The Amazon Jungle with a French Twist

Last night I had an opportunity to go to a new restaurant with one of my new friends that I made at the yoga retreat. She wanted to grab a cocktail and have a chat, which I always up for. We ended up heading over to the Lagoa (Lagoon) which is located in the middle of the southern part of Rio and has a beautiful view at sunset. There is this restaurant there called Palaphita Kitch that serves Amazonian food with a TWIST. It was the PERFECT place to spend a Thursday evening having some girl talk and enjoying a few cocktails.

The restaurant includes foods like “Mujica de Tambaqui” (amazon fish soup), several drinks made with mangarataia (Amazonian ginger), and cupuaçú (an

Amazonian super fruit that rivals acai). What surprised me the most about the restaurant was that their entrees were all FONDUE. Yes, like the Swiss/French melted cheese or chocolate dish. FONDUE. In the AMAZON? I thought that fondue was only served when it was cold in the Swiss alps with an enormous amount of French Bordeaux. I would NOT want to drink a French Bordeaux in 96 degree weather as it has been here in Rio. Globalization is so interesting!  Another neat item on the menu was an appetizers of camembert cheese (French) stuffed with Amazonian fish and fried bananas.  Totally nuts!

My girlfriend and I ended up sharing an eggplant bruscheta and we each had a caipirinha (Brazil’s national drink) made with Absolute Vodka, tangerines,

Amazoinan ginger and sugar. DELICIOUS! I would like to go back to try their other tropical fruit cocktails, as those caipirinhas really sneak up on you and you have to kind of space them out.  If you ever check this place out if you make it to Rio, just be aware of the GIGANTIC ants everywhere, and lizards that may try to get in on your fondue. Its a jungle out there after all.

Slow Food Orange County: Luncheon in the Garden

In a world full of fast food and wide-spread impatience, there is one group in Orange County trying to slow things down, at least when it comes to food. Slow Food Orange County is a non-profit, community organization whose mission is to ensure equity, sustainability, and pleasure in the food we eat. They focus on ensuring that the community has access and knowledge about good (healthy), clean (free of pesticides and harmful chemicals), and fair (available to all) food.

Slow Food Orange County sponsored a luncheon this weekend at Il Garage, an extension of Park Ave restaurant in Stanton. Il Garage restaurant serves up locally grown Italian fare. To this restaurant, local does not just mean purchased from local farmers, but actually grown in their large garden located on the property itself. The chef David Slay allows the garden to inspire and create his dishes for the day. The majority of the meals feature fruits, vegetables, and herbs picked from the garden that day.

This past Sunday, Slow Food Orange County, hosted a lunch at Il Garage. Guests were greeted by a glass of champagne paired with a tomato tart, eggplant bruschetta, and baked clams. These delicious appetizers were enjoyed during a tour of the garden where guests were given a detailed explanation of the organic gardening practices the restaurant employs. In order to reduce the amount of pesticides used, specific flowers are planted at the end of each bed to help attract beneficial insects and minimize the harmful ones. Bees and lady bugs are especially important to keep the garden pollinated and aphid free.

The lunch was served family style at long tables. Guests could choose a white or red wine to pair with their meal, both selected by the chef to compliment the food. The lunch included: mixed salumi ravioli, garden herb gnocchi, pork loin with caper sauce, and fresh clipped greens straight from the garden. The meal was finished off by an amazing vanilla bean panna cotta with candied citrus. All of the food was fresh, delicious and served in generous portions.

Chef David Slay was greeted by applause at the end of the meal, it was so fantastic! What a great way to spend a sunday afternoon, slowing things down and eating delicious food.

The RDN and AND

Most of you non-RDs probably don’t know, but the American Dietetic Association recently changed its name to the Academy of Nutrition and Dietetics (AND). This change didn’t really make sense to me because I feel like it sounds like a school now with the word “academy” in the title. Then, this month on National Registered Dietitian day, they also decided that RDs (Registered Dietitians) can also start using the title RDN (Registered Dietitian Nutritionist). I think the RDN is ok because half the people I work with want to call me a nutritionist anyway. So, now I no longer have to correct them. Great!

The purpose of this post is not to update you on the pointless name changes, but to discuss something that has been really upsetting me lately in my profession. AND has done a good job of promoting RDs as “THE” experts in nutrition and dietetics. In terms of clinical nutrition, in the US, RDs are the only ones who can practice medical nutrition therapy in hospitals, nursing homes, and long-term care facilities. RDs do have a specific set of training and skills which is standardized and determined by the Commission for Dietetic Registration. This standardization gives RDs a lot of job flexibility in that they are eligible to do a variety of different jobs including clinical nutrition, food service, and community nutrition. I am happy with those options, as I know that with my RD license I will always have a job. Awesome for RDs!

But, it has come to my attention that although AND has promoted the RD as the nutrition expert and the CDR has standardized our qualifications and education, AND is now (and has been for awhile) doing us as nutrition professionals a great disservice. One of the primary reason I am not a member of AND (other than it is expensive and I don’t see the real benefit), is the fact that they gladly accept corporate sponsorship from companies like PepsiCo and McDonald’s. Companies like this are allowed to sponsor continuing education units and lectures at the annual AND meeting. Coca-cola particularly has been allowed to give presentations regarding how sugar is “not that bad” and provide RDs with information like this (I particularly enjoy the part where they say that increased sugar intake cannot be linked to obesity…WHAT???). In a recent article, an RD was discussing how McDonald’s breakfast (the SUPER high sugar oatmeal) is a healthy choice. I will challenge you to eat the oatmeal and see how you feel a few hours later, my bet is that you will be STARVING and looking for more carbs. How is this a good thing? Not to mention how excess sugar and carbohydrates are the primary cause of the obesity epidemic, this clip from the movie Fat Head explains it beautifully.

I think RDs need to stand together and take back their organization. I don’t think its bad for RDs to work for these corporations, as maybe they can promote positive change, but I think our message needs to be clear. Real food = good nutrition. Fake food (filled with chemicals, sugar, trans fats) will NEVER be an ideal diet for humans. There is NO man-made food that can replace the nutrition provided by locally grown, organic fruits, vegetables, and grass-fed meats. It may be idealistic to think everyone can eat this way, but RDs and other nutrition professionals are determined and smart enough to figure out ways to impact real change in our food systems, especially if we take back our organization and start a real conversation without the influence of corporate sponsorship. If you are an RD, consider joining the Facebook group “Dietitians for Professional Integrity” to learn more.

How to actually lower your cholesterol

As a Registered Dietitian, I have seen hundreds of patients trying to lower their cholesterol via a low fat, low cholesterol diet. Many patients come to me desperately trying to figure out why their cholesterol keeps increasing after years of avoiding fried foods, meat, bacon, eggs, and cheese. I learned in school,

that if a patient was not seeing results with a low fat, low cholesterol diet it probably meant they weren’t REALLY avoiding the foods they needed to avoid. Just a few years ago I believed that if a patient was truly eating lots of whole grains, very little fat, and avoiding red meat at all costs, they should have low cholesterol. But, after a while in this field, seeing one unsuccessful patient after another, I started to see that this was clearly not happening. How could ALL my patients be lying to me about what they were actually eating? Sure, there is a genetic component to high cholesterol and some people’s numbers are high no matter what they do, but these cases are rare. I didn’t feel that genetics was accounting for the lack of change I was seeing in my patients when they changed their diet according to my recommendations

The thing is that I was eating a “heart healthy” diet myself, exactly as I had learned in school. I knew I had a family history of high cholesterol and had to be careful with my diet.  But, even in following the traditional recommendations (and who knew them better than me?), my total cholesterol was over 200. My LDL (bad cholesterol) was borderline high. How could this be?  I ate oatmeal with fruit for breakfast, whole grain bread with fat free mayo, low fat cheese (or fat free, yuck!), and turkey for lunch, and whole wheat pasta with veggies for dinner! I used only olive oil for cooking, didn’t eat fast food, never ate anything fried, avoided eggs, and didn’t eat much red meat. Why was my cholesterol so high at only 27 years old? I had all the information and was following the recommended diet I had learned in school. Why couldn’t I lower my own cholesterol? Why were my patient’s struggling as well? Clearly there was something that was not right.

Part of the reason I became a dietitian is because I love how often the field changes, requiring a lot of research and constant learning to stay on top of all the new information. I like to try things out on myself before I make recommendations and don’t like to recommend diets if I am not seeing the results I think I should.  I couldn’t accept that the low fat diet I was following was not keeping my cholesterol under control, especially since I was following exactly what I was taught and what was fully accepted by the medical and nutrition communities.

So, I hit the internet and did some research, I desperately wanted real results for my patients and myself, and didn’t want to provide information that clearly wasn’t working. I attended a few “alternative” nutrition conferences to try to discover different ways of thinking about heart health. After a lot of research into what would actually lower my cholesterol, I changed my diet. I quit following the “recommended” heart-healthy diet and I added back many foods that I had been avoiding for years.

After 6 months on this new diet, my cholesterol went down 32 points, my LDL was down 27 points, now all within normal levels. I also convinced a coworker to try the diet with me and her total cholesterol dropped 20 points and LDL dropped 25 points after only 2 months. Her HDL also increased by over 20 points, and she was not exercising (exercise usually raises HDL)!

When I told my doctor what I had done, including the dietary changes I had made, he told me it was impossible, that it couldn’t have been my diet that changed my cholesterol. He said “You must have a different kind of metabolism from other people!” Really? Clearly, he was wrong, it was my diet. It’s not his fault, his area of expertise is not nutrition and he is just following what the rest of the medical community has accepted as dogma. When you know better, you do better.

So I wrote a program manual called “How to actually lower your cholesterol” to help people like myself who are doing everything they can, following all the recommendations as closely as possible, and still not seeing the results they want with their cholesterol levels. It outlines exactly what you need to do to get your cholesterol down fast.

Product Review: Orgain

I am always on the look out for new products to try out. Of course patients are always asking me about products, but its hard to stay on top of so many.  A friend of mine gave me a new meal-replacement shake that she wanted me to test out. Its called “Orgain” and claims to be an organic, high protein, nutritional drink.  She gave me the chocolate protein flavor to try and she has been using both flavors (chocolate/vanilla) as a meal replacement for after workouts or as a snack. Orgain was developed by a doctor who was undergoing cancer treatment. He used this product to help stay healthy and maintain his weight during treatment.

There are several things I like about the product. First, its gluten free. Not that their would be any reason for there to be gluten in the product to begin with. Also the taste was pretty good. I used it as a meal replacement for breakfast and was not hungry at all until lunch (I did pair it with a banana).

It is sweetened with brown rice dextrin, cane juice, and brown rice syrup. But, because of those ingredients, it is pretty high in carbohydrates (32g of carbs, 13g of those are added sugar). You need to get the sweet taste from somewhere and I would rather have it be real sugar than the fake stuff. Some of the other “low carb” drinks are sweetened with Nutri-sweet or Splenda. If you are going to have something sweet, its definitely better to have the real stuff.

I was pretty impressed with the amount of antioxidants included in the product. There are 130mg worth of antioxidants from fruits and vegetables in the product. The equivalent of 10 servings of fruits and vegetables. Of course, you can’t just drink this and not eat your fruits/veggies! It is NOT a replacement of those foods it just adds to it!

I wish it had more protein. Maybe 20g of protein and a little less carbohydrate. It would be 2 servings worth of carbs for a diabetic, but it does have enough protein (16g) to balance out the effect of those carbs.

The main issue that people may have with the product is the cost. It is $3-4 per 11oz box. The cheapest I found it online was $3.22. I think thats pretty expensive for something you are going to drink every day (if you are going to use it that way), it would cost you over $100 a month! That’s probably 3/4 of what I spend on food for the month! (I eat for free at the hospital where I work, 2 meals per day).

Ok, so who should drink this stuff?  First, I would use it with my hospitalized patients. I think it is slightly better than the Ensure/Boost products usually recommended for patients who can’t eat much food. It definitely has less sugar and more protein than those products. If you are going through cancer treatment or have a lack of appetite for whatever reason, using this product could help get you some much needed protein and vitamins.

Orgain could also be used as a meal replacement for weight loss, but I would use it sparingly. Liquid food is not a good idea for losing weight, but if its between drinking this product or having nothing at all, its better to have something. If you are not trying to lose weight and only want to gain muscle, try adding some fruit/protein powder to it and use it as a base for a smoothie after a weight lifting workout. So, overall, I would recommend this product to people looking for some type of shake or meal replacement. It is a little expensive, but it can be worth it to try to maintain strength or for a easy post workout shake or meal replacement! Enjoy!

Coffee Creamer

I am going to make a confession, there is nothing that I love more than Coffee Mate coffee creamer.  Even when I was eating almost 100% Paleo, I still had an occasional weakness for Hazelnut creamer.  Now that I am on a tight budget, regular Starbucks trips are out of the question, but I don’t miss Starbucks because I have allowed myself Hazelnut creamer instead. Hey, I’m saving money right?  I am completely and totally aware that the 3rd ingredient is “partially hydrogenated…oil”. Partially hydrogenated = trans fat, which is increasing inflammation in my body and is basically like eating plastic. Terrible! I also see the long list of other ingredients, none of which are good for me. But, what is a girl on a budget to do?

Coffee Mate Ingredients

Ingredients in Hazelnut flavored Coffee Mate: WATER, SUGAR, PARTIALLY HYDROGENATED SOYBEAN AND/OR COTTONSEED OIL, AND LESS THAN 2% OF SODIUM CASEINATE (A MILK DERIVATIVE)**, MONO- AND DIGLYCERIDES, DIPOTASSIUM PHOSPHATE, COLOR ADDED, CELLULOSE GEL, NATURAL AND ARTIFICIAL FLAVORS, CELLULOSE GUM, CARRAGEENAN, DEXTROSE

Coffee Mate Natural Bliss Creamer

Enter a “better” (not fantastic) solution today! The new “Natural Bliss” creamers by Coffee Mate. Check out the difference in the ingredients: NONFAT MILK, HEAVY CREAM, SUGAR, NATURAL FLAVOR.  That’s it!!! 4 ingredients!! I had seen it advertised on TV recently, so I decided to check it out at the store today since I was feeling guilty about my daily creamer consumption. I was ecstatic to see a short ingredient list and no trans fat! The only SMALL problem I have with it is the “natural flavor” part of the list. Natural flavors is a code word the food industry uses so it doesn’t have to spell out exactly what the ingredient is (usually a bunch of chemicals used to give foods flavors, that are not tested for safety). If you want to read more about natural flavors check out an article I wrote about it here. Anyway, I think I am a convert to the new Natural Bliss Coffee Mate. I know it’s not making me healthier, but I think overall it’s probably not hurting me that much. Plus, I think the happiness that delicious cup of coffee gives me every morning probably evens out any harm. Drink up!

Coconut Water

Every morning I walk down along the shore of Ipanema beach for about an hour and then end my morning walk with a delicious young, fresh coconut. First thing in the morning it is delicious after a long walk.  Coconuts are found at every beach stand here in Rio, ice cold, and ready to be consumed. The guy at the beach stand will usually chop the top of it open with a giant machete and then its ready to drink! They sure hit the spot when its over 95 degrees in the summer.

The word coconut means “monkey face” because it kind of looks like the face of a monkey. In Sanskrit, the coconut is known as kalpa vriksha which means “tree which gives all that is necessary for living”.

In case you are unfamiliar, coconut water is the liquid found inside of a young coconut. The coconuts here are usually green and a little smaller than a basketball. The “water” is found in the young coconuts because the older ones will eventually fill up with coconut “meat”. A really young coconut has a gel-like meat inside which starts to grow and get harder as it matures.

Coconut water has a significant number of health benefits. Unless it has been contaminated it is completely sterile and can be used for IV hydration if needed

because it has the same electrolyte balance as the body. WOW! It is very high in potassium (294 mg), magnesium and contains a significant number of antioxidants.   Can potentially promote heart health, weight loss, and improve kidney function. And one cup of coconut water has only 46 calories! Awesome! So if you ever have the opportunity to grab yourself a fresh, ice cold coconut on the beach of Ipanema, know that you are getting a ton of health benefits along with it. Enjoy!

Coconut Water for Dogs

Many of the cariocas (residents of Rio) give coconut water to their dogs and its really cute to see dogs roaming around the beach with a coconut hanging from their mouth.

Roasted Veggies and Fish

Roasted Root Vegetable Medley

  • Preheat oven to 400 degrees.
  • Chop carrots, radishes, turnips, potatoes, kohlrabi, and beets. Add 1 whole head of garlic (do not chop). Mix all with olive oil, rosemary sprigs, salt/pepper to taste.
  • Place in oven, uncovered for 40-45 minutes until veggies are soft and start to brown. Serve hot!

Simple Fish

  • Mix 1/4 diced onion, 1-2 Tbsp garlic, 4 Tbsp chopped cilantro, juice from 2 lemons, 1 Tbsp olive oil, salt/pepper to taste.
  • Place White Roughy fillets in pan. Add the sauce over the fillets.
  • Place in oven at 350 degrees for 10-15 minutes or until fish flakes easily.

Paleo and Cholesterol

The first time I ever heard about the Paleo diet was at my Crossfit gym a little over a year ago. We were going to do a 30-day “Paleo” challenge (which I think I actually ended up winning). Anyway, when my coach presented the information about the diet to me, my first reaction (out loud) was “This is totally going to raise our cholesterol”. My coach simply responded “No it won’t” and moved on from my commentary, probably knowing I was not informed of the details and benefits of the Paleo diet. Hey, I learned in school as a Registered Dietitian that a high fat/high saturated fat diet raises cholesterol, heart disease, cancer, etc. I learned it is a great idea to eat low fat foods to reduce calories and lose weight. I told my patients over and over, NO BACON! NO SAUSAGE! NO FAT! Switch to Smart Balance or olive oil! Avoid butter! Eat fat free dairy (btw fat free cheese is nasty and I could never tell anyone to eat it, but I digress…)

So, I started the Paleo challenge….and a year later I would still consider myself Paleo-ish. I have decided not to stress myself out about it, but I would say that 80% of my meals are Paleo. I eat cheese (so I guess, Primal? Who cares?), sometimes enjoy a Starbucks soy latte, and like to have milk in my tea on the weekends. I also don’t stress out if I eat some pizza with my boyfriend sometimes or if I have a freshly baked cookie at work (the smell makes them hard to resist!). I would say 100% of breakfasts and lunches are Paleo (pretty easy during the week) and most of my weeknight dinners. I will admit my compliance is not incredibly high, but I am working on a happy medium.  I also converted one of my coworkers to Paleo (the others are vegetarians- not going to happen) and that makes it easy to have a support person. Even the server at the cafeteria knows my diet and gives me the evil eye when I start eying the ravioli or rice.

After a year on Paleo (with varying degrees of compliance) here are my cholesterol results (I have genetically high cholesterol btw):

My results (after 1 year) My coworker’s results (after 2 months)
Before After Before After
Cholesterol 218 186 249 229
LDL 136 109 164 139
HDL 54 57 59 79
Triglycerides 142 101 79 55

Basically, as you can see, my numbers went from borderline high, to pretty normal. I realize I can still work on the triglycerides a  little bit (there are definitely places I can reduce fruit, added sugar, or wine), but overall my numbers are pretty good. My coworker didn’t have as much time as me for her before/after results, but there was a significant drop in her LDL and an increase in her HDL (even though she stopped exercising due to an injury during that time). These numbers decreased even though neither one of us lost any weight during the time we have been on Paleo, so the numbers cannot be attributed to a significant weight loss. I have always been pretty active with either Crossfit or boot camp, even at the time these numbers were measured.

What scares me is, that about a year ago I would have told everyone that a diet which included eggs and bacon DAILY would raise your cholesterol. Clearly that is not true for reasons I have discussed in other posts. So what do I do with this information? Do I go back to work and continue teaching a low fat, low cholesterol diet because that is what is required of my job? How do I even convince people that everything we were taught is pretty much completely wrong? How do you work within a society that does not believe that this is possible due to years of misinformation? I haven’t really figured out how to reconcile all of this with my actual job, since there is an expectation for me to provide a certain type of information. In the meantime, I have decided to speak really loudly in the cafeteria of the hospital where I work while serving myself bacon and eggs…..”hey do you know lowered my cholesterol by almost 40 points by eating this way???”….and I just pray that maybe the doctors are listening

Doctors and Diet

I went to see my rheumatologist about 2 weeks ago and had an interesting experience. I have seen him about every 4 months or so for the last 2 years since being diagnosed with “Undifferentiated Connective Tissue Disease”. We have an interesting relationship. At times  he doesn’t understand where I am coming from at all. When I was first diagnosed, I asked him what sort of diet/lifestyle changes I should look into and his answer was basically that those factors wouldn’t really help much (at this time he was trying to convince me I needed to be on meds and I was refusing). Its kinda odd considering he and I are about the same age and I would think that we would get along better, both being kinda young. I can’t bash the guy too much, he is thorough, tries to connect with me by asking about recent trips or my personal life. He’s a nice guy, you can just tell he has read too many books and hasn’t had much life experience.

Anyway, he was reviewing my records and for the last 2 years my labs have been pretty good. He said, wow you are healthy! Yeah, I eat pretty well, try to manage my stress, sleep ok, and exercise. Then he got to my cholesterol and congratulated me on the 40 point drop. I said, “yeah, I did the opposite of everything I was ever taught in school. I ate more fat, more bacon, more eggs, more meat. I eliminated most refined carbs from my diet.”

His response? “Thats not possible, maybe you just have a different metabolism”.

So, I responded, “Have you read the book Good Calories, Bad calories?” Of course he hadn’t.

I briefly explained the premise of the book, the lipid hypothesis, and told him that most things we have come to believe about nutrition are not true. He gave me a weird look and moved on. Totally not open to the discussion at all and probably thinking I am a nut job.

Ok, so I know its hard for some guy who spent 100 years in medical school to understand what a crazy RD is telling him. But, buddy the proof is RIGHT IN FRONT OF YOU. So quit being so close-minded, quit believing 100% of what you read in books, and understand that popular beliefs are not always true. Books are not always right. Research results are not always correcltly interpreted.  Open your mind 10%. I am a dietitian. I have training in nutrition. I wouldn’t follow a fad diet just because I felt like it. I am still learning…but the thing is at least I am willing to experiment wtih it! Anyone have a similar experience?