By Barbara Day, M.S., R.D., C.N.

Insulated bags equipped with freeze packs will help keep your child’s fresh and safe. Using a plastic sandwich container will help keep from having to buy plastic bags. Here are some suggestions: Choose whole grain bread, tortillas, or pita bread for sandwiches. For protein source: sliced lean turkey, roast beef, chicken, tuna salad, egg salad, or nut butters like peanut or almond butter. Add cheese, tomato, shredded carrots, romaine lettuce or spinach, sliced cucumbers, sliced peppers, and sliced bananas or Grape Nuts® to butters to build a healthier sandwich. Add veggies like carrots, fresh green beans or edamame, or cucumbers along with hummus or a yogurt based dip. Pack a cold pasta salad, coleslaw or potato salad with added vegetables like shredded carrots. Prepared low fat yogurt with fruit or add your own fresh fruit & send a container of multigrain cereal like Kashi® Go Lean Crisp Toasted Berry Crumble to be mixed at lunch. For a healthy sweet, add one Dove® dark chocolate promise (42 calories) which is high in the antioxidants called flavanols.

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHEALTHWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 11 grandchildren.     

By Barbara Day, M.S., R.D., C.N.

Summertime is a great time to take advantage of all the Farmer’s Markets and access to fresh vegetables. Here’s a quick and easy recipe that you can make indoors or outdoors in a skillet on your grill. Enjoy!

Nutritional Information Per Serving with ½ cup whole grain couscous: 618 calories, 26 grams protein, 35 grams of fat, 54 grams of CHO, 8 grams of fiber,  670 mg sodium.

Nutritional Information Per Serving: 513 calories, 22 grams protein, 34 grams of fat, 31 grams of CHO, 5 grams of fiber,  670 mg sodium.

Preparation Time: 15 minutes Cook Time: 12 minutes

Serves: 4

Ingredients

• 1 cup reduced sodium chicken broth
• 1 tbsp reduced sodium soy sauce
• 2 tsp cornstarch
• ½ tsp ground ginger
• 1 lb boneless, skinless chicken breasts, thinly sliced
• 4 tbsp extra virgin olive oil
• 2 cups zucchini*
• 2 cups broccoli
• 1 cup sliced carrots
• 1 small onion, chopped (1/2 cup)
• ¼ cup fresh chopped cilantro

*The recipe calls for 5 cups of veggies so you can used any veggies you like to stir fry.

Instructions

Combine broth, soy sauce, cornstarch, lemon juice and ginger in a bowl and set aside. Season chicken with salt and pepper if desired.  Heat 2 tbsp olive oil in skillet over medium-high heat and cook chicken, stirring occasionally, 5 minutes or until chicken is thoroughly cooked.  Remove from skillet and set aside. Add the remaining 2 tbsp olive oil in the skillet and cook vegetables, stirring occasionally, 4 minutes or until crisp-tender.  Stir in broth mixture. Bring to a boil over high heat. Reduce heat to a medium and return chicken to skillet; heat through.  Sprinkle with cilantro, then toss.  Serve, if desired, over hot whole grain couscous (1 cup dry whole wheat couscous) or brown rice.

Shopping List

• reduced sodium chicken broth
• reduced sodium soy sauce
• cornstarch
• ground ginger
• 1 lb boneless, skinless chicken breasts
• olive oil
• zucchini
• broccoli
• sliced carrots
• 1 small onion
• fresh cilantro

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHEALTHWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 9 grandchildren.

Image from: www.positivehealthsteps.com

By Barbara Day, M.S., R.D., C.N.

Sweet potatoes are one of my favorite vegetables! Try this recipe instead of the traditional potato salad recipe this summer. But you don’t have to just make the sweet potato salad in the summer. Sweet potatoes are year round vegetables. Great source of nutrients and dietary fiber, too.

Nutritional Information Per Serving: 163 calories, 5 grams protein, <1 grams of fat, 36 grams of CHO, 5 grams of fiber, 95 mg sodium.

Preparation Time: 10 minutes Cook Time: 1 hour Cool Time: 1 hour

Serves: 8

Ingredients

• 3 lbs sweet potatoes*
• Salt and freshly ground pepper to taste
• 1 green pepper, seeded & chopped
• 2 celery stalks, chopped
• Chopped canned chilies to taste (optional)
• 1 ½ cups nonfat plain yogurt
• 2 tbsp fresh cilantro, minced
• 2 tbsp shallots, minced
• 1 tbsp fresh lime juice

Instructions

Preheat over to 400 degrees. Scrub sweet potatoes and piece all over with fork. Bake until soft, about 1 hour. While potatoes are baking, prepare dressing. Make dressing by mixing together yogurt, cilantro, shallots and lime juice. Add salt to taste. Chill at least an hour at least an hour before adding over sweet potatoes. When sweet potatoes are baked, cool, peel and cut in ½-inch cubes.  Place in a large bowl and mix in salt & pepper to taste. Mix sweet potatoes with bell pepper, celery and chilies. Mix yogurt dressing into sweet potato salad. Serve chilled.

*Can use frozen cooked sweet potato, not canned sweet potatoes.

Shopping List

• 3 lbs sweet potatoes
• Salt and freshly ground pepper to taste
• 1 green pepper, seeded & chopped
• 2 celery stalks, chopped
• 1 ½ cups nonfat plain yogurt
• 2 tbsp fresh cilantro, minced
• 2 tbsp shallots, minced
• 1 tbsp fresh lime juice

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHEALTHWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 9 grandchildren.

Image from www.cooking-books.blogspot.com.

By Barbara Day, M.S., R.D., C.N.

Here’s an easy-to-fix salad for a party or just great family eating.  The recipe calls for a 5 hour refrigeration period but hey you can shorten the time if need be.

Nutritional Information Per Serving: 123 calories, 7 grams protein, 8 grams of fat,  8 grams of CHO, 2 grams of fiber, 233 mg sodium.

Preparation Time: 30 minutes Refrigerate: 5 hours

Serves: 12; 1 cup serving

Ingredients

• 4 cups spinach or torn romaine lettuce
• 1 ½ cup shredded 2% fat shredded cheddar cheese, divided
• 2 cups sliced fresh mushrooms
• 1 small red onion, sliced, separated into rings
• 2 medium tomatoes, chopped
• 1 pkg. (10 oz) frozen peas, thawed
• ½ cup light mayonnaise or Miracle Whip salad dressing
• ½ cup light sour cream
• ¼ cup chopped basil
• 2 slices of cooked bacon, cooked, crumbled*

Instructions

Layer spinach, 1 cup of cheese, mushrooms, onions, tomatoes in 3-qt bowl. Mix mayo, sour cream and basil; spread over salad, completely covering top of salad.

Top with remaining cheese and bacon. Refrigerate 5 hours.

*May substitute 1 cup bacon bits

Shopping List

• spinach
• shredded 2% fat shredded cheddar cheese, divided
• fresh mushrooms
• 1 small red onion
• 2 tomatoes
• 1 pkg. (10 oz) frozen peas
• light mayonnaise or Miracle Whip salad dressing
• light sour cream
• chopped basil
• bacon

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHEALTHWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 11 grandchildren.

Image from: www.overwaitea.com

By Barbara Day, M.S., R.D., C.N.

High fructose corn syrup also called corn sugar is a popular ingredient that is a common sugar added to lots of processed foods and sodas.  High fructose corn syrup was invented in 1966 in Japan.  It was introduced to the American market in 1975.

In the mid 1970’s the USDA, AMA and AHA all called for the reduction of dietary fat because high fat diets helped to increase the risk of heart disease. When the fat was taken out of many recipes in the 1970s, high fructose corn syrup replaced the fat because of the much improved taste.  The added carbohydrate increased the sweetness thus masking the fat content that was removed. High fructose corn syrup increased the palatability in these low fat high carbohydrate foods.  Remember fat-free brownies – 250 calories per brownie but NO fat?

High fructose corn syrup initially seemed chemically similar to table sugar (sucrose). Both contain fructose and glucose. All added sugar increases the risk of weight gain, increases triglyceride levels, and increases in blood sugar which can a; increase your risk of developing heart disease. Each gram of sugar and each gram of high fructose corn syrup has 4 calories.

High Fructose Corn Syrup Is Found In Every Type of Food

High fructose corn syrup in many cases has less to do with sweetening of a product but more to do with providing stability to a product. High fructose corn syrup provides greater stability in acidic carbonated sodas than sucrose, so flavors remain consistent and stable over the entire shelf-life of the product. For example, in baked goods, high fructose corn syrup gives a pleasing brown crust to breads and cakes, contributes fermentable sugars to yeast-raised products, reduces sugar crystallization during baking for soft-moist textures, and enhances flavors of fruit fillings. High fructose corn syrup added to yogurt provides fermentable sugars, enhances fruit and spice flavors, controls moisture to prevent separation, and regulates tartness.  High fructose corn syrup added spaghetti sauces, ketchup and condiments enhances flavor and balance.  In addition, high fructose corn syrup protects the firm texture of canned fruits and reduces freezer burn in frozen fruits.

High Fructose Corn Syrup Metabolized Like Alcohol

Recently, at the 8^th Annual Nutrition and Health Conference in San Francisco, CA, Robert Lusting, M.D., with the Division of Endocrinology of the Department of Pediatrics at University of California, San Francisco, discussed the fact that high fructose corn syrup is actually metabolized like alcohol because of its structure.  Earlier research suggested high fructose corn syrup was metabolized like sucrose but this is not the case. Dr. Lusting’s research suggests that chronic fructose exposure promotes metabolic syndrome particularly in children. In addition, chronic fructose exposure can cause hypertension, myocardial infarction, dyslipidemia, pancreatitis, obesity, hepatic dysfunction, and fetal insulin resistance. To see what Dr. Lusting has to say check this You Tube video out – Sugar the Bitter Truth! http://www.youtube.com/watch?v=dBnniua6-oM.

Comparison of High Fructose Corn Syrup to Trans Fat Research

This enlightening research has been under heavy scrutiny because high fructose corn syrup is used in many products. In fact, many health professionals from physicians to dietitians have embraced the idea that HFCS is no different than using sugar. But I liken this transient endorsement to the margarine/trans fat controversy in the 1990s.

University of Maryland premier lipid researcher, Mary Enig, PhD, determined in the late 1970s, that trans fat was very destructive in our blood vessels. Trans fat was created when hydrogen was added to oil to turn the oil into soft margarine that was easily spreadable. This margarine was used in all types of prepared products. Trans fat was found to help promote the plaque build-up in blood vessels thus increasing the risk of a heart attack or stroke. Margarine companies as well as many health professionals did not seriously consider trans fat as being a health risk.  In fact, much of Dr. Enig’s research was actually buried. (I was a graduate student at the University of Maryland when Dr. Enig was doing her research. I knew Dr. Enig personally.  She told me that the biggest opponent to her research was margarine companies and they lobbied against her research very loudly and fought to keep her research out of the news).

Finally, in 1992, Dr. Enig’s research and extreme insistence that trans fat was destructive to our health started to receive some interest.  Fast forward to 2006, the USDA finally decided that trans fat was indeed a health problem and food labels began to indicate the trans fat content of products. The recommendation from the American Heart Association and the National Institutes of Health is that Americans should eat as little trans fat as possible. In fact, restaurants are now the target of getting the trans fat out of their menu choices as well. Will HFCS be the next target for food labels and restaurant choices?

As a registered dietitian since 1973, I look at today’s obese problem and it’s apparent that obesity is different today than even 20 years ago. Some people have so much fat on their bodies, it’s hard to figure out how they can actually eat that many extra calories but with Dr. Lusting’s research, it may gives us some real insight into the metabolic differences that HFCS has, just like the differences that were seen with trans fat. Who knew?

Fructose vs High Fructose Corn Syrup

While it’s true that fruit and fruit juice both contain fructose, it appears that the combination of fructose with dietary fiber which is found in the actual fruit rather than the fruit juice helps to deter the same metabolic catastrophe that is seen in high fructose corn syrup. Juicing the actual fruit and drinking the juice with the fiber intact would help to decrease the metabolic problems with HFCS.

High Fructose Corn Syrup and Exercise

Dr. Lusting suggested 60 minutes of daily exercise could help decrease the metabolic problems associated with a high intake of HFCS. But according to current research, less Americans are exercising daily even though exercise can decrease the risk of heart disease, stroke, cancer, diabetes and obesity.

Removing High Fructose Corn Syrup will Increase the Costs of School Lunch

Check this resource out and you will learn that almost every item on your typical school lunch meal contains some HFCS except hummus, fresh fruit, fresh vegetables and milk.  http://www.sweetsurprise.com/sites/default/files/SchoolLunchMenuJan2010.pdf. Obviously, removing HFCS from the school menu completely will be next to impossible but by adding some type of exercise program each school day not only would help to alleviate the metabolic problems associated with HFCS but will also help the children to be healthier by burning calories and excess energy that is built up during the school day. In addition, it has been well documented that exercise helps to increase one’s ability to concentrate and learn more.

America’s Sugar Intake Out of Control

The current intake of sugar in America is 22 teaspoons (tsp) per day. The American Heart Association (AHA) recommends women consume no more than 100 calories a day (25 grams of sugar) of added sugar and men should consume no more than 150 calories a day (37.5 grams of sugar) per day or less. This AHA recommendation actually comes out to about 6 tsp of added sugar for women and 9 tsp for men.

Consumer Tips for Decreasing the High Fructose Corn Syrup in Your Diet

Tips: 1. avoid sugary sodas. 2. Choose breakfast cereals carefully. 3. Eat less processed & packaged foods like cookies and cakes. 4. Snack on fresh fruits, fresh veggies, & whole grain crackers instead of candies and cookies. Author of In Defense of Food: An Eater’s Manifesto Michael Pollan suggested, “Eat all the junk food you like as long as you prepare them yourself. We need to un-refine our refined foods.”

Image from: www.hivehealthmedia.com

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 11 grandchildren.

Before leaving home you may want to do some homework. You can review some menus online to have an idea what is available. You may need to bring your own gluten free bread and crackers. Many franchised restaurants offer gluten free choices. Locally – BJ’s Restaurant, Bonefish, Carrabbas, Chili’s, The Old Spaghetti Factory, Outback, PF Chang’, Ruby Tuesdays, Uno Chicago Grill, Olive Garden, Jason’s Deli, California Pizza Kitchen, some Godfather’s Pizza locations, . You can go to several websites to help you as well: www.glutenfreeregistry.com, www.glutenfreetravelsite.com, or www.gfrestaurants.com. GlutenFreeRegistry offers apps for the I-Phone, I-Pod Touch, I-Pad, Android and Smart Phone. Dining out suggestions: appetizers – vegetable salad with olive oil & balsamic vinegar. Entrée- grilled or broiled steak, skinless chicken breast or fish seasoned with olive oil or spices, not a marinade. Vegetables – unlimited. Starch-baked white or sweet potato plain, plain brown or white rice. Amaranth, millet or quinoa. Dessert – fresh fruit or simple flavored ice cream, sherbet or gelatin.

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 9 grandchildren.

As a dietitian, in most cases, I promote FRESH IS BEST but let me explain. If you buy fresh foods & they end up hibernating in your refrigerator for weeks then fresh may not be best choice. I typically keep an array of frozen vegetables to use in recipes in case I don’t get to the store to pick up fresh vegetables like peppers, squash, and spinach. Here are some nutrition specifics  about cooked vegetables: tomatoes – when cooked (canned) have more cancer-fighting lycopene; zucchini has more beta-carotene when stir-fried (cooked); raw spinach has more vitamin C and folate when it’s cooked it has more calcium and zinc. However when you cook vegetables in lots of water rather than steam or stir fry, nutrients can be leached out and lost when you throw out the water. The good news is that spring time is great for purchasing fresh vegetables economically at farmer’s markets across the county. Here’s where you can get specific information: www.louisvilleky.gov/HealthyHometown/healthyeating/FarmersMarkets.

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 9 grandchildren.

By Barbara Day, M.S., R.D., C.N.

This is an easy recipe that even a son could make for his mom. She’ll love that you cooked for her! Add a green leafy salad with cherry tomatoes and whole wheat rolls.  For dessert, fresh strawberries with Cool Whip and shaved dark chocolate.

Nutritional Information Per Serving: 471 calories, 36 grams protein, 20 grams of fat,  38 grams of CHO, 5 grams of fiber, 815 mg sodium.

Preparation Time: 20 minutes Cook Time: 20 minutes

Serves: 6, 1 – 1/3 cups each serving

Ingredients

• 1 lb extra-lean ground beef, ground turkey, ground bison or 2 cups Boca ground crumbles
• 3 cups whole wheat penne pasta, cooked
• 1 jar (24 oz) spaghetti sauce
• 1/3 cup grated reduced fat Parmesan Cheese
• 1 ½ cup shredded Mozzarella Cheese or low fat Jack cheese
• 1 tsp Italian seasoning (optional)
• 3 minced garlic cloves (optional)

Instructions

Heat oven to 375 degrees. Brown meat in a large skillet. Add pasta, sauce, and ½ of the Parmesan cheese. Mix well. Spoon into 13 X 9-inch dish. Top with remaining cheese. Bake for 20 minutes or until heated thoroughly. If using Boca for ground beef, you do not need to brown or thaw the crumbles. Just add to ingredients and bake as directed.

Shopping List

• 1 lb extra-lean ground beef, ground turkey, ground bison or 2 cups Boca ground crumbles
• whole wheat penne pasta
• 1 jar (24 oz) spaghetti sauce
• grated reduced fat Parmesan Cheese
• shredded Mozzarella Cheese or low fat Jack cheese

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 9 grandchildren.

Image from: www.kraft.com

By Barbara Day, M.S., R.D., C.N.

Recently I participated in a webinar sponsored by the Coca Cola Company. Ron Maughan, PhD, discussed Hydration, Health and Performance. He presented some very interesting data regarding chronic dehydration (hypohydration) in the elderly and how it affects their health status*. Dr. Maughan reported chronic dehydration in the elderly may be associated with a decline in physical function and also a decline in their cognitive status. Apparently, dehydration can be due to a reduced thirst sensation which occurs as people get older.

In addition, some drugs that seniors routinely take may also suppress their thirst.  These drug classes include: SSRI’s, ACE Inhibitors and also anti-Parkinson drugs. Selective serotonin reuptake inhibitors or serotonin-specific reuptake inhibitor (SSRIs) are a class of compounds typically used as antidepressants in the treatment of depression, anxiety disorders, and some personality disorders. They are also typically effective and used in treating some cases of insomnia. Many seniors routinely take anti-depressants.

Signs & Symptoms of Dehydration

Unfortunately, some of the signs and symptoms of dehydration can be identical to senile dementia symptoms, age dementia symptoms and Alzheimer’s symptoms. Correcting dehydration can allow the senior to return to a full and normal life. But, not correcting the dehydration may actually ensure the hospitalization of the senior.

The most common signs and symptoms of dehydration include persistent fatigue, lethargy, muscle weakness or cramps, headaches, dizziness, nausea, forgetfulness, confusion, deep rapid breathing, or an increased heart rate. Dehydration is a very serious condition, more than most people realize. Since seniors often have a reduced sense of thirst, dehydration is one of the most frequent causes of hospitalization after age 65.

Other less common signs and symptoms of dehydration can include:

• Excessive loss of fluid through vomiting, urinating, stools or sweating
• Poor intake of fluids, “can’t keep anything down”
• Sunken eyes
• Dry or sticky mucous membranes in the mouth
• Skin that lacks its normal elasticity and sags back into position slowly when pinched up into a fold
• Decreased or absent urine output
• Decreased tears

After reviewing these symptoms, if you or your family member has any of

these symptoms, maybe dehydration is the cause of the confusion rather than a diagnosis of dementia or Alzheimer’s.

Dehydration Can Cause Death

According to Dr. Maughan, about 50% of elderly hospitalized with dehydration died within a year of admission. In fact, readmission rates are high due to repeated dehydration. Hospitalization of elderly with a diagnosis of dehydration is a serious and costly medical problem but preventable.

Prevention of Dehydration in Seniors

Prevention is key to helping seniors remain healthy and also will help drive down costs. Although most people get about 20% of their fluid intake from food, most seniors get about half their fluid intake from solid foods such as fruits and vegetables because seniors have a reduced sense of thirst.  In addition to a reduced sense of thirst seniors also have a reduced appetite.  Reduced thirst and reduced appetite may also be due to their medications. Proper hydration may be a challenge but one strategy that will help keep seniors healthy, alert, active and out of the hospital.

Institutionalized seniors may need between 1,700 milliliters or 56 ounces and 2,000 milliliters or 67 ounces of daily fluid**. The Institute of Medicine advises men to consume about 13 cups of fluids per day and women should consume about 9 cups per day.

Another way to determine hydration is the color of one’s urine. Urine color for the first void of the day is typically yellow but as the day goes on urine color should be pale (slightly yellow) to colorless. If not, more fluids need to be ingested.

Here’s a Urine Color Chart that you might find useful, http://www.rte.ie/tv/useitorloseit/hydration.pdf.  Check out Table 1. Water Content of Fruits & Vegetables.

Table 1. Water Content of Fruits & Vegetables

Food                                                % of Water

*Warren et al (1994). The burden and outcomes associated with dehydration among US elderly. 1991. Am J Public Health 84, 1265 – 1269.

**Chidester JC et al (1997). Fluid Intake in the institutionalized elderly. JADA, 97, 23-28.

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 9 grandchildren.

Images from: www.celsias.com and www.news.bbc.co.uk.com

Compiled by Barbara Day, M.S., R.D., C.N.

From Victoria Maizes, MD, University of Arizona Center for Integrative Medicine at Nutrition & Health Conference 2010

General

1. Eat a wide variety of foods with as much fresh food as possible.
2. Eat an abundance of vegetables and fruits (7 – 9 servings per day).
3. Include omega-3 fatty acids in your diet.
4. Reduce fat to approximately 33 grams per day.*
5. Consider eliminate cow’s milk dairy.
6. Any dairy or beef should be organic to avoid exposure to estrogenic hormones present in conventionally raised cows. @
7. Minimize consumption of refined carbohydrates, processed foods and fast food.
8. Include carbohydrates, fat and protein at each meal.
9. If you use a microwave, never microwave in plastic or using plastic wrap as this introduces estrogenic hormone mimics into food

*Especially important in receptor negative breast cancer.

@Especially important in receptor positive breast cancer.

Carbohydrates

1. The majority should be vegetables, fruits, beans, whole or cracked grains – or less refined, less processed foods with low glycemic loads.
2. Reduce your consumption of foods made with wheat flour (including whole wheat flour) and sugar.
3. Avoid products made with high-fructose corn syrup.

Fat

1. For omega-3 fatty acids, eat salmon (preferably fresh or frozen wild or canned sockeye), sardines packed in water or olive oil, herring, black cod (also known as sablefish or butterfish), omega-3 fortified eggs, hemp seeds, flaxseeds (preferably freshly ground) and walnuts; or take fish oil supplements.
2. Use extra-virgin olive oil as your main cooking oil, For a neutral tasting oil, use expeller-pressed-organic oil.
3. Include avocados & nuts, especially walnuts, cashews, and almonds.
4. Reduce your intake of saturated fat by eating less butter, cream, cheese, and other full-fat dairy products. Also reduce unskinned chicken, fatty meats, and products made with coconut and palm kernel oils.
5. Avoid safflower and sunflower oils, corn oil, cottonseed oil, and mixed vegetables oils.  Strictly avoid margarine, vegetables shortening, partially hydrogenated oils and all products listing them as ingredients.

Protein

1. Decrease your consumption of animal protein except fish. Especially reduce consumption of beef (including organic).  Avoid eating burnt meat, fish, or poultry.
2. Eat more vegetable protein, especially from beans and nuts.
3. Soy foods are controversial.  In 2009, the LACE trial revealed reduced risk of breast cancer recurrence in  women who ate soy.  This was especially true for women on Tamoxifen. (The Shanghai Breast Cancer Survival Study confirmed these findings.)

Fiber

1. Include 1 tablespoon of freshly ground flaxseed in your diet daily. (mix into yogurt, sprinkle on cereal or oatmeal, include in a smoothie).
2. Eat about 40 grams of fiber a day. To do so increase your consumption of fruit, especially berries, vegetables, beans, and whole grains. Cereals can be good fiber sources but read labels to be sure that flour or sugar is not the first ingredient and that they have at least 4 -5 grams of fiber per one-ounce serving.

Phytonutrients

1. Choose fruits and vegetables from all parts of the color spectrum especially berries, tomatoes, orange and yellow fruits, and dark leafy greens.
2. Choose organic produce when ever possible. Lean which conventionally grown crops carry the most pesticide residues and avoid them (www.foodnews.org)
3. Eat cruciferous vegetables daily (cabbage, broccoli, cauliflower, Brussels sprouts, and kale).
4. Include turmeric and ginger as spices in cooking.

Beverages

1. Drink 3 – 5 cups of green tea daily.
2. Drink 4 cups of pure water a day or drinks that are mostly water (tea, very diluted fruit juice, sparkling water with lemon).
3. Minimize alcohol.
4. Get a home water purifier if your tap water taste of chlorine or other contaminants or if you live in an area where the water is known or suspected to be contaminated.

Vitamins & Minerals

1. The best way to obtain your daily vitamins, minerals and micronutrients is by eating a diet in fresh fruits with an abundance of fruits and vegetables.
2. The exception is Vitamin D which is made in the skin through exposure to sunlight. Get your 25 (OH) Vitamin D level checked. Supplement dose will depend on your level.
3. When not on chemotherapy or radiation therapy, supplement your diet with a multivitamin that contains:

●   Vitamin C, 200 milligrams a day

●   Vitamin E, 400 IU of natural mixed tocopherol (d-alpha-tocopherol with other tocopherols, or 80 milligrams of mixed tocopherols and tocotrienols)

●   Selenium 200 micrograms

●   Mixed carotenoids, 10,000 to 15,000 IU daily.

●   Calcium supplementation should be calculated – based on how much is in the diet and then what needs to be supplemented.

●   The multivitamin should not contain iron or preformed vitamin A (retinol palmitate)

Source: Victoria Maizes, MD. University of Arizona Center for Integrative Medicine.

Image from: www.mibcc.org

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 9 grandchildren.