Prevent Hypertension Before it Starts

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Hypertension, or high blood pressure, is considered an “insidious disease” because it doesn’t come with any obvious symptoms.  For most adults, there’s no one definite cause of hypertension, but things like stress, physical inactivity, eating a lot of salt, using tobacco, and drinking a lot of alcohol can all increase your risk.¹ Many people don’t know they have it until it starts to cause complications,² such as damage to the blood vessels, stroke, heart attack, vision loss, memory problems or kidney failure.^1–3 Adults over the age of 50 have a 90% risk of developing hypertension⁴ but until you start getting complications, the only way to know whether you have it is to get your blood pressure checked.  When you do, your doctor will tell you your blood pressure as one number “over” another number.  The first number is your systolic pressure, or the pressure your blood puts on your arteries when your heart is contracting.  The second number is your diastolic pressure, or the pressure your blood puts on your arteries when your heart is relaxed.³

A healthy blood pressure is considered to be 120/80 millimeters of mercury (mmHg), but some researchers believe the risk of complications increases beginning at a blood pressure of 115/75 mmHg, well before 140/90 mmHg when hypertension would be diagnosed.⁴ This means it’s crucial to get your blood pressure checked regularly and take a few precautions in your diet and lifestyle to prevent hypertension in the first place.

Achieve or Maintain a Healthy Weight

Many studies show that weight loss lowers blood pressure.  Ideally your body mass index should be at or below 25, but weight loss will improve your blood pressure even before you reach your goal weight.  Losing about 11 pounds can lead to a reduction of about 4.4/3.6 mmHg.⁴ If you’d like to lose weight, talk to a registered dietitian to learn some strategies to reduce your calorie intake that you’ll be able to maintain for the long term.

Stay Active

The American Heart Association recommends that people do some type of aerobic exercise for at least 30 minutes every day to keep their blood pressure low.  Aerobic exercises include power walking, jogging or running, dancing, cycling, swimming, and anything else that gets your heart rate up.  In general, the more intensely you exercise, the better.  Some studies also suggest that resistance exercise, such as weight lifting, can also improve your blood pressure.⁵ Since both aerobic and resistance exercises are also known to help you maintain weight loss, reduce your risk for diabetes, and maintain your muscle mass and balance as you get older, lowering your blood pressure is just one more reason to get active every day!

Choose Nutrient-Dense Foods

The DASH (Dietary Approaches to Stop Hypertension) Diet was developed specifically to help people keep a healthy blood pressure.  Other healthy-eating plans, such as the Mediterranean diet, the OmniHeart diet, and the vegetarian diet, are also known to improve blood pressure.  In general, you should aim for 8-10 servings of fruits and vegetables and 2-3 servings of low-fat dairy each day.  These food groups are high in potassium; people who consume about 4.7 grams of potassium each day tend to have lower blood pressures.⁴

Fruits, vegetables, and whole grains are also good sources of fiber, which is associated with reduced blood pressure.  Although your recommended daily intake of fiber is 25-30 grams, most Americans do not meet this recommendation.  Studies have shown that increasing your fiber intake by 14 grams per day can lead to modest improvements in blood pressure.⁴

 Drink Alcohol in Moderation

Studies have shown that the more alcohol you drink, the higher your blood pressure will get, especially if you have more than two drinks per day.  This will happen regardless of your weight, age, and other dietary factors; however, reducing your alcohol intake will lead to improved blood pressure.  At the most, men should have no more than two alcoholic drinks per day and women should have no more than one.⁴ One drink is considered to be 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor.  All of these provide about 14 grams of pure alcohol.⁶

Limit Added Salt and Sugar

It’s pretty well known that eating a lot of sodium can increase your blood pressure.  Studies have shown that blood pressure rises as sodium intake does.  To combat this, people should limit themselves to no more than 2300 milligrams of sodium each day, and people who are over the age of 50 or African American should have no more than 1500 milligrams every day.  Using herbs and spices to flavor your foods and limiting the amount of processed foods you eat will help you keep your sodium intake within these recommendations.⁴

At the same time, studies suggest that eating added sugar will increase your blood pressure four times as much as sodium.  Researchers believe that eating a lot of sugar causes hypertension by promoting inflammation, insulin resistance, and obesity.  The blood sugar spike after eating sugar causes water to move out of the cells and into the blood vessels, raising blood pressure.  It doesn’t take long for a high-sugar diet to impact blood pressure.  After just a few months, people who ate a high-sugar diet had blood pressures that were an average of 7.6/6.1 mmHg higher than those who ate a low-sugar diet.⁷ To combat this, satisfy your sweet tooth with fruits rather than candy or desserts high in added sugar.  Also check the ingredients list on foods such as bread, canned sauces, yogurt, and cereal to make sure that some type of sugar hasn’t been added.

While these recommendations are important for a healthy blood pressure, following them will also help you maintain your weight, reduce your risk for Type 2 Diabetes, and stay healthy while you age. Stay active, choose a variety of fruits, vegetables, lean protein, and whole grains, limit alcohol, sodium, and sugar intake, and speak with a registered dietitian if you’d like more personalized recommendations!

References:

1.         High blood pressure (hypertension) Causes. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/causes/con-20019580. Accessed March 1, 2017.

2.         Hypertension. Tutorials - Pathology Subjects. http://library.med.utah.edu/WebPath/TUTORIAL/HYPERTEN/HYPERTEN.html. Accessed February 15, 2017.

3.         5 things you should know about high blood pressure - Nutrition Action. http://www.nutritionaction.com/daily/heart-and-disease-cat/5-things-you-should-know-about-high-blood-pressure/?mqsc=E3871758&utm_source=WhatCountsEmail&utm_medium=Nutrition_Action_Daily_TipsNutrition%20Action%20Daily&utm_campaign=2017.02.13%20Heart%20and%20Disease. Accessed February 14, 2017.

4.         Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM. Dietary Approaches to Prevent and Treat Hypertension. Hypertension. 2006;47(2):296-308. doi:10.1161/01.HYP.0000202568.01167.B6.

5.         Brook RD, Appel LJ, Rubenfire M, et al. Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure. Hypertension. 2013;61(6):1360-1383. doi:10.1161/HYP.0b013e318293645f.

6.         What Is A Standard Drink? | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/what-standard-drink. Accessed March 1, 2017.

7.         DiNicolantonio JJ, O’Keefe JH. Hypertension Due to Toxic White Crystals in the Diet: Should We Blame Salt or Sugar? Prog Cardiovasc Dis. 2016;59(3):219-225. doi:10.1016/j.pcad.2016.07.004.

Keep Your Heart Healthy

Submitted by Amy Sercel MS RD CD

Edited By Marcia Bristow MS RDN CSSD CD

February is National Heart Health Month!  During this month every year, we are reminded to take care of our hearts and take steps to prevent heart disease.  Heart disease is the leading cause of death for Americans, but it is considered a “silent killer” because people often aren’t aware they have it until it starts to cause serious problems.¹ For this reason, it’s really important to have regular visits with your doctor where you get your blood pressure, triglycerides, and cholesterol levels checked.  At the same time, maintaining a healthy weight, staying active, and following a heart-healthy diet are valuable ways to slow or prevent heart disease from developing in the first place.

A heart-healthy diet is full of fruits, vegetables, whole grains, low-fat dairy, fish, legumes, vegetable oil, and nuts, and lower in sweets, sugar-sweetened beverages, processed red meats, and sodium.  If you’d like a more specific meal plan, both the DASH diet and the Mediterranean diet have been shown to reduce the risk for heart disease.² You can also modify your current diet to incorporate some heart-healthy elements; the first step could be to eat more fruits and vegetables.  Studies have shown that eating more than five servings of fruits and vegetables every day improves blood pressure and the health of your small blood vessels, and eating more than seven servings of fruits and vegetables each day can reduce your risk of death from cardiovascular disease by 31%.³ One possible explanation for this is the high fiber content in fruits and vegetables.  Fiber can keep you full for longer so you won’t be tempted to snack later in the day, make you absorb sugar more slowly so your blood sugar stays even, and reduce the amount of cholesterol you absorb from food.  Vegetables seem to have a stronger impact on heart disease risk than fruits,³ so consider adding an extra serving of vegetables to your lunches and dinners.

It is also important to limit the amount of saturate fat you eat, and choose unsaturated fats instead of saturated fats whenever possible.  Unsaturated fats are liquid at room temperature and are found in vegetable oil, nuts, seeds, fatty fish, and avocados.  Saturated fats are solid at room temperature and are found in full-fat dairy, red meat, animal fat, and coconut oil.⁴ Reduce the amount of saturated fat you eat by choosing lean meat, vegetable oil, and low-fat dairy instead.  Low-fat dairy in particular has been shown to help reduce blood pressure, possibly because it contains a lot of potassium and calcium.³

In addition to modifying your diet, the American Heart Association recommends at least 2½ hours per week of moderate-intensity physical activity, or 1¼ hours per week of vigorous activity to reduce your risk for heart disease.² Studies have shown that active people are about 30-35% less likely to develop heart disease than inactive people.  Among active people, spending less time sitting every day further lowers your risk for heart disease. Among inactive people, even small amounts of activity can help you reduce your risk for heart disease – there is no “minimum threshold” where activity becomes helpful.  In general, though, the more active you are, the lower your risk of heart disease gets.⁵ 

The American Heart Association says the entire population would benefit from eating a heart-healthy diet and engaging in regular physical activity.² In addition to protecting you against heart disease, following these recommendations can help you maintain a healthy weight, lower your risk for Type 2 Diabetes, and keep you healthy as you age.  It is never too soon to start working to prevent heart disease.  This National Heart Health Month, make one change that will benefit you for a lifetime!

References:

1.         The Heart Foundation. http://www.theheartfoundation.org/heart-disease-facts/heart-awareness-month/. Accessed February 21, 2017.

2.         Millen BE, Wolongevicz DM, Jesus JM de, Nonas CA, Lichtenstein AH. 2013 American Heart Association/American College of Cardiology Guideline on Lifestyle Management to Reduce Cardiovascular Risk: Practice Opportunities for Registered Dietitian Nutritionists. J Acad Nutr Diet. 2014;114(11):1723-1729. doi:10.1016/j.jand.2014.07.037.

3.         Berciano S, Ordovás JM, Berciano S, Ordovás JM. Nutrition and Cardiovascular Health. Rev Esp Cardiol. 2014;67(9):738-747. doi:10.1016/j.rec.2014.05.003.

4.         Saturated fat, regardless of type, linked with increased heart disease risk. The Nutrition Source. https://www.hsph.harvard.edu/nutritionsource/2016/12/19/saturated-fat-regardless-of-type-found-linked-with-increased-heart-disease-risk/. Published December 19, 2016. Accessed February 21, 2017.

5.         Shiroma EJ, Lee I-M. Physical Activity and Cardiovascular Health. Circulation. 2010;122(7):743-752. doi:10.1161/CIRCULATIONAHA.109.914721.

Nutrition for Peak Performance

 

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Between the Australian Open, the Super Bowl, and the World Alpine Ski Championships, there are a lot of major winter sports competitions.  While the physical demands of these sports vary quite a bit, the athletes that play them all have something in common: their careers depend on their athletic performance, making it even more important for them to properly fuel up to achieve their maximum potential.

It’s crucial for an athlete to be well nourished going into an event.  The nutritionist for the Atlanta Falcons stresses that an athlete can’t correct a “low-energy and/or poorly hydrated state” right before a game, so instead the athlete needs to focus on meeting his or her calorie, protein, and carbohydrate needs every day.¹

Within these guidelines, there are many ways to create a nutritious diet.  For example, Patriots quarterback Tom Brady says he largely avoids any white flour or sugar, instead focusing on whole grains and consuming a plant-based diet where vegetables make up around 80% of his meals.  On the other hand, his rival Matt Ryan of the Falcons eats a variety of fruits and vegetables, striving to make his plate as colorful as possible, while still enjoying the occasional slice of cake.  Like Brady, the fat in Ryan’s diet primarily comes from vegetable sources.² Each quarterback has a unique eating plan that meets his energy, carbohydrate, and protein needs and provides some healthy fat.

No matter what the sport, athletes depend on carbohydrates stored as muscle glycogen for energy while they’re in a competition.  If an athlete doesn’t eat enough carbohydrates throughout each day, he or she will fatigue more quickly and not perform as well during a competition.^3,4 Before an event, a meal should be high in carbohydrates such as pasta, rice, bread, and fruit, contain a good source of lean protein, and be lower in fiber and fat to promote easy digestion.^1,4

During an event, it’s important to keep muscle glycogen stores high and maintain blood sugar levels in the normal range.  The nutritionist for the Falcons suggests that his athletes eat every 3 hours so they never get hungry.² Blood sugar can drop within 30 minutes of vigorous activity, leading to difficulty concentrating and decreased neurological function.  To combat this during events, athletes eat fast-digesting sources of carbs, such as sports drinks that also help with hydration.¹ Athletes usually avoid high-fat and high-fiber foods during prolonged exercise, as these are digested more slowly and may sit in the stomach and slow the athlete down.

After exercise, an athlete should strive to replenish muscle glycogen as soon as possible so his or her stores will be full for the next competition.  Within 90 minutes, the athlete should eat about 1 gram of carbohydrate per kilogram of body weight.  Consuming protein right away will also help keep muscle glycogen stores high and aid in muscle repair.⁴ The New England Patriots and the Atlanta Falcons will usually be seen eating a recovery snack on the field immediately after a game.¹ These recovery foods ensure that the athlete will be properly fueled and will achieve peak performance at every competition and practice!

References:

1.         Atlanta Falcons’ Team Nutritionist Dr Dan Benardot On Super Bowl Nutrition. http://www.cleanplates.com/know/people-places-know/atlanta-falcons-head-nutritionist-reveals-game-day-secrets/?utm_source=My+Sports+Dietitian+Connect&utm_campaign=4be72f173d-EMAIL_CAMPAIGN_2017_02_05&utm_medium=email&utm_term=0_c3aed6e419-4be72f173d-128820021. Accessed February 10, 2017.

2.         Doheny K. Dueling Quarterback Diets: Matt Ryan vs. Tom Brady. WebMD. http://www.webmd.com/diet/news/20170201/dueling-quarterback-diets-matt-ryan-vs-tom-brady. Accessed February 10, 2017.

3.         Baranauskas M, Stukas R, Tubelis L, et al. Nutritional habits among high-performance endurance athletes. Medicina (Mex). 2015;51(6):351-362. doi:10.1016/j.medici.2015.11.004.

4.         Klossner D. Nutrition and Performance Resources. NCAA.org - The Official Site of the NCAA. http://www.ncaa.org/health-and-safety/nutrition-and-performance/nutrition-and-performance-resources. Published November 22, 2013. Accessed February 10, 2017.

Flex Your Self Control

Submitted by Amy Sercel MS RD CD

Edited By Marcia Bristow MS RDN CSSD CD

Whether you realize it or not, you exercise self control throughout the most of the day, every day.  You use willpower to get up in the morning when you’d rather sleep in, to act cheery at times when you might not feel very friendly, or to motivate yourself to work out.  You also use willpower to make over 200 food choices every day, especially when you’re deciding between a less-healthy but quick snack and something that will take longer to prepare but might be lower in calories.² It just happens that you might not have an unlimited supply of willpower.  When you use it repeatedly, you might not have any left over to make a healthy choice later on.

Researchers believe that willpower is like a muscle – early on, you can use it easily, but after repeated use you’ll experience something called “willpower depletion” where your willpower runs out and it’s harder to resist temptations.^2–4 When this happens, your desires feel more intense than usual and it can be more difficult to stop or hide your natural response to a stimulus.⁴ For example, if you spend all day using willpower to keep yourself on track at work, by the time you go to the grocery store you may crave a chocolate bar more strongly than usual, and you will find it more difficult to stop yourself from buying it.  Willpower depletion isn’t related to physical fatigue, but you do tend to have more willpower earlier in the day, and willpower depletion will occur more slowly if you're in a good mood.³ In several studies, people who were put into a good mood through receiving a gift or through watching a pleasant film showed more willpower when faced with a complicated task than the people whose moods were neutral or unhappy.  It’s apparent that being in a good mood will help you maintain willpower over a longer period of time, but it’s not clear whether the good mood actually replenishes willpower, or whether it just gives you the extra energy you need to exert willpower even when your willpower reserves are low.⁵

Lots of studies have looked at the impact of willpower depletion on food choices.  In one study, people were brought into a room with a bowl of radishes and a plate of cookies on a table and asked to solve a puzzle.  Some people were offered the radishes, and others were offered the cookies.  When people were offered the cookies, they worked on the puzzle for about 19 minutes.  On the other hand, the people who were offered radishes and therefore had to use willpower to stop themselves from eating the cookies gave up on the puzzle after about 8 minutes.  In another study, people who were told to hide their emotions while watching a sad movie ate about twice as much ice cream as the people who were not trying to restrict their emotional response.³

Does this mean that we’re all doomed to make poor decisions after we’ve been using self-control to get through our day-to-day responsibilities?  Not necessarily.  For starters, people who are strongly motivated by an internal goal or an external reward are able to resist willpower depletion.^2,3 This suggests that setting a meaningful health-related goal that you are driven to achieve will make it easier to stick to your original plan when you’re faced with a tempting, less healthy, alternative.

Lastly, your environment plays a huge role in your choices, even when your self-control is running low.  In one study, people who had their willpower depleted still made nutritious food choices when they believed the nutritious option was more popular than the calorie-dense option.⁶ For this reason, going grocery shopping with someone who is strongly motivated to choose nutritious foods may influence you to make similar choices.  Making your health-related choices earlier in the day when you have the most willpower, instead of in the evening after you’ve been using a lot of willpower, may also help you keep on track with your goals.⁴ Finally, keep a bowl of fruit out in your kitchen or office, and rearrange your cabinets so the less healthy items are at the back, so you will need less willpower to make a healthy choice.

References:

1.         Image Source: Brain Science Secrets to Increasing Leadership Willpower. Empower Bus. May 2014. http://www.empoweredbusiness.com/brain-science-secrets-to-increasing-leadership-willpower/. Accessed February 1, 2017.

2.         Salmon SJ, Adriaanse MA, Fennis BM, De Vet E, De Ridder DTD. Depletion sensitivity predicts unhealthy snack purchases. Appetite. 2016;96:25-31. doi:10.1016/j.appet.2015.08.027.

3.         Weir K. What You Need to Know about Willpower: The Psychological Science of Self-Control. The American Psychological Association; 2012. http://www.apa.org/helpcenter/willpower.aspx. Accessed January 26, 2017.

4.         Baumeister RF. Self-regulation, ego depletion, and inhibition. Neuropsychologia. 2014;65:313-319. doi:10.1016/j.neuropsychologia.2014.08.012.

5.         Tice DM, Baumeister RF, Shmueli D, Muraven M. Restoring the self: Positive affect helps improve self-regulation following ego depletion. J Exp Soc Psychol. 2007;43(3):379-384. doi:10.1016/j.jesp.2006.05.007.

6.         Salmon SJ, Fennis BM, D T, Adriaanse MA, de Vet E. Health on impulse: When low self-control promotes healthy food choices. Health Psychol. 2014;33(2):103-109. doi:10.1037/a0031785.

5 Strategies to Prevent Diabetes

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Diabetes is a health problem that has greatly increased over the past 20 years.  More and more people are diagnosed with Type 2 Diabetes each year, and an estimated 25% of people with the disease don’t even know they have it.  Type 2 Diabetes occurs when your blood glucose is consistently higher than it should be, either because your pancreas is not producing enough insulin or your cells aren’t able to respond to insulin’s signals. 

In addition to the increases in Type 2 Diabetes, another 1 in 3 people have prediabetes, or blood glucose higher than normal but not high enough to be diagnosed with diabetes.¹ People with diabetes and prediabetes are at a higher risk for heart disease, stroke, vision loss, and amputations, and they pay almost twice as much in healthcare costs as people without diabetes.¹ The good news is that both prediabetes and Type 2 Diabetes are preventable.  There are several dietary and lifestyle changes you can make today to help reduce your risk for diabetes, keep your blood glucose within a healthy range, and reverse the progression of the disease even if you already have prediabetes or Type 2 Diabetes.

1.  Maintain a healthy body weight. 

People who are overweight and obese are more likely to develop Type 2 Diabetes.  Although the exact relationship between weight gain and diabetes is unclear, researchers believe that excess fat tissue produces signals that cause cells to become insulin-resistant.  At the same time, it's likely that obesity causes the pancreas to produce so much insulin in response to high blood glucose that the pancreas becomes damaged and is eventually not able to produce enough insulin.² Either way, studies have shown that blood glucose levels improve when people who are overweight or obese lose just 7% of their initial weight.³ To find out how much weight you would need to lose to reduce your risk for diabetes, simply multiply your weight in pounds by 0.07.

2. Be physically active.

All adults should get at least 150 minutes of moderate-intensity physical activity every week, or about 30 minutes every day.  During exercise your cells take glucose from your blood to use for energy, leading to an immediate drop in blood glucose and improving blood glucose levels throughout the rest of the day.  One study found that people who engaged in 45 minutes of high-intensity exercise experienced high blood glucose levels about 2 hours per day less than sedentary people.  Even taking a 15-minute walk after a meal can help by causing a short-term drop in blood glucose, but may not lead to the same long-term blood glucose control that vigorous exercise can cause.⁴ It’s important to note that you should check your blood glucose levels before and after exercise if you are already taking diabetes medication because combining that medication with exercise can cause your blood sugar to fall dangerously low. 

3. Choose foods with a low glycemic index.

A food’s glycemic index is an estimate of how that food will impact your blood glucose levels after you eat it.  In general, foods with a high glycemic index are made up of refined carbohydrates and sugar, which are digested and absorbed quickly and do not include much protein, fat or fiber.  Some foods with a high glycemic index include white bread, sugar-sweetened drinks, sweetened breakfast cereals, cookies, and cakes.   

Foods with a low glycemic index tend to be higher in fiber or protein, so they take longer to digest and therefore cause your blood glucose to rise more slowly. Whole grains, fruits, vegetables, nuts, and legumes are all carbohydrate-rich foods that tend to have lower glycemic indexes.  The fiber in whole grains may be especially helpful for reducing the risk of Type 2 Diabetes.³ Protein and fat do not impact blood glucose, and since they slow digestion adding them to a meal will decrease the meal’s overall glycemic index.

4. Eat yogurt.

Although overall dairy intake is not associated with Type 2 Diabetes, people who eat yogurt are less likely to develop the disease.  One study of nearly 195,000 people found that eating one serving of yogurt per day is associated with a 4% lower risk of developing Type 2 Diabetes.  People still saw this benefit regardless of whether the yogurt was plain, flavored, full fat, or low fat.⁵   

One possible reason for this is yogurt’s high magnesium content.  Studies have shown that people who do not eat enough magnesium are at a higher risk for diabetes,³ and increasing magnesium intake by 100 mg per day can decrease that risk by 15%.⁶ Taking magnesium supplements alone has not been shown to help prevent Type 2 Diabetes, so there could be some other benefit to eating whole foods that are naturally high in magnesium.  Instead of relying on supplements, meet your daily need for magnesium with foods like yogurt, as well as whole grains and leafy vegetables, which are also high in fiber.

5. Eat less red meat.

Both processed and unprocessed red meats are associated with the development of Type 2 Diabetes.^3,7 There are lots of possible explanations for this relationship.  Red meat is high in heme-iron, a pro-oxidant that can damage pancreatic cells.  Red meat also tends to contain nitrites, which your body converts into nitrosamines that are toxic to the pancreas.  Eating a lot of red meat is also linked with future weight gain, which could independently lead to Type 2 Diabetes.  Try substituting poultry, fish, beans, or low-fat dairy for one serving of red meat to reduce your risk for Type 2 Diabetes.⁷

Overall, the keys for diabetes prevention are not much different from the recommendations for a healthy lifestyle.  Engaging in regular physical activity, choosing whole grains and fiber-rich fruits and vegetables, limiting sugary foods and drinks, and replacing a few servings of red meat each week with lean protein or yogurt will help you reduce your risk for many other diseases as well as Type 2 Diabetes.

References:

1.         CDC Features - Diabetes Latest. http://www.cdc.gov/Features/diabetesfactsheet/. Accessed January 20, 2017.

2.         Eckel RH, Kahn SE, Ferrannini E, et al. Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized? Diabetes Care. 2011;34(6):1424-1430. doi:10.2337/dc11-0447.

3.         Association AD. 4. Prevention or Delay of Type 2 Diabetes. Diabetes Care. 2016;39(Supplement 1):S36-S38. doi:10.2337/dc16-S007.

4.         Dijk J-W van, Venema M, Mechelen W van, Stehouwer CDA, Hartgens F, Loon LJC van. Effect of Moderate-Intensity Exercise Versus Activities of Daily Living on 24-Hour Blood Glucose Homeostasis in Male Patients With Type 2 Diabetes. Diabetes Care. 2013;36(11):3448-3453. doi:10.2337/dc12-2620.

5.         Chen M, Sun Q, Giovannucci E, et al. Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. BMC Med. 2014;12:215. doi:10.1186/s12916-014-0215-1.

6.         Office of Dietary Supplements - Magnesium. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/. Accessed January 20, 2017.

7.         Pan A, Sun Q, Bernstein AM, et al. Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. Am J Clin Nutr. 2011;94(4):1088-1096. doi:10.3945/ajcn.111.018978.

Recipe Review: Spinach & Pearl Barley Risotto

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Prep time: 30 minutes

Cooking time: 15 minutes

Ingredients:

1 Tbsp vegetable oil

2 small red onions, chopped

2 cloves garlic, minced

1 cup pearl barley

3 1/3 cups vegetable stock

1 pint cherry tomatoes, halved

7 oz fresh spinach or 4 cooked beets

2 oz coriander

1 Tbsp lemon juice

1 15-oz can garbanzo beans, drained and rinsed

Instructions:

1.     Add oil, onions, and garlic to a large sauté pan and cook over medium heat until onions have softened.  Add all of the pearl barley and stir around the pan for about a minute, or until the barley starts to become translucent.  Add the stock one ladle-full at a time, stirring until the barley absorbs the stock before adding another, until about 1 ½ cups of stock remain.

2.     Pour the remaining stock into the pan, cover, reduce heat to medium-low, and allow the barley to cook for 15 minutes.  Stir occasionally.

3.     While the barley cooks, put the spinach or cooked beets into a blender or food processor and puree until smooth.  If no blender is available, chop spinach or beets finely.

4.     When the barley is cooked and the liquid has been absorbed, add the puree along with the halved cherry tomatoes, garbanzo beans, lemon zest, and coriander.

5.     Serve warm.

Yield: 6 Servings

Nutrient Facts:

275 calories, 10 g protein, 51 g carbohydrate, 5 g fat, 10 g fiber

92 mg calcium, 633 mg potassium, 584 mg sodium, 4 mg iron, 83 mg magnesium

169 mcg vitamin A, 20 mg vitamin C, 1 mg vitamin E, 162 mcg vitamin K, 145 mcg folate

This risotto was quick, flavorful, and satisfying.  I made a few changes to the original recipe and was very happy with the result.  The original recipe says to roast the tomatoes in the oven while the barley cooks, but I wanted to make the meal a little simpler.  Cutting the tomatoes in half and adding them directly to the risotto allowed them to cook a little and also helped the flavor of the tomatoes blend with the rest of the dish.  This was a great way to still include cooked tomatoes without having to worry about them burning in the oven while I concentrated on the barley.

I also modified the recipe by adding garbanzo beans.  Usually a risotto might be served as a side dish to accompany chicken or fish, but I wanted to make this a one-pot meal.  Using garbanzo beans increased the risotto’s protein and fiber content.  It also added a little depth to the meal’s flavor, and the softer texture of the beans complemented the chewiness of the barley.  These changes ultimately streamlined my cooking process because I didn’t have to turn on my oven or make a side dish to serve as a protein source.

The last modification I made was to chop the spinach by hand and add it earlier in the cooking process since I didn’t have the means to puree it.  This didn’t appear to change the texture or flavor of the dish, but I believe it did change the color.  Cooking the spinach for longer made it come out a duller green, and the color might have been brighter and more interesting if I had pureed the spinach and added it after the barley was cooked instead.  If you plan to serve the dish to children who would be excited by a brightly colored meal, I would recommend adding the spinach at the end so the color stays vibrant.

Although I had never cooked with barley before making this dish, it is definitely going to become a staple in my kitchen.  People have been depending on barley for a long time.  In 1324, the King of England declared an inch to be equal to “three grains of barley, dry and round, placed end to end lengthwise.”¹ Barley is similar to rice because it is a small, hard grain that has to be cooked in water or broth before you can eat it, but whole grain barley (also known as hulled barley) has more protein and fiber than brown rice.  Hulled barley has also been shown to help with blood sugar control because it is high in the soluble fiber beta-glucan.  Unfortunately, pearl barley is not a whole grain.  You could easily substitute hulled barley to get more fiber out of this meal, but you might end up cooking it for 15-20 minutes longer.   In the grocery store, you can find barley either in the bulk section or in the rice aisle.

Overall, this was a wonderful dinner.  It was a great way for me to learn how to cook barley, and I will be enjoying the leftovers for a few days!

Recipe Source: http://www.honestlyhealthyfood.com/blogs/honestly-healthy-food/17968997-spinach-pearl-barley-risotto

References:

1.         Barley – February Grain of the Month | The Whole Grains Council. http://wholegrainscouncil.org/whole-grains-101/easy-ways-enjoy-whole-grains/grain-month-calendar/barley-%E2%80%93-february-grain-month. Accessed January 13, 2017.

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