Ketogenic Diets


By: Nikki Nies

While the title of this blog post is “Ketogenic Diets”, the word ‘diet’ may be presumed to be synonymous with the Atkins diet.   Yet, the word ‘diet’ may be misperceived in this instance. imagesTherefore, for this post, diet means medical nutrition therapy. Those with nervous system or neurological disorders (i.e. epilepsy) could benefit from ketogenic consumption.

The ketogenic diet is comprised of high fat, low carbohydrate intake.  Since ketone bodies behave as inhibitory neurotransmitters, mild dehydration is needed to prevent dilution of ketones.  A 4:1 ratio of fat to non-fat grams is recommended. A ketogenic diet contains 70-90% fat and the remainder as protein and carbohydrates.

One will also need calcium, vitamin D, folate, vitamin B6 and B12 supplements. MCTs are more ketogenic, more rapidly metabolized and absorbed. MCTs alleviate some of the obstacles of compliance and acceptance. Patients and clients should be aware that this high fat diet can lead to slower growth, even with overall calorie restriction, which is supposed to increase efficacy of ketogenic diet.

The ketogenic diet mimics the fasting state and has been found to successfully treat seizures. However, it may be unpalatable. Stimulants, like coffee, tea, colas and alcohol are to be limited.  With an adequate amount of fiber and fluid, this can aid in the relief of constipation.  A gradual change is diet is advised and it’s important  to note cough syrups, laxatives and certain medications can contain large amounts of carbohydrates, so one should monitor interactions with the diet.

Furthermore, with a high fat diet, this can lead to nausea and vomiting. A small drink of fruit juice can mediate such symptoms. If you’re in the need to increase long chain triglycerides, by adding sour cream, whipped cream, butter, margarine and/or oils can be added to desserts, casseroles and entrees. To use MCT, it’s advised to use in salad dressings, fruit juice, sandwich spreads (i.e. guacamole) and casseroles.

If you’re apprehensive about the ketogenic diet, a low glycemic index is considered a less strict route, with more liberal total carbohydrate intake. If hyperuricemia or hypercalciuria, increase fluid intake and consider using diuretics.

Photo Credit:Lurie Children’s

Sources:http://www.ketogenic-diet-resource.com/ketogenic-diet-plan.html

http://www.uwhealth.org/healthfacts/nutrition/517.html

http://www.ncbi.nlm.nih.gov/pubmed/19049580

http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/dietary-therapies/ketogenic-diet

Milk Substitutes


By: Nikki Nies

For hundreds of years, milk derived from animals only, such as cow’s, sheep and goat. Yet, with lactose intolerance, maldigestion and the preference for non-dairy sources of milk emerging in recent years, the market and need for milk substitutes as increased multifold. Like there are differences in whole milk, 2% and skim milk, the nutrition content, flavor, color and texture of non-dairy milks–soy, rice, oat, 7 grain, hazelnut, hemp, almond and coconut vary.

 

Milk Type Description Texture/consistency Nutrients–1 cup Use
Whole great source of vitamin D, B12 and calcium 147 calories; 8.1 g fat; 98 mg sodium; 12.9 g carbs; 12.9 g sugar; 7.9 g protein; 276 mg calcium; 349.4 mg potassium; 98 IU vitamin D
1% great source of vitamin D, B12 and calcium 91 calories; 0.7 g fat; 130 mg sodium; 12.3 g carbs; 12.3 g sugar; 8.7 g protein; 316.2 mg calcium; 419.1 mg potassium; 98 IU vitamin D
Soy–plain obtained from soy bean; closest option to cow’s milk; contains vitamin B12 and D; processed; can be high in sugar; comes in sweetened, unsweetened and flavored varieties such as chocolate and vanilla creamy 100 calories; 4 g fat; 120 mg sodium; 8 g carbs; 6 g sugar; 7 g protein; 300 mg calcium; 300 mg potassium; 119 IU vitamin D vegan–baking, coffee, as is, cereal
Almond made from ground almonds, water and sweetener; has ⅓ of calories as 2% milk; magnesium and protein content is good for bone strength; contains less sugar than soy or rice milk; tends to be high in sodium; contains vitamins A, D & E; low in protein; higher in fat than skim milk thick 60 calories; 2.5 g fat; 150 mg sodium; 8 g cars; 7 g sugar; 1 g protein; 200 mg calcium; 180 mg potassium; 100 IU vitamin D cereal, coffee, sipping, baking
Coconut richest, creamiest of all milk alternatives; when purchased in a carton, tends to have a lower fat content and is not as creamy as in can form; high in saturated fat and calories thick, creamy 80 calories; 5 g fat; 30 mg sodium; 7 g carbs; 6 g sugar; 1 g protein; 450 g calcium; 40 g potassium; 100 IU vitamin D ice cream, Thai curry, moistens cakes; coffee; tea
Hemp best for those with nut or soy allergies; rich in omega 3 fatty acids; low in saturated fat; mixture of hemp seeds  and water; contains essential amino acids; fortified with vitamin D and A; low in protein thick, creamy; “earthy” 100 g calories; 6 g fat; 110 mg sodium; 9 g carbs; 6 g sugar; 2 g protein; 300 mg calcium; N/A potassium; 100 IU vitamin D smoothies; porridge; baking; cereals
7 Grain–original Oats, Brown Rice, Wheat,  Barley, Triticale, Spelt and Millet thin 140 calories; 2 g fat; 27 g carbs; 3 g protein; 115 mg sodium; 125 mg potassium biscuits, smoothies and cereals
Hazelnut considered “more agreeable” in flavor with coffee; supposedly “froths” better thin 110 calories; 3.5 g fat; 120 mg sodium; 16 g carbs; 0 g sugar; 2 g protein coffee, baking, vegan cooking
Oat Void of cholesterol and saturated fats; high in fiber, iron; contains phytochemicals, which can protect against heart disease and some cancers; must be avoided by those that need to adhere to gluten free diet thick and grainy 130 calories; 2.5 g fat; 24 g carbs; 110 mg sodium; 19 g sugar; 120 mg potassium on its own as a beverage, cereal, gravy, cupcakes, hearty cookies
Rice most hypoallergenic option of all milk alternatives; good for blood pressure due to niacin and vitamin B6 content; low in protein; not recommended for diabetics; highly starchy; often enriched with calcium, vitamin A & D watery, thin 70 calories; 2.5 g fat; 80 mg sodium; 23 g carbs; 10 g sugar; 1 g protein; 300 mg calcium; 0 mg potassium; 100 IU vitamin D oatmeal, smoothies and cereals–not recommended to be used in baking or cooking due to watery texture

With cow’s milk allergy reported to be the largest allergy in infants and children, it’s safe to say that these milk substitutes are a valuable resource. What’s your experience with these different milks? Have a particular preference you want to share? If you’re up to the challenge, why not make your own milk?
Sources: http://www.medicalnewstoday.com/articles/273982.php

http://www.eatingwithfoodallergies.com/milksubstitutes.html

http://www.wellnesstoday.com/nutrition-recipes/which-nut-milk-is-right-for-you

http://www.latimes.com/food/dailydish/la-dd-is-hazelnut-milk-the-new-almond-milk-20140416-story.html

https://www.behance.net/gallery/2681739/Primer-Milk-Alternatives

http://www.pacificfoods.com/food/non-dairy-beverages/nut-grain-beverages/organic-7-grain-original.aspx

https://www.behance.net/gallery/2681739/Primer-Milk-Alternatives

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.

Sprinkles Fortified Supplement


packages_sprinklesBy: Nikki Nies

Nearly 300 million children are impacted anemia, with parents finding their children listless and prone to illness.   With damage in the first 1000 days of life to a badly malnourished child is irreversible. In the late 1990s, UNICEF introduced Sprinkles, which were created by Dr. Stanley Zlotkin. Dr. Zlotkin is a professor of pediatrics, nutritional sciences and public health.  Sprinkles is an innovative treatment for the treatment of anemia in children under the age of five, formed of zinc.

Prior to the creation of Sprinkles, the normal treatment was the unpleasant, unflavorful iron supplements via pill or syrup.  Sprinkles is a specially coated, powdered supplement in the form of rice or corn porridge without the untasty flavor.

Regulation of iron absorption is two fold: dietary and store regulator.  There is a short term increase in dietary iron that’s not avidly absorbed and while iron stores increase in liver, hepicidin is released.  Hepcidin is a hepatic peptide that diminishes intestinal mucosal iron ferroportin release.  As body iron stores fall, hepcidin decreases and intestinal mucosa’s signaled to release absorbed iron into circulation.  Dietary citrate and ascorbate from citrus foods can also impact absorption, by forming complexes with iron that increase abruption while tannins found in tea decrease absorption.

The supplements are provided through UNICEF and the Centers for Disease Control and Prevention. The Sprinkles fortified food supplement is provided to those between the ages of six months to two years old and to all pregnant and lactating women.  Those younger than six months are encouraged t be exclusively breast fed in accordance with WHO guidelines for breast feeding. In the past, Sprinkles was delivered in the form of drops, but due to complains of stain to teeth and inability for many parents to “know” how many drops to use due to illiteracy, these supplements are provided in the form of a pap for infant and in drink form for women This is supplement is designed to treat and prevent anemia.  In addition, the amount of vitamin D in Sprinkles is meant to meet the RDI for vitamin D, which in turn is able to prevent rickets.

Additionally, stool color in infants that use Sprinkles are known to change to a dark or black color as iron itself is dark in color.  Sometimes some quantities are left unabsorbed and the iron is excreted in the stool, causing the change in color.

Therefore, due to the positive impact of the Sprinkles implementation into children’s nutrition profile, iron is my favorite micronutrient as it can mean the difference between life or death.  Iron’s mainly absorbed in the duodenum and upper jejunum, with divalent metal transporter 1 (DMT1) facilitating the transfer of iron across epithelial cells.  With the help of ferroportin in the bloodstream, this is released within the enterocyte and is bound in bloodstream by transferrin, a transport glycoprotein.  There is an equal balance of storage and use of iron, with half of absorbed iron put into storage pool in cells, while other half is recycled into erythropoiesis.

Photo Credit: SGHI

1. Worldwide programs. Sprinkles Global Health Initiiative Web site. http://www.sghi.org/worldwide_program/mexico_pg1.html. Accessed 10/24/14, 2014

2. Loewenberg S. Easier than taking vitamins. NYTimes Web site. http://opinionator.blogs.nytimes.com/2012/09/05/easier-than-taking-vitamins/?_php=true&_type=blogs&_r=0. Published 9/5/12. Updated 2012. Accessed 10/21, 2014

3. O’Brien TX. Iron metabolism, anemia, and heart failure. J Am Coll Cardiol. 2011;58(12):1252-1253.

4. Rambousková J, Krsková A, Slavíková M, et al. Trace elements in the blood of institutionalized elderly in the czech republic. Arch Gerontol Geriatr. 2013;56(2):389-394.

Great Meals for One!


Handsome black man preparing salads in a modern kitchen.By: Nikki Nies

Several of my friends and family, including my parents, struggle with making meals that they can adequately eat since many of them are either not big eaters and/or would be cooking for one.  While I personally don’t struggle with making too many quantities of food as I love not having to cook every night, I can understand why the extra leftovers can be daunting.

In case you need tips on what to do with leftovers, you’re in luck! There’s tons of ways to reduce spoilage and to make your meals last longer.  However, if you need further incentive to get in the kitchen instead of opting for take out or a bowl of cereal, let me direct you to some worthwhile tips!

The best part of cooking for yourself? You get to eat what you want, how you want without any compromises!  Yes, there may be more freedom in the kitchen in terms of artistic creativity, but it doesn’t mean you have to throw out all you’ve learned regarding healthy cooking!

  • Utilize your muffin pan for more than just muffins! Whip up some rice and/or barley, making individualized portions using your muffin tin
  • Have leftover bread or English muffins? Wrap the leftovers up tightly in a sandwich bag to prevent freezer burn and/or use some of the leftover bread to make croutons or for dipping
  • Head to a bulk warehouse store, such as BJ’s, Sam’s Club or Costco and stock up to decrease waste and often times less expensive per pound.  Bulk produce is only worth the investment if the quantity is a realistic amount for you to consume before spoilage.
  • Opt for frozen fruits and veggies, which are often times more convenient and last longer than fresh food.  Make sure to choose frozen packages that do not have added sauces, syrup or sugar
  • Enjoy the more perishable produce, such as berries and spinach, earlier in the week.  Heartier produce such as carrots, cabbage and potatoes can be eaten later in the week
  • Make sure to always have eggs on hand! They’re a great addition to many dishes and contain a great amount of vitamin D and choline
  • Take the plunge and buy a whole package of meat and/or poultry, wrap in individual portions, date and freeze!

I’ve found the best part of cooking for myself is that I’ve gotten quite well acquainted with my freezer.  I don’t have to worry about rushing home to get dinner on the table, but when I make a casserole or have leftover soup, I can individually package the leftovers to get out for a later date.

For those of you cooking for yourselves, what tips have you found to make cooking hassle free?

Sources: http://www.eatright.org/Public/content.aspx?id=6442477582

http://greatist.com/health/healthy-single-serving-meals

http://www.helpguide.org/life/cooking_for_one_fast_easy_healthy.htm

http://www.usa.gov/Citizen/Topics/Health/Recipes.shtml

MyPlate for Older Adults


mpoaEnglishFrontSmall2

Source: http://fycs.ifas.ufl.edu/extension/hnfs/enafs/MyPlate.php

Guide to Vitamins


vitamin-chart-final

Source: http://www.huffingtonpost.com/2014/08/14/vitamins-in-food-infographic_n_5678662.html?utm_hp_ref=food&ir=Food