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.
Protein in Greek yogurt: Greek yogurt is a protein powerhouse. It has almost twice the protein of traditional yogurts and provides the same gut-friendly bacteria. #HarvardHealth
A salad combination you may not have thought of, but will now be hooked on
This salad is a perfect addition to a large dinner menu when you have guests over for dinner and have a lot of other dishes to prepare. It’s bright and flavorful, and you can make the dressing a day or two ahead to prep!
Ingredients
Dressing
1 1/2 cups frozen raspberries, thawed 2 to 4 tablespoons orange juice (depending on thickness desired) 1 tablespoon white wine vinegar 1 teaspoon sugar 1 tablespoon orange zest 4 tablespoons chopped fresh chives
Salad
1 pound romaine lettuce, washed, dried and torn into bite-sized pieces 1 pound radicchio, washed, dried, shredded 3 carrots, peeled and grated 1 cup mandarin oranges, drained, patted dry 20 cherry tomatoes, quartered
Directions
Assemble salad ingredients in salad bowl and toss.
Put all ingredients for the dressing in food processor or blender (except for 2 tablespoons chives), and process.
After all is processed, stir in the remaining 2 tablespoons chives.
Pour over salad just before serving and toss.
Nutrition information (per serving)
Calories: 107 Total fat: 0.5 g Saturated fat: 0.1 g Protein: 3 g Carbohydrate: 25 g Fiber: 5.4 g Sodium: 37 mg
—Recipe developed and copyrighted by Kristine Napier, MPH, RD, LD.
You go to the store to pick up some apples. Seems simple enough — until you’re faced with a dozen different varieties in the produce aisle. You want the healthiest apple, so which one will keep the doctor away? Dietitian Mira Ilic, RD, LD, reveals the juicy details about this popular fruit. Big difference in taste, not nutrition Apples have slightly different nutrients depending on their type and color. For instance, Red Delicious apples have polyphenols that are exclusively found in dark red fruits. Polyphenols are plant compounds that may help prevent cancer, heart disease and other conditions. But if the thought of biting into a Red Delicious isn’t appealing, don’t worry. Any apple you buy will deliver a punch of health-boosting nutrients. “The nutritional differences among apple varieties are small,” says Ilic. “But the taste differences are big. Don’t choose an apple based on a small nutrient difference if you don’t like the taste.” Choose fresh and local apples Whatever apple variety you pick, make sure it’s fresh. Old apples aren’t as nutritious, don’t taste as good and could be rotten. “Choose a firm apple with no bruises,” says Ilic. “Look for bright color, keeping in mind that some apple varieties are naturally more colorful. Fresh apples usually have a nice aroma, too.” Whenever possible, go with local apples. The less your apple had to travel, the more nutritious it is when it gets to you. July through October is prime apple season in the U.S. During these months, local apples are easy to find. When you choose apples in the off-season, check the sticker for its country of origin. If your apple traveled a long distance, it probably lost some of its nutrition in transport. Try to choose apples that come from a nearby country. “We don’t have the option to eat local apples year-round,” Ilic says. “In the off-season, we have to get apples from other parts of the world. No matter where they come from, wash them thoroughly.” You don’t need any chemicals or tools to wash your apples. Wash your hands first. Then wash your apple with running water. Gently scrub the skin with a cloth or brush. Are organic apples healthier? Some organic fruits may be slightly more nutritious than conventionally grown ones. But you don’t need to buy organic apples. They tend to cost more, which can be a downside if you’re sticking to a grocery budget. “Growers use different growing practices for organic apples and while pesticides are used on conventionally grown apples, some organic growers may actually use pesticides approved for organic farming,” explains Ilic. “The government has guidelines about what pesticides growers can use. Both types are safe and nutritious. Just wash them well if you’re still concerned about pesticide residue or you can peel your apples, but you’ll lose some nutrients and fiber found in the skin.” Have fun with apple sampling With so many apple varieties, you’re bound to find one you like. Hold an apple sampling by picking a few different types. Cut them into bite-sized pieces, put them on a plate and label them. Have your family members try the different apples and choose their favorite. An apple sampling can be a fun way to get kids to eat more apples, too. Kids often like having some control over the types of foods they eat. All apples are amazing Whether your favorite is a sour Granny Smith or a sweet Honeycrisp, you can’t go wrong with apples. “All apples are a good source of fiber, including pectin, which may help lower cholesterol,” Ilic says. “They also contain phytochemicals like polyphenols, which are antioxidants linked to multiple health benefits. Some studies have suggested that apples may also help reduce the risk of some cancers.” Bottom line: An apple a day is a healthy habit, so don’t stress about picking the right one. “Eat the apples you like because they’re all healthy,” Ilic says. FACEBOOK TWITTER LINKEDIN PINTEREST Email applesfiber
Registered dietitian Lara Whitson, RD, LD, shares how watermelon is actually healthy for you, along with five watermelon recipes.
Is watermelon healthy?
Watermelon is 92% water. No surprise there, considering it’s in the name. But more than keeping you hydrated during hot summer days, watermelon has a number of other health benefits. It’s packed with antioxidants like lycopene that can help protect against chronic diseases like diabetes and cardiovascular disease.
And when eaten regularly as part of a healthy balanced diet, it can help make you feel fuller longer. With a low amount of calories, sodium and cholesterol, alongside higher amounts of calcium, vitamin C and magnesium, watermelon is one fruit you don’t want to miss out on year-round. Even the rind and its seeds offer some benefits.
“You can stir-fry the rinds with other vegetables and add spices to the seeds, like you might do with pumpkin seeds, for an easy and healthful snack,” says Whitson.
Watermelon basil granita
This shaved ice dessert gets a fruity twist with watermelon chunks. It also pulls in star ingredients like fresh lime juice and basil leaves, which offer their own health benefits for a refreshing mid-afternoon sweet escape.
Watermelon, tomato and herb salad with feta
Calorie-conscious dishes can still go big on flavor. This refreshing salad, perfect for picnics and cookouts, pairs watermelon with tomatoes bountiful in benefits, alongside red wine vinegar, fresh mint, almonds and feta cheese.
Fresh watermelon fruit smoothie
This is just one of several ways to crank up your chill summer drinks: Puree 1-1 1/2 cups chopped watermelon with 1 cup ice and a little water or fresh juice for a sip-worthy smoothie as you soak in the sun.
Watermelon salad with cucumber, tomato and almonds
This recipe doubles down on the use of veggies by incorporating beefsteak tomatoes, cucumber, a fresh ear of corn and basil, along with a hearty serving of watermelon for a subtly sweet finish.
Fruit salad spring rolls
Not only is this sweet snack filling, but it also puts a dessert-like twist on classic Vietnamese and Thai spring rolls. By wrapping julienned watermelon, green apple and pineapple in spring roll wrappers made from rice paper, and creating a dipping sauce with Greek yogurt and tahini, this recipe makes for a great palate cleanser for any summer cookout.
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
Does slow running have a place in your run routine? 🏃♂️
A cardiologist (and a runner) explains how the idea of slowing your pace can prevent injuries, help you log more run miles and train your body for all the stress that comes with running: https://t.co/59Q7kSUsxmpic.twitter.com/n7a04aTE76
Why not try your hand at making homemade tomato sauce? The freshness of the tomatoes and the smokiness of the roasted vegetables make this a great topping for spaghetti. If you don’t have your own garden, use canned Roma tomatoes for a tasty dish that includes roasted mushrooms, broccoli and peppers.
Ingredients
Tomato sauce
Olive oil cooking spray 2 garlic cloves, minced 1 small carrot, minced 1 shallot, minced 4 cups peeled, seeded, and diced ripe tomatoes or one 28-ounce can no-salt-added diced tomatoes, drained 1/4 cup dry red wine 1 1/2 tablespoons balsamic vinegar 1/4 teaspoon crushed red pepper flakes, optional 1/4 cup chopped fresh basil
Pasta
1/2 pound whole wheat spaghetti 3/4 pound broccoli florets and stalks, peeled and cut into bite-size pieces 2 portobello mushrooms, halved and thinly sliced 1 red, yellow or orange bell pepper, seeded and coarsely chopped 1 1/2 tablespoons extra-virgin olive oil 1 1/2 tablespoons balsamic vinegar Freshly grated pepper 2 tablespoons freshly grated Parmesan cheese
Directions
Preheat oven to 400° F. Line a rimmed baking sheet with aluminum foil.
To make the sauce, coat a large pot with cooking spray and saute the garlic, carrot and shallot over low heat until they begin to wilt, about 5 minutes. Stir in the tomatoes, wine, vinegar and red pepper flakes (if using). Cover and simmer slowly for 30 minutes.
Stir in the basil and simmer for 10 minutes more. (To make a smoother sauce, cool and process in batches in either a blender or food processor.) Set aside.
Place the broccoli, mushrooms and bell pepper on the prepared pan. Toss with oil and vinegar. Roast about 10 minutes until crisp or done to your taste. Sprinkle with pepper.
Cook the pasta according to package directions. Drain.
In a large serving bowl, toss the pasta with 2 cups tomato sauce. Top with the roasted vegetables and sprinkle with Parmesan cheese.
Nutrition information (per serving)
Makes 4 servings
Calories: 363 Total fat: 4 g Protein: 15 g Carbohydrate: 71 g Dietary fiber: 4 g Cholesterol: 0 mg Sodium: 100 mg Potassium: 93 mg
Multiple cardiac benefits result from frequent consumption of dark chocolates rich in flavanols, including our response to stress.
Recently when talking with my 7-year-old daughter, I asked her what was the best food she could eat for a snack. As the daughter of a cardiologist you may imagine that she would have been taught the enduring virtues of eating fruits and vegetables and how these are the best foods to use as snacks. She told me that my question was easy and replied, “the best snack is chocolate.” I asked her where she learned that and she told me her mother told her so. How can you really argue against that logic?
This question posed to my daughter then led to more investigation during my clinic. I asked many patients informally what were their favorite snacks. Since they were in a cardiologist’s office they would often say some sort of fruit or vegetable and then add they only consume it in a small quantity.
I then would ask, “now what really is your favorite snack?”
I particularly enjoyed the response of a couple in their mid 70s. I have seen both of them both for atrial fibrillation for over 5 years. She said, “my true favorite snack is chocolate.” Then almost immediately after, as if there was a sense of guilt in admitting this, she said, “but chocolate is healthy right? I try to eat dark chocolate.” Her husband laughed at her and said she eats more than dark chocolate. He then replied, “my favorite snack is anything you put in front of me.” In my informal poll of true favorite snacks, chocolate was mentioned in about two thirds of my patients. Most of my patients felt dark chocolate in particular was healthy.
Dark chocolate and other cocoa products have gained a lot of attention worldwide as dietary supplements to improve heath. These products are rich in in flavanols. Flavanols are felt to mediate some of the heart healthy properties of chocolate. Flavanols are also found in many other food sources felt to be heart healthy such as grapes, apples, blackberries, legumes, red wine, and green tea. But of all of these food sources, the relative concentration of flavanols is highest in chocolate. As you may have guessed, dark chocolate contains much higher concentrations of flavanols compared to milk or white chocolate. In some chocolates the production process all but eliminates flavanols.
What Are the Heart and Vascular Benefits of Eating Dark Chocolate?
Lower Blood Pressure. Consumption of cocoa increases nitric oxide, studies show. For a good review of benefits, see Cocoa and Cardiovascular Health. Nitric oxide is a naturally occurring chemical in our bodies. Nitric oxide acts on small receptors in our blood vessels and prompts the vessels to dilate. This process lowers blood pressure. High blood pressure as discussed in many of my prior columns is associated with many types of heart disease including heart failure, atrial fibrillation, and atherosclerosis. High blood pressure is also associated with cognitive decline, dementia, and stroke.
Coronary Artery Health and Stability. As our arteries become diseased from atherosclerosis, plaques grow and over time begin to impair blood flow. If the surface of these plaques becomes disrupted or inflamed the plaques may ulcerate. The body responds to the ulceration by forming a clot in an effort to heal the wound. This process can lead to a heart attack. Cocoa may help stabilize plaques and minimize their risk of rupture by reducing smooth muscle cell proliferation (a process that causes plaques to grow), platelet adhesion (a process that results in clot formation in the artery), and preventing leukocyte adhesion and migration (processes that causes these plaques to become inflamed and unstable).
Lower Cholesterol. People with elevated total cholesterol with increased levels of low-density lipoprotein (LDL) cholesterol have a higher risk of cardiac disease, in particular coronary atherosclerosis and heart attacks. Flavanols reduce cholesterol absorption in our gastrointestinal track and also the synthesis of LDL cholesterol, research shows. They may also help raise high-density lipoprotein (HDL) cholesterol, the part of our cholesterol that is felt to be protective of heart disease, a clinical trial reported. Lower LDL and higher HDL levels after cocoa consumption were seen in people with both normal cholesterol levels to begin with and those with elevated levels that needed treatment. Multiple medications reduce LDL cholesterol, but very few things and essentially no medications raise HDL cholesterol consistently.
Dark Chocolate Changes Our Body’s Response to Stress
My wife often says, “I eat chocolate when I am stressed.” As I mentioned in a prior column, stress and our response to it can be a very potent risks of heart disease. In this regard, what if chocolate can improve how we respond to stress?
This brings me to the newest study regarding dark chocolate that I found very interesting. When we are stressed our body signals out chemicals that raise our blood pressure and help us fight the stressor. These chemicals or hormones are stored in the brain (pituitary gland), the adrenal glands, and other parts of the nervous system. A rececent study looked at how the body responded to stress by measuring these chemicals (cortisol, epinephrine, adrenocorticotropic hormone [ACTH], and norepinephrine) in 31 men consuming dark chocolate (“Noir 72 percent”; Chocolat Frey AG, Buchs/Aargau, Switzerland) versus 34 men that received a placebo chocolate that did not contain flavanols. The men then underwent a significant stress.
The stress was a 5-minute mock job interview and then a 5-minute mental arithmetic task in front of an audience. It is probably easy for most of us to imagine feeling very stressed if we had to try to solve a complex math problem in our head in 5 minutes while others watched, or we had to receive an intense job interview.
What these researchers found about the effect of chocolate was significant. Those men consuming dark chocolate had lower levels of cortisol and epinephrine after the stress. Although their brain response to stress was similar (ACTH levels were identical in both groups) the body’s response to the brain signals of stress was blunted. In particular, the response of the adrenal gland, which produces cortisol, was much less. Less released cortisol and epinephrine with stress is important as these are strong stimulants of the heart and blood vessels. With repetitive stress over time, both the heart and blood pressure have be negatively effected. Finally, since the body response was less significant, men consuming dark chocolate reported having less feelings of stress during the process.
My daughter was right, dark chocolate or chocolate rich in flavanols is a healthy food choice. The benefits of dark chocolate need to be carefully considered with the calories consumed, but in general there are multiple heart-related advantages with frequent consumption. In addition, as my wife mentioned to me, dark chocolate also may help you deal with stress, not only how you perceive it mentally, but also how your body responds to it.
The risks and harms associated with drinking alcohol have been systematically evaluated over the years and are well documented. The World Health Organization has now published a statement in The Lancet Public Health: when it comes to alcohol consumption, there is no safe amount that does not affect health.
It is the alcohol that causes harm, not the beverage
Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago – this is the highest risk group, which also includes asbestos, radiation and tobacco. Alcohol causes at least seven types of cancer, including the most common cancer types, such as bowel cancer and female breast cancer. Ethanol (alcohol) causes cancer through biological mechanisms as the compound breaks down in the body, which means that any beverage containing alcohol, regardless of its price and quality, poses a risk of developing cancer.
The risk of developing cancer increases substantially the more alcohol is consumed. However, latest available data indicate that half of all alcohol-attributable cancers in the WHO European Region are caused by “light” and “moderate” alcohol consumption – less than 1.5 litres of wine or less than 3.5 litres of beer or less than 450 millilitres of spirits per week. This drinking pattern is responsible for the majority of alcohol-attributable breast cancers in women, with the highest burden observed in countries of the European Union (EU). In the EU, cancer is the leading cause of death – with a steadily increasing incidence rate – and the majority of all alcohol-attributable deaths are due to different types of cancers.
Risks start from the first drop
To identify a “safe” level of alcohol consumption, valid scientific evidence would need to demonstrate that at and below a certain level, there is no risk of illness or injury associated with alcohol consumption. The new WHO statement clarifies: currently available evidence cannot indicate the existence of a threshold at which the carcinogenic effects of alcohol “switch on” and start to manifest in the human body.
Moreover, there are no studies that would demonstrate that the potential beneficial effects of light and moderate drinking on cardiovascular diseases and type 2 diabetes outweigh the cancer risk associated with these same levels of alcohol consumption for individual consumers.
“We cannot talk about a so-called safe level of alcohol use. It doesn’t matter how much you drink – the risk to the drinker’s health starts from the first drop of any alcoholic beverage. The only thing that we can say for sure is that the more you drink, the more harmful it is – or, in other words, the less you drink, the safer it is,” explains Dr Carina Ferreira-Borges, acting Unit Lead for Noncommunicable Disease Management and Regional Advisor for Alcohol and Illicit Drugs in the WHO Regional Office for Europe.
Despite this, the question of beneficial effects of alcohol has been a contentious issue in research for years.
“Potential protective effects of alcohol consumption, suggested by some studies, are tightly connected with the comparison groups chosen and the statistical methods used, and may not consider other relevant factors”, clarifies Dr Jürgen Rehm, member of the WHO Regional Director for Europe’s Advisory Council for Noncommunicable Diseases and Senior Scientist at the Institute for Mental Health Policy Research and the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto, Canada.
We are missing the bigger picture
Globally, the WHO European Region has the highest alcohol consumption level and the highest proportion of drinkers in the population. Here, over 200 million people in the Region are at risk of developing alcohol-attributable cancer.
Disadvantaged and vulnerable populations have higher rates of alcohol-related death and hospitalization, as harms from a given amount and pattern of drinking are higher for poorer drinkers and their families than for richer drinkers in any given society.
“So, when we talk about possible so-called safer levels of alcohol consumption or about its protective effects, we are ignoring the bigger picture of alcohol harm in our Region and the world. Although it is well established that alcohol can cause cancer, this fact is still not widely known to the public in most countries. We need cancer-related health information messages on labels of alcoholic beverages, following the example of tobacco products; we need empowered and trained health professionals who would feel comfortable to inform their patients about alcohol and cancer risk; and we need overall wide awareness of this topic in countries and communities,” adds Dr Ferreira-Borges.
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