Nutrition News

August 2002

In this issue:

• Hormone Replacement Study Halted
• Go Nuts with Almonds
• High Protein Diets
• The low down on Pizza!
• NutritionWorks Bookstore going Live Soon!
• Recipe of the Month: Baked Marinated Tempeh
• Favorite Product of the Month – Fruitwater
• NutritionWorks upcoming events and happenings

Hello!

What a great time to continue to take advantage of this weather, enjoying the sunshine, and all the opportunities the region has to offer: hikes, walks, swimming, kayaking, festivals, and outdoor games. September is a wonderful time of renewal. Children return to school and a new season sets in. A reassessment of what is important to us and where we would like to commit our time and energy can be a good way of preparing for the change of season. It also is a nice time to try something new and different! Sign up for a cooking or yoga class or try a new hobby. In this issue, we cover some requested topics from our readers.

We appreciate the requests, comments and feedback so we can continue to bring you information, ideas, and recipes for you to enjoy and benefit from.

Kathleen and Sandi

Hormone Replacement Study Stopped
This July, the estrogen plus progestin (hormone replacement therapy, HRT) study of the Women’s Health Initiative (WHI) was stopped early because of an unacceptable number of adverse events. The results gathered are very informative, as they finally clear up some very important questions.

Currently, HRT is the 2nd most widely prescribed drug in the US (so it has the potential
to benefit or harm many women). Given that there seemed to be both benefits and risks
for HRT, the National Institutes of Health began a research study among a large group of ethnically diverse women to assess the cumulative benefits and/or risks of taking HRT. Between 1993 and 1998, the WHI enrolled 161,809 postmenopausal women between the ages of 50 and 79. This is a massive study. These women were then funneled into one of several studies (all of which are continuing, with the exception of the HRT wing).

The HRT study had over 16,000 women enrolled, and the scientists were to follow them for about 8.5 years. But in the spring of both 2000 and 2001, something happened. An outside safety board observed an increased number of cardiovascular events and an increase in a global health index (cumulative score or 7 different health events) of adverse events. However, at that time, the adverse events weren’t high enough to stop the trial. But this May, the safety board found that the adverse effects in heart disease, stroke, breast cancer, deep vein thrombosis, pulmonary
embolism, and the global health index were high enough that the risks of taking HRT significantly outweighed the benefits. The trial was stopped, having followed the women for about 5.2 rather than 8.5 years.

While some benefits were observed in the HRT group—a decrease in fractures and colorectal cancer—these benefits were not significant enough to override the increased risks (and there are other FDA approved medications for osteoporosis). An accompanying editorial in JAMA stated, “the whole purpose of healthy women taking long-term estrogen/progestin therapy is to preserve health and prevent disease. The results of this study provide strong evidence that the opposite is happening for important aspects of women’s health, even if the absolute risk is low”. They further go on to end the editorial with, “the WHI provides an important health answer for generations of healthy postmenopausal women to come—do not use estrogen/progestin to prevent chronic disease.”

While this study does answer several important questions, it doesn’t answer others. It doesn’t answer whether even short term (less than 1 year) use of HRT for the treatment of hot flashes and other menopausal symptoms has risks. It also doesn’t answer whether estrogen therapy without progestin has elevated risks (for those women who don’t have a uterus).
These results will be available from the WHI in a few years.

For now, if you are taking HRT or estrogen or are considering taking them, I suggest that you talk with your doctor.

Article adapted from Miriam Nelson

Go Nuts with Almonds!
Research published in the August issue of Circulation says so! Eating almonds improves cholesterol levels and therefore may lower the risk of cardiovascular disease. In the past there has been hesitation to eat almonds regularly because of concern about the calorie and fat content. Research continues to show that eating almonds as part of a low saturated fat and cholesterol diet instead of a whole grain bakery item produced improved cholesterol levels. The type of fatty acid ratio in almonds is favorable of monounsaturated to polyunsaturated which has improved cholesterol levels in numerous studies.

Don't like almonds? Although almonds have been researched most rigorously, walnuts, pecans, peanuts, macadamia, and pistachios have all been shown to lower cholesterol levels as well! Dry roasted or raw is the recommend form of nuts to purchase.

You don’t need to get too “nutty” though in order to reap the benefits; it doesn’t take much. In this study both doses of 37 g and 74 g, or a "handful or two", produced the cholesterol lowering results.

Many clients benefit from the protein and fatty acids found in nuts when incorporating into their meal plan.

High Protein Diets
A recent study published in the August issue of the American Journal of Kidney Disease gives us another sobering reason high protein diets may not be worth the long-term consequences. A large quantity of protein in the diet results in a high acid load to the kidneys. This high acid load may result in kidney stone formation and possible bone loss. Dr. Reddy conducting the study commented that although some people following high protein, low carbohydrate diets lose some weight "they should be aware of the risk of kidney stone formation and the potential risk for long term consequences of osteoporosis." He recommends people with a family history of kidney stones, kidney disease, as well as osteoporosis should not follow high protein diets.

Adapted from Reuters Medical News 2002

Pizza Strategies
Two slices of the Pizza Hut's stuffed crust Pepperoni Lover's pizza is 1,050 calories, over a day’s worth of fat and more than a whole day's recommended sodium at 2,830 mg. The Nutrition Action Newsletter June 2002 reviewed the nutritional data on one of our nation’s favorite fast food. So, what is one to do? Pizza Strategies offered for all pizza lovers include: pick vegetable, chicken, and ham toppings. Ask for 1/2 the cheese or no cheese at all. Skip the hidden cheese, in the crust or above and below toppings. Avoid the multi-meat pizzas: sausage, pork and beef on pizzas add a great deal of calories, saturated fat and sodium to the pizza. Eat a side salad with your pizza. Avoid the other "side" dishes at the pizzeria. Cheese bread, dessert pizza, and wings will only add to the calories and fat.

Source: Nutrition Action Newsletter, June 2002

NutritionWorks Bookstore coming soon!
This month we will be launching our favorite picks on our website at www.NutritonWorkSeattle.com. We are often asked about our favorite cookbooks and good nutrition/lifestyle resources. We put careful thought into our picks, all of which have been reviewed and used by one or both of us at NutritionWorks. We plan to update the bookstore quarterly to bring you the latest valuable nutrition releases. Enjoy and we look forward to hearing what you think!

Recipe of the Month
Baked Marinated Tempeh as a Main Dish
From The Millennium Cookbook, by Tucker and Westerdahl

As promised in our last month's newsletter, here is a delicious, easy tempeh recipe. It is important to bake the tempeh in an oven as instructed in the recipe as the texture is preferable to microwaving. I have brought this to potlucks and receive numerous complements. "This is what? Tempeh? What is it? Really...soy? It is good!"

Bake twice the amount the recipe calls for and freeze what you will not use for a week for a second meal! The Millennium Cookbook is from a successful gourmet vegetarian restaurant in San Francisco. We have not yet had an opportunity to visit, but think it is probably worthwhile for those of you heading to the Bay Area in the upcoming months!

Enjoy!

Marinade:

1 cup red or nonalcoholic red wine
4 cups vegetable stock
1/2 cup tamari
4 cloves garlic, minced
1 Tbsp. Dijon mustard
1 tsp. dried sage
2 tsp. dried thyme
1/2 tsp. nutmeg
1/4 tsp. dried red chili flakes
2 tsp. maple syrup, honey, or Sucanat
6 four-ounce portions soy tempeh

Instructions:

Preheat oven to 350. Mix all the marinade ingredients together. Place the tempeh in a baking dish and pour the marinade over the tempeh. Bake for 1.5 hours. Either remove the tempeh from the marinade to serve or freeze, or store the tempeh in the marinade for up to a week in the refrigerator. Serve over a bed of brown rice, mixed greens, stir fry vegetables, whole-wheat cous cous, or barley.

Nutritional Information:
285 calories (28% from fat), 24 g protein, 27 g carbohydrates, 9 g fat, 0 mg cholesterol, 385 mg sodium, 6 g fiber

Favorite Product of the Month
Yes, this time it is a beverage! It is called Fruitwater by Glaceau. It is a new bottled water product found now in most grocery stores. We have brought this product to some of our classes and received rave reviews and wanted to share it with our readers who are having a difficult time drinking enough water daily. Some may find drinking adequate water is easier with this product. It is vaporized distilled water with fruit essence. One of our favorites is the watermelon flavor. Be sure when trying this to smell the water first…yum!

We also enjoyed the advertising on the product: “May result in a desire to apply a simple and clearer way of thinking to other aspects of your life. No carbonation, no calories, no carbohydrates, no sugar, no sodium, no preservatives, no stress, no worries, no anxiety. Suggested usage: as often as the urge for vapor distilled water with the subtle essence of fruit arises. This, admittedly, may become very often.”

Okay, so the marketing ploy got us to try it and … we are glad!

NutritionWorks Happenings
We have another fall quarter packed with a variety of fun, informative nutrition classes. Below are a few highlights, but visit our website at www.NutritionWorkSeattle.com for a complete list of upcoming classes.

We are back in the Northgate area at Discover U teaching our Food Combining class on Sept. 23. For more information and registration call (206) 365-0400 or visit www.discoveru.org.

In October we will be co-teaching a few cooking/nutrition classes for Third Place books and PCC. More to come in the September newsletter!

Eastside classes include Bringing in the Harvest, 5 a Day, Occupational Eating Hazards, and Supplements. Please call (425) 899-3000 to learn more about dates, times, and future offerings.

We look forward to having you join us!

• Thank you to those of you with questions and suggested recommended topics. Continue to let us know if you have any questions.
• If you'd like to share experiences or successes with managing your health, favorite recipes, or newly discovered foods...we'd love to hear from you!
• If you know anyone who would like a nutrition/wellness presentation offered, please tell them about NutritionWorks!

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