medications. That’s not true at all. Since lifestyle is so difficult, we have no other choice but to go to pharmacotherapy.”

Yes, kids deserve to be treated. But please “lifestyle is so difficult” and “no other choice”. That is outrageous!

Trans Fats Out in California

Governor Schwarzenegger made it official: trans fats “won’t be back” in California. The heart nemesis must be excised from restaurant products beginning in 2010, and from all retail baked goods by 2011. Packaged foods will be exempt.

Trans fats have been known to be all around detrimental to health. There is no recommended amount of intake and the upper limit is a measly 2 grams a day. They raise the LDL (bad) cholesterol and lower the HDL (good) cholesterol… the opposite of what you are trying to do if you are following a heart healthy diet.

I have a feeling if more states jump on the fat BANd wagon, that soon there will be action at the Federal level to remove trans fats from our processed food supply.

If there is a healthier alternative (trans fat free oils) then why not change? I do think it is sad that we need laws to inspire change. What about doing it because it is the right thing to do?

Hairspray Sequel? I can hear the bells!!!

OK, this is completely off topic of my blog. But hey, it’s my blog and I can write what I want, right? I just read that John Waters has inked a deal to ink a Hairspray sequel… and with director/choreographer Adam Shankman, producers Craig Zadan and Neil Meron and Tony-winning songwriters Marc Shaiman and Scott Wittman all on board it is sure to be a toe-tapping, booty-shaking, heart-pounding hit. I hope all the original cast agrees to do the project because I just can’t imagine it continuing without them.

If you are following my marathon training you know I am doing my long runs to the Hairspray soundtrack. I credit the catchy tunes to my pace improvements. You can run forever listening to Queen Latifah belt out Big Blonde and Beautiful and of course You Can’t Stop The Beat just makes you want to sprint and dance across the finish line. All the songs are great. I’m convinced Marc Shaiman and Scott Wittman can’t write a poor song. I’ll be listening to the soundtrack during my half marathon this weekend.

If you haven’t seen the movie, it is a must. You can’t help but love “Tracy Turnblad” and Nikki Blonsky is so talented. Hard to believe she was a newcomer holding her own with seasoned actors. Watch it. You’ll be happy you did and you’ll probably be just as happy as me that there will be a sequel.

I wonder what Waters will think of as far as plot….

Hurry up guys, chop chop, get on it already. I’ll need some new tunes when I run my triathalon in a couple years.

Recipes for Health: New Series in NYT

As if there aren’t enough free recipes on the internet, New York Times is starting to offer a series of recipes. I thought I would share the link. Their first one is a summer salad with feta, tomato, and cucumber. It looks and sounds delicious. They don’t include the nutrition information and they really should if they are calling it a healthy recipe. One other piece of advice… I would add the olive oil in steps if you are like me and don’t like your salads swimming in oil. 1/4 cup sounds like a lot of olive oil although it is only about 1 tablespoon or less per serving. I’m just saying it is a lot easier to add more bits at a time. I also think 1/2 fresh squeezed lemon and some zest would be very nice in here. Oh and take their advice on the add-in red onion!

Scary Outcome for a Fad “Detox” Diet

52-year-old Dawn Page was told to drink an extra four pints of water per day and reduce her salt intake in a bid to prevent fluid retention and lose weight. She began vomiting uncontrollably within days of going on ‘The Amazing Hydration Diet‘. Her “nutrition therapist and life coach” Barbara Nash, told her that it was part of the detox process.

She ended up suffering from brain damage and just won money after a 6-year court battle.

Hmmmm… lesson: avoid detoxes and check the creds of your nutritionist. In the US, demand the RD credential or equivalent outside the US.

visit the news story

Congress “Tackling” Childhood Obesity Again?

Why do I feel like every couple of years Congress has a hearing or two and begins to “tackle” childhood obesity again? Is it just me or is everything old new again?

The Senate Subcommittee on Children and Families held the first hearing of a two-part series, “Childhood Obesity: The Declining Health of America’s Next Generation.” It focused on what external factors were causing American children to be obese.

Speakers included Dr Francine Kaufman, past national president of the American Diabetes Association, Bruce Lesley, president of kids advocacy group First Focus, Dr Jeff Levi, executive director of the non profit health group Trust For America’s Health, and Dr Margaret Grey, professor at the Yale School of Nursing. (no dietitians oh well… )

Chairman Dodd called rising obesity rates a “medical emergency” and he already knew why our country’s children were getting bigger.

“We all can point to the reasons why this is happening,” Dodd said. “Junk food is rampant and marketed to children. Television has paved the way for children to have more sedentary lifestyles. We spawn our public schools with soft drink machines and fast food restaurants, which local schools allow because they’re so under funded, they turn to corporate sponsors for financial assistance.”

The lack of physical activity in school is also an issue. According to CDC data, fewer than 4 percent of elementary schools, 8 percent of middle schools, and about 2 percent of high schools provide daily physical education or its equivalent. In addition, fewer than 1 in 5 children walk to school.

Other than updating the archaic USDA school nutrition guidelines, it isn’t clear what action they plan to take.  Certainly bringing fresh fruits and vegetables to the school breakfast and lunch program and increasing minimum physical activity requirements is a step in the right direction.  I would like to see more done at the community level. Affordable dance and sports programs for youth, family walking programs, free use of indoor swimming pools, etc. Education. Education. Education. Out in the community - YMCAs and community centers, in the schools - health classes, and in after school programs like Brain Food in DC - a group I am am pleased to be affiliated with. I volunteer on a regular basis and provide interactive nutrition presentations and cooking demos. We can wait forever for government action or we can do something today. Speaking of… why doesn’t this committee talk to community groups that are making a difference and find out what works. Do we really need the government calling childhood obesity a “medical emergency”?

Shape Up Your Burger

Shape Magazine provided me with these recipes from their upcoming August issue. They are published here with permission from the PR firm. But first, here’s my personal take on burgers. Burgers can have a bit of a bad rap - mostly because the ground meat is made with beef and fat, which add saturated fat (heart unhealthy). But if you use the extra lean ground beef (93% is common and sometimes you can find 96% lean) you cut the saturated fat and get more of the quality meat which provides vitamins and minerals. Also - as usual - just keep the portion size in check. A cooked patty should fit comfortably in your palm. Take the opportunity to veg out your burger with the “staples”: lettuce, tomato, onions or go for something different like cole slaw or jicama. Use a light cheddar cheese (or 1/2 ounce of the regular stuff) if you feel like a cheeseburger. Meatless? No problem! Shape provided a recipe for a black bean “burger” yummy - get in the kitchen!

Build a better burger- These creative recipes bump up the flavor and health benefits of a summer cookout fave.

Although Grilling is one of the healthiest cooking techniques around, your barbecue can quickly turn into a dietary disaster if you make your burgers with fatty cuts of beef and serve them alongside a plateful of potato salad. But there is another way. All burgers are not created equal!   Creativity in the kitchen will pay off in both the health and taste departments.

Black Bean Tostada Burgers

You can substitute a store-bought chunky salsa for the pico de gallo.

Serves 4

Prep time: 25 minutes

Total time: 32 minutes

For the pico de gallo

1          large beefsteak tomato, seeded and chopped (about 3⁄4 cup)

1⁄4       cup finely chopped red onion

1 to 2 jalapeños, seeded and finely chopped (about 1⁄4 cup)

1          tablespoon lime juice

1          teaspoon extra-virgin olive oil

2          tablespoons chopped fresh cilantro

Kosher salt and freshly ground black pepper to taste

For the burgers

1          15.5-ounce can low-sodium black beans

Cooking spray

1⁄3       cup finely chopped red onion

3          cloves garlic, minced

1⁄4       cup panko (Japanese bread crumbs), preferably whole-wheat

1⁄2       teaspoon ground cumin

1⁄2       teaspoon dried oregano

1⁄4       teaspoon kosher salt

Freshly ground black pepper to taste

8          small (6-inch) corn tortillas

1          large California avocado, peeled and sliced

To make the pico de gallo, combine tomato, onion, jalapeños, lime juice, olive oil, cilantro, salt, and pepper in a medium bowl. Stir, cover, and set aside at room temperature for up to 30 minutes, or refrigerate for up to 3 hours to allow flavors to blend.

To make the burgers, rinse black beans in a colander and set aside. Meanwhile, coat a medium skillet with cooking spray and heat to medium-low. Add red onion and cook, stirring occasionally, about 5 minutes, or until soft. Add garlic and cook, stirring constantly, 2 minutes more.  In a large bowl, combine black beans, onion mixture, panko, cumin, oregano, salt, and pepper. Mash,allowing some chunks to remain. Form bean mixture into four patties about 3 inches wide and half an inch thick.  Divide tortillas into two stacks of four and wrap each stack loosely with foil. Place burgers and tortilla packets on a lightly oiled grill and cook for 4 minutes. Flip burgers and packets and cook for 3 minutes more, or until burgers are lightly browned. To serve, arrange two tortillas on each of four plates. Top with a burger, salsa, and avocado slices and serve.

Nutrition score per serving
(1 burger, 2 tortillas, 1⁄4 cup salsa, 1⁄4 avocado): 348 calories, 10 g fat (25% of calories), 1 g saturated fat, 56 g carbs, 11 g protein, 13 g fiber, 77 mg calcium, 3 mg iron, 317 mg sodium

Confetti Burgers with Cilantro Sauce

Lean ground beef gets a flavor kick from chopped veggies and lime-spiked cilantro sauce made with creamy Greek yogurt.

Serves 4

Prep time: 20 minutes

Total time: 35 minutes

For the cilantro sauce

1⁄2       cup packed cilantro leaves

3⁄4       cup nonfat plain Greek yogurt

2          tablespoons lime juice

1          teaspoon extra-virgin olive oil

Kosher salt and freshly ground black pepper to taste For the burgers

1          pound lean ground beef

1⁄4       cup sliced scallions

1⁄4       cup finely chopped red bell pepper

1⁄4       cup corn kernels, fresh or thawed frozen

2          teaspoons Worcestershire sauce

1⁄4       teaspoon kosher salt

Freshly ground black pepper to taste

4          whole-wheat hamburger buns

Sliced tomato and romaine lettuce

To make the cilantro sauce, place cilantro, yogurt, lime juice, olive oil, salt, and pepper in a blender and pulse, scraping down the sides as needed, until cilantro is finely chopped and ingredients are combined. Transfer to a bowl, cover, and chill.

When you’re ready to grill, combine beef, scallions, bell pepper, corn, Worcestershire sauce, salt, and pepper in a large bowl and mix well, using your hands or a large spoon. Form into four patties about 3 1⁄2 inches wide and half an inch thick.

Place patties on a lightly oiled grill and cook for 5 minutes. Flip and cook 4 to 5 minutes more, or until an instant-read thermometer inserted in the center of a burger reaches 160°F. Transfer to a plate and tent with foil. Split the buns and lightly toast on the grill. Place a burger, tomato slice, lettuce, and cilantro sauce between each bun to serve.

Nutrition score per serving
(1 burger, 1 bun, 3 tablespoons sauce): 477 calories, 19 g fat (39% of calories), 7 g saturated fat, 35 g carbs, 33 g protein, 4 g fiber, 125 mg calcium, 4 mg iron, 524 mg sodium

Southern “Fried” Chicken Burgers

Buttermilk and seasonings give this juicy burger the flavor of spicy fried chicken.

Serves 4

Prep time: 20 minutes

Total time: 34 minutes

For the coleslaw

2          tablespoons nonfat plain Greek yogurt

1          tablespoon reduced-fat mayonnaise

1          tablespoon plus 1 teaspoon apple cider vinegar

1          teaspoon sugar

1⁄4       teaspoon celery seed

2          cups loosely packed pre-shredded coleslaw mix

Kosher salt and freshly ground black pepper to taste

For the burgers

5          whole-wheat English muffins

1⁄4       cup lowfat buttermilk

1⁄4       teaspoon freshly ground black pepper

1⁄4       teaspoon cayenne pepper

1⁄8       teaspoon kosher salt

1          pound lean ground chicken

6          teaspoons honey mustard

To make the coleslaw, stir together yogurt, mayonnaise, vinegar, sugar, and celery seed in a medium bowl. Add the coleslaw mix and stir well to coat. Season with salt and pepper. Cover
and chill until ready to serve.  To make the burgers, tear one English muffin into chunks and add to the bowl of a food processor. Process for about 10 seconds to make medium bread crumbs. In a large bowl, stir together crumbs, buttermilk, black pepper, cayenne pepper, and salt. Add ground chicken and mix well, using your hands or a large spoon. Form into four patties about 3 1⁄2 inches wide and three-quarters of an inch thick. Place on a lightly oiled grill and cook for 5 to 6 minutes. Flip burgers and cook 5 to 6 minutes more, or until an instant-read thermometer inserted in the center of a burger reaches 165°F. Transfer to a plate and tent with foil.  Split the remaining English muffins and lightly toast on the grill. To serve, spread one side of each muffin with 1 1⁄2 teaspoons honey mustard. Top each with a burger, one-third cup coleslaw, and the other half of the muffin.

Nutrition score per serving
(1 burger, 1 English muffin, 1⁄3 cup coleslaw): 442 calories, 18 g fat (37% of calories), 0 g saturated fat, 43 g carbs, 29 g protein, 6 g fiber, 283 mg calcium, 4 mg iron, 591 mg sodium

Get the Most of Fresh Fruits and Veggies

Summer brings the cream of the crop when it comes to fresh fruits and veggies. Here are some tips courtesy of University of Nebraska Lincoln to help you prep and store them to maximize their freshness — and your pleasure eating them!

Enjoy!

- Rebecca

The 24-minute Anytime, Anywhere Toning Workout

Pressed for time and can’t make it to the gym, yoga studio, pool, track, or wherever it is you get your fitness groove on? Or maybe you are just getting back into exercise. Either way, I have a full body workout for you. I love this because the movements are big and they use your whole body. Also, it is only 6 exercises, but you repeat the circuit twice. Two minutes each exercise and you have yourself a 24-minute workout you can do anywhere! You can even do these while you are watching tv! Try it out…

If you have never tried some of these workouts, you’d be better off setting up an appointment with a certified trainer first to learn form and technique. (I am ACSM certified so I am partial to trainers with that credential.)

1. push ups (floor, knees, or modified wall)
2. bench dips (need a sturdy chair or coffee table)
3. plie squats (w/ bursts of pulses) with shoulder press - use light weights or soup cans if you got ‘em
4. lunges (w/ bursts of pulses and alternate legs) with biceps curls - use light weights or soup cans if you got ‘em
5. leg lifts (outer thigh, buttocks, inner thigh 1-minute each leg)
6. abdominals (crunches, sit ups, crunch twists for oblique muscles)

Don’t forget to stretch before, after, and between the sets. You can set a stop watch to beep every 1:50 which gives you 10 seconds to transition and rest. Take a rest when you need. Exercise should be a struggle but not painful. Grab a sip of water between the first and second set. Pump up the volume - crank your favorite tunes and before you know it your workout is done.

Have fun, be safe, and let me know what you think!

Cheap Lettuce and Calories in New York City

I have a couple interesting stories to share in this post about cheap lettuce and the consumer reaction to calories on restaurant menus in NYC.

First, the lettuce… I think everyone can relate to issues with “the economy” these days. Whether it’s gas or food prices we’re all feeling the squeeze. Usually people avoid buying fresh produce because of a perception that it is expensive. The reality is that fresh produce is within reach, especially if you use strategies like buying in season, looking for sales, and avoiding the lure of convenient fresh foods. Case in point - lettuce for $.62 a bag rather than the $2.50 you’d normally see. All you need to do is buy the whole head and prep it on your own. You can even introduce darker greens to a family of Iceberg lovers by mixing iceberg and romaine or red leaf lettuce. Read the blog post to learn how they did it.

Now onto the calories: You may have seen my previous posts about calories on restaurant menus on this blog. At first, I wasn’t sure that this information would be useful if consumers didn’t really understand the meaning of the numbers - calories, fat, whatever. I thought they needed more context. But then I really started thinking that it could be a meaningful form of nutrition education that is clearly lacking today. Everyone involved in this policy knows that most states are waiting to see the fallout from the early adopters. If it is positive and the restaurants learn they can still make their money then I think calories on menus will become the norm.

So what is going down in the Big Apple? Well, all of a sudden the 270 calorie steak at TGI Fridays has become the best seller - so much the restaurant ran out! This is proof positive that people who eat out use the information to make meal decisions. As expected, people are shocked that breakfast muffins are around 500-600 calories. (they are huge - the real portion size is about half that so share with a friend). Others are annoyed and prefer to not know so they asked for a menu without the info. Check out the MSNBC article… it is an interesting read!