Archive for October, 2017

October 31, 2017

Technology as a Health Advocate

There are many ways to use technology as a health advocate! Being an informed patient can help you make better decisions regarding nutrition, fitness, disease prevention, disease management, and disease treatment.

DNA Analysis

My daughter-in-law was adopted from Korea. She arrived in the US without an extensive family medical history. When she learned she was expecting her first child, she and my son decided it could be beneficial to know more about her DNA. In addition to the battery of early screening tests offered by their doctor, they chose to have DNA analysis done by 23andMe®.
23andMe
After some initial problems with FDA approval, 23andMe is now approved to offer DNA screening for genetic markers that may indicate a high risk for certain conditions. The list of approved tests include those for genetic variants that may make you more likely to have Celiac Disease (gluten intolerance), Age-Related Macular Degeneration, Alpha-1 Antitrypsin Deficiency (can lead to COPD or emphysema) , Hereditary Hemochromatosis (the body absorbs too much iron from the diet), Hereditary Thrombophilia (abnormality of blood coagulation that increases the risk of blood clots), Late-Onset Alzheimer’s Disease, and Parkinson’s Disease. A complete list of currently available tests is listed on the 23andMe website.

While this service is not intended for diagnosis of any disease, the results provide important knowledge that you can share with your physician. If this additional information lessens the time it takes to secure a diagnosis, it may increase the treatment options available to you. That’s more than worth the $199 price tag.

For that price, you’ll receive additional wellness reports for things such as lactose intolerance, muscle composition, deep sleep and genetic weight; and reports for traits like male hair loss, earwax type, earlobe type, and sweet taste preference. Also included are over 40 reports identifying whether you carry a variant gene for diseases such as Bloom Syndrome (short stature, higher cancer risk, genomic instability), Cystic Fibrosis, Sickle Cell Anemia, Hereditary Fructose Intolerance, and Glycogen Storage Disease Type lb (plus 35 more).

Research Participation

As a 23andMe customer, you can also choose to be a research participant. According to the website: “On average, a customer who chooses to opt into research contributes to over 230 studies on topics that range from Parkinson’s disease to lupus to asthma and more.” This participation has led to publication of 84 research papers since 2010.

Other research participation is facilitated by Apple’s ResearchKit app. For instance, you can participate in the Mount Sinai Asthma Health and Stanford Medicine MyHeart Counts large-scale
medical studies through this software. And the number of research and disease management apps is growing. Hopefully, the ease of using personal electronic devices to participate will increase the number of volunteers for research studies and give researchers an easy avenue for providing research results to participants – an often neglected follow-up.

Disease Management Apps

Health related phone apps reach far beyond research. There are disease management apps that focus on education and awareness, behavior tracking, medication reminders, community and networking. Visit any app store and you’ll find a long list of medical apps in addition to health and fitness apps. That’s great progress in making technology available as a health advocate.
glapps

In spite of such progress, obstacles remain. Last week while I sat through a meeting at the local teaching hospital, I was struck by how many times meeting participants were told that the hospital, med school, research institute, and clinic records are not integrated. The systems will not talk to each other. Information is not shared.

I had two thoughts – 1)This is horrible. Fixing that problem would save the staff time and improve user friendliness and patient care. 2)This could be a good thing. If all records were integrated there would be a huge increase in privacy and accuracy concerns. At least everything gets a 2nd look now because there’s no way to avoid it.

I’m sure I’m not alone in this mixed response. While I’m excited about the knowledge leaps we can make using technological tools, privacy and accuracy are legitimate concerns when using technology as a health advocate. At this specific moment in time, we must carefully weigh how much privacy risk we’re willing to take in order to move knowledge forward or make our healthcare easier.

Should I use the technology?

There are many reasons to embrace the integration of technology into our personal health plans. It can be a great health advocate. If I could have taken a genetic test to my doctor that showed I had a variant marker for Celiac Disease when I was attempting to get a diagnosis for whatever was causing me to break out with unbearably itchy rashes, have abdominal pain, weakness, fatigue, and achy joints, perhaps it would have improved my experience and lessened the time I continued to suffer. I also love the ease with which 23andMe customers can contribute to research. And I can see the benefit of using software to assist with a variety of aspects of disease management.

I suppose any decision regarding technology as a health advocate should be guided by the premise that knowledge is power. Before swabbing saliva or downloading an app, read the
privacy policy. Before participating in a study, ask lots of questions. But beyond that, apply self-knowledge and personal boundaries. If you know that you’re not likely to use a disease management app, don’t download it. Figure out another system that works better for you. If you’re not comfortable participating in research that tests drugs, choose other studies. It is possible to help advance medical knowledge without doing something that violates your boundaries.

For fun, you can let yourself be curious! After all, DNA testing can also help you locate long-lost or surprise relatives.

Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”

https://www.23andme.com/

https://www.23andme.com/research/

https://www.23andme.com/publications/

https://www.theverge.com/2015/10/21/9581555/fda-23andme-health-data-limited-approval

https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm376296.htm

https://itunes.apple.com/us/genre/ios-medical/id6020?mt=8

https://play.google.com/store/search?q=medical&c=apps&hl=en

October 24, 2017

No Need to Argue Over Dinner

There’s no need to argue over dinner, even if everyone is hungry for something different! Ever decided to start cooking dinner at home only to meet resistance from family members who are used to customized choices in a restaurant? Your husband wants Indian, your son wants Mexican, your daughter doesn’t want either of those, and you just want dinner on the table.
pot pie
When you’re trying to get in the swing of regular meal prep, resistance can be discouraging. You may be willing to cook so that your family will eat more fresh food, but that doesn’t mean you’re all that excited about the added work you’re taking on. Before frustration grows or food fights begin, it can be helpful to explore some ways you can customize without changing your overall plan.

Using a little creativity can help your family transition to meals at home without feeling like personal preferences are limited. Once everyone realizes there’s some flexibility, they’ll relax. That doesn’t mean you have to be a short order cook. It means that you recognize that years of eating out have conditioned the family’s expectations and some retraining is required.

During the transition, it is important to set some boundaries while keeping the atmosphere positive. How can you accomplish this without laying down the law that you eat what’s put in front of you…period?

Here are some ideas:
chops
Flexible seasoning.

With the family in the mood for Indian and Mexican and something else, you can take a flexible approach to seasoning. In other words, establish that the cook chooses the protein, but each family member can choose how his/her serving is seasoned.

Before you let the idea scare you, here’s what dinner could look like: Four pork chops seasoned as follows: 1)Simple – seasoned with salt, pepper, & garlic powder. 2)Indian – seasoned with salt, pepper, garlic powder, garam masala, and applesauce. 3)Mexican – seasoned with salt, pepper, garlic powder, and cumin. 4)Alternative Mexican – seasoned with salt, pepper, garlic powder and mole sauce.

Place all 4 chops on the same broiling pan and broil. Any of these will be delicious served with rice and a salad, thereby keeping the menu simple while accommodating several flavor preferences.

This could also be accomplished using steak seasoned multiple ways or grilled with basic seasoning, then sliced and finished with various sauces — salsa verde, chimichurri, teriyaki, and blue cheese for example. Steamed spinach, sautéed mushrooms, and mashed potatoes will round out this steak menu.

Grilled or broiled chicken is easy to season independently, but cook simultaneously. Baked chicken can be shredded and served over salad or added to sour cream and green chile peppers then served over black beans and lime cilantro rice. It can be tossed in barbecue sauce and served as a sandwich. It can be added to enchiladas or used in chicken spaghetti.

In short, independent seasoning doesn’t have to take additional time or add another trip to the store. All you need is a little flexibility and creativity.

Choose a pot.

If weekends are when you have the most time to cook, make several one pot meals at the beginning of the week, then let the family help themselves to their preference each day. Include vegetables in the pots or steam a few separately to serve as sides. In addition, stock the kitchen with fresh fruit and salad components to compliment your prepared items.

Consider one pot meals like chicken & rice with broccoli; ground turkey with sour cream, Parmesan, and English peas; tuna with pasta, cheese, and spinach or kale; ground beef with taco seasoning, black beans, and cheese; beef stew; or chicken pot pie.
broccoli salad
Beat the heat.

In the summer, you may want to offer salad samplers — chicken salad, tuna salad, and egg salad paired with 5 bean salad, broccoli salad, black bean & corn salad, caprese salad, or a build-your-own green salad. There are so many options with salad!

If your kids like to help in the kitchen, creating salad recipes can be a great introduction to experimenting with flavor combinations. The more involved they are the more likely they are to consume the end product.

Warm your insides.

Soups can give you nutritious variety in the winter. There’s something about soup that’s extremely satisfying — especially in cold weather. Prepare two or three types for the week and let the family choose a preference at meal time. Chicken vegetable, chicken with rice, chicken noodle; tomato, cream of tomato; chili; clam or corn chowder; potato; minestrone; white bean; matzo ball; and split pea are all good options. This list could go on and on and your family is sure to have some favorites. Most soups freeze well, so your prep could be as simple as taking something out of the freezer.

Soup can be supplemented with bread, cornbread, or crackers; raw vegetables with a favorite veggie dip; sandwiches; or salads.

breakfast
Make breakfast a wild card.

Obviously, it’s important to establish that meal choices when you’re cooking are not a free-for-all. If you don’t, you’ll have chaos and a full time job on your hands. On the other hand, there’s no reason for anyone to go hungry because they simply can’t stomach steak when that’s what you are serving.

Preparing for this possibility in advance can prevent a power struggle later. One way to do this is to make breakfast a wild card. If your daughter can’t stand steak, she can play a wild card and cook her own breakfast for dinner. As long as she uses ingredients already on hand, cooks it herself, and cleans up her dishes, you agree to refrain from comment on her choice.

Of course, you can set age limits and weekly limits for use of the established wild card. (No wild cards until you are in first grade and only 1 wild card per week.) The wild card doesn’t have to be breakfast. It could be sandwiches, loaded baked potatoes, salad, pasta, or something out of the freezer.

Keep track on a calendar or dole out printed monthly coupons to be redeemed. The rules are yours. Just make them clear, concise, and consistently enforced. For the best chance of success with this plan, all negotiating should take place prior to a rule’s instatement. Review dates can be established in advance to insure that the system can be improved without diminishing its enforcement.

Inspiration may be a side effect.

Cooking at home has many health advantages. The key to making it a habit is removing the obstacles that prevent you from cooking on a regular basis. Families that are used to custom ordering in restaurants may resist a sudden change to one-size-fits-all meals. That doesn’t mean you need to argue over dinner.

Using the techniques listed here to create an easier transition from restaurant ordering to uniform meals can help you avoid complaints and resistance and the resulting emotional fatigue that may make you feel like implementing a healthier lifestyle is too much trouble.

As an added bonus, providing variety in a way that only requires a tiny bit of additional thinking and no additional work could actually turn out to be fun! I love the process of visualizing new menus, unexpected combinations, and solutions. It’s the kind of mental activity that inspires me.

Try these ideas and who knows, you may get inspired along the way too!

October 17, 2017

Can You Pivot?

When things don’t turn out as planned, can you pivot? Today, I thought I was going to make enchilada sauce. Over an hour into the process, I realized there was no way my combination of ancho and pasilla chiles, charred vegetables, marjoram and Mexican oregano was going to turn out like any enchilada sauce I’ve ever tasted or hoped to make. The flavors had potential, but not as the end product I’d planned.
pivot
I face similar situations regularly. No matter how meticulously I plan, things change. I can either let that throw me, or I can pivot. At those moments, I usually remember my grandmother saying, “There’s more than one way to skin a cat.” Hearing that over and over let me know that it was not unusual to have to look for another solution.

Changing course is not always easy. Sometimes it requires significant physical, mental, or emotional effort. But with life throwing challenges my way, the ability to pivot has made me less wasteful, more efficient, more creative, more knowledgeable, more confident, and infinitely more resilient. This is true when I’m developing recipes, but it is also true throughout all areas of my life.

Pivoting requires engagement, flexibility and decision making. If I had been determined to end up with enchilada sauce, my efforts would have been wasted. An hour of wasted time with my current schedule can mean I must say no to lunch with a friend or rearrange anticipated down time. That would feel discouraging.

Being able to see potential in the work I’d done allowed me to make a subtle shift that turned the effort into an acceptable mole sauce that can be easily tweaked into perfection. Visualizing a different outcome is one component of a graceful pivot.

Recognizing I’m in a moment that could benefit from a shift comes even before visualization. That was pretty clear to me when adding salt didn’t head the sauce in the right direction. My taste buds called for sweet and something to mellow the bitter overtones. Honey, anise, and chocolate all fit that bill.

Connecting my taste instincts with my food knowledge led to an immediate association of the sauce on my stove and mole sauce. Exploring that thought excited me because most of the jarred mole sauce I’ve found in stores contains crackers or bread. I added a few ingredients to see if my visualized flavor profile would work as I anticipated. It did!

I recorded the changes in the recipe plus a few that I think will improve it next time. Of course, I also had to revise the dish I had planned for dinner. My enchilada pie turned into enmolada pie. It wasn’t that much of a shift and didn’t require a trip to the store.

The pivot, which included recognition of my dilemma, connection to a possible change, exploration of that change, visualization of a new end product, and implementation of the new plan, allowed me to turn a kitchen failure into a successful recipe albeit not the anticipated one.

Imagine what that did for my mood, energy level, and motivation! Instead of feeling defeated or discouraged, I felt excited about all the dishes I can make with mole. Woohoo, my mind is now moving full speed ahead!

The ability to absorb, process, and turn unfortunate events into positive momentum is what allowed a pharmacist I know to purchase and grow his pharmacy into the largest in the county seat, marry and have two beautiful children, and become a pillar of the community in spite of having had polio as a child that rendered him minimal use of his legs.

Instead of viewing his disability as something to hide, he chose to showcase his amazing upper body strength — a pivot that clearly fed positive momentum into the rest of his life. I think of his example each time I walk into his pharmacy.

A willingness to pivot is important for businesses too. If Anheuser-Busch had not reimagined its end product during Prohibition, there would most likely be no Bud Light, Franziskaner, Natty Daddy, or Rolling Rock today. Someone at Molex had to envision a future beyond flower pots and salt tablet dispensers for the company to begin to manufacture electrical appliances. We don’t always notice when a business innovates, but we certainly notice when it doesn’t. We soon become dissatisfied and move on.

It’s common to resist change. But things change whether or not we’re resistant. Hurricanes, floods, fire, and tornadoes reshape communities. Acute or chronic health problems arrive. Spouses leave. Jobs are lost. Violence touches our families. Any of these things can happen at a moment’s notice when we have done nothing wrong. It is at those moments that pivoting becomes a critical skill.

We all want to emerge from shock, trauma, loss, and grief feeling optimistic, energetic, positive, and poised for joy. We all can, but some of us don’t know that we can or don’t know how to get from A to B. That path starts with a simple pivot away from the devastation and toward the possibilities created by that devastation.

I feel fortunate that I can pivot both in and out of the kitchen, but the ability was hard earned. Some tough circumstances early in my life led me to hone this skill. While I’m not all that grateful for some of those circumstances, I am grateful for the resulting resilience. Enough so that I would encourage you to develop this skill even if you don’t see its merits right now.

Sometimes the stakes are much higher than enchilada sauce vs mole.

October 10, 2017

Trick or Treat?

halloweenIf you offer something besides candy, will the little ones think it’s a trick or treat? Halloween is swiftly approaching. I love the costumes and watching the kids. I don’t love all the candy. It’s predicted that 2.7 billion dollars will be spent on candy in the US this Halloween. That’s a lot of sugar that none of us really need.

I not opposed to occasional candy or dessert and I don’t want to take the fun out of trick-or-treating, but this year I’m going to explore some edible candy alternatives rather than giving you lists of gluten-free candy or non-candy items. After all, getting something different to eat is fun too!

ghostsGarden Veggie Ghosts and Bats

If you’re a fan of Sensible Portions® Garden Veggie Straws (which I like because they’re actually straws that you can blow air through), you’ll love Garden Veggie Ghosts and Bats! They’re crispy, salty snacks shaped like, you got it, ghosts and bats. Packaged in .05 oz bags for Halloween, these crisps have less fat than potato chips.

Popchips® Galaxy Puff’s

Who doesn’t think Darth Vader is scary? Aged White Cheddar Popchips shaped like Star Wars ships and characters are now available in .8 ounce bags perfect for Halloween. These gluten-free chips have no cholesterol and no trans-fats.

Caramel Apple Chips

Seneca 100 calorie bags of Caramel Apple Chips are gluten-free, kosher and have 30% less fat than regular chips. I like the plain apple chips, but the caramel apple flavor is a great riff on retro Halloween treats.

Popcorn Mini Bags

These look just like regular bags of microwave popcorn, but are only 1.6 ounces. Some years you can find orange and black packages especially for Halloween. Other years, it’s only the smaller size that differentiates these from regular microwave popcorn. Several brands are available online and from brick and mortar retailers.

Already Popped Corn

Snack sized bags of SkinnyPop Popcorn are GMO and preservative free. Flavors include Sea Salt & Pepper, White Cheddar, Jalapeño, and Dusted Dark Chocolate in addition to regular. If you prefer SMARTFOOD® Popcorn, the White Cheddar Cheese, Theater Butter, and SMARTFOOD Delight® Sea Salt and White Cheddar Cheese flavors are gluten-free.

popcorn ballHalloween Popcorn Balls

While we’re talking about popcorn, you may like Kathy Kaye Foods’ Halloween Popcorn Balls. This option contains sugar in a retro presentation. Remember when these were homemade? Each ball is 110 calories and 18 g of sugar. That’s the same amount of sugar as a Snickers® Miniature, but with 60 less calories and a lot more novelty.

Go-Gurt

Individual yogurt servings in an easy to carry, easy to open, package. The packages have trivia, games, and jokes on them making them fun to unpack from your trick-or-treat bag. Although each flavor contains 8 grams of sugar, it also has probiotic cultures, calcium, Vitamin D, and protein.

raisinsRaisin Mini Snacks

Wouldn’t it be great if they packaged these as monster poop for Halloween? The size is good. The raisins are sweet and healthy. The only thing lacking is themed packaging. Nonetheless, this is a good gluten-free option.

Sunflower or Pumpkin Seeds

Although I love them, I hesitate to recommend nut mixes for Halloween. Seeds are an alternative to nuts. FritoLay® offers a variety pack of Spitz® Seeds in various flavors. Salted Sunflower Seeds, Chili Lime Sunflower Seeds, Cracked Pepper Sunflower Seeds, Dill Pickle Pumpkin Seeds, Dill Pickle Sunflower Seeds, Salted Caramel Sunflower Seeds, Seasoned Pumpkin Seeds, Seasoned Sunflower Seeds, Smoky BBQ Sunflower Seeds, and Spicy Sweet Chili Sunflower Seeds are all made without gluten-containing ingredients. Please note that these flavors are not made in a dedicated facility or on dedicated gluten-free equipment. Use appropriate caution.

Cheetos, Fritos, Doritos

Variety snack packs of mainstream chips are available everywhere. If you need to grab something at the last minute, this can be an easy option. Avoid Sun Chips and stick with the gluten-free flavors of Cheetos, Fritos, Doritos, and Lays Potato Chips.

I realize that some of these options may be more expensive than what you’re used to buying. Keep in mind that most of them are bulkier than mini candy bars, so children are less likely to grab a handful meaning you won’t need to buy as much to begin with.
food group
If you live in a neighborhood like mine where many children are food insecure, you can also think of this as a way to reduce hunger in your community. Spend a little more and give fruit and vegetable pouches or individual cups of applesauce, mandarin oranges, peaches, or pineapple. Put a box of raisins and an individual serving packet of peanut butter in a plastic bag (you may only want to give these to older children who can monitor their own allergies) for a do-it-yourself sandwich kit. Include individual cups of salsa along with corn chips. Give instant oatmeal cups, individual bowls of Cheerios, microwaveable brown rice, or pouches of tuna.

If you decide to give substantial food items, but don’t want kids to feel awkward about taking them, get some Halloween treat bags (Oriental Trading has a good selection) or create your own Boo Bags using brown paper bags, bag up the food and hand out the bags instead of individual items. The surprise factor will entice. Hungry kids will be appreciative. Any child who is disappointed will get plenty of candy from other homes.

Getting something different to eat is fun! Getting something gluten-free is special when you’re gluten intolerant. Getting something nutritious to eat is critical! I let this be my guide to trick or treat.

https://www.sensibleportions.com/en/products/ghosts-bats-garden-veggiechips/

http://www.sunmaid.com/products-details/raisins.html

http://shop.popchips.com/Galaxy-Puffs-Multipack/p/POP-218142&c=PopChips@GalaxyPuffs

https://www.amazon.com/Seneca-Apple-Chips-Caramel-Ounce/dp/B004981WJW/ref=sr_1_7_a_it?ie=UTF8&qid=1507647315&sr=8-7&keywords=seneca%2Bapple%2Bchips&th=1

https://www.skinnypop.com/our-popcorn/

http://www.smartfood.com/

https://kathykayefoods.com/collections/kathy-kaye-popcorn-balls/products/kathy-kaye-halloween-popcorn-ball

https://www.snickers.com/Nutritional-Info#SnickersMiniatures

https://www.gogurt.com/tube/

https://fritolayvarietypacks.com/home

http://www.fritolay.com/snacks/special-dietary-needs/us-gluten-free-products-and-products-not-containing-gluten-ingredients.htm

http://www.cooking2thrive.com/blog/booooooooo-gluten-free-halloween-candy/

http://www.cooking2thrive.com/blog/halloween-treats-dont-candy/

Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”