Fuel up with protein and healthy fats for breakfast!
A meal that’s heavy in sugar and starch is no way to start your day – especially if you’re following the ketogenic diet.
These recipes from functional medicine specialist Mark Hyman, MD, are a great way for anyone — keto or not — to bring real, whole, fresh foods (including non-starchy vegetables) to your plate first thing in the morning.
Swap regular fries for these delicious, and nutritious, potato wedges
These crispy sweet potato wedges come out Cajun spicy and sweet. Don’t tell anyone but they’re also really healthy. They’re loaded with antioxidants and phytonutrients and are a great source of beta-carotene. Another plus? As complex carbs, they digest slowly and raise blood sugars gradually — keeping you from a spike and drop-off.
Ingredients
2 sweet potatoes, cut into wedges (about 8 wedges per potato)
1 tablespoon olive oil
2 tablespoons Cajun seasoning
Directions
Preheat oven to 425 F.
In a large mixing bowl, combine the sweet potatoes, oil and Cajun seasoning. Mix well to evenly coat wedges.
Spread the wedges in a single layer on one (or two, if needed) ungreased baking sheets.
Bake for 30 minutes or until crispy and brown on one side.
Flip fries over and bake for another 30 minutes or until the wedges are crispy on the outside and tender inside.
Ingredient health benefits
Sweet potatoes: These root veggies are beloved the world over for their flavor and versatility. But did you know there’s more to sweet potatoes than … well, just being sweet? They’re also packed with essential vitamins and minerals like vitamin B6, vitamin C, vitamin A and potassium. These nutrients help support many aspects of your overall health, including your immune system, metabolism, blood pressure and vision. Sweet potatoes also have carbohydrates and fiber to fuel your cells and promote healthy digestion.
Olive oil: This cooking oil is one of those ingredients that’s actually worth the hype. Olive oil is full of unsaturated fats and polyphenols. These compounds support your heart and fight inflammation that can harm your cells. Vitamin E and vitamin K, also known as fat-soluble vitamins, maintain radiant skin and strong bones. Olive oil also elevates your good “HDL” cholesterol while lowering your “bad” (LDL) cholesterol. And powerful antioxidants suppress free radicals, damaging little particles that harm your cells in ways that can lead to cancer. While all olive oil has these benefits, extra virgin olive oil (EVOO) is the highest quality, so don’t hesitate to pick some up if it fits within your budget!
Strawberries are an iconic summer fruit — delicious in lemonade, on shortcakes or just straight out of the basket. And it turns out they may be the sweetest way to stay healthy, too. Registered dietitian Bailey Flora, MS, RDN, LD, explains the benefits of strawberries and what nutrients they contain that make strawberries so good for you.
Why are strawberries good for you?
“Strawberries give you a lot of nutritional value for very few calories,” says Flora. “They’re tasty but naturally low in sugar. That’s a combination that’s hard to beat.”
For starters, strawberries are loaded with vitamin C. Eight medium strawberries contain 160% of your daily recommended amount — the amount that the U.S. Food and Drug Administration (FDA) recommends you eat every day. That’s more vitamin C than you get from an orange, the fruit famous for its vitamin C.
Strawberries are also packed with antioxidants, which protect cells from damage. The primary antioxidant in strawberries is anthocyanin, which gives the fruit its color. The amount of anthocyanin in strawberries increases as the fruit ripens. So, the redder the berry, the more antioxidants it contains.
Strawberries also have fiber and several other important vitamins and minerals, including manganese, potassium and folic acid. And strawberries have less natural sugar than other popular fruits such as apples and bananas.
Health benefits of strawberries
Strawberries are a nutrient-rich snack that can:
1. Boosts brain power
As your brain ages, it can lose some of its mental sharpness. But according to research, eating strawberries protects your brain’s processing powers as you get older.
The Nurses’ Health Study measured brain function in more than 16,000 participants over six years. It found that people who ate the most blueberries and strawberries had less cognitive decline — their thinking and processing abilities didn’t weaken as much. They had the brain power of someone up to two and a half years younger.
Researchers believe the protective effects are due to the antioxidants that safeguard cells. Some of the antioxidants in strawberries also reduce systemic inflammation, when your body is in a state of constant inflammation (swelling and irritation). Systemic inflammation is a key factor in the development of Alzheimer’s disease.
2. Strengthens your immune system
Strawberries are a great source of vitamin C (ascorbic acid), which you need to get from food, as your body can’t produce it. In rare cases, people who don’t get enough of this crucial vitamin develop scurvy, a disease that causes bleeding, bruising and anemia.
Vitamin C plays an important role in wound healing. And it may prevent and treat respiratory and systemic infections too. Research shows that vitamin C increases the production of:
T-cells, which remove infected and cancerous cells.
B-cells, which create antibodies so your body can better defend against germs in the future.
Vitamin C is also anti-inflammatory, lowering your stress response triggered by illness or just your busy life. To ward off germs, researchers suggest getting 100 to 200 milligrams (mg) of vitamin C a day — and more when you’re sick. As eating eight medium strawberries gives you 160 mg, it takes just a handful of berries to help keep your immune system in good shape.
“There isn’t enough evidence to say whether vitamin C can prevent colds and the flu,” says Flora. “And it can be more beneficial to choose vitamin-C-rich foods like strawberries over vitamin C supplements, as you get additional health benefits. With strawberries, that includes fiber and other phytonutrients and vitamins that cannot be replicated in a vitamin supplement.”
3. Protects heart health
Flora says that popping a few strawberries in your mouth isn’t just a way to stave off hunger — it’s also a heart-healthy food choice. Research shows that strawberries can help prevent several conditions that can lead to heart disease and stroke, as well as diabetes, which increases the likelihood of heart disease. Eating more strawberries can help you:
Lower cholesterol
In one small study, participants consumed two drinks a day, each made with 25 milligrams of freeze-dried strawberry powder blended with water. That’s about the same as eating 3.5 cups of fresh strawberries a day. After a month, the participants’ total cholesterol was 5% lower.
The cholesterol-lowering results of that study were echoed in another study that gave participants the same amount of freeze-dried strawberry powder. But this time, they consumed the drink for two months. Researchers compared the results to a group that just drank more water. Those who sipped the strawberry drink saw their cholesterol decrease by 10%.
Decrease triglycerides
Triglycerides are fats found in your blood. Having high triglycerides increases your risk of heart disease. And when triglycerides break down, they leave byproducts that trigger inflammation, attracting sticky deposits to blood-vessel walls. That material can clog your arteries (atherosclerosis), explains Flora.
But eating a pound of strawberries a day may reduce triglycerides by 20%. That’s the result of one study, which also found that strawberries reduced total cholesterol by 8%.
4. Reduces inflammation
Widespread internal inflammation contributes to multiple diseases, including heart disease. Lifestyle factors like a poor diet, low physical activity and smoking can lead to inflammation.
Eating more strawberries is a step in the right direction to boost your heart health, says Flora. That’s because the most prevalent antioxidants in strawberries are anthocyanins, known for their anti-inflammatory effects.
5. Helps manage blood sugar
Too much glucose (sugar in your blood) is a risk factor for Type 2 diabetes, making you more likely to develop heart disease, too. If you’re watching your blood sugar levels, strawberries are a good way to satisfy your sweet tooth.
In a Finnish study, people who ate strawberries with a piece of white bread released 26% less insulin compared with eating bread with a cucumber. Participants also ate the bread with other berries, including raspberries and cranberries. Only strawberries weakened the post-meal blood sugar spike.
Strawberries are a great addition to a healthy diet, especially when you eat them on their own — Flora advises laying off the calorie-laden whipped cream, cake or ice cream. (Sorry!) They’re delicious, full of good-for-you nutrients and low in sugar. Try this strawberry smoothie. (Surprise — it’s green!) And for a strawberry treat that’s not too sweet, make these strawberry pretzel squares at your next get-together.FACEBOOKTWITTER
Nutrition Essentials | Food as Medicine: Can It Work for You? with James Carter, MD
Podcast Transcript
John Horton:
Hey there, and welcome to another episode of Nutrition Essentials, a spinoff of our Popular Health Essentials podcast. I’m John Horton, your host. If you’re a regular listener, you know the general premise behind the show. Certain foods can improve your health. That’s the foundational belief behind everything we’ve talked about since day one, and despite that heavy emphasis, it seems we’ve been underselling the full impact of a healthy diet on your body. That’s what the podcast team was left feeling after a recent mesmerizing chat with Dr. James Carter. He took what we’ve been talking about and somehow elevated it to a completely different level, which is why he’s with us today. Who is this Dr. Carter that absolutely blew our minds? Let’s get a more proper introduction from Julia Zumpano, our resident dietitian on Nutrition Essentials.
Julia Zumpano:
Thanks, John. Dr. Carter began his career as an interventional cardiologist before finding his way to functional medicine. He now serves as the Medical Director for Cleveland Clinic’s Center for Functional Medicine. He’s a big believer in the concept of using food as medicine to keep people as healthy and vibrant as possible. I’m looking forward to talking with him about how we can all ben:efit from that prescription.
John Horton:
Oh, absolutely, Julia, so let’s get started. Welcome to the podcast, Dr. Carter. I have to tell you, we have been looking forward to this day ever since we first spoke. You’ve just got such a powerful message that needs to be shared.
Dr. James Carter:
Thank you for inviting me. It’s a pleasure to be here. I always like talking about issues that sometimes are not talked about enough, so I applaud you for the work you’re doing.
John Horton:
Well, to get us started, Dr. Carter, can you walk us through your career path, from the surgical suites of cardiology to the world of functional medicine, and maybe share how that journey opened your eyes to what you called a different truth?
Dr. James Carter:
Well, I started out loving invasive cardiology. I still remember the first coronary angiogram I ever did. I was like, “Oh, wow. This is what I want to do the rest of my life. I want to be the one that helps decide what should happen for a patient and do this comprehensive care,” but I was always a little different because I didn’t want to just be in the cath lab. I liked the opportunity to help people in critical moments like when they’re having a heart attack but I also liked keeping them out of my cath lab suite, so I was always a little different. I like the clinic, I like meeting people, I like being in the community. Along the way, along my journey, I met a nutritionist who sent me an article on leaky gut.
Back then, as a relatively arrogant interventional cardiologist, I opened the email and I said, “This is quackery. Why is she sending me this?” But I read it, to my credit, I guess, and I realized there was a lot in there that I didn’t know. That led to an online functional nutrition course and that led me to functional medicine. My first week of training there blew me away because I actually expected to hear quackery. When I got there, I heard science, and it was evidence-based, and a lot of it turned out to be in my literature, my cardiovascular literature, just de-emphasized or neglected.
John Horton:
Wow. It is amazing, I know you talk a lot about how there are things that can be done ahead of time so, that way, somebody wouldn’t have to meet you in the cath lab.
Dr. James Carter:
Well, I always knew that, but my view of it was, in retrospect, a little simplistic. I would give community lectures, identifying people who were obese and emphasizing the importance of smoking cessation, and controlling blood pressure, and eating right, eating healthy, and back then, I focused on salt and fat. It was a pretty limited view of what actually nutrition is.
John Horton:
Yeah. Now, this whole theory of food as medicine isn’t exactly new. I mean, we talk about it and it dates back supposedly to Hippocrates and Ancient Greece. If we knew this way back then, why does this advice still seem so difficult for folks to swallow today?
Dr. James Carter:
I like the pun. That was very good.
John Horton:
You try to have a little fun. You got to have a good time.
Dr. James Carter:
That was good. I’m going to steal that. That’s good. I actually don’t think it is. I think people want this. When they come in the door to me, they want to know how they can participate in their healthcare journey. There has been this misconception that it’s hard to have conversations about nutrition and that we have to be precise in order to have the conversation, and I think that’s a mistake, but I actually find people want to know. I think when clinicians educate themselves, they will find that it’s easy to deliver the message.
Julia Zumpano:
One thing I want to add to that is there’s a lot of conflicting information, where I think then it sometimes can degrade really good sound nutrition advice that we may have, because there may be a study that says eggs are bad, and then eggs are good, and olive oil is good, and seed oils are bad. Really, what is the true answer to some of these questions? I think that’s where we lose a good portion of people, is the fact that there’s so much information out there that can commonly be conflicting, that people put their hands up as like, “You know what? I don’t even know what to eat, so I’m just going to eat whatever I want and be done with it.”
I think that’s one of the biggest challenges in my opinion, but I do agree with Dr. Carter that people do want to know. They do want to heal their bodies with nutrition and it is possible. But another challenge I find is that, as a society, our food industry is very driven by large companies that provide food products that are most likely not healthy and are marketed as being healthy. I think that is also where some of that confusion lies, is that there’s tons of brands, and food companies, and food products out there that are clouding people’s understanding of what is truly healthy for our bodies.
Dr. James Carter:
I think that’s a very important point. The way that I try to address that is with simplicity. I often start the conversation with patients, “Well, what do you think you should eat?” After we drill down, usually they’re pretty close. I do think there’s an opportunity to do first things first. Let’s do the basics first. Sometimes there’s context why people want convenience, but very often, if we simplify it, we don’t need to get into a fad diet for most people. If we incorporate the basic elements of what the science says about cardiovascular health and nutrition, I think people will find importantly that it’s joyful to do that, so I do try to emphasize the reimagining the joy of eating and just doing it in a different way. I think they’ll find that it’s effective, and it’s quickly effective. The other misconception is that it takes months and months to see an effect, and most of the science doesn’t suggest that. My clinical experience is that you can find very quick improvements just by cleaning up the food plant.
John Horton:
I’m really struck by how both of you have kind of mentioned it, that people have these visions of what they think is healthy. I’m laughing, I’m thinking of the discussion we had right ahead of this. I was talking about what I like to eat for breakfast, thinking I’m making a good choice, and both of you are a little like, “I don’t quite know.” Are people just, I guess, unknowingly making bad choices or is it a case where maybe they can just get a little bit better by tweaking it and start making some small advances?
Julia Zumpano:
I mean, I think it’s a matter of education. Educating yourself on what is considered healthy and why, why we include those nutrients into our bodies. I think the why is the big piece, because if you understand what it does to your body and the insides, then you’re more likely to make better decisions. As I mentioned, I do think that there’s a lot of food noise around from nonmedical professionals that might be providing some confusion. Again, even just food companies or non-professionals that are giving you ideas of what might be healthy and truly may not be. I think it’s also a matter of where you’re getting your education from and making sure you’re going to really science-backed nutrition information and data.
John Horton:
It sounds like you’re telling me the little heart on the front of the cereal box might not be the best medical information I could be getting.
Julia Zumpano:
Absolutely. That’s exactly what I’m saying.
Dr. James Carter:
Yeah. It’s not just the food companies. I think that it’s complicated. I even have patients who say, “Well, I’ve been drinking this soda since I was hospitalized because they served it to me in the hospital so I figured it was okay.” I’m not so sure it’s only the food companies, but I do agree that it’s a humanitarian issue. Do we want to all work together to keep ourselves as healthy as we would like to be? There’s a financial argument for it, there’s a functional argument for it, so I think, very often, we can appeal to those things in patients. When I ask patients what their goals are, what their goals of life are, I can work back to, “Well, maybe stopping at that fast food restaurant every day doesn’t align with that goal, and maybe having boxed ice cream in your freezer doesn’t align with that.”
When I really want to be effective, we have a dual monitor, so I’ll pull up what they eat. I said, “Tell me what you eat. What do you snack on?” They tell me, I said, “Okay, let’s look at it.”I pull it up and I’ll show them the ingredients, and I said, “So how does that sound to you?” They look at it like, “I don’t want to eat that.” It’s something they eat all the time, so it’s quite an exercise. Sometimes it’s just people just don’t take the time to really think it through. That’s to your point, Julia, that it’s out there. It’s convenient. It’s easy to do it without thinking.
Julia Zumpano:
I think, Dr. Carter, you couldn’t have said it any better. It’s complicated. There’s so many influencing factors, it’s so complicated. But to simplify, as you mentioned before, is really key, really making it as simple as possible, because eating healthy is quite simple, really.
John Horton:
Dr. Carter, your background is in cardiology, as we kind of discussed here, so I want to spend some time talking about our tickers. To kind of quote what you told us when we spoke earlier, you said a proper diet can have a miraculous effect on cardiovascular health. Can you walk us through how that happens?
Dr. James Carter:
Well, the reason for it is because of what I learned in functional medicine. It was a different way of looking at systems biology. I learned to focus on what the body is trying to do, and the body’s trying to assimilate the things we get to use it to our advantage, as building blocks to communicate between cells and between the organs, to transport things throughout the body, to repair us, to be resilient so we can be protected from things. It’s fairly complicated, and importantly, we need nutrients for all of those things. When things go a little awry, we need nutrients to turn off inflammation so that we don’t stay inflamed. I used to think of getting injured and having an inflamed joint and I say, “Okay, it just goes away on its own,” and then later to find out that it’s actually a triggered event and we need nutrients for those things. The food helps us through every aspect, and the heart is very complicated. We have to move fluid. We have to get blood and oxygen to the heart arteries.
We have to be the key hub to get all the things transported around the body. The key aspect is how food helps tamper down inflammation and how it helps our immune system work properly. I tell patients 70% of the immune system is located in the gut. Nowadays, a few know that, but most still don’t, and the food helps the immune system, which is a big part of hardening the arteries. I used to think it was just LDL cholesterol or bad cholesterol, as some people call it, but it’s actually what happens when that LDL gets into the vessel wall. It stimulates this whole process of the immune cells getting activated. These are the same immune cells that react when we get a cold or if we get pneumonia, and those immune cells talk to our inflammatory pathways and tell our organs what to do.
I try to simplify that concept graphically so that people understand that the chemicals in the food, for example, the colors of the food that have what we call phytochemicals, they fight inflammation and they help the immune system um um. We know that there’s a connection between the gut and every organ in the body, including the heart, but also the brain kidneys, so we talk about all those things. That gives people.
John Horton:
When you’re talking about colors, you’re not talking about red dye number two. You’re talking about the actual mother nature’s colors here, right? Blueberries.
Dr. James Carter:
I’m talking about red apples, purple carrots. I tell people there are purple carrots, there’s black rice.
Julia Zumpano:
Blackberries, yep.
Dr. James Carter:
Blackberries, blueberries.
Julia Zumpano:
All those beets. All those sharp-
Dr. James Carter:
Red beets, golden beets.
Julia Zumpano:
… bright colors.
Dr. James Carter:
Yeah. I said, “That’s where the joy is hiding. The joy is hiding in the rainbow.”
Julia Zumpano:
That’s for sure.
John Horton:
Julia always talks about the rainbow and inflammation. I’ve heard that from her over and over again, and I know how strongly she feels about all of that and how important it is.
Julia Zumpano:
Absolutely. I mean, those go hand in hand. We’re eating the rainbow to suppress inflammation. It’s really the key there. As you know, Dr. Carter, we’ve seen an enormous increase in the use of statins in recent years to help people lower cholesterol and reduce their heart disease risk. Can more of a functional medicine approach make us a little less reliant on this sort of medication?
Dr. James Carter:
It’s a strong word, reliant. I had a patient once who, after he was put on statins, and he came in with an event, and talked to me about what he was eating, and I explained the biology we just talked about, and he said, “I thought all I had to do was take a statin.” I said, “Well, the science actually doesn’t say that. The guidelines don’t even say that.” I think it’s an opportunity to focus on all of the guidelines and all of the evidence and not just focus on a small amount of it, a small part. I think we already know that statins don’t prevent everyone from having heart attacks, so there’s a small absolute risk reduction of preventing heart attacks. There’s a very significant relative risk reduction, but we also have data on the power of food to do that, and the data is quite compelling of how effective it is. I do focus on that data and that science, and I make sure people understand that it’s the guidelines, actually, that say to do all of it.
John Horton:
It sounds like, in a lot of ways, people should look at food as really a tool that they can use to just improve their health. I think, like you said, too many people, they look at a pill as just the solution. It may help a little bit, but it’s not going to solve everything. You have a responsibility on your own to make some proactive decisions to really better your health.
Dr. James Carter:
As long as people have that information, so we have to tell them that that’s what the science says.
Julia Zumpano:
Yeah, I couldn’t agree more. I think there’s definitely room for medications and they do great things, although what I don’t like is when patients are using that as their means of controlling their risk factor and that alone. I think it’s really a key form of education, of really allowing people the opportunity to have the power of their own choices to really lower their risk. It can be in combination with medication, but changing their diet, getting good sleep, not smoking, exercising, reducing stress, and obviously, maximizing nutrient intake to really support healthy insides from head to toe, so decreasing inflammation, and reducing cell damage, and providing antioxidants, and building your immune system. I mean, every single body system is intertwined and connected.
Dr. James Carter:
That connection is all part of having heart attacks and strokes. In fact, this is a really good point, what you just brought up. When patients come to me and they’re focused on the target number, I ask them why. Most of the time, they can’t tell me. They said, “Oh, I want to get my LDL down. Do I need to take a statin to do that?” I said, “Well, why do you want to get your LDL down?” They just look at me and they’re like, “Well, because it’s supposed to be low.”
John Horton:
We all have a number. We have a number we know we all have a number.
Dr. James Carter:
That always opens the path for me to discuss how heart attacks occur and how strokes occur. Once they hear that, the complicated physiology that you just described, they’re more open.
John Horton:
Is it not as easy as just looking at those LDL and HDL numbers? Are we just fixated on those and it’s just we’re only seeing one little part of the story?
Dr. James Carter:
Well, I’m not sure who you mean by we.
John Horton:
We, the general public.
Dr. James Carter:
Okay. But yeah, we already know that. We have a lot of randomized clinical trials that tell us that lowering LDL is not enough.
John Horton:
Clearly, our hearts love a healthy diet from everything you just laid out, but I know when we spoke before, you emphasized how the positive effects of eating healthy extend basically from the hair on our heads down to our toenails. You even mentioned how diet can help wounds heal, which I’d say I’m still blown away by a little bit just trying to think of that. Can you just expand a little bit on just all of these benefits that we might see by just eating a little better?
Dr. James Carter:
Some years ago, I decided, partly because of my work trying to open up clogged arteries, once I learned about the importance of nutrition, I decided to become a wound care doctor. The secret was I realized that if I could get a wound to heal, that I was going to prevent heart attacks and strokes. Now, I did not tell people that upfront. It was just my secret to get people to understand the importance of nutrition. No one could argue with me. If I used the nutrition in prescription and the big hole in the leg went away in four weeks when it had been there for a year, who’s going to argue? That was the way I started to build a reputation for this, and then it expanded to cardiovascular. I said, “Well, what about this person who’s about to have open heart surgery? What about this person who’s about to have a transaortic valve implantation? Is there a way to help them?” It was pretty fascinating. Often in wound care, believe it or not, the only thing I would do different would be to change what someone ate.
John Horton:
That’s amazing.
Dr. James Carter:
It was stunning. We called it miracles. It’s time for miracles. Is everyone ready for a miracle?
Julia Zumpano:
Would you have a target, Dr. Carter, on what you would really focus on when it comes to wound healing, wound care?
Dr. James Carter:
Yeah, gut health and micro and macronutrients. People had been mistakenly focused on protein and calories for wound healing, and that’s ineffective. It’s the quality of the protein, so it’s not just any protein. Good fat is actually very necessary as building blocks, and making sure people aren’t deficient in critical micronutrients like zinc, and copper, and selenium, and making sure they have a process to repair the gut with prebiotic food, so that’s the fiber that the gut bugs eat to be healthy, and probiotic foods, things like kombucha. I don’t use kombucha as much anymore, but kimchi, sauerkraut.
Julia Zumpano:
Kefir.
Dr. James Carter:
Kefir was my number one.
Julia Zumpano:
Is it? That’s one of my favorites.
Dr. James Carter:
I gave it to every single patient in wound care and they healed.
Julia Zumpano:
Now, did you do any testing to check the condition of the gut to begin with or the micronutrient deficiencies?
Dr. James Carter:
I do now. Back when I was at a different institution, I wasn’t allowed to do it a lot. I did a little bit, but mostly, it was by good history taking. I could tell. I would give them a quick questionnaire. Based on the questionnaire, I could tell their gut was impaired, and so I would just restore it or help them restore it.
John Horton:
The wound care part just sounds so sci-fi to me. I picture these movies we watch where somebody just heals instantly, and I know some probiotics aren’t going to make that happen that quickly, but it sounds like you really saw some just amazing results when there just wasn’t much advancement maybe going on before that.
Dr. James Carter:
Cellular biology is like sci-fi. It actually is. When you think about what it takes to fold and unfold proteins inside the factory that’s called our cells, and using the battery called the mitochondria to do that, and then having to have a process to dispose of the waste that’s created from those factories, and how interconnected that process is and how to move those waste products, either get it out through the urine, or get it out through the stool, or get it out through the sweat, it is like science fiction.
Julia Zumpano:
One thing that you mentioned that was fascinating is we can do this without testing, without really knowing what’s going on on the inside specifically, but being able to know what nutrients are needed for that wound healing and to do it through food versus supplements. There’s always room for supplemental support, if needed, but I think the key here is that if you’re eating this nutrient-rich diet, you don’t have room or time to consume some of those unhealthy foods. If you just focus on what nutrients you need to get in, what high-quality protein you need to get in, what micronutrients you’re focusing on. Did I get enough zinc today? Did I get enough vitamin C? Did I get enough healthy omega fats? Did I get enough high-quality protein? Have I consumed enough prebiotic foods? That will consume your day and your intake so greatly that you don’t even have time to think about unhealthy foods, and you won’t need supplemental forms of these. You can certainly do it through food alone in most cases.
Dr. James Carter:
Yeah, I think of food first. There are times that people need a little boost. When I do prescribe supplements, I try to make it short course, one month, two months, three months. There are a few supplements because of the quality of the food that sometimes we keep longer. People struggle to get the right amount of magnesium in, and there’s of course-
Julia Zumpano:
Omega-3 fatty acids, I find.
Dr. James Carter:
Omega-3 fatty acids, high-quality ones. Yeah. But I agree with you, I think it’s a food first strategy. I do more of the testing now because people want some perspective, and so I was trained to do diagnostic testing. “What am I going to tell you to do?” kind of testing. “Do you have this or don’t have this? What surgery do you need?” kind of testing, but now I do more perspective testing. Generally speaking, your gut looks a little off based on this, so this is supporting why we’re taking this more aggressive approach. This is the sign that maybe your cells are struggling a little bit. There’s some oxidative stress, it’s called, which is just the stress on the cells that produces that toxic waste. We can measure that some, and sometimes I do do that, but we do a lot without testing. Patients do come in expecting testing, so we have to say, “Hey, why don’t we try eating first?”
John Horton:
Dr. Carter, one of the things that I really love about your perspective is just how you’ve obviously been on the one side, where you’re doing these hardcore surgeries and, like you said, the more invasive sort of medicine. Now, you’re obviously very in with the functional side. How do we blend those two together to get the max benefits out of both?
Dr. James Carter:
Having conversations like this is a good start. Leading with empathy and kindness and not starting with animosity is a good start. Being open-minded, being willing to accept that there’s a lot of uncertainty in what we do, and so we’re trying to move forward in the same direction. I think most people I talk to want to collaborate and they want to know how to have these conversations, and I think we should be… Those of us who have the conversations every day should kindly share how we do it. I have found it to be warmly received when I take that approach, as opposed to back in the day, my approach was like, “Don’t you know what atherosclerosis is?” That used to be my approach. I don’t do that anymore. I just gently say, “Maybe we could affect the endothelial function and the detoxification that we all know as part of having a heart attack.”
John Horton:
We spent a lot of time talking about the good that can come from eating, so now let’s kind of put some food on our plates. Julia, let’s lay out some kind of potential meals for folks, starting with a healthy breakfast and working our way through the day. Dr. Carter, feel free to jump in, too, because I’m guessing that you probably eat a pretty healthy diet.
Dr. James Carter:
I’m pretty intentional about it. I wasn’t always that way. I had a lot of food addictions and I had to develop my own strategy. I tried every diet. Almost every diet known to man, I tried and it didn’t work, so there were certain things that I had to incorporate to get myself out of that rut of being unhealthy. The nudge of almost dying a few times helped.
John Horton:
Pretty big incentive. Yeah.
Dr. James Carter:
That was good incentive.
Julia Zumpano:
Wow.
Dr. James Carter:
But to be truthful, actually, I had already started the journey before almost dying. I believe that I would’ve died if I hadn’t already been eating healthy.
John Horton:
Wow. All right. Well, I can’t think of a better intro to what we should be eating for our meals. Let’s start with the breakfast that is going to keep us alive.
Julia Zumpano:
Well, as I think Dr. Carter mentioned, is just finding your own path of what you enjoy. We know there’s several great options for breakfast. My personal favorite is a chia seed pudding. I think just starting off with a high fiber, high protein breakfast, loading that up with some fresh berries. Also, if dairy’s in your daily routine, you could do a Greek yogurt for some high protein, and overnight oats is another great option with berries and nuts on top. Those are three of my top breakfast options. I think they’re filling, high in fiber, have some good quality protein in there. Lunch ideas, I really think leftovers are a great lunch, especially if you’re cooking really great dinners. I usually recommend my patients batch cook, cook extra for dinners so they have extra for lunches, because I think people struggle with lunch more than anything. I love stews and soups, especially hearty ones with a ton of great warm vegetables, a lot of colorful vegetables, some beans and some protein in there. Those are definitely a fan favorite.
Especially during the winter months when you just can’t warm up, those stews really, really help. They’re very filling, more comfort-based in this time of year. Summertime is great for fresh salads and fresh veggies too. Dinner, I do focus on balance, so protein, complex carbohydrate, plate full of veggies. You can kind of vary those. Of course, one of my favorites is wild salmon with some quinoa and various roasted veggies are one of my favorite dinners. For snacks, I do recommend whole foods, of course, so like nuts, fresh fruit, any seeds we can throw in there like pumpkin seeds, any kind of various different nuts and seeds. I will make little type of desserts, so like energy balls or date balls, something like if you do want something a little more sweet that’s naturally sweetened with fruit would be nice too to have on hand to avoid you from reaching for those other commercial-baked desserts.
Dr. James Carter:
Yeah, I like those. I’ve discovered that I personally do better with protein in the morning, and I think that matches some of the science, especially people who are trying to lose weight, and so opportunities to get protein in that also has fiber early in the day actually can work for a lot of people, keeps you feeling full through that morning, gives you energy. For certain texture, I actually use red lentils in the morning because it has that same texture that I grew up with from grits and wheat-based cereals, so I will use red lentils and I’ll add tempeh on the side to that. I always believe in throwing in some greens, so I think greens are mixed with everything to me. I always just mix it in and it’s easy to prepare. I do agree with meal prepping, although I advocate for prep to the freezer and not to the refrigerator. I ask people to, “If you’re going to make one meal, then make it six or eight. Get your labeler out and label it, put it in the freezer, and then that can be your varied lunch later on.”
Lunch, I agree. Meal-prepped lunches are the way. I used to buy those box lunches. I’m so happy that I found a path away from that. Breakfast, so often, if I don’t do that type of breakfast I described, I’ll do smoothie bowls or smoothies with kefir, which is, as you mentioned, a fermented milk probiotic drink and mixing fresh greens, frozen or fresh berries. I do do that. I like your idea of snacks and thinking about snacks ahead of time. What’s become my favorite tool is a scale. Now I weigh out my nuts and seeds so I know that I’m having a serving. 28 grams, I have pumpkin seeds and almonds.
Julia Zumpano:
Another thing you can use if you don’t have a scale handy would be just a quarter cup measuring cup, which would be about the same.
Dr. James Carter:
About the same, yeah.
Julia Zumpano:
Yeah, just if you don’t have that scale around.
Dr. James Carter:
Yeah, if you don’t have the scale. But if you can afford it, the scale’s great because it gave me-
Julia Zumpano:
It’s great, it’s great.
Dr. James Carter:
For some reason, it resonated with me to see it weighed, because I was stunned at how little it was and so I had to get used to savoring my food. Instead of taking a handful of pistachios, I think I’m going to eat one at a time so that it will last.
Julia Zumpano:
Another thing that I found fascinating was tracking your food. I’ve always kind of visually mentally tracked it. I just have that running number in my head anyway. But when I actually went to write down every single thing I ate and looked at it, it was fascinating. Even I was shocked. I was like, wow, I didn’t realize how many servings of nuts I have in a day or nut butter or how it adds up. It also really helped me meet my fiber target goals and my protein target goals. It helps you target towards what you’re looking for, so if you’re trying to meet a specific fiber-protein goal, whatever, zinc goal, whatever your goal is, tracking can really help. There’s a lot of great apps. I mean, we have the Cleveland Clinic Diet App, which is the one I use, and I found it to be extremely helpful.
Dr. James Carter:
I think tracking is very important for what I call the try-to crowd. “I try to eat right, I try not to eat this, I try to eat that,” and they lose track of how often the try-to doesn’t work. When they lead with, “Well, I try to do this,” well, how often? They can’t tell me, so the tracking really helps.
Julia Zumpano:
Absolutely.
John Horton:
I’m struck by everything that you just said. It seems like how much of it comes down to just planning out what you’re going to eat, and I think a lot of us are guilty of life just gets busy sometimes. All of a sudden, it’s, 6:00, 6:30, you’ve got to eat, and it becomes really easy to just order that pizza and call it a night. It’s something, if you put a little thought into it, you can really make some just incredible changes to your diet that can just help your body and how you function.
Julia Zumpano:
I mean, we all have those busy nights. I mean, we’re all busy, but it’s that meal prep piece that really helps. Having something available in the freezer, grab and go, you know you prepared it, you know everything in it, and it’s already set for you. You don’t have to worry. You don’t have to try to scramble to find something healthy to consume. I always tell people to have an inventory of basics, that if you find yourself in a pinch, have a quick, easy, healthy meal that you can throw together in 10 to 15 minutes too.
Dr. James Carter:
Yeah, yeah. Today, for lunch, that’s what I had to do because I didn’t plan properly. I had quinoa and roasted vegetables from my freezer for lunch.
Julia Zumpano:
Perfect.
John Horton:
Well, unfortunately, I did not plan properly last night and I had pizza, and then I had leftover pizza today for lunch. As anyone who watches this podcast knows I am a work in progress, and so I’m slowly getting there through discussions like these.
Dr. James Carter:
One of the confusing things is people think that it’s all about weight, and it’s not even all about fitness. I’ve seen many, many people who are at their optimal weight, who are fit, who have heart attacks and strokes because these foods are reaching their havoc on a cellular level and at a gut level, we don’t know what’s happening. I do think that the intentionality is the key. You have to be taught how important it is, and then people have the opportunity to slowly or quickly, depending on their point of view, make a shift.
John Horton:
I’m sure none of what we’ve just gone over, which would on the best foods maybe to eat or just suggested foods to eat, I don’t think any of this stuff’s going to shock people, as you’ve kind of said. I mean, deep down, we all know that carrots are just… They’re going to be a little better for us than cookies. But Dr. Carter, I know you mentioned seeing folks experience a light bulb moment when they finally adjust their diet and they really see those changes take place in their bodies and just how they feel.
Dr. James Carter:
Oh, and it varies. It can be they come in and they report, “I’m sleeping better. I used to have this ache in the morning. I don’t have the ache anymore.” It could be that, “I’m not irritable like I was before.” It’s so varied because food touches so many different parts of the body. The benefit is vast. Even importantly, just the experience of cooking for yourself and realizing that you love yourself enough to do it, and how affirming that is and reassuring that is to realize that you’ve made this step and know that it’s a good one.
Julia Zumpano:
And then I think extending that step upon. If you’re preparing meals for yourself and then a family, you’re also serving all that you touch, all your family members, your children, your spouse, your parents, whoever you’re preparing meals for. You’re really also improving their health and their food choices, so I think it really extends upon who you touch and who you bring in with you on the journey. I think it’s those who do have young children like myself, I also think it’s a great way to educate. Educate starting with the youth and educating on what foods are healthy for our bodies, why they’re healthy for our bodies. I’m always educating them to read labels and turn the food around and see. They’re running up to me with something bright red and they say, “Can we buy this?” I’m like, “Well, why don’t you figure it out. Turn it around and see if there’s anything on there that I don’t like.” It’s just a matter of educating yourself and educating those around you, those that you love, that you care about.
Dr. James Carter:
Yeah, it’s not the easiest thing to do. I’ve learned to ask permission for that. “Is it okay if we talk about what you’re bringing to my pantry?” I try to have those discussions. I agree. I mean, I have guilt from… My kids are older, so I carry some guilt with me because even as a cardiologist, I didn’t know what I was doing to them, and so I worry about that. I know how important gut health is for brain health, and anxiety, and infections, and things like that, so I do try to flip it as an opportunity for the next generation, the next group of people, whether it’s grandchildren, or cousins, or nephews, nieces, and try to pay it forward that way. Even community engagement, getting out into the community. You can have one conversation with one person. You don’t know who they’re going to go talk to. They may talk to 10, and those 10 may talk to 100, so we’re never going to give up having this type of conversation.
Julia Zumpano:
Right.
John Horton:
Let me ask you this. If somebody does make some changes in their diet, if they really make a dedicated effort to make some better choices, to eat more whole foods, all the things that we’ve been talking about, how quickly do you start to see results? Is this just kind of a gradual thing where we’re talking weeks, or months, or years? Or is it something where you almost feel something within a few days, you might feel a little more pep in your step?
Dr. James Carter:
I personally see it within weeks. I’ve seen it within two weeks. I was very surprised when I started to see that because I was taught that it wasn’t true, then I dug into the literature and said, “Oh, there’s plenty of studies that show it happens within weeks.” Yeah, I see it within weeks.
Julia Zumpano:
Yeah, I usually tell people, “Give me two weeks. Give me two weeks. Just try it for two weeks.” Even 10 days, I like the number 10 days. People can manage 10, for some reason, but I’m usually like, “Just try these things for 10 days,” and then I’m like, “Okay, well let’s try for two weeks and let’s see how.” Usually, they’re feeling a little better in some form. Whatever form of inflammation that’s being decreased is kind of the symptoms that they see go down, whether it might be headaches, or fluid retention, whatever, breathing a little easier, whatever it might be, but I would agree with Dr. Carter.
John Horton:
All right, Julia. I have to say, I see a future podcast for us here, where you can lay out my diet for 10 days and we can see what happens. It would be fascinating.
Julia Zumpano:
I’m ready for the challenge. Dr. Carter, I may need to call you in for backup.
John Horton:
I have to tell you that this conversation is exactly why we wanted you on the podcast, Dr. Carter. I felt like you and Julia, you’ve explained things in a way that just really drives home the reality, that we’ve all got some control over our health with the choices that we make every time we sit down for a meal or grab a snack. But I guess before we say goodbye here, if there’s one thing you want people to take away from today’s chat, what would it be?
Dr. James Carter:
That there’s joy to be had with being intentional.
Julia Zumpano:
Mine would be that you have the power to change-
John Horton:
All right. Well, those are-
Julia Zumpano:
… your choices.
John Horton:
Yeah, those are great sentiments. I think it really does just sum up everything that we’ve talked about and gives us all a little reason to do things differently, going ahead and make ourselves feel better, so thank you both so much for the time today and what has just been an incredible conversation.
Dr. James Carter:
Thank you for having me.
Julia Zumpano:
Dr. Carter, I just want to say your wisdom, and your approach, and your compassion is very contagious.I really want to thank you for the time you’ve taken to join us today.
Dr. James Carter:
Thank you for having me. I’ve learned a lot from you today.
Julia Zumpano:
Thank you.
John Horton:
“Let food be thy medicine and medicine be thy food.” It’s said that Hippocrates spoke those words a few millennia ago and they still ring true today. What you eat affects everything in your body. Making healthier choices at mealtime can make you healthier overall. Give it a try and odds are you’ll feel the difference. If you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Till next time, eat well.
Speaker 4:
Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children’s. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.
What to know before grabbing an ice-cold beer to beat the heat:
It’s a warm summer day and you’re hanging out with friends and family for the first time in over a year, celebrating being vaccinated and just being together. And to help beat the heat, you reach in the cooler for an ice-cold beer.
While that might be refreshing at the moment, though, there’s good reason to grab some water, too. The heat of summer can be brutal, sometimes, and its effects are amplified when you’ve had a little too much alcohol.
To better understand the risks you face when drinking alcohol during this hot vaccine summer, we spoke with registered dietitian Julia Zumpano, RD.
The biggest danger: dehydration
Whenever you’re outside in the heat for prolonged periods – like at the beach or picnic – you’re at risk of dehydration. Consuming alcohol only heightens that risk.
Alcohol reduces the release of the hormone vasopressin, which keeps your body fluids balanced. At the same time, alcohol is also a diuretic which means more urinating and that can lead to dehydration even without the heat. Add in all that sweat from the hot sun and it’s a recipe for dehydration disaster.
One thing Zumprano points out, too, is that caffeine – whether via coffee, soda or as a mixer for liquor – heightens that dehydration risk even further.
Dehydration can also compound certain aspects of intoxication, she notes. “Altered thinking, altered abilities to drive and make reasonable decisions or even just to have conversations are all things that intoxication can cause.”
Liquor versus beer: Is one worse than the other in the heat?
Given that alcohol content is usually higher in spirits than in your average beer, it makes sense that drinking beer instead of mixed drinks might help you avoid dehydration. But the reality is a little more complex, according to Zumpano.
“If you’re consuming liquor at a volume equivalent to the volume of beer, like 12 ounces of margaritas compared to 12 ounces of an average beer, you will get drunk a lot quicker,” she says. “But if you’re drinking what’s considered an alcoholic drink equivalent, there’s not much of a difference because your alcohol intake is the same.”
According to the National Institute of Health, one alcoholic drink equivalent, also referred to as a “standard drink,” contains around 14 grams of pure alcohol. By those measurements, an average 12-ounce can of beer contains the same amount of alcohol as a 5-ounce glass of wine or a typical shot of distilled spirits like rum, vodka, gin or whiskey.
One thing to keep an eye on, though, is the alcoholic content of your beer. While major brands generally run between 4% and 5% alcohol per 12-ounce can or bottle, certain styles of craft beer are as much as 9% alcohol per the same volume. In other words, one can of your favorite local IPA delivers almost twice the amount of alcohol to your system.
Beware a false sense of hydration
Another mistake you should avoid, Zumpano says, is thinking that drinking all that liquid rehydrates you. “If you’re drinking a lot of beer or alcoholic seltzer, it can feel like you’re drinking a lot of liquid and staying hydrated, but the alcohol offsets that because it’s the dehydrating factor,” she points out.
Not that drinking mixed drinks is any better, according to Zumpano. “If you’re drinking a sugary, sweet mixed drink, you run into the same thing. It feels like you’re staying hydrated because they go down so much smoother than drinking spirits on the rocks. But it’s the same effect as with beer: The alcohol is still dehydrating you unless you’re also drinking enough water.”
Sugar, the hidden villain
All of these drinks have other adverse health effects, too. They can pack a bunch of calories into a single serving – as many as 400 to 500 calories in some mixed drinks and craft beers – and they can come loaded with carbs.
There’s more, though. “If you’re drinking high sugar, high caloric intake beverages and you’re drinking a lot of them, they can be very filling,” Zumpano says. If you’re feeling full, you might not eat any food which can otherwise help absorb some of the alcohol.
How to counter dehydration: water, water, water
So what can you do to avoid dehydration troubles when you’re sipping your favorite boozy beverage by the pool? “To counteract the dehydration risk of alcohol,” Zumpano says, “drink 8 to 12 ounces of water for every alcoholic drink. It slows your intake, keeps you hydrated and can mitigate negative hangover effects.”
She suggests keeping a reusable water bottle with you that you can refill as the day goes on, taking time to drink the necessary water between beers or margaritas. Another option is to buy a pack of 8-ounce bottles of water and alternate with your booze. And you can always infuse your water with fruit to keep it flavorful.
“It’s also important to know what your trigger for over-consumption is,” she adds. “If you’re triggered by over-consuming beer or alcoholic seltzer, you want to be mindful of that. Try to switch a drink you have better control of and keep the water bottle handy.”
This dairy product can help you lose weight, manage blood sugar and strengthen bones
Cottage cheese doesn’t typically receive a lot of attention. It gets left out from the fancy cheese counter at the grocery store. It doesn’t make the cut for a charcuterie (meat and cheese) board. And it isn’t typically included in recipes for favorite foods such as pizza, grilled cheese or baked ziti.
It’s a soft, white, fresh cheese that’s different in texture and taste than more popular cheddar, Parmesan and blue cheeses. But cottage cheese holds a prominent place in the dairy aisle for good reasons, says registered dietitian Julia Zumpano, RD, LD.
“It’s a portable food that’s easy to add to your diet,” she says. “And cottage cheese offers lots of health benefits.”
As a dairy product, cottage cheese is a great calcium source, which is important for bone health. Having healthier bones makes you less likely to get osteoporosis (weak bones). Cottage cheese in your diet can even help with your blood sugar levels.
Thinking about giving cottage cheese a go? Zumpano explains what you need to know.
Is cottage cheese healthy?
Cottage cheese is low in calories while providing protein and vital nutrients, Zumpano says, making it one of the healthiest cheeses you can eat. It’s made by curdling pasteurized (sterilized) cow’s milk — when milk turns acidic, the milk protein separates and forms curds (clumps). These loose curds serve as the base for cottage cheese.
Depending on the fat content of curdled dairy milk, cottage cheese is available as nonfat, low fat (1% or 2%) or whole fat. The milk type affects the nutritional content.
“To get the most bang for your buck, choose a low-fat or even full-fat cottage cheese,” Zumpano advises. “Nonfat cottage cheese may sound like a good idea, but it contains less protein and won’t be as satisfying.” Full-fat cottage has 1.5 grams more of saturated fat when compared to 2% but can be the most satisfying.
Health benefits of cottage cheese
Cottage cheese may be mild in flavor, but it packs a punch when it comes to potential health benefits. Some of the many benefits of cottage cheese include:
Provides good nutrition
A 100-gram serving (just under a half cup) of low-fat (2%) cottage cheese provides:
Three factors make cottage cheese a great choice if you’re looking to lose pounds or maintain your weight:
High in protein:Research finds that eating a high-protein diet helps curb your appetite and manage hormones associated with appetite, digestion and insulin release.
Low in fat: Full-fat cottage cheese contains less fat than some other cheeses (4% fat versus 30% fat in cheddar), and its high protein makes it an excellent low-fat option.
Provides calcium:Studies show that increasing calcium can help you lose weight when combined with a calorie-restricted diet.
Cottage cheese isn’t the only dairy food to provide these advantages. Greek yogurt can also check these boxes. But if you’re deciding between the two, Zumpano recommends cottage cheese. “Full-fat cottage cheese and full-fat Greek yogurt have the same amount of fat, but cottage cheese has 25% more protein.”
Provides essential amino acids
Cottage cheese is rich in casein (pronounced “KAY-seen”) protein. It’s a complete protein that provides essential amino acids, which are all the building blocks of protein that your body needs.
Amino acids help your body work smoothly. They affect your:
Phosphorus is critical for proper bone development and strength, especially during growth spurts or when healing from a fracture.
Protein helps maintain bone mineral density and can reduce the risk of fractures.
“Bone health is critical as you age,” Zumpano shares. “Adding cottage cheese to your diet is an easy way to strengthen them.”
Helps you control blood sugar levels
Plain cottage cheese is low in carbohydrates, making it a great option for anyone watching their blood sugar. The slow-digesting casein protein in cottage cheese also helps prevent blood sugar spikes.
“To get this benefit of cottage cheese, choose plain cottage cheese,” Zumpano recommends. “Avoid cottage cheese pre-packaged with fruit and check the label for added sugar.”
Contributes to a balanced gut
Probiotics are live microorganisms that can improve the balance of good and bad bacteria in your gut (gut microbiota). The curdling process used to produce cottage cheese adds beneficial bacteria that can promote better gut health. But unlike Greek and regular yogurt, which almost always contain probiotics, not all cottage cheese is created equal.
“If you want cottage cheese that provides probiotics,” Zumpano says, “check the label to see if it says it contains ‘live and active cultures.’”
Promotes muscle development
The slow-release protein in cottage cheese doesn’t just help with digestion. It’s also important for building muscle tissue and helping your muscles recover after a workout.
“Casein protein provides your cells with amino acids consistently over a longer period, which helps muscles recover instead of breaking down,” Zumpano explains. Consider having cottage cheese after a workout to get the maximum benefit for your muscles.
Reduces your risk of some cancers
Research shows that increasing dairy intake may lower your risk for some (though not all) cancers. “There’s still a lot to learn about the connection between dairy and cancer prevention,” Zumpano states. “But it’s clear there are protective benefits to including dairy in a balanced diet.”
Experts believe getting more calcium may offer protection from:
Bladder cancer.
Breast cancer.
Colorectal cancer.
Stomach (gastric) cancer.
Tips for adding cottage cheese to your diet
The United States Department of Agriculture (USDA) recommends that adults get three cups of dairy daily. Cottage cheese can help you reach that goal.
When you incorporate cottage cheese into your diet, remember to:
Check the nutrition label: Single-serve containers of cottage cheese may vary in size and nutritional content.
Consider your lactose tolerance: The lactose in cheese decreases with age. As a fresh, unripened cheese, cottage cheese often contains more lactose than aged cheeses. If you have lactose intolerance, consider a cottage cheese that’s lactose-free.
Keep an eye on sodium: Cottage cheese can be high in sodium, so opt for low-sodium or sodium-free cottage cheese to protect yourself from high blood pressure and heart disease.
Get creative: There are many ways to eat more cottage cheese. Consider adding cottage cheese to your eggs or pancake mix. Bake it into muffins or cakes. Or use it as a substitute for sour cream or ricotta cheese.
Avocados are jam-packed with nutrients and vitamins and can make a delicious, nutritious addition to your diet.
Millenials may get flak for being the “avocado toast generation,” but honestly, they may be onto something! Avocados are as nutritious as they are delicious, and they’re jam-packed with vitamins and nutrients.
Avocados include vitamins C, E, K1, B6 and folate, plus essential minerals like potassium and copper. They’re low in sugar, loaded with fiber and high in monosaturated fats, aka “good” fats. Oh, and did we mention that they taste great and they’re super versatile?!
Registered dietitian Julia Zumpano, RD, LD, shares a few more good reasons to give these wrinkly green fruits a second look — plus, how to add them to your regular rotation.
Are avocados good for you?
“Avocados are a great addition to a healthy diet,” Zumpano confirms, “and there are hundreds of varieties to choose from, ranging from big to small and wrinkly to smooth.”
What they have in common: A big round pit, creamy green flesh and a whole lot of nutrients crammed into a handy, pear-shaped package.
Just don’t go overboard. Avocados are packed with nutrients, but they’re also packed with calories. A 50-gram portion — about a third of a medium-sized avocado — has about 75 calories. And an entire large avocado can add upward of 400 calories to your daily diet.
Like most things, Zumpano says, moderation is key. “As long as you’re paying attention to portion sizes, avocados are very healthy foods to include in your food repertoire.”
Benefits of avocados
Whether you’re adding a slice to a salad or sandwich or using them as an ingredient in a more complicated recipe, Zumpano says avocados have a lot going for them health-wise.
Here are some of the many nutrients and vitamins packed into just a single avocado:
High in ‘good’ fats
You might’ve heard that avocados are high in fat — and that’s true, but it doesn’t mean you should avoid them! A medium avocado has 22 grams of fat, which includes 15 grams of monounsaturated fats, aka “good” fats.
“Avocados are rich in heart-healthy monounsaturated fats, which help lower your LDL, or ‘bad’ cholesterol,” Zumpano says. “Low LDL levels reduce your risk of heart disease and stroke.”
The American Heart Association says most of the fats you eat should be monounsaturated or polyunsaturated, confirming that avocados fit the bill as part of a healthy diet.
You can even swap avocado in for less-healthy fats in your home cooking. Here are some additional ways you can add this smooth, creamy fruit to your diet.
Spread avocado on a sandwich in place of mayonnaise.
Instead of dunking veggies into dips made with cheese or sour cream, try guacamole.
Forego shredded cheese on your salad and add avocado slices instead.
In baking recipes, replace butter or oil with mashed avocado, like in these chocolatey avocado brownie bites.
“If you use avocado to replace other fats, you can enjoy the flavor and nutrients and also cut down on saturated fats,” Zumpano says.
Lots of vitamins
Let’s talk vitamins: In simple terms, avocados have a lot of them! Here are the vitamins that are most abundant in avocados and what they do for your health:
Vitamin K1, or phylloquinone, is important for blood clotting, which helps stop wounds from bleeding. It also plays a role in strengthening your bones. For most adults, the daily recommended amount of vitamin K ranges from 90 to120 micrograms. Half an avocado has about 21 mcg.
Vitamin C, aka ascorbic acid, helps keep your immune system healthy. It also plays a role in the health of your tissues, blood vessels, bones and more. Depending on your age and sex, you need anywhere from 75 to 120 milligrams of vitamin C per day; half an avocado has about 10 mg.
Vitamin E, or alpha-tocopherol, is a powerful antioxidant that prevents cell damage and helps maintain muscle function. Most adults only need 15 mg of vitamin C per day, and half an avocado will give you about 4 mg of it.
Vitamin B6, also known as pyridoxine, helps your body convert food into energy. You only need a small amount of vitamin B6 each day (just 1.2 to 2 mg, depending on your age and sex), but half an avocado has about .25 mg, putting you well on your way to that daily goal.
Folateis a B vitamin that’s important for normal cell function and tissue growth. It helps your body form red blood cells and DNA, which is especially critical when you’re pregnant (but still important if you’re not). Half an avocado has about 20% of your daily recommended amount.
Low in sugar
Though most fruits are high in natural sugars, avocados rank very low on the sweetness scale. “A whole avocado has under 1.5 grams of sugar, while one medium apple, by comparison, has about 19 grams,” Zumpano points out. (Psst: It’s important to note that not all sugars are created equal! Fruit is still super-healthy.)
High in fiber
Avocados are a good source of fiber, which is a type of carbohydrate that your body can’t break down. You need both soluble and insoluble fiber — and lucky for you, avocados have both.
“Fiber can lower cholesterol and blood sugar, keep you regular and help you feel full and satisfied after a meal,” Zumpano states. Most adults need 25 to 35 grams of fiber per day, depending on your age and sex. Half an avocado provides about 7 grams.
Packed with potassium
Surprise! “Avocados actually contain more potassium than bananas,” Zumpano reveals. Half a large avocado provides about 485 mg of potassium, while a whole banana provides about 420 mg. (Most adults need 2,600 to 3,400 mg per day.)
This essential mineral is beneficial for blood pressure control and heart health. Low blood potassium can increase your blood pressure, raise your risk of kidney stones and even pull calcium out of your bones.
Increases your copper intake
Think past pennies: Copper is actually an essential trace mineral that your body needs in order to function correctly. Most Americans don’t get enough of it in their diets, but half an avocado will get you 20% of your daily recommended amount.
“Copper helps your body metabolize iron, and it plays a role in a healthy immune system and nervous system,” Zumpano explains.
Tips for enjoying avocados
“A perfectly ripe avocado is slightly firm but not rock-hard,” Zumpano says. “If it’s not ripe but you can’t wait to eat it, store it in a paper bag on the counter until it gives a little when you squeeze it.”
A ripe-but-not-too-ripe avocado is a time-limited treasure, so dive right in and get creative with your avocado creations, or embrace the millennial method and enjoy some avocado toast.
But if you need to store it for a couple of days, just be sure to keep it in the fridge — not submerged in water, as some TikTokkers recommend. Some people call it a “food hack,” but it can easily lead to foodborne illness.
“You can even freeze avocado slices if you’re worried you won’t use them in time,” Zumpano suggests. “Then, you can easily throw them into a smoothie.”
Oats and oatmeal have powers you probably didn’t know about — like nutrients to help lower cholesterol and enough fiber to help you feel fuller longer. They just might be quiet heroes of #BetterBreakfastMonth.
(Arx0nt/Moment via Getty Images)
By Michael Merschel, American Heart Association News
Let’s admit it: Oatmeal is a total nerd. It lacks fashion sense – the color they named after it is somewhere on the drab side of beige. It’s often seen with Sesame Street’s Bert, who also loves bottle caps, paper clips and pigeons.
But when it comes to healthy eating, oatmeal and the oats it comes from can definitely hang with the cool kids at the breakfast table.
“It has many, many good qualities,” said Candida Rebello, director of the nutrition and chronic disease research program at Louisiana State University’s Pennington Biomedical Research Center in Baton Rouge.
Extensive studies have associated oats and oatmeal with plenty of heart-healthy benefits, such as lowering cholesterol (both total and “bad” LDL cholesterol) and helping with weight control.
Oatmeal has a host of vitamins and minerals. Two examples: According to the U.S. Department of Agriculture, a one-cup serving of cooked oatmeal has about 1.8 milligrams of vitamin B1, or thiamin. That’s close to 15% of what an adult needs each day. It also has 1.36 mg of manganese, which is 59% of the daily recommendation for men and 76% for women. Manganese has roles in immunity, blood clotting and the way cholesterol and blood sugar are metabolized.
But that’s not what makes oats stand out, Rebello said. That same cup of cooked oatmeal has just 166 calories and nearly 4 grams of dietary fiber.
And the type of fiber is where oats start to distinguish themselves. It’s called beta-glucan. Put that in the conversation, and it’s like the scene in a movie where oatmeal takes off its glasses and everyone realizes just how beautiful it is.
Not literally. It’s a soluble fiber, which means it dissolves in hot water, where it thickens. “When you eat oatmeal, the kind of sliminess that you see – that comes from this viscosity that beta-glucan generates,” Rebello said.
That helps you feel full longer, she said. And it helps undigested food travel farther down your digestive tract, where it feeds the friendly bacteria living there.
Beta-glucan is abundant in oats and barley and has been shown “quite unequivocally” to help maintain healthy cholesterol levels, Rebello said.
Oats also are rich phytonutrients – plant-derived substances that may boost health. One class of such phytonutrients is avenanthramides, which are found only in oats. Avenanthramides may have antioxidant and anti-inflammatory effects, although Rebello said their possible benefits are not as well-researched as those for beta-glucans.
Oats have been linked to heart-health benefits since the 1960s and come in many forms. The differences involve levels of processing.
Oats grow in an inedible casing called a hull. Inside the hull is a seedlike groat. That groat is encased in bran. “In other whole grains, like in wheat, you can remove that bran layer,” Rebello said. “But in oats, this groat is very soft, so that bran layer cannot really be removed.”
That means oats are almost always a whole-grain food, and those are a key part of a healthy eating pattern.
If oats are labeled “steel cut,” it simply means they were processed with a steel cutter, Rebello said. Rolled oats are steamed first, then pressed with a roller. “If the roller crushes it into thinner flake, then you get quick-cooking oats,” she said. “If it is then rolled into an even thinner flake, you get your instant oats.”
Rebello said that nutritionally, there is little difference between steel cut and rolled oats. Instant oats, however, have a higher glycemic index, meaning they raise your blood sugar faster.
When oats are ground to flour, the coarser portion is extracted and called oat bran. The beta-glucans will be concentrated in the flour rather than the bran, she said.
Oat milk is derived from oats and water, but processing may add ingredients such as sugar, salt, oil and more. Oat milk has some dietary fiber, Rebello said – commonly 2 grams per cup – but the amount of beta-glucan is rather small.
Unfortunately, Rebello ruled out sugar-filled oatmeal cookies as a healthy food (although she’s not averse to having one as a treat now and then).
How, then, to embrace oats? “Just eat regular oatmeal,” she said. Half a cup of rolled oats cooks up quickly and will keep you full a long time.
Oatmeal with your favorite fruit can be a sweet way to start the day. Cook it in low-fat milk for creaminess and add unsalted nuts to bolster its heart-health value. If you’re time-pressed in the morning, try a healthy version of overnight oats, which can be prepared the night before.
It’s important to remember that no single food, even oats, can do it all, Rebello said, noting that if you eat a nutritious breakfast but then load up on sugar and fat the rest of the day, “that’s really not going to help you much.”
But you should go ahead and invite oatmeal into your breakfast club, Rebello said. “I definitely recommend eating oats.”
If you have questions or comments about this American Heart Association News story, please email editor@heart.org.
If you run regularly, whether it’s an easy jog around the block to stay fit or an intense training regimen to prepare for a marathon, you need proper nutrition.
Here are some tips to help keep runners well-nourished and ready to win.
Foods for Runners and Joggers
A good diet can boost your physical health and help you meet your fitness goals. Make sure your meals emphasize the following basic components:
Fruit and vegetables for vitamins, minerals and antioxidants
Lean protein such as fish, poultry, beans, lentils and tofu
Healthy fats such as olive oil, avocado and nuts
Healthy carbohydrates such as rice, whole grain breads/pastas and oatmeal
Individuals may have different optimal balances, but in general, people who include running or jogging as part of their fitness regimen should get 60% to 70% of their calories from carbohydrates, with lean protein and healthy fats each accounting for 15% to 20% of their remaining calories.
Don’t skimp on carbohydrates
Although low carbohydrate diets are popular go-to’s for people wanting to lose weight, they’re not ideal for distance runners, who thrive on carbohydrates for endurance.
That is why very low carbohydrate diets, such as the ketogenic diet, plus running is not a good idea. Experts do not recommend keto to runners unless they have been told by their doctor that this a medically safe option for them and they are being monitored while in ketosis.
Distance runners need more carbs than people who aren’t training. Undereating carbohydrates can be hard on your body and affect your recovery after your run.
Here’s why: Running uses both glucose in the blood and your stores of glycogen. Glucose is the form of sugar that circulates in the bloodstream, and glycogen is the sugar stored in your liver and muscles that acts as the primary fuel for endurance exercise.
Eating plenty of carbs helps ensure that these energy stores are ready to support your training. When those stores get too low, runners are more likely to run out of energy and “burn out” or “hit a wall” while training.
Running Diet — Vitamins and Minerals
Running changes your body and your nutritional needs. Often when people start a running regimen, they are trying to lose weight or get in shape quickly, and they don’t realize they need to adjust their diet.
Especially in women runners, dietitians report seeing a tendency to overdo the running while not eating enough, and this can have an effect on health if they do not adequately replenish lost vitamins and minerals in their diet.
For women in particular, calcium and vitamin D are essential for bone health to avoid loss of bone mineral density and the risk of stress fractures.
For more vitamin D, include these foods in your meals:
Vitamin D-fortified dairy and almond, soy or rice based beverages
Eggs
Cereal fortified with vitamin D
Tuna
Salmon
For more calcium, try:
Yogurt and cheese
Tofu
Edamame
Almonds
Canned fish with bones (such as sardines)
Iron deficiency can affect women and even have an impact on their running performance. Menstruation puts people at higher risk of iron deficiency, and if iron isn’t replenished in the diet, decreases in hemoglobin can occur and bring on anemia. Hemoglobin is what carries oxygen throughout the body, including the muscles, so if there is a deficit, the muscles may feel the effect of insufficient oxygen during exercise.
Iron-rich foods include:
Poultry and other meat
Legumes, such as peas and beans
Dark, leafy green vegetables such as kale
Dried fruits and raisins
Iron-fortified breads and cereals
Dietitians recommend eating eating iron rich foods in combination with foods high in vitamin C, such as citrus, bell peppers or berries, since vitamin C helps increase the body’s absorption of iron.
What to Eat Before Running ― and When
The best time to eat a full meal is about two to three hours before you hit the road, track or trail. Have a good source of carbs paired with protein, making sure the meal focuses on a healthy carb source.
If it’s been more than three to four hours since you’ve eaten, a carbohydrate-rich snack a half-hour before running can ensure you have adequate glucose available before you head out. Directly before a run, it’s best to stick with easy-to-digest carbohydrates to avoid gastrointestinal [GI] distress such as cramping or diarrhea.
Try these:
Bananas
Applesauce
Crackers, pretzels or cereal
White bread
Potatoes
Glucose Boosters for Long Distance Runners
If you are training for a marathon or distance event and are going to be out for over an hour, you will want to bring some fuel with you. Energy drinks, gel tubes and other sources of quick blood-glucose boosters are available, but you can also use something as simple as fruit snacks.
Try practicing with these items as you train so you can pick the formulas that are best for you, and you can work on accessing and ingesting them smoothly without breaking stride.
What foods should runners avoid?
Before a run or the night before a big race, Eidel recommends going easy on:
Spicy foods or foods overly high in fat, which can cause GI upset
Foods that are very high in fiber, which can cause gas and cramping
Caffeine ― Although it is tempting to grab a caffeine boost right before a run, runners should remember that for some people, caffeine can stimulate the GI tract, which can result in diarrhea or the need for an emergency bathroom break
Does carb-loading work?
It might. Carb loading is the practice of eating a lot of carbohydrates ― particularly those that are easily absorbed, such as white bread, pasta and rice ― for 24 to 48 hours before a big race or distance run, to shore up your body’s stores of glycogen and lessen the risk of burnout before finishing the event.
Some studies show carb loading is beneficial for people preparing for a race, but it’s important to make sure during that time you’re also allowing your body to rest and giving it time to store what you are ingesting. The number of carbohydrate grams will be differ from person to person, but in general, evidence shows carb loading can be beneficial prior to a distance event.
In contrast, casual runners likely do not need to carb load. Ensuring that their day-to-day diets include extra carbohydrates can be sufficient.
What to Eat After a Run
It’s common for people not to feel hungry after a run, but a snack or light meal of complex carbohydrates and protein within the first hour after running can help replenish glycogen stores and to support recovery and rebuild stressed muscles. For example:
Peanut butter and banana
Egg on toast
Sandwich with deli meat
Pasta with meat or plant-based protein
Veggie burger on a bun
Protein shake or smoothie
Running to Lose Weight
If you’re interested in running as part of a weight loss plan, getting adequate nutrition is a must. Even casual running or jogging burns calories and can be hard on the body. Runners can become undernourished at first because they don’t understand how much energy they’re burning when they run and what they need to properly recover.
Eating enough is also essential to building muscles, which can aid in fat burning ― a plus for people working on achieving or maintaining a healthy weight.
For optimal weight loss, your plan should not rely on running alone but also include strength training and proper nutrition.
Listen to your body
If you run regularly, you should pay attention to the effects of what you eat and when, especially on running performance. Learning what works best for you can take some time and a little trial and error, but it is worth it, since running, jogging and other regular aerobic exercise offers so many health advantages.
Always feel free to consult a dietitian or doctor, and listen to your body if you’re not keeping up with your training goals.
Physiotherapy (also known as physical therapy) places full and functional movement at the heart of what it means to be healthy. It involves treating patients of all ages with a range of illnesses and conditions, including those with back and neck problems, sports injuries, arthritis, or those recovering from strokes and operations. The focus of our treatment is exercise prescription.
Physiotherapists may be part of a multidisciplinary medical team that includes physicians, nurses, speech and language therapists, psychologists, occupational therapists and social workers among others. Alternatively, they may work from clinics or specialise in particular areas of the discipline.
Physiotherapy: The course for you?
Physiotherapy is both physically and academically demanding and an interest in working with people is an requirement, alongside strong communication skills. Visiting a local general hospital or other area where physiotherapists work will give you a good understanding of what exactly is involved.
Physiotherapy at Trinity
Physiotherapy is based in the Trinity Centre for Health Sciences in a purpose built complex at St. James’s Hospital. This complex houses other health science disciplines and allows physiotherapy students to share courses with those in the other health sciences to give a multidisciplinary approach to studying and working. The centre is about 3km from the main campus and is beside a Luas station on the line running between Tallaght and Connolly Station.
All students will have clinical placements at Trinity’s associated teaching hospitals of St. James’s and AMNCH in Tallaght, where there is an established expertise in most areas of physiotherapy. These placements allow students to gain experience in some of the specialist areas of physiotherapy including neurology, respiratory care, coronary care, orthopaedics, women’s health, care of the elderly, sports and out-patients.
Graduate skills and career opportunities
Successful completion of the course entitles you to membership of the Irish Society of Chartered Physiotherapists, the accrediting body for physiotherapy in Ireland. Physiotherapists are sought throughout the world and you will be able to work with a wide range of conditions or to specialise, as you wish. There is also great scope for you to continue to develop your skills and expertise in areas such as sports medicine, neurology, cardiology, respiratory, research, education, management or private practice. Students may also work with a professional sports team as part of multidisciplinary athlete support.
Your degree and what you’ll study
The major objective of this four-year course is to enable you to become a competent professional with the ability to work independently with patients. There are two components to Physiotherapy: theory and clinical practice. In the first year the emphasis is on laying a foundation of theoretical knowledge and the second year introduces students to the clinical skills and procedures used by physiotherapists. Clinical sciences are taught mainly in the second and third years. In the third and fourth years students spend up to fifty percent of their time on clinical placement. In the fourth-year, students have an opportunity to develop specialist knowledge in a particular area of physiotherapy and undertake a research project.
First and second years
In first and second year as you will have approximately 20 hours of teaching each week, divided between lecture and practical classes.
Courses covered in the first two years include: Physiology, Anatomy, Physics, Chemistry, Pathology, and Exercise. You will also start to study various conditions and specialities frequently seen in physiotherapy, such as respiratory conditions and musculoskeletal conditions.
At the end of second year you will start clinical placements under the supervision of skilled and experienced tutors. These may be taken in hospitals, clinics, day centres or within private and community practice.
Third and fourth years
In the third year, half of the time is spent on academic studies and the other half on clinical placements in a variety of settings both within and outside the Dublin area.
In fourth year, you will undertake an investigative project and study the following subjects: sports and exercise medicine, ergonomics, professional issues and advances in physiotherapy.
End-of-year written examinations and tests in certain subjects, such as anatomy, make up the theoretical assessment structure. There are a number of submitted assignments in third and fourth years.
In addition, you will be continuously assessed during your clinical placement and will have practical exams on the skills element of the course, including your assessment of a patient while on a clinical placement.
Click here for further information on modules/subjects.
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