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Can Supplements Combat COVID-19?

12/31/2020

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As COVID-19 infections continue to rise, many have turned to supplements to boost immunity.  Though eating a balanced diet high in nutrients (like vitamins) can support a healthy immune system, there are many false claims that exaggerate benefits of supplementation.  Here’s a summary of the evidence for common supplements associated with COVID-19:
 
  • VITAMIN D:
There is no conclusive evidence that vitamin D affects COVID-19 risk or severity of infection, though some research trials are underway.  While low levels of the vitamin have been found in COVID-19 patients, deficiencies are common in high-risk groups disproportionately hit by the virus, like the elderly.

If you are interested in taking vitamin D, aim for 400-1000 IU (international unit) daily from a USP-verified supplement.  Do not take more than 4000 IU a day, unless advised by a medical professional.  Taking high doses can result in elevated levels of calcium in the blood, which can cause heart and kidney problems.


  • VITAMIN C:
There is no strong evidence that vitamin C can prevent or treat COVID-19.  If you take vitamin C supplements, do not take more than 2000 milligrams daily.  This can result in uncomfortable side effects such as abdominal pain, diarrhea, and cramps. 

If you’re interested in vitamin C, add foods such as strawberries, peppers, oranges, and broccoli to your diet. 


  • ADAPTOGENS: 
Adaptogens are substances derived from plants believed to improve the body’s resistance to environmental and emotional stressors.  Adaptogens, such as ashwagandha and astragalus, have not been shown to prevent or treat COVID-19. 

Pregnant women should avoid using these adaptogens. Ashwagandha may cause miscarriages and there is concern astragalus could be toxic for both moms and babies.


  • ELDERBERRY:
There is no solid evidence to support the claim that elderberry can prevent or treat COVID-19.  

  • OLEANDER:
Oleander is poisonous and should not be taken as a dietary supplement.  There is no data to support using oleander as a treatment for COVID-19. 
 
Important things you can do to support your immune system:
​
  • Eat a balanced diet (need tips? start here)
  • Exercise regularly
  • Get enough sleep 

Also, don't forget to follow COVID-19 prevention protocols.  Taking a supplement is nowhere near as important as wearing a mask and practicing social distancing.

REFERENCES (subscription necessary to view):
Don't Rely on Natural Products and "Immune Boosters" for COVID-19 Prevention.  Natural Medicines Research Collaboration.  Accessed December 2020.
What to Tell Patients About Vitamin D.  Natural Medicines Research Collaboration.  Accessed December 2020.
Why Ashwagandha & Adaptogens Are Growing in Popularity. Natural Medicines Research Collaboration.  Accessed December 2020. 


By Kylie Sakaida, MS, RD, LDN
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Plant-based Swaps for Wintertime Classics

12/3/2020

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Research shows plant-based diets containing vegetables, whole grains, fruits, nuts, seeds, soy, and beans are beneficial for your heart and weight. But you don’t need to go vegan to reap the rewards. The key: eating plants most of the time, over time. 
 
Making the switch to a plant-powered diet is a lifestyle. Start on a festive note with these comfort food swaps:
 
  • SWAP HIGH FAT DAIRY WITH SOY MILK
 
Creamy, slightly sweet, and a source of protein and heart-healthy omega-3 fats, soy milk makes an excellent dairy alternative. Instead of leaning on heavy cream in rich drinks, like eggnog, try swapping in soy milk.  Use this recipe for inspiration or look for soynog at the grocery store.
 
  • SUB IN BAKED TOFU AS THE PROTEIN IN HEARTY SOUPS AND STEWS
 
You can find pre-baked tofu in most grocery stores to reduce prep time. Add baked tofu to these protein-packed, portion-controlled pot pies.
 
  • GIVE JACKFRUIT A TRY IN PLACE OF SHREDDED MEAT
 
Say what? A fiber-containing fruit with a neutral flavor and meaty texture that shreds like pulled meat? Yup. With the right amount of moisture and seasoning, jackfruit can make for an excellent plant-based swap for shredded beef, pork, or chicken. Rinse, drain, shred and season one 20-ounce can for your next taco night or check out this recipe. 
 
REFERENCES:

Medawar E, Huhn S, Villringer A, Veronica Witte A. The effects of plant-based diets on the body and the brain: a systematic review. Translational Psychiatry. 2019; 12;9(1): 226. 
Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutrition. 2014; 17(12): 769-82. 
Turner-McGrievy G, Harris M. Key elements of plant-based diets associated with reduced risk of metabolic syndrome. Current Diabetes Reports. 2014;14(9):524. 
Yokoyama Y, Levin SM, Barnard ND. Association between plant-based diets and plasma lipids: a systematic review and meta-analysis. Nutrition Reviews. 2017; 75(9): 683-698. 

By Ayten Salahi, MS, MGH Dietetic Intern
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Healthier Holiday Treats

11/12/2020

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Research has shown that, on average, adults gain 1 to 2 pounds between Thanksgiving and the start of the new year. No need to panic. Here are some tips on how to treat yourself while staying on track: 

  • Try fresh fruit (orange slices, strawberries, or bananas) dipped in melted dark chocolate and topped with chopped pistachios or peanuts. Fiber from the fruit, plus the fat and protein from nuts, will help prevent overeating and keep you full.
 
  • Make mini versions of cupcakes or slice brownies into small bite-sized squares for built-in portion control.
 
  • Choose pies made from pumpkin, sweet potatoes, squash, berries, or apples, which have fiber and disease-fighting nutrients. When possible, opt for open-faced versions. Since they are made with less crust, they are lower in saturated fat (the type linked to heart disease).
 
  • Substitute half of the cream cheese in cheesecake with 1% cottage cheese for less saturated fat and more protein - whip or blend the cottage cheese until smooth before adding it in.

REFERENCE
Díaz-Zavala RG, Castro-Cantú MF, Valencia ME, Álvarez-Hernández G, Haby MM, Esparza-Romero J. Effect of the Holiday Season on Weight Gain: A Narrative Review. J Obes. 2017;2017:2085136. 


By Rosanne Walsh, MGH Dietetic Intern
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Tapping Into Tofu

9/25/2020

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With several new meat alternatives coming to market in recent years, tofu has taken a backseat.  However, tofu remains a good source of protein and, unlike more processed meatless products, it typically contains few additives and is low in sodium.

Tofu also contains more isoflavones, plant compounds with potentially protective properties.  Research shows eating tofu may lower the risk of heart disease and could help protect against breast cancer. 
 
The amount shown to be beneficial ranges from eating it at least once a week to consuming a serving (1/5 of a block of tofu) at least 3 to 4 times per week.
 
Not sure how to incorporate tofu into your diet?
  • Try marinating and baking it – then add it to sandwiches and salads (try this recipe)
  • Use firm or extra-firm tofu as your protein for a stir-fry
  • Blend silken tofu into soups or smoothies

REFERENCES:
Bhagwhat S, Haytowitz DB, and JM Holden. USDA database for the isoflavone content of selected foods: release 2.0. USDA Nutrient Database Laboratory Beltsville Human Nutrition Research Center. 2008; 1-69.
Ma L. et al. Isoflavone intake and the risk of coronary heart disease in US men and women: results from 3 prospective cohort studies. Circulation. 2020; 141(14):1127-1137.

Messina V. Tofu’s many faces. Today’s Dietitian. 2015;17(4):22-26.
Nechuta SJ. et al. Soy food intake after diagnosis of breast cancer and survival: an in-depth analysis of combined evidence from cohort studies of US and Chinese women. The American Journal of Clinical Nutrition. 2012; 96(4):123-132.
Wu AH, Lee E, and C Vigen. Soy isoflavones and breast cancer. American Society of Clinical Oncology Education Book. 2013; 13: 102-106.

By Meredith Berman, MGH Dietetic Intern

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In Matters of Health Does Dairy Really Need to Be Avoided?

8/28/2020

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It can be hard these days to sort diet facts from fiction.  One food group that tends to be portrayed negatively in the media is dairy.  Does it actually promote significant health risks?

Here's What the Research Shows:


  • Weight Control
Those who regularly consume dairy, particularly whole fat sources, may have a reduced risk of becoming overweight or obese. Consuming dairy has also been associated with lower waist circumference.

  • Disease Risk
Consuming at least two servings of dairy daily may reduce risk of hypertension and diabetes. Eating dairy has been associated with lower blood pressure, triglycerides, and blood sugar.

  • Nutrient Content
Dairy is a good source of both protein and calcium.  Although whole dairy products contains saturated fat, more research is needed to better understand what role this type of fat might play when it comes to our health.  It has been suggested that other nutrients in dairy may help moderate cardiac risk factors.

So if you like yogurt, cheese, and milk there is little evidence to support avoiding them to reduce major disease risks.


REFERENCES
Astrup, A. Yogurt and Dairy Product Consumption to Prevent Cardiometabolic Diseases: Epidemiologic and Experimental Studies. The American Journal of Clinical Nutrition. 2014; 99(5): 1235S-1242S.
Bhavadharini, B. et al. Association of Dairy Consumption with Metabolic Syndrome, Hypertension and Diabetes in 147, 812 Individuals from 21 Countries. British Medical Journal Open Diabetes and Research Care. 2020; 8:e00826.
Rautianinen, S. et al. Dairy Consumption in Association with Weight Change and Risk of Becoming Overweight or Obese in Middle-aged and Older Women: A Prospective Cohort Study. The American Journal of Clinical Nutrition. 2016; 103(4): 979-988.


By Lauren Sorel, MGH Dietetic Intern

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How to Add Mindfulness to Your 'Work From Home' Routine

7/24/2020

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Mindfulness is a commonly used term these days - it means having enhanced awareness of the present moment.  It is associated with improved stress management and quality of life. 

Mindful eating is mindfulness targeted at behaviors that promote eating with attention and awareness.  Mindful eating is linked to a health body mass index (BMI) and can reduce distracted eating habits that lead to unnecessary food consumption.

As many people continue to work from home, incorporating mindfulness can help reduce anxiety around eating and support productivity.

Here are some tips to incorporate mindfulness into your work routine:
  • Set a schedule with time set aside for taking lunch and breaks
  • Eat meals away from your "desk" and free from your phone or computer
  • Slow down and savor each bite to help your brain recognize when you are full
  • Place a glass of water next to you while you work to help stay hydrated
  • Go for a 10 to 15 minute walk (or try a meditation) if you get restless

REFERENCES:
Durukan A and A Gul. Mindful Eating: Differences of Generations and Relationship of Mindful Eating with BMI. International Journal of Gastronomy and Food Science. 2019; 18: 100172.
Framson, C et al. Development and Validation of the Mindful Eating Questionnaire. Journal of the American Dietetic Association. 2010; 109(8): 1439-1444.
Fung TT, Long MW, Hung P, Cheung LW. An Expanded Model for Mindful Eating for Health Promotion and Sustainability: Issues and Challenges for Dietetics Practice. Journal of the Academy of Nutrition and Dietetics. 2016; 116(7): 1081-1086.
Mantzios, M and JC Wilson. Mindfulness, Eating Behaviours, and Obesity: A Review and Reflection on Current Findings. Current Obesity Reports. 2015; 4(1): 141-146.
Winkens, LH, et el. The Mindful Eating Behavior Scale: Development and Psychometric Properties in a Sample of Dutch Adults Aged 55 Years and Older. Journal of the Academy of Nutrition and Dietetics. 2018; 118(7):1277-1290.


By Cameron Allen McDonald, MGH Dietetic Intern

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Hydrate Right This Summer

6/26/2020

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Studies suggest that even mild dehydration - a water loss of 1 to 2% - may affect how well our brains function.*  Dehydration can also cause cramping, especially for those participating in sports like tennis, soccer, and cycling.

For most of us, the best way to hydrate is with water.  Eating regular meals also helps support hydration through the consumption of electrolytes like sodium, chloride, and potassium in our food.

That said, hydrating with drinks that contain electrolytes may be helpful for some people.  For instance exercisers who experience heavy sweating, especially those participating in high intensity activities in hot weather, may benefit from a drink that include electrolytes.

Some people may be concerned about sports drinks that contain artificial coloring and added sugar.  Luckily, you can also make a hydrating electrolyte drink from home - check out the recipe below.

Homemade Electrolyte Drink
provides 80 mg sodium and 60 mg potassium per cup
  • 2 cups coconut water
  • 2 cups filtered water
  • Juice from 1/2 a lemon
  • 1/8 teaspoon salt

*A loss of 2% body weight is 3 pounds for a 150-pound person.

Please note:
If you are exercising for longer than an hour at a high intensity, you may benefit from commercial sports drinks - they contain a specialized ratio of electrolytes, plus added carbohydrates to help with proper fueling.  Also, if you have a medical condition, like kidney disease or high blood pressure, talk to your doctor or dietitian before making any significant changes to your beverage intake.

REFERENCES:

Huang WC, Tung YT, Wu MS, et al. Low-Osmolality Carbohydrate–Electrolyte Solution Ingestion Avoid Fluid Loss and Oxidative Stress after Exhaustive Endurance Exercise. Antioxidants (Basel). 2020; 9(4):336.
Riebl SK and BM Dav. The Hydration Equation: Update on Water Balance and Cognitive Performance. The American College of Sports Medicine Health & Fitness Journal. 2013; 17(6): 21–28.

Sawka MN, Burke LM, and Eichner R, et al. American College of Sports Medicine Position Stand. Exercise and Fluid Replacement. Medicine & Science in Sports & Exercise. 2007; 39(2):377-390

By Courtney Cayer, MGH Dietetic Intern

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Resources to Feed You and Your Family

5/22/2020

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Are you or someone you know struggling with having enough food to eat?  In Eastern Massachusetts, 1 out of 11 of our community members is at risk for hunger. Hunger affects people from many different backgrounds, especially during a pandemic.

Need extra support? Here are some resources that can help:

The Greater Boston Food Bank
  • Search here for services offering food in your community.
  • They also support mobile markets providing fresh foods to community members in need - here are some locations.

Supplemental Nutrition Assistance Program (SNAP)
  • This service is available to both employed and unemployed people based on income limits.  Once enrolled, an electronic card can be used like a bank card at most supermarkets, convenience stores, and farmers' markets.
  • Here's how to apply in Massachusetts.

COVID-19 Food Resources in Boston
  • Check out a map and list of resources here (including school meal programs, food pantries, and soup kitchens).

Need more help?

Call Project Bread's FoodSource hotline at 1-800-645-8333.  They can help  determine if you are eligible for SNAP and assist in finding other resources in your area.  They have material available in 160 languages too.


REFERENCE
Ending Hunger.  The Greater Boston Food Bank. Accessed May 2020.

By Alysia Vega, MGH Dietetic Intern


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Spring Has Sprung: Grow Fresh Herbs Indoors

5/15/2020

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Commonly used herbs, like sage, rosemary, and thyme, contain protective plant chemicals that may help fight chronic diseases, like heart disease and cancer. These compounds have been shown to attack inflammation and may inhibit the growth of cancer cells.

Aim to optimize the potential benefits of herbs by eating them regularly. One way to do this is to grow them at home.

Tips for starting an indoor garden:


  • Select a supportive pot: look for one that is 6 to 10 inches in diameter with holes in the bottom, which will allow water to drain out.
  • Use indoor potting soil (not garden soil).
  • Place them in a sunny spot (ideally one that gets at least 6 hours of sunlight daily).
  • Keep the temperature stable: 65 to 70 degrees is optimal.
  • Use those herbs frequently - regular harvesting helps promote growth.

Looking for starter plants?  Check out your local home improvement or garden store online.

REFERENCES
Chohan, M, Naughton DP, Jones L, Opara El. An Investigation of the Relationship Between the Anti-inflammatory Activity, Polyphenolic Content, and Antioxidant Activities of Aooked and In Vitro Digested Culinary Herbs. Oxidative Medicine and  Cellular Longevity. 2012;2012:627843.
Jiang, T. Health Benefits of Culinary Herbs and Spices. Journal of AOAC International. 2019; 102(2): 395-411.
MacCaskey M and B Marken. Gardening for Dummies. New York, NY: Wiley Publishing.2006.
Opara M and M Chohan.Culinary Herbs and Spices: their Bioactive Properties, the Contribution of Polyphenols and the Challenges in Deducing their True Health Benefits. International Journal of Molecular Sciences. 2014; 15(10): 19183-19202.
Tapsell, L et al. Health Benefits of Herbs and Spices: the Past, the Present, the Future. Medical Journal of Australia. 2006; 185(4): S1-S24.

By Kristin Otto, Dietetic Intern

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Simple Tips to Make Fresh Food Last Longer

4/24/2020

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Though there are no major shortages of food in this country, canned and frozen foods may be difficult to find due to consumer stockpiling.  Fear not - fresh foods can also be frozen at home. Refer to our chart below to learn how to freeze them.

Plus Here's 4 Tips to Make Your Produce Last Longer:

  • Separate and layer heads of lettuce with paper towels - the towels will absorb excess moisture and help prevent premature spoilage
 
  • Give your berries a quick vinegar bath - mix 1 cup distilled white vinegar with 3 cups water in a bowl and soak the berries for a few minutes (this will kill mold spores, which can make fruit spoil quicker), then rinse and dry thoroughly
 
  • Wrap whole cucumbers, zucchini, and summer squash in plastic wrap - this minimizes moisture loss and helps keep them crisp
 
  • Try frozen grapes - if refrigerated grapes don't last as long as you'd like, throw them in the freezer for a sweet, refreshing snack that will keep for months
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REFERENCES

Coronavirus Disease 2019 (COVID-19) Frequently Asked Questions. FDA. Accessed March 2020.
Demichele, K. How to Store Fruits and Vegetables. Cook's Illustrated. 2019. Accessed March 2020.
Refrigerator and Freezer Storage Chart.  FDA. 2018. Accessed March 2020.
The Big Thaw - Safe Defrosting Methods for Consumers. USDA Food Safety and Inspection Service. 2013. Accessed March 2020.


By Kylie Sakaida, MS, RD, LDN
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