Monthly Archives: January, 2013

Using E-Cigarettes to Quit Smoking

Electronic cigarettes, or e-cigarettes, seem to be everywhere nowadays – you see people “smoking” them on subway platforms and at restaurants, and they can even be purchased for around $20 at your local 7-Eleven.  But with the ubiquitous presence of this new smoking cessation method comes several important questions:  Are e-cigarettes effective?  And more importantly, are they safe?

E-cigarettes are so new, as far as smoking cessation therapies are concerned, that there have been no definitive studies on their effectiveness, or safety.  However, a 2011 study in the American Journal of Preventive Medicine http://download.journals.elsevierhealth.com/pdfs/journals/0749-3797/PIIS0749379710007920.pdf found that, in a small sample of users, over the course of 6 months e-cigarettes led to complete abstinence from smoking in 31% of those sampled.  Loosely translated, this means that e-cigarettes are effective in quitting smoking about 1/3 of the time.  Almost as important, if not more so, the study also showed that e-cigarettes reduced the number of regular cigarettes smoked in almost 70% of users. 

The fact that e-cigarettes led to users cutting down on regular cigarettes is important because e-cigarettes deliver a lower dose of harmful nicotine than their tobacco-filled counterparts.  E-cigarettes work by delivering an inhalable vapor (containing nicotine and some of the other chemicals in cigarettes) via a battery-operated device.  So, users are inhaling a vapor rather than smoke, and the chemicals in the vapor are found in much lower quantities than in cigarette smoke.  However, there are still chemicals involved, some of which (such as various nitrosamines and the highly toxic diethylene glycol) have been shown to be harmful to humans.  An FDA analysis also revealed that the amount of chemicals varies from puff to puff, so there is no surefire way to determine exactly how much nicotine is being inhaled.  This finding, as well as e-cigarettes’ chemical content and a few other factors, including the absence of definitive validating studies, has resulted in e-cigarettes NOT being approved by the FDA.  Users can take this for what it’s worth, as many drugs and products approved by the FDA are eventually recalled, and there may be more evidence in the future to support and approve their use as a smoking cessation therapy.  For now, the bottom line is that e-cigarettes are safer than regular cigarettes, but other smoking cessation methods, such as nicotine gum or the patch, deliver fewer chemicals and are more effective in helping users quit.  E-cigarettes may be a good gateway to other means of quitting smoking, but, until their safety and efficacy have been more thoroughly studied, they should probably not be used long-term.

Healthy Ingredient of the Week – Pumpkin

Pumpkin is not just for Halloween – thanks to the miracle of canning, this seasonal staple can be enjoyed all year long.  Canned pumpkin, similar to last week’s healthy ingredient, peanut butter, can be used in sweet and savory dishes and snacks, any time of the day.  Pumpkin is low in calories and high in fiber.  Its bright orange color is a giveaway that it’s packed with nutrients (generally, the darker and deeper in color the fruit or veggie, the more nutritious it is).  One cup of canned pumpkin has almost 250% of your Recommended Daily Intake of Vitamin A (an antioxidant that is critical in maintaining eye health), and is a good source of other antioxidants, including Vitamins E and C. 

Canned pumpkin can be stirred into plain yogurt and oatmeal, or used to make my quick, easy, and healthy spin on mac and cheese. 

Pumpkin Mac

Ingredients

1 box 100% whole wheat pasta (any kind works, although I prefer angel hair or penne)

15 ounces canned pumpkin (one small can)

One package (8 wedges) Laughing Cow Light Creamy Swiss cheese

Two tablespoons (or more, to taste) grated parmesan cheese

Dash black pepper

Milk (optional) to thin out the sauce

Instructions

  1. Cook pasta according to package directions.  Reserve a small amount of the pasta water.
  2. In a medium saucepan over medium heat, combine remaining ingredients.  Stir until warm, about 3-5 minutes.
  3. Add the reserved water and milk to reach your desired consistency.
  4. Add pasta to the sauce.  Serve hot or cold. 

Choose MyPlate to Learn Your Nutritional Needs

In doing research for an upcoming seminar, I ended up at the USDA’s choosemyplate.gov, which I discuss and recommend in several of my Lunch ‘n Learns.  I was surprised to discover that the MyPlate website offers up so much more information than just what to put on your plate.  In fact, you can use the site to, among other things, look up nutritional information for over 8,000 foods; create a weekly meal plan based on your specific activity level and nutritional needs; and find all sorts of tips on topics like healthy eating on a budget, adding more fruits and veggies to your meals, choosing whole grain foods, food safety, and kids’ nutrition. 

I used MyPlate to figure out how many servings of each food group adults need to eat every day.  All the food you eat in a day should add up to:

2 cups fruit                             

2-3 cups vegetables               

6 ounces/servings grains (and at least 3 servings of whole grains)

5-6 ½ ounces lean protein                             

3 cups low-fat or fat-free dairy                                 

6 teaspoons oil (choose oils that contain heart healthy unsaturated fats, like olive oil)     
I also used MyPlate to come up with ideas for meals and snacks that can satisfy the above requirements.          Here are a few examples:

 

Breakfast

½ cup old-fashioned oats cooked with:
1 tbsp raisins
1 tbsp walnuts
½ cup 1% milk
½ cup water
1 glass orange juice

1 flour tortilla with:
1 scrambled egg
1 oz. shredded cheese
2 tbsp salsa
cup black beans
1 medium banana

Lunch

Turkey sandwich:
2 slices whole wheat bread
3 oz. low-sodium turkey breast
2 slices lettuce and tomato
1 tsp mustard
1 slice cheese
1 medium apple

White bean-vegetable soup:
1¼ cup chunky vegetable soup
½  cup white beans
1 whole wheat roll
8 baby carrots
1 medium banana
1 cup 1% milk

Dinner

3 oz. roasted boneless skinless chicken breast
1 large baked sweet potato
½  cup peas and onions
1 whole wheat dinner roll
1 cup leafy greens salad
3 tsp sunflower oil and vinegar dressing
½ cup unsweetened applesauce

Vegetable stir-fry:
4 ounces tofu (firm)
¼ cup green and red bell peppers
½  cup bok choy
2 tbsp vegetable oil
1 cup brown rice
1 medium orange

Snacks

1 medium apple
1 tbsp peanut butter

2 cups air-popped popcorn
1 tbsp grated parmesan cheese

1 cup sliced veggies
2 tbsp hummus

1 string cheese
½ cup cantaloupe

1 low-fat fruit on the bottom Greek yogurt
1 tsp slivered almonds
I could have spent all day playing around on MyPlate, and I hope to explore it in even more detail sometime soon.  If you are stuck for meal or snack ideas, or just want to learn a little more about your nutritional needs, I encourage you to visit the MyPlate website.  It provides a trusted source of nutrition information and is really an eye-opening learning experience.

Healthy Ingredient of the Week – Peanut Butter

When most people think of peanut butter, they think of the classic kids’ lunchtime staple of PB&J.  However, peanut butter is not just for kids’ meals, and it should have a regular place in most adults’ diets, due to its high nutritional content.  Peanut butter is an excellent source of heart-healthy polyunsaturated and monounsaturated fats (these are the fats you want to include in your diet – in moderation, of course), provides 8g of protein per 2-tablespoon serving, is a good source of fiber, and is very low in sodium and sugar.  Both the fiber and protein in peanut butter help maintain blood sugar levels and keep you feeling full for a long time. 

Peanut butter is a very versatile food – it can be part of any snack or meal, from breakfast to dinner, and can be used in both sweet and savory dishes.  I have included two savory recipes to get you thinking about different ways to use this healthy ingredient.  When choosing a peanut butter to use in cooking, baking, or snacking, the best varieties have only one ingredient – peanuts – and are usually labeled “natural.”  Natural peanut butter may appear oily at first, but all you need to do is give it a good stir before your first use, and then you can store it in the fridge.  Some natural peanut butters also include salt, and these are okay to eat if you need a little extra flavor.  Avoid peanut butters that contain any more than these two ingredients, as they’ll probably be full of sugar and hydrogenated oils (AKA trans fat) – these types of peanut butters are anything but healthy! 

Moroccan Chicken

My friends Abhishek and Jody sent me this favorite recipe, adapted from Betty Crocker, to use in my brand-new slow cooker.  The original recipe calls for chicken thighs, but I made it a little healthier by substituting white-meat chicken breasts.

Ingredients

1 tablespoon olive or vegetable oil

3 lbs boneless, skinless chicken breast

1 large onion, chopped (1 cup)

2 cans (14.5 oz each) diced tomatoes with green chilies, undrained

1 can (14.5 oz) crushed tomatoes, undrained

2 tablespoons honey

1 1/2 teaspoons ground cumin

1 teaspoon ground cinnamon

1/3 cup creamy peanut butter

2 cups hot, cooked, whole wheat couscous (couscous takes only five minutes to cook – follow directions on the package to ensure the proper consistency)

 Instructions

  1. In 12-inch nonstick skillet, heat oil over medium-high heat. Cook chicken in oil about 4 minutes, turning once, until brown.
  2. In 4- to-5-quart slow cooker, mix onion, diced and crushed tomatoes, honey, cumin and cinnamon. Add chicken. Spoon tomato mixture over chicken.
  3. Cover and cook on Low heat setting 7 to 8 hours.
  4. Stir in peanut butter until melted and well-blended. Serve chicken and sauce over couscous.

Makes 4 servings.

Perfect Peanut Sauce

Ingredients

1/4 cup creamy or crunchy peanut butter

2 teaspoons low-sodium soy sauce

1 tablespoon brown sugar

1/2 cup water

red chili flakes and black pepper to taste

Instructions

  1. Combine all ingredients in a small saucepan using a whisk or rubber spatula, adding the water last. 
  2. Cook over low heat until sauce begins to bubble or thicken (about 3-4 minutes).
  3. Serve over pasta, rice, or protein, hot or cold.

Want to lose a pound a week? Get moving!

To many people, losing weight can seem like a daunting challenge, especially when it comes to choosing the best method to do so.  This decision can become further complicated by the glut of new fad diets and exercise plans that seem to be popping up everywhere you look.  The simple truth is that there is no “miracle pill,” or “miracle” anything, for that matter, that can lead to rapid weight loss and successful weight maintenance.  The easiest, and safest, way to lose weight is to put your body in a calorie deficit.  All it takes is a deficit of 500 calories each day to lose a pound a week.  So, you either need to eat 500 calories less, or burn 500 calories more, than you normally do (or, you can do a combination of the two).  Other blog posts have focused on cutting calories, and that topic will be the subject of posts in the very near future, but increasing physical activity is just as important.  Adding extra activity to your day doesn’t have to be difficult or exhausting – by making simple tweaks to your routine, you can easily burn several hundred more calories than you normally do.  Some good ways to start:

  • Get off the subway or bus a few stops early, and walk the rest of the way to work.
  • Park your car in a space that’s far away from the entrance.
  • Walk to errands nearby, instead of driving there. 
  • Exercise while you’re watching tv.  Lift weights, walk in place, or do jumping jacks. 
  • Take the stairs instead of the elevator – when going down and up.
  • Choose activities that require standing up and moving – think dancing or bowling – rather than sitting (like going to the movies).

Now could also be the time you decide to take on a new activity that helps you burn calories while still having fun.  The following activities, when done for an hour by a 150-pound person, burn about 500 calories:

  • Low-impact step aerobics
  • Fast dancing
  • Ice skating
  • Downhill skiing
  • Snowshoeing

To find out how many calories you can burn doing other physical activities, go visit the WellMASS website, and click on Learn & Share > Calculators.

Shop Smart, Eat Healthy

With the holiday season behind us, you would think that it’s now a lot easier to eat healthfully and resist temptation, since there are no more seasonal goodies to lure you into sabotaging your healthy diet.  Unfortunately, it’s easier than you think to succumb to junk food, any time of year – all you have to do is step foot into a grocery store!

Grocery shopping can either help your diet or hurt it.  If you don’t put any unhealthy foods into your cart, they won’t make their way into your home and you’ll have fewer chances to eat them.  If, however, you fall prey to clever marketing and ubiquitous sale prices on junk food, you’ll be more likely to overindulge on the bad stuff, since it will be right under your nose, calling your name every time you are home.  The easiest way to avoid overdoing it on unhealthy purchases is to shop the perimeter of the store.  I challenge you to look around your grocery store the next time you’re there; you’ll notice that most of the healthiest foods – things like low-fat dairy, lean meats, whole grain breads, fruits, and veggies – are kept in the outside aisles.  The middle aisles are mostly filled with junk food, although you will find some healthy choices there, such as nuts, whole grain pastas, beans, and canned and frozen fruits and veggies. 

Adding lots of fruits and vegetables to a meal is one of the easiest ways to increase its nutritional value, and the Fruits and Veggies – More Matters initiative offers some great tips on how to do so.  Here are a few to get you started:

  • Include frozen, canned and dried forms of fruits and vegetables on your list. They are all nutritious and handy for quick-fix meals. (When buying canned fruits, look for those packed in water or 100% fruit juice – not heavy syrup.  When it comes to canned veggies, choose low-sodium varieties and rinse the veggies before preparing them.)
  • Plan meals around fruits and vegetables that go a LONG WAY. Plan to include fruits and vegetables you can grab as quick snacks or turn into soups and casseroles that you can eat a couple of times during the week.
  • Buy in season. Although most fresh fruits and vegetables are available year-round, some are less expensive when they are in season. Also keep in mind that all forms of fruits and vegetables are nutritious, so canned and frozen forms are OK too!
  • Buy more. When there are specials on fruits and vegetables, buy extra. They can be frozen, or you can prepare a dish to be frozen for a busy night’s dinner. But don’t buy it if you won’t use it or you’ll just be tossing the money in the garbage.

By shopping smart, you can build a diet full of delicious and nutritious foods.  It’s a lot easier to watch what you eat during the week  if you make healthy decisions during your weekly trip to the grocery store.

I Say Sauna, You Say Banya

By Guest Blogger Liz Layton, GIC

You think it’s cold here?  WIMPS!  Check out some real winter weather – and prescriptions for warming up.

In Vermont, cold weather and snow can start in October and last through April.  Lake Champlain towns may get 60 inches of snow a year, while the Green Mountains get covered in up to 120 inches.  The average winter temperature is 22 degrees Fahrenheit.   So it’s understandable that ski places really took to the Jacuzzi after it was invented by an Italian family in California in the late sixties.

In Hokkaido, Japan’s big island of the north, winter temperatures average 21°F while inland basin areas can drop to a frigid -22° F. The lowest recorded temperature in Japan was -42°F (Asahikawa, January 1902).  No wonder Japanese baths have a long tradition as community meeting places – from the many hot springs to public bathhouses.

Northern Russian winters are long and harsh, with plenty of snow and temperatures falling below -40°F. The coldest inhabited place on Earth is the Russian Far East. The lowest temperature registered there was −96.2 °F (Yakutia, 1924).   Clearly there’s a reason for banyas – the winter Russian steam bath ritual. 

In Finland winter is the longest season and lasts from 100 days in southwestern Finland to 200 days in Lapland. The coldest temperatures in winter go as low as -58°F in Lapland and eastern Finland; to -13°F in the “warmer” regions.  So of course Finns built little heated houses where you could sit inside and sweat while the wind blows outside.  According to the Lonely Planet travel blog, “Sauna is seen as a sacred place in Finland, where babies were once born and ailments treated. Finns still take their sweating needs seriously – there are two million saunas in this country of five million. No wonder Finland is home to the International Sauna Society.”  

A sauna is a small room or house where people communally enjoy heat that promotes sweating and relaxation.  When they say heat, they mean it.  Russian and European saunas can achieve temperatures over 200°F, but the United States limits sauna heat to 194°F. Infrared saunas are generally less hot. The key to enjoyment is alternating periods of hot and cool – generally about 15 minutes of heat to 10 minutes of cooling off.

Although even today “many middle-aged Finns boast of being born in the sauna,” American doctors caution pregnant women, particularly in the first trimester, to avoid high heat including steam rooms, saunas, hot tubs, and Jacuzzis.  However, there are also studies which have found that saunas can be helpful to cardiac patients.  If you have concerns, talk with your doctor before visiting a sauna (and take a look at the medical journals referenced at the end of this blog).

BEFORE YOU GO
Ask about the type of sauna and how hot it will be inside:

Finnish dry saunas 160°-194°F

Russian steam saunas 90°-120°F

Infrared saunas 80°-125°F

Finns say “In the sauna one must conduct himself as one would in church.” Ask about etiquette at the sauna you visit – particularly if you care whether or not there are separate sections for men and women and if clothing is optional or not.

If you’re visiting a hotel or have a gym membership, use of the sauna, steam room, or Jacuzzi is probably included.  For other rates, check the list of Local Saunas and Steam Baths below.  All of them cost much less than a ticket on a plane, boat, or train to a warmer place!

TIPS

  • Do not drink alcohol beforehand.
  • Shower before entering the sauna.
  • Bring a towel to sit on.
  • Remove jewelry – metal gets hot!
  • Remove contact lenses.
  • Drink plenty of water during the sauna.
  • Spend 8-10 minutes in the first dry sauna session and no more than 15 minutes on later sessions. Limit steam saunas to 10 minutes.
  • Between each session in the heat, spend 10-15 minutes cooling down.
  • Make showers cool, not cold.

LOCAL SAUNAS AND STEAM BATHS

Dillons Russian Steam Bath
Chelsea, MA
http://www.dillonsrussiansteambath.com/

Banya Russian Steam Bath & Spa
Allston, MA
http://www.russian-spa-boston.com/

YMCA/YWCA
Health clubs/Gyms
Hotels
Spas
REFERENCES

Arch Phys Med Rehabil. 2009 Jan;90(1):173-7. doi: 10.1016/j.apmr.2008.06.029.
Safety, acceptance, and physiologic effects of sauna bathing in people with chronic heart failure: a pilot report.
Basford JR, Oh JK, Allison TG, Sheffield CG, et al, Mayo Clinic Rochester, Rochester, MN, USA.
Sauna bathing under the moderate and supervised conditions of this study appears to be well tolerated and may be safe for people with CHF. More research is needed to further evaluate the safety and potential benefits of this approach.

Can Fam Physician. Beever R, 2009 Jul;55(7):691-6.
Far-infrared saunas for treatment of cardiovascular risk factors: summary of published evidence.
Four papers support the use of FIRS therapy for those with congestive heart failure and 5 papers support its use for those with coronary risk factors.

Int J Circumpolar Health. Kukkonen-Harjula K, Kauppinen K, 2006 Jun;65(3):195-205.
Health effects and risks of sauna bathing.
Baths did not appear to be particularly risky to patients with hypertension, coronary heart disease and congestive heart failure, when they were medicated and in a stable condition.

Ann N Y Acad Sci. Kauppinen K, Canadian Sauna Society, 1997 Mar 15;813:654-62.
Facts and fables about sauna
Cardiovascular patients with essential hypertension, coronary heart disease or past myocardial infarction, who are stable and relatively asymptomatic in their everyday life may also take sauna baths without undue risk. As a rule of thumb, if a person can walk into a sauna, he or she can walk out of it. Misuse and abuse of the sauna are another matter.

For more about Finnish saunas and Russian steam baths:
http://www.lonelyplanet.com/travelblogs/35/115856/My+first+Finnish+sauna?destId=359152#ixzz2HPI4qdV5

http://www.cyberbohemia.com/Pages/historyofnordic.htm

http://www.examiner.com/article/how-to-enjoy-a-russian-steam-bath

Drop pounds with the DASH Diet

As the WellMASS Weight Loss Challenge begins to be rolled out at agencies across the state, I thought it might be helpful to share some diet and exercise options that you may not have previously thought about.  As I mentioned awhile ago, the best “diets” out there are not really diets at all, and according to U.S. News & World Report, which ranks diets annually based on their effectiveness in helping you lose weight and prevent heart disease and type 2 diabetes, and their safety, nutritional value, and ease of use, one diet comes out on top time and again:  The DASH Diet.  DASH stands for Dietary Approaches to Stop Hypertension, and was created to help people manage their high blood pressure.  However, it’s also consistently ranked as the best eating plan for weight loss, for one main reason:  it shuns processed and convenience foods in favor of whole foods that are as close to their natural states as possible.  Processed and convenience foods are often loaded with excess sugar, salt, and saturated fat and are major sources of empty calories.  By cutting out these foods and focusing on “real” foods with beneficial nutrients like unsaturated fat, fiber, and lean protein, you’re more likely to feel full and satisfied, on fewer calories.

The DASH Diet was created by the National Institutes of Health, a government entity, which means it can be downloaded and followed free of charge.  The diet recommends the following daily combination of nutrients:

Total Fat:  27% of calories
Saturated Fat:  6% of calories
Protein:  18% of calories
Carbs:  55% of calories
Sodium:  <2,300 mg
Fiber:  >30 g

These nutrient recommendations can be obtained by eating the following each day:
6-8 servings of grains (at least half of which should be whole grains)
4-5 servings of veggies
4-5 servings of fruit
2-3 servings of low-fat or fat-free milk and dairy products
6 ounces or less of lean meats
2-3 servings of fat or oils (choose mostly heart-healthy unsaturated fats)
4-5 servings of nuts (per week)
5 servings of sweets (per week)

Both the nutrient and serving recommendations are based off of a 2,000-calorie diet, so make sure to adjust up or down based on your calorie needs.  By sticking to this “diet” and limiting your intake of processed food and instead focusing on getting your recommended servings of each food group from unprocessed, natural sources, you should feel full and satisfied after each meal, without consuming too many calories.  Processed and convenience foods may be tempting, but in the long-run, they’ll make you hungry well before your next meal, may pack on extra calories, and aren’t worth sabotaging your weight loss goals.

Ready to Lose Weight in 2013? Join the WellMASS Weight Loss Challenge!

The WellMASS Weight Loss Challenge is almost here!  Throughout the six-week Challenge, you’ll receive educational materials with tips on incorporating healthy eating habits and physical activity into your daily routine that will help you lose 1-2 pounds each week.

Completing the Challenge is easy…

  • Sign up with your agency’s Wellness Champion or GIC Coordinator and receive your Weight Loss Challenge packet
  • Aim to exercise 30 minutes a day, most days, and incorporate mini-moves and nutrition swaps each week
  • Keep track of your weight each week – The agency with the greatest average percent body weight lost will win a prize!

How do I register?

See your agency’s Wellness Champion or GIC coordinator to sign up for the Weight Loss Challenge and receive your Tracking Form with instructions on how to complete the Challenge. 

When you register, you will receive a Challenge Tracker in which you can track your exercise and mini-moves and nutrition swaps for 6 weeks.  Your agency’s Wellness Champion or GIC Coordinator will let you know when the Challenge starts and ends.

You can also keep track of your weight each week using the Tracker.  Your weight loss will be counted toward your agency’s total for a state-wide weight loss competition.

In order to increase your agency’s chances of winning the weight loss competition, take your FREE Health Assessment.

For more information, contact your agency’s Wellness Champion or GIC coordinator.  If you don’t know who that is, send me an email.

The Weight Loss Challenge is designed for you to follow on your own, or as part of a group.  We’ll provide you with all the tools you’ll need to safely and successfully lose weight and keep it off.  If your New Year’s resolution involves losing a few pounds, I hope you will be able to use the Challenge to help you do so.