Choose Farmers’ Markets

by Mara Boggs, University of Saint Joseph, DI ’17

This is something many of us have heard over and over – maybe on TV, the radio, online or in the newspaper. But… Do we know why this is such a trend? Does buying local REALLY matter? Let’s see…

Today, we are constantly subdued to corporate marketing and commercialism. While these products are strategically placed at our convenience, and can be wonderful – we do not realize the underlying consequences of choosing a multi-million dollar corporation over our neighbors. In certain areas of the U.S. we are becoming more focused on the importance of our local nutrition resources and their influence on the health of our nation. We can see more restaurants and grocery stores opt to provide local foods for our consumption. But, one of the best places we can find farm fresh foods are right at the source: farmers’ markets.

Why?  Choosing local products when grocery shopping or when stopping by your nearby farmer’s market is a great way to help your neighboring farmers make a living. Operating a farm is not cheap – you have to factor in equipment, time, labor, seed, livestock feed, taxes, etc. Really, they have a tough job that many of us tend to take for granted. But, we shouldn’t!!! This our food we’re talking about here – our nourishment to keep our bodies going! On top of that, it’s important for us to think about the additional consequences of NOT buying local.

Does buying local really matter? Definitely! It’s a domino effect. By not choosing local foods it takes away business from local farms,  increasing the need for shipped goods from various places in the nation or even internationally, and thus increasing the carbon footprint of those apples you just bought. It’s important for us to be mindful of where our food comes from and live sustainable lives. Creating something that can last for generations to come. When we choose local foods, we tend to eat healthier in general since these foods are whole foods fresh from the farm. We know where/how/when our foods was produced and raised. Choosing farmers’ markets also provides us with a sense of community and culture. This is something that I think is so important, and we don’t really see it as much anymore. Most of all, it’s a great way to meet your neighbors, make friends, and know where your money is going 🙂

Here’s a video I found on YouTube that sums farmers’ markets up perfectly!

https://www.youtube.com/watch?v=-I9WSDWobuw

Visit http://nourishlife.org. Food and community come together at the farmers market. Farmer Nigel Walker, chef Bryant Terry, and others celebrate the joys of buying fresh, local food direct from the farmer.

Last, here is a link to use as a guide for finding markets in your area:
http://www.ct.gov/doag/cwp/view.asp?a=3260&Q=568176&PM=1

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5 Reminders to Create the Perfect Puree Plate

by Hanna Kelly, University of Saint Joseph, DI’ 17

“We eat with our eyes first,” a quote many of us are familiar with and live by in our everyday lives.  As dietitians and health care professionals, many of us are aware of the challenges associated with making food look visually appealing to our patients, especially when the texture must be modified.  So here are some reminders to help create perfect puree plate presentation!

1.) Consistency…The consistency of pureed food is not only important for ensuring safety with chewing and swallowing, but it can have a huge impact visually and in terms of mouth feel as to whether or not someone chooses to eat the food in front of them.  As we know, all pureed foods should have a pudding-like consistency.  That means, no bumps, no lumps, and no runniness!  Uniform texture throughout foods on the plate is essential, and who really wants liquids from one food group running into another on their plate…?

2.) Spacing…kind of goes hand-in-hand with consistency.  If you’re not working with an already divided plate, spacing food groups appropriately on the plate can affect how appetizing a meal looks.  Especially if the preparation of pureed foods does not involve molds or piping, you may just be using a scoop to put foods on the plate.  In which case, make sure foods are not piled one on top of the other and are neatly scooped on to the plate

3.) Color…Make the color on the plate pop!  For some who may have difficulty seeing, using a colored plate instead of a white one may help make foods stand out better and therefore make it easier for them to eat.  Also, take the couple of extra minutes to puree food items separately (let’s say, spaghetti and meatballs).  Although it takes a little more time,  the end results will be much more visually appealing as the person receiving the dish will be able to distinguish between the spaghetti and meatballs instead of having to guess what ‘that brown stuff is.’

4.) Molds and Piping…are awesome ways to help make pureed foods look natural again, add interest, and really improve plate presentation!  Molds can be used to turn the pureed food back into its original shape. For instance, roast beef can be pureed and poured into plastic molds, which are then frozen, and when ready to prepare a meal the purees can be defrosted, heated, and pressed onto the plate.  Piping can be used as well to add unique characteristics to pureed foods that would be found in certain foods naturally, such as the stems on carrots.  Piping is as simple as adding the pureed mixture into a plastic piping bag and adding the appropriately shaped tip to create a beautiful plate!

5.) Clean Edges…are super important not only for food safety, but for plate presentation in general.  It only takes a few seconds and can have a huge impact on the reception of the plate and food.  So next time you go to plate a pureed dish, do not forget a clean cloth to wipe the edges and perfect the plate!

Images resources

1-http://redtri.com/bump-baby/avocado-puree-recipes-for-babies/slide/2

2-http://texturedconceptfoods.com.au/

3-  http://www.unidine.com/resources/puree-with-purpose-for-seniors/

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The Good, the Bad, and the Eggy

By: Heidi Harris, University of Saint Joseph, Dietetic Intern ‘17

Pastas, soufflés, mayonnaise, cookies, cakes, pudding… and the list goes on and on! What do all of these delicious foods have in common? That’s right, you guessed it!

Eggs.

Eggs are a great staple food! They are found in most baked goods and prepared meals and are an excellent source of protein! In fact, despite what many fad diets claim, eggs can be healthy for all ages!  They contain all nine of the essential amino acids our bodies need for proper health and nutrition and one large egg typically packs six grams of protein. Plus, they are a decent calorie source, offering about 70 calories per one large egg. And! They are rich in fat-soluble compounds that can have healthy benefits on nutritionally “at-risk” populations, such as the elderly, pregnant woman, and children.¹

So, you might be thinking, if eggs are so good for you, why do they get such a bad rap?

The answer may seem simple, but the truth is a little more complex. So, bare with me as I dive into today’s foodie myth: Eggs Are Evil!

Over the past 40 years, eggs have gotten a bad rap because of their saturated fat content. There are about three grams of saturated fat per 100 grams of egg and 210 milligrams of cholesterol per one large egg yolk.² The public has been warned by health professionals, the media and more, against the frequent consumption of eggs. The idea was that consuming eggs and their high saturated fat and cholesterol content would lead to increased levels of cholesterol and would increase the risk of developing cardiovascular disease, especially for individuals with diabetes.³

But, egg lovers rejoice! New research suggests that dietary cholesterol and the cholesterol in eggs have limited effects on the blood cholesterol level and on the risk for developing cardiovascular disease.⁴

In fact, the type of dietary cholesterol found in eggs actually has heart healthy characteristics! I know, most people run and hide whenever ‘cholesterol’ enters the conversation, but the research shows that the consumption of eggs can cause the body to produce good cholesterol, or HDL cholesterol, which can transport the bad cholesterol, or LDL cholesterol, to the liver for bile production and eventually be excreted from the body!⁵

Now you might be asking yourself: Well, if eggs really aren’t that bad, then why do people still warn us against eating them?

I’m going to be honest with you, there have been some studies that support a correlation between increased blood cholesterol and egg consumption. For example, one study supported that eating four eggs in one week led to a six-percent increase in the risk of developing coronary artery disease and a 29% increase in the risk of developing diabetes.² But in 2013, this argument against eggs was rebutted as another source found that there was no significant relation of egg consumption and cardiovascular disease, coronary artery disease or diabetes. Instead, the source drew the conclusion that there was an increased risk for these diseases because of the foods that are closely accompanied with eggs, such as bacon, sausage, ham, and the fatty oils and butters used to cook eggs.⁶

So, with that being said, how many eggs should the average American be eating?

Good question!

Currently, the Dietary Guidelines recommends Americans to limit dietary cholesterol intake to 300 mg per day.⁷ But, as more scientific literature is published and supports that there is a lack of correlation between egg intake and cardiovascular disease, it indicates that healthy people are able to eat at least one egg per day.⁶

What exactly does that mean for you?

Well, before cutting back on those eggs all-together, I’d suggest taking a moment and reflecting on your daily dietary cholesterol intake. If you are following a low cholesterol diet for medical reasons and try not to consume over 300 mg of cholesterol per day, maybe having an egg everyday might not be the best option for you. But, if you’ve got some wiggle room and want to add a little extra protein, get some healthy cholesterol into your diet, and absorb as many healthy fat-soluble compounds into your system as possible, I’d suggest cracking open that egg and cooking them up your favorite way!⁸ (May I suggest hard-boiling them? Let the pot come to a complete boil, add a teaspoon of baking soda to make that shell slide right off, and boil for 10 minutes –  delicious!)

After all, no one knows you better than you!

Check Out Where I Got My Facts!

1. Miranda J, Anton X, Redondo-Valbuena C, et al. Egg and Egg-Derived Foods: Effects on Human Health and Use as Functional Foods. Nutrients. 2015;7(1):706-729. doi:10.3390/nu7010706.
2. Spence JD, Jenkins DJ, Davignon J. Dietary cholesterol and egg yolks: Not for patients at risk of vascular disease. Canadian Journal of Cardiology. 2010;26(9). doi:10.1016/s0828-282x(10)70456-6.
3. Djousse L, Gaziano JM. Egg Consumption and Risk of Heart Failure in the Physicians’ Health Study. Circulation. 2008;117(4):512-516. doi:10.1161/circulationaha.107.734210.
4. Fuller N, Sainsbury A, Caterson I, Markovic T. Egg Consumption and Human Cardio-Metabolic Health in People with and without Diabetes. Nutrients. 2015;7(9):7399-7420. doi:10.3390/nu7095344.
5. Beynen AC, Katan MB. Effect of egg yolk feeding on the concentration and composition of serum lipoproteins in man. Atherosclerosis. 1985;54(2):157-166. doi:10.1016/0021-9150(85)90175-3.
6. Rong Y, Chen L, Zhu T, et al. Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. Nutrients. 2013;346(jan07 2). doi:10.1136/bmj.e8539.
7. Burke JD. Dietary Guidelines for Americans. Nutrition Today. 2015;50(4):174-176. doi:10.1097/nt.0000000000000104.
8. Kritchevsky SB. A Review of Scientific Research and Recommendations Regarding Eggs. Journal of the American College of Nutrition. 2004;23(sup6). doi:10.1080/07315724.2004.10719429.

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The Buyers Guide: Selecting the Highest Quality Olive Oil

by Nicole Arruda, University of Saint Joseph, DI’ 17

By now, I think most of us can agree that olive oil is among one of the healthiest of oils available on supermarket shelves. It’s minimally processed, liquid at room temperature, shelf stable, and even tastes good, heck, it’s everything I’ve ever looked for in a healthy cooking oil. But with all the new olive oils that are lining the shelves these days, how can you be sure that you are buying just the right type of olive oil, and what exactly should you even be looking for anyway?

Update: Not all olive oil is created equal!

And well, while I do wish the answer to those questions could be so simple, they really do get complicated. Between the way that olive oil is graded, labeled, and uniquely advertised (for example, by altering the shape and size the bottle to change consumer perceptions of health) selecting the best product can sometimes feel like a self-doubting, and nonetheless daunting task.

Which brings us here, and to the reason that I have created this guide, as a go-to reference for shoppers like you and me, trying our best to fulfill a balanced lifestyle and reap the benefits of even the most basic of foods, i.e. olive oil.

But first, let’s talk about why olive oil is so important! For starters, olive oil is healthy fat, and contains nearly 89% mono and polyunsaturated fats. These types of fatty acids have been shown to be really beneficial for our health, by lowering LDL cholesterol and decreasing overall incidence of coronary heart disease. Olive oil is also a main proponent of the Mediterranean diet, which has been associated with lower risks of high blood pressure, heart disease, and stroke.

Extra virgin olive oil.

If there is something that I want you to take away from this guide, it’s this. BUT identifying which oils are “extra virgin” has proven itself a greater challenge than one would think. Look for olive oils that clearly advertise themselves as, “extra virgin,” or “premium extra virgin,” only. Like each type of olive oil, these oils begin by manufacturers juicing up to 90% of olive oils natural juices. However, with extra virgin olive oil, high heat and chemicals are not allowed and beyond some moderate heat, the oil is neither further processed nor refined.

These oils both contain a very low pH, differing only by about half a percent. However, this fraction creates a distinguishable difference in taste and quality. Premium extra virgin olive is the highest quality olive oil, and its best used uncooked in dishes. Trust me and don’t cook it, you want to savor this stuff! You can try it in salad dressing, or to create an aroma-filled and flavorful dip for bread.

Extra virgin olive oil is slightly less acidic (with a cut off at 0.8% acidity), and yields a fruitier taste than its premium counterpart. It also varies greatly in color, with a wide array of shades ranging from yellow to bright green. As a rule of thumb, the deeper the color, the more flavorful the olive oil should be. This type of  olive oil is more flexible, and can be best appreciated cooked or uncooked.

Then comes the next class of olive oils: the “virgin” olive oils, or as I am going to call it, the confusion type of oils- because how genius of a marketing strategy was it to give an entirely new class of olive oil nearly the identical name? These oils sit behind words like, “fine virgin,” or simply “virgin” olive oils. They either have acidity higher than 0.8% or have been refined/processed in some way. They may also be filtered and heated at a high temperature during manufacturing. They must also have 2% or less acidity.

Then finally we have the “Semi Fine virgin” olive oils. These oils are best used for cooking, and reach acidity higher than 3.3%. With these oils, there is more leeway and they can be heated to higher temperatures, further processed, and also refined.

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TIME TO GET HEMP HEALTHY

by John Cappola, University of Saint Joseph, DI, ’17

HEMP; a seed coming from the famously known cannabis plant is the most underrated plant in the world. Hemp does much more than make the drug marijuana, it has a plethora of benefits that the world needs to know.

Hemp fibers can be woven and combined to make:

1). Paper

2). Clothes

3). Plastics

4). Biofuel

Hemp fibers are very strong and actually waterproof.  Hemp is now starting to see a big increase in production as it starts gaining popularity. The resurgence is gaining steam, as hemp seems to be the future. The amount of benefits seen from hemp is far to great to be sidelined. Corn and soy need to move aside because its time for hemp to finally get the respect it deserves.

Hemp is environmentally friendly, as it requires far less room to cultivate than other crops. Less room means more plants. Or even less land needed to be used for the same amount of area. Less land=less money, and who doesn’t like saving money! Farmers can benefit and most importantly the Earth we all live in.

SAVING MONEY AND SAVING THE WORLD

One acre of hemp will equal the amount that two to three acres of cotton will produce. Actually double and triple the amount! Not only does less make more; it will last longer, is water proof, and softer than cotton.

Growing hemp is easier too, in fact, hemp requires less water, can resist frost, does not need pesticides, and can literally be grown in any state in the US. This means everyone wins! Fewer pesticides used means less money spent on pesticides and happier customers. Hemp only takes about 100 days to grow, which means hemp everywhere and all the time. Less time means more hemp and more money for businesses to make.

Not only will businesses benefit from this booming industry but also the customers are getting a better product for a cheaper price. Not only does hemp make fibers but is now showing to be a fantastic fuel source.

Hemp as a biofuel is just what the world needs. The oil from the seeds and stalk can be used to make biofuel from hemp. With fossil fuel issues all around the world another source that could help save the environment is from the hemp plant. Now with how easy and fast hemp can be grown, oil can now be produced fast as well. No more carbon monoxide affecting the atmosphere? No more greenhouse effect? These are just some of what impact using hemp biofuel can have on the world. A person who grows hemp would already have enough oil to power the farm, and if that little oil can have that big of an impact the possibilities are endless. Hemp has plenty of uses for the environment but how about for the everyday person?

Hemp seeds can actually be eaten and have shown to have an incredible benefit for the body. Since the seeds are 30% fat they are comprised of linoleic and alpha- linolenic fatty acids. Commonly known as omega 6 and omega 3 respectively. Also there are some traces of gamma-linolenic, which has an abundance of health benefits as well. The seeds also are jam packed with protein; comprising 25% of the seed is protein. In fact, hemp seeds have more protein than both chia and flaxseed. Hemp seeds are also filled with vitamins and minerals such as vitamin E, phosphorus, potassium, sodium, magnesium, sulfur, calcium, iron, and zinc.

Gamma-linolenic: Proven to lower inflammation in the body, with this reduction in inflammation you can help reduce chance for heart disease. Hemp seeds can also reduce blood clots, which in turn will help lower blood pressure.

Alpha-Linolenic: Used to help fight heart attacks, fight high blood pressure, help with migraines, and even some cancers.

Linoleic acid: Helps fight numerous cancers such as breast, lung, skin and stomach.

–asthma

-cardiovascular disease

-high blood pressure

-inflammation

-lower body fat

PROTEIN, my personal favorite! As a big protein guy,

I am always looking to find different sources of protein and hemp seems to pack a good punch. Hemp is actually a complete protein source which means it has all the essential amino acids needed to survive. Finding a complete protein source from a plant is very rare, this can be a great source for any type of diet looking to get their protein needs in.

Can’t get enough? Well there are still more benefits especially to our women out there (and even some men). That’s right hemp actually helps reduce PMS! So all you guys out there start sneaking some hemp in your girl’s morning oatmeal. Just one gram of fatty acids helped reduce symptoms. It is a win-win for everyone!

Hemp has it all so lets give it the love it deserves and start spreading some healthy hearts to the environment and especially to us.

Resources:

Bjarnadottir, Adda “6 Evidence-Based Health Benefits of Hemp Seeds” https://authoritynutrition.com/6-health-benefits-of-hemp-seeds/

Hemp Basics, http://www.hempbasics.com/shop/hemp-information

Buckley, Christine, “Hemp Produces Viable Biodies, Uconn Study Finds”, Uconn Today. http://today.uconn.edu/2010/10/hemp-produces-viable-biodiesel-uconn-study-finds/

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10 Mobile Applications Every RD To Be Needs in their Pocket

Ariana Cerro, University of St. Joseph, DI ’17

As dietetic interns, we are constantly facing a fast-paced, often stressful
environment with answers that are expected of us instantaneously. Preparation
and education leading up to the internship will help us to become better
Registered Dietitians, but it is also helpful to have resources at our disposal for
use throughout the learning process. The future of dietetics involves integrating
technology into our practice as a benefit to our patients, as well as ourselves to
further our education and knowledge. Mobile applications are a convenient and
simplified mode of nutrition information that can help us as clinicians to be able
to continue to learn throughout our internship and to provide better care. Here’s
a list of ten different mobile applications that may facilitate learning throughout
your internship:

# 1   USDA DRI : This free app features the daily
allowance for vitamins and minerals based on gender, age, weight and height. As an added bonus, this app will also calculate BMI and estimated energy needs.

 

# 2  Nutriguides: Nutriguides is an easy way to see #2 summaries of medical nutrition therapies for specific disease states. It is presented by the Academy of Nutrition and Dietetics and is evidence-based, which we as dietitians live by. There are a variety of topics covered, such as diabetes, Celiac disease, and HIV, and it includes the nutrition care process for each disease. This app costs $1.99,
but is an easily accessible form of the Evidence
Analysis Library (EAL) without having to remember
your Academy login credentials.

 

 

 

# 3 Epocrates: Do you find yourself struggling
with food and drug interactions? FDIs or defining
medications can be a real challenge in the beginning of your clinical experience. Epocrates
simplifies adverse effects and FDIs of medications
in their free application. This app also has a calculator for corrected serum calcium and various other features, check it out!

 

 

# 4 Stop, Breathe, & Think: Internships
are stressful and we all need to stop, breathe, and think. Guided meditations can be used when stressed on
the job, when commuting to your location, or even to
improve your sleep. It is important that we take care of
ourselves during this time, so that we can absorb all that
there is to learn. Feeling stressed? Use this free app to take a
step back from the chaos and relax.

 

 

 

 

 # 5 Tube Feed Calculator: The tube feed calculator is a helpful tool to help you double check your tube feed calculations. ***Important*** You still NEED to learn how to calculate tube feeds manually!

 

# 6 Calorie Calculator: A super helpful tool if
you use the calories per kilogram method, Mifflin St.
Jeor, or Breton Jones 2002 equations. You can
calculate energy needs in seconds by inputting
gender, age, weight, height, and specifying an activity
factor. Again, you should learn how to manually
calculate these before resorting to an app to do all of
the work for you.

# 7 Nestle/Abbott Product Guide: Depending
on your facility formulary, either/both of these apps are
a quick way to look up the indications for use of oral
nutrition supplements or enteral formulas along with
their nutrition contents. This is especially helpful for
times when you don’t have your paper formulary handy.

# 8 Daily Quote: Set your app to schedule daily
motivational quotes! A little bit of extra inspiration or
words of wisdom can keep us on track during the
internship, especially when overwhelmed or stressed.

# 9  Registered Dietitian Exam Prep 2016 
Edition: It is never too early to start studying for the RD
exam! This app sends notifications for ‘questions of the day’ to help prepare for the exam one day at a time. Each question has a comprehensive explanation for the correct answer and a reference source.

 

# 10  Journal of the Academy of
Nutrition and Dietetics: This is
another great resource from the Academy of
Nutrition and Dietetics. It allows you to view the
latest research articles right from your
smartphone to keep up with the most current research and recommendations.

 

 

Technology is helping us advance the practice of dietetics and the way that
interns can learn and have resources at the tips of our fingers. Add your
favorite apps to your ‘pocket’ as your dietetic internship journey continues.
All images found on the Apple App Store.

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Nutrition…Proven to Reduce Crime

Shane Gamble, University of St. Joseph, DI’ 17

Can fruits and vegetables serve other benefits besides eating them to stay healthy? Calling all foodies, gardeners, nutrition fanatics, and those who just want to learn more about this trendy subject! Well then I will tell you all about an amazing nutrition program called, The Garden Project which launched in 1992 out of the hilly city of San Francisco, California.

We’ll first start off with some basic background info and move into more specific content later. Back in the 1980s, there was a push for keeping inmates out of trouble and reducing the likelihood of criminal behavior relapse or recidivism in many parts of the USA especially California. So from 1982 to 1992 a woman named Catherine Sneed created a program for inmates called the San Francisco County Jail Horticulture Project. It provided inmates with the opportunity to grow vegetables and give them away to individuals that were in need. Her program was such a success, but then there was the question of what’s next? These inmates get out of jail and then how can we encourage this same giving back and positive behavior aspect?  

Well, that’s exactly how The Garden Project was created! Without Catherine Sneed this program would not have been here today. So we must thank her for her hard work and time dedicated to this cause. The Garden Project started off as a program to provide support and employment opportunities for former inmates or offenders of the law. It also involved the same idea of growing organic vegetables to give away to people, but also did other great things such as planting more than 10,000 street trees in the city of San Francisco! The idea was to incorporate exercise trying to make a difference by providing the opportunity of a second chance.

Its mission was to help offenders of the law by: providing job training, counseling, continuing education, and evolving their community into a more positive one. At this time, they were the only organization that had a focus on this particular mission. Nowadays, The Garden Project not only helps former inmates, but also youth in high school and young adults in college. In addition, they are able to transform the urban environment that they live in. The United States Department of Agriculture hailed The Garden Project as “one of the most innovative and successful community-based crime prevention programs in the country.” So they must be doing something right if the government is on board and an avid supporter am I right?

Within The Garden Project there is a program called, The Earth Steward’s Program. In order to participate, the individual must be 18 to 24 years old, a resident of San Francisco, and enrolled in college. Program participants can work daily throughout the entire year and are also enrolled in a mentoring program. They must be enrolled in the program for at least 3 years. This program provides individuals with experience in horticulture and teaches them how to grow organic produce that can be shared with families throughout San Francisco. Zucchini, collard greens, potatoes, garlic, Swiss Chard, kale, and broccoli are all grown throughout the 15 acres of land that the program resides on. Program participants become involved in neighborhood greening projects, construct and take care of gardens at police stations, housing developments, and support their community clean-up efforts. Other skills taught include: planting techniques, composting, propagation, and weeding.

The Garden Project brings the community together through meetings, fairs, and projects. They are also a partnership of more than 25 public and private organizations including the San Francisco Sheriff’s Department, the San Francisco Police Department, and the California Department of Forestry to name just a few. The program educates the community about their nutrition by providing quick, easy, and fun recipes that encourage healthy eating habits. So it’s not a surprise that people from all over the world come to visit and learn firsthand why The Garden Project is so successful at crime prevention.

Now you know that The Garden Project is very popular, powerful, and successful. It’s a program that has kick started a new perspective regarding nutrition and education. It allows offenders and the at-risk youth to make the choice to turn their lives around and get back on the right path. What I found most surprising about The Garden Project was that it allows its participants to grow into more successful people through the use of nutrition education. Who knew that learning to grow vegetables could have such beneficial effects regarding crime?

Sources:

http://www.gardenproject.org/about_us

http://www.gardenproject.org/earthstewards

 

 

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Should L-Citrulline Supplant L-Arginine in These Wound Healing Supplements?

Matthew Harmon,  USJ Dietetic Intern, ’17

About a month ago, a supplement rep came to my school to talk about the company’s catalog of products, and given my long history of working with supplements, I was very excited about the lecture. The rep explained to the class about all of their various wonderful products, such as nutrition formulas for pediatrics that contain real food ingredients, specialized tube feeding formulas and many others. As the rep was explaining about this next supplement, my ears immediately perked up because this product continues to use L-arginine as an active ingredient in their wound healing supplement. Most researchers in the sports nutrition world have already taken their attention off of L-arginine and redirected their work onto L-citrulline. Athletes, both the runner and the weight lifter, now recognize its benefits in decreasing fatigue and enhance endurance. So, it begs the following question: If sports nutrition supplement companies are making the switch, is it warranted for medical nutrition supplement companies to follow?

L-Arginine and Wound Healing

Image source

Here is a quick overview of L-arginine: It is a conditional amino acid, manufactured endogenously in the body, and it can be consumed from various foods, turkey has the highest amount. The main benefits include the stimulation and release of growth hormones and insulin. But it really made its mark in the health world for its nitric oxide (NO) producing ability. Studies have demonstrated that NO is a key player in many biological processes, such as vasodilation, brain health and the immune system.

NO is a vasodilator. Vasodilation is a critical step in the recovery/wound healing process. NO participates in antimicrobial activities and allows for more blood flow into tissues and organs, which allows the inflamed/injured site to receive an increasing demand of nutrients and oxygen for optimal repair ⁽¹⁾. In addition, ornithine plasma is increased, and it serves as an active player in collagen development and increases the wound integrity from breaking ⁽²⁾.

It is manufactured in the body and can be obtained from some fruits and vegetables, watermelon being the highest source. Like L-arginine, L-citrulline possesses the same ability to assist in the stimulation of growth hormones, insulin and NO. This is accomplished by the kidneys by converting L-citrulline into arginine. In other words, health benefits are similar in a lot of ways due to the fact that it is a precursor to the amino acid, L-arginine.

Image source

L-Arginine versus L-Citrulline

Arginine

Oral consumption of L-arginine poses several problems: The primary concern lies within absorption. Research has indicated its bioavailability ranges of 57–77% at a 6-gram dose, and 20% at 10 grams ^(3,4). Moreover, in the same study conducted by Tangphao O, et al., noted a range as low as 5–50% absorption ⁽⁴⁾. The other possible concern, if taken with food, the absorption of the amino acid can decrease, making it cumbersome for consumers/patients that may follow a random eating schedule. Therefore, in order to maximize L-arginine absorption, it is best recommended that the amino acid should be taken on an empty stomach. Furthermore, large doses of L-arginine have been reported to cause gastrointestinal distress and diarrhea.

Citrulline

For athletes, it seems that the research suggests the effective dosage is 6 grams of L-citrulline, and compounded to a malate molecule. It does not trigger gastric distress or diarrhea when taken at 15grams ⁽⁵⁾. It is absorbed at a higher amount in the gut than L-arginine ⁽⁶⁾. Studies suggest that approximately 83% of the supplement is absorbed by the kidneys ⁽⁷⁾. Moreover, L-citrulline consumed at 0.18g/kg produces an increase and a sustainable plasma level of arginine than arginine itself ⁽⁸⁾. It also produces a higher plasma count of ornithine by approximately 200 percent ⁽⁹⁾, which has been demonstrated in studies as one of the key amino acids involved in the healing process ⁽²⁾.

Conclusion 

Although the athlete’s motivation is a lot different than the patient, both consumers can still receive L-citrulline’s benefits. As stated earlier, it does not cause any issues with intestinal distress. It is better absorbed and outputs a higher arginine and ornithine serum count in the body over L-arginine supplementation itself. Therefore, in theory, a higher increase of arginine and ornithine in the human body should result in a better wound healing supplement. So, back to my question: if sports nutrition supplement companies are making the switch, is it warranted for medical nutrition supplement companies to follow?

I think the answer is yes.

Bibliography

1. Stechmiller JK, Childress B, Cowan L. Arginine Supplementation and wound healing. Nutr Clin Pract. 2005;20(1):52–61. doi:10.1177/011542650502000152. http://ncp.sagepub.com/content/20/1/52.long. Accessed October 21, 2016.

2. Shi HP, Fishel RS, Efron DT, Williams JZ, Fishel MH, Barbul A. Effect of supplemental Ornithine on wound healing ☆☆☆. Journal of Surgical Research. 2002;106(2):299–302. doi:10.1006/jsre.2002.6471. http://www.sciencedirect.com/science/article/pii/S0022480402964711. Accessed October 21, 2016.

3. Bode-Böger SM, Böger RH, Galland A, Tsikas D, Frölich JC. L-arginine-induced vasodilation in healthy humans: pharmacokinetic–pharmacodynamic relationship. British Journal of Clinical Pharmacology. 1998;46(5):489-497. doi:10.1046/j.1365-2125.1998.00803.x. Accessed October 21, 2016.

4. Tangphao O, Grossmann M, Chalon S, Hoffman BB, Blaschke TF. Pharmacokinetics of intravenous and oral l-arginine in normal volunteers. 1999;47(3). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014227/. Accessed October 21, 2016.

5. Moinard C, Descartes UP, Nicolis I, et al. Dose-ranging effects of citrulline administration on plasma amino acids and hormonal patterns in healthy subjects: The Citrudose pharmacokinetic study | British journal of nutrition | Cambridge core. British Journal of Nutrition. 2008;99(4):855–862. doi:10.1017/S0007114507841110. https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/dose-ranging-effects-of-citrulline-administration-on-plasma-amino-acids-and-hormonal-patterns-in-healthy-subjects-the-citrudose-pharmacokinetic-study/914C4C4EA85887DC2935740ACF8E36DE. Accessed October 21, 2016.

6. Curis E, Crenn P, Cynober L. Citrulline and the gut: Current opinion in clinical nutrition & metabolic care. September 2007. doi:10.1097/MCO.0b013e32829fb38d. http://journals.lww.com/co-clinicalnutrition/pages/articleviewer.aspx?year=2007&issue=09000&article=00010&type=abstract. Accessed October 21, 2016.
7. Windmueller HG, Spaeth AE. Source and fate of circulating citrulline. Article. 1981;241(6):473–480. http://ajpendo.physiology.org/content/241/6/E473.abstract. Accessed October 21, 2016.

8. Rougé C, Robert CD, Robins A, et al. Manipulation of citrulline availability in humans. MUCOSAL BIOLOGY. 2007;293(5):1061–1067. doi:10.1152/ajpgi.00289.2007. http://ajpgi.physiology.org/content/293/5/G1061.long. Accessed October 21, 2016.

9. Demura S, Yamada T, Yamaji S, Komatsu M, Morishita K. European journal of clinical nutrition – abstract of article: The effect of L-ornithine hydrochloride ingestion on performance during incremental exhaustive ergometer bicycle exercise and ammonia metabolism during and after exercise. European Journal of Clinical Nutrition. 2010;64(10):1166–1171. doi:10.1038/ejcn.2010.149. http://www.nature.com/ejcn/journal/v64/n10/pdf/ejcn2010149a.pdf. Accessed October 21, 2016.

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INSIDE THE POD: AN EXPLORATION OF PULSES

by Ewelina Borkowska-Coghlan MS, DTR/Dietetic Intern at the University of Saint Joseph

Have you ever heard the word ‘pulse” and instantly though that the information you were about receive, or a conversation you were about to carry, will regard a heartbeat? If you had that experience you were probably surprised to learn that ‘pulse’ is also a food and not just a vital sign measurement. As a dietetic student, with broad exposure to various foods and diets, I thought I had a good understanding of the nutritional benefits of pulses. However, looking back I can admit that I wasn’t fully aware how much pulses have to offer, and how important these “ancient grains” are to our health and well-being. My recent visit to FNCE, Boston 2016, and particularly a presentation by John Sievenpiper (Associate Professor and a Faculty of Medicine in the Department of Nutritional Sciences, University of Toronto) helped me realize that I, as a future dietetic professional, need to reinforce the need of including pulses in my diet, but most importantly in the diet of my future clients.

Ó http://www.youbeauty.com/nutrition/healthy-beans/

Before I start explaining why we all should put more effort into including these often overlooked nutrition reservoirs in our everyday living…

What exactly are pulses?  

Most of us are probably more familiar with the word “legumes” and often think of pulses as legumes. Well, you are right! Pulses belong to the legume family, but there is a distinction between these two. Legumes include plants which fruit/seeds grow in an enclosed case, called a pod, and include fresh beans, fresh peas and other fresh seeds, while pulses only include the dried seeds (1,2). There are 11 types of pulses that have been recognized by the United Nations Food and Agriculture Organization (FAO), which include: dry beans, dry broad beans, dry peas, chickpeas, cow peas, pigeon peas, lentils, Bambara beans, vetches, lupins and pulses NES (Not Elsewhere Specified) (2).  The legume species that are used as vegetables (i.e. green beans) or used for oil detractions (i.e. soybean) and sowing (i.e. alfalfa) are not considered pulses, by FAO. However, this selection is only a small representative of hundreds of pulse varieties grown and consumed by humans and animals around the world.

Ó http://www.pulsecanada.com/about-us/what-is-a-pulse

 What about the nutrition?

What makes pulses such a great addition to our meals is their variety of colors, shapes and sizes along with the form they can be consumed in (whole, split or ground as flour). Moreover, pulses are packed with proteins, fiber and high levels of vitamins and minerals such as: zinc, phosphorus, iron, calcium, magnesium and potassium, as well as folic acid and other B vitamins, potent phytochemicals and antioxidants (3,4,5). As we know pulses are a key part of any vegetarian or Mediterranean diet, but they can be used in any diet or meal: including salads, side dishes, soups or as snacks. Combining pulses with other foods i.e. grains or foods rich in Vitamin C, and using appropriate preparation and cooking techniques, can contribute to better bioavailability of its nutrients, and lower activity of the anti-nutrients such as phytic acid, lectins and other compounds (4,5).

Ó http://www.cookinglight.com/cooking-101/what-are-pulses

Turns out, this so called “Protein for the poor”, can provide us with a wealth of nutrients.

…and finally the health benefits

Considering a multitude of vitamins and minerals present in pulses, it should not be surprising that they possess a spectrum of health benefits. One of the recognized health benefits mentioned by Dr. Sievenpiper is the ability of pulses to offer better glycemic control. As mentioned before pulses are high in fiber, plant proteins and slowly digestible carbohydrates. A study conducted by Dr. Sievenpiper et al, based on meta-analysis of randomized controlled trials, investigating the effect of pulses on the glycemic control in people with or without diabetes, demonstrated that pulses contributed to improved markers of long term glycemic control (5). Additionally, the research shows clinically meaningful improvements of blood pressure, blood lipids and weight, which is strongly associated with lower rates of cardiovascular disease, obesity and other chronic diseases. Considering the multifaceted benefits, it is important to encourage consumption of pulses amongst communities and slow down the onset, and progression of these highly mortal diseases.

Ó https://foodal.com/knowledge/how-to/pinto-beans-cheap-nutritious-meal/

Wait! There is more…

It is also important to mention that pulses are considered one of the most sustainable crops in agriculture. Nitrogen is an essential nutrient in crop production. Legumes, including pulses, have the ability to fix the nitrogen into the soil, because of their relationship with the bacteria living in the soil, therefore improving the quality of the soil and reducing the need for additional fertilizers (6). The water usage estimates suggest that it takes approximately 43 gallons of water to grow a pound of pulses, compared to 216 gallons for soybeans, and 368 gallons for peanuts (2). This can result in decreased greenhouse gases, improved soil health and less water usage. Therefore…

Let’s allow these “ancient grains” to lead us into a healthy and sustainable future!!

Óhttp://www.pulsecanada.com/environment/sustainability/non-renewable-energy/how-do-pulses-help

References:

• org. What are pulses? Internet: http://pulses.org/what-are-pulses (accessed October, 20 2016).
• Pulse Canada. What is a pulse? Internet: http://www.pulsecanada.com/about-us/what-is-a-pulse (accessed October, 20 2016).
• Food and Agriculture Organization of the United Nations. Nutritional benefits of pulses. Internet: http://www.fao.org/fileadmin/user_upload/pulses-2016/docs/factsheets/Nutrition_EN_PRINT.pdf (accessed October 20 2016).
• North Dakota State University. Anti-Nutritional Properties of Pulses-The Bad and the Good. Version current January 2nd, 2015. Internet: https://www.ag.ndsu.edu/food/pulse-crops/research/anti-nutritional-properties-of-pulses2014the-bad-and-the-good (accessed October 20 2016).
• Sievenpiper J, Kendall C, Esfahani A, Wong J, Carleton A, Jiang H, Bazinet R, Vidgen E, Jenkins D. Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diabetologia 2009;52:1479-95.
• Suárez-Martínez SE, Ferriz-Martínez RA, Campos-Vega R, Elton-Puente JE, de la Torre Carbot, Karina, García-Gasca T. Bean seeds: leading nutraceutical source for human health. CyTA-Journal of Food 2016;14:131-7.

 

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Grocery Shopping for One:

Tips on how to shop for healthy, affordable food for one person!

by: Erika Grover, USJ Dietetic Intern, ’17

As a person who is new at “adulting” I have had to learn how to go grocery shopping for just me while also trying to keep it low cost and mostly healthy (chocolate can be good for you!). Here are some tips that I have come up with to become a master solo shopper!

1. Plan your meals! – Pick a few meals to cook each week and eat leftovers for the other nights. How many meals you make will depend on how much food you have left over and how many meals you eat from home. If you still have a lot of food left, then wait another day or so to cook again.  You can also cook multiple meals on one day and eat leftovers throughout the week.  This is a good idea if you have a full schedule but be careful not to make too much.
2. Make a list! – Write down anything you need for recipes and any staple items that you are getting low on, like bread or milk. This keeps you on track and prevents you from buying food you don’t need. I have the items I need in red and items I already have in blue, find a system that works for you. Remember: You must bring the list with you to the store!
3. Become a coupon queen or king! – Look for weekly circulars, find them online or get an app for coupons. Search for them after making your list and only clip coupons for items you need. Make sure to keep an eye on the expiration date, some coupons are good for a week and some are good for months. If you don’t need a product right now but could use the coupon before it expires then clip it just in case. Weekly circulars will also tell you what items are on sale and you may want to make substitutions to your meal if a similar option is on sale, like buying fresh green beans instead of broccoli.
4. Watch the dates! – Look for the “use by” or “sell by” date and pick one that is reasonable for you. Items at the back of the shelf usually have a date that is further away. Remember that you don’t have to throw away food on the use by date, you can if want to but you can also use your best judgement and keep eating it for few more days. You may also want to write the date on containers, like milk or cereal, when you open them so you know how long it has been open and if you need to use it up.
5. Your freezer is your friend! – Buying in bulk is cheaper but only if you are actually eating the food you buy. If you buy in bulk or if one package is just too big for you, you can section out the food you will use for the week and freeze the rest in plastic baggies. This is good for meat, bread, vegetables, pretty much anything can go in the freezer. Freeze the food into single servings so you only have to take out one baggie at a time. It’s a good idea to label and date the food so you know what it is and how long it has been there.
6. Cut out the junk! – It’s easy to avoid cookies and chips when you are on a budget. Do you really need ice cream for $4.99 when you could buy 3 bags of carrots for a similar price? That ice cream may last a few days but those carrots could last for months (in the freezer, of course). I know you’re not going to completely get rid of the less healthy stuff, at least I know I’m not, so instead watch for these items to be on sale and make them a special treat.

   By using these tips I have been able to reduce my food waste which makes me feel better and helps me to save money. Now, I’m still figuring this all out for myself but I hope these tips can get you going in the right direction and help you begin the process of becoming a master solo shopper!

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