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Welcome to Spring!
In This Issue
Vegetable of the Month
Community Event on May 19th!
Meet a Registered Dietitian
'Diet' Food Dilemmas
FREE DXA Scans!
Recipe Round Up
Do you take Fosamax?
Osteoporosis Lectures

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Vegetable of 
the Month:  
Belgian Endive
 
belgian endiveBelgian Endive is a member of the chicory family.  While cultivation of endive originated in Belgium, France is currently the largest producer of endive. Endive is actually grown twice! In the first stage, the roots are grown for approximately 130-150 days.  In the second stage, the endives are placed in a dark, damp environment.  This process allows for endives to be grown year-round.  Belgian endives can be eaten raw or cooked.  Endive has different pronunciations depending on the type. Belgian endive is actually pronounced "on-deev", where as curly endive is pronounced "en-dive"

Nutrition Information per 1 head of endive:
 calories, 2.12 g carbohydrates (1.6g fiber), 0 g total fat,  0 g cholesterol, 0.5 g protein.  Complete nutrition facts available here.
 
Belgian Endives are a good source of:  manganese, vitamin A, folic acid, niacin and thiamin. 

 

Healthy Recipes:
 
Fennel, Radicchio & Endive Salad

High Fiber Grapefruit & Avocado Salad

Braised Fennel & Endive

Endive Stuffed with Goat Cheese & Walnuts
 
Kitchen 101:

Choose endives that are covered (to prevent exposure to light).  Look for endives that are pale, smooth, plump and crisp with tight leaves 

 

Refrigerate endives in the crisper and use within 2 weeks.

 

How to prepare endives (video)  

 

Did you know.... 

Belgian endives are actually grown in the dark!  Sunlight causes the leaves to turn green, resulting in a bitter tasting endive. Only the very tips of the leaves are visible while the rest of the vegetable is in the soil. 

 

Additional Information:



DCR on the road!
Visit our table at the San Ramon Senior & Community Live Well Resource Fair, Breakfast and Presentation

On Saturday, May 19th, Diablo Clinical Research will be offering free bone heel scans at the Alcosta Senior & Community Center in San Ramon.  

Location:   
 
* Event Hours  8:30am-1:00pm
* Breakfast  8:30am-10:30am
* Vendor Fair  8:30am-11:30am
* Panel Presentation
11:00am-1:00pm

All ages FREE

Start the day with a pancake breakfast prepared and served by the San Ramon Valley Fire Protection District, then visit numerous tables with valuable resources on housing, transportation, finance, health and wellness, travel, recreation and more!  Various health screenings will also be available. Following the breakfast and vendor fair, a panel of experts led by Shirley Krohn from CASE (Communities Against Senior Exploitatiotion) will address ways seniors and/or their families can protect themselves from financial exploitation.  Tote bags with valuable information on avoiding scams and frauds will be handed out.  Registration is not required.

For more information about the fair, call (925) 973-3250

 

Discuss your Diet with a Registered Dietitian! 

Confused about calcium? Lost about leafy greens? Questions about quinoa? A Registered Dietitian (RD) can answer all these questions and more in a nutrition consultation.  You will review your diet and exercise regimen and focus on behavior modification.  It's all part of small steps towards a healthier you! As a service to the community, Diablo Clinical Research's nutrition consultations are specially priced at $50/hour. For more information, please contact our Registered Dietitian, Kelley Bradshaw MS, RD. 

Phone: (925) 930-7267  

kbradshaw@diabloclinical.com
Advancing Health Newsletter May 2012
Health Fair at DCR!
Image via A.D.A.M. and Pub Med.

Learn about Osteoporosis 
and Diabetic Neuropathy!

Join us for a free health fair on Tuesday, May 8th from 2-7pm.
 
 Diablo Clinical Research will be offering:
  • Free bone heel scans
  • Osteoporosis lecture with Dr. Christiansen (starts at 6pm)
  • Osteoporosis handouts
  • Calcium and Vitamin D nutrition handouts
  • Free snacks and beverages
  • Free diabetic neuropathy exam (limited number of exams)
Those who attend will be entered into the drawing to win one of the following:
  • Full-body DXA scan ( $200-$300 value)
  • 1 hour nutrition consultation ($100-$150 value)
  • Goody bags filled with health and wellness-related items
Do you have a friend or family member who has never heard of Diablo Clinical Research? Bring them with you and you'll receive a free gift, as well as TWO entries into the drawing!

For more information or to RSVP, 
please call (925) 930-7267 and ask for Kelley, or send an email to kbradshaw@diabloclinical.com

Nutrition FAQs:  
'Diet' foods and weight gain
  "Why do diet foods and beverages cause weight gain even though they usually have little to no calories or are sugar-free?"
 

Excellent question!  Theoretically speaking, diet beverages and foods shouldn't cause weight gain-you can't make something (weight gain) out of nothing (zero calories, no sugar), right?  But yet, more and more research is showing a link between diet beverages (and other 'diet' foods) and weight gain.  At the very least, these products clearly aren't helping to reverse the obesity pandemic.  But why?   The causes of obesity are multi-factoral, just as are the theories behind weight gain caused by diet beverages.  Some of the theories discuss an indirect cause and effect, while other theories attempt to pinpoint direct causes of weight gain by looking at what these artificial sweeteners have on taste and satiety. 

 

Here are a few explanations of why artificially-sweetened ('diet') foods and  beverages may cause weight gain:

  • We rationalize our food choices:  When choosing a food that is marketed as "low-calorie", "fat-free", "sugar-free", "diet", many people tend to rationalize this as a 'healthier' option, so they don't pay attention to the amount or frequency of their food consumption.  We think, "Oh, it's low fat so it's not going to matter if I have another..." or "I got the large value meal at the drive-thru but at least I got diet soda!" As a result, we may end up talking ourselves into eating more as a justification for making a 'healthier' choice. 
  • We're not saving THAT many calories:  As several studies have shown, we may actually overestimate the benefit of eating low calorie foods and beverages. Sure, regular soda typically has 150 calories/can while diet soda has 0 calories, but what about diet foods such as sugar-free ice cream? Dreyers Grand regular vanilla ice cream has 140 calories for cup (about the size of of your fist) but the sugar free version still has 100 calories. And if we start to use the rationalization process mentioned above, we may wind up with 3 or 4 servings, or 300-400 calories. A large fry and a Big Mac still have a 1,000 calories even if you choose diet soda!
  • Diet foods only create a "short-term" calorie deficit:  A few studies have shown that artificially sweetened foods and beverages may help with reducing caloric intake, which can be beneficial in the short term, but then later results in long term weight gain as the individual's metabolic rate has now slowed. (1)  Several studies have looked at the relationship between dietary intake and metabolic syndrome. One study discovered that a Western diet (fried foods, processed meats, refined grains, soda) is associated with a greater risk with metabolic syndrome (4). This study also found that those who consume diet soda are at greater risk for metabolic syndrome. Those who consumed the most soda had a 34% greater risk for metabolic syndrome compared to those who consumed little to no diet sodas.  Of course, it is possible that those who consumed the most diet soda are individuals who are already overweight and turn to diet sodas to reduce calorie intake.
  • Foods with sugar alcohols aren't sugar free:  Many of the sugar-free candy and ice cream products use some type of sugar alcohol (also called polyols). Sugar alcohols are carbohydrates that have been hydrogenated (have added hydrogen atoms) to decrease some of the sugar content.  As a result, sugar alcohols have fewer calories per gram (1-3 cal/gram) than sugar (4cal/gram).  However, they are still metabolized by the body; you're just getting a bit fewer calories and carbohydrates than you would if you ate the regular version.  For example, Malitol has 2.1 cal/gram, which is about of what regular sugar has.   To identify sugar alcohols in a product, look for an ingredient that ends in -tol, such as malitol, sorbitol, or xylitol (the exceptions to this are hydrogenated starch hydrolysates  and isolmalt).  Sometimes, sugar alcohols can cause a laxative effect, with symptoms such as bloating, cramping and diarrhea.  And since sugar alcohols still contain some sugar and carbohydrates, they can raise blood glucose levels if they are overeaten.   
  • Macronutrient composition changes:  Sugar free foods can still have calories, carbohydrates and fat.  When sugar is taken out of a product, something else needs to be added back in to give the product taste. When additional fat is added to make up for the missing sugar, it usually means the calorie content is higher than the original product, as fat has 9 calories/gram compared to 4 calories/gram in sugar (carbohydrates).  Moreover, sugar produces a feeling of satiety.  If we don't feel satisfied with our food and are still hungry, we're going to eat more.  We may only have 1 or 2 sugar-free cookies, but then go overboard with crackers (which can contain a surprising amount of sugar!)
  • Physiological adaptations & "taste distortion":  Since artificial sweeteners are anywhere from 180 to 7,000 times sweeter than regular sugar, researchers are questioning if they have altered our ability to detect how sweet a food really is.  Moreover, it is possible that these artificial sweeteners cause an increase in appetite for extremely sweet, high calorie foods (1, 5).  Animal studies in rats have shown that excessive consumption of aspartame can damage parts of the hypothalamus, which controls levels of leptin, a hormone that helps regulate energy (calorie) intake and energy expenditure (1).  A similar study from Purdue University noticed similar trends when rats were given saccarhin (i.e. Sweet 'n Low) (2,3).  In this study, rats who had regular sugar showed an increase in core body temperature at meals, meaning their bodies were getting ready to burn calories from the upcoming meal.  The rats on the saccharin diet did not show a rise in body temperature, perhaps due to their bodies know that they weren't going to receive as many calories, thus prompting their body to not 'burn' as many calories and creating a slower metabolism (3). 

So what's a person to do? Have regular soda and gain weight, or have diet soda...and possibly gain weight?  It's unrealistic to think that you'll have to avoid all sweets and soda, diet or regular, but cutting back on both is a smart move.  If you're looking to cut back on artificial sweeteners (and regular sugar too!), here are several good suggestions:

 

  • Read the ingredients:  If you can't pronounce, you probably don't need it in your diet.   Remember, there's a reason why they discontinued Olestra! If you see aspartame, sucralose,  or acesulfamate potassium on the label, the product has been artificially sweetened.
  • Gradually reduce your intake:  If you use three packets of Splenda in each cup of coffee, try reducing it to two packets, then one, until can . Yes, people do drink their coffee black!
  • Make your own flavored water:  Slice up citrus fruits (or berries) and place them in a pitcher of water. When you pour the water into a cup, the berries stay in the pitcher, giving your water a hint of flavor with any artificial ingredients.
  • Give Stevia a try, but use sparingly:  Stevia (brand names: Truvia, Stevia in the Raw) is derived from a plant. Some studies have found that steevia may not create a sugar craving like artificial sugar substitutes are believed to do.  However, there is some degree of processing to turn it into fine little sugar-like granules, so it's best to use it small amounts. 
  • Make a dessert a real treat:  As they say,absence makes the heart grow fonder. If you're used to having several sugar-free items a day, you'll appreciate them a lot more if you don't have them as often. You'll learn to savor the experience and truly enjoy it. Same goes with regular (non-sugar -free food and beverages).

 

References

1)  Fowler SP, et. al.  Fueling the Obesity Epidemic? Artificially Sweetened Beverage Use and Long-Term Weight Gain.  Obesity.  2008; 16: 1894-1900.

 

2)  Swithers SE, Davidson TL.  A role for sweet taste:  Calorie predictive relations in energy regulation by rats.  Behavioral Neuroscience.  2008; 122 (1):  161-173.

 

3)  Park, Alice.  "Can Sugar Substitutes Make You Fat?"  TIME on-line.  February 10, 2008. Accessed on April 26, 2012.

 

4)  Lutsey PL, Steffen LM, Stevens J.  Dietary Intake and the Development of the Metabolic Syndrome.  The Atherosclerosis Risk in Communities Studies.  Circulation. 2008; 117: 754-761

 

5)  Dhingra R., et. al.  Soft Drink Consumption and Risk of Developing Cardiometabolic Risk Factors and the Metabolic Syndrome in Middle-Aged Adults in the Community.  Circulation. 2007; 116: 480-488.


Other Relevant Studies

 

Gardener H, et. al . Diet Soft Drink Consumption is Associated with an Increased Risk of Vascular Events in the Northern Manhattan Study.  Journal of General Internal Medicine. Published online 27January2012.

 

 Stellman SD, Garfinkel L.  Patterns of artificial sweetener use and weight change in an American Cancer prospective study.  Appettite.  1998; 11 (1):  8591.

 

 

"You owe it to yourself and the ones you love to find out if your bones are healthy." Dr. Weinstein
Bone Comparisons
Are you at risk for osteoporosis? 

For the month of May, Diablo Clinical Research is continuing to offer FREE DXA bone density scans for women age 60+ and postmenopausal who also have 3 or more qualifying risk factors.
 
Qualifying Risk Factors* for a DXA screening include:
  • History of fractures (any broken bone) after age 50
  • Family history of fractures or osteoporosis (mother, father, sister, brother)
  • Loss in height of 2-3 inches.
  • History of falls
  • Cigarette smoking
  • Excessive alcohol intake
  • Low calcium and vitamin D levels
  • Persons of Caucasian, Asian or Latino races
For more information, please call (925) 930-7267 and ask for Jimmy. 

* must have 3 or more to qualify for the free DXA.
 

Recipe Roundup 

 
Do you currently take Fosamax? 
If you are currently taking Fosamax for less than 3 years, you may be eligible for research opportunities!  Please call (925) 930-7267 for more information. 

 

May Lecture Series:  Osteoporosis
Join us at our clinic for FREE talks on osteoporosis! Dr. Mark Christiansen, an endocrinologist and Certified Clinical Densitometrist , will be discussing: 
  • controversies surrounding osteoporosis medications, including risk and benefits of medication use
  • who should be treated and when
  • signs, symptoms and risk factors
  • current osteoporosis/osteopenia research opportunities

Our registered dietitian will be on-hand to answer any questions about diet and bone health. Nutrition-related handouts will also be available.   

 

Dates and Times:

  • Tuesday, May 8: 6-7pm (during our DCR Health Fair, which starts at 2pm.  See page of this newsletter for more information.)
  • Saturday, May 19: 10:30-11:30am

Address:  2255 Ygnacio Valley Road, Suite M, Walnut Creek, CA 94598

 

Feel free to bring a guest with you! To RSVP for one of the lectures, please call (925) 930-7267 x 244 or send an email to kbradshaw@diabloclinical.com  

   

Diabetic Neuropathy Pain Study

Have you been experiencing pain from your Diabetes such as tingling, burning or numbness? If so, you may be suffering from Diabetic Neuropathic Pain and may qualify for a research study in your area.
 
Participants Must Be:
  • Aged 18-75
  • Diagnosed with Type 1 or Type 2 Diabetes
  • Experiencing pain from diabetes such as tingling, burning or numbness for at least 6 months 
Qualified participants will receive at no cost:
  • Study-Related Visits
  • Medical Exams
  • Study Medication
Health insurance is not needed to participate and you may be compensated for time and travel.
 
Please call Diablo Clinical Research: (925) 930-7267
 
Love healthy cooking? MORE recipes are available on our website at  http://diabloclinical.com/subcat_studyvolunteers_health.php
And don't forget to check out our blog,  http://diabloclinicalresearch.wordpress.com/, for health,nutrition & fitness articles!