FNCE Day 1

The first full day started off with a breakfast sponsored by the Public Health and Community Nutrition Practice Group of which I am a member.  This breakfast was sponsored by Mrs. Dash and the Avocado Board.  The speaker was presenting on Produce for Better Health Foundation.  This was very interesting to hear about the shift from the 5 a day program to Fruits and Veggies More Matter Campaign.  If you are not familiar with the new program, make sure to check it out. 

 

Of course with those sponsors and presenters, the breakfast was an omelet with avocado and my plate was filled with fruit and some potatoes.  I did a good job making half my plate from produce.

Then I went to hear some great presentations.  First up was called The truth about weight loss diets: From detox to nutrient composition- what really works.  I am sorry to say that the breakfast ran late and I missed the first speaker, which was Frank Sacks, MD.  The second speaker was Christine Gerbstadt, who is an RD and a MD.  At first I was nervous because she was speaking on detox diets and has a detox diet book coming out in the future.  Yes, I heard detox and I was nervous.  The good news is that she does not mean flush your system on fasts or juice diets.  She reviewed the science behind what is excluded on fasts, and concluded that if this is short term and helps psychologically get someone going on a “real” weight loss plan, then it may not be harmful.  Those first quick water loss pounds can really inspire someone to get their act together and clean up their diet.  Keep this RD’s name in mind because when her book comes out, I know I am going to buy it and read it.  I loved how she brought the science to this hot topic. 

The last speaker in this session was Joy Bauer, RD, who you may know from the Today Show.  She has the Joy Fit Club.  She is also a very inspiring presenter who cares about the success of her clients, so she shared with us 10 tips for weight loss success.  The best part was the personal stories and success of her clients that she shared.  While there was really no new information in her presentation (at least for me), she is truly an inspiration to those of us in weight loss.  She also encourages RDs to write in with their clients stories who have lost 100# or more and kept it off, assuming they wouldn’t mind being on TV.

The next session I was headed to, I admit I got side tracked in the member showcase section and never made it all the way to hear the session.  Good thing there are materials online so I can go back and view them later.  One thing I found there was information on IBS and talk of the FODMAPS diet, which you may know of if you read Gina's blog.  After I looked at the member showcase, and accidentally gave myself an allergic reaction (a lady was giving away chapstick and my lips were chapped from the wind, so without thinking I applied it and then realized it was mint, which I am allergic to…Oops!…also another reason why I did not make it to the session) I headed to the expo for a little bit. 

Here are some of the products I found on Sunday:

Body Quest Ice Cream: Here is the thing, I see it is advertised for body building because protein is so important, but I think it has a better application and that is LTC for elderly patients who like and want ice cream and are at risk for pressure ulcer development and just over all low protein intake.  I tried the chocolate flavor and it was only fair.  It was hard to scoop out and a bit freezer burned, but I bet if it was not in a deep freeze prior, it would be good.  Honestly, I think this is great for LTC or cancer patients, but not really necessary for a body builder, although they may enjoy it.

Next up is Storye Bread: My first word for you is YUM!  My second word is DELISH!  In loved this bread and it was so moist.  I don’t usually like rye because of the caraway seeds, and this did not have those and was so good.  This is made from European grains and is a specialty product, so the price is high, but worth trying.  It is about $4 for a pack of 4 slices, so like a dollar a slice.  The website states European grains, pure water, yeast free, no preservatives.

Look at this insane loaf of bread.

 

 Clif Bars: I could not resist stopping by here, actually multiple times, but don’t tell anyone.  I tried Clif, the Clif PB crunch granola bar (which I loved), Z Bar, Luna products and the Clif Builder’s bar.  Loved them all.  They really make a tasty product.

Next I found Upstate Farms Yogurt: They sampled two flavors and both were good.  I like that it was gelatin free.  Oh, and it is nonfat.  If you see this anywhere, give it a try.

Really? Probiotic dark chocolate candies.  I am not kidding and this was not the only “flavor”.  There were other health candies there.  they look like peanut m&m’s.  This is put out by Ostrim, which is a nutrition supplement group for sports and body builders.  I actually played their spin the wheel game and won a sports nutrition meal stick and was like “yuck, seriously, I am a vegetarian” and so the kind employee gave me a sample bag of these candies instead.  I have yet to actually try them so I will update you later on taste.

Oh yes, Popchips were there.  I got some tasty samples here.  I know many of you are familiar with this product, but if not, give these popped chips a try.

When I hear Blue Diamond I think almonds.  I did not realize they had these cool nut products too.  These are the Nut-Thins crackers, yes, made from almonds, and are gluten free.  You heard me right, these are gluten free.  They were tasty and come in so many flavors.

 Amy's made for a great lunch.  They sampled the rice crust pizza and the rice mac and cheese.  For rice based gluten free products, these were pretty darn good.  I would even by them for myself.  Overall, you can’t go wrong with Amy’s.  I have always been a  fan because I am a vegetarian and these products give me delicious options.

More snack bars.  I can’t tell you how many snack bars I tried, and how many samples I lugged back over the Atlantic Ocean.

Next up: Kettle Cuisine.  These are prepackaged convenience soups that come in a variety of flavors.  I was most impressed they had 3 vegetarian options for me to try.  This pictured here is a vegetable soup.  It was really tasty.  Many are gluten free.  As with any soup, the sodium is a tad up there at around 700 mg in one soup container.  not the worst, not the best, but if watching sodium all day, this can certainly fit in the diet.  I like that it is convenient and good fit in my lunch bag.

Lastly, Sunland Peanut Butter.  I was excited to try this raspberry PB, and it was delicious.  I certainly think this is worth giving a try if you see it.  They had many other flavors too.  they also have some other products, so check them out at the link posted just above.

Then I went back to the sessions.  The next topic was The Future of Dietetics: Nutritional Genomics, Chronic Disease and You.  Can I first say, this sounded like it would have been so interesting.  Now, I am sorry to say that the presenter had a thick accent, was in a large room, and the microphone did him no justice.  It was too hard to hear and many people left early.  It really was so hard to make any sense and I was in the back so it was hard to see.  I am happy to say that at least the powerpoint slides are online.  The presenters were Jose Ordovas (he was very hard to understand) from Tufts and Ruth DeBusk.

Some of the information from this presentation includes:

-Nutritional Supplements and CVD: no data to support use of b-carotene supplements to reduce CVD risk; data does not support use of folic acid and other b vitamins to reduce the risk of CVD; more research needed on vitamin D and the role in CVD risk reduction; data does not support use of vitamin E to reduce CVD risk

-There is probably a need for nutritional genomics; based on individual needs, and there are differences in genetics as a result of genetic polymorphism, in other words, humans are diverse.

-Genetic testing can allow for early detection of chronic diseases

-If genetics show low risk, then it can be inferred they will benefit from the standard local diet, or the standard nutrition advice

-Nutritional genomics will help with the science based link between the interactions of genes and nutrients, and on a global level

-Nutrigenomics is the link between gene and nutrient interactions

-Nutrition professionals and researchers have major opportunities presented to them at this time to play a role in research, and are experts in variety of areas that make them appropriate to study in this area

I think for me personally, as a science based person, this is an area that research needs to look at and can’t be ruled out and I think this can help because cultures are different genetically and what may work for one subgroup, may not work for another.

The final session I went to for the day was sponsored by the Vegetarian Nutrition Dietetic Practice Group, which I just joined after attending this session.  This was a workshop discussion group where we were told about vegetarian nutrition and then worked at our tables to discuss barriers and how to overcome them when it comes to vegetarian diets in nutrition therapy, school food service and sports nutrition.  My table had sports nutrition.  We thought some barriers included under education by others in the sport which would result in people telling someone they simply can’t be an athlete and a vegetarian.  We also included lack of resources or product availability in some areas.  Some people are uncomfortable dining around others because they do not want to be questioned.  Overall we thought education was essential and if people were aware how easy it is to still eat a balanced diet and not need meat to be a performance athlete, then more people would be comfortable with this if a vegetarian lifestyle is what they desired.

After all the sessions were over, I was invited to the LAHIDAN (Latinos and Hispanics in Dietetics and Nutrition, which is a member interest group) reception.  My good friend and former intern is very involved with this group and on the board so she asked me to come.  It was an awesome experience and I think when I work again with this population, I will join this group for the resources and networking.

Chef Ana Garcia, who is big in Mexico and on TV and who runs a Mexican Culinary Vacation did a cooking demo for the group.

After that, the current American Dietetic Association president, Judy Rodriquez spoke to the group, as she has been involved with LAHIDAN too and is our first Hispanic president.  She was there to present an award.  It was great to hear her speak and address this group which is so near to her heart.

By then I was exhausted, so I headed back to the hotel.  We went to the concierge level, which we had access too, and raided the evening dessert bar.  Really i was not too hungry, so I had a cookie.

After a nice shower, I headed across the street to Shaw's, which is an awesome grocery store.  I could not resist despite having spent all day on my feet looking at food product.  I just wanted to check it all out and buy food to send home.

They had some giant lobsters in the tank.

Look at all the fun stuff.

Here are my goodies.  It is amazing, but when I would have normally bought prepackaged grains already seasoned, I realized now after all the cooking I have done, that I would rather get the plain and just use it for my own dish.

The brown rice couscous is one of those examples.  It came in flavors, but I thought the plain would be easier to work with now for my own recipes.  I also bough some red rice, like the black rice my dad sent me awhile back.

My other kasha molded and so I bought a new box.

I can never resist Indian, so I did buy these premade meals.  If you have never tried these, you really should.  If you are vegetarian and like camping out, you can’t go wrong with these. 

I am thinking this 7 grain pilar will be great with some berries and almond butter for breakfast.  that was my first idea because I found it with the breakfast foods.

Wow, that was it for my first day at FNCE 2010.  Boy I am tired now just thinking about all that I fit in.

QUESTIONS:  Have you ever heard of any of these foods I tried at the expo?  Do you like Amy’s product?  What is your favorite gluten free food/company?  Ever been to Shaw’s?

Thursday Thoughts: Gluten Free

The other day I had posted about seeing some gluten free products in the local grocery store, as well as an increase in products in our American commissary.  One of the comments I recieved really got me thinking, and I am happy to announce a new segment in my blog...

Welcome to Thursday Thoughts!

I think I want to use this section to address certain hot topics within the field of nutrition and even health in general.  I especially want to address those topics that really drive me nuts when I hear them in the media or just around from people not trained in nutrition or any other health science.  My responses will be mainly my thoughts and opinions, which will be based on my learning in dietetics and health, my experience with patients and clients, my own insights from clinical experience, as well as support from the literature when available.

This week, I want to talk about gluten free diets. 

Sophia commented yesterday: I'm just wondering: why are there so many people who need a gluten-free diet? I only discovered this disease in America, too. It's kind of uncommon in Asia...

Here are some of my thoughts right off the bat when it comes to a rise in gluten free diets.  I am not so sure that there is enough research or evidence out on this topic to really say for sure, but these are some of my speculations, or rather thoughts to jump off of for further research and investigation.

1) First off, there are different reasons for gluten free.  One is that someone has a wheat allergy, and by going gluten free, the eliminate wheat.  However, they also eliminate all gluten, which is more than just wheat.  The wheat allergen is labelled on food products, but this labeling does not mean gluten free, so sometimes, I think people may use this interchangibly when they really might mean wheat free, although they eat many gluten free products because it does ensure wheat free.  The real reason for gluten free is celiac sprue, which is a disease where the lining of the intestine is damaged from a response to the cells being attached when gluten is digested.  So my thought may be is that some people claim they are gluten free when the issue is really just wheat, not gluten.  The trouble with finding this out is in the testing.  There are people with both conditions that never have the proper testing either because they assume they have the condition as it resolved with the elimination of the foods, or because they followed a gluten free diet before a biopsy for celiac, which can give a false negative, as the bowel has healed itself with treatment.

2) My next thought is that people are self diagnosing, which goes along with number 1.  Because information on celiac can be found on websites, people may assume this is the condition they have and just follow the gluten free diet, and if it works, they feel better and then assume this was the conditon they had.  But, if they follow the diet and never have the disease confirmed by a blood test and/or biopsy, this can't really be counted as a case, as it is unconfirmed, and rather just a suspected case.  Many more people are self diagnosing and treating now with otu medical advice, and my thought is this is due to easy access to information on the internet and knowing other people who may have the condition.  Assuming is not always the best idea, especially if it limits you foods options and forces you uneccessarily to purchase more expensive food products.

3) My next thought is an advance in medical knowledge.  It could be possible that we know more about the condition and how to diagnose this now.  A rise in cases could be just that more people are being legitimately diagnosed versus having the condition but never finding out what was causing the problems.  Many people could have had celiac in the past, but because the condition was not discovered, people were not diagnosed or classified as this.  If a doctor knows what to look for and there are clinical tests to confirm, it is possible that more cases can be identified, not just that more cases exist.  Some people are asymptomatic and therefore do not get diagnosed and there are many cases that are not or will not be diagnosed for this reason.  I guess this means we have no really clear numbers on the incidence of this disease, although I have seen the number listed as 1 out of 133 people have celiac (reference), and only 5% of those with celiac know they have it (reference).  I am not sure if these are the most accurate numbers out there, but if only 5% now know they have celiac, and before testing even less knew, it may be an issue with just not knowing, not that more people now have this than in the past.

4) I think some of this may have to do with the health perspective.  I have seen many books out there, not based on readily accepted science, that claim we are not meant to eat wheat so we should not tolerate it and it needs to be eliminated from the diet.  I have yet to see multiple studies showing this evidence, although I am sure a few do exist.  This leads to a fad like diet where something needs to be eliminated and the cause it not based on science.  The other issue with this is that I think people find products labeled gluten free to appear healthier.  Here is an interesting example I found.  I was sent this WOW cookie sample, and all I could think was WOW!

You can see this is a thick cookie.

But this was the part that concerned me, from a nutrition standpoint.

I know it is hard to see, but this cookie is 2 servings.  Each serving has 170 calories and 8 grams of fat, of which 5 grams are saturated.  This is a huge amount of saturated fat.  Anyone looking at this and thinking it is a health product is mistaken.  On the other side of this, the cookie may be a welcomed addition to the diet of someone with celiac, who needs to gain weight because they were malnourished from the celiac before they were diagnosed.  There are many products like this out there that look healthy but the other grains used may produce a denser food, meaning more calories packed into a smaller area, or additional fats and sugars may be added to boost taste. 

This was Ryan's response when he said he wanted a cookie and I offered him the WOW cookie to try:

If a  product is marketed as a health food, and I am no longer commenting on the WOW cookie, which I assume is designed for someone who really needs a gluten free diet, not just doing it because they think it is healthy, you should still read the food label.

I once had a client who gained a lot of weight after she was diagnosed and was following the right diet.  She had been undiagnosed for so many years that she was very amlbourished when she first came to me.  But, she was just happy to have food options, and did not understand having to pay attention to calories, and she rapidly gained weight.  She came back to me a year later as a weight loss client.  It was a dramatic difference, but she really thought the gluten free breads meant she could eat what she wanted of them.  Portions for her often included multiple slices, which conatined many more calories per slice than regular bread.

5) This is to address specifically the comment I started with where more Americans seem to have a need for this diet than Asian cultures, specifically in Asia.  I have two thoughts on this, so let me try my hypotheses out on you.

A) Celiac is linked with many autoimmune disorders, and it could be that these certain autoimmune disorders, from a genetic standpoint, are more common in Americans, or more specifically those of European decent (as is stated here http://www.nlm.nih.gov/medlineplus/ency/article/000233.htm).  From my own experiences, I have see far fewer Asians as patients with many of these autoimmune conditions.  I am only making an observation here and I do not know the research on this matter, but it could be a possibility that these are just less common in general in Asian populations.

B) This thought I think is the more probable.  I think that we see less of this in Asian countries because wheat, rye, oats and barley are not as common in Asia as they are in the United States.  Rice is a staple, and this provides many with a naturally gluten free diet.  Again, only an observation, but I do think this is a possibility and could be an interesting area for research.  I wonder is Asians in the4 US who follow a more American diet have increased rates of celiac over their counterparts in Asian countries.  I think it could very well be on the rise because they could have had the condition all along, but never had symptoms in Asia if they ate little gluten at all.

Well, those are my thoughts on the topic.  What do you think?

If you have any questions you would like for me to address during future installments of Thursday Thoughts, comment here or send me an email.  I enjoy hypothesizing based on my own knowledge and experience, so I hope you enjoy the hypotheses as well and maybe you can share some of your own hypotheses on these topics.

I didn't post yesterday, but I wanted to share the link for the post I made one year ago (yesterday): CLICK HERE to see how much we would (accidentally) spend on ice cream.  The good news is that we have never ever made this mistake again.

Quick and Easy Pasta

While Ryan was out of town, I had some time to play around in the kitchen.  I looked through some of the available ingredients in the house, and then I whipped up this delicious dish.

I had both frozen shrimp and broccoli, which I thought would be great with some pasta.

 

Here is where my creativity kicked in.  I had some left over slivered almonds from my chickpea dish the week before, so I added them to some olive oil, and made them a little crispy.  Then I added some green olive mustard, which I love to add to just about everything.  I used enough olive oil for the almonds, but a little extra, as this was the sauce for my pasta.

When the broccoli and shrimp were done steaming, I added them to the almonds and then tossed in some fusilli pasta.  This dish was nice and light.  I loved the flavor from the almonds and it went really well with the shrimp.

On another note, I have noticed more gluten free products around.  I am not sure if it is because the demand went up or that more companies are just taking it upon themselves to make gluten free products.  The most common reason for a gluten free diet is celiac sprue, which is a malabsorptive disorder where the body basically attacks the intestine in the presence of gluten.  The end result is flattened vili, which are the absorptive lining of the intestine.  So when they are flattened, as opposed to their normal folds, the body can't absorb nutrients as it normally would.  The end result is that the person will need to eliminate gluten, and then the intestine will heal and the vili will return to their normal shape.  Gluten is a protein found in wheat, along with rye, oats, and barley.  Oats are questionable on the list and sometimes can be safe, if not crossed with wheat.  There are some products out there labelled as gluten free oats.

Not only has our base commissary started carrying mroe products, but I managed to find the "health" food section at the local grocery store.  I am not sure why I never found this section before, but I managed to find it now.  I think in the far back corner, it is likely to be overlooked.  Oh well, I did find it.  There was a ton of vegetarian stuff back there too.  Here are some pictures of my Portuguese finds.

First up is gluten free bread.  Seems that the Portuguese also find a need for gluten free, just like Americans.  I am wondering if they have the same rates of celiac as Americans.

Next, these are some vegetarian meatless meat products.  I did not buy any on this trip, but I plan to in the near future.  It seems like it could be comprable to gardein.

Last up, they even had gluten free pasta, and mutliple products to choose from. 

Over all I was very impressed with the selection.  The only thing that drove me nuts was the diet/weight loss products, which are usually no better than other products, or it the same, but with less of a portion size on the label so it appears less calories.  It appears the never ending quest for the perfect weight can be seen in multiple cultures.  I just wish the marketing was not so confusing to consumers.

Moving on to my last picture.  Ryan was visiting his mom back in the States, and she was kind enough to send him home with some gifts for me.  I took a picture of this necklace, which she made for me, and matches one she has, and one that her twin sister (Ryan's aunt) has.  It was made from an old school chandelier, at least that is what I think Ryan told me.  It is really neat, funky, chunky, nearly clear plastic.  Ryan's mom can find a creative use for just about anything, and her jewelry is amazing, not to mention her knitting and other items.  She has some serious talent.

QUESTIONS:  Have you noticed an increase in gluten free options at your grocery store?  Do you have any homemade jewelry?  What was the last creative pasta dish you made at home?