Recommendations for Dietitians and Dietary Books

Recommendations for Dietitians and Dietary Books

Question:

I live in Florida and need a dietician due to cholesterol, triglycerides and other issues. Can you recommend a good dietician or books?

– Myles V.

Answer:

There are several directories for Registered Dietitians in the state of Florida such as www.DietitianCetnral.com and https://www.eatright.org/find-an-expert. You can narrow your search to a specialty such as “cholesterol management” or “heart health,” or to your city.  Even if medical nutrition therapy is not a covered service under your health plan, you may find a list of providers from your insurer.

You can verify a dietitian’s license with the Dietetics and Nutrition Practice Council of Florida through https://appsmqa.doh.state.fl.us/MQASearchServices/HealthCareProviders.

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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Freaky Fungi

Freaky Fungi

MUSHROOMS can be deadly! They have gills but aren’t fish (obviously), they aren’t vegetables and can hardly be considered “plants” – without roots, leaves, flowers or seeds. What are they, then? They’re part of the fungi kingdom. Don’t worry, culinary mushrooms from the produce aisle in grocery stores are cultivated and safe to consume1, unlike some of the wild mushrooms picked up during foraging. Here are three reasons why you shouldn’t avoid the mysterious living organisms known as mushrooms: 


 

Nutrition 

Mushrooms contribute to a plant-based diet high in nutrients2, though content varies based on mushroom variety. They are low in fat and calories, high in carbohydrates, fiber, protein3 (by calories), B vitamins, phosphorus, potassium, as well as magnesium, selenium, copper, and Vitamin D. Mushrooms are the only “plant” that provides a natural source of vitamin D, from the conversion of ergosterol to D2 or D4 when exposed to ultraviolet light (look for “UV-treated” on the label). Shiitake and morel varieties naturally contain more vitamin D than other mushrooms typically consumed by Americans4.  To offer protein equal to that from an ounce of meat, it takes about two cups of white button mushrooms – a significant quantity that contributes to fullness and decreased hunger but provides only 42 calories. 

Health 

Though hundreds of mushrooms have medicinal and disease-fighting properties1,3, Japanese varieties notably contain the most phytochemicals (naturally occurring plant chemicals)2. Oyster mushrooms contain antioxidants such as selenium and L-ergothioneine, which provide protection to cells against free radical damage2. These compounds are fortunately resistant to cooking2. King trumpet (aka. king oyster) also contains statins shown to reduce blood lipids2.   

Additionally, white and brown beech, shiitake and maitake mushrooms contain beta-glucan fiber2 which may help lower insulin resistance, blood cholesterol, and risk of obesity5. Mushroom beta-glucans may not affect glucose absorption, but they could decrease the glycemic response by up to 25%5. Portobellos can lower glycemic responses when consumed with food1. Japanese studies of isolated beta-glucans from mushrooms show promise to boost the immune response to fight cancer cells3,5 and may help prevent the recurrence of hormone-dependent breast cancers1,3 

Cuisine 

Mushrooms offer umami, the 5th basic taste after sweet, salty, bitter and sour. The darker the mushroom the more umami it contains, and cooking intensifies this flavor1,2. Mushrooms are known for their unique earthy flavor and chewy, meaty texture1. White button mushrooms are milder than their darker counterparts, crimini (aka “baby bellas”) which are immature portobello mushrooms3. Dried versions of most types have super-concentrated flavor and make great additions to soups, sauces, and stocks.  

Mushrooms are great for trimming meat in dishes or used as a stand-out ingredient in stir-fries (shiitake best) or raw salads (enoki best)1. For those who have a palate issue with them on their own, finely dicing mushrooms to match the consistency of meat then blending into traditional recipes alongside ground meat, makes them more tolerable1. To cut back on meat you can use finely diced mushrooms as replacement for half the ground beef in tacos, lasagna, meatballs/loaves, burgers, and pasta sauce1. 

MYCOPROTEIN is a mold member of the fungi family. Wait, what? We are told to avoid mold on foods because it is dangerous! Approved in 2001 by the FDA as a Generally Recognized As Safe (GRAS) food, mycoprotein is grown in large fermentation vats. Mycologists have studied the safety of the mold strain used and determined it produces an almost undetectable less than 0.5 parts per million mycotoxins in production6 

Mycoprotein is high in fiber and protein (12% protein by weight) and contains all essential amino acids in concentrations similar to egg6. Due to its stringy nature, it is predominantly used as a meat substitute, though modified mycoprotein can also be used as a fat replacer in dairy products or as a grain replacement in cereals.  

As with all foods, some people may be intolerant or allergic (rare) to mycoprotein. Such cases have prompted the nonprofit Center for Science in the Public Interest to request that the FDA revoke mycoprotein’s GRAS status. If you are looking for a non-soy, non-dairy vegetarian protein source then you might consider mycoprotein. On the other hand, if you are looking for natural ‘clean’ foods, then these highly engineered mycoprotein products are not for you. 

 In summary, there are benefits to mushrooms including some that other plants can’t provide, while mycoprotein’s only value seems to be as a meat replacer. Now that you’re armed with details about each, don’t let edible fungi haunt you! 

References: 

  1. Fabulous Fungi — Here’s Why Your Clients Should Be Trading Meat for Mushrooms
    L Getz.Today’s Dietitian Dec. 2014; 16 (12): 14-15. 
  2. From A to Shiitake — Japanese Mushrooms May Offer Certain Benefits. LK Kay.Today’s Dietitian Nov. 2010; 12 (11): 20-21. 
  3. Medicinal Mushrooms. J Ilkay. Today’s Dietitian Sept. 2011; 13(9): 30-32.
  4. Are Mushrooms a Significant Source of Vitamin D? Journal of The Academy of Nutrition and Dietetics Sept 2016; 116(9): 1520.
  5. Betting on Beta-Glucans.  D Webb. Today’s Dietitian May 2014; 16(5): 16-17.
  6. Food Mycology: A Multifaceted Approach to Fungi and Food.  J Dijksterhuis, RA Samson. CRC Press, 2007.

 

Grilled Stuffed Portobellos

Ingredients 

The gills on the underside of portobello caps have an unpleasant chalkiness and, therefore, should be scraped away with a spoon before grilling. Olives and feta cheese tend to be salty so keep that in mind when seasoning to taste. 

  • large portobello mushrooms, stemmed 
  • 2 T balsamic vinegar 
  • 2 T extra-virgin olive oil 
  • Fine sea salt and pepper 
  • 1/2 cup jarred roasted red peppers, chopped 
  • 1/4 cup pitted kalamata olives, chopped 
  • 1 garlic clove, minced 
  • 11/2 tsp chopped fresh oregano 
  • 2 oz crumbled feta cheese (1/2 cup) 

Method

  1. Using a spoon, scrape out the gills from the underside of the mushrooms and discard. Gently toss the mushrooms together with the vinegar, 1 T of oil, and salt and pepper to taste in a large bowl, taking care to not break the mushrooms. Let sit for 10 minutes while the mushrooms absorb the marinade.
  2. Combine the peppers, olives, remaining 1 T of oil, garlic, and oregano in a small bowl, and season with salt and pepper to taste.
  3. Prepare a hot fire on the grill. Place the mushrooms gill side up on the grill directly over the fire and cook, covered, until well browned on the first side, about 5 minutes.
  4. Flip the mushrooms and continue to cook, covered, until well browned on the second side, about 5 minutes.
  5. Finally, flip the mushrooms one last time (they should be gill side up again) and spoon the pepper-olive mixture evenly among them. Top each mushroom with feta cheese and grill, covered, for 1 minute longer. Using a spatula, transfer the mushrooms to a platter and serve.

Serves 4 as a side dish 

Nutrient Analysis per serving: Calories: 180; Total fat: 13 g; Sat fat: 3 g; Cholesterol: 5 mg; Sodium: 470 mg; Total carbohydrate: 11 g; Dietary fiber: 2 g; Sugars: 6 g; Protein: 7 g 


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Pulp vs. Pulp-Free Juices, Which is Healthier?

Pulp vs. Pulp-Free Juices, Which is Healthier?

Question:

How healthy are fruit juices like orange juice with no pulp? Do fruits/vegetables from concentrate in smoothies typically only have the water removed with most of the fiber intact? Does it matter if the juice is from concentrate in terms of limiting sugar intake per day?

– Nick S.

Answer:

We often think the pulp retains the fiber, while the expressed juice does not. Taking a look at the labels from three major bottled OJ brands, the nutritional information was nearly identical:

1 cup pulp-free had 110 calories, 22-23 grams sugar, 0 gram fiber

1 cup high pulp had 110 calories, 22-23 grams sugar, 0 gram fiber

But where’s the fiber? When fiber is less than 1 gram and no fiber claims are made, the Nutrition Facts panel may not even have Dietary Fiber listed. The type of fiber, called pectin, is a beneficial soluble fiber that helps lower blood cholesterol and slows the passage of food through the gut.

Citrus pulp is also promoted as containing nutrients such as vitamin C, beta-carotene and several minerals. But the evidence of such nutrition is a mystery to me. Not one online article about fruit pulp that I found had an original source citing micronutrient content. The USDA’s Food Composition Database’s ONLY standard reference pulp is that of Naranjilla (lulo), a South American fruit. Hardly something found in American grocery shelves. I found the Nutrition facts panel for a passion fruit pulp sold in the US and it has 1 gram fiber, 9 grams sugar, 2% DV calcium, and 2% DV iron per half-cup serving.

So… although I’ve always been taught (at home and professionally) that the pulp is nutritious, there appears to be a lack of resources to substantiate anything other than a small amount of fiber content. But I still promote consuming fruit skins, pulp, and pith. Here’s why – humans’ teeth and GI tracts were meant to consume as much of a plant as is edible, and to receive the full benefit of a fruit’s nutrients and phytochemicals we need to eat all of its components.  Eating raw, whole foods is always better than a processed version.

Sources:

  1. Juicing 101: Nutrition Tips for Consumers. Nutrition.gov, 9.24.2018. https://www.nutrition.gov/subject/shopping-cooking-meal-planning/juicing-101
  2. Types of Fiber and Their Health Benefits. WebMD.com, 6.1.2018. https://www.webmd.com/diet/compare-dietary-fibers

Fruit concentrate is basically fruit puree with the water removed, and usually the skin and membranes as well. Already the overall nutrition will differ from that of the raw fruit. Concentrates that are pasteurized will be lower in heat-sensitive vitamin C unless the product is fortified. On food labels, the sugar from concentrate is considered “added sugar.”

Fruit juice concentrate is made when water is extracted from the juice. This is beneficial for both preserving the juice and reducing shipping weight. Concentrates are higher in sugar and energy by weight and volume. If the concentrate is reconstituted, water is added back to form the liquid state and the result should be no different than the original juice. Reconstituted juice’s sugar and energy content would be restored to their initial levels.

Sources:

What Is ‘Fruit Concentrate,’ Anyway? And Is It Good For You? NPR 9.1.2017. https://www.npr.org/sections/thesalt/2017/09/01/545336956/what-is-fruit-concentrate-anyway-and-is-it-good-for-you

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

Ask our Dietitian

Have a nutrition question? Our registered dietitian is ready to help!

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Is Vegetarianism a Good Move for Distance Athletes?

Is Vegetarianism a Good Move for Distance Athletes?

Question:

I’m a 23-year-old, 150lb, male triathlete that trains pretty heavily, about 20 hours on a normal week, and when in Ironman training it’s around 25+. I’ve read several books that cite vegetarianism as a good move for distance athletes, and I want to give it a try for a couple of months after my next race. How much protein do I need daily? I read some sources that state 60 grams daily, others state 140+.

– Chis C.

Answer:

I am glad you are doing your research before embarking on your endeavor! Vegetarian athletes can meet their protein needs exclusively with plant foods*. Estimated daily protein needs for a 150-pound male triathlete that trains four hours five times a week are 1.7-2.0 grams/kg body weight. This equates to 116-136 grams protein per day.

Although it’s possible, you shouldn’t get all of that from one source. Protein quality matters – it’s important to consume adequate essential amino acids. Since plant proteins may be limited in one of those amino acids, eat a variety of grains, beans, legumes, and vegetables. Here is a sample vegan day with approximately 120 grams of protein and 3500 calories, divided into 3 meals and 3 snacks:

  • 2 vegan sausage patties
  • Medium waxy potato with onion and peppers cooked in tablespoon oil
  • Banana
    • Multigrain bagel with tablespoon peanut butter
    • 1.5 cups of soymilk
  • ½ cup whole beans, two 8” wheat tortillas, 2 oz cheese substitute, ½ avocado, unlimited salsa
  • 1 cup broccoli
  • Orange
    • 6 oz. plain non-fat Greek-style soy yogurt with ¼ cup dried fruit and ¼ cup granola
  • 1 cup mixed vegetables and 3 oz meat substitute, stir-fried in teaspoon oi
  • 1 cup quinoa
  • Apple
    • One bag of low-fat microwave popcorn

* Lacto-ovo vegetarians may include some milk, yogurt, and eggs.

Sources:

  1. Nutrition for Triathletes: Adding Protein Into A Vegetarian Diet. Triathlete.com, 7.30.2010. https://www.triathlete.com/2010/07/nutrition/accomplishing-the-feat-of-being-a-vegeterian-triathlete_11093
  2. The Triathlete’s Guide to Protein. Ironman.com, 1.19.2016. http://www.ironman.com/triathlon/news/articles/2016/01/triathletes-guide-to-protein.aspx#axzz5S2QQPAa1

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

Ask our Dietitian

Have a nutrition question? Our registered dietitian is ready to help!

Email nutrition@lafitness.com or submit your question below and it may be featured in an upcoming article!

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How to Lower Triglycerides to Normal Levels

How to Lower Triglycerides to Normal Levels

Question:

In my recent blood test, my triglycerides were borderline high. How do I get my triglycerides down to acceptable levels?

– Anthony C.

Answer:

Triglycerides in the blood are basically free-floating fats that are not bound to cholesterol. A lab value showing hypertriglyceridemia is an indication of increased risk for stroke, heart attack, and heart disease, or maybe a sign of other medical conditions. Dietary factors that increase triglyceride levels include alcohol, excess carbohydrate, sugars, and calories.

Here are tips for lowering blood triglycerides:

  • Avoid sugar and refined carbohydrates – Limit starchy foods, sugary drinks, and caloric sweeteners. Avoid added sugars and desserts. Choose whole grains over white flour products. Consider limiting calories from carbohydrates to 60% of all calories.
  • Choose healthier fats – Reduce saturated and trans-fat. Eat the lowest-fat dairy and animal proteins available. Instead of cheese or eggs, choose plant proteins. Snack on nuts and seeds versus fried pork skins. Instead of fatty meats containing saturated fat, choose fish with omega-3 unsaturated fat. Opt for oil-based dressing and sauces over cream-based ones.
  • Limit alcohol – Consume fewer alcoholic beverages.
  • Exercise regularly – A healthy minimum for physical activity is 150 minutes (30 mins x 5 times) of moderate-intensity exercise per week.
  • Lose weight – If you are overweight, losing just 5% body weight can lower triglycerides.

Sources:

  1. Foods to Avoid If You Have High Triglycerides. Web MD.  https://www.webmd.com/cholesterol-management/ss/slideshow-triglyceride-foods-to-avoid
  2. Triglycerides: Frequently Asked Questions. American Heart Association.  www.my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_425988.pdf
  3. Triglycerides: Why Do They Matter? The Mayo Clinic, 9.13.2018 https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

Ask our Dietitian

Have a nutrition question? Our registered dietitian is ready to help!

Email nutrition@lafitness.com or submit your question below and it may be featured in an upcoming article!

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