September 26th, 2011 | by Pam Stuppy
Here are some TV clips from a recent show I was featured on. On these clips I speak about the new Oakhurst dairy milk with Omega-3 fatty acid:
September 26th, 2011 | by Pam Stuppy
Survey research tells us that a large percentage of Americans are not consuming the recommended intake of calcium, especially from food sources.
In previous decades, milk and cheese were this country’s major source of calcium. Because of the dramatic increase in the variety of beverages now available to us, milk intake has declined.
Why the concern about reduced calcium in our diets? One big issue is that calcium is a major component of bone. From conception to our last days, we need adequate amounts of all the ingredients needed to build, maintain, and repair bone. There are, in fact, other important nutrients needed for these processes, but if adequate calcium is not available, bone will suffer. Calcium is also beneficial for normalized blood pressure, muscle, and other body functions.
Depending on the source, recommendations for calcium intake can vary slightly. For reference, 8 ounces of milk provides 300 mg. Generally, those 1 to 3 should get about 500-700 mg/day, those 4 to 8 should get 800-1000 mg/day, 9 to 18 should get around 1300 mg daily.
Middle-aged adults and women on hormone replacement therapy need about 1000 mg/day. Persons older than 50 years of age should include about 1200 mg daily. Someone with established osteoporosis, reproductive-age women not getting a regular menstrual cycle owing to low estrogen levels (as in anorexia nervosa), or anyone taking medications that are detrimental to bone could benefit from closer to1500 mg/day. Don’t forget that all age groups need adequate vitamin D to maximize uptake of this calcium.
The preferred sources of calcium are from the diet, since healthy foods containing calcium provide a wide range of additional nutrients that can contribute to bone health. There is some concern for high levels of calcium from supplements, as this can increase the risk of kidney stones and other issues. Generally, keep calcium intake less than 2500 mg/day (teens can go to 3000 mg/day) or less than 2000 mg a day for older adults.
If you choose to take a supplement, remember that the body can absorb no more than 500 mg at a time — so split doses as needed. Also, separate calcium and iron supplements as they compete for uptake. Calcium carbonate forms should be consumed with food for better uptake (owing to the acid in the stomach). Older adults or people taking antacids should use the calcium citrate form.
There are a number of dietary sources of calcium — milk, buttermilk, yogurt, cheese, fortified foods like soy milk or OJ, almonds, dark leafy green vegetables, legumes/beans, calcium-processed tofu, and others. (For cardiovascular health, fat-free or low-fat versions of the dairy products are recommended).
On a food label, calcium is noted as “% Ca” and is based on the noted serving size. To convert this to “mg”, just add a zero (example: 30%Ca = 300mg).
Some ideas for adding more calcium might be having a glass of milk or soy milk at each meal, using milk instead of water to make hot cereals or cream soups, having milk or chocolate milk as a recovery beverage after exercise, having cold cereal with milk or yogurt for breakfast or a snack. Try adding hot milk to granola for breakfast or for a warm snack. Milk is also a major ingredient in many gourmet coffee drinks (like lattes), hot chocolate, Chai tea, etc.
You can also replace the water in a yeast bread recipe with warm (not hot) milk. Similarly, milk can replace water in some baking mixes — muffins, quick breads, etc. Powdered milk can be added to baking recipes as well.
Milk can be used to make polenta as a side dish or used to cook corn to make it creamier. Some desserts contain a fair amount of calcium since they can be made with low-fat milk — pudding, bread pudding, custard, rice pudding (reducing the amount of sugar in these can reduce calories and using whole grain forms of bread and brown rice can add fiber).
Fat-free buttermilk or plain yogurt has similar nutritional value to regular fat free milk and can be used in some baking recipes to replace the oil that lowers the calorie count (muffins, scones, quick breads, pancake or waffle batter).
Yogurt is a great source of calcium and can be used as a snack, mixed with cinnamon for a fruit dip, in a smoothie or dessert parfait with fruit.
Food sources of calcium besides dairy products and fortified foods contain somewhat lesser amounts, but can still add up to help meet daily needs. Try consuming dark leafy greens (broccoli, bok choy, collard greens, kale, etc.) in larger amounts and more often throughout the week. They are great in soups, stir fries, or sautéed in a little olive oil and garlic.
Beans are another source of calcium. Add beans (like kidney beans, black beans, etc.) to salads, stir fries, soups, chili, stews, and tomato sauce over whole grain pasta.
Almonds stand out as a nut that has the highest amount of calcium. Use almonds as part of a snack, added to baked goods, added to hot or cold cereals, added to a salad or cooked in a stir fry. Sesame seeds are another source.
These are just a few of the ways to slip in more calcium along with other nutrients beneficial to bone. Make a point to include adequate amounts in your diet each day.
Pam Stuppy, MS, RD, CSSD, LD, is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and Portsmouth. She is also the nutritionist for Phillips Exeter Academy. Visit www.pamstuppynutrition.com for more nutrition information, some healthy cooking tips, and recipe ideas.
September 5th, 2011 | by Pam Stuppy
Printed in Seacoast Online
As the baby boomers are getting older, more and more are opting to undergo joint replacement. Joint problems can be caused by a number of factors, but can be aggravated by some of the changes that occur as we age. For instance, some people have experienced increasing problems with joints as their body weights have gone up over time. Even a few extra pounds can add unwanted stress on joints and supporting tissues.
If you are considering having joint replacement surgery, there are a number of action steps you can take ahead of time to improve your chance of a successful recovery. These include getting closer to a healthy body weight, increasing your level of physical fitness and strength as much as you can within the constraints of your joint issues, eating a healthy diet to allow your body to heal more quickly from the surgery, good sleep habits so you are well rested going into the surgery, and reducing emotional stress.
Losing weight means less pressure on the joint(s). It also makes it easier to be more active before the surgery. In most cases, there are cardiovascular and strength-building activities that you can do to help you achieve your goal of weight loss. A physical therapist can assist you in planning possible activities with consideration of your joint issues.
Losing weight does not mean restrictive dieting, which can weaken your body before surgery. Instead, it means being attentive to appropriate portion sizes, choosing foods that fit into one of the healthy food groups, limiting high calories extras (in foods and beverages), and being as physically active as possible.
Cardiovascular activity not only helps burn calories, but improves fitness as well. Being more fit is helpful going into the surgery and improves outcomes after surgery. Since joint issues vary, see what you are able to do. Some people can do several short walks in a day without feeling too much pain. Others prefer non-weight-bearing exercise like swimming.
Activities to increase or maintain flexibility/range of motion in as many joints as possible can be helpful, too. This can reduce the risk of injury and make other types of physical activity easier. It is also recommended for people with arthritis.
The public health recommendation is for all of us to take each of our major muscles to fatigue two to three times a week —to increase/maintain muscle. In preparation for joint replacement, this strengthens the supporting tissues so that you can be more compliant with rehab. It also means you can establish or return to an active lifestyle as soon as possible after the surgery. This allows for continued success of the replaced joints and being able to achieve or maintain a healthy body weight.
Although it can dramatically improve movement and reduce pain, joint replacement surgery creates stress for the body. This means in the weeks or months leading up to the surgery, you should maximize your nutrient intake. This speeds recovery of the body tissues. It helps to keep your immune system functioning well to ward off illness and infection. A registered dietitian can review your current food intake and suggest possible improvements based on your particular food preferences, medical issues, and lifestyle.
In general, both before surgery and in the months that follow, try eating moderate amounts every three to four hours. This helps to maintain energy levels, maximize your metabolism, and to have better control over the types and amounts of foods you eat (because you are not excessively hungry going into a meal/snack). Small, frequent meals also give you more opportunities to get in at least your baselines needs from the healthy food groups — three servings of fruit, 2½-3½ cups of veggies, four servings of low-fat dairy or alternative for calcium (1200-1500mg/day), some whole grains, lean proteins, and a moderate intake of healthy fats (nuts, seeds, olive or canola oil, avocado, etc.) daily.
Adequate vitamin D is important for both bones and muscle tissue. A simple blood test can determine if your vitamin D level is sufficient. Since this nutrient is difficult to get from food sources alone, a supplement is often warranted. If you have not had your blood level checked, a supplement of 1000-2000 IU would be an appropriate estimate of needs.
Sleep is highly under-rated. It not only allows us to recover from our daily physical and mental activities, but also contributes to a healthy immune system. This is important as you prepare for joint surgery. You want your body to be in top physical condition and well-rested for all the work is has to do while healing and during rehab.
If you are overweight, you have a higher risk of having sleep apnea (when you stop breathing for periods of time during sleep). This results in inadequate and poor quality sleep. If you suspect that you might have sleep apnea, it might be a good idea to have a sleep study done so that this issue can be addressed. Studies have also shown a strong connection between lesser amounts of sleep and an increased risk of being overweight. Treating the sleep apnea, then, could actually help in your attempt to reach a healthier body weight. If you do not have sleep apnea but have other sleep issues, check out the National Sleep Foundation Web site (www.sleepfoundation.org) for ways to improve sleep.
Emotional stress can negatively affect your physical body as well. It triggers your body to produce substances that can cause tissue damage, can increase inflammation, and can lower your immune system. It may also be the cause of some sleep problems. Consider action steps you can take to reduce your emotional stress. This might include directly addressing causes of stress or it might mean finding ways to change the way you respond to stressors. Purposeful times for relaxation, yoga, meditation, biofeedback, progressive relaxation, and working with a therapist are some ideas.
As noted, all of the above actions steps can help to prepare you for your joint replacement. Even better news is that by continuing these behaviors, you will be fit and healthy in the years ahead.
Pam Stuppy, MS, RD, CSSD, LD, is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and Portsmouth. She is also the nutritionist for Phillips Exeter Academy and is teaching healthy cooking classes at Stonewall Kitchen. Visit www.pamstuppynutrition.com for some healthy recipe ideas.