Newsletter MARCH 2007

Article
Heart Disease: Why Women are Unique

Ask the Doc
Community Supported Agriculture and Local Flavors Cookbook by Deborah Madison

Research Review
Blood Sugar and Cancer

Doctor’s Pick
TamPontification and Seventh Generation

Recipes of the Month
Spring Tonic Soup
Tilapia with Tangerine Cilantro Salsa
Green Quinoa Pilaf

Quote:
“You can only become truly accomplished at something you love. Don’t make money your goal. Instead, pursue the things you love doing, and then do them so well that people can't take their eyes off you.”
Maya Angelou

>>>>>>>>>>>>>>>>>>>>>>>>>>>

Heart Disease: Why Women Are Unique
By Sarah Cimperman, ND

Heart disease is the leading cause of death in the United States. It kills more women than men and the American Heart Association (AHA) estimates that one women dies from heart disease every minute. Mortality isn’t the only difference between the sexes – discrepancies in risk, diagnosis, testing, and treatment also exist. The good news is that heart disease is often preventable and a basic understanding of the unique ways it affects women is the first step toward saving lives.

Diagnosis and Treatment
Cardiovascular disease is a comprehensive category of conditions affecting the heart and circulatory system, from atherosclerosis and arrhythmia to murmurs and stroke. Heart attack, also known as myocardial infarction, is one of the most serious conditions because failure to identify symptoms and seek immediate care can quickly result in death.

The most common symptoms of heart attack, for both men and women, are pain, pressure, squeezing or feelings of fullness in the center of the chest; and pain, numbness or tingling sensations radiating to the neck, jaw or shoulder. However, women are less likely than men to experience chest pain and more likely to have other symptoms, such as shortness of breath, weakness, unusual fatigue, nausea, vomiting, flushing, dizziness, anxiety, perspiration, back pain, and discomfort in the lower chest or upper abdomen.

This difference in symptoms can create confusing pictures for patients and doctors alike. When misdiagnosis occurs, testing and treatment may be delayed until significant damage has already been done. Even with the correct diagnosis, women are less likely to receive life-saving procedures. Only thirty-three percent of angioplasties and stents are preformed on women, according to the AHA.

Because research studies on testing and treatment for heart disease have historically focused primarily on men, there is insufficient information on their safety and effectiveness in women. Women still lack equal representation in cardiovascular research, accounting for only thirty-eight percent of subjects in co-ed studies funded by the National Institutes of Health.

Risk Assessment
Risk for heart disease is another area where women differ. When it comes to predicting problems, some factors apply to both sexes: high blood pressure, high total cholesterol, low HDL (high-density lipoprotein) cholesterol, lack of physical activity, excess body weight, and family history of a mother or father having a heart attack before age sixty.

Other factors play a more prominent role in the development of cardiovascular disease in women, compared to their male counterparts. These include smoking, depression, low levels of estrogen before menopause, and metabolic syndrome (a combination of increased blood glucose, elevated levels of triglycerides, and high blood pressure). Experts don’t entirely understand the reason behind the discrepancy, but some have theorized that estrogen receptors on heart tissue may play a part.

Annual Examination
Yearly visits to the doctor for a physical exam and routine tests are essential to assessing risk and diagnosing cardiovascular problems. Basic testing includes blood pressure (it should be below 120/80), total cholesterol (below 200 mg/dl), low-density lipoprotein (below 100 mg/dl), high-density lipoprotein (above 50 mg/dl), triglycerides (below 150 mg/dl), homocysteine (below 15 micromoles per liter), and C-reactive protein (below 1 mg/l).

Homocysteine is an amino acid produced by the normal breakdown of proteins in the body and abnormally high levels may help predict risk of heart disease and stroke. C-reactive protein is a nonspecific measure of inflammation in the body and can indicate conditions other than heart disease, such as infection, rheumatoid arthritis, and cancer. Experts have questioned its value but a in recent study, researchers at Brigham and Women’s Hospital concluded that CRP can be helpful in determining risk and treatment guidelines for heart disease in women.

Prevention
The best prevention strategies against heart disease include not smoking, eating a healthy diet, exercising regularly, getting plenty of sleep, and achieving and maintaining ideal body weight. Before beginning a new exercise routine or stepping up a current one, get approval from your doctor. Start slowly and increase the time and intensity of your workout gradually, never adding more than ten percent at once. Aim to walk at least 10,000 steps daily (easily measured with a pedometer) and exercise intentionally a minimum of thirty minutes each day, at least five days per week. Always cool down for five to ten minutes after aerobic exercise and make sure your heart rate drops to 100 beats per minute, or below, before stopping.

Sleep is another important factor in heart health. A recent study in Norway followed 8,860 adults between the ages of forty and forty-five. Researchers found that short sleep duration was associated with obesity, high blood pressure, and elevated levels of total cholesterol and triglycerides, all of which increase chances of cardiovascular disease. Individual needs vary, but children generally need ten to fourteen hours of sleep each night and adults usually require six to nine hours nightly.

A heart-healthy diet is high in vegetables, fruits, whole grains, legumes, and wild cold-water fish. Trans fats, saturated animal fats, processed and fried foods, and those high in sodium should be avoided and women should limit alcohol intake to one drink per day. Red wine is a good choice, thanks to antioxidant anthocyanins found in the skin of grapes.

Individuals who don’t eat fish at least three times per week should talk to their doctor about a fish oil supplement. Those who do should be concerned about environmental contaminants and the sustainability of harvesting practices. The Oceans Alive website (www.oceansalive.org) rates seafood choices on their environmental impact as well as their content of omega-3 fatty acids, mercury, and poly-chlorinated biphenyls (PCBs). It also offers consumption advisories, detailed species-specific information, and recipes.

>>>>>>>>>>>>>>>>>>>>>>>>>>>

Ask the Doc: Community Supported Agriculture

Because I don’t always have time to go to the farmers market, I’m interested in joining a CSA. How do I get started?

Hector
Lower East Side, New York City

Community Supported Agriculture groups, or CSAs, partner regional rural farmers with urban individuals, families and institutions. The farmer sells shares of the upcoming harvest to pay for growing and distributing a season’s worth of produce. The farmers get a living wage and city folk get a wide variety of seasonal farm-fresh foods each week from June to November (distribution may vary with growing seasons).

Different farms offer different packages. Most include vegetables and fruits; some offer flowers, baked goods, dairy products and eggs from free-range chickens. Produce is usually organic (check with the farmer) and always fresh-picked. An average share provides enough weekly produce for two to four adults, and some farmers offer half shares.

If you live in New York City, visit the website of Just Food to find CSAs in your borough: http://www.justfood.org/csa

If you live outside of New York City, visit the website of Local Harvest to search by zip code or state: http://www.localharvest.org/csa

Joining a CSA not only helps support sustainable food systems and local farmers, but it helps to ensure a healthy, whole foods diet. Most likely, you will be introduced to new foods and/or new varieties of your old favorites. If you are looking for serving suggestions, check out Deborah Madison’s cookbook Local Flavors: Cooking and Eating from America’s Farmers’ Markets (ISBN 0767903498). From seasonal recipes to tales from farmers’ markets all over the United States, she will delight your appetite and inspire nutritious, healthy meals.

>>>>>>>>>>>>>>>>>>>>>>>>>>>

Research Review: Cancer and Blood Sugar

A study in Sweden followed 33,392 women and 31,304 men to assess the association between blood glucose (blood sugar) and cancer risk. All participants were nonsmokers and none had been diagnosed with diabetes or cancer (other than nonmelanoma skin cancer) when the study began.

Researchers found that both men and women with high levels of blood sugar had significantly increased risk of cancer, specifically malignant melanoma and cancers of the pancreas and urinary tract.

Women were found to have additional risk for hormone-related cancers. Compared to women with low levels of blood sugar, those with high levels had an increased risk of endometrial cancer. Women under age 49 with high levels of blood sugar had a higher risk of breast cancer as well.

Stattin P et al. Prospective study of Hyperglycemia and Cancer Risk. Diabetes Care, 30:561-567, March 2007.

>>>>>>>>>>>>>>>>>>>>>>>>>>>

TamPonification and Seventh Generation

For healthier bodies and a healthier environment, Seventh Generation is committed to making organic cotton tampons and pads without chlorine. They are also committed to donating free personal products to women’s shelters in the United States, Canada and Kenya.

You can help. Visit the TamPonification website at http://www.tampontification.com/donate.php to select a state, province or country, and Seventh Generation will donate a box of organic cotton tampons or chlorine-free pads to a women’s shelter in that area. There is no cost to you and it takes less than a minute.

For more information on living green and Seventh Generation’s nontoxic products, from bathroom tissue and laundry detergent to diapers and dish soap, visit their website at http://www.seventhgeneration.com.

>>>>>>>>>>>>>>>>>>>>>>>>>>>

Spring Tonic Soup

Often compared to spinach, nettle greens are flavorful and nutritious, rich in potassium, calcium and magnesium. They can be prepared like any green leafy vegetable, but they must always be cooked. The fresh leaves contain constituents that can irritate skin and mucus membranes, like the throat, but cooking inactivates these compounds. If fresh nettles are not available, use dried nettles instead, available as teas in health food stores. If you are avoiding nightshade plants, substitute zucchini for the potato.

6 oz fresh nettles or 2 nettle tea bags or 1 tbsp dried nettles
2 tbsp extra virgin olive oil
2 leeks, halved lengthwise, thinly sliced and thoroughly cleaned
2 carrots, diced
1 large or medium potato, diced, or 4 small ones, quartered
1 sprig fresh thyme or 1 tsp dried
1 bay leaf
2 cups beet greens or chard, chopped
5 cloves garlic, smashed and minced
Water or bean broth * or vegetable broth, about 6 cups
½ cup fresh or frozen peas
Apple cider vinegar to taste

If using fresh nettles, handle them with gloves or tongs. Rinse the leaves in cold water before plunging them into boiling water for 2 minutes. Drain them, discard any tough stems, and chop them coarsely.

If using dried nettles, steep 2 tea bags or 1 tbsp leaves in 1 cup of water for at least 15 minutes. Strain and set aside.

In a soup pot, heat olive oil over medium heat. Add the leek, carrot, potato, thyme and bay leaf. Cook over medium heat, stirring occasionally for 5 to 7 minutes, until the vegetables begin to soften. Add the beet greens, garlic, and chopped nettles (if fresh ones are available). Cook 5 minutes more, stirring occasionally and taking care not to burn the garlic.

Add enough water or broth to cover the vegetables by one inch, increase the heat and bring the mixture to a boil. Then reduce the heat to low and simmer, uncovered, for 15 minutes. Add the peas and the nettle tea (if fresh nettles are not available) and cook 3 minutes more. Remove the soup from the heat. Add a splash of apple cider vinegar and a pinch of sea salt. Stir to combine, taste, and adjust seasoning if necessary.

Remove the bay leaf and thyme stems. Serve as is or cool briefly and puree the soup for a smooth texture. Alternatively, puree just half the soup for a chunkier texture.

* To make a surprisingly rich bean broth, soak 1 cup of dry white or adzuki beans overnight. Discard the soaking liquid, rinse the beans and add them to a soup pot with a bay leaf, a chili pepper, an onion, quartered, and any of the following vegetables: carrot, celery, parsnip, leek, garlic. Add 10 cups of water, bring the mixture to a boil, and simmer over low heat for 3 hours. Strain and boil to reduce stock to one quart. Add sea salt to taste. Cool and store in the fridge for use within 2 days or freeze for future use.

>>>>>>>>>>>>>>>>>>>>>>>>>>

Tilapia with Tangerine Cilantro Salsa

This recipe calls for tilapia but you can substitute any white fish, such as Alaskan halibut, or even bay scallops.

1 tangerine
1 fresh chili pepper (serrano, jalapeno, or other)
2 scallions, thinly sliced in cross section
½ yellow, orange or red bell pepper, diced
¼ cup chopped cilantro
Sea salt
Juice of ½ lime
Tilapia fillets, 4 to 6 oz per person
Ground black pepper
1 to 2 tbsp extra virgin olive oil or coconut oil
1 fresh lemon

For the salsa:

Peel the tangerine and separate into 2 halves. Place each half, flat side down, on a cutting board and use a serrated knife to slice in cross section, into half-moon shapes. In a small bowl, separate the triangles in each slice, getting as much of the juice as possible into the bowl.

Cut the chili pepper in half lengthwise; keeping the stem intact. * For a mild salsa, remove the seeds and membranes. For a spicier salsa, leave them intact. Hold the stem as you thinly slice the halved pepper in cross section.

Add the pieces of chili pepper to the bowl with the sliced scallions, diced bell pepper, chopped cilantro, a pinch of sea salt and fresh lime juice. Toss to combine, taste and adjust seasoning if necessary.

For the fish:

Season the fish fillets with ground black pepper and a small amount of sea salt. Sauté the fillets in the olive or coconut oil over medium heat, turning once, until opaque and flaky. Remove from heat and squeeze fresh lemon juice over the fish. Serve immediately with a spoonful or two of the tangerine cilantro salsa.

* If you are sensitive to chili peppers, wear gloves while you work with them.

>>>>>>>>>>>>>>>>>>>>>>>>>>

Green Quinoa Pilaf

If you’re avoiding nightshades, substitute zucchini for the bell pepper. This recipe is very flexible and easily adapted to what you have on hand or what you find at the farmers’ market. Any chopped green can be used in place of spinach (kale and chard work well) and any fresh herb can be substituted for the cilantro.

½ cup dry quinoa
2 cups fresh chopped spinach or other green leafy vegetable or 10 oz frozen chopped spinach *
2 tbsp extra virgin olive oil
1 medium onion, chopped
½ red, orange or yellow bell pepper, chopped
1 cup chopped mushrooms
2 cloves garlic, minced or crushed
Ground pepper to taste
¼ cup chopped cilantro
Sea salt to taste

Rinse quinoa and add to 1 cup boiling water. Reduce heat to lowest setting and simmer until water is absorbed and grains are tender, about 25 minutes.

Meanwhile, heat olive oil in a skillet over medium heat. Add the onion, bell pepper, spinach, mushrooms, garlic and black pepper. Sauté over medium heat until all of the vegetables are tender.

Add the quinoa to the vegetable mixture with the chopped cilantro and toss everything together. Add sea salt, taste and adjust seasonings if necessary. Serve hot, at room temperature, or cold.

Yield: 2 main course servings or 4 side dish servings

* If you’re using frozen spinach, thaw it, wrap it in a clean dishtowel and squeeze out all the moisture. If you are substituting another dark green leafy vegetable such as kale or chard, blanche it first by adding to boiling water for one minute.

>>>>>>>>>>>>>>>>>>>>>>>>>>


Click here to download the March 2007 newsletter*

* You will need the Adobe Acrobat Reader to view this file.   Click this button to get this free-ware.
To subscribe to this newsletter
Those who would like to receive a monthly email with the link can email with “subscribe” in the subject field. Those who do not wish to receive such reminders can send an email to the same address with “unsubscribe” in the subject field.