Happy Healthy Long Life

Prepping for Thanksgiving - Ellen Goodman's Wisdom, Cooking a Turkey with Vegan Sides, the Helpful Husband, and High Chair Clean-Up

Real Life Adventures-Gary Wise & Lance Aldrich

"I'm hardly a Pollyanna about family life.  I know about the stress of the sandwich generation, trying to be all things to all bosses, parents, children, spouses.

I know that every family has troubles.  At some time or other, in some light or other, we all look dysfunctional.  But the fact is that most of us are functioning.  And loving."

-Ellen Goodman, "The Functional American Family",  The Boston Globe, November 24, 1994-

 

 

I have no business taking time off to write a Thanksgiving post--but right now I need a break from shopping, cooking, and scrubbing down a hand-me-down highchair--ick!  

OK, I cannot tell a lie--my husband handled the highchair clean-up duties--thank goodness!  And, he took care of the crib assembly--which now looks like it needs to be disassembled in light of massive of crib recalls. Oh well!

But my real reason for posting--I just love this cartoon & I want an excuse to use it.

Actually, I'm basically chilling this Thanksgiving--even though the gang is coming in from New York City, St. Louis, Cincinnati, and Pittsburgh.  The first guests arrive on Tuesday night.  Very late.  Midnight late.

Everyone is pitching in this year.  My husband did the bulk of the grocery shopping.  Poor guy had never experienced the Thanksgiving rush, and was clueless where to find "meatless" meatballs, Wheat-a-Bix, toasted pecan pieces, Lemonaise, currants, Larabars, red pepper spread, and more. 

His first call to me at work with "grocery location questions" was all jokes & laughter.  By the fourth call--this time I was away from my desk--he'd about had it. 

Here's the voicemail message he left me:  "I don't know where anything is.  There's no one to ask and if I don't hear back in 5 minutes, you're on your own with the shopping!"

In the end, he found almost everything--without my help.  On my way home from work, I picked up what he had missed.

Cleaning a Farm Fresh Turkey is a Great Reason to Eat Vegan

This year I got a pastured organic Kosher turkey from a nearby farm, about 7 miles from where I live.  Who knew what a project cleaning a "farm fresh" turkey would be?  

There's the rinsing, the pin feather-plucking--with my husband's tweezers--then ruining my knife trying to cut off the neck--the awkward seasoning maneuvers trying to turn a wet slippery 20 pound turkey.  Not my idea of fun.

Washing my hands about 20 times--every time I needed to open a drawer, a cabinet, sprinkle salt, pepper, paprika, rosemary, turn on the faucet, get a pot holder, open the oven--there has to be an easier way!

And the clean-up:  the grease, the raw turkey juices, the sanitizing of the sink, the counters, the cutting board. Who knew that easy grease-free clean-up turns out to be a good reason to eat plant-based?

Glad it's done.  All cooked, quartered, and in the freezer.

Except for the Turkey--the Gracious Guests are All Cooking Vegan

• Nephew Josh--a professional chef at La Via Vite--is bringing Red Pepper Bisque, and instead of cream he's using Tal Ronnen's cashew cream.  Click here for the cashew cream recipe.
• My sister--a professional baker--is baking a Vegan Chocolate Cheesecake, out of the November, 2009 Gourmet Magazine.  Click here for the recipe.  She's also cooking up a vegan version of an Oatmeal Crust Apple Tarte Tatin.

• My husband is making Tal Ronnen's Whipped Chipotle Sweet Potatoes and Martha Rose Shulman's fresh Cranberry Orange Relish.  Click here for the sweet potato recipe.  Click here for the cranberry recipe.

• Niece Anna is making vegan Mashed Potatoes.
• Niece Jamie is making a vegan vegetable tart.
• My kids are making maple-roasted Brussels sprouts with shallots, traditional stuffing, and setting the table.  They just don't know it yet.
• Is this going to be a low-fat healthy Thanksgiving?  Probably not.  But it's a special day!
• As for me--I'm sure I'll find something to do--like playing with my grandbaby.

 

Ellen Goodman's Wisdom.  "The Functional American Family", The Boston Globe, November 24, 1994

As it always happens, last week I randomly came across this ever-so-wise fifteen-year-old Thanksgiving column written by Boston Globe writer, Ellen Goodman.  I'd give you the link to it, but none exists. 

For everyone who is busy getting ready for Thanksgiving company, take a minute to savor this memory of preparing for a family homecoming.   Listening to the news, you'd think we're all in dysfunctional families.  Ellen disagrees with that assessment:

 

"I am up to my elbows in Thanksgiving prep when the phone rings. There are macadamia nuts to the right of me, pecans to the left. Flour and eggs are wrestling in my mixing bowl.

 I reach for the phone, cradling it between my ear and my shoulder and hear the voice of a television producer. She wants to know whether I might be available to comment on the decline and fall of the American family. A story for the season.

As I stand there, covered in batter, she rattles off the horrific list of stories that make her case. The South Carolina mother who drowned her children. The 19 toddlers found in a squalid Chicago apartment without food or clothes. The Pittsburgh couple who took off for two weeks without warning, abandoning three kids to teen-age babysitters.

 I listen to this familiar litany with an equally familiar sense of gloom, and then I decline. I'm sorry, but this afternoon, I promised to visit my mother. Tomorrow, the cousins are coming from California. The next day is our wedding anniversary. Tuesday, the young adults we call "the kids" are arriving. And there is a crisis in the care of an aged aunt.

 I hang up the phone, wiping pastry dough from my hair and savoring the irony that flavored this exchange. The irony of being too busy with family to comment on its breakdown.

 Folding in the last ingredients of my much-too-elaborate recipe, the annual proof of Stewart's (as in Martha) Disease, I wonder how many of us live with this duality. We are convinced that the great amorphous, generic American family is falling apart. At the same time we are occupied with family maintenance.

All year, I have heard a steady drumbeat of despair about "family values." The overwhelming majority of Americans agree - 98 percent in one recent poll - that other people are not living up to their commitments. Yet in the same poll only 18 percent believe they're irresponsible themselves.

 Everywhere I go, when people talk about what they value, the topic is their family. The coin of the conversational exchange between friends and even strangers is the state of their parents, their children, their spouses.

In our daily lives, we work at and for family. At 4 o'clock in the morning, when we worry, it's about our family.

Today, we have higher demands on ourselves as the parents of growing children and longer demands as the children of aging parents. But every morsel of evidence of success - did you read that 8 out of 10 high school juniors and seniors list parents as the people they trust? - comes lost in a survey of family woes.

What do we make of this duality? I wish the producer had asked me that. Some of it comes perversely from the very struggle to do a good job. The harder most of us try, the angrier we are at those who don't and at the price society pays.

But we are also reeling from something akin to negative advertising about the American family. The horror stories that make the front page, because they are so extraordinary, have slowly begun to be accepted as ordinary.

The radio talk shows, the Limbaughs and Liddys, provide an endless stream of antigovernment messages. But the Jenny Joneses and Montel Williamses, and the Sally Jessy Raphaels  present an unbroken stream of pathological families.

On any day, we can channel surf across this electronic byway from murderous mothers to husband-stealing sisters to proud mothers of teen-ager strippers. If Norman Rockwell's Thanksgiving family were on the air, grandpa would be a child molester, grandma a recovering drug abuser and the kids would bear sexually transmitted diseases. The abnormal is the norm.

I'm hardly a Pollyanna about family life. I know about the stress of the sandwich generation, trying to be all things to all bosses, parents, children, spouses.

I know that every family has troubles. At some time or other, in some light or other, we all look dysfunctional. But the fact is that most of us are functioning. And loving.

Somewhere along the way Americans have lost a sense of proportion. We've come to believe that I'm OK, but you're not, and that thing called The American Family is most certainly not.

This Thanksgiving Day has always been been more about family than food. It's the time when Americans travel through airports, highways, ZIP codes, in order to squeeze around the family table and discover how many adults can sit on a piano bench.

Standing in my kitchen, covered in homebaked proof of my holiday excess, I wonder if those of us who are connected by bonds of DNA, marriage, affection and above all else, commitment, can forget for a while that we're supposed to be falling apart."

Happy Thanksgiving to Everyone!

 

 

Everybody's Fine: The White Lies We Tell Our Parents about How Life's Going - Robert De Niro's Film about Family. See the Movie - Skip the Popcorn & Candy!

 

Everybody's Fine.  Robert De Niro's New Movie

Click Here if you aren't seeing the trailer or you're reading this from your email

 

Frank, the dad:  "I don't know what it is with you kids.  You always told your mother everything.  You never told me anything."

Frank's daughter:  "We tell you the good news.  We spare you the bad."

Frank's son:  "Mom used to say, 'Make your dad proud.'  I know you're not proud of me."

Frank, the dad:  "As long as you're happy, I'd be proud of you no matter what you did."

Frank's daughter:  "Really?  Really, dad?"

I got to see the sneak preview of this movie on Thursday night--and I loved it.  It was funny, touching, thought-provoking and certainly rang true for me as a daughter and as a parent.  My parents heard the good stuff, not the bad, unless I "was up against the wall".  As for my kids...well, I can only guess. 

Here's the pitch:

Frank Goode's a recent widower and a recent retiree who has worked hard all his life making protective coatings for telephone wires.  Why?  So his kids would have a chance at successful careers--making a living doing something they love--something that expresses their unique talents.  He was their ever-present coach--pushing them to excel.  Encouraging their successes--but maybe a tad-too-invested.

And it worked. One's a well-known  New York artist.  One's a musician and an orchestra conductor.  One runs a big Chicago ad agency.  One's a successful Las Vegas dancer and actress.  Frank's busting with pride.

But, when one by one everyone cancels for a weekend homecoming reunion, Frank decides to crisscross the country to make a surprise visit to each of his children.  And that's all I'm going to tell you.

Who is going to "get" this movie?

• If you're a son or a daughter who has ever felt that unspoken (or spoken) pressure to make your parents proud--and didn't quite buy into your parents' idea of "success"--you'll "get" this movie.

• If you're now a parent who only wants the best for your kids--you'll "get" this movie.

• If you're a parent who can't break the worry-habit when it comes to your kids--you'll "get this movie.

• If you're a dad, who leaves the nitty-gritty details of your kids' lives to their mom--you'll "get" this movie.

• If you're programmed to answer, "Everything's fine," when your parents ask you how things are going--you'll "get" this movie.

If you're old enough to know that things never go as planned, and the dreams for ourselves and our children are dreams, not reality--and that grown-up kids--well, they can take care of things just fine for themselves, thank-you very much!--you'll "get" this movie.

Is This Strictly a Chick Flick?

I had two burly guys sitting next to me, and I definitely detected some eye-wiping action.  Guys crying?  Big plus in my book.

As for my husband, whose tastes lean toward action, adventure & war stories--he loved it!  When I asked him if he thought it was a chick flick, he said, "No way!  I'd rate it a 10 on a scale of 1-10, and I think this is Oscar material for De Niro."

Hey, we're certainly not film critics.  Reuters describes this film as, "Robert De Niro movie a 'Fine" mess".   Well, fine for them! 

The Best Advice I Ever Got When It Comes to Grown-Up Kids, click here

I Knew That Movie Snacks Were Bad--But This Bad? Glad I Skipped the Free Popcorn!

Photo Credit: Stephen Schmidt

A medium combo at Regal has 1,610 calories and 60 grams of saturated fat. That's roughly the saturated fat of a stick of butter and the calories of two sticks of butter.

Check out the December 2009 cover story in the Center for Science in the Public Interest's Nutrition Action Healthletter.  Click here for the complete story.  Another reminder to skip the movie snacks.  I knew movie popcorn was bad--but this bad?  Yikes!

• Regal says that its medium popcorn has 720 calories and that its large has 960. But CSPI's lab tests found that those numbers were understated. Regal’s medium and large sizes each had 1,200 calories and, thanks to being popped in coconut oil, 60 grams of saturated fat.  That’s about as many calories as a Pizza Hut Personal Pan Pepperoni Pizza—except the popcorn has three times the saturated fat. Even shared with another person, that size provides nearly an entire day’s worth of the kind of fat that clogs arteries and promotes heart disease. And every tablespoon of "buttery" oil topping adds another 130 calories. Asking for topping is like asking for oil on French fries or potato chips, according to CSPI.

• AMC, the second largest theater chain, also pops in coconut oil but has smaller serving sizes. Its large popcorn has 1,030 calories and 57 grams of saturated fat. That's like eating a pound of baby back ribs topped with a scoop of Häagen-Dazs ice cream—except that the popcorn has an additional day’s worth of saturated fat. A medium has 590 calories and 33 grams of saturated fat; and a small has 370 calories and a day’s worth—20 grams—of saturated fat. (Like Regal, AMC reports calorie counts lower than those returned in CSPI's lab tests.)

• Cinemark pops in heart-healthy canola oil. A large has 910 calories with 4 grams of saturated fat; a medium has 760 calories and 3 grams of saturated fat; and a small has 420 calories and 2 grams of saturated fat. Though popping in canola gives this chain’s popcorn far less saturated fat than its competitors, it's almost as high in calories and has the most sodium—about twice as much as Regal or AMC. With 1,500 milligrams of sodium—a day's worth of sodium for most people—a large popcorn without topping from Cinemark will be less likely to clog your arteries but more likely to elevate your blood pressure. And while Cinemark uses a "buttery" oil topping similar to the toppings used at Regal and AMC, at some outlets, particularly in the West, it uses a topping made with real butter. That version has 9 grams—half a day’s worth—of saturated fat per tablespoon.

Photo Credit: Stephen Schmidt

 

Eating an 8-ounce bag of Reese's Pieces is like eating a 16-ounce T-bone steak and a buttered baked potato.

From CSPI's December 2009 Nutrition Action Healthletter

 

 

Tal Ronnen, The Conscious Cook's Delicious Meatless Recipes - I Took a Second Look, Lowered the Fat, and Decided I Love This Cookbook

 

The Conscious Cook shows readers that avoiding the health risks and ethical dilemmas of eating meat and dairy does not mean sacrificing taste and appetite. This is not a cookbook of sprouts and tofu burgers, but of mouth-watering, hearty meals that keep the protein at the center of your plate. Featuring 75 original recipes that will satisfy the fussiest foodies and the most dedicated of carnivores, The Conscious Cook is a breakthrough in meatless cuisine that will revolutionize the way readers experience food.

-Amazon's Description of "celebrity-chef" Tal Ronnen's new vegan cookbook-

If You Receive This Blog via Email, Click Here to Go to the HHLL Website

 

When I picked up a copy of "The Conscious Cook"  at my local library three weeks ago I hadn't a clue who Tal Ronnen was. 

But I soon found out! 

He's one of the most well-known vegan chefs around--with stint as Oprah's chef when she tried out vegan eating--adviser to the top vegan restaurants--and master vegan teacher-chef at culinary schools nationwide.

Not to mention he's friends with just about everyone in the vegan world.

• Yves Potvin, the Canadian who invented my favorite "garden protein": Gardein--a delicious blend of vegetables and grains with the texture of meat.
• Bob Goldberg, the inventor of Vegenaise (vegan mayo) and Follow Your Heart--vegan casein-free cheeses.
• Don McKinley, the American who "discovered" quinoa growing in Bolivia, and started importing seed and growing it in Colorado back in 1982.
• Serafina Magnussen, a master vegan baker--baking without butter or eggs.
• Seth Tibbott, maker of artisan tempeh, and the founder of Turtle Island Foods in Hood River, OR

The photos in this cookbook are stunning & mouth-watering--and the 75 delicious-sounding recipes are well-constructed and easy to follow. 

But then I took a closer look with a critical eye.   So many of these recipes include generous amounts of olive oil, Vegenaise (the egg-free mayo), or Earth Balance, a vegan butter substitute.

Darn!  I was ready to just return this book and chalk it up to vegan junk food--albeit delicious junk food.

First off--I've got to say this.  There are basically two kinds of vegans (yeah, sure, I'm generalizing here).

1.  The "ethical" vegan who doesn't eat animal products for moral, environmental or ethical reasons.

2.  The "health conscious" vegan who doesn't eat animal products for health reasons--and that usually means they are very conscious of lowering their fat consumption--including oils.

Since, I'm the "health conscious" (mostly) kind-of-vegan, Tal's generous use of oils, Earth Balance spread, cashew cream (I'll explain what this is later), and Vegenaise kind of defeats the purpose of a vegan diet for me.

I'm Glad I Gave the Conscious Cook a Second Chance

Before returning the book I decided to take a second look.  Hey, I can adapt these recipes to make them healthier--not zero fat--but healthier.  I decided to try out a few before I discounted Tal's book altogether.

So far , everything I've tried has been a culinary winner.  Yes, it's not everyday fare, given the higher fat content.  But Tal is truly a master chef.

• If you are a confirmed meat eater I'm certain you'll enjoy these recipes. 
• If you're tipping your toe in the water of vegan eating I'm certain you'll enjoy these recipes.
• And if you're already a vegan who's looking for some dazzling delicious recipes--and you're OK with a little oil or cashew cream occasionally--and you're willing to cut all that in half--I'm certain you'll enjoy these recipes!
• If you want no-fat fare--skip this cookbook

Conscious Cook recipes I'm looking forward to trying:

• Mediterranean Chickpea Wrap
• Vietnamese-style Tofu Hero with Asian Slaw
• Old Bay Tofu "Crab Cakes"
• Tempeh Creole over Brown Rice
• Paella with "Sausage", Nori-Dusted Oyster Mushrooms, and Wine-Braised Artichoke Hearts
• Asparagus and Meyer Lemon Risotto

 

Tal's Split Pea Soup with Tempeh Bacon and Chipotle Cream

Here's the first of Tal's recipes I tried, and the one that won me over.  I prepared it one morning before I went to work--it was that easy.  The smoked paprika, fresh rosemary, shallots & leeks make it a cut way above the usual split pea soup.  And I've always loved tempeh bacon!  I used the left-overs for an amazing "Bacon Tomato Avocado" sandwich.

 

 

Makes 4-6 servings.  

Prep time:  1 hour 15 minutes

Sea salt

2 TBS Earth Balance  (Tal uses 4 TBS.)

2 shallots, minced

2 leeks, thinly sliced

1 large carrot, coarsely chopped

3 cloves garlic, minced

2 tsp. chopped fresh rosemary (Tal uses 1 tsp.)

1 bay leaf

1 tsp smoked paprika

5-cups vegetable stock.  I used Imagine's No-Chicken Broth

1 1/2 cups green split peas, rinsed

Freshly ground pepper

1 tsp. canola oil (Tal uses 2 tsp.)

4 slices tempeh bacon  (Fakin' Bacon at Whole Foods)

Chipotle Cream (I left this out, although I'm sure it's delicious.  Too much extra fat! It's a combo of 1/4 cup vegan mayo, 1/2 cup thick cashew cream (recipe follows later in post), 1/2 can chipotle in adobo sauce, salt, pepper, & juice of 1 lime).  Put it all in a processor & blend until well mixed.

 

1.  Place a large stockpot over medium heat.  Sprinkle the bottom with a pinch of salt and heat for 1 minute.  Add the Earth Balance (I'm sure olive oil would work just fine)  and stir until melted, being careful not to let it burn.  This will create a nonstick effect.

2.  Add the shallots, leeks, carrot, and garlic and saute for 5 minutes.  Add the rosemary, bay leaf, and paprika and continue cooking for 2 minutes.  Add the stock and split peas and season with salt and pepper to taste.  Bring to a boil, then reduce the heat and simmer, uncovered for 1 hour.

3.  Meanwhile, heat the tiniest amount of oil you can in a small skillet over medium heat.  Add the tempeh bacon and fry on both sides until crisp.  Cool and coarsely crumble.  Serve the soup with a sprinkle of tempeh bacon & chipotle cream (which I omitted). TIP: "Fry up all the bacon & keep in the fridge for BLTs.

 

 

Tal's Agave-Lime Grilled Tofu with Asian Slaw and Mashed Sweet Potatoes

This one was OMG mouth-watering-I-can't-get-enough-of-this-delicious!  This recipe I made with my husband last Sunday.  A bit of a pitchky-potchky, but well worth the effort.  The sweet potatoes were so delicious I decided to make a large batch of them for Thanksgiving.  The chipotle & cashew cream combo in them is outstanding.

 

Even My Version Came Out Picture Perfect!

Servings: 4

Prep Time:  1 hour, plus 2 hours for marinating the tofu

Warning:  This recipe uses thick cashew cream that YOU make.  It takes minutes to make, BUT, you have to soak 2 cups of whole raw cashews in water overnight, so you have to plan ahead.  The Cashew Cream recipe is at the bottom of this recipe.

For the tofu:

**This tofu is fantastic and worthy of making all by itself for sandwiches or to cut in strips on top of salad.

1 pound extra-firm tofu, cut into 8 (1/4 inch thick) slabs.  Wrap in a dish towel & press for 30 minutes under a heavy pot or brick to remove excess water.

1/4 cup light agave nectar (available everywhere now)

1/2 cup shoyu soy sauce (I used regular)

3 garlic cloves, smashed

2 sprigs of fresh thyme

1 tsp. fresh ground black pepper

Juice of 2 limes

1 1/2 TBS lightly packed brown sugar.

 

Make the tofu:

1.  Make the tofu:  Place the tofu in a single layer in a shallow nonreactive dish.  In a small bowl, whisk together the remaining tofu ingredients.  Pour over the tofu and marinate in the refrigerator for 2 hours.

2.  Preheat the oven to 300 degrees F.  Lightly oil a baking sheet.  Using a slotted spoon, remove the tofu from the marinade (reserve the marinade) and arrange it in a single layer on the baking sheet.  Bake for 15 minutes.

3.  Meanwhile, pour the marinade into a small saucepan.  Cook over medium-high heat until reduced to a syrupy glaze, about 8 minutes.

4.  Heat an outdoor grill or preheat a grill pan over medium high-high heat.  Transfer the tofu slabs from the baking sheet to the grill and grill for 3 to 4 minutes, or until grill-marked.  Turn the tofu over and generously brush with the glaze; cook for 3 to 4 minutes, or until grill-marked.  Remove the tofu to the baking sheet, turning it over so the glazed sie is down, then glaze the top side.

For the slaw:

3 TBS. rice vinegar

1 tsp. light agave nectar (add more if you like a more sweet tangy taste)

1/2 tsp. sea salt, or more too taste

2 TBS. freshly squeezed lime juice

1 tsp. soy sauce

2 TBS. canola oil (Tal uses 1/4 cup safflower oil)

1 large carrot, peeled and julienned (save yourself time & buy the julienned carrots in a bag)

1/2 daikon radish, peeled and julienned (I bought this--never had one before--but when I unloaded my groceries I couldn't find it)

1/2 head napa cabbage, shredded

1 scallion, thinly sliced (Tal juliennes)

1/2 tsp. toasted sesame seeds (Tal uses mixed black and white sesame seeds)

Make the slaw:

1. In a large bowl, whisk together the vinegar, agave nectar, salt, lime juice, and soy sauce.  Continue whisking vigorously in one direction as you slowly pour in the oil in a thin stream until emulsified.  Add the remaining slaw ingredients to the bowl and toss to coat.

For the sweet potatoes:

2 very large sweet potatoes, peeled and diced. (I short-cutted with pre-cut sweet potatoes from Trader Joe's)

1/4 cup thick Cashew Cream (Tal uses 1/2 cup) *recipe to follow

1 TBS. Earth Balance (Tal uses 2 TBS.)

1 canned chipotle pepper, seeded and minced

Sea salt and freshly ground black pepper

Make the sweet potatoes:

1.  Cook the sweet potatoes in a pot of boiling water for 20 minutes, or until tender.  Drain.  Put the sweet potatoes, Cashew Cream, Earth Balance, and chipotle pepper in a bowl and use a portable or stand mixer to whip up at medium-high speed until smooth and fluffy.  If you have a whisk attachment for your mixer, use it!  Season with salt and pepper.

Assemble the dish:

1.  Place one quarter of the sweet potatoes in a scoop in the middle of a serving plate.  Top with one quarter of the slaw.  Place 1 tofu slab on the top of the slaw, and 1 slab angled against the sweet potatoes and slaw, as in my picture.  Repeat with remaining ingredients.

Cashew Cream:

2 cups of whole raw cashews (not pieces, which are often dry), rinsed very well under cold water. 

Put the cashews in a bowl and add cold water to cover the them.  Cover the bowl and refrigerate overnight.

Drain the cashews and rinse under cold water.  Place in a blender with enough water to just cover the cashews.  Preferably use a Vita-Mix for this.  It's quick & easy.

Blend on high for several minutes until very smooth.  (If you're not using a professional high-speed blender like a Vita-Mix, which creates an ultra-smooth cream, strain the cashew cream through a fine-mesh sieve.)

Makes at least 2 1/2 cups of thick  cream.  Prep time: 10 minutes, plus the overnight soak

Storage:  Can be stored for 2-3 days in the refrigerator, or store in small servings in the freezer for up to 6 months.  If it's a bit lumpy after defrosting, give it a spin in the blender.

Many of Tal's recipes use Cashew Cream, so it won't go to waste.

It gives vegan recipes the same sort of flavor that can come from cream.  I'd use this only sparingly, for company fare.

Tal's California Gardein "Chicken" Salad.  My Curried Variation

 

 

 

 

 

 

My Variation:

Serves 8

Prep Time: 10 minutes

3/4 cup Half the Fat Flax Seed & Olive Oil Vegenaise (vegan mayo) Tal uses 1 cup of the regular Vegenaise
 

2 tsp. rice vinegar

Juice of 1 lime

1 TBS agave nectar

1 1/2 pounds Gardein chicken-style strips (find them as "Chicken-Less" Strips in the refrigerated case at Trader Joe's  or use the frozen Morningstar Farm version called "Meal Starter", thawed)--pulsed in a food processor or chopped by hand   Tal uses 2 pounds of Gardein "chicken"  Click here to read more about Trader Joe's "Chicken-Less" strips.

3/4 cup walnuts, toasted and coarsely chopped (single layer in a 350 degree oven for 8-10 minutes-watch carefully)

1/2+ cup dried currants  (Tal uses 1 cup champagne grapes, which weren't available)

3 stalks of celery, diced 1/4 inch

2 tsp. curry powder (Not in Tal's recipe--but I added for more intense flavor)
 

 Sea salt & freshly ground black pepper to taste.

Place all of the ingredients in a large bowl  and toss to combine.

Serve on the bread or wrap of your choice.

I used Ezekiel bread with sliced tomatoes & a little avocado.  Delicious.  Next time I would make 1/2 the amount, but it kept well for 4 days.

The Consumer Reports Tested BPA Levels in Canned Food. It's Time to Ditch the Cans and the Thanksgiving Green Bean Casserole. Safe Levels Are Much Lower Than the FDA Allows

 

Consumer Reports' latest tests of canned foods, including soups, juice, tuna, and green beans, have found that almost all of the 19 name-brand foods tested contain measurable levels of Bisphenol A (BPA).  Find the full article by clicking here. 

"Children eating multiple servings per day of canned foods with BPA levels comparable to the ones we found in some tested products could get a dose of BPA near levels that have caused adverse effects in several animal studies.

The lack of any safety margin between the levels that cause harm in animals and those that people could potentially ingest from canned foods has been inadequately addressed by the FDA to date."

 

-Dr. Urvashi Rangan, Director of Technical Policy, at Consumers Union-

That long-loved-favorite green bean casserole you planned to make for Thanksgiving...  Forget about it!

You don't want to feed your family any extra doses of BPA--and that's exactly what they'll get from a dish made with Del Monte Fresh Cut Blue Lake Green Beans (the canned food that ranked #2 in CR tests for the highest level of BPA) and canned Campbell's Cream of Mushroom Soup.

Back in May 2008 when the "BPA-Thing" first surfaced, all the news was about getting rid of our Nalgene bottles, plastic baby products, and other hard plastics.  But cans are the real insidious problem.  Here's what I wrote back then:

Until the FDA starts labeling plastics and cans so we know which ones have BPA why not do what Dr. Fred vom Saal and every other scientist who studies BPA has done.

• Stay away from cans. Eden Organic Beans are the only ones documented to not have BPA. (*but the consumer union found trace amounts in these) The  Environmental Working Group  says cans, more than plastic, are the predominant way we are getting exposed to BPA.  They're lined with an epoxy that contains BPA that can leach out when heated during processing. In the presence of acids like tomatoes, and alcohol even more is leached out.  Think canned beer.  Organic Grace  is maintaining a very helpful list of which manufacturers have BPA in their cans. It's continually updated, so keep checking back.  That means no soft drinks, no canned beer, no cans of V-8, no canned soups, no canned tomatoes, you name it!  By the way, Japan eliminated 95% of the BPA from their cans 10 years ago.  But stay away from cans from China-it's in theirs.

 

The Results of the Consumer Reports Tests on Bisphenol A in Canned Products

• The canned products with the highest levels of BPA: Del Monte Canned Green Beans (54.5-102 ppb of BPA), Progresso Vegetable Soup 67-134 ppb of BPA), and Campbell's Condensed Chicken Noodle Soup 54.5-102 ppb of BPA).  The Consumer Union tested a sampling of canned foods, like tuna, baby formula, beans, meats, vegetables, and juices.  Every product was tested 3 times for accuracy.  For a pdf of the complete Consumer Reports test results of food products click here
  
  
• Why should I care?  What's a dangerous level?  Now don't zone out on these numbers!  I've really worked hard on these conversions to make sense of them. The food safety experts at the Consumer Union put the upper limit for daily exposure of BPA at .0024 micrograms of BPA per kilogram of body weight. 
  

Here's What Those Safe Limits Really Mean:

For a 50 lb. child:  .054 micrograms/day    (1 serving of Del Monte Green Beans (14.9 BPA mcg/serving) is 275 times the upper safe limit)

For a 130 lb. woman:  .14 micrograms/day  (1 serving of Del Monte Green Beans (14.9 BPA mcg/serving) is 106 times the upper safe limit)

For a 180 lb man:   .2 micrograms/day (1 serving of Del Monte Green Beans (14.9 BPA mcg/serving) is 74 times the upper safe limit)

Want to figure out how much you or your child can safely ingest daily?  First convert your weight from pounds to kilograms by clicking here for a handy converter.  Then multiply .0024 by your kilogram weight.  That's your upper daily limit for micrograms of BPA.  If you look at the PDF of the Consumer Reports test results you'll find the BPA micrograms/serving for the products they tested--in the right-hand column.  Click here for the table.  Bottom Line: Stay away from cans!

• What about babies & children?  Formula & Juice?  Bad news!  Similac Advance Infant Formula liquid in cans averaged .85 mcg/serving of BPA and a 15 pound infant's limit should be .016 mcg of BPA/day!  Powdered Similac in a can was a much safer alternative with no measurable levels of BPA.  Juicy Juice Apple juice in a can had 2.3 mcg/serving of BPA--45 times times a 50 pound child's limit of .054 mcg/day of BPA.  No worries--juice boxes to the rescue.  No measurable BPA was found in the Juicy Juice boxes!

• Was there any BPA found in the BPA-free cans?  There aren't too many of these around, only Eden Organics beans and Vital Choice tuna, as far as I know.  The tests on Eden baked beans found .15 mcg/serving.  Bush's Baked Beans in "regular cans" had .6 mcg/serving.  Vital Choice tuna in "BPA-Free" cans averaged 1.15 mcg/serving, which was more than in conventional cans of  Starkist Chunk Light Tuna in water--which had only .2 mcg of BPA/serving.

• Which packaging is safest?  Good news here!  Just ditch buying food in cans, until manufacturers wise up & eliminate the BPA-containing epoxy liners.  Here's what was safe:  Starkist Tuna in a pouch, Bird's Eye Steam Fresh frozen vegetables in plastic steam bags (even after microwaving there was no increase in BPA--big surprise to me), juice boxes.  Although not specifically tested, I would assume that soup and tomatoes in the Tetra-boxes would be safe.

Comparing the FDA Safe Limits for BPA to the Consumer Union's Limits

• The FDA currently puts the upper limit for BPA exposure to 50 mcg BPA/kg of body weight.(Consumer Union food-safety scientists say .0024 mcg BPA/kg of body weight).
  

For a 50 lb. child:  1100 mcg of BPA/day

For a 130 lb. woman:  2950 mcg of BPA/day

For a 180 lb man: 4100 of mcg of BPA/day

• Why is this so much higher than the Consumer Union's?  The FDA's upper safe limits are based on experiments done in the 1980's--rather than using the hundreds of more recent animal & laboratory studies that found serious health risks from much lower doses of BPA.

 

• What has newer research found?  Adverse effects have been shown at exposures of 2.4 mcg of BPA/kg of body weight/per day.  Compare that to the FDA's "safe level" of 50 mcg of BPA/kg of body weight/per day--based on research over 20 years old.
  

 92% of Americans have BPA in their urine.  Hundreds of animal studies show potentially cancerous changes in the mammary and prostate tissue of animals when they ingest the same small amounts of BPA that humans ingest. Increased risk for diabetes, heart disease, reproductive problems, and behavior problems (including ADHD & autism) have been linked to BPA, as well as decreased testosterone levels in men (a study just published on 11/11/09  found sexual problems were 4-7 times higher in workers exposed to BPA ), breast and uterine cancer in women.  It's long been known as an "endocrine disrupter", which means it interferes with the body's hormonal balance.  To read more about the risks, click here and here.  

• Bills are pending in Congress to ban the use of BPA in all food & beverage containers.  BPA is restricted in Canada, Japan, Norway, and in some U.S. states.  A congressional subcommittee found in 2009 that the FDA relied too heavily on the research sponsored by the American Plastics Council, and the FDA will soon decide if their current upper safe limits for BPA need to be revised.

"When you have 92% of the American population exposed to a chemical, this is not one where you want to be wrong.  Are we going to quibble over individual rodent studies, or are we going to act?"

-Dr. Ted Schettler of the Science and Environmental Health Network-

Want to read more?

The Consumer Reports December 2009 article Click here . You'll need to click on each section on the left.

The excellent Consumer Union's "Buy Safe, Eat Well Blog" about the article.  Click here.

Nicholas D. Kristof's op-ed New York Times article "Chemicals in Our Food, and Bodies" about the Consumer Reports article.  Click here.

 

What am I going to do?
 

• Cut down on canned beans. Start cooking my own beans in batches in my crockpot & freezing them.
• I found chopped tomatoes in a Tetra brik box made by Pomi at Whole Foods.
  
• Look for food packaged in Tetra brik boxes, pouches, glass jars, and in frozen bags or boxes.
• I'm confident that consumer demand will soon ban BPA in cans--it worked for baby bottles.

 

 

Kids Say the Darndest Things! What Kids Wish Grown-Ups Knew

Art Linkletter's House Party September 5, 1952-September 9, 1969

Anyone remember this perennial Sunday night favorite?  I grew up with this show.  And my most favorite part--Kids Say the Darndest Things--came at the end of the show, when sweetheart Art interviewed kids from age 5-10.  They spilled all the family secrets.  Oh how I wanted to be on that show!  Click here if you want to see some clips of Art & "the kids".

When I spotted Dr. Cara Barker's essay, "What Our Kids Wish We Knew", in today's Huffington Post, I thought it was going to be like a trip down 1950's memory lane.  Well, not exactly.  Times have certainly changed. 

Back in April 2008 parents had a chance to have their say in a New York Times contest on "Things Kids Need to Know".  Click here to read my favorites.

Now, courtesy of Dr. Cara Barker's interviews with 40 kids--age 3 to 16--the kids have a chance to give out the advice:  "Things Parents Need to Know"

"What do you wish grown-ups knew?"

• Amy, age 3: "Everyday, please, cuddles and marshmallows, please!"

• Jerry, age 4: "When daddies get so mad their heads could blow up!  Singing makes your head blown up better!  Oh, also, we need stories, too!

• Annie, age 5: "They need to send my new baby brother back where he came from! He cries too much. Then they could play with me and we'd all be happy and Mommy would get to sleep with me... It's a lot of work to be a big sister. No one told me about this part. I'm pooped! My brother poops a lot. Yuk!"

• Alexi, age 5: "Little kids need grandpas. Mine comes back to see me sometimes, but I can't tell anyone."

When asked why she can't tell anyone, Alexi answered:   "I told them the first time he came after the 'funeraling' but they told me not to make things up. He really did come to see me and winked. It made me feel better.  Big people should believe you. Maybe grandpa would come see them, too, and then they'd feel better."

• Andy, age 8: "My dad shouldn't worry so much. I'm scared he'll get sick. I don't want to move, but it's O.K. with me if my dad doesn't have to worry about his job. My head hurts when he worries..."

• Marlee, age 10: "Moms should know when their kids are lonely and sad, like the boy in "Where the Wild Things Are."   Only we can't go away like he did. Moms need to throw away their phones.
  O.K., that's dumb. But they need to unplug it.   Moms need to rest, and not stress us out."

• Mary Jo, age 15: "I wish parents knew how hard we try to get good grades, and make them happy. When I get a 'B' they don't say anything, not like when I get 'A's."

"I worry I won't get into a good school, and then there'll be more fighting. I wish parents would just stop fighting. Or, at least remember their kids are listening. There should be a 'parent pill,' where they could learn to 'chill.'  That would be 'rad.'  Oh, also, I think dads should be nicer to the mother, even if they are divorced. It makes us feel bad when they are mean to our moms."

• Brad, age 14: "Dads should be more than tourists in our lives. I wish they knew we're not trying to give them a hard time.  O.K., so they probably think we're pushing them away. But we need to know they're there when things get dicey.  I wish they knew everything is moving too fast out there for us.
  I wish they knew they need to turn off the news. Like the Fort Hood massacre thing is terrible; hearing it over and over is too much."

• Jeremy, age 16: "I wish parents knew we worry about them. When they lose their job, we don't need to go to the big-buck places. It probably sounds 'cheesy,' but it would be awesome to just sit and just play board games, and have popcorn. That's cheap if you make it yourself."

If Fever is the Body's Defense, Should You Treat a Swine Flu Fever? Yes! A Pediatric Infectious Disease Specialist Explains Why

Do you want to lower a fever with Tylenol or is the fever actually the body's defense?

It's conceivable that mammals evolved fever to fight infection, and some authorities believe fever is the body's way of fighting off infection, but according to Dr. Rick Malley, "On the other hand, there's no evidence that blunting the fever response prolongs illness."

Why?  "When people have too much fever, they don't eat, they don't drink, and they can become dehydrated.  And they feel much worse."

-Dr. Rick Malley, pediatric infectious disease specialist at Harvard-affiliated Children's Hospital in Boston-

Over at Shots, NPR's  excellent Health Blog, Dale Moss wondered if it's really wise to treat a fever. 

I was interested in hearing the answer, because this is something I've always wondered about myself--but of course I've always treated my family's and my own fevers with Tylenol.

Here's Dale's Question:  "The body's main defense against viral illness is a strong fever, but the medical profession appears to be suffering a mass amnesia on this point."  Wasn't it the aspirin used during the Spanish flu pandemic of 1918-19 that caused many cases of flu to "morph into a raging pneumonia", and that the medicine actually killed many people?

Thankfully, Moss has it all wrong, as Dr. Malley pointed out. 

And as for the Spanish flu--it turns out that aspirin may have been responsible for many deaths, but it was because the doses given at the time were twice the amount considered safe today. Here's how aspirin may have caused the pneumonia-related deaths:

Dr. Karen Starko, who writes about the phenomenon in this month's issue of Clinical Infectious Diseases, notes that the suggested dose of aspirin in 1918 was twice the daily dosage considered safe today.

Aspirin toxicity, she says, can cause leakage of fluid into the lungs and account for some of the deaths attributed to viral pneumonia.

So, if you or your child get a flu-related fever, go ahead and treat it with Tylenol or Motrin.  But, Malley does offer two important cautions:

• When a flu patient gets better and then worse again, this is an important danger sign that a bacterial infection may be following on the heels of the flu virus. Continuous treatment with anti-fever drugs can mask this signal. So Malley recommends reevaluating fever symptoms when each dose of Tyelenol or Motrin wears off, rather than automatically giving the next dose.

• Parents should never give their children aspirin (and teenagers up to age 19 should never self-administer it) to treat fever. The medicine can increase the risk of Reye's syndrome, a dangerous disorder involving buildup of fat around liver, brain and other organs.

Back when my kids were little & had a fever, I used to consult a handy dandy flowchart that helped me to figure out what they had, how to treat it, and when to call the doctor.  My kids are long grown-up, and that chart is "history",  but I was glad to see that NPR's Richard Knox provided this helpful link from the American Academy of Family Physicians.

Fever Flowchart - What's Causing It, What to Do About It, and When to Call the Doctor

By the way, when Dr. Malley's own kids recently got the swine flu, he gave them ibuprofen (Motrin) to lower their high fevers.

Stay Well!

After 28 Days on Dr. Oz's Vegan Challenge, Cowboy Rocco is on His Way to Health--"If I Can Do It, Anyone Can!"

 

Click Here If You Don't See the Video

On September 24th, 53 year old Rocco Wachman of Scottsdale, Arizona was overweight, diabetic, with the heart of an 85 year old.  On his meat-heavy diet he was eating the equivalent of 2 1/2 pounds of saturated fat a week!  If he kept up this lifestyle, he was headed for serious trouble.

Dr. Oz came to the rescue--challenging him to take on a 28 day vegan diet that cut out meat, dairy, and eggs.  He was coached and monitored by Dr. Oz's sidekick, Dr. Michael Roizen--known as the "Enforcer" for his caring, consistent, "positive pushiness".  To read "Dr. Oz's 28-Day Vegan Challenge for Cowboy Rocco - Heart Disease Reversal Through a Plant-Based Diet Goes Mainstream - Sort Of"  click here.

Dr. Oz's 4 week plan for Rocco

Rocco is going to be followed by a cardiologist--thank goodness--and the plan is to totally reboot his taste buds.  No meat, no dairy, no eggs.  The emphasis is more on ditching the animal protein--not so much on the importance of adding in high nutrient vegetables, like greens, eating high fiber low-glycemic grains, or eliminating added fats.

Rocco is concerned about how this diet will affect his sugar.  Apparently he has type-2 diabetes and is on medication.  Dr. Oz says, "Not to worry.  I bet when you get rid of your belly, your blood sugar will come down, and you'll probably be able to get off your medications."

Week 1

Detox week.  No meat. No dairy.  No eggs.  Break fundamental habits.  Replace meat protein with nuts, beans, and seeds.  Take a B12 or multivitamin.  Rocco loves the taste of Oz's bean chili.

Week 2

Go forward.  Find alternatives to meat.  Emphasis is substituting meat for "fake meat" alternatives, like seitan, fake soy burgers,  faux barbecued ribs, or faux hot dogs.  Lots of soy protein here.

Week 3

Learn to avoid the junk food. Be cautious.  Just because it's not meat, dairy or eggs doesn't mean it's good for you.  Eating French fries & potato chips is not what the diet is about.  Oz encourages Rocco to find healthy snacks--fruit, vegetables, whole-grain or soy chips.  A little chocolate is OK as long as it has a 75% cacao content. 

Week 4

"Vegan meets reality"  Dr. Oz says it's now time to add back a tiny bit of meat--but just as an  "accoutrement".  In my opinion, this could be the downfall of this LITE version of a "heart-disease-reversal-diet".

28 Days Later--How Did Rocco Do?

On November 6, Rocco returned to Dr. Oz's show to see how well the diet had worked! 

It worked--check out Rocco's numbers:

Rocco's A1C Test--a measure of how one's body is managing glucose.  Diabetics need to keep their A1C below 7%.  A non-diabetic will have a level between 4-6%:    

Before:  9 (diabetic)    After:  7.7 (not perfect, but a lot better)

What's New With Rocco?

• "Everything feels different, as if a huge weight has been lifted off of me." -- "If I can do it, anyone can." -- "You've literally kick-started my life, and I have the opportunity of a lifetime!"
• He now walks 12,000 steps a day--keeping track with a pedometer.  He quit using his ATV and truck to get around his ranch.  To get in his 12,000 "steps" he now gets out of the house at 5:30 am, instead of the usual 9:00 am.
• Before the diet he was on 3 different medications--but he after only 28 days he was able to come off of 2 of these, one for cholesterol, and one for his diabetes. 
• His blood sugar is now in the normal range--99--down from 172.
• His acid-reflux is gone!
• Although he was supposed to re-introduce meat in week 4, after eating some meatloaf, he didn't find it as satisfying.  "I figure I will stay way from anything with a face or legs for a few more weeks at least."   Roizen recommends doing it slowly, only 2-3 ounces twice a week.

Rocco's Biggest Surprise with the Vegan Diet

• "Old Rocco" used to eat meat at every meal. The "New Rocco" now eats 5-7 times a day choosing from nuts, seeds, soy protein, vegetables and fruit.
• He's never hungry!  He learned that when he eats the amount of food the size of his palm--he isn't hungry any more--and that he just eats again 2 to 3 hours later.
• He now eats more times a day than he did as a meat-eater, but at the end of the day he's consumed less calories, and can lose weight.
• The first 7 days were the hardest.  "I had to retrain myself to wait for my stomach to tell my brain I was hungry.  Previously,  I let my brain tell my stomach when to eat."
• He plans ahead.  There's no meat or junk food in Rocco's house.  He keeps a stash of healthy foods on hand when traveling so he isn't tempted by fast foods restaurants. I did spot what looked like a gallon on milk in his fridge.
• Favorite vegan meal:  A soy burger, pan-fried, served with green onions and garlic, spread with hummus, and layered between two pieces of tomato.
• Rocco says that changing his diet isn't anything that he couldn't have done by himself, but the fact that he had the "hands on" support and prodding from Dr. Roizen upped his odds.  Besides, he had the pressure of millions of viewers counting on him, wanting to be inspired by his win!

Rocco Says His Former Meat-Eating/Junk Food Diet Was An Eating Disorder

• "I have an eating disorder & no one is out there to save fat guys."  Thank goodness for Drs. Roizen & Oz.
• "It's a problem.  I have to stay away from the things that created it--no different from drinking alcohol.  No different than if I was addicted to drugs, or some other behavior."

I'm really excited for Rocco.  He looks fabulous, and all his blood work, and body measurements have shown that diet & exercise can really improve one's health--and it can be done without drugs. 

If he continues on the straight and narrow he's going to be an inspiration to many.

But I still think he's playing with fire if he goes back to eating meat.  It's pretty easy to fall back into bad habits & bring back the food cravings that got him into trouble in the first place.  He said it himself:  "I have to stay away from the things that created it (his health problem)--no different from drinking alcohol."

The advice that I gave Rocco when he started his challenge still stands:

My advice to Rocco:  Read Dr. Calwell Esselstyn's book now that you've completed your 28-day challenge.  Stick to real whole foods and don't rely on faux soy foods.  Learn to cook.  Load up on healthy greens.  Get a VitaMix and start making Green Smoothies (low on fruit).  You really can change your taste buds!  Get inspired by the experience of Michael F., who lost loads of weight, changed his taste buds, and best of all--got healthy!

Rethinking Mammograms - What the Breast Cancer Experts Now Recommend. The Risks, the Benefits, and Who Gains the Most From Regular Screening

"I'm admitting that American medicine has overpromised when it comes to screening.  The advantages to screening have been exaggerated."

-Dr. Otis Brawley, chief medical officer of the American Cancer Society, on Oct. 21, 2009-

Dr. Brawley's comment, which appeared in the New York Times (read the article here), was in response to a groundbreaking essay by Laura Esserman, Yiway Shieh, & Ian Thompson that appeared in the Oct. 21, 2009 issue of JAMA:  Rethinking Screening for Breast Cancer and Prostate Cancer.  

"It's just not true to say that 'if you get a mammogram, all will be well.'  A recent study indicates that most stage II and III breast cancers actually turn up clinically, between normal planned screens.

A central problem with the screenings for both of these cancers seems to be that they have increased the burden of low-risk cancers without reducing the burden of more aggressive cancers.

We are not saying that screening is bad. It's what you do with the information that makes it good or bad. We need to refocus and figure out how to tailor screening.

I think people like the simple message that screening is good and are uncomfortable with complexity. I understand that. However, cancer is a complicated disease.

We need to expand our messages to say, among other things, that many screen-detected cancers are slow growing and may not need treatment."

-Dr. Laura Esserman, University of California, San Francisco School of Medicine, lead author of the JAMA "Rethinking Screening for Breast Cancer and Prostate Cancer"-

If Mammograms Aren't Perfect, What Are We Supposed to Do Now?

OK, so mammography isn't the wonderful screening tool we all thought it was.  It can pick up slow-growing-non-life-threatening-insignificant cancers, while sometimes missing the fast-growing-aggressive ones.  Although, mammograms do save lives, they can result in unnecessary biopsies, unnecessary treatment, unnecessary fears, and at the same time, they sometimes give us undeserved peace-of-mind when we hear our latest mammogram is just fine. 

Not to mention the large Norwegian study published last year that found about 22% of mammogram-diagnosed cancers might have disappeared without treatment.

What's a woman to do?  Well, thank goodness for Denise Grady, a medical writer for the New York Times, who interviewed several breast cancer experts to find out what exactly we should do--now that we know there's a "dark side" to mammograms.

I recommend everyone read Denise's article, "Quandary With Mammograms:  Get a Screening, or Just Skip It?"  that was published on November 3, 2009.  Click here for the article.

Most importantly--when we go in for our next mammogram, we need to have our EYES WIDE OPEN!  We need to know what mammograms do well, what they miss, which women benefit most, and what are the real risks of screening and biopsy. 

We also need to push for a better way to distinguish the aggressive cancers from the low-risk cancers.

The Breast Cancer Experts' Advice on Mammograms--Compliments of Denise Grady

Dr. Laura Esserman, breast surgeon from UC San Francisco:

1. In terms of growth & aggressiveness, breast cancers are: slow, medium, or fast, and mammograms don't do an equal job of diagnosing all three.
2. Mammograms are good at finding the slow ones--which probably don't need treatment.  
3. Mammograms might not catch the aggressive ones before they begin to spread.  A recent study showed most Stage II & III breast cancers turn up clinically between screenings.
4. Mammograms are good at picking the "medium" ones--and those are the women who benefit most from mammography.
5. Women over 70-75 can stop being screened--no studies have shown that it helps this age group.  Most of the cancers in this age group are likely to be the slow-growing-non-life-threatening variety.
6. There's no evidence of benefit for screening women from age 40-50 unless they have a strong family history of breast cancer or the BRCA gene.
7. Know your risks.  Be proactive.  If you have a high risk, talk to your doctor about taking tamoxifen or raloxifene, which can lower your risk.  Other risk factors include: taking hormones for menopausal symptoms, having a history of biopsies, no pregnancies before 30, a mother or sister with breast cancer, and of course, aging.
8. For the National Cancer Institute Breast Cancer calculator click here.  Dr. Susan Love advises: the calculator is not so good for determining individual risk!
9. Women from age 50-60 benefit most from mammograms--and screening can reduce the risk of cancer by 20-30%.
10. If you are in the over 50 age group--find out if you have dense breasts.  Most doctors don't mention this, and it should be on the radiologist's report.  No one ever told me--I had to ask.  Having dense breast tissue is a double risk.  It's hard to find cancers on mammograms--like finding a polar bear in a blizzard--and for unknown reasons, cancers are more likely to occur in dense breasts.
11. If you have dense breast tissue you might consider an ultrasound. However, even though it does a better job of picking up small hidden breast cancers--it increases the biopsy rate.  A very recent article in BMC Cancer 2009, 9:335doi:10.1186/1471-2407-9-335 looked at ultrasounds for dense breasts. "Early detection of breast cancer: benefits and risks of supplemental breast ultrasound in asymptomatic women with mammographically dense breast tissue. A systematic review"   Click here for the article.  Positive note: Exercise has been found to lower density.

Dr. Susan Love, a breast surgeon & researcher in Santa Monica, CA:

1. "I really don't think we should be routinely screening women under 50.  There's no data to show it works."
2. Women who are 50-70 years old need to find out if they have dense breasts.  If they're dense she recommends yearly mammograms.  Click here to read Dr. Susan Love's advice about dense breasts.
3. If you don't have dense breasts, you can have less frequent mammograms.
4. European countries screen every other year, and their breast cancer rates are not higher than the U.S.

Dr. Larry Norton, deputy physician-in-chief for the breast cancer program at Memorial Sloan-Kettering Cancer Center:

1. Even though mammography isn't perfect, it shouldn't be abandoned. 
2. According to Norton, "If an individual woman wants to reduce her odds of dying of breast cancer by at least 24 %, she should follow the current guidelines."
3. Norton disagrees that 1 in 3 cancers found by mammography aren't fatal--he says, "There's no way to be sure."
4. Finding tumors when they are small, which mammograms can do, increases the odds that a woman can avoid mastectomy and chemotherapy.

Dr. Silvia C. Formenti, the chairwoman of radiation oncology at New York University, Langone Medical Center:

1. "Screening does not pay off the way we expected."
2. All women should have a doctor do a manual exam for lumps & abnormalities.  Experienced doctors can feel lumps as small as 1 centimeter, and even with those as large as 5 centimeters, it's possible to only have a lumpectomy, and perhaps no chemotherapy.
3. Her biggest concern is that mammography will find tumors in older women (over age 70), and these tumors are likely to be not life-threatening.  "The diagnosis turns them into cancer patients and erodes their peace of mind forever.  The psychological cost of becoming a cancer patient is underrated."
4. Best times for screenings:  the 50-60 age group--and women over 60 may still benefit, even though the evidence isn't as strong.
5. It was misleading and "a giant misconception" that  groups like the American Cancer Society led us to believe that screening prevents cancer.

How to Improve Screening--What Drs. Esserman, Shieh, & Thompson Recommend

4-Point Plan to Improve Screening.  From Medscape Medical News "Rethink" of Cancer Screening Triggers Comments and Controversy.

1. More powerful markers that identify and differentiate cancers with significant risk from those with minimal risk are needed.
2. The treatment burden for minimal-risk disease must be reduced. Methods currently exist to identify low- and high-risk cancers in both the breast and prostate, they emphasize. For instance, in prostate cancer, low-volume lesions with low Gleason scores have a low-risk for death. Minimal-risk disease should not be called cancer; it should be called indolent lesions of epithelial origin (IDLE), they say.
3. Improved tools to support informed decisions are needed. "Information about risks of screening and biopsy should be shared with patients before screening," they write. Currently, an estimated one third of PSA tests take place without even the most basic doctor–patient discussion, as reported by Medscape Oncology.
4. A greater emphasis on prevention, including the use of proven cancer preventive agents, such as finasteride for preventing prostate cancer and tamoxifen and raloxifene for preventing breast cancer, is needed.

The Risks and Benefits of Breast Cancer Screening

According to Esserman, Shieh, & Thompson:

Although evidence indicates that breast cancer screening saves lives, 838 women, aged 50 to 70 years, must undergo screening for 6 years to avert 1 death. However, this 1 life saved generates "thousands of screens, hundreds of biopsies, and many cancers treated as if they were life-threatening when they were not."

To Read More on the Subject:

1. Medscape's excellent article by Nick Mulcahy, "Rethink" of Cancer Screening Triggers Comments & Controversy, click here

2. Dr. John McDougall's October 2009 newsletter:  The American Cancer Society Reverses Its Strong Position on Mammograms and PSA Testing  McDougall's reminder: The truth is breast and prostate cancer are caused by the rich Western diet full of beef, chicken, cheese, milk, and oils, and contaminated with powerful environmental cancer-causing chemicals. A sizable share of that $20 billion must be spent on advertising, education, and subsidy programs to bring about monumental changes in our eating.

3.  Dr. Susan Love on the breast density/breast cancer connection and what to do about it.  Click here.

4.  My previous post: Archives of Internal Medicine Study Asks: Can Cancer Disappear Naturally? Lessons to Learn - Diet & Exercise May Help  click here

Advice From the Experts on How to Protect Yourself From Colds and Flu. How to Boost Your Immune System and Avoid Germs. What Foods and Supplements Will Help the Most?

"The swine flu is dangerous and spreads much faster than the usual seasonal flu.  It's not being over-hyped, and everyone should take it seriously."

-Dr. Williams Schaffner, president-elect of the National Foundation for Infectious Diseases-

I got my H1N1 vaccination last Wednesday when the medical center where I work made them available to employees without front-line patient contact.

 Here's What I Wanted to Know About the Vaccine & H1N1

1.  How long until the H1N1 vaccine takes effect?  For adults it will take 7-8 days to provide protection.  Children will take longer.  The seasonal flu vaccine takes 10-14 days before it provides protection.

2.  Common side effects?  Most common is a sore arm, with possible redness & swelling.  About 10-15%  of people feel a little tired or get a headache.  A low-grade fever is even possible.  I had zero reaction--not even a sore arm.  And for anyone still wondering--you can't get the flu from the vaccine.

3. Incubation period after you're exposed to the flu?  It takes 1-2 days to get the flu after you're exposed, but it can take up to 4 days.

4.  How long does H1N1 flu normally last?  There will be a few days of feeling really bad--but most people will be back on the mend in 5 days. 

5.  How long is a person infectious?  You can infect others from one day before you are even symptomatic, until about one week after symptoms first start.  You can return to work 24 hours after the fever ends, but the weakened virus may still keeping shedding from nasal & cough secretions for days after.

To get answers to all your questions look here:

NPR Boost Your Flu IQ.  Questions Answered.  11/2/09

WebMD Focus on Flu--CDC & WebMD experts answer your questions.

New York Times Answers Your Flu Vaccine Questions

CDC's Key Facts About the H1N1 Flu & Vaccines

Keep Up-to-Date With the CDC 2009-2010 H1N1 Flu Map and Situation Update

Everything You Ever Wanted to Know About Protecting Yourself from the Flu & Colds

I picked up the December 2009 Prevention magazine yesterday, and it had a terrific-advice-filled article written by Nancy Kalish: Flu-Proof Your Winter--How to Survive the Worst Cold and Flu Season in Half a Century. (maybe just a little exaggerated--but good advice none-the-less)

The best part is that it offers explanations of how certain foods, supplements, & practices work to help you prevent getting the flu or colds.

Here are some of the highlights:

Surprising Signs Your Immune System Needs a Boost!

• You drink well-water.  Possibly 25 million Americans drink well water that contains more than the EPA safe level of arsenic--which can affect the immune response to H1N1.  This arsenic-H1N1-connection research discovery came out of Dartmouth Medical School. The study was conducted on mice who were given arsenic-laced water to drink for 5 weeks, and then were inoculated with H1N1.  The arsenic-laced water suppressed their immune systems and many died from H1N1, while all the mice who drank untainted water recovered completely.  I guess it's time to get my well water tested!
• You eat too much sugar.  Research published in the American Journal of Clinical Nutrition found that the ability of white blood cells to kill bacteria was significantly hampered for up to 5 hours after eating 100 grams of sugar--the equivalent of 3 cans of soda.  I (mostly) cut out sugar almost a year ago, and even the Halloween candy had no appeal for me this year.  No colds this year, either!
• You're obese.  Excess weight can cause hormone imbalances and inflammation that impairs the immune system's ability to fight infection.  Having a BMI (body mass index) over 40 (morbidly obese) can put one at risk for becoming seriously ill with H1N1.  I'm wondering if there is a connection between lower immunity in the obese, and their lower levels of Vitamin D absorption--less than 50% of normal.
• You have dry nasal passages.  Get out the neti pot, Sinucleanse, NeilMed Sinus Rinse, a saline solution squeeze bottle, or the humidifier!  If your nasal passages are too dry, viruses have an easier time invading.  Irrigating your nasal passages provides a healthy environment for the tiny nose hairs to remove germs from the nose--which is really the first line of defense in keeping those germs out of your body.  Read more here.
• You're dehydrated.  Again--you need plenty of liquids to flush out the toxins, viruses & assorted germs.  When your urine is pale yellow you're drinking enough.  For my "How Much Water Do You Really Need?" post click here.
• You get a lot of colds.  If you're getting more colds than everyone else--chances are your immune system is under-performing!  The Average:  Adults get 1-3 colds per season--and they last 3-4 days. 
• You're always stressed.  It's no surprise that an American Psychological Association report states that long-term stress weakens the response of the immune system.  According to Philip Tierno, PhD director of clinical microbiology and immunology at the New York University, "If you become stressed while you have the flu, your symptoms can get worse."

Boost Your Immune System With These Foods

• Probiotics.  Lactobacillus reuteri is a probiotic shown to stimulate the infection-fighting white blood cells.  In a study of shift workers in Sweden, those taking L. reuteri took 33% fewer sick days than those in the control group.  In August 2009 the journal Pediatrics reported on a Chinese study where the children taking the probiotic Lactobacillus Bifidobacterium in combination with Bifidobacterium animalis got sick less, recovered faster, and needed less antibiotics than the control group.  The probiotic combo used in the Pediatrics study is now being marketed as HOWARU Protect, by Danisco of Madison, Wisconsin.  (I don't know a thing about this product--but it sounds interesting!)  Elizabeth Somers, an RD recommends looking for products that contain Lactobacillus acidophilus, as well as L. Bifidus, and L. rhamnosus.
• Garlic.  In a study published in Advances in Therapy, subjects taking a garlic capsule for 12 winter weeks were two-thirds less likely to catch a cold or had a cold of shorter duration than the control group.  The allicin in the garlic is the active ingredient--a potent fighter of infections & bacteria.  Elizabeth Somers, RD says eating the "real thing" beats capsules--add 1-3 cooked cloves to your food each day!  The conservative Cochrane Database of Systematic Reviews recently said garlic has promise but more studies are needed.
• Black Tea.  Out of a Harvard study comes news that 5 cups of tea a day will get your T-cells to produce 10 times more interferon--the protein that will fight  cold and flu infections.  Supposedly green tea will do the same.
• Mushrooms.  They've got more than 300 compounds that will increase the production of white blood cells and boost your immune system.  The #1 mushrooms for boosting immunity are: shiitake, maitake, & reishi.
• Omega-3s or fatty fish.  A study by Britain's Institute of Human Nutrition found that the omega-3s (get them in supplements, leafy greens, or fatty fish) are shown to increase phagocyte activity--which destroys bacteria & can fight flu.  Other research has shown that the omega-3s can increase airflow & protect the lungs from colds & respiratory infections; the DHA & EPA enable cell membranes to more efficiently absorb nutrients & remove toxins; and fish contains selenium which helps the white bloods cells clear viruses.  Aim for 1 gram a day of an omega-3 supplement, or 3 servings of fatty fish a week.

Boost Your Immune System With These Supplements

• Vitamin D.  My all-time favorite comes to the rescue once more!  In a study that followed subjects for 3 years published in Epidemiology and Infection, those who took 2,000 IUs of vitamin D had 70% few colds and flu than the control group.  For more on vitamin D read my latest post:  Everything You Ever Wanted to Know About Vitamin D from the Expert, Dr. Michael Holick. How Much Do We Need? Why Is It So Hard to Get Enough? What About Breast-Fed Babies? Why Is It So Important for Good Health?
• Cold-fX.  In a study conducted by the Center for Immunotherapy of Cancer & Infectious Diseases at the University of Connecticut,  subjects who took 2 daily capsules of Cold-fX, which contains a North American ginseng extract, got 50% less colds or had colds that lasted half as long as the control group.  This type of ginseng works by increasing the white blood cells & interleukins, which boost the immune system.
• Zinc.  According to Dr. David Katz, the director of Yale's Prevention Research Center, "30 mg of zinc taken at the very start of a cold will shorten it by about half a day."  Again, the zinc helps in the production of white blood cells. Take too much, like more than 50 mg daily, and you risk suppressing your immune system, and blocking the absorption of other essential minerals.  I'm a fan of

Boost Your Immune System With Sleep & Exercise

• Moderate Exercise.  Out of a study in Medicine & Science in Sports & Exercise, regular moderate exercise decreases the risk of upper-respiratory infections.  It does this by increasing blood flow, speeding nutrients to your cells, and decreasing immune-depressing stress hormones.  For an excellent article on how exercise can help, or hamper your immune response, read Gretchen Reynolds' recent article in the New York Times.  Click here.
• Get at least 7 hours of sleep a night.  Just one night of "not enough" sleep will depress your immune system.  In a study published in the Archives of Internal Medicine--when 153 healthy subjects were exposed to a cold virus, those who slept more than 7 hours a night during the preceding 14 days reduced their risk of contracting the cold by 300%.  And make sure you get at least 7 hours of sleep before you get your flu vaccination.  In a JAMA study, men who only got 4 hours of sleep the night before a vaccination developed only half the usual number of antibodies.

Simple Ways to Protect Yourself from Cold & Flu Viruses

• Wash often and wash well.  Washing your hands often, and making a conscious effort to avoid touching your face, is your best defense against the cold & flu.  That means soap & water on every surface of your hands, and under your nails for a full 20 seconds--which is a quite a long time.  It's singing the Happy Birthday Song two times and not too fast!  And the latest word is that washing your hands with cold water is just as good as washing them with hot water.   Of course we all know to use a paper towel in a public restroom to turn the water on & off, and when exiting the bathroom.  And it's important to dry your hand really well.  Sounds like overkill--but experts advise it!  If you can't wash, use an antibacterial gel or foam with at least 60% alcohol.  It will remove the cold germs, and dissolve the outer layer of the flu virus, according to Philip Tierno, PhD of NYU. 
• Don't share toothpaste tubes.  Never thought of this one--but it's good advice.  People touch their toothbrush to the opening of the tube all the time, passing along germs.
• Paper towels rule!  We do this in our home.  Replace the hand towels in the bathrooms with paper towels, especially during cold & flu season.  At work, use paper towels to open the community fridge, microwave, the bathroom faucets, & to exit the bathroom.
• Sanitize at work, the gym, and in hotel rooms.  There are more germs on shared computers, phones, and desktops than on the average toilet seat.  If you share equipment at work, wipe them down with disinfectant or sanitizing wipes before using them.  The same goes before & after using shared gym equipment, including hand weights, yoga mats, and spinning bikes.  In a hotel room, disinfect the remote control (the germiest item in the room), the clock radio, light switches, and door handles. 
  
• Use anything but your hands.  For elevator buttons, ticketing machines, or ATMs use a key, a pencil, or a gloved hand.  Think elbows or hips for opening doors. And keep your hands off of escalator and staircase railings!  They're just teeming.
• The 5-foot rule.  Keep 5 feet away from anyone who is coughing or sneezing--because gravity is forcing the droplets to fall, rather than travel farther away.  If you see someone who is obviously sick--sneezing or coughing--when you're on a train or bus, try to sit at least 3 rows away.  Too bad it's not possible to do this on an airplane.

You might find this hard to believe, but I'm really not a germ-a-phobe who is armed with Lysol wipes!  I'd rather concentrate my energy on just staying healthy--rather than worrying about hidden germs.  It seems to have worked so far.

So many of these practices are just good common sense.  Many I've adopted over the years--and a number are brand-new to me--and definitely worth a try.  Can't hurt!