Healthy Ideas Column

Each month, our Healthy Ideas Column covers important topics like food safety, health and nutrition, community events and more. Check past columns to the right.

This Month's Column:

Osteoporosis

What is osteoporosis?

Osteoporosis is a disease that causes very weak and brittle bones that break easily. Osteoporosis is sometimes called a "silent disease" because there are usually no symptoms to let you know you have it. Unfortunately, a broken bone in the hip, spine or wrist is often the first sign. There is no way to stop or cure osteoporosi, but there are things you can do to slow it down.

What causes osteoporosis?

Bone is living tissue that is constantly being remodeled. Osteoporosis occurs when formation of new bone can't keep up with the removal of old bone. In growing children, new bone is made faster and bones increase in size and strength, reaching their peak when people are in their early 20s. As we age, old bone is removed faster than new bone is formed. You are less likely to develop osteoporosis if you achieved a higher peak bone mass when you were young.

Who is at risk for osteoporosis?

Osteoporosis can strike at any age, but occurs mostly in women over 50 and men over 70.
Women are five times more likely than men to get osteoporosis.
Women who've gone through menopause are more likely to have it.
It can run in families. You are also at greater risk if you are white or of Asian descent.
Men and women who are thin and have a small body frame may have less bone mass to draw from.
Anyone not getting enough calcium and vitamin D in the diet, especially during childhood, can end up with weak bones.
Not getting enough exercise leads to weak bones.
Smoking and excessive alcohol intake increases the risk of osteoporosis.
Certain medications can interfere with the bone-rebuilding process.

Talk with your health-care provider to determine if you may be at risk for osteoporosis.

How do I know if I have osteoporosis?

There are no symptoms in the early stages. Loss of height, stooped posture, bone pain or fractures occur later. Your doctor may order a test to measure bone density.

How can I lower my chances of getting osteoporosis?

Get enough calcium. Women between 19-50 years old need at least 1,000 mg calcium each day. Women over 50 years old need 1,200 mg calcium each day. If you are not able to meet your body's calcium needs with food, you may need a calcium supplement. Ask your doctor or a registered dietitian to help you choose the best supplement for your needs.

Get enough vitamin D. Sunlight is a good source of vitamin D but if you are housebound, use sunscreen or avoid the sun, you may need a vitamin D supplement. The recommended amount for adults is 600 to 800 IU (international units) a day through food or supplements. Your doctor may prescribe a higher dose.

Get exercise everyday. Weight-bearing exercise such as walking, running, dancing and weightlifting is beneficial for strengthening bones. Building muscle strength and balance through regular exercise also helps lower the risk of falls and fractures.

Don't smoke.

If you drink alcohol, keep to no more than one drink per day. A "drink" is 5 ounces of wine, 12 ounces of beer or 1 ½ ounces of distilled spirits.

Your doctor may also prescribe a medication to prevent osteoporosis.

What is the best diet for bone health?

MyPlate provides a simple guide to building a balanced, healthy diet. The foods that promote bone health - dairy products, fruits and vegetables, legumes and nuts - are also the foods recommended for a healthy diet. Plus, many foods rich in one bone-building nutrient also contain other helpful ones. Supplements may be useful in helping to meet adequate intake of vitamins or minerals but they don't provide many of the other nutrients that are present in whole foods.

Calcium is needed on an ongoing basis to build new bone. Calcium is also needed for other critical functions involving muscles, blood vessels and nerves. Your bones store more than 99 percent of the calcium in your body. When calcium is in short supply from the diet, the bones will give up their calcium to keep those other functions going. Keep your body supplied with calcium from dairy products, dark green leafy vegetables and calcium-fortified foods such as cereals and fruit juice. Aim for 3 servings of nonfat or low fat dairy products a day for adequate calcium.

Vitamin D is needed by bones to absorb calcium and by muscles to maintain strength. Vitamin D does not occur naturally in many foods, so we need to rely on foods fortified with vitamin D. Look for milk and soy products with vitamin D added. Some cereals and juices are also fortified with vitamin D.

Vitamin K works with vitamin D so calcium can be used by the bones. Taking vitamin K supplements will not increase bone mineral density or reduce fractures. However, a balanced diet that includes foods rich in vitamin K such as broccoli, Brussels sprouts, cauliflower, kale, dairy products, chick peas and seeds is recommended.

Potassium and magnesium are minerals that are part of bone structure. Potassium-rich foods include fruits and vegetables, legumes, milk products and nuts. Magnesium is usually present in foods that are good sources of potassium.

Protein is needed to maintain bone density and muscle strength. Eating enough protein may be a challenge for the elderly who are also at greater risk for osteoporosis and fractures. However, eating excess amounts of dietary protein, whether from animal or plant sources, may be harmful to bone health if you don't get adequate amounts of calcium and vitamin D. MyPlate recommends eating lean protein from seafood, meat, poultry, legumes and nuts. Keep portions under control by filling just one-fourth of your plate with protein foods.

Fruits and vegetables provide bicarbonate, which helps to buffer acids in the body that come from the food we eat and from metabolism. When there isn't enough bicarbonate, the body uses calcium from bone to buffer the excess acids. The typical American diet that is too high in protein (meat) and grains (bread, pasta, baked goods) produces too much acid that can harm bones. Note that acidic foods like citrus do not create acid in the body. It's important to eat more fruits and vegetables to preserve the calcium in bones. Follow MyPlate recommendations to fill half your plate with fruits and vegetables. Choose lean protein and whole grains for the remainder of your plate to maintain balance.

Naturally Gluten-Free Foods

People with celiac disease can't eat foods containing gluten, a protein found in wheat, rye, barley and some other grains. The only treatment for celiac disease is eating a gluten-free diet that excludes most breads, cereals, pasta, crackers and cookies.

The Food and Drug Administration (FDA) uses the following definitions for "gluten-free" foods:

Cannot contain wheat, rye, barley or hybrids such as spelt, triticale or kamut
Cannot contain ingredients from grains that haven't been processed to remove gluten (e.g., wheat flour)
If ingredients from grains have been processed to remove gluten (e.g., wheat starch) the product must contain less than 20 parts per million (ppm) gluten
Must contain less than 20 ppm gluten

To the FDA's knowledge, 20 ppm is the lowest level that current technology can reliably and consistently detect gluten in a variety of foods. This level is consistent with international standards. The scientific literature indicates that most people with celiac disease can safely tolerate trace amounts of gluten in foods. The FDA's goal is to define "gluten-free" in a way that protects the majority of people with celiac disease without unnecessarily restricting their food choices or making it more difficult or costly to follow a gluten-free diet.

How to Find Naturally Gluten-Free Foods

Many packaged foods contain a long list of ingredients. Allergen statements will declare whether wheat is present in a food product, but that does not necessarily mean that the product is gluten-free. The product may contain barley, rye or one of the other gluten-containing grains. Gluten may sometimes be hidden in ingredients that come from these grains. Gluten can also enter a product by cross-contamination during growing, harvesting or processing.

Following a gluten-free diet may seem overwhelming at first, but there are plenty of foods to choose from that are naturally gluten-free and will provide the nutrients needed to stay healthy. The best way to stay gluten-free is to choose fresh foods and cook from scratch. This can be time-consuming but is often necessary to prevent symptoms. Many recipes only use a few ingredients and take less than 30 minutes to prepare and cook.

Take a look at the various sections in the supermarket that carry naturally gluten-free foods:

Produce: Fresh fruits and vegetables are naturally gluten-free. Contamination can occur if produce is peeled, cut or prepared in an area where gluten-containing ingredients are also prepared.

Groceries: Canned fruits in water or juice, canned vegetables without sauces and canned or dry beans are naturally gluten-free. Other safe items include honey, molasses, jams, jellies, marmalades, brown and white sugar, baking soda, gelatin and black pepper. All 100% distilled vinegars, cider vinegar and apple vinegar are gluten free. (Malt vinegar and vinegars flavored with malt contain gluten.) Check herbs and spices to make sure they do not contain wheat flour to prevent clumping.

Meat, Poultry and Seafood: Fresh meats, fish and seafood are naturally gluten-free if there are no other added ingredients. Check the label for additives such as marinades, flavorings and brines that may contain gluten. Most deli meats are gluten-free, but ask to see the label to make sure.

Dairy Aisle: Whole eggs in the shell are naturally gluten-free. Milk fortified with vitamins A and D that does not contain flavorings or thickeners is naturally gluten-free. Plain, unflavored yogurt, as well as most cheeses and butter are also naturally gluten-free.

Fat and Oils: Any single-ingredient vegetable oil is naturally gluten-free. Nut butters without additives are also naturally gluten-free. Packaged nuts and seeds in the shell or out of the shell are also safe. Be wary of nuts and seeds that are sold in bulk because cross-contamination from other bins storing gluten-containing items can occur.

Other Grains and Starches: This is where you should be most careful. Naturally gluten-free grains include rice, amaranth, buckwheat, corn, quinoa and teff. Naturally gluten-free starches include potatoes, tapioca, arrowroot and cassava. Look for the words "gluten-free" on the label of these products for assurance that there has been no cross-contamination. If you can tolerate oats, only buy oats that are labeled gluten-free.

Look for "Gluten-Free" Claims on Food Packages

If a package says "gluten-free," it means the manufacturer has ensured there is no gluten in that food product. However, food products that seem like they would be gluten-free, such as a rice mix, may have traces of gluten if the manufacturer makes other products with gluten in the same facility. If a food does not have a "gluten-free" claim on the package, check directly with product manufacturers for more information.

Heart Health

You're never too young or too old to improve your heart health. Take action by scheduling a visit with your doctor, making changes to your diet and increasing your physical activity. Here are some suggestions to get you started:

1. Know Your Numbers
Your physician or cardiologist will interpret your lab results and give you goals for your cholesterol numbers. If you are taking medication to lower cholesterol or blood pressure, follow a heart-healthy diet, get active or stay active and lose extra weight to stabilize or improve your health.

Total Cholesterol: Your body makes all the cholesterol it needs. Eating foods high in calories, saturated fat and sugars can raise cholesterol levels. When cholesterol gets too high, it sticks to arteries and forms plaque. Plaque build-up hardens and closes the arteries, leading to heart disease. Particles called LDL and HDL move cholesterol through the blood.

Low density lipoprotein (LDL) is sometimes called "bad" or "lousy" cholesterol. High LDL is linked to a higher risk of heart problems and plaque build-up. Choosing foods high in fiber, low in saturated fat and low in added sugars may lower your LDL. Avoid foods with trans fats or partially hydrogenated fats.
High Density Lipoprotein (HDL) is often called the "good" or "healthy" cholesterol. HDL takes cholesterol and fat out of the blood to prevent plaque build-up. To raise your HDL, increase physical activity, lose extra weight and substitute saturated fats with monounsaturated fats such as olive oil or canola oil.
Triglycerides are fats that travel in the blood. High levels can cause plaque build-up. To lower triglyceride levels, lose extra weight, limit sugars and alcohol and include fatty fish such as salmon for heart-healthy omega-3 fats.

2. Eat Right to Reduce Your Risk
Take control of your heart health by eating a variety of nutrient rich foods lower in calories. Follow these guidelines recommended by various health organizations.

Control the calories you eat to lose weight or prevent further weight gain. Find out how many calories you need through the Interactive Tools at www.ChooseMyPlate.gov.

Add fruits and vegetables to meals and snacks. Fruits and vegetables are relatively low in calories and sodium and provide nutrients such as potassium, which may help lower blood pressure.

Focus on fiber: Challenge yourself to include 20-30 g of fiber in your diet each day. Eat a variety of fruits and vegetables and choose whole grains, beans (legumes), seeds and nuts. Increase soluble fibers to help lower your cholesterol. Soluble fibers are found in oats, apples, pears, bananas, carrots, broccoli, beans and soy products such as tofu.

Choose unsaturated fats such as olive and vegetable oils instead of butter, stick margarine, and coconut or palm oil for cooking and baking. Try tub margarines with plant stanols and sterols, which may help lower cholesterol.

Eggs and dairy: Choose egg whites, egg substitutes and low fat or fat free dairy products. Low fat or non-fat milk, cottage cheese and yogurt are sources of nutrients with less cholesterol and saturated fat than other dairy products.

Lean meats, poultry and oily fish: Choose lean cuts of pork and beef such as loin, leg and round cuts. Leaner poultry cuts such as skinless chicken breast and turkey tenderloin are also good options. Fit in two servings of fatty fish such as salmon or tuna each week to increase omega-3s.

Nuts and seeds provide unsaturated fat to help improve cholesterol levels. Choose unsalted almonds, walnuts, peanuts or pine nuts. Limit portions to 1.5 ounces each day (about 1/3 cup) to control calories.

Reduce added sugars: High sugar intake is linked to weight gain and increased heart disease risk. Choose fresh or frozen fruits and vegetables over products with added sugar. Drink water instead of juice cocktail and soda. Added sugars should provide no more than 100 calories per day for women and 150 calories per day for men. A 12-ounce can of cola contains about 8 teaspoons of added sugars or 130 calories.

Limit sodium and salt by using herbs and spices to flavor foods instead. Too much sodium may raise your blood pressure. Diet plans such as the DASH diet cut out salt and sodium for heart health.

*Look for products marked with the Healthy Ideas symbol in Giant Stores to help you be a heart healthy shopper!

3. Get active
Whether your weight is within or above the recommended range, physical activity is important for heart health. Exercise 30 minutes a day, 5 days a week. Walk, swim, hike or join fitness classes to get moving. Check with your doctor before starting an exercise program. Start slowly and work your way up to being more active.

Resources

10 Easy Tips to Help You Keep Your Weight Loss Resolution

Especially after the holiday season, it's no surprise that one of the most popular New Year's resolutions is to lose weight, or at least start to lead a healthier lifestyle. However, many of us have a hard time holding true to our healthy ambitions and fall off track after a few weeks or months. Follow these easy tips so this is the year you keep your weight loss resolution!

Follow the MyPlate guidelines to help you build a better, more balanced plate at each meal.
- Make at least half of your grains whole grains
- Vary your veggies
- Focus on filling half your plate with fruits and vegetables
- Switch to reduced-fat dairy products
- Go lean with protein
Visit http://www.choosemyplate.gov/ for more information
Find someone with a similar goal. Many people do better when they have someone to motivate or push them to stay on track. You are less likely to give up if a co-worker, friend, sibling, parent or spouse keeps working toward their goal!
Instead of setting one BIG goal, set smaller, more realistic goals. Many of us get discouraged and quit if we don't meet our weight loss or exercise goals, but it is probably because we set our goals too high too soon. Setting smaller goals that are easier to achieve encourages you to keep going each time you meet one of those goals.
Find ways to incorporate activity into your day, even if you need to divide up the time. It's recommended that we get an hour of exercise everyday, but many of us don't have the time or motivation to exercise for an hour all at once. Break it up throughout the day and work yourself up to longer periods of exercise. Get up and walk for 10 minutes, 3 times a day (that's 30 minutes right there!); park further away and walk into work, the grocery store, or mall; or do sit-ups, jumping jacks or other exercises while watching TV. The possibilities are endless-be creative!
Weigh yourself often. It is recommended that you weigh yourself at the same time every day. This will help you better determine what you are doing that is good and bad for your weight loss goals. If you notice you've lost weight that day, try to remember what worked from the day before; if you gained weight, determine what may have caused the gain and work to correct it. Aim for a weight loss of no more then 1% of your total weight each week.
Stock your fridge, pantry and snack drawer at work with healthy and satisfying foods. Keeping healthy snacks on hand will deter you from the unhealthy treats that always seem to find a way into your sights!
Plan meals, lunches and snacks ahead of time. Planning and preparing dinners for the entire week will make you less likely to pick up something quick, easy and most likely bad for you on the way home! Look for 30-minute recipes that use lean meats and lots of vegetables. Plan for leftovers for lunch or make sure you have food on hand to pack for lunches and pack them the night before.
Take time to eat breakfast every morning, even if it is 2 hours after you wake up. Packing your breakfast with protein (eggs and lean meats), fruits, and vegetables will keep you focused and satisfied until your next meal, making you less likely to overeat.
Be flexible. Realize that not everything will work, and you'll have to adjust your weight loss plan until you find a routine that works for you. Even after you find something that works for you, you will need to adjust it once you start losing weight to keep up with the weight loss.
Remember portion control, moderation and discipline. You can still enjoy some of your favorite foods, just less of them less often. If you do indulge, get up and move an extra 20 minutes or half hour that day to compensate. Don't feel like if you go off track once, your entire resolution is ruined. Make it your goal to get back on track the next day!

The most important thing to remember is that for most of us, weight loss is not always easy, but benefits our overall health. So keep pushing yourself to meet your goals!

Take time to eat to enjoy the holiday season

With the busyness of holiday shopping, decorating and entertaining you need to eat well to help you maintain your stamina! Pay attention to eating habits to keep you feeling in a holiday mood.

Keep to your normal meal schedule. If you stop to eat while shopping, choose a meal that includes a salad or vegetables. Drink water to stay hydrated.
Resist the urge to graze while you are cooking, baking or clearing the table. Take time to sit down and eat a balanced meal to give you the energy you need to get things done.
Prevent overeating and indigestion by eating slowly, savoring every bite and giving your stomach a chance to digest the food. Remember to show kindness to yourself as you extend good will to others.

American Diabetes Month

This November, The American Diabetes Association is encouraging everyone to find out if they are at risk for developing diabetes. Chances are you - or someone you love - have been affected by diabetes in some way. About one out of four people who have diabetes don't even know it.

There is no cure but prevention is the key to reducing the risk of developing type 2 diabetes, which is associated with being overweight. If you are overweight, you can do the following:

Consult with your physician to have your blood glucose checked.
Modify your diet to achieve a modest weight loss. A registered dietitian/nutritionist can help you develop an eating plan that is right for you.
Increase physical activity to improve your health and help manage your appetite.

Breast Cancer Awareness

October is National Breast Cancer Awareness Month. Although breast cancer affects mostly women, men are also susceptible. Here are some actions you can take to reduce your risk:

Breast cancer screening and early detection are the most important strategy for improving survival. Make and keep your appointments for screening procedures.

Research shows obesity may also be linked to breast cancer. If you need to lose weight, consider lifestyle changes that include exercise and eating right. Try to include at least 30 minutes of moderate physical activity most days of the week to maintain a healthy weight and avoid gaining weight as you age.

A diet that is low in saturated fat and includes plenty of whole grains and a variety of fruits and vegetables may offer protection.

Women should limit alcohol to one drink a day to reduce risk.

Grocery Shopping with Kids

Grocery shopping can be a true learning experience for kids. They will appreciate what it takes to plan and cook meals if they are involved in the process. It's also easier to keep your children nearby if you engage them in activities to help you shop.

Let kids have their own list of healthy items to look for while shopping. They can use the Healthy Ideas symbol on shelf tags to help choose items.
Younger kids can find items by colors, letters, or package shapes.
Teach older kids how to read nutrition labels, compare prices and use coupons.
Estimate the weight of fruits and vegetables, then check them on the scale.
Older kids can help bag groceries by sorting them for the refrigerator, freezer, pantry and household.

Packing Healthy Lunches

The kids will be going back to school, and that means back to the routine of packing lunches. Each time you fill your child's lunchbox, think of it as an opportunity to set them on the right path to good nutrition! A few things to keep in mind when choosing and preparing lunches:

Aim for at least four food groups in each meal. Choose whole grain breads or wraps, nut butters or lean meats, low-fat milk or cheese, vegetables on a sandwich or on the side and fresh or canned fruits.
Involve your children in planning and preparing their lunches. They are more likely to eat healthy items if they choose them.
Don't forget about food safety. Always start with a clean lunchbox and include an icepack with perishable foods.

Cleaning Fruits and Vegetables

Summer is salad season! Whether it's a pile of crisp greens or a sweet mix of your favorite fruits, it's important to always wash fruits and vegetables thoroughly before you serve or consume them to avoid the risk of food borne illness.

Some year-round tips for cleaning produce:

Choose produce with no decay, insect holes or cuts in the surface that may harbor bacteria.
Wash produce with clean running water before cutting or peeling. Use a soft brush on firm fruits and vegetables and those with edible peels.
Use separate cutting boards for produce and meats to avoid cross-contamination. Whether you use plastic or wood cutting boards, make sure you wash them thoroughly with soap and water after using.
Clean and sanitize your refrigerator often, especially produce drawers.