Food & Nutrition Magazine

Gardening Made Easy with the Veritable Exky Classic Garden

Andrea Mathis — Tue, 07 Jun 2022 10:00:26 +0000

Product reviewed: Veritable Exky Classic Garden

I absolutely love fresh herbs. They are a simple way to completely change the flavor profile of a dish. Because I love fresh herbs so much, I tried to grow my own in my backyard — which didn’t go that well. I often forgot to water them or make sure they were receiving the adequate amount of sunlight. And because of this, they eventually died. When I heard about the indoor Veritable Exky Classic Garden, I was so excited to try it.

The Veritable Exky Classic Garden is the smallest and most efficient indoor garden that allows you to effortlessly grow herbs and vegetables in your kitchen. When I first opened the package, I was pleasantly surprised by its chic appearance. Its ultra-compact and sleek design makes it a great fit in any kitchen and was the perfect addition to my counter. Everything was included in the packaging: sweet basil and parsley lingots (perfectly sized pieces of soil with seeds and nutrients to help herbs grow), instructions and even labels for the herbs. It took less than five minutes to set everything up.

It was very easy to put together the garden. Once I placed the lingots into their proper places and added water, all I had to do was plug it in and watch it grow. Because of the machine’s advanced technology, I was able to see growth in a few short weeks. When growing my own herbs outside, I didn’t notice this type of growth until several weeks after planting the seeds.

My kids really enjoyed seeing the herbs grow, which made this garden a great family activity. Because this in an indoor garden, it utilizes high-efficiency LED light, which guarantees faster plant growth while activating essential oil production to provide rich flavors. The Exky Classic Garden has an automated day and night cycle; it turns on for 16 hours and goes off for eight hours. It also has a built-in water tank that allows for automatic watering for up to three weeks.

Be sure to keep the Exky Classic Garden out of reach from any pets. I made the mistake of placing it on the floor and my dog decided to have a little fun playing in the soil. I was able to salvage the garden, but it was definitely a lesson learned!

Overall, I think the Veritable Exky Classic Garden is a great product for those who want a hassle-free herb garden. It requires very little maintenance and is a great experience for the whole family. Once the herbs are fully grown, my kids and I plan to make our very own pesto!

Nutrition for People with Lung Cancer

Ginger Hultin — Fri, 27 May 2022 16:35:47 +0000

Lung cancer is the third most common cancer in the country and is the leading cause of cancer-related death worldwide. Over the past 20 years, lung cancer rates in the U.S. — as well as the death rate — have been declining and the five-year survival expectancy is trending up. However, data collected from 2012 to 2018 shows lung cancer has a much lower survival rate for people in the U.S. (22.9%) compared to five-year survival estimates for other types of cancers, such as “female breast cancer” (90.6%) or cancer of the prostate (96.8%). That being said, survival rates vary based on stage of diagnosis with better rates for those with early diagnosis and localized disease (cancer has not spread) and much lower rates for advanced disease.

There are two main types of lung cancer: non-small cell lung cancer, or NSCLC, and small cell lung cancer, or SCLC. NSCLC includes large cell and squamous cell carcinomas and adenocarcinoma and accounts for 80% to 85% of lung cancers. Accounting for 10% to 15% of all lung cancers, SCLC also is called “oat cell cancer” and tends to grow and spread faster than NSCLC. Other subtypes of NSCLC, such as adenosquamous and sarcomatoid carcinomas, are much less common.

Lung Cancer Risk Factors

While a reduction in tobacco smoking is one reason for positive changes in lung cancer rates, there are many other risk factors including exposure to secondhand smoke; use of beta-carotene supplements by heavy smokers; family history of lung cancer; HIV/AIDS infection; and environmental risk factors such as radiation therapy, imaging tests including CT scans and radon exposure.

Although supplementing with beta carotene is a risk factor for people who smoke, there is evidence that eating more foods containing carotenoids can help decrease lung cancer risk. Studies have shown an inverse relationship between the consumption of a combination of fruit and vegetables and a lower risk of lung cancer. The same protective relationship has been associated with higher fruit intake, but studies evaluating vegetable consumption have yielded inconsistent results. Other research shows that a traditional Mediterranean dietary pattern may lower risk of developing lung cancer and that foods containing isoflavones may decrease risk in people who have never smoked. Limited research suggests those who are physically active may have a decreased risk of lung cancer.

Role of RDNs

Since both diet and physical activity may play a role in decreasing the risk of lung cancer, registered dietitian nutritionists can guide patients and clients regarding interventions and advice related to food, nutrition, dietary supplements and lifestyle factors. RDNs are critical members of the interdisciplinary cancer health care team and should assess patients with lung cancer diagnoses for malnutrition. Evidence has shown positive outcomes when RDNs provide medical nutrition therapy to adult cancer patients who are undergoing chemotherapy or radiation treatment. Nutritional interventions — especially during treatment — are key, and RDNs play a crucial role in helping to manage any potential side effects.

According to Dolores D. Guest, PhD, RD, a research assistant professor in the department of internal medicine’s division of epidemiology, biostatistics and preventive medicine at the University of New Mexico School of Medicine and director of the Behavioral Measurement and Population Science Shared Resource at the UNM Comprehensive Cancer Center, the location or type of lung cancer could cause several abnormalities and syndromes such as hypercalcemia, anemia, Cushing’s syndrome and others that need nutritional intervention. “It’s not uncommon for one thing to be resolved and another to appear,” Guest says. “Working with an RDN throughout treatment is very important for these patients.”

Oncology dietitian Tricia Cox, MS, RD, CNSC, LD, who works at Baylor Scott & White Medical Center in Dallas, Texas, explains that in her oncology research, many RDNs may have to focus their time on patients with head and neck cancer or esophageal tumors. The research Cox has helped to conduct shows RDNs are often understaffed in outpatient oncology settings and many of them must focus on the most critically ill patients. “While this is good for [critically ill] patients, RDNs are often unable to adequately see all of the patients who need to be seen,” she says. “This could include patients with lung cancer.”

While other members of the medical team serve critical roles, an RDN is qualified to understand the science of lung cancer and how treatment interplays with nutritional status. “RDNs are trained to be able to mitigate these effects in a very personal way, providing individualized advice so patients can make both incremental and overall improvements,” Guest says. Her research shows that the key role RDNs serve in treating high nutrition-risk cancer patients, such as those with lung cancer, is more appreciated by fellow oncology team members than ever before. “Oncologists and nurses really value and have come to rely on RDNs to be the experts when it comes to assessing and working with patients to meet their nutritional needs.”

Assessing Nutrition and Nutrient Needs

About 45% to 69% of people with lung cancer experience malnutrition, which is associated with reduced quality of life, increased symptom severity and shorter survival rates. Concurrent chemotherapy and radiation, radiation to the esophageal region and being classified with stage 3 or 4 cancer all increase the risk of malnutrition. Evidence supports using the Malnutrition Screening Tool to assess for malnutrition(undernutrition) in adults; the Academy and the American Society for Parenteral and Enteral Nutrition have released a joint consensus statement that serves as a guide for assessing malnutrition (undernutrition) in adults who may be at risk.

Guest emphasizes that malnutrition screening is crucial for people with lung cancer and should be conducted at diagnosis and at regular intervals using validated instruments without modifications. The Malnutrition Screening Tool and the Patient-Generated Subjective Global Assessment are both recognized by the Academy’s Evidence Analysis Library as being valid and reliable tools for “identifying malnutrition risk in adult oncology patients” and within inpatient and outpatient settings. “Nutrition issues that are addressed proactively — not reactively — set the patient up for the best possible outcome,” Guest says.

Nutrition therapy for people who have undergone treatment, such as radio or chemotherapies, is critical. Published in 2021, a systematic review of 25 studies suggests that taste function can be impaired as early as three weeks into radiotherapy treatment and can remain impaired for three to 24 months after treatment. For people undergoing chemotherapy, impaired taste function varied and was less predictable, according to the authors, and could occur within days of treatment. A few studies also included patient reports of experiencing reduced appetite and dietary intake.

In general, nutrient needs per day for those with lung cancer can range from 25 to 30 calories per kilogram of body weight and 1 to 1.5 grams of protein per kilogram of body weight. RDNs should complete ongoing nutrition assessments for patients or clients with lung cancer throughout treatment and adjust calorie and protein recommendations as needed. Pay close attention to symptoms that may impact nutrition, such as early satiety, nausea and vomiting, diarrhea or constipation, and oral problems such as altered taste, pain, dysphagia, dry mouth, problems chewing or mouth sores, as these can reduce the patient’s ability to meet nutrition needs.

Dietary Strategies

Because people with lung cancer are at an increased risk of malnutrition, RDNs can help patients and clients maintain body weight and protect lean body mass.

“Lung cancer is often diagnosed at a later stage,” Guest says. Weight loss is very common for these patients, and it can occur or be exacerbated by factors such as the location of the tumor, metastasis or treatments including surgery, radiation and chemotherapy and immunotherapy medications. “RDNs work with these patients and their caretakers or families to mitigate the effect of malnutrition on their bodies, which can help them withstand long-term treatment and improve medical outcomes and quality of life.”

Preventing severe loss of muscle mass, or sarcopenia, is a top priority. Studies have shown 47% to 61% of patients already have sarcopenia before they start chemotherapy or chemoradiation therapy, respectively, for lung cancer. Additionally, sarcopenia increases adverse outcomes and mortality rates in those with cancer and is a hallmark of cancer cachexia, which is a multifactorial syndrome often associated with reduced food intake, systemic inflammation, and catabolic metabolism characterized by weight loss greater than 5% in the past six months (not related to simple starvation) or a body mass index under 20 with any degree of weight loss more than 2%, or muscle wasting consistent with sarcopenia (as indicated by the appendicular skeletal muscle index) and any degree of weight loss more than 2%. Nutrition for any patient with cancer cachexia increases up to 35 calories per kilogram of body weight per day and up to 2.5 grams of protein per kilogram of body weight per day.

Research shows nutritional counseling can help increase food intake in people with cancer-related weight loss. Some data also shows patients who followed nutrition counseling advice while being treated for head and neck cancer experienced better health outcomes such as increased muscle mass and survival rates. Unfortunately, some studies have shown that only 50% to 61% of patients who receive nutritional counseling are able or willing to follow an RDN’s advice due to a multitude of barriers. A recent study that included “dietitian-identified barriers” for patients with advanced forms of cancer and cachexia revealed that non-symptom related barriers — such as restrictions from a prior medical diagnosis, conflicting nutrition information or lack of motivation — were cited as barriers more often than those associated with symptoms.

In one study of 310 patients with lung cancer, those with better nutritional status had better emotional and social functioning as well as less severe symptoms including fatigue, nausea, vomiting, pain, dyspnea, loss of appetite, coughing, mouth or tongue pain, difficulty swallowing and hair loss. The most significant differences between the patients with normal nutritional status compared to the patients at risk of malnutrition or considered to be malnourished (based on the Mini Nutritional Assessment questionnaire) were improvements in insomnia, diarrhea, shortness of breath, tingling in the hands or feet, and chest, arm or shoulder pain.

For people identified as at risk of or diagnosed with malnutrition, RDNs can provide education on dietary strategies such as encouraging meals and snacks dense in calories and protein and ways to meet vitamin and mineral needs. Small, frequent meals and snacks can be helpful if appetite or intake is poor. Because many patients undergoing treatment for lung cancer may have trouble swallowing or have pain in the esophagus, texture modification may be needed.

Depending on the type of treatment, tube feeding or, in some cases, parenteral nutrition may be needed. Parenteral nutrition can be used if the gastrointestinal tract is not functioning or is not accessible, such as with a blockage in the digestive tract. Artificial nutrition in the form of enteral nutrition may be warranted if a patient isn’t able to meet their needs through diet alone. Enteral nutrition should be strongly considered if the patient is unable to eat food for a week or longer or if they only meet 60% or less of their needs through food for more than two weeks. It also should be considered if the patient is malnourished and has poor oral intake. For patients with other types of cancer (such as gastrointestinal), evidence shows nutrition interventions including modified oral diets and parenteral and enteral nutrition have the potential to not only improve outcomes, but also generate millions of dollars in cost savings annually.

Dietary Supplements

Especially for those at risk for malnutrition and not meeting nutrient needs through food, it is wise to educate patients on appropriate and safe use of dietary supplements when warranted.

Omega-3 Fatty Acids

Omega-3 fatty acid supplementation may be helpful in maintaining weight and muscle mass, especially for those with advanced NSCLC undergoing chemotherapy. Potential benefits of omega-3 fatty acid supplements for those with lung cancer may include reduced inflammation and less severity of chemotherapy-induced oral and esophageal mucositis. However, more research is needed. Additional benefits include a potential reduction of peripheral neuropathy from chemotherapy drugs or increased effects/clinical benefits of other medications used in cancer treatment.

Possible Risks of Antioxidant Supplements

Research has shown that taking beta-carotene supplements increases the risk of lung cancer in people who smoke, especially one or more packs per day. Risk is further compounded in people who smoke and drink one or more alcoholic beverages per day.

Results from animal studies show that supplementing with N-acetylcysteine, or NAC, accelerates tumor progression, but more research is needed to support these findings in humans. Other studies indicate that both NAC and antioxidant vitamin E may promote cancer metastasis because they reduce the natural reactive oxygen species that cancer cells produce, which opens a path to tumor progression. This has been shown in both human and mouse lung cancer cell study models

Also, antioxidants may reduce enzyme activity designed to promote apoptosis (the process of programmed cell death). Conversely, some research on NAC based on in vitro studies with bromelain and gastrointestinal cancer cells indicates NAC may be used to enhance the cytotoxic effects of chemotherapy drugs while protecting host tissues from the drugs’ toxicity. However, supplements that contain NAC are technically illegal at this time due to being excluded from the Federal Food, Drug, and Cosmetic Act’s definition of a dietary supplement. NAC is available as a prescription drug, and the U.S. Food and Drug Administration is evaluating whether certain NAC-containing products can be lawfully marketed as dietary supplements in the future. The Natural Medicines database by TRC Healthcare also indicates NAC is currently “considered an unlawful ingredient in dietary supplements” and is “likely ineffective” for lung cancer.

The Vital Role of RDNs on the Cancer Care Team

RDNs working with lung cancer patients can provide nutritional counseling, supplement guidance and lifestyle modification suggestions to help improve outcomes. New research and analysis published in two articles in the February 2021 Journal of the Academy of Nutrition and Dietetics highlight the role nutrition may play in cancer risk and treatment, as well as the barriers cancer survivors face in maintaining a healthful diet.

According to one of the articles, American adult lung cancer survivors with obesity (ages 30 to 64 and current smokers) had a diet quality score that was significantly lower compared to the reference group, based on data from the National Health and Nutrition Examination Surveys from 2005 through 2016. In the study, adherence to the 2015-2020 Dietary Guidelines for Americans — specifically the dietary recommendations for whole grains, greens and beans, sodium and fatty acid — had “less than 50% of the maximum possible scores” based on the Healthy Eating Index 2015, which is a measure of diet quality. RDNs play an important role in providing nutrition education so cancer survivors can better meet these guidelines.

References

2020 Standards and Resources. The American College of Surgeons website. https://www.facs.org/quality-programs/cancer/coc/standards/2020. Updated December 6, 2016. Accessed March 25, 2022.
Cancer Stat Facts: Breast Cancer. National Institute of Health National Cancer Institute website. https://seer.cancer.gov/statfacts/html/breast.html. Accessed May 3, 2022.
Cancer Stat Facts: Lung and Bronchus Cancer. National Institute of Health National Cancer Institute website. https://seer.cancer.gov/statfacts/html/lungb.html. Accessed May 3, 2022.
Cancer Stat Facts: Prostate Cancer. National Institute of Health National Cancer Institute website. https://seer.cancer.gov/statfacts/html/prost.html. Accessed May 3, 2022.
Center for Evidence and Practice Improvement. Agency for Healthcare Research and Quality. https://www.eatrightpro.org/-/media/eatrightpro-files/news-center/on-the-pulse/regulatorycomments/academy-comments-to-ahrq-sead-nutrition-for-improved-cancer-outcomes.pdf?la=en&hash=4A8664E51C13992B1E2A9668CC912A16540E0719. Published December 1, 2021. Accessed March 25, 2022.
Du H, Cao T, Lu X, Zhang T, Luo B, Li Z. Mediterranean Diet Patterns in Relation to Lung Cancer Risk: A Meta-Analysis. Front. Nutr. 2022;9.
Ester M, Culos-Reed SN, Abdul-Razzak A, et al. Feasibility of a multimodal exercise, nutrition, and palliative care intervention in advanced lung cancer. BMC Cancer. 2021;21(1):1-3.
FDA Releases Draft Guidance on Enforcement Discretion for Certain NAC Products. U.S. Food and Drug Administration website. https://www.fda.gov/food/cfsan-constituent-updates/fda-releases-draft-guidance-enforcement-discretion-certain-nac-products. Accessed May 3, 2022.
Kasprzyk A, Bilmin K, Chmielewska-Ignatowicz T, et al. The role of nutritional support in malnourished patients with lung cancer. In Vivo. 2021;35(1):53-60.
Kiss N, Symons K, Hewitt J, et al. Taste Function in Adults Undergoing Cancer Radiotherapy or Chemotherapy, and Implications for Nutrition Management: A Systematic Review. J. Acad. Nutr. Diet. 2021;121(2):278-304.
Lee E, Zhu J, Velazquez J, et al. Evaluation of diet quality among American adult cancer survivors: Results from 2005-2016 National Health and Nutrition Examination Survey. J. Acad. Nutr. Diet. 2021;121(2):217-32.
Lung Cancer – Health Professional Version. National Institute of Health National Cancer Institute website. https://www.cancer.gov/types/lung/hp. Accessed March 22, 2022.
Lung Cancer Prevention (PDQ®) – Patient Version. National Institute of Health National Cancer Institute website. https://www.cancer.gov/types/lung/patient/lung-prevention-pdq. Updated August 4, 2021. Accessed March 22, 2022.
Lung Cancer. World Cancer Research Fund International website. https://www.wcrf.org/dietandcancer/lung-cancer/. Accessed March 24, 2022.
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Marra M, Bailey R. Position of the Academy of Nutrition and Dietetics: micronutrient supplementation. J. Acad. Nutr. Diet. 2018;118(11):2162-73.
N-Acetyl Cysteine (NAC). Natural Medicines Database website. https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=1018. Accessed May 3, 2022.
Nasrah R, Van Der Borch C, Kanbalian M, et al. Defining Barriers to Implementation of Nutritional Advice in Patients with Cachexia. J Cachexia Sarcopenia Muscle. 2020;11(1)69-78.
Nigro E, Perrotta F, Scialò F, et al. Food, Nutrition, Physical Activity and Microbiota: Which Impact on Lung Cancer?. Int. J. Environ. Res. 2021;18(5):2399.
Nutrition in Cancer Care (PDQ®) – Health Professional Version. https://www.cancer.gov/about-cancer/treatment/side-effects/appetite-loss/nutrition-hp-pdq. Updated March 3, 2022. Accessed March 22, 2022.
Physical Activity and Cancer Risk. World Cancer Research Fund website. https://www.wcrf.org/diet-activity-and-cancer/risk-factors/physical-activity-and-cancer-risk/“. Accessed April 30, 2022.
Polański J, Jankowska-Polańska B, Mazur G. Relationship between nutritional status and quality of life in patients with lung cancer. Cancer Manag Res. 2021;13:1407.
Sarangarajan R, Meera S, Rukkumani R, Sankar P, Anuradha G. Antioxidants: Friend or foe?. Asian Pac. J. Trop. Med. 2017;10(12):1111-6.
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Tackling the Conundrum of Cachexia in Cancer. National Institute of Health National Cancer Institute website. https://www.cancer.gov/about-cancer/treatment/research/cachexia. Published November 1, 2011. Accessed April 22, 2022.
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Wiel C, Le Gal K, Ibrahim MX, et al. BACH1 stabilization by antioxidants stimulates lung cancer metastasis. Cell. 2019;178(2):330-45.

New Approaches to the Kidney Diet

Esther Ellis — Fri, 27 May 2022 16:35:36 +0000

According to the Centers for Disease Control and Prevention, more than 15% of adults in the United States have chronic kidney disease — approximately 37 million people. Until recently, CKD nutrition guidelines focused more on limiting certain nutrients, such as sodium, phosphorous and potassium. Because of this, many plant foods including fruits, vegetables and whole grains, which are higher in these nutrients, were often restricted for people with CKD.

However, recent research and newer guidelines, such as the National Kidney Foundation’s 2020 Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guideline for Nutrition in CKD, created in partnership with the Academy, recommend focusing on total diet quality — which includes more plant foods. This approach, along with an individualized nutrition intervention, may be more effective at slowing progression of CKD than sticking to strict nutrient ranges.

Some research suggests eating patterns associated with better kidney health outcomes include the Mediterranean, DASH, Nordic and vegan and vegetarian diets, all of which place heavy emphasis on plant foods. People adhering to these eating patterns tend to have less incidence of CKD. What’s more, when individuals with CKD adopt these eating patterns, their disease progression often slows.

Plant Versus Animal Protein

The KDOQI guidelines and Academy’s Evidence Analysis Library support reduced protein consumption and close monitoring for adults with CKD stages 3 through 5 who are “metabolically stable” and not receiving dialysis. But while both state there is insufficient evidence to recommend one protein source over another — meaning animal versus plant protein — there may be reason to give this another look, since the guidelines are based upon the best information available as of April 2017 (or through August 2018 for any of the consensus opinion statements).

“While there was insufficient data to support a strong recommendation at that time, additional evidence favoring plant-based proteins has been published since,” says Annamarie Rodriguez, RDN, LD, FAND, who has been a nephrology dietitian for almost 25 years and has served on several boards of renal-related groups and held positions in Academy and affiliate groups. She works full time with an infusion company and runs a private practice.

Regardless, there is enough evidence to support the benefits of incorporating more plant foods and plant proteins for patients or clients with CKD or at risk for CKD, whether plant proteins are the basis of protein consumption or not.

Benefits of Plant Foods for CKD

Potential benefits of plant protein consumption and a plant-based diet for people with CKD may include decreased inflammation, less uremic toxins, reduced metabolic acidosis, improved gut microbiome from increased fiber intake and reduced bioavailability of certain nutrients such as phosphorus and potassium.

Inflammation

People with CKD are at higher risk of inflammation and inflammatory comorbid conditions. For instance, 40% of people with CKD also have Type 2 diabetes; 65% also have cardiovascular disease, and 50% to 75% have hypertension. Cardiovascular disease is the primary cause of death for people with CKD.

Diets higher in plant foods such as the Mediterranean, DASH and vegan and vegetarian diets have been associated with lower comorbidities and inflammation. A 2019 study found eating at least 800 grams of fruits and vegetables per day, or about five servings, showed heart-protective benefits. Furthermore, Rodriguez says there are dozens of epidemiological studies to suggest the protective and anti-inflammatory benefits of increased fruit and vegetable consumption.

“The phytochemicals and antioxidants in fruits and vegetables are so essential to what our patients need when we look at the comorbid conditions and inflammatory response mechanisms that are triggered with CKD,” Rodriguez says. “Eating an abundance of fruits and vegetables is the more natural way to combat that.”

Metabolic Acidosis

Metabolic acidosis, or the buildup of too many acids in the blood, can be both a contributor and a consequence of CKD, occurring because of the kidney’s reduced ability to filter and eliminate acids through urine. Too much acid in body fluids can lead to osteoporosis, insulin resistance and other endocrine disorders, muscle loss or protein energy wasting and worsening kidney disease.

Rodriguez explains that a diet high in animal protein favors acid production due to organic sulfur found in amino acids such as methionine and cysteine, which are oxidized to sulfate. “If we look at plant-based foods such as fruits, vegetables and legumes, they have natural alkaline precursors, such as citrate and malate, which are converted to serum bicarbonate that can act as a buffer.” While there are oral alkali medications, Rodriguez argues that eating a diet high in alkaline foods can be just as effective while providing the benefits of fiber, antioxidants and phytonutrients that are often lacking in the historic or traditional CKD diet.

Reviews in 2013 and 2015 both found a diet higher in fruits and vegetables is beneficial in treating and preventing metabolic acidosis. Randomized controlled trials published in 2012, 2013 and 2014 found eating more fruits and vegetables was as effective as oral sodium bicarbonate for people with CKD stages 2, 3 and 4 with metabolic acidosis.

Rodriguez says even if patients or clients aren’t ready to give up animal-based proteins, finding ways to incorporate more plant foods such as fruits and vegetables may help balance it out.

Bioavailability of Phosphorus and Potassium

Sweeping restrictions of foods high in phosphorus and potassium was once foundational to the CKD diet for people with CKD stages 3 through 5 and on dialysis. This generally resulted in people limiting their consumption of plant foods. However, research suggests the phosphorus and potassium in plant foods are less bioavailable, meaning the body does not absorb all the phosphorus and potassium present in plant sources. A 2018 study adds that animal proteins such as meat, poultry and fish can contain additives of phosphorus and potassium, in a more bioavailable form. The updated KDOQI guidelines suggest practitioners consider bioavailability of phosphorus sources.

“Any time I talk to dietitians about incorporating more plant-based proteins in patients with CKD, they’re more concerned about potassium and phosphorus,” Rodriguez says. She explains that the phosphorus in some plant foods comes in the form of phytic acid, which is largely indigestible in humans because they lack the enzyme phytase, which is needed to convert phytic acid into a more bioavailable form of phosphorus. She says the higher fiber in plant foods may help reduce absorption of both phosphorus and potassium. Additionally, newly introduced potassium binders can help patients and clients keep serum potassium levels within range while also eating more plant foods.

However, processing such as sprouting, fermenting and cooking can make phosphorus more bioavailable, which Rodriguez says she always discusses with her patients or clients. Rodriguez recommends registered dietitian nutritionists educate patients or clients on inorganic sources of phosphorus, which often are found in highly processed foods and beverages such as soda. Virtually all added (or inorganic) phosphorus is absorbed by the body.

RDN Takeaways

Despite the staggering amount of people who have CKD and the potential for medical nutrition therapy to slow the progression of the disease, only 10% of people with non-dialysis CKD are estimated to ever see an RDN. Barriers to MNT may include a lack of physician awareness and referrals, plus RDN availability. Whatever the cause, RDNs may want to consider advocating for the importance of nutrition for CKD whenever possible.

For some people, the cost of seeing a dietitian may be a reason they don’t receive or seek out medical nutrition therapy. To make appointments more affordable, RDNs in private practice could consider becoming Medicare providers, which cover a select number of appointments for beneficiaries with CKD who are not on dialysis or received a kidney transplant within the past 36 months and were referred by a physician.

Patients or clients may have preconceived notions or misconceptions that eating fruits, vegetables and whole grains will have a negative effect on their disease process. When counseling patients or clients, present the updated data and explain the benefits of eating more plant-based foods and create an individualized care plan. If patients or clients are not ready to make big changes, emphasize the impact of small, gradual shifts over time.

“Even small goals, even baby steps, can make a significant impact on health outcomes,” says Rodriguez. “Simple steps, such as swapping out one or two meals a week for a plant-based meal, can really add up.”

MORE TO LEARN

Watch these Academy webinars to take a deeper dive into the benefits of a plant-based diet for CKD and practical applications:

References

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Picard K. Potassium additives and bioavailability: Are we missing something in hyperkalemia management? Journal of Renal Nutrition. 2019;29(4):350-353. doi:10.1053/j.jrn.2018.10.003
Kramer H, Jimenez EY, Brommage D, et al. Medical nutrition therapy for patients with non–dialysis-dependent chronic kidney disease: Barriers and solutions. J Acad Nutrition Dietetics. 2018;118(10):1958-1965. doi:10.1016/j.jand.2018.05.023
Chronic Kidney Disease. Academy of Nutrition and Dietetics Evidence Analysis Library website. https://www.andeal.org/topic.cfm?menu=5303&ref=692D90EB3962C711EAE5386E380B7620DADC270410246E10A063DE0778C4DD55A3C4472DD408D81DC4D0EB1576E99915003B3CA183A6DA99. Accessed April 15, 2022.
Parpia AS, L’Abbé M, Goldstein M, Arcand J, Magnuson B, Darling PB. The Impact of Additives on the Phosphorus, Potassium, and Sodium Content of Commonly Consumed Meat, Poultry, and Fish Products Among Patients With Chronic Kidney Disease. J Ren Nutr. 2018;28(2):83-90. doi:10.1053/j.jrn.2017.08.013

Chopsticks: Useful Utensil from Kitchen to Table

Miho Hatanaka — Fri, 27 May 2022 16:35:31 +0000

They’re some of the world’s oldest and simplest utensils: chopsticks. Used by about one-fifth of the world’s population, especially in East and Southeast Asia, it’s believed that chopsticks originated in China at least 5,000 to 7,000 years ago. Documentation from the Han Dynasty supports their use as eating utensils around 220 B.C.

Chopsticks are believed to have originated as a cooking utensil rather than dining utensils. The increased use of fire and development of various cooking methods led to the need for cooking utensils to avoid injuries. While spoons once were preferred, people over time came to favor chopsticks because they could easily pick up a growing variety of food items such as noodles, dumplings and sticky rice.

Today, chopsticks are sold at most Asian supermarkets and online. The most common types are made of wood or bamboo and cost between $5 and $10 for multiple pairs.

Mastering the Technique

A set of chopsticks consist of two identical sticks that are used together like tongs in one hand. One chopstick functions as the base, which does not move; secure it by the arch between the thumb and index finger and support it by the first joint of the ring finger. Hold the other chopstick by the tips of the thumb, index finger and middle finger, as if you’re holding a pencil. Move the top stick up and down, like you’re drawing a vertical line with a pencil, and pinch food between the two sticks.

Cooking with Chopsticks

Chopsticks also are used in food preparation. Generally, these are longer to maintain distance from hot surfaces and heat sources and allow for precise fine motor movements to prepare a dish without touching the food. Use chopsticks to whisk eggs, stir noodles in boiling water, rotate food when frying, garnish prepared foods and selectively pick up and transfer food items.

Global Varieties

Chopsticks used as eating utensils typically are 9 to 10½ inches long; those used as cooking utensils are 12 inches or longer. Commonly made of bamboo, wood or metal, chopsticks come in different body shapes such as round, squared or flat.

Their shape and material vary by region and intended use. In China, where people often dine in groups around a large table, chopsticks generally have a square body, rounded ends and are longer (typically 10½ inches) to more easily reach food from a distance. In Japan, it is common to use chopsticks to pick up the vegetables in soup. Japanese chopsticks tend to be thinner and pinpointed at the end, which provides finer motion to pick small bones out of fish. Chopsticks in Korea generally are made of metal, have a flat body and are used with spoons during meals.

Cleaning Up

To clean chopsticks, wash with soapy water and stand them in a jar or cup to air dry. They typically do not need to be scrubbed hard. Depending on the material, they may be dishwasher safe; chopsticks made of wood or finished with lacquer or precious metal may not be suitable for the dishwasher.

References

Magazine S, Bramen L. The History of Chopsticks. Smithsonian Magazine website. https://www.smithsonianmag.com/arts-culture/the-history-of-chopsticks-64935342/. Published 2022. Accessed April 13, 2022.
Wang Q. Chopsticks. Cambridge: Cambridge University Press; 2015.
Surprising Facts About the History of Chopsticks. FifteenEightyFour, Academic Perspectives from Cambridge University Press website. http://www.cambridgeblog.org/2015/03/surprising-facts-about-the-history-of-chopsticks/. Published 2022. Accessed April 13, 2022.
How To Use Chopsticks. Food Unfolded. https://www.foodunfolded.com/article/how-to-use-chopsticks. Published 2022. Accessed April 13, 2022.
Chopsticks. Webstaurant Store website. https://www.webstaurantstore.com/search/chopsticks.html. Accessed May 24, 2022.

Strawberry Basil Goat Cheese Burgers

Kaleigh McMordie — Fri, 27 May 2022 16:30:55 +0000

Servings: 4
Serving size: 1 burger
Prep time: 10 minutes
Cooking time: 10 minutes

Ingredients

1 pound 85% lean ground beef
2 tablespoons balsamic vinegar, divided
½ teaspoon freshly cracked black pepper
2 cups arugula
1 teaspoon olive oil
4 brioche or whole-grain buns
½ cup soft goat cheese, crumbled
1 cup strawberries, sliced
12 fresh basil leaves, roughly torn

Instructions

In a large bowl, mix ground beef with 2 teaspoons balsamic vinegar. Form into 4 patties, handling as little as possible to keep the meat tender. Season both sides with salt and pepper.
Preheat grill to medium. Once hot, grill the patties for 8 to 10 minutes over direct heat, flipping once halfway through, until cooked to a minimum internal temperature of 160°F.
In a small bowl, toss arugula with remaining balsamic vinegar and olive oil.
Assemble burgers by placing each patty on the bottom half of a bun, then add 2 tablespoons goat cheese, ¼ cup sliced strawberries, 4 torn basil leaves and ¼ cup arugula. Top with the bun top and serve immediately.

NUTRITION PER SERVING: 489 calories, 24g total fat, 10g saturated fat, 107mg cholesterol, 755mg sodium, 31g carbohydrate, 1g fiber, 4g sugar, 36g protein, 576mg potassium, 390mg phosphorus

Analysis uses whole-grain buns.

Topacio A. Ortiz, RDN, LMNT: A Community Nutrition Advocate

Lauren Fox — Fri, 27 May 2022 16:30:52 +0000

Selfless service, respect, teamwork. These are values instilled in Topacio A. Ortiz, RDN, LMNT, throughout life.

At age 17, Ortiz joined the military and is a medic in the Nebraska Army National Guard. A career in nursing felt like an obvious choice until she realized how many patients have chronic illnesses that could have been prevented. “My focus shifted from the acute side of health care to overall wellness and chronic illness prevention,” she says. “It wasn’t until I took my first college nutrition course that I started to understand the substantive role nutrition plays in general wellness and disease prevention.”

While in graduate school, Ortiz participated in a study abroad opportunity in Zambia. Focusing on food security, health and nutrition, the students in the University of Nebraska-Lincoln and University of Mississippi partnership spent the summer working with the Copperbelt University School of Medicine in Ndola, Zambia. “As a Mexican-American who focuses on Spanish-speaking populations and rarely has to think about micronutrient deficiencies, I took this opportunity to move out of my comfort zone and learn about an entirely different context and culture in a country in the throes of a nutrition transition,” Ortiz says.

In 2015, Ortiz began working with the Nebraska Extension as an assistant in the Nutrition Education Program, supporting mainly Spanish-speaking families with limited resources. About four years later, she joined the Omaha VA Medical Center’s MOVE! Weight Management Program as a clinical dietitian, encouraging healthful eating and physical activity for veterans. Then came the COVID-19 pandemic.

“My career path changed once again when the pandemic hit,” Ortiz says. “I worked with the state of Nebraska’s COVID Response Team while being activated with the Nebraska Army National Guard. We assisted the state by providing COVID testing to populations throughout Nebraska. Shortly after, I accepted a position with Nomi Health to continue the efforts of rapid COVID response across the country.”

So much of Ortiz’s life and career experiences helped her thrive in Nomi Health’s field operations department, including operational knowledge acquired while serving in the National Guard and adaptability skills developed while working in community nutrition. Now, as the company expands its health care services, Ortiz is taking on a new role as senior operations analyst. “I hope to contribute to the design of new programs that address overall wellness and health care improvement initiatives,” she says. “As an RDN, I want to emphasize prevention and treatment measures for Type 2 diabetes, heart disease and obesity, especially for underserved and minority communities.”

This sentiment has spanned Ortiz’s work thus far. “All of my work has been community-based and focused on leaving communities better off than when we began our collaborative exchange,” she says. “Although there have been times in my professional life where I felt that I was wasting time because I was not focusing all my efforts on becoming the best dietitian and nutrition expert possible, I have realized that I must experience different settings and cultures to offer the best and most comprehensive services in nutrition and health care.”

Homemade Popcorn Trail Mix with Blueberries, Walnuts, Seeds and Chocolate

Mary Ellen Phipps — Fri, 27 May 2022 16:30:48 +0000

Servings: 2
Serving size: About 1 cup
Prep time: 5 minutes

Ingredients

½ cup fresh blueberries
1 ounce walnut halves
1 cup air-popped popcorn
1 tablespoon shelled pumpkin seeds
1 tablespoon dark chocolate chips

Instructions

Combine ingredients in a bowl and gently stir to combine. Eat within 24 hours.

NUTRITION PER SERVING: 187 calories, 14g total fat, 3g saturated fat, 0mg cholesterol, 1mg sodium, 15g carbohydrate, 3g fiber, 7g sugar, 5g protein, 182mg potassium, NA phosphorus

Nutrition information not available for dark chocolate chips.

A Bevy of Milk Alternatives

Serena Ball — Fri, 27 May 2022 14:35:32 +0000

Today’s dairy case contains numerous milk alternatives, derived from plant-based sources including soybeans, almonds, peas, oats and others. Made by processing water with nuts, grains, legumes or seeds, then straining out any solids and adding thickeners, emulsifiers and other ingredients, the resulting drinks vary widely in taste, thickness, nutrition and, in some cases, best uses.

Legumes, grains and nuts have qualities that naturally lend themselves to milky beverages. When cooked, legumes and grains both absorb water and become creamy. On Food and Cooking by Harold McGee explains that the fats in nuts and soybeans feel naturally creamy, not greasy, on the tongue.

Grains, legumes and nuts also have specific flavor compounds, which are sometimes detectible in plant-based drinks. McGee explains that the unsaturated fatty acids in legumes and nuts can have notes of floral or mushroom flavor, while the phenolic compounds in whole grains can have vanilla and toasted flavors.

Most plant-based beverages are marketed for use in cereal, smoothies, coffee and occasionally as an ingredient in baked goods and cooked savory dishes. Depending on the production method, some can separate when heated such as with soups. While this separation is not harmful, it may be undesirable, depending on the recipe.

Nutrition Overview

Plant-based milks do not have some components found in cow’s milk, including lactose and casein, which is helpful for those with a milk allergy or lactose intolerance. Dairy milk from cows is pasteurized and fortified with vitamins A and D, but beyond that, cow’s milk is one ingredient in its natural form.

Some plant-based drinks have fortification of nutrients at levels above those of dairy milk; amounts vary by brand, and some evidence suggests absorption may not be equal to that of cow’s milk. Unsweetened and fortified nondairy milks may be a choice if a child is allergic to cow’s milk, is lactose intolerant or does not eat dairy foods, but are otherwise not recommended as a full replacement for dairy milk. Like dairy milk, plant-based alternatives should not be used as infant formula or introduced to a child before age 1.

Additives

To turn a plant into a beverage, more processing is required, including cooking a grain or hydrating a seed, removing most fiber-rich solids, and in many cases adding additional protein, fat, preservatives, flavorings, thickeners, emulsifiers or other additives. As a result, the nutritional profile of plant-based drinks varies widely.

Foods such as barley, short-grain rice, oats and split peas become creamier, more gelatinous or thicker than others, such as quinoa. These hydrophilic plants “melt” into water. Still, to yield a mouthfeel similar to cow’s milk, several issues need to be resolved, including grittiness, sandiness, separation of solids and thin, watery consistency.

Soy and pea proteins: These are used to increase the protein content of drinks made from other plants, which are generally much lower in protein than dairy milk (except for soy, which is a complete protein). Soy and pea proteins can provide one of the creamiest textures compared to other plant proteins because they are some of the most soluble. Both also help emulsify beverages into a unified liquid because they hold water well. While these proteins solve many processing problems, they’re usually used in an isolate form, meaning they have been stripped of some minerals, fiber and healthy fats.

Calcium fortification: For added nutrition that’s closer to cow’s milk, calcium is often added in the form of calcium phosphate or calcium carbonate.

Potassium fortification: Dairy milk is a natural source of potassium, with about 390 milligrams per serving of 2% milk. Dipotassium phosphate and potassium citrate are buffering agents used to regulate pH, prevent coagulation and stabilize a drink; in “barista” beverages, these ingredients also can balance out the low pH of coffee so curdling doesn’t occur when added to a hot liquid. Fortification also results in higher potassium content, with some beverages having more than dairy.

Emulsifiers and thickeners: Commonly used to keep fat and water from separating and solids from settling on the bottom of beverage cartons, soy lecithin and sunflower lecithin are two examples of emulsifiers. Lecithin is a mixture of fatty acids naturally derived from plants (as well as animals) that attracts both water and fats. Chicory root fiber, pectin and native starches, such as tapioca starch, can give a drink a thicker mouthfeel. Locust bean gum and guar gum are derived from vegetables, whereas xanthan gum is obtained via microbial fermentation; all are used to create a thicker, more stable liquid. Seaweed and algae gums including agar-agar, alginic acid and carrageenan polysaccharides act as stabilizers and thickeners. Gellan gum, which can grow on aquatic plants but also is produced commercially through bacteria, is often used with fortified beverages to keep calcium suspended so it doesn’t sink to the bottom of the container.

Natural flavorings: These may include cinnamon and vanilla, for example, and often are proprietary. Therefore, the U.S. Food and Drug Association allows “natural flavors” to be listed in the ingredients list.

Added sugars: Most plant-based milks have a plain variety, which is generally free of added sugars. Some drinks taste especially sweet due to the natural flavors of the plant, such as barley and oats. Beverages with flavors such as vanilla, chocolate and even “original” may contain added sugars. Check the label for cane sugar and other sweetener ingredients or look at the amount of added sugars.

Plant-Based Beverages

Calcium-fortified soy: While milk-like drinks have been made from soybeans for centuries, commercial soy milks are produced using different processes than traditional Chinese and Japanese methods, which involved the use of natural enzymes to break down soybeans, yielding a milky product with a strong soy flavor.

With a similar nutrient profile to dairy, this is the only plant-based drink that is acceptable as a dairy alternative, according to the 2020-2025 Dietary Guidelines for Americans. Fortified soy milk also is the only plant milk that is recognized as an acceptable substitute for dairy milk in federal nutrition programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children.

The fatty acid profiles and types of proteins differ between dairy milk and soy drinks, but the total grams of protein are similar: 7 to 9 grams per serving. Soy beverage also has comparable levels of vitamins A and D, riboflavin and more vitamin B₁₂ due to fortification. Soy drinks are usually made with whole soy beans, not soy protein isolates, so they are included in the soy foods that may bear an authorized health claim in relation to their soy protein content and risk of coronary heart disease.

Soy beverages generally yield more comparable baked goods to those made with dairy milk, rather than items made with other plant drinks. Soy beverages can be used in cooked dishes, too, such as bread pudding, strata and custard, which is unusual for plant drinks.

Pea: A newer option on the market, it is made with yellow pea protein powder, which is easier to emulsify in a liquid than some other plants. Therefore, most manufacturers can use less emulsifiers and thickeners while still producing a thicker viscosity. The nutrition profile of some plain pea drinks is similar to soy beverages. One brand touts protein levels around 8 grams, 50% more calcium and half the carbohydrates of dairy milk. Some brands use fortification to provide DHA and up to 100% of the daily value for vitamin B₁₂ , which is important for vegetarians and vegans.

Results from baking and heating pea beverages are similar to those with soy drinks. Pea beverages also are very versatile in smoothies and baked goods. When heated or added to other hot drinks, some brands become even thicker.

Almond: The nutrient profiles of different brands of almond beverage vary greatly. A few brands use only almonds and water, yielding a very watery consistency but a short ingredient list. Other brands add emulsifiers, thickeners and ingredients such as oats for a blended drink. In general, most almond drinks are low in protein and carbohydrates and are fortified with minerals and vitamins including vitamin E, which is naturally found in almonds.

Almond milks can sometimes add a pleasantly nutty flavor to baked goods, but this flavor is often undetectable when drinking it. Baked items made with nut milks tend to brown quicker and have a more golden hue and squishier texture than those made with dairy milk. While it is not recommended to boil almond beverages, they can be heated into sauces or soups and a slightly sweet flavor may be present.

Rice: Some are made with partially milled or brown rice, which is preferable because more of the germ and bran of the whole grain remain. Per cup, rice drinks generally contain 1 gram of protein, 2 to 3 grams of fat (mainly from canola, sunflower or safflower oils) and most are fortified with calcium and vitamins A, D and B₁₂ at levels close to cow’s milk. The carbohydrate count is 13 to 23 grams, with about 13 grams of natural starch — higher than most plant-based milks. Products made from rice may be a source of arsenic, so it is recommended to consume a variety of foods to limit exposure, especially for young children.

In general, rice drinks are very thin and watery, a consistency that lends itself to smoothies and other liquid recipes. Because of the beverage’s high carbohydrate content, most baked recipes can be successful. The bland, blank-canvas flavor is helpful when making savory dishes, but it should be heated at lower temperatures for the best texture in soups.

Coconut: While both are made from grated coconut flesh, refrigerated varieties of coconut beverage are diluted with more water than canned coconut milk. The refrigerated type also may contain more additives to maintain a thicker texture without the same amount of saturated fat in the dense canned kind. Different refrigerated brands often have unique fortification amounts, including a high amount of vitamin B₁₂, which may be helpful for vegetarians and vegans. Coconut beverage is low in protein and carbohydrates, and many have about the same amount of total fat as 2% dairy milk but a higher amount of saturated fat.

Refrigerated coconut milk tends to have excellent frothing abilities and works well in smoothies and frothed warm drinks. Do not use it as a substitute for canned coconut milk in baked or stovetop recipes, since it is much lower in fat and the coconut flavor is less pronounced.

Sesame: Sesame beverage is rich in calcium, both naturally and through fortification (390 milligrams per 1-cup serving). One sesame drink maker uses sesame seeds after they are pressed for oil, upcycling a product previously considered food waste into a sesame protein concentrate. Other ingredients, such as pea protein, are added to increase the viscosity and protein (8 grams in regular and 4 grams in barista per 1 cup). Use the “barista” blend for frothy warm drinks and the regular version for baked goods to avoid altering the pH.

Oat: Because oat is a sweet grain that is naturally thick and gelatinous when hydrated, it produces a sweet and naturally thick drink. Surging in popularity, oat became the second best-selling plant-based drink in the United States in 2020, with almond as the top-selling plant drink and soy third.

The main ingredients are oats and water, with some additives and fortification. One manufacturer uses natural enzymes to break down the sugars in oats into maltose, creating a sweeter taste. The FDA considers these sugars “added,” since they were created during the production process.

In general, oat beverages have around 2 to 5 grams of fat, 16 to 19 grams of carbohydrates, 2 grams of fiber (with 1 gram soluble and some brands retaining the healthful beta glucans), 2 to 3 grams of protein and are fortified with calcium, potassium and vitamins A and B₁₂. Oat drinks perform well in baked goods and can produce a slightly sweet flavor when cooked.

Hemp: Hemp seeds are soaked until they swell and are then wet-milled and strained to produce this drink. Thickeners, emulsifiers, flavors and sweeteners are usually added. Because of their amino acid profile, hemp seeds are considered a source of high-quality protein. However, most hemp drinks contain only 2 to 3 grams of protein per serving. Hemp seeds also contain high amounts of omega-3 and omega-6 fats. While amounts vary between brands, some hemp beverages contain up to 3.5 grams per serving of these healthy fats. Unsweetened varieties contain no carbohydrates. Hemp beverages are best used in cool preparations, as cooking and baking can produce a strong flavor.

Pistachio: As of May 2022, the three most widely available pistachio drinks do not have any added oils. This is unusual as sunflower, rapeseed/canola, coconut and palm oils are generally added to help emulsify the solids, fats and liquid and give plant drinks a creamy texture. Therefore, most of the total fat listed on the Nutrition Facts label is from pure pistachio unsaturated fats. These drinks provide varying amounts of potassium due to natural potassium and dipotassium phosphate, which may be added to avoid curdling when added to hot coffee, for example. Even without oils, pistachio drinks froth up nicely and cook well, with baked goods having textures similar to those made with almond and cashew beverages.

Barley: There are two barley milk beverages on the market as of May 2022. One is made from spent beer brewing grains, previously a waste product that is upcycled. While most plant-based drink companies market their products for sustainability, this spent-grains process is unique (although somewhat similar to the production of sesame drink). In the process, sugars are extracted from malted barley and sent to fermentation for beer; what’s left is a protein-rich substrate called “brewer’s spent grain.” Using a special process, the spent grain is converted into a highly soluble protein to make barley beverage.

Nutrition profiles for plain and flavored varieties range from 3 to 8 grams of protein, 0 to 12 grams of added sugars and 70 to 140 calories; fortification provides 35% of the daily value for calcium and 25% to 50% of the daily value for vitamin D. Using barley beverage in recipes with cold and warm preparations works well.

Cashew: This is one of the only milk beverages that can be made without straining after solids are blended with water. Because the nut is softer, some companies produce drinks in which more of the whole nuts remain. Depending on fortification levels, some brands fortify calcium at levels above the 300 milligrams naturally found in 1 cup of dairy milk. Some cashew beverages separate when cooked on the stove top. Baked goods turn out similar to those made with other nut drinks.

Blended: A mix of several plant-based beverages and ingredients, these drinks have qualities not found in a single-origin beverage. For example, pairing a fruit flavor such as banana with sunflower seeds to increase protein and healthy fats, or adding oats for viscosity and pea protein for thickness and protein. With the substantial growth in plant-based milks, the blended category continues to produce innovative options.

References

2020-2025 Dietary Guidelines for Americans. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf. Accessed April 22, 2022.
Almond Milk vs. Milk: Which Bakes the Best Muffin. Teaspoon Of Spice website. https://teaspoonofspice.com/almond-milk-muffins/. Accessed April 22, 2022.
Code of Federal Regulations Title 21. National Archives website. https://www.ecfr.gov/current/title-21/chapter-I/subchapter-B/part-101/subpart-E/section-101.82. Accessed May 24, 2022.
Gellan Gum. Bakerpedia website. https://bakerpedia.com/ingredients/gellan-gum/. Accessed April 22, 2022.
Healthy Beverage Consumption in Early Childhood. Healthy Drinks Healthy Kids website. https://healthydrinkshealthykids.org/app/uploads/2019/09/HER-HealthyBeverageTechnicalReport.pdf. Accessed April 30, 2022.
Hope and Sesame website. https://hopeandsesame.com/. Accessed April 22, 2022.
How We Make our Oat Drink. Oatly website. https://www.oatly.com/stuff-we-make/our-process. Accessed April 22, 2022.
How we upcycle. Take Two Foods website. https://taketwofoods.com/pages/how-we-upcycle. Accessed May 24, 2022.
McGee, H. On Food and Cooking: The Science and Lore of the Kitchen. New York, Scribner, 2004:459, 493-494.
Milk, 2% milkfat. Food Data Central website. https://fdc.nal.usda.gov/fdc-app.html#/food-details/746778/nutrients. Accessed May 24, 2022.
Oatmilk brands to update Nutrition Facts panels in light of FDA guidance on added sugar labeling. Food Navigator website. https://www.foodnavigator-usa.com/Article/2019/07/09/Oatmilk-brands-to-update-Nutrition-Facts-panels-in-light-of-FDA-guidance-on-added-sugar-labeling. Updated July 9, 2019. Accessed April 22, 2022.
Oatmilk edges past soy milk for #2 slot in US. Food Navigator website. https://www.foodnavigator-usa.com/Article/2020/09/25/Oatmilk-edges-past-soymilk-for-2-slot-in-US-plant-based-milk-retail-market-as-almondmilk-continues-to-drive-category-sales. Accessed April 22, 2022.
Original Plant Based Milk. Ripple Foods website. https://www.ripplefoods.com/original-plant-milk/. Accessed April 22, 2022.
Overview of Food Ingredients: Types of Food Ingredients. Food and Drug Administration website. https://www.fda.gov/food/food-ingredients-packaging/overview-food-ingredients-additives-colors#types. April 30, 2022.
Plant Proteins Come of Age. Institute of Plant Technologists website. https://www.ift.org/news-and-publications/food-technology-magazine/issues/2021/march/columns/ingredients-plant-proteins-come-of-age. Accessed April 22, 2022.
Plant-Based Milks: Almond. IFAS Extension University of Florida website. https://edis.ifas.ufl.edu/publication/FS410. Accessed April 22, 2022.
Plant-Based Milks: Cashew. IFAS Extension University of Florida website. https://edis.ifas.ufl.edu/publication/FS413. Accessed April 22, 2022.
Plant-Based Milks: Coconut. IFAS Extension University of Florida website. https://edis.ifas.ufl.edu/publication/FS411. Accessed April 22, 2022.
Plant-Based Milks: Hemp. IFAS Extension University of Florida website. https://edis.ifas.ufl.edu/publication/FS420. Accessed April 22, 2022.
Plant-Based Milks: Oat. IFAS Extension University of Florida website. https://edis.ifas.ufl.edu/publication/FS419. Accessed April 22, 2022.
Plant-Based Milks: Rice. IFAS Extension University of Florida website. https://edis.ifas.ufl.edu/publication/FS412. Accessed April 22, 2022.
Plant-Based Milks: Soy. IFAS Extension University of Florida website. https://edis.ifas.ufl.edu/publication/FS422. Accessed April 22, 2022.
What are the Uses of Potassium Citrate? Food Additives website. https://foodadditives.net/acidity-regulator/potassium-citrate/. Accessed April 22, 2022.
What is a Natural Flavor? Elmhurst website. https://elmhurst1925.com/blogs/news/natural-flavors-elmhurst-explains. Accessed April 22, 2022.
What is Dipotassium Phosphate in Food and Fertilizer? Food Additives website. https://foodadditives.net/phosphates/dipotassium-phosphate/. Accessed April 22, 2022.
What is the difference between the barista edition and regular oat drinks? Oatly website. https://www.oatly.com/random-answers. Accessed April 22, 2022.
What You Can Do to Limit Exposure to Arsenic. Federal Drug Administration website. https://www.fda.gov/food/metals-and-your-food/what-you-can-do-limit-exposure-arsenic. Accessed May 24, 2022.

Blackened Cod Tacos with Pico de Gallo

Julie Andrews — Fri, 27 May 2022 14:35:24 +0000

Servings: 4
Serving size: 2 tacos
Prep time: 15 minutes
Cook time: 10 minutes

Ingredients

Pico de Gallo:

2 medium ripe tomatoes, cored and diced
½ small white onion, peeled and minced
½ medium jalapeño, seeded and minced (optional)
¼ cup fresh cilantro, chopped
Zest and juice of 2 medium limes
½ teaspoon kosher or sea salt

Fish Tacos:

1 pound cod fillet, skin removed and cut into 8 2-ounce portions
2 teaspoons olive oil
2 teaspoons blackened seasoning
¼ cup low-fat or fat-free plain Greek yogurt
Juice of ½ medium lime
8 corn tortillas, toasted
1 medium avocado, peeled, cored and sliced

Instructions

In a medium bowl, stir together tomatoes, onion, jalapeño, cilantro, lime juice and zest and salt. Cover and refrigerate.
Heat a large nonstick skillet or grill to medium heat. Brush both sides of the fish fillets with oil, then coat with blackened seasoning.
Cook in the skillet or on the grill 2 to 3 minutes per side until fish reaches a minimum internal temperature of 145°F or flakes easily with a fork.
In a small bowl, stir together yogurt and lime juice.
Serve fish on toasted corn tortillas with slices of avocado, pico de gallo and a drizzle of lime yogurt.

Cooking note: To make your own blackened seasoning, stir together 1 tablespoon smoked paprika, ½ tablespoon onion powder, 1 teaspoon garlic powder, 1 teaspoon Italian seasoning, ½ teaspoon ground black pepper and ¼ teaspoon cayenne pepper. Add salt as desired.

NUTRITION PER SERVING: 329 calories, 13g total fat, 2g saturated fat, 44mg cholesterol, 409mg sodium, 33g carbohydrate, 6g fiber, 3g sugar, 23g protein, NA potassium, NA phosphorus

Analysis includes jalapeño. Assumed amounts for lime juice and lime peel (subbed lemon peel). Assumed size of corn tortilla to be 6-inch. Reliable nutrition information not available for blackened seasoning and corn tortillas.

Lazy Delicious: Volume 11 Issue 2

Food & Nutrition Magazine — Fri, 27 May 2022 14:35:20 +0000

Pilfer your pantry and make something out of nothing!

Easy Zucchini “Noodles”: In a skillet, heat 1 tablespoon olive oil over medium heat. Add ½ chopped onion and 1 pound lean ground beef seasoned with salt and pepper. Cook for about 10 minutes. Add a jar of pasta sauce to the meat and let it simmer over medium-low heat. Use a potato peeler or spiralizer to create “zoodles” with 4 to 5 zucchinis. Place zoodles in a separate skillet with olive oil over medium heat. Cook for about 5 to 6 minutes, then combine with the sauce mixture. Top with cheese of your choice.

– Marissa Coral

Ingredient Improv: Instead of ground beef, use ground turkey or meatless crumbles. Create “noodles” with other vegetables such as carrots, sweet potatoes or parsnips and cook until fork tender.

Hummus-Stuffed Omelet: Whisk 4 egg whites with turmeric — just enough to color the whites a sunny yellow. Cook eggs omelet-style in a skillet with 1 teaspoon olive oil. Fill the cooked omelet with ¼ cup roasted red pepper hummus, then sprinkle generously with sumac and fold. Top with diced tomatoes.

– Sherri Hoyt, RDN, LD

Ingredient Improv: Create a tangy twist with feta or goat cheese. Add paprika and make it spicy with crushed red pepper or garlic chili sauce.

Peanut Butter Stir-Fry: In a skillet with olive oil, sauté ¼ onion and ½ a block of extra-firm tofu, cubed, over medium heat. Once the onion is soft, add 2 cups frozen broccoli and 1 to 2 cups frozen brown rice. When cooked, add 2 cloves chopped garlic, a splash of orange juice (fresh or refrigerated), 3 tablespoons soy sauce and 2 tablespoons peanut butter. Stir to combine.

– Ashley Reaver, MS, RDN

Ingredient Improv: For extra protein or an alternate texture, use wild rice or quinoa in place of brown rice. Add more colorful vegetables such as chopped carrots and red bell pepper. Any nut butter or sunflower seed butter can be used instead of peanut butter.

Mango Avocado Salsa: Dice 1 mango, 1 avocado and about ½ sweet onion. Place in a large bowl and gently stir to combine. Add ¼ cup (or more) fresh chopped cilantro, juice of ½ or 1 whole lime, a sprinkle of salt and pepper. Gently stir to mix. Eat salsa with tortilla chips, on top of a taco or chicken breast or in a salad.

– Sierra Atkinson, CSCS

Ingredient Improv: To keep the salsa chunky, choose a mango and avocado that are slightly firm. Add sliced cherry tomatoes and cooked black beans or, for a seasonal twist, incorporate diced strawberries or peaches.

Quick Quinoa Bowl: Spoon refried beans or drained and rinsed canned black beans on top of cooked quinoa. Then layer on toppings such as chopped lettuce, diced tomatoes, bell peppers, onions, plus some guacamole and salsa. Mix and enjoy!

– Anna Tseng, MPH, RDN, LDN

Ingredient Improv: Use any type of cooked beans or lentils. Add other ingredients or seasonings such as shredded cheese and chopped fresh cilantro. For a touch of sweetness, toss in some canned pineapple chunks.

Chickpea Edamame Salad

Mackenzie Burgess — Fri, 27 May 2022 14:35:16 +0000

Servings: 6
Serving size: 1 cup
Prep time: 20 minutes

Ingredients

Salad:

½ cup red pepper, diced
½ cup shredded carrots
½ cup yellow pepper, diced
1 cup shelled edamame, cooked
½ cup blueberries
1 cup quinoa, cooked
1 15-ounce can chickpeas, drained and rinsed

Dressing:

¼ cup olive oil
2 tablespoons vinegar of choice
1 tablespoon maple syrup
1 teaspoon Dijon mustard
½ teaspoon salt
¼ teaspoon fresh ground black pepper

Instructions

In a large bowl, mix red pepper, carrots, yellow pepper, edamame, blueberries, quinoa and chickpeas until combined.
In a small bowl or jar with lid, combine olive oil, vinegar, maple syrup, Dijon mustard, salt and pepper. Whisk or shake until smooth.
Pour dressing over salad and mix to lightly coat.
Chill in the refrigerator for 10 minutes and serve cold.

Cooking note: Balsamic, red wine, champagne, rosé, honey apple or apple cider vinegars work well in this recipe. Top salad with chopped fresh herbs such as mint, basil, thyme or cilantro, if desired.

NUTRITION PER SERVING: 269 calories, 12g total fat, 1g saturated fat, 0mg cholesterol, 377mg sodium, 32g carbohydrate, 7g fiber, 9g sugar, 9g protein, NA potassium, NA phosphorus

Analysis uses balsamic vinegar; chopped red bell pepper for yellow pepper; and frozen edamame for shelled and cooked. No potassium or phosphorus nutrition data available for Dijon mustard.

Summer Peach and Ricotta Grilled Pizza

Brynn McDowell — Fri, 27 May 2022 14:35:02 +0000

Servings: 4
Serving size: 2 slices
Prep time: 10 minutes
Cooking time: 5 minutes

Ingredients

1 ready-made pizza crust
1 teaspoon olive oil
1 cup part-skim ricotta cheese
1 medium peach, pitted and thinly sliced
2 tablespoons shelled pistachios, chopped
1 tablespoon fresh basil, chopped
1 tablespoon regular or hot honey

Instructions

Preheat grill to medium. Drizzle both sides pizza crust with olive oil. Once the grill is warm, add crust and cook until golden brown and lightly charred, about 2 to 3 minutes per side.
Remove crust from grill and allow to cool slightly. Use a spoon to spread ricotta cheese on top of the crust. Add peaches, pistachios and basil. Drizzle with honey and cut into slices to serve.

NUTRITION PER SERVING: 244 calories, 9g total fat, 4g saturated fat, 19mg cholesterol, 269mg sodium, 30g carbohydrate, 1g fiber, 8g sugar, 11g protein, NA potassium, NA phosphorus

Reliable nutrition information not available for the assumed 8-inch pizza crust.

Mushrooms: An Earthy Accent with Notable Nutrition

Food & Nutrition Magazine — Fri, 27 May 2022 14:35:01 +0000

Often overshadowed by brightly colored vegetables that boldly showcase their phytonutrients, the meager mushroom seems to pale in comparison. Yet, the mushroom has rightfully gained a reputation as a nutritional superstar.

Mushrooms that are cultivated in temperature- and humidity-controlled environments are available year-round. Wild mushrooms — some of which have defied attempts at cultivation, including morels and truffles — appear in fall and spring, when mild temperatures and plenty of moisture help them grow. Take caution if you forage for wild mushrooms; go with an expert who can identify different types of mushrooms, especially those that may be unsafe to eat. Often, they are not distinguishable. Plus, toxins produced by mushrooms are not affected by heating, so serious illness or death may occur regardless of if they are eaten raw or cooked. It’s best to rely on reputable suppliers for any type of mushroom intended for consumption.

In the Clinic: Mushrooms are about 90% water, virtually fat free and have approximately 20 calories per 1 cup of raw sliced mushrooms. They also contain varying levels of nutrients. For example, the selenium content of mushrooms ranges from 0.1 micrograms per cup of raw enoki mushrooms to 36 micrograms per cup of cooked shiitakes, with the latter providing 65% of the Daily Value for this trace element.

Most mushrooms also are a good or excellent source of several B-vitamins including riboflavin, pantothenic acid and niacin. They also provide copper and are one of the only plant sources of vitamin D. However, the amount can vary and may not be significant unless they are exposed to ultraviolet light. According to the USDA’s FoodData Central, 1 cup of chanterelle and morel mushrooms can provide 14% and 17% of the Daily Value for vitamin D, respectively, compared to maitake mushrooms, which may provide close to 100% of the DV.

In the Kitchen: Complex flavors and appealing textures make mushrooms a versatile ingredient. Add crunchy raw enokis to salads or soup. Stir-fry almost any fresh mushroom or sauté in oil with garlic and toss with pasta. Top steaks, chicken and omelets with sautéed mushrooms. Creminis, which look like brown button mushrooms, may be oven-roasted with a drizzle of olive oil and eaten hot, or allowed to cool and tossed into salads. Portabellas are large creminis, perfect for brushing with toasted sesame oil and soy sauce and grilled. Dried mushrooms such as porcini and shiitake add flavor to stocks, sauces and risotto. Just cover them with hot water and soak for 15 minutes before using.

For fresh mushrooms, choose those that are firm and smooth and store them in a paper bag for up to a week in the refrigerator. Since mushrooms can absorb water, opinions differ on whether to wash mushrooms or just brush off obvious dirt. Most chefs agree a quick rinse won’t make mushrooms soggy. Plus, for food safety reasons, it is recommended that produce be washed before preparing or eating it. Trim off the stem end before using.

In Quantity: Mushrooms appear on many restaurant menus. Some potential reasons are that substituting mushrooms for more costly proteins may offer a “value added” perception, achieve greater customer satisfaction and potentially increase profitability without adding calories or fat. For example, mushrooms can be used as a substitute for some ground beef in burger recipes. Or, they can add a visual impact of “more” as a topping for steaks and sandwiches. Mushrooms also provide an umami experience, thanks to the presence of glutamate, which is concentrated and more pronounced when using dried mushrooms.

Mushrooms of all types are easy to work with in foodservice. Consider ordering pre-sliced mushrooms to save time and labor. The product is not compromised if used within a few days. Always store them at about 34 degrees Fahrenheit.

Use dried varieties of mushrooms for specialty cooking. Morels, porcinis or other specialty blends offer the great flavor of fresh when rehydrated and also save time. Plus, they have good shelf-lives for long-term storage.

Article updated and adapted from July/August 2008 ADA Times with copy by Janet Helm, MS, RD; Sanna Delmonico, MS, RD, LD; and Alma Kay Nocchi, RD, LD.

References

Bad Bug Book. Food and Drug Administration website. https://www.fda.gov/media/83271/download. Accessed May 24, 2022.
Health Care Utilization and Outcomes Associated with Accidental Poisonous Mushroom Ingestions — United States, 2016–2018. Centers for Disease Control and Prevention website. https://www.cdc.gov/mmwr/volumes/70/wr/mm7010a1.htm?s_cid=mm7010a1_w. Published March 12, 2021. Accessed May 24, 2022.
How to Cook with Dried Mushrooms. Cook’s Illustrated website. https://www.cooksillustrated.com/how_tos/13317-an-economical-way-to-enjoy-fancy-mushrooms. Accessed May 24, 2022.
Mushrooms, Chanterelle, raw. FoodData Central website. https://fdc.nal.usda.gov/fdc-app.html#/food-details/168422/nutrients. Accessed May 24, 2022.
Mushrooms, enoki, raw. FoodData Central website. https://fdc.nal.usda.gov/fdc-app.html#/food-details/169382/nutrients. Accessed May 24, 2022.
Mushrooms, maitake, raw. FoodData Central website. https://fdc.nal.usda.gov/fdc-app.html#/food-details/169403/nutrients. Accessed May 24, 2022.
Mushrooms, morel, raw. FoodData Central website. https://fdc.nal.usda.gov/fdc-app.html#/food-details/168423/nutrients. Accessed May 24, 2022.
Mushrooms, oyster, raw. FoodData Central website. https://fdc.nal.usda.gov/fdc-app.html#/food-details/168580/nutrients. Accessed May 24, 2022.
Mushrooms, portabella, raw. FoodData Central website. https://fdc.nal.usda.gov/fdc-app.html#/food-details/169255/nutrients. Accessed May 24, 2022.
Mushrooms, white, raw. FoodData Central website. https://fdc.nal.usda.gov/fdc-app.html#/food-details/169251/nutrients. Accessed May 24, 2022.
Umami in Foods: What is Umami and how do I Explain It? Academy of Nutrition and Dietetics Evidence Analysis Library website. https://www.andeal.org/files/files/Umami/Umami_in_Foods_White_Paper.pdf. Accessed May 24, 2022.
USDA National Nutrient Database for Standard Reference Release. Selenium. https://ods.od.nih.gov/pubs/usdandb/Selenium-Content.pdf. Accessed May 24, 2022.
Why Dried Mushrooms Are Always in Our (Cool, Dark) Pantry. Bon Appetit website. https://www.bonappetit.com/story/how-to-use-dried-mushrooms. Published March 10, 2017. Accessed May 24, 2022.

Back to Basics (Version iOS 1.2.42)

Marisa Moore — Fri, 27 May 2022 13:46:14 +0000

Synopsis: Back to Basics is an educational app that promises to help users learn to be healthy without dieting.

Price and Platform: Free seven-day trial, then paid: $12.99/month to $79.99/year. Apple and Android.

RDN Score: 4.5/5

Pros

Attractive app with bright, appetizing food photography and cheerful graphics.
Provides insight into the all-or-nothing mindset, habit formation and mindful eating.
“Personalized plan” is based on whether you eat a regular, vegetarian or pescatarian diet and if you are pregnant or breastfeeding or postpartum.
More than 500 recipes with substitution ideas for dietary needs such as dairy- or gluten-free. Consistent with the app’s theme, the recipes do not include calories, macros or points.
Includes an easy-to-use meal planner with an automatic shopping list and the option to swap and delete recipes with ease.
Handy and informative hunger check-in tool allows users to rate hunger using an in-app sliding scale version of a hunger scale, then offers insight into the ratings.
Offers meditation and mindset videos and 5- to 20-minute at-home workouts including more than 100 pregnancy-safe exercise options.
Created by an accredited practicing dietitian (Australian equivalent to the registered dietitian nutritionist credential).
Experience the full app using a free seven-day trial.

Cons

Must sign up for a cancellable, automatically renewing subscription to access the free seven-day trial.
Recipes include descriptors such as “free-range eggs” and directives including “don’t buy pre-cut store-bought fruit,” which may limit accessibility for some and be counter to some of the messaging around creating a good relationship with food.
Privacy disclosure indicates that usage data is not linked to your identity but may be used to track you across apps and websites owned by other companies.

Bottom Line: Back to the Basics may be a good fit for pregnant women and newbies to the intuitive eating space who enjoy more mainstream flavors.

CapCut (Version iOS 5.5.0)

Marisa Moore — Fri, 27 May 2022 13:46:12 +0000

Synopsis: CapCut is an all-in-one mobile video editor with music.

Price and Platform: Free. Apple and Android.

RDN Score: 4/5

Pros

Easy for beginners with simple controls to cut, change speed, reverse clips and more.
A product of ByteDance (TikTok’s parent company), CapCut seamlessly integrates music into video editing. Sign in with TikTok to sync your favorite sounds or use the tracks available in CapCut.
Access trending fonts, stickers and text and easily add background layers, blur effects and more for all or part of any video.
Adjust color, brightness, exposure and other settings and apply filters and “magical” effects to get the look and feel you want. Add voiceover, slow motion and reverse effects and transitions to further enhance videos.
Option (on iOS) to control how many photos can be accessed; allow access to all photos, select photos or none. Note: Allowing access to “none” effectively renders the app useless.
Create video projects using existing videos, still photos and live photos and access CapCut’s stock video library, which includes a small collection of animated clips and end cards.
CapCut prompts users to add a cover, ending and proper transitions to each project.
Easily adjust resolution and frame rate from the project home screen and download to your mobile device.
Share completed videos to TikTok, Instagram, Facebook and WhatsApp, or send via text or email — all without a watermark.

Cons

CapCut may use your device ID to track you across third-party apps and websites. The app also may collect a significant amount of personal data from users including contact information, identifiers, diagnostics, user content and usage data.
It’s a little tedious to delete selected image access from the app. To do so, users must select each image to disallow from the mobile device’s settings — not in the CapCut app itself.

Bottom Line: Ideal for beginner and experienced creators alike and with features usually only available with paid apps, CapCut is an all-in-one tool for creating and editing videos from a mobile device.

Chopra (Version iOS 1.2.3)

Marisa Moore — Fri, 27 May 2022 13:46:07 +0000

Synopsis: Chopra delivers tips for mindfulness and self-care wherever you are.

Price and Platform: Free or Premium at $69.99/year. Apple Only.

RDN Score: 4/5

Pros

Attractive and user-focused and friendly design with content for users ages 4 and up.
Explore a wide range of topics including sleep, stress and anxiety relief, health and weight, energy, relationships, confidence and personal and spiritual growth.
Includes almost 500 meditations with sessions that range from five to 30 minutes.
Participate in free seven- or two-day meditation challenges.
Content is tailored to a variety of different user groups including parents, students, workplace/co-working, leaders and personal relationships.
Explore free collections of brief audio sessions designed to help users move through difficult emotions such as anger, worry, sadness, anxiety and resilience.
Sessions are well produced and led by a diverse group of wellness experts.
Selects and recommends sessions based on your onboarding responses.
Includes a few free sessions. Upgrade to the premium app to access new content each day and the full library of content.
Apple Health users can sync the app to automatically track meditation sessions.

Cons

Requires an email address (or sign-in from other Chopra products) and account creation to access any content.
Requires a quick but personal onboarding questionnaire to get started.
The developer’s privacy policy reveals that it may collect and link your identity to your user content, usage data, device ID and other identifiers, contact information, and health and fitness data. It also may collect location and diagnostics data but not link it to your identity.

Bottom Line: Ideal for meditation newbies and anyone seeking resources on how to meditate and slow down, the Chopra app is a great tool for expanding your practice and a path to self-discovery or getting a quick break from daily stress.

Freeletics (Version iOS 22.10.0)

Marisa Moore — Fri, 27 May 2022 13:46:05 +0000

Synopsis: Freeletics delivers personalized high-intensity interval training (HIIT) and other types of workouts.

Price and Platform: Limited free version. Paid plans at $114.99/year. Apple and Android.

RDN Score: 3/5

Pros

Attractive design with high-quality, well-produced exercise videos.
Workout anytime, anywhere with a digital personal trainer in five- to 20-minute sessions. Select calisthenics, weights, running or HITT style workouts.
The free version offers 20 HIIT bodyweight workouts, 25 exercises and 20 audio sessions. Upgrade to the paid version for more than 300 bodyweight and gym exercises, tracking stats for sprints and runs, overall training stats and more than 100 recorded audio sessions with tips for healthy mindset and nutrition, plus integration with Spotify.
Build a personalized training plan using Freeletics’ AI-Coach and easily adjust your workout to fit your day.
App includes options for people at different fitness levels.
New users can select their fitness level on a sliding scale from “not fit at all” to “really fit.” The levels include descriptors to help inform the user about what qualifies for each level such as “I lose my breath when walking up a couple flights of stairs.”
Includes a 14-day money-back guarantee.

Cons

Limited free content.
App lacks images of people in larger bodies.
Not for those who don’t like sharing information. Freeletics asks for a lot of personal details upfront in an onboarding questionnaire before granting access to the personalized training plan.
With training program names such as “Shred & Burn,” some users may feel the app is too intense; it is most suitable for exercise enthusiasts rather than new or casual exercisers.
The app privacy disclosure reveals a long list of data that may be linked to your identity and that Freeletics may use, including contact information, purchases, usage data, identifiers and location information to track you across apps and websites owned by other companies.
Although it costs less than most gym memberships, at $114.99 per year, Freeletics is on the higher end for online fitness programs.

Bottom Line: Freeletics is ideal for anyone seeking fitness motivation and a library of workouts that can be done from wherever they are with or without equipment.

Heali (Version iOS 0.3.8)

Marisa Moore — Fri, 27 May 2022 13:45:38 +0000

Synopsis: Heali delivers recipes, meals and product information to meet personalized nutrition needs — all with evidence-based recommendations.

Price and Platform: Free. Apple and Android.

RDN Score: 4/5

Pros

Set your personalized nutrition preferences, then use the app to scan a barcode or read a menu or product ingredient list to receive personalized, evidence-based recommendations.
Users can select from more than 70 therapeutic plans which include a list of diets such as vegan, vegetarian, pescatarian, gluten-free, dairy-free, GERD, AIP and Whole30.
Database of more than 1 million recipes, food products and restaurant menu items.
Choose nutrients you want to track or eat less or more of.
Heali provides an easy-to-review database to learn about research-backed nutrition therapies for a plethora of conditions.
Heali offers detailed, researched nutrition information on a variety of foods and implications for certain dietary choices such as the impact of dairy on acne.
The leadership team includes a registered dietitian and medical doctor. The scientific, clinical and dietetic advisory boards feature many experienced and respected researchers and practitioners.

Cons

Requires a phone number to get on the waitlist for access to the full app.
Although there is a lot of useful information in the app, Heali is currently under development, making it less than ideal for now — at least compared to similar apps on the market.
Privacy disclosure reveals the app uses user contact information to track across third-party apps and websites and may collect data linked to your contact information and device identifiers.

Bottom Line: For now, Heali is a space for both practitioners and the general public to gain insights on the impact of nutrition on different conditions. Keep an eye out for the full and updated app release.

Creamy Mushroom Soup

Ginger Hultin — Fri, 27 May 2022 13:36:12 +0000

Creamy Mushroom Soup

This dairy-free twist on a classic is just as creamy as the traditional version. The secret ingredient is cooked whole oats, blended until smooth.

See more “A Bowl for Every Belly” recipes!

Developed by Ginger Hultin, MS, RD, LDN

Ingredients

1 tablespoon grapeseed oil
1 large yellow onion, chopped
3 cloves garlic, minced
16 ounces crimini mushrooms, quartered or chopped
1 teaspoon salt
5½ cups low-sodium vegetable stock
⅔ cup old-fashioned rolled oats
2 tablespoons white miso paste
½ teaspoon black pepper
¼ cup fresh parsley, chopped

Directions

Heat oil in a large soup pot over medium-high heat. Sauté onion 2 to 3 minutes or until translucent.
Add garlic, mushrooms and salt, reduce heat to medium and cook 4 to 5 minutes, stirring occasionally.
Add stock and oats, cover and simmer for 8 minutes.
Place miso and pepper in a large blender.* After soup has cooled slightly, pour into blender. Puree 45 seconds to 1 minute or until completely smooth. Garnish with parsley. Serves 5.

Cooking Note

Boiling miso can destroy its probiotic properties. Be sure the soup is warm, but not boiling, as you add it to the blender.

Nutrition Information

SERVING SIZE: 1½ cups

CALORIES 130; TOTAL FAT 4g; SAT. FAT 1g; CHOL. 0mg; SODIUM 884mg; CARB. 20g; FIBER 4g; SUGARS 6g; PROTEIN 5g; POTASSIUM N/A; PHOSPHORUS N/A

Note: Nutrition information for potassium and phosphorus in low-sodium vegetable stock not available.

Gruyere Risotto with Marsala Mushrooms

Jen Plaggemars — Fri, 27 May 2022 13:35:47 +0000

Serves: 6
Serving size: ¾ cup risotto plus ½ cup mushrooms
Prep time: 15 minutes
Cooking time: 30 minutes

Ingredients

Risotto:

4 cups low-sodium chicken stock
1 tablespoon olive oil
1 tablespoon unsalted butter
1 small yellow onion, chopped
3 garlic cloves, finely chopped
1½ cups Arborio rice
½ cup white wine
1 cup grated Gruyere cheese
½ cup grated Parmesan cheese
Juice of ½ lemon
½ teaspoon salt

Mushrooms:

2 tablespoons unsalted butter
2 garlic cloves, finely chopped
1 pound sliced cremini mushrooms
½ cup Marsala wine
¼ teaspoon dried thyme
¼ teaspoon salt
Pinch black pepper

Instructions

In a saucepan over medium heat, warm chicken stock. Once simmering, reduce heat to low.
In a saucepan or Dutch oven over medium heat, heat olive oil and butter. Add onion and garlic and cook for 2 minutes. Add Arborio rice and stir for 1 minute. Add white wine and cook until absorbed.
Add warm chicken stock, about ½ cup at a time as it is absorbed, and cook over low heat, stirring often, until the rice is cooked through (but not mushy).
While rice cooks, prepare mushrooms by melting butter over medium-high heat in a skillet. Add garlic and cook for 30 seconds or until fragrant. Add mushrooms and cook for 5 minutes, stirring occasionally. Add wine and cook until absorbed. Finish with thyme, salt and pepper.
Add Gruyere and Parmesan cheeses to the risotto and stir to combine. Finish with lemon juice and salt.
Scoop risotto onto serving plates and top with mushrooms.

NUTRITION PER SERVING: 392 calories, 16g total fat, 8g saturated fat, 44mg cholesterol, 594mg sodium, 43g carbohydrate, 2g fiber, 3g sugar, 18g protein, NA potassium, NA phosphorus

Analysis uses generic mushrooms for cremini and adds 4 calories to account for wine in recipe.