HAPPY


upload-1953577346869692832By: Nikki Nies

There’s nothing wrong with striving for happiness.  The problem at hand isn’t that we want to be happy, but what we think will bring us happiness.  Will the latest iPad really bring your happiness? Will losing those extra 5 lbs. of your muffin top bring happiness?  Maybe. Temporarily.

Watching only 2 minutes into the “Happy” documentary, I knew I had to share this profound Netflix documentary with you! While Thanksgiving just passed,I hope you have the chance to watch this documentary and walk away with a renewed gratititude and understanding of what happiness is. It’s not the material goods you’ve recently bought, but pure joy from within!

Photo Credit:  ebrcs

AA’s Protective Body Against Osteoporosis


Image-10-21-13-at-4.30-PM-560x440By: Nikki Nies

Between 2012 and 2013, the growth of the Asian American (AA) community increased by 2.9%, making them the fasting growing ethnic group in the U.S.19 Representing 19.4 million of the American population, the AA bone biology and calcium and vitamin D intake deserve better understanding, as intake is often times lower than the recommended dietary guidelines.2  Many AA families have immigrated to the U.S., bringing not only physical possessions, but dietary and cultural practices as well.  AA tend to consume less dairy products due to perceived and/or actual lactose maldigestion and lack of culturally inundated use.7  Of the calcium rich foods consumed, AA tend to consume calcium more from orange  juice, soy and dark green leafy vegetables.5,18,19 Yet, there is a 47% prevalence of  vitamin D deficiency for Asian emigrants, with mean 25(OH)D 23.7-60.1 nmol/L for ethnic minorities in comparison to white at 65.4-79.6 nmol/L.13  vitamin D deficiency is  associated with female gender, dark skin, being covered while indoors and longer residency in host country (>2 years).13

AA women possess some of the same risk factors are associated with osteoporosis in Caucasians, even though rates of fragility fracture differs among groups.7,8 Additionally, AA hip fracture incidence is lower than Caucasians, which is hypothesized as due to shorter height, lower incidence or severity of falls, lower bone mass, better bone quality-including shorter femoral neck axis length (FNAL) and hip axis length (HAL) and/or differences in soft tissue thickness.3,6,12,15,16  The biological differences in Caucasians and AA body composition provide AA a protective layer, literally, against osteoporosis even with suboptimal calcium and vitamin D intakes. It has been surmised AA reach peak growth velocity sooner than other ethnicity groups, with earlier epiphyseal closure, which leads to shorter leg length and FNAL.3 Potential explanations of lower bone mineral density (BMD) may include AA skin pigmentation, reduced sun exposure, lower vitamin D intake, smaller bone size in hip geometry, with suggestions that AA have greater resistance to buckling, compressive and/or impact forces.3,6,8,16 Furthermore, use of imaging technology indicates the Chinese skeleton compensates for smaller bone size in trabecular and cortical bone compartments, which provides greater bone strength.3  Cortical bone has been found to be a protective barrier to fractures due to its thickness, cross sectional area, cortical porosity, mineralization, crystallinity and presence of microcracks.7calcium.figure2

During the menopause transition, a decline in ovarian function beginning about 2 years before the final menstrual period (FMP) is followed by an increase in bone resorption and then bone loss. The magnitude of the increase in bone resorption is inversely associated with body mass index (BMI).15  With a higher BMI, this may influence osteoporosis through increased weight bearing and increased adiposity, which is a source of leptin and estrone; they are known to positively affect the maintenance of BMD.15 AA tend to have lower BMIs than Caucasians, which may correspond in bone resorption, appearing to account for the ethnic variation in perimenopausal bone loss.15

With extensive research on postmenopausal women’s bone health, it is equally important to understand adolescent calcium needs as the growth period is crucial for optimal bone health due to the bone accumulation and as half of adult peak bone mass occurs at this time.2,19   A randomized crossover design studied 29 AA adolescents’ calcium intakes, ranging from 600-1600 mg/day, measuring bone turnover rate and calcium absorption using double stable calcium kinetic analysis.19 Both genders had low habitual mean intake, low mean serum 25-hydroxyvitamin D concentrations, with true fractional calcium absorption inversely related with calcium load and calcium retention increased with increased calcium consumption.19  Calcium retention is dictated by calcium intake, with absorption efficiency increased within the  first year after spermatorrhea in boys, but decreased with menstrual cycle in girls.20  The most important factors of calcium absorption include sex–higher absorption rate for boys, age, pubertal development  and retention.10,20

With the minimal calcium intake at 1110 mg/day for Chinese American boys and 970 mg/day for girls, it leads to maximal retention, which is considerably lower than that for Caucasian girls.  The study suggests lower calcium recommendations for AA adolescents than for Caucasian adolescents. Although, AA adolescents habitually have lower calcium and vitamin D intake, bone gain is similar in comparison to Caucasians, which due to increased calcium absorption efficiency and renal calcium conservation and due to the inverse relationship of calcium load and true fractional calcium absorption.9,10,19  Boys retained significantly more calcium than girls as calcium intake increased through lower fecal excretion and higher net absorption.  As a controlled feeding crossover study, both genders were studied, providing insight into adolescent populations’ calcium intake, which has a limited amount of data.  However, by using Chinese American participants, it is hard to generalize results to the entire AA adolescent population.  Future research can and should compare Wu et al’s results using more ethnically diverse AA participants.19

Talk about bone health is not complete without looking into AA women’s lifestyle predictors of peak BMD.4 In a cross sectional study of 48 Mexican American (MA) and 58 AA women, participants were tested for BMD, body composition, aerobic fitness and muscle function.  Pearson’s correlations and multiple linear regressions found AA hip BMD was lower in MA when adjusted for age, BMI, income and physical activity.4  Lean body mass was the strongest predictor of BMD for both ethnicities, but stronger for AA.4  A potential explanation of this mechanism includes earlier plateau in AA BMD compared to other ethnic groups, lower rates of skeletal remodeling, differences in hormone concentrations and effects.4 Also, AA had significantly lower total, spine and hip BMD (P<0.05).4

N (MA/AA) MA AA
Total BMD (g/cm2) 47/57 1.11 ± 0.008 1.05 ± 0.06**
Spine BMD  (g/cm2) 47/57 1.05 ± 0.13 1.00 ± 0.10*
Hip BMD (g/cm2) 47/57 0.98 ± 0.11 0.86 ±0.11**
Spine t score 47/57 -0.002 ± 1.14 -0.364 ± 0.90
Hip t score 47/57 0.130 ± 0.83 -0.741 ± 0.84**

*Significant at P <0.005, **significant at P <0.01

While these results are the first of its kind, dietary recall bias has to be noted and causal relationships can not be drawn from any variables and BMD.4 However, all questionnaires were given in the participants’ preferred language and questionnaire and lab assessments were performed by the same research team. Again, by using specific minority groups-MA and CA,  it is hard to generalize results to the entire AA population.4

Moreover, by observing CA cortical thickness and cortical volumetric BMD (Ct.BMD), it can help shed light on the microarchitectural differences between AA and Caucasian risk for fractures.1 In a cross sectional study, pre and postmenopausal women were observed, with CA having smaller bone area at radius and tibia, greater cortical volumetric bone density and thickness and greater trabecular thickness than white women, which provides additional resistance to fractures.1 In CA, lower cortical porosity and higher tissue mineral density contribute to higher mineral BMD, more dense, thicker cortices.1,9

Premenopausal white women (n=46) Premenopausal Chinese women (n=46) Postmenopausal white women (n=68) Postmenopausal Chinese women (n=29)
Height (cm) 165±7 162 ± 6** 162± 6 157± 5***
Weight (kg) 63± 17 56 ± 10* 66±12 58±8***
BMI (kg/m2) 23.1 ± 5.5 21.6±3.5 25.3± 4.9 23.6± 2.6±*
Calcium intake (mg/d) 1394 ± 1570 885 ± 557* 1557± 730 901± 544***
OCP duration (years) 7.4 ± 6.4± 3.7 ± 3.3* N/A N/A
Baecke sport index 1.6 ± 0.7 1.1 ± 0.6*** 1.2± 0.5 1.2± 0.7
PTH (pg/mL)b 31 ± 13 37 ± 13* 38± 12 37±11
25-hydroxyvitamin D (ng/mL)c 36 ± 14 25 ± 9*** 38± 14 31±10*

OCP=oral contraceptive use; PTH=serum intact parathyroid hormone  bData for 174/192 women  cData for 152/192 women

*p < 0.05 between race by menopausal status;**p <0.001 between race by menopausal status ***p < 0.001 between race by menopausal status

The above listed results show CA have thicker, denser cortices due to lower cortical porosity and higher tissue mineral density.1 Studies have shown a strong relationship between cortical porosity and bone strength, with each SD increase in cortical porosity increasing risk of fracture 22-55% depending on skeletal site.  However, with noninvasive assessment, this may have led to confounding errors in density assessment as thicker cortices may result in more beam hardening artifact of measurement.1image_(2)

Repeatedly, Asian women are found to have lower areal BMD, which is the amount of bone mineral divided by the bone scanned area, and lower wrist, arm and hip fracture rates than Caucasians.1,9,17 Using high resolution technology, a study led by Walker et al., 2010 aimed to better understand this paradox, assessing cortical and trabecular bone noninvasively.17 32 white and 31 Chinese American women’s 25-hydroxyvitamin D, serum calcium, creatinine, alkaline phosphatase activity, intact PTH and thyroid stimulating hormone were measured.  Biochemical data was analysed using two sided t test and Pearson’s correlation for BMD and microarchitectural variables.17

Results showed CA were shorter, at lower weights, higher parathyroid hormone and a trend of less sun exposure than Caucasians.17 At the radius and tibia, CA women’s trabecular BMD was 22% and 15% higher respectively.17  Although, CA have smaller bone size, cortical thickness was 22.5% greater in CA than white.  When weight and physical activity factors were adjusted, differences in bone size decreased in radius and tibia, which suggests protective effects.2,17 In this study, the physical difference between CA and Caucasian women provide AA lower rates of hip fractures: greater trabecular and cortical thickness at radius and tibia, at tibia, trabecular number is greater, trabecular separation and inhomogeneity are lower.11,17 Participants were obtained as a convenience sample, which may instill selection bias–with healthy premenopausal, not postmenopausal women used and it can not be discerned if the results are applicable to postmenopausal.  This variation in menarche may skew the results and considerations must be made in regards in FMP.

The AA population’s body composition has a lowered risk for osteoporosis and fractures, with  body composition changes that accelerate bone loss within the FMP. In a eight year cohort study, 3302 Japanese and African American women spanning premenopausal age and beyond, estradiol, FSH and urine N-telopeptide (NTX) was measured.14 Results showed that in postmenopausal women, urinary and serum type I collagen NTX, a marker of bone resorption, levels were higher in perimenopausal women due to decreased estrogen production in perimenopausal and postmenopausal ovaries.14 The mean increase in urinary NTX was most markedly see in those with BMI >25 kg/m2, with increases greatest in Japanese Americans.  The study concluded ethnic variation in BMI helped explain the variation in perimenopausal bone loss as there was a decline in ovarian functioning starting 2 years before FMP with an increase in bone resorption and bone loss.14  Limitations of the study included the sole use of Japanese Americans as the AA experimental population and the obtainment of hormone levels on basis of single annual sample, which may not provide the best portrayal of hormone levels as menstrual cycles are irregular and the timing of blood sampling could have impacted the hormone levels.14 Causal relationships can not be determined from the results, with BMI as a measure of obesity, but not an indicator of contribution to increased fat mass, lean mass or both.

While AA are classified at increased risk of osteoporosis due to their lower calcium intake, their bone biology and metabolism show protective effects against osteoporosis in comparison to Caucasians.  Future research should expand on past studies’ findings, including using additional sample sizes when feasible and more consistent use of the type of ethnic participants.  While CA are the largest sub-minority group of AA, if future research states study’s are looking at AA, ethnic groups beyond CA should be used to elevate studies’ findings.  In addition, longitudinal studies may provide greater insight in the long term effects of AA calcium intake, bone health and risk of fractures.

From this extensive research, it is understandable and reasonable to lower calcium and/or vitamin D recommendations for AA in comparison to Caucasians due to AA’s increased calcium absorption efficiency at lower intakse, while continuing to promote the importance of bone health education.   By explaining the AA physical differences– lower bone mass, bone quality-including shorter femoral neck axis length (FNAL) and hip axis length (HAL) and/or differences in soft tissue thickness, this may curb fears about suboptimal calcium intake.3,6, 12,15Additionally, it would be helpful to recommend additional dairy rich calcium products as many AA obtain calcium from orange juice, soy products and dark leafy green vegetables..19 These recommendations would be appropriate to enhance the AA diet.  While the AA bone biology and cultural differences physically provide a protective layer against osteoporosis even at lower calcium intakes than other ethnic groups, adequate bone health education should be provided to this particular population.

 

Photo Credit:Vegan American Princess, Asian American Business Expo and Pointe Med

References

  1. Boutroy S, Walker MD, Liu XS, et al. Lower cortical porosity and higher tissue mineral density in chinese american versus white women. Journal of Bone and Mineral Research. 2014;29(3):551-561.
  2. Burrows M, Jones A, Mirwald R, Macdonald H, McKay H. Bone mineral accrual across growth in a mixed-ethnic group of children: Are asian children disadvantaged from an early age? Calcified Tissue International. 2009;84(5):366-378.
  3. Cong E, Walker M. The chinese skeleton: Insights into microstructure that help to explain the epidemiology of fracture. Bone Research. 2014;2.
  4. Crespo N, Yoo E, Hawkins S. Anthropometric and lifestyle associations of bone mass in healthy pre-menopausal Mexican and Asian American women. Journal of Immigrant and Minority Health. 2011;13(1):74-80.
  5. CROSS NA, KIM KK, YU ESH, CHEN EH, KIM J. Assessment of the diet quality of middle-aged and older adult korean americans living in chicago. J Am Diet Assoc. 2002;102(4):552-554.
  6. Finkelstein J, Lee M, Sowers M, et al. Ethnic variation in bone density in premenopausal and early perimenopausal women: Effects of anthropometric and lifestyle factors. J Clin Endocrinol Metab,. 2002;87(7):3057-3067.
  7. Jackson K, Savaiano D. Lactose maldigestion, calcium intake and osteoporosis in african-, asian-, and hispanic-americans. Journal of the American College of Nutrition. 2001;20(2):198S-207S.
  8. Khandewal S, Chandra M, Lo JC. Clinical characteristics, bone mineral density and non-vertebral osteoporotic fracture outcomes among post-menopausal U.S. south asian women. Bone. 2012;51(6):1025-1028.
  9. Nam H, Shin H, Zmuda J, et al. Race/ethnic differences in bone mineral densities in older men. Osteoporos Int. 2010;21:2115-2123.
  10. Opotowsky S. Dietary calcium intake, fractional calcium absorption, urinary calcium excretion, and levels of calcitropic hormones and bone markers in young, healthy chinese-american and caucasian women .DORIS DUKE MEDICAL STUDENTS’ JOURNAL. 2001-2002;I:44-50
  11. Renzaho AMN, Halliday JA, Nowson C. Vitamin D, obesity, and obesity-related chronic disease among ethnic minorities: A systematic review. Nutrition. 2011;27(9):868-879.
  12. Sowers M, Zheng H, Greendale G, et al. Changes in bone resorption across the menopause transition: Effects of reproductive hormones, body size, and Ethnicity. J Clin Endocrinol Metab. ;98(7):2854-2863.
  13. Thomas P. Racial and Ethnic differences in osteoporosis J Am Acad Orthop Surg. 2007;15(1):S26-S30.
  14. Tung W. Osteoporosis among asian american women. Home Health Care Management & Practice. 2012;24(4):205-207.
  15. Walker MD, Liu XS, Zhou B, et al. Premenopausal and postmenopausal differences in bone microstructure and mechanical competence in Chinese-American and white women. Journal of Bone and Mineral Research. 2013;28(6):1308-1318.
  16. WIECHA JM, FINK AK, WIECHA J, HEBERT J. Differences in dietary patterns of vietnamese, white, african-american, and hispanic adolescents in worcester, mass. J Am Diet Assoc. 2001;101(2):248-251.
  17. Wu L, Martin BR, Braun MM, et al. Calcium requirements and metabolism in chinese-american boys and girls. Journal of Bone and Mineral Research. 2010;25(8):1842-1849.
  18. Yin J, Zhang Q, Liu A, et al. Factors affecting calcium balance in Chinese adolescents. Bone. 2010;46:162-166.

Black Bean Brownies


IMG_8358By: Nikki Nies

What would you say if I told you that to make brownies I need chocolate AND black beans?! Shocked? Surprised? Agreeable?

I admit, the first time I heard about this combination, I scrunched my face. Like many, I head to the dessert section of the restaurant menu to satisfy my sweet tooth, not for BEANS! Yet, during my latest rotation at Illinois’ Will County Women, Infants and Children Clinic, I had the opportunity to not only do a food demo, but to show women and children how they can use their dried beans that they may receive with their coupons in a guilt free, delicious manner!

nko[nk]o

 

 

—–>

 

 

Preparing: place black beans in a colander, sort thoroughly and remove any tiny pebbles; rinse under cold water

How to soak: the larger the bean, the longer they need to soak. The longer you soak the beans, the faster they cook.  Soaking beans allows dried beans to absorb water, which begins to dissolve the starches that causes intestinal discomfort. Soak beans in 3x their volume of cold water for 6 hours before cooking.

  • 1/3 cup dry beans=1 cup cooked beans
  • 1/2 cup dry beans=1 1/2 cup cooked beans
  • 2/3 cup dry beans=2 cups cooked beans
  • 1 cup dry beans=3 cups cooked beans
  • 2 cups/1 lb. dry beans=6 cups cooked beans

Black Bean Brownies

Prep Time: 15 minutes Cook Time: 20 minutes Servings: 12 Serving: 1/12 of recipe

Ingredients

  • 1 can (15 ounces) black beans, rinsed and drained
  • 1/2 cup semisweet chocolate chips, divided
  • 3 tablespoons canola oil
  • 3 eggs
  • 2/3 cup packed brown sugar
  • 1/2 cup baking cocoa
  • 1 teaspoon vanilla extract
  • 1/2 teaspoon baking powder
  • 1/8 teaspoon salt

1. Mash  beans, 1/4 cup chocolate chips and oil with a fork

2. Add eggs, brown sugar, cocoa, vanilla, baking powder and salt; cover and process until smooth.

2. Transfer to a 9-in. square baking pan coated with cooking spray.

3. Sprinkle with remaining chocolate chips. 3. Bake at 350°F for 20-25 minutes or until a toothpick inserted near the center comes out clean. Cool on a wire rack. Cut into bars.

Adapted from TasteofHome

Nutrition Facts per serving: 115 calories; 2.6 g of fat; 15 g carbohydrates; 2.9 g of protein

Black Bean Brownies with Mix

Prep Time: 10 minutes Cook Time: 25 minutes Servings: 12 Serving: 1/12 of recipe

Ingredients:

  • ½ 15 oz. can black beans, rinsed and drained
  • ½ package brownie mix
  • ½ cup water
  • ½ cup chocolate chips, divided
  1. Preheat oven to 350°F. Lightly grease a 9×13 inch baking dish
  2. Mash black beans and water together until smooth.  Pour into a bowl.
  3. Stir brownie mix into black bean mixture until batter is smooth; fold in ¼ cup chocolate chips.
  4. Pour batter into prepared baking dish. Sprinkle remaining ¼ cup chocolate chips over batter.
  5. Bake in preheated oven until a toothpick inserted two inches from side of pan comes out clean, 25-27 minutes. Cool brownies completely on a wire rack before cutting into squares.

Adapted from AllRecipes

Nutrition Facts per serving: 150 calories; 5.6 g of fat; 25 g of carbohydrates; 2.3 g of protein

Nutrition Benefits of black beans:

  • ½ cup serving contains 113 calories
  • 1 cup serving of black beans ~15 grams of fiber and 15 grams of protein
  • Boost iron intake: 3.6 mg iron per cup
  • Folic acid, magnesium and potassium rich
  • 0 saturated fat

While the black bean brownies with mix recipe is great to have to have on hand with a time crunch, do you see a difference in nutrients between the black bean brownie recipe made from scratch and from the box? Have you tried black bean brownies before? What other ways have you added black beans into your dishes?

Photo Credit: Health and Happy Herbivore

Sources:http://healthyeating.sfgate.com/eating-black-beans-good-you-3605.html

http://www.webmd.com/diet/features/beans-protein-rich-superfoods

http://www.healthdiaries.com/eatthis/6-health-benefits-of-black-beans.html

http://www.healwithfood.org/health-benefits/black-beans.php

KYF2


By: Nikki Nies KnowYourFarmer_KnowYourFood

Know Your Farmer, Know Your Food (KYF2) Initiative launched in 2009, has the mission of strengthening the critical connection between farmers, consumers, local and regional food systems.

Utilize the KYF2 Compass map to understand the efforts supported by the USDA and its partners. The interactive map includes data and resources on all your farm to table needs!

Photo Credit: Charity Jen

Sources: http://www.ams.usda.gov/AMSv1.0/getfile?dDocName=STELPRDC5097957

http://www.usda.gov/wps/portal/usda/knowyourfarmer?navid=KNOWYOURFARMER

http://www.usda.gov/wps/portal/usda/usdahome?navid=KYF_COMPASS

http://sustainableagriculture.net/blog/usda-know-your-farmer-compass-expanded/

 

Making Perfect Rice Everytime


By: Nikki Nies fluffy-rice

Whenever I tell someone I use the oven to cook my rice they do a double take. No, I don’t use a rice cooker or stove top, but this route of rice cooking has been a tried a true way!

Pre-heat oven to 350°F. In a greased, covered oven-proof casserole, put one-cup white* rice, two-cups water, one Tablespoon butter, one teaspoon salt. Cover, bake for 50 minutes. Fluff with fork.
*Brown or black rice takes longer; if not done in 50 minutes, bake ten minutes longer. Experience will tell you exactly how long it will take.

Thanks mother for this fool proof way of making rice!

Photo Credit: Feminiya