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FROM THE DOC
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"WNL....NOT SNL"
II was born in the era of SNL (Saturday Night Live)...the late-night sketch comedy show....so this acronym is well known to me, but a lesser know acronym more generally is WNL. It's just as famous....but only in the world of medicine.
What is WNL? It stands for 'Within Normal Limits', and it is a commonly used phrase in general medical practice. It is meant to encompass both normal results and those that although slightly outside the normal range, are still not enough of an outlier to cause concern.
Why is this so important? Simple....knowing when 'something is nothing' is the most important part of my job. That is what I specialize in.....the range of what is normal.
Is that blood test, slightly out of range, a concern. Nope...WNL! Is that finding on the scan, that variation in my lung tissue or pancreas cause for concern.....not likely....WNL!
Sure...WNL can cover a wide swath of territory, and we can even be wrong when we see a slight outlier and call it WNL...not to worry about it, but 99% of the time we are right, and this gives us, your doctors, a great amount of confidence in what we do.
This is why 'the art' of medicine is part and parcel of good practice, and like Malcolm Gladwell, the famous journalist and author of OUTLIERS and other well-known books, has noted....only with 10,000+ hours of practice can one become an expert (not surprising ...that is the minimum amount of time spent in a medical residency training program.
So....WNL is something you won't find on your GOOGLE SEARCH. Dr. Google does not know from WNL....but I do!
Yours in good health,
Dr. Lakin
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Meet Our Featured Healthy Lifestyle Couple: Ernst, 85yrs & his wife, Anastassia, 73 yrs YOUNG!
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"We are both physicists working and living together for many years. "
Several years ago Ernst had high cholesterol and Anastassia had high blood pressure. By making life changes we were able to improve so that medication is not needed.
The genes are responsible only to some extent for our health, the rest is our responsibility. We can gain some measure of control over our fates by:
1) Find good MDs who are able to guide us to improve the health. We were very lucky to "find" Dr. D. Lakin 10 years ago. It is impossible to imagine more excellent care than the care he gives his patients.
2) Have a healthy life style consisting of healthy diet, physical activity and work.
Our diet consists of: seafood (3 times weekly), chicken (two times), red meat (lamb) one time only and a lot of yogurt, nuts, vegetable and fruits every day.
Ernst walks and Anastassia dances 6 times weekly for 30 min.
Ernst also swims, hikes and skiis.
We work in University 9 hours daily 6 days per week. Now we are finishing writing a scientific book. We also travel a lot for research and conferences (Italy, Germany, Japan, Hong Kong) and like to spend time together with our children, grandchildren and friends.
We believe that because our life is very dynamic "Mr. Alzheimer" can't catch us. He can't catch our brains, because they are permanently in use.
For the near future we are planning to reduce the working hours and to increase our physical activity. We feel very blessed with good health but we are aware that we have to put a lot of effort to keep this blessing for the rest of our life.
"In old age, double effort is needed to achieve half of the shape of our young years."
Keep up the good work Ernst & Anastassia!
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| VOL 10 / Issue: #1 | Winter/ 2014 |
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4 Ways To Keep Those Good 2014 Resolutions Going All Year!
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The new year motivates you to make healthy changes. You may feel ambitious now, but to help your resolutions stick past February, start with small changes that you can incorporate into your everyday life.
You want to: Lose weight
Try this: Set your alarm
You've heard too much or too little sleep might lead to extra pounds; now, new research out of Brigham Young University suggests sleep consistency may also influence body weight. Scientists tracked 300 women for a week and found those who woke up at the same time each morning had lower body fat than those with inconsistent sleep patterns. The study was small and needs more research, but experts do know that maintaining a regular sleep-wake schedule seven days a week is necessary to help you sleep more soundly and wake up alert. Another tip: Have protein for breakfast. A study presented at a scientific meeting for the Obesity Society showed that women who ate a breakfast based on sausage and eggs curbed hunger throughout the morning. More lean protein choices: a slice of Canadian bacon or cheese, a container of low-fat yogurt, or peanut butter on whole-grain toast.
You want to: Get fit
Try this: Short bursts of intense activity
Known more formally as high-intensity interval training (or HIIT), this exercise technique alternates brief speed and recovery intervals, can get results in not a lot of time, and is predicted to be the top fitness trend of 2014, according to a survey by the American College of Sports Medicine survey. Practice this high-intensity training method periodically, maybe one to two times a week max for up to six weeks at a time. And keep in mind it may not be safe for everyone; talk to your doctor before incorporating it into your exercise plan.
You want to: Eat healthier
Try this: Cut artificial trans fats
They're found in many fried and baked foods made with partially hydrogenated oils, and they can raise bad cholesterol levels, increase your risk of heart disease and stroke, and are associated with an increased chance of developing type 2 diabetes. Under current regulations, however, companies can claim their product has 0 grams of trans fat if it contains less than 0.5 grams per serving. So in the meantime, in addition to checking the nutrition label for trans fat, read the ingredients list: if it contains partially hydrogenated oil, there may be small amounts of trans fat present.
You want to: Reduce stress
Try this: Hug a loved one
That simple act can ease fear and anxiety, lower blood pressure and even boost memory, according research from the Medical University of Vienna. Experts believe the "love hormone" oxytocin gets a boost when you embrace family or friends.
- The Doctors, USA Weekend
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Winter Birding Takes Off. . . .
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 A ngry Birds isn't the only exploding pastime with feathers. An estimated 85million of us enjoy observing, photographing or feeding wild birds during the year. But wintertime proves prime time for exercising "citizen science," the ultimate in crowdsourcing. Using your peepers and the right app, you can join 300,000 others pushing citizen science to new heights.
eBird.org, a website launched in 2002 by the National Audubon Society and the Cornell Lab of Ornithology, has revolutionized fieldwork with its BirdsEye tracking app. Members worldwide submit data on bird sightings to create a real-time glimpse of migration and location.
The annual Great Backyard Bird Count, a snapshot of bird activity held this year Feb. 14-17, set a record in 2013 of 100,000 common-bird checklists.
Chirpy smartphones, nearly as ubiquitous and mobile as birds, put encyclopedic guides in your palm and connect fellow peeps (try #birding or #birdwatch on Twitter). Monitor rare-bird alerts or bird cams (Cornell Lab's portal at cams.allaboutbirds.org). Share your bird photos or enter contests like the one at hbwcontest.com.
Glass Birds for Google Glass from Mitch Waite, creator of the field guide app iBird Pro, is set to be released this month ($30 for iPhone; $10 for Android). Imagine: You spy a bird in a tree. Tell Glass: "Identify bird." The app knows your location and eliminates possibilities based on range and habitat, then narrows attributes by shape, size, color, etc.
Project FeederWatch. App-happy actress Lili Taylor, 46, for three years has fed data to Cornell's project (running Nov. 9 to April 4), counting bird visitors to her "little patch" in Brooklyn. She says the iPhone kicked a longtime passion into high gear: "I realized there was a way to communicate with other birders ... that there's a tribe out there."
- Terry Byrne, USA TODAY
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SUPER BOWL SUNDAY...... February 2, 2014!
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Be Sure You Have Our Correct Address!
| Paradise Valley Medical Clinic
Ninety Mountain View 9977 N. 90th Street, Suite 180
Scottsdale, AZ 85258
480.614.5800 (Phone)
480.614.6322 (Fax)
**Additional Top Floor Ramp Parking:
The 2nd floor ramp parking is very close to our door, but the entrance is at the VERY NORTH END of the parking area of the two buildings. You drive all the way North...enter at the NORTH END, then drive down to the SOUTH END of the 2nd FLoor Parking to get a space very near the entrance.
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To Age Gracefully, Do As French Women Do. . . .
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From the woman who introduced Americans to the French way of savoring foods comes an enlightened approach to aging.
"Prevention, preparation and planning will go a long way" in helping you look and feel your best, says Mireille Guiliano, author of French Women Don't Get Facelifts and the best-selling French Women Don't Get Fat. Her tips: Rethink food and drink. The metabolism slows as we age, so you need less food to maintain the same weight. "But we do need vitamins, minerals and fibers, so fruit, calcium and fiber-rich foods are all good for us," she says. "Pick your indulgences carefully, and eat more soups, vegetables and fruit." Dress your age. Women of a certain age should aim to look smart and sexy; some dress too young or wear colors that emphasize flaws. Also, "avoid shoes that are unstable or uncomfortable." Exercise. Don't slow down. "Use it or lose it, from sex to swimming," she says. "At least build daily movement into your life. Too many people give up or let themselves go. Don't underestimate the impact of staying in shape." - Cheryl Alkon, USA WEEKEND
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Ahhh. . . . Sunlight May Lower Your Blood Pressure!
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Here's why sunbathing feels so good: It may lower your blood pressure, British researchers reported Friday.
Just 20 minutes of ultraviolet A (UVA) sunlight lowered blood pressure by a small but significant amount in 24 volunteers, they report in the Journal of Investigative Dermatology. Further checks suggest the sun does this by increasing levels of nitric oxide, a chemical linked to blood flow.
The effects are so strong they may help explain why people who live in the darker north, like the Scots, have higher rates of death from heart disease, Richard Weller of the University of Edinburgh and Martin Feelisch of the University of Southampton say.
"We are concerned that well-meaning advice to reduce the comparatively low numbers of deaths from skin cancer may inadvertently increase the risk of death from far higher prevalent cardiovascular disease and stroke, and goes against epidemiological data showing that sunlight exposure reduces all cause and cardiovascular mortality," they concluded.
Their volunteers got the equivalent of 30 minutes of natural sunlight at noon on a sunny day in Southern Europe. They protected their volunteers from the warming effects, just in case that was the cause. It lowered blood pressure by about five points, and the effects lasted half an hour.
In other words, a little sunshine really may warm your heart. 
- Maggie Fox, NBC News
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What To Buy In January & February: Fitness Equipment & Champagne!
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What better way to start off 2014 than with extra cash in your pocket? Along with post-holiday decoration discounts and deals on HDTV's, here's what you can save on this month:
Exercising. Health club memberships go on sale in January and February to take advantage of all those well-meaning resolutions. So too can you find sales on workout DVDs and home gym equipment. Take advantage of low fees at clubs and deferred payment options on equipment. (Just be sure you use it, or it's no deal at all!) Sweaters. Department stores need to make room for the new season's merchandise. Bulky items, like sweaters and coats, take up valuable floor space, so they get an extra push to sell. Look for markdowns of 50% or more. Often, you can find coupons for additional discounts. Bargains on bubbly. Post-New Year's Eve, many liquor stores are left with an over-supply of champagne and sparkling wine. Many will have sales in January and February to try to maximize profits on these festive beverages. Buy now, save it for Valentine's Day! And finally ... in case you have any cash left over to spend after the holidays, experts say this is the month to negotiate for great deals on grown-up toys, including sailboats and motorcycles. Come spring, foot traffic picks up as the weather gets nicer; stop in a store now and you'll find salespeople eager to strike a deal. -
Julia Savacool, USA Weekend
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The History of Valentine's Day
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The origins of Valentine's Day trace back to the ancient Roman celebration of Lupercalia. Held on February 15, Lupercalia honored the gods Lupercus and Faunus, as well as the legendary founders of Rome, Romulus and Remus.
In addition to a bountiful feast, Lupercalia festivities are purported to have included the pairing of young women and men. Men would draw women's names from a box, and each couple would be paired until next year's celebration.
While this pairing of couples set the tone for today's holiday, it wasn't called "Valentine's Day" until a priest named Valentine came along. Valentine, a romantic at heart, disobeyed Emperor Claudius II's decree that soldiers remain bachelors. Claudius handed down this decree believing that soldiers would be distracted and unable to concentrate on fighting if they were married or engaged. Valentine defied the emperor and secretly performed marriage ceremonies. As a result of his defiance, Valentine was put to death on February 14.
After Valentine's death, he was named a saint. As Christianity spread through Rome, the priests moved Lupercalia from February 15 to February 14 and renamed it St. Valentine's Day to honor Saint Valentine.
What's Cupid Got to Do with It?
According to Roman mythology, Cupid was the son of Venus, the goddess of love and beauty. Cupid was known to cause people to fall in love by shooting them with his magical arrows. But Cupid didn't just cause others to fall in love - he himself fell deeply in love.
As legend has it, Cupid fell in love with a mortal maiden named Psyche. Cupid married Psyche, but Venus, jealous of Psyche's beauty, forbade her daughter-in-law to look at Cupid. Psyche, of course, couldn't resist temptation and sneaked a peek at her handsome husband. As punishment, Venus demanded that she perform three hard tasks, the last of which caused Psyche's death.
Cupid brought Psyche back to life and the gods, moved by their love, granted Pysche immortality. Cupid thus represents the heart and Psyche the (struggles of the) human soul.
Fun Facts
- Approximately 1 billion Valentine's Day cards are sent each year. Half of those are sent through Care2 (OK, maybe not HALF... or even half of half... but we are growing fast!)
- In order of popularity, Valentine's Day cards are given to: teachers, children, mothers, wives, sweethearts, Koko the gorilla.
- The expression "wearing your heart on your sleeve" comes from a Valentine's Day party tradition. Young women would write their names on slips of paper to be drawn by young men. A man would then wear a woman's name on his sleeve to claim her as his valentine.
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Question On Your Lab Results? Check out: DoctorDoug's Academy
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Dr. Lakin's guide videos on how to better understand your lab work results.....
Check the first edition here: | | DoctorDoug's Academy: Lesson #1 CBC |
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We Need Your Help!
| Keeping you on your correct medication is as important to us as it is to you. With your help, we can be more efficient and be sure you are getting your refill requests on time and to your correct pharmacy.
Tips: 1. If you need a refill, be sure to call your pharmacy FIRST, not our office. They will know if you have more refills, and if not, they will call/fax/electronically message us with your request. Then we will contact you if there is a question or concern.
2. Remember to call your pharmacy in plenty of time so you do not run out of your medications. Sometimes we need up to 48 hours to complete a request and we do not want this to be a hardship for you.
3. Register and use our SECURE PATIENT PORTAL for refill requests. We monitor this continually and again will contact you if there is a problem.
4. Remember we do not refill pain medications on Fridays or weekends and all pain medications must be picked up at our office. We cannot mail or any medications outside our office. Please plan ahead and make arrangements!
We are always here to help you and appreciate the opportunity to care for your healthcare needs!
Yours in good health, Dr. Lakin & Staff
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Acid Reflux or GERD? Serious Heartburn May Require Meds. . . . . .
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It's that time of year again - big dinners, lots of parties and celebratory toasts. For some holiday revelers, that means more heartburn. Getting a burning sensation in your chest now and then is normal, particularly after overdoing fatty or fried foods, chocolate and alcohol. But when it's more than twice a week, you may have GERD, or gastroesophageal reflux disease. This chronic condition results when stomach acid or bile backs up into the esophagus; the "reflux" of acid irritates sensitive tissue that lines your food pipe. What you need to know:
It causes more than heartburn. Though that's the telltale sign, not everyone with GERD experiences it. Other signs: regurgitation of food or a sour-tasting liquid, nausea, chest pain, hoarseness or sore throat. Some may have difficulty swallowing or feel as if food is stuck in their throat. GERD can also cause dry cough or bad breath.
Losing weight can help. That's because excess fat around the belly increases pressure on the stomach, which forces acid back up into your esophagus. Maintaining a healthy weight both reduces risk of developing GERD and helps treat it. Other changes that may help: wear loose-fitting clothing around your waist; quit smoking; eat smaller meals and skip foods that trigger heartburn. Also: wait at least three hours after eating before you lie down; if possible, raise the head of your bed with wood blocks or a wedge between your mattress and the box spring. The goal is to elevate your body from the waist up so gravity can help keep stomach acid down. (Pillows don't provide the same effect.)
You'll likely need medicine, too. Diet adjustments, lifestyle changes and antacids may help mild symptoms, but for many people with GERD, stronger meds are needed. H-2-receptor blockers reduce acid production; proton pump inhibitors block acid production to allow the esophagus to heal. Both are available in over-the-counter or prescription strength. If drugs don't help, your doctor may discuss surgery. Some medical centers now offer a new, less invasive procedure called the LINX system, which involves laparoscopically implanting a magnetic ring at the bottom of the esophagus to improve symptoms.
Talk to Dr. Lakin to determine your best course. Left untreated, GERD can sometimes cause serious complications, from an ulcer to precancerous changes in the esophagus.
- The Doctors, USA Weekend
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Yoga Moves In The Office? Gentle Stretches At Your Desk. . .
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Spending lots of time hunched over a computer keyboard at work causes tight, sore muscles that lead to tension headaches and neck pain. Here are a few stretches, based on yoga poses, recommended by the Cleveland Clinic; they can all be done at work so you don't miss an e-mail or phone call.
All begin with a basic seated posture. Sit at the front edge of your chair with spine lengthened, chest lifted, shoulders relaxed down and away from your ears, feet flat on the floor and knees directly over ankles.
Neck rolls:
Gently drop your head forward and roll from side to side. Let the weight of your head gently stretch your neck. Small popping noises are OK but there should be no pain. (Avoid letting your head drop back, to protect your cervical spine.)
Shoulder rolls: Gently lift your shoulders and rotate them backwards in slow circular motions. Repeat a few times then reverse the motion. This loosens and lubricates joints and helps open the chest for better breathing.
Fan pose: Sitting forward in your chair, gently move arms behind you until you can hold onto the back of your chair. Keep elbows straight; adjust the height of your hands until you feel a good stretch in chest, arms and shoulders. This is a great pose to open the chest and improve posture and breathing.
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Have You Scheduled Your Physical Yet?
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As you all know, Dr Lakin is a strong supporter of annual physicals. This is a time we can visit and explore any unresolved medical problems and any new health issues that need to be addressed. Annual physicals are one of the best ways to safeguard your health.
The American Medical Association recommends that if you are between the ages of 40 - 49 years, physicals should be done every two years. If you are 50 years plus, it is recommend you have yearly exams, especially if you have any chronic medical conditions that need to be monitored. Call to schedule your well care visit today!
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Are You registered For Dr. Lakin's Secure Patient Portal?
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Now is the time! For help on how to register and FAQ, check our these videos: It's as easy as that!
**Please note that our Patient Portal is not 100% optimized for
Internet Explorer 11. Some of the functions will not work as intended. The software development team is working on it. Until then, please use Internet Explorer 8, 9, 10, or Mozilla Firefox, a free browser.
Please contact Nan at nan@doctordoug.com if you have further questions or concerns.
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"American Hustle"
"12 Years a Slave"

"Gravity"
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AT THE MOVIES WITH BARB A. . . . .
|  A MUST SEE! + + + + +
GREAT + + + +
ENTERTAINING + + +
RENT THE MOVIE + +
FORGET IT! +
**EMAIL ME! ???
CAPTAIN PHILLIPS + + + +
This is a true story about a survival against huge odds. There is so much suspense and terror between Tom Hanks the ship's captain and the four Somali men who have climbed on his ship. The men on the ship are "sitting ducks" and totally unarmed except for water hoses. Tom Hanks was fabulous. The last scene post rescue is riveting and so real. One of the girls in the office because nauseous from the swaying back and forth of the lifeboat.
PHILOMENA + + + + + Anything with Judy Dench I cannot miss. I had a hard time finding it because it had left Camelview and had odd starting times at the new theaters. Steve Coogan plays a sarcastic journalist who is trying to find Judy Dench's daughter who was born out of wedlock at a nunnery and then adopted. She looks for 50 years until the end of the film which I won't discuss or it will spoil the film for you. This is a true story and Dench's Irish background score an A for acting and accuracy. Please see this. Lots of laughing and crying.
SAVING MR BANKS + + + + +
I didn't want to see this thinking it was "Oh well, another Mary Poppins tale"but it was Joan's turn and so off we went. Well folks, it was a real life tale of the making of the film Mary Poppins and Mr. Walt. Disney. This is Tom Hanks portraying Walt Disney and Emma Thompson playing P.L. Travers (the author)at their best. I loved it - Every minute. My friend cried so hard I almost had to move. The flashback scenes are riveting and be sure to stay for the credits for some actual voice recordings of Ms. Travers and Walt Disney. See it!!!!! The Book Thief + + + + + During World War II a young girl in Germany Liesel find it comforting to steal books and share with her friends. This young girl is adopted into a German family and one gets a first hand view of war time Germany bombing, burning of books, youth groups and propaganda. Her interaction with her adoptive father is compelling and all actors are believeable and riveting. Barb A. Back To Top |
Recipe:
Winter Citrus Fruit Parfait With Whipped Cream 
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The chefs at the CIA can keep you eating better in 2014 with something they like to call the "dessert flip." This parfait is a delicious example. By focusing on fresh seasonal fruits and using only a small amount of the topping, you get all the flavor and crunch-and still feel good about keeping your healthier eating resolution.
With a little thought, you can "flip" many of your own favorite dessert recipes to make them healthier. Use seasonal fruit when you can and only small amounts of other sweets.
Click to learn more about The Culinary Institute of America, the world's premier culinary college.
WINTER CITRUS FRUIT PARFAIT WITH WHIPPED CREAM
This is a plan-ahead dessert; allow two days to prepare so the gelatin can set.
2 cups water
¾ cup lemon juice
1/2 cup sugar
1 teaspoon vanilla extract
1 cup packed chopped fresh mint leaves (optional)
1 pink grapefruit
2 oranges
2 blood oranges, if available; otherwise, use 2 more oranges
¼ ounce (1 envelope) powdered gelatin
For the whipped cream:
1 cup heavy cream
In a medium saucepan, combine 1 cup water, lemon juice, sugar, vanilla, and mint leaves (if using), and bring to a boil. Turn off the heat and let steep for 30 minutes.
While the mint mixture is steeping, supreme your citrus fruits: peel the fruit and cut individual segments from the citrus by slicing along both sides of the membrane that separates the segments. Cut the grapefruit supremes in half (see the video, above) . Evenly divide the citrus segments across six glasses of your choice.
Place the remaining one cup of water into a small bowl and sprinkle the gelatin over the water. Allow to sit for 15 minutes.
Strain the mint mixture into a 4-cup container with a spout for pouring. Using a double boiler, melt the bloomed gelatin over a pot of hot water. Add the melted gelatin to the strained mint liquid.
Top the citrus segments with the gelatin liquid, filling each one about 1/3 of the way up the glass. Chill overnight to set.
To make the whipped cream: For best results, be sure cream is very cold. Start whipping at medium speed and keep whipping until the cream just starts to thicken. At this point, increase the speed to high and keep whipping until it increases in volume by half, to soft peak, about 2 minutes.
Using a spoon, drop the whipped cream on the top of each parfait. Top with toasted almonds and serve.
TOASTED ALMONDS
Makes 1/2 cup
½ cup sliced almonds
Preheat oven to 350 degrees F.
Arrange the sliced almonds in a single layer on a parchment-paper-lined sheet pan. Place in the oven and bake until the nuts are toasted, approximately 10 minutes.
PER SERVING (one parfait glass): 356 CALORIES,
5 g PROTEIN, 43 g CARBOHYDRATES, 5 g FIBER,
22 g TOTAL FAT (10 g saturated fat), 5 mg SODIUM,
53 mg CHOLESTEROL
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Happy Winter!
Dr. Douglas Lakin & Staff
Paradise Valley Medical Clinic PC
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