Prost!

For this blog, I chose to write about something that I would consider a hobby. And my timing couldn't be better; it's Beer Week in Toronto! I know...I'm a dietitian! I mean, health professionals don't usually write blogs about alcohol, right? Well, please note: I'm not endorsing over-consumption of alcohol. I do think about alcohol the way I do about food: mindfulness is key.

For about 3 years now, I've been part of a weekly beer club of sorts. Before this beer club, I drank beer rarely...and then, it was only Guinness. I knew nothing about beer, and I guess I was used to the big Canadian brands (no need to name them here)...and I really didn't like them. Guinness was very different, so once I tasted it, it was my safe choice. Now, I can't remember the last time I had a pint of Guinness! I think the reason I'm so into beer is that is pretty complex, both in the process of how it's made and in the different flavour profiles it can have. I have learned a lot about beer over the past three years, and now I'd like to share some of that with you.

A Little History of Beer

Please don't quote me on this, because I'm going on my memory of my early days at my beer club. Our beer sommelier taught me everything I know about beer. And I was an attentive student! No one can know for sure how beer was discovered, but it was quite by accident....Likely what happened was that grains (maybe even bread) were left out and got wet. Then the yeast that was in the ambient air dropped into the mush and fermented the sugars contained in the grains. Imagine being the person who thought: "this looks interesting...let me put it in my mouth". Yikes! (Nick, I hope I got that history correct!)

Traditional beer is made from 4 ingredients:

(1) Barley

This is the grain that contains the sugar that is fermented. It is malted to various levels, which imparts both flavour (sweet and bitter, caramel, chocolate, coffee) and colour (from very pale to black). The proteins in the barley provide viscosity in the beer and foam.

(2) Water

Water is heated in order to release the sugar from the barley. The better the water, the better the drink that's made with this water. Beer is no different. Nuff said!

(3) Yeast

Without the yeast, there will would be no alcohol in beer. Sugar combines with the yeast and ferments, producing alcohol and carbon dioxide. Yeast also imparts flavour to the beer (like sweetness, fruity, biscuity or spicy).

(4) Hops

This is my favourite ingredient in beer. Some people have called me a beer snob or beer nerd, but hop-head is a better description. I don't really like beer that isn't hoppy. So what are hops then, and what do they do? Well, think of hops as adding seasoning to the mixture. They can be quite bitter and herbal. They are also an ingredient that helps preserve the shelf-life of the beer.

Anything else in beer is an adjunct. Adjuncts are unmalted grains (such as wheat, rye, rice, corn, and oats) or other products (ie orange peel, vanilla, lactose, etc) used in the brewing process which are added to the malted barley mash, often with the intention of cutting costs, but sometimes to create an additional feature, such as better foam retention, flavours or nutritional value.

Two Types of Beer

Ale or lager...which do you prefer? Well the difference is in the type of yeast used. The type of yeast dictates how it is fermented. I'm an ale person all the way! Here's how I learned to differentiate between the two:

(1) Ale has 3 letters, just like "red" (as in red wine). The yeast is fermented on the top of the mixture, using warm water. It can have quite a complex nose and taste, and is usually higher in alcohol. It can produce quite fruity beer. My favourite type of beer is known as India Pale Ale (IPA) and each can taste quite different from the other depending on the hops and barley used. But that can be an entire blog on its own...

(2) Lager has 5 letters, just like "white". The yeast is fermented on the bottom of the mixture, using cold water and takes longer to brew than ale. Lager is generally quite "clean" tasting (just like white wine). Except it's not usually fruity (without the addition of adjuncts) and for me anyway, I find I really have to search for a smell that's not "beer".

That's my intro to beer 101. And to quote one awesome beer sommelier, "There is no bad beer; just good beer and better beer". Are you interested in trying some beer now? Well I'd be remiss if I didn't mention the guidelines to alcohol consumption in Canada. The recommended intake is a maximum of 10 drinks per week for women, with no more than 2 drinks per day most days and 15 drinks per week for men, with no more than 3 drinks per day most days. So try something new! Or something you love! Either way, please enjoy your brew responsibly :)

PS...Heineken is a pilsner (a type of lager)

Charcoal Ice Cream

If you like ice cream as much as I do, then you'll know there have been  2 new ice cream crazes this summer, and one of them contains activated charcoal. The deep black, purple and green hues of this ice cream drew me in. I had to have it. Except the only place it's available in Toronto always has a block-long line-up (I guess it's to be expected since I'm always in that neck of the woods on a sunny weekend afternoon). But one Wednesday evening when I walked out of yoga, hungry because I hadn't eaten dinner yet, I lucked out (yes, I had ice cream for dinner). It was nearly 9pm and only a handful of people in line!

As I was enjoying my ube black (purple yam and coconut) in a charcoal-infused cone, I started to wonder some things. How much activated charcoal is in this thing? Will this delicious black and purple treat do anything to my body? I mean, I know what activated charcoal is used for, medically.  The next day my thoughts became: Why is my poop this scary colour?

What is Activated Charcoal?
Activated Charcoal is traditionally used as a treatment to a drug overdose or poisoning (although does not work for some poisonings, including alcohol). Essentially, it binds to almost everything in the stomach and potentially the small intestine and removes it from the body. It has not got radar that detects the bad stuff (ie poison) over the good stuff (ie nutrients); it gets rid of it all.

What Else Is it Used For?
Lately, Gwyneth Paltrow (well that's a sign) and others have been using activated charcoal as a cleanse. This is absolutely unnecessary and can even be dangerous. There are 3 organs involved with cleansing the body (liver, kidneys and colon) and none of them require a lot of help, for most people. The danger is that it cleanses the body of toxins, nutrients and medications. Taken long term, it can even cause a bezoar (kind of like a lump of goop in your gut...not very cleansing). I  also know some people that take activated charcoal when they are hungover or have eaten something that does not agree with them.

What Are the Potential Side Effects of Eating Charcoal Ice Cream?

- Black tongue, lips and teeth

- Black, grey or green stool

- Can render meds ineffective, since they will be removed from the body so quickly (ie birth control pill, diabetes meds, blood pressure meds, etc)

- Nutrient deficiencies (long-term use)

Bottom Line
Black ice cream is yummy (all ice cream is, really). If you want to have it once in awhile, and you're not on medications, then it's probably safe. However, if you take medications, then you might want to take extra precautions (ie alternative methods of birth control) when you eat charcoal-based ice cream. It's not clear how much activated charcoal you will get in just one serving (also served in a charcoal cone), but it was enough to give me symptoms...

What is Clean Eating?

The idea for this blog came to me when my boyfriend mentioned to me that Panera Bread's stocks are skyrocketting (over $230 a share...compare that to Apple at $100 less). That's a lot of Thai Chicken Wonton Garden Bowls...or Bear Claws...or whatever it is that people buy there. But why would this fact spawn a nutrition blog? Glad you asked...

Have you seen Panera advertisements lately? Well they are all about clean eating! What the heck is clean eating? My comeback used to be: washing your hands (and food, depending on what it is), but that lighthearted response just doesn't get at the seriousness of this trend. And it is a trend. And Panera is cashing in on it. They even have a No No List! Now THAT sounds scary!

Clean Eating Defined

I'm sure you've heard of it! You probably know at least one person who's doing it. Or maybe that local juice place or raw eatery boasts they make all their food using clean ingredients. It seems like every week someone tells me they try to eat only clean foods. But what does it actually mean? Just do a Google search and you will see lots of definitions...and rules. 

Clean eating is not necessarily about the food itself, or the amount eaten. It's more about the steps involved in turning the raw food it into the edible form you are consuming. And sometimes that means it is raw....virtually picked, washed and on your plate. Quite simply put, clean eating is about eating foods that are not processed or at least minimally processed; whole foods, as close to their natural form as possible.

Sounds like a good idea, right? In theory, sure. But most foods we eat are processed to some extent. The question is, how processed is it? Buying pre-cut veggies because you don't have time to cut them yourself? Processed. That whole grain, high fibre bread you love? Processed. What about those whole grain cackers, frozen fruit + yogurt or canned tuna you like to have for snacks? Also processed. Potato chips? Obviously.

Why the Movement?

Our society is seemingly obsessed with food...and health. So no wonder this is happening. Ultra processed foods can contain a lot of sodium, sugar, trans fat, preservatives and other "undesireables". Eating too much of this can have an impact on our physical and mental health. But processing isn't necessarily a bad thing. Sometimes it makes certain foods more convenient, nutritious and edible/safe to eat. Sometimes processing makes food last longer on the shelf. And sometimes processing is just for the yumminess factor.

As mentioned above, it is also important to distinguish between the different types of processing. Some foods are minimally processed, meaning not much has been done to them before you eat them (ie fresh fruits and veggies, fresh meats, nuts and dried legumes and some whole grains [ie brown rice, quinoa and whole wheat berries, dsteel cut oats, etc]). Processed foods have an added step, like milling, canning, freezing or pasturization (not necessarily a bad thing). Ultra processed foods, however, have been stripped of most of their nutrition for the sake of convenience and preservation, and often have added sugar, sodium, fat and preservatives, as well as vitamins and minerals (because they took out the natural ones).

How The Term Clean Eating Can Be Problematic

If some foods are clean then some foods dirty, right? With this language, they have to be. How do you feel at the thought of eating dirty food? What comes to mind? Does it make you feel dirty somehow? Unhealthy? Well, issues with food and health don't just boil down to one food; it's about the pattern of eating (how much, how often, etc). Rigid eating patterns can affect your health in a negative way. In addition, clean eating can be seen as elitist eating. However, eating in a certain way doesn't make you a better (or worse) person than your best friend, or your spouse, or your colleagues...or anyone.

So how about thinking of food as food? No moral qualities. Just food. Instead, think about how that food makes you feel (physically and mentally) when you eat it.

For me, I think of certain foods as staples (everyday foods) and others as sometimes foods. If I ate sometimes foods all the time, I wouldn't feel great physically or mentally. But if I avoided them altogether, I wouldn't feel my best either. The key is finding balance...and learning what that is for you.

PS I looked at Panera's No No List. Artificial sweeteners are on that list...yet they sell Diet Pepsi. Hmmmmm.....

Exercising in Winter

I was asked to write this blog for our family health team's quarterly patient newsletter, but then I thought that maybe this could benefit many more people, so I changed it a bit and posted it here.

Winter is upon us (although it currently doesn't feel that way) and for many people living in Toronto, this means a decrease in physical activity. But it doesn't have to! There are plenty of fun ways to move your body both outdoors and indoors this winter. 

Benefits of Being Physically Active All Year Long

The list of the benefits of exercise is a long one, so here are some of my favourites:

- Improved mood

- Increased energy levels

- Increased strength

- Improved self-esteem

- Improved sleep

- Improved blood pressure

- Improved blood sugars

Ready to Get Moving, But Looking for Some Ideas?

Walking Trails can be found on the City of Toronto website (www1.toronto.ca). Here you can search for Natural Environment Trails, Discovery Walks, and much more. This year, there was a big ceremony held in the beaches as they lit up the boardwalk with Christmas lights....the lights will illuminate your evening walks until February 17th, 2017. If you don’t like walking alone, there are many Walking Groups you can join (listed on the website above).

Cross Country Skiing and Snowshoeing can be great cardiovascular workouts that really allow you to embrace winter! Find a trail and rent some skis/snowshoes...if you enjoy it you can buy some in sports stores (and second-hand sports stores).

 Many would say that Skating is Canada’s national winter pastime. There are plenty of indoor and outdoor rinks in Toronto for you to glide across the ice. If you've never been on skates before, there are many rinks that offer skate rentals as well as lessons.

For those of you with joint pain, Aquafit might be right for you. Being in the water takes the pressure off your joints and the water provides resistance to help you gain strength. Most pools used for aquafit are kept at warmer temperatures than the pools used for lane swimming. If you're interested in trying out a class without commitment, many pools across the city (ie Regent Park Aquatic Centre) offer FREE classes!

If working out in a Gym is your thing, there are plenty of gyms and studios in Toronto to choose from, depending on what your budget and needs/wants are. There is program called Class Pass (http://www.classpass.com) that allows you to sign up for classes at numerous fitness studios all over the city for a fee. I had no idea how many small studios (ie spin, yoga, dance, pilates, etc) are all over the city until I signed up. Now the possibilities are nearly endless! Another option is Groupon; they frequently have offers for fitness classes, to give you a chance to try it out without committing to an annual membership. Parks and Recreation even offers some free drop-in workout space and classes, regardless of your income or neighbourhood (in other words, you don't have to live in the neighbourhood where the free classes are offered). They also offer a Welcome Policy, for those who cannot afford to join their regular programs. For more information, check out their website: http://www1.toronto.ca/wps/portal/contentonly

Maybe you enjoy the equipment and group classes that gyms offer, but you find gyms intimidating. There are many size-inclusive gyms and studios around the city. Some of these include: Variety Village, YMCA, Parks and Recreation, Fitzone-Plus, and Yoga For Round Bodies, to name a few.

If you like walking, but walking outside in the winter might not be safe for you due to the ice, Mall walking is a great option. Call your local mall to learn what they offer.

If you're not in Toronto, that's ok; many cities offer similar opportunities. The point of this was to give you some ideas. And remember: every little bit counts. So find something you enjoy and have some fun with it!

What's the Deal with Yogurt?

One of my readers has asked me to write about yogurt. Since there are so many types to choose from, it can be really confusing.

So, what is yogurt exactly? Yogurt is a semi-solid food produced from the fermentation of milk by bacteria. The milk is heated and then cooled to about 109-115°F (43-46°C), at which point the bacteria is introduced and the fermentation process begins. The bacteria produce lactic acid and the resulting sour yogurt is born. Sugar is often added in order to decrease its sour taste...but many people like it just how it is. Yogurt has been around for centuries, but it has been gaining more and more popularity over the past couple of decades.

Potential health benefits of eating yogurt

Aside from its delicious taste (in my opinion) and its ability to satiate my appetite at times, yogurt also offers some potential benefits to health.

(1) Nutrient dense. Since it is made from milk, yogurt is a great source of many nutrients, including calcium, protein, B12, riboflavin, phosphorus, and potassium. Some yogurt is also a good source of Vitamin D, but not all, because it is not required to be made from Vitamin D fortified milk.

(2) Probiotics. As mentioned above, yogurt also contains bacterial culture (probiotics). Probiotics have many potential health benefits when consumed, including improved digestive health, reduction of LDL (also referred to as "bad cholesterol"), and improved oral health. But, the health benefits are associated with different bacterial species and in certain amounts. And these health benefits may not always apply to yogurt consumption, because yogurt is often pasteurized after the probiotics are added, which kills the bacteria. Therefore, if you are eating yogurt because of the bacteria, it is best to choose one with active or live cultures.

(3) Reduction in blood pressure. One large study has shown a link between regular yogurt consumption and prevention of high blood pressure: https://www.sciencedaily.com/releases/2012/09/120919190600.htm. Another study has found a link between consumption of probiotics (in yogurt or supplements) and a reduction in blood pressure. The association was stronger when more than one species was taken and in people who had higher blood pressure to begin with (read more here: http://hyper.ahajournals.org/content/early/2014/07/21/HYPERTENSIONAHA.114.03469.abstract). But, there are also studies showing no impact of yogurt on blood pressure.

(4) Bone heath and osteoporosis. We've often heard that milk is good for our bones. Why is that? Well milk and yogurt contain calcium and calcium is needed to help with bone remodelling (the continuous removal of mature bone tissue and replacing it with new one). Other nutrients involved with this are vitamin D, magnesium, phosphorus and vitamin K. Incidentally, weight bearing physical activity (like walking) is also important in preventing bone loss.

Potential adverse effects

For people with lactose intolerance or milk allergy, yogurt can be potentially harmful. There is no cure for a milk protein allergy except to avoid eating any foods with milk in it. However, with lactose intolerance, people lack the enzyme (lactase) that breaks down lactose (the sugar found in milk). People with lactose intolerance can often (but not always) tolerate yogurt, because the probiotics help to break down the lactose. Another option for people with lactose intolerance is to buy lactose-free yogurt or take the lactase enzyme (in a chewable pill format).

Something else that people don’t often think about when it comes to yogurt is the added sugars, which can be quite substantial. Plain yogurt does not contain added sugar. Does that mean you should never eat flavoured yogurt? Noooooo! It’s all about awareness and moderation...and your own preferences.

Things to consider when choosing a yogurt

(1) Greek vs regular. Greek yogurt is made the same way as regular yogurt, but is then strained extensively. The end product is lower in carbohydrate (lactose) and higher in protein and fat than regular yogurt. It is also thicker, so has a different mouth-feel and tastes a little different. The first time I had it, I hated it (but I grew to love it). So the choice is yours...and might depend on many things, including how you are using it (to eat vs as a replacement to sour cream), your health goals (for example, are you looking to add more protein to your meal/snack?) and what you feel like eating at that moment in time.

(2) Active probiotics. As mentioned above, probiotics are killed in yogurt because of the pasteurization process. So, if having a yogurt with probiotics in it is important to you, be sure to buy one that says it contains active or live bacterial cultures.

(3) Flavoured vs plain. This is a tricky one. Yogurt is sour. Many people prefer sweet taste over sour, so manufactures add sugar (up to 5-6 teaspoons per serving) to their yogurts when they flavour it. The only type of yogurt without sweetener is plain yogurt. However, not all sweetened yogurt has sugar added; sometimes it is sweetened with Splenda, Stevia, Aspartame or other non-nutritive sweeteners. I usually (but not always) buy plain and add my own fruit or sugar (I like to add frozen blueberries or a little maple syrup). Again, it’s all about personal preference. I will tell you that it took awhile for me to get accustomed to plain yogurt but now I find flavoured yogurt to be way too sweet for my taste. 

(4) Fat content. The fat content of a yogurt (or any milk product) can be found right on the front and is listed as a %MF. Fat free is 0%MF and yogurt tends to range from 0-10%MF. There has been some research to show that full fat dairy doesn’t have the same impact on cholesterol levels as was once thought. For me, part of the problem with fat free yogurt (besides the taste) is that I just don’t find it to be as satisfying as a 2%...or 9% yogurt. Thickeners (ie gelatin, locust bean gum, starch, guar gum and pectin) are often added to fat-free yogurt to give it a creamy texture.

(5) Organic. What's the deal with organic yogurt? Is it more nutritious? Well, there is no evidence to support that. However, it does ensure that there are no antibiotics or hormones in there. One thing though...antibiotics given to cows have not been shown to have negative long-term effects for humans.

Bottom Line

Choosing a yogurt should not be a stressful process, although many people have confided to me that it is. These days there are so many choices available that it can become a bit overwhelming. I hope that this post has helped you understand a bit more what the options are all about. I would suggest that when you head to the store, you have a couple of priorities in mind so that you can focus your search. Maybe it is about price, or taste or probiotics or protein or sugar...or something else. This should make it a lot easier to choose the right yogurt for you.

Foods that This Dietitian Wouldn't Feed A Child (or anyone for that matter)

I'm sharing this blog That I wrote last October with you now, because I have seen so many stories in my feed lately about what to eat and what not to eat ("7 Worst Foods You should Never Eat for Breakfast" or "8 So-Called Healthy Foods Registered Dietitians Wouldn't [or Rarely] Eat")...and many of them are written by dietitians! I hate that, because it reinforces what many people think dietitians are all about. Well not all of us are rigid and strict. Many of us don't believe in demonizing and restricting foods.  Some of us even teach people to  listen to their bodies and recognize what moderation (for them) looks like.

Originally posted on October 21, 2015 — Julie Seale, RD

I'm sure you've seen them: the articles about what dietitians won't eat...or won't feed their kids...or the offspring of their worst enemy. Today I was talking to my friend (she's also a dietitian) and she showed me a blog written by a dietitian about the 7 foods she won't feed her kids. Now, as with any other profession, dietitians have different ways of practicing...and we are influenced by our own belief systems. So please don't read this as me saying she's wrong. I present another point of view. My friend and I had a lot to say about this list of 7...she feeds many (if not all) of those foods to her kids. If I had kids, I wouldn't have off-limits foods either. Well...except for this list:

1. Moldy Bread

2. Milk that has chunks in it

3. Generally, any food that is bound to make anyone sick (ie from food poisoning or allergies or whatever)

Now, as for the list that the other dietitian wrote...sure, I agree to some extent; those are not foods to eat every day. They are high in sugar and low in vitamins and minerals. But "never" is a really long time. Telling children that certain foods are bad can set them up with food struggles when they are older. I get that it comes from a place of love: giving your child the food that will nourish her. I agree...a diet high in added sugars and low in whole foods won't promote healthy growth and development. But, a diet completely void of those hitlisted foods is also not healthy. When you put a label on it, it just makes them want it more. It is very difficult to learn moderation when they never get to eat it. It all comes down to balance.

Many of you will disagree...some might even say I can't possibly know, because I'm not a parent. But, I do see a great deal of adults in my office struggling with food. Heck, I even see 6-10 year olds saying things like "I'm fat so I can't eat [chips, chocolate, pizza, whatever]" and "That's junk food so I can't have it".  I believe the best way to teach children about healthy eating is to stop labelling foods as "good", "super", "bad" and "junk" and talk to kids about food in a neutral way. In the end, as parents, you decide what foods your children eat. Sure, limit ultra processed foods and teach them where food comes from. But let them discover how food makes them feel.