Farmers’ Market Shopping

This is the time of year to visit a Farmers’ Market.  Here is a rough schedule of some of what is ripe and available at different times in the summer.

Freestone Peaches in July

Freestone Peaches in July

May: Oranges, Summer squash, Broccoli, Broccollini, Kale, Swiss Chard, Onions, Garlic; In late May, Cherries, Apricots, Rhubarb and Strawberries

June: Cucumbers, Swiss Chard, Fennel; Cherries, Apricots, Cucumbers, Summer squash, Peppers, early Peaches (cling,) early Nectarines, Strawberries, Raspberries, early Pluots, Santa Rosa Plums

July: Peaches (freestone), Nectarines, Tomatoes, Pluots, Strawberries, Blackberries, Raspberries, Plums

August: Peaches (freestone and cling), Tomatoes, Pluots, Blueberries, Corn, Zucchini and other Summer Squash, Figs, Melons, Anise bulbs, Carrots, Cucumbers, Cauliflower, Broccoli

September: Apples, Figs, Peaches, Tomatoes, Corn, Cauliflower, Asian Broccoli

October: Apples, Pomegranates, Blueberries, Tomatoes, Pears

I usually wait until May to start going to my local Farmers’ Market–because I know in Northern California–cherries ripen in late May.  Early varieties of apricots often start showing up at markets at the same time.

One reason to shop at Farmers’ Markets is for the unique produce that you will not find in the average grocery store.  Large grocery chains often place their purchase orders long before the produce is ripe–so the quality may not be ideal when it is finally delivered. At a Farmers’ Market, you get to see what is ripe this week–and decide then and there if you want to buy it and eat it–depending on its quality.

For instance, with cherries, you may have a choice between Garnet or Bing cherries–or the lesser cherries that are planted for pollinating the Garnet and Bings–which are the Larian and other cherries. The Larian are softer and have less of the classic cherry flavor.  I actually like Garnet cherries better than Bings.

Garnet Cherries from The Peach Farm, Winters, CA

Garnet Cherries from The Peach Farm, Winters, CA

When I can find them, I also like Van cherries, sometimes used as a pollinator, too.  Brooks cherry is a later variety. Lapins and Sweetheart are other varieties. All cherries are not Bings and all cherries are not the same. Sellers feel, however, that they can sell their cherries for more money if they call them “Bing.”

Also, some growers sort their cherries very carefully, leaving out all the “duds” and the ones that have split or been pecked at by birds. That does make a difference when you are paying $4.00/pound.  I buy from a grower that sorts them very well and they do not have a lot of field dust or blemishes on them. I have never found cherries in a grocery store that compare to the quality I find at a Farmers’ Market. If you love cherries, it’s worth the trip to your local Farmers’ Market.

With apricots, you will have your choice of which variety you want to buy. And, different varieties ripen at different times of the summer. My favorite apricot is the Royal or Blenheim, sometimes called the Royal-Blenheim apricot.

Royal-Blenheim Apricots

Royal-Blenheim Apricots

It is often a small apricot and it has freckles on the skin. It “ripens from the inside” which means the outside can look quite green up until the moment it is fully ripe. People are put off by that–which is a shame–because it such a delicious fruit and has that classic apricot taste you may remember if you have ever had an apricot tree.

The other common varieties of apricot are Patterson, Goldbar, Tilton, Poppy, Katy and Castlebrite.  They vary in texture and size and also in their acid content.  Usually, the more acidic the fruit is, the firmer the fruit is.

Apples will ripen over a 2-3 month period and then make it to the markets. Fuji and Gala apples are usually the first ones to show up. Then you will see Red Delicious, Pink Lady, Golden Delicious, Jonagold and Rome Beauty apples in the markets.

Gala apples

Gala apples from the Farmers’ Market

Photos and Text © 2013 Ann M. Del Tredici

Posted in Apples, Apricots, Cherries, Peaches, Pears, Pomegranates, Tomatoes, Uncategorized, Vegetables | Leave a comment

Let’s Get Real About Gluten, People!

I need to blow off some steam here. I am a Registered Dietitian who specializes in gastrointestinal problems and I see patients referred from my region’s physicians and gastroenterologists.  I counsel people about the food they eat and I am getting really frustrated and concerned about all of the people out there who are restricting their diets to avoid gluten–when they have no real justification for doing it.  Let me explain.

I routinely see patients who have been diagnosed with celiac disease by small intestinal biopsies and/or by sophisticated blood tests, like serum Tissue Transglutaminase antibody IgA and HLA-DQ2 and HLA-DQ8 Celiac Disease genetic testing. I eagerly counsel them on how to find foods that are gluten-free and I help teach them how to make foods without gluten. I help them order foods in restaurants and how to make food choices away from home–things that will keep them safe and free of gluten.  I also see people who have some kind of sensitivity to gluten that does not test positive in the current blood tests for celiac disease. I try to help them find ways to protect their guts and to eat in a way that will not harm them.

It is generally accepted that celiac disease  and other gluten-related problems are greatly under-diagnosed in the world’s population. But that does not mean everyone has celiac disease or gluten-sensitivity.

There are people who just decide it would be a good idea to stop eating gluten–often without any gastrointestinal symptoms at all. They’ve read “horrible” things about gluten and it seems to them that “no one should eat gluten.” They might be a little constipated or have some intestinal gas or soft stool and they have decided they must have an allergy to gluten or they are gluten-intolerant.  These symptoms, by themselves, do not mean a person has a sensitivity to gluten. Or, they may have serious symptoms like frequent diarrhea and abdominal pain. But, they may not be considering other reasons for why they have those symptoms and they may not have had the celiac blood test. Spending 6 months on a gluten-free diet may be a loss of time–that would be better spent trying to diagnose other gastrointestinal problems. Just because we are bombarded by media messages about “gluten-free” does not mean everyone should be eating a gluten-free diet. It could also be Irritable Bowel Syndrome, Irritable Bowel Disease, Crohn’s Disease or even diverticulosis–or other less common problems in the small intestines or large intestines. Celiac disease and gluten-related problems usually occur in the small intestines.

Many people have even tested “negative” for celiac disease but still think it must be the reason for their problems. They may have a real sensitivity to gluten–or they may not. Some “gluten avoidance” lists of symptoms about what gluten can do are very long “laundry lists” of symptoms–and would probably include almost everyone. If you see a list with symptoms in every part of the body, including a lot of mental symptoms, your suspicions about its validity should go up. Avoiding gluten will not cure every uncomfortable symptom you have in your body.

These days, some people are going overboard about avoiding gluten. In this age of the internet and the quick dissemination of personal stories and health advice from non-experts, it appears some people are avoiding gluten unnecessarily. This in no way is meant to diminish the importance of avoiding gluten in people with celiac disease and gluten-intolerance–they need to avoid gluten.  But for everyone else, I just wish people would look a little more deeply into the science and medical knowledge of gastrointestinal functioning–and try to resolve their gut problems in a much more systematic and rational way.

This quick jump to assume that gluten is causing gut problems is well on its way to becoming a “crazy” diet fad. It is often the first thing a person thinks is wrong when they don’t think their intestines are functioning correctly. In reality, a lot of other problems should be ruled out first.  Maybe it is because people can now go “gluten-free” so easily that they decide to do it on their own. That in and of itself is okay to do–but not if you cling to it when you should be considering other diagnoses.

People also don’t realize, that if you really do have a sensitivity to gluten, you need to avoid it completely. Studies have shown that as little as 1/4 teaspoon of wheat flour can cause damage in the small intestines of a celiac patient or a person with a gluten intolerance.  Many patients I have who insist that they are eating “gluten-free” are actually eating quite a bit of gluten in the form of conventional foods like pizza, crackers and other wheat-containing foods. Yet, they are very restrictive at other times. If they say they are eating gluten-free, but they are still eating some gluten–they cannot honestly determine what their symptoms are and if their diet choices are making any difference.

One of the biggest misunderstandings about how food affects the gut is not understanding the timing of the body’s reaction to a food. Most people assume that if they just ate a food and then a short time later they didn’t feel good, or they had some gas, or they had diarrhea, they jump to the conclusion that the food they just ate must have been responsible.  This is usually not the case–because it takes many hours for something to go from your stomach to the bottom of your intestines–where gas is formed and where diarrhea happens. The gut is one area of the body where people think they know what is going on–but they usually don’t really know. See a doctor, a nurse practitioner, a health professional or read a book or read what a real expert on the internet has to say.  Don’t go by what a sales clerk in a store says, what you read from a random person on the internet or what a friend told you.

Make sure that if you do eliminate gluten that you don’t change a lot of other things, too.  If you go gluten-free, that’s not the best time to also become vegetarian, too–because a lot of things will be changing at the same time. If you go gluten-free, you need to make sure you get enough gluten-free sources of carbohydrate to make up for the gluten-rich foods you used to eat.  Not doing this can dramatically affect how you feel–for the worse.

Restrict gluten if you really need to–and people like me are out there to help you do it. But, if you don’t really have any evidence that you need to avoid gluten, do some research first and monitor your gastrointestinal symptoms carefully so you will really know if going gluten-free is helping.

Keep a food and symptom diary–and review it carefully. If after a certain period of time (weeks) you don’t see results, then go back to eating gluten and see how you feel (also several weeks)–making good observations and taking good notes. This is known as a “before and after” test. If you have eliminated gluten, “before,” note your symptoms, then add gluten back, “after,” and note your symptoms. If there is no difference between the two time periods, you may not be sensitive to gluten.

One in 100-130 people, worldwide, has celiac disease and an additional small number of people have a gluten sensitivity that does not test positive for celiac disease. Celiac disease is a genetic condition–so if someone in your family has it, you have an increased risk of having it yourself.

Before you jump to the conclusion that you should try a gluten-free diet, please read up on gastrointestinal problems a little more. Try to figure out what else could be causing your problems.  See a gastroenterologist and a Registered Dietitian who specializes in gastrointestinal problems. Do your homework on the subject. If you really need to avoid gluten, you will know with certainty that you are doing the right thing.

Posted in Celiac Blood Test, Celiac Disease, Constipation, Crohn's Disease, Diarrhea, Diverticulosis, Gluten, Gluten sensitivity, Gluten-free, HLA-DQ2 Testing, HLA-DQ8 Testing, Intestinal Biopsy, Intestinal Gas, Irritable Bowel Disease, Irritable Bowel Syndrome, Large Intestines, Small Intestines | 4 Comments

Probiotics: They are NOT Created Equal

(probiotics.org)

Probiotics! (Artist’s rendition, from probiotics.org)

Our large intestine (colon), in a healthy state,  has zillions of microorganisms living and thriving in it. Some estimates say that stool is made up of 90% dead microorganisms and sloughed intestinal cells and only 10% undigested fiber and food remnants.

These microorganisms are all competing with each other for survival and frequently they get out of balance and cause diarrhea, constipation or the unhealthy predominance of one or more organisms, such as when a person has a C. difficile infection or a colonic yeast overgrowth. Taking antibiotics will also upset the balance of which microorganisms live in the colon.

People do different things to try and get back to a state of intestinal balance, such as eating yogurt every day or eating a certain kind of fiber in specific amounts. Some people take probiotics which are the purified and isolated specific strains of bacteria that people, practitioners and research have shown help to reintroduce the favorable bacteria to the colon.  All probiotics are not the same and they are not equal in benefit. The organisms in different probiotics vary greatly and the total number of organisms in products also vary tremendously.

Homemade yogurt full of natural probiotics (daneyalmahmood.com)

Homemade yogurt full of natural probiotics (Photo by daneyalmahmood.com)

Research has shown that certain specific probiotic strains help specific problems, such as L. reuteri for diarrhea and for chronic bladder bacterial infections.  Women commonly find that after taking systemic antibiotics they often get a vaginal yeast infection, which is helped or corrected by eating yogurt or taking the probiotics that contain the bacterial strains commonly in yogurt, such as L. acidophilus, L. bulgaris, L. casei and S. thermophilus.  Bifidus Regularis® may help with chronic constipation. Research has shown that Irritable bowel syndrome (IBS) may be helped by taking probiotics.

In reality, the situation is infinitely more complicated than this and there are factors going on that many people, including physicians, registered dietitians and other health practitioners, do not understand.  For example, it was only recently discovered that one of the roles of the intestinal appendix is to be a reservoir of bacteria and yeast that normally populate a person’s gut.  When an individual has food poisoning or something else that causes diarrhea or a die-out of his gut microflora, the appendix may be responsible for re-inoculating the colon with the microorganisms it grew in a healthy state.

Interesting discussion of the appendix’s function: http://news.sciencemag.org/sciencenow/2013/02/appendix-evolved-more-than-30-ti.html?ref=hp

Appendix below the colon (Image from

Artist’s rendition of the appendix below the ascending colon (Image from Ingram Publishing/Thinkstock)

When physicians and labs try to do stool tests to find either pathogenic microorganisms or favorable organisms, it is impossible to measure all the species that are present. And, to make the situation worse, most microorganisms that grow in the colon do not tolerate any light or oxygen. So when a stool sample is collected by a patient and processed by a lab, it is always exposed to some light and oxygen—automatically killing many important organisms. This makes it impossible to say with confidence that someone has or does not have certain microorganisms growing in his gut. DNA analysis is the newest, most sophisticated way to determine which microorganisms are present–but that will take a while before that knowledge makes it into everyday practice.

And, the current trend is to make probiotic products with patented organisms—so that a company can sell it and do studies with it—without any competition. Product examples include Culturelle®  and Align® probiotics and Activia yogurt with Bifidus Regularis®. And, to make matters worse, some of the organisms in probiotic preparations are not self-propagating, which means the “effect” of taking them goes away shortly after stopping them. Instead, ideally, a good probiotic is one that will grow well, make the gut healthier and self-propagate itself so that you can eventually stop taking it and still benefit.

Most probiotics we take, or eat in yogurt, are destroyed by our stomach acid. Only a fraction of 1% makes it to the colon to grow. Therefore, you do need to take them frequently and in large amounts—in the billions. An enteric coating probably helps.

My recommendations for a good probiotic are as follows:

Take one with the largest number of different organisms (sometimes up to 10 can be found) and the largest number of total organisms (or CFUs, colony forming units, usually in the billions.) Examples are: (I am not in any way promoting these brands–they are just very good examples of what products are out there. I am not endorsing these products and these companies are not compensating me for mentioning them here.)

  • Jarrow’s “Jarro-Dophilus” EPS®, 8 different organisms, 5 billion CFU
  • Ultra Jarro-Dophilus®, 10 different organisms, 40 Billion CFU
  • Renew Life Ultimate Super Critical Probiotic, 10 different organisms, FOS, 200 Billion CFU
  • VSL#3, 8 different organisms, 450 billion bacteria
  • VSL#3-DS, (DS = double strength) 8 different organisms, 900 billion bacteria (VSL#3-DS by prescription only)

When you rely on yogurt for your probiotic organisms, look at the label for the phrase “Active Cultures,” a listing of which microorganisms are in the yogurt and a statement of how many organisms were present at the time of shipping.  Again, you will want as many different organisms as you can get and as large a total number of organisms as possible, too.

If you want to eat yogurt–but you are also lactose intolerant–there are finally lactose-free yogurt products available. Be sure to read the lable for the words “lactose free.” Current products available:

“Pre”biotics are the plant materials that intestinal bacteria like to grow on. They are usually sources of soluble fiber. Sometimes prebiotics are added to probiotic preparations, the thinking being that as soon as the probiotic is activated, it will have fuel present with it. That is probably largely symbolic because the probiotic organisms will be dispersed widely and the prebiotic is probably not there in large enough amounts to do a lot.  Examples of prebiotics are FructoOligoSaccharides (FOS) and Inulin. A diet high in soluble fiber will also help support the growth of beneficial microorganisms–just one more reason for people to eat a high fiber diet.

For more information, for an in-depth, more technical discussion of this subject, please read this summary of the topic from the medical journal: Clinical Gastroenterology and Hepatology.

“A Gastroenterologist’s Guide to Probiotics:” http://www.cghjournal.org/article/S1542-3565%2812%2900369-2/fulltext

© 2012 Ann M. Del Tredici, MS, RD, CDE

Posted in Antibiotics, Appendix, Bladder Infections, Constipation, Diarrhea, Fiber, Gut Microorganisms, Irritable Bowel Syndrome, Prebiotic, Probiotics, Uncategorized, Yeast Infection | Tagged , , , , , , , , , , , | Leave a comment

Diarrhea: How to Get Help From Diet

Diarrhea is not a subject most people like to talk about–but I talk to people about it all the time in my practice. When people have diarrhea, it is sometimes hard for them to find useful help. Since dietary choices greatly affect diarrhea, it is important to know what food choices to focus on. Also, most people blame the food they ate right before the diarrhea started, which is not usually the culprit. Let me try and help minimize and control it with you here.

If you have diarrhea, you first need to try to figure out what is causing it and then determine what to do to control it.  If it has gone on for more than a couple of days, you should see your doctor and determine if there may be a medical reason for it. If you have done that and now want to try to control it, here are the dietary modifications to try and help.

Diarrhea can be caused by many different things, including food poisoning, bacterial and viral infections, lactose intolerance, celiac disease (gluten intolerance), excessive sugar-alcohol consumption (like sorbitol and maltitol), intestinal parasites, irritable bowel syndrome, colitis, ulcerative colitis, Crohn’s disease, diverticulitis, too much thyroid medication,  too much caffeine, chemotherapy, radiation treatment in the abdomen,  a C. difficile infection, surgery to the intestines and other conditions including gastric bypass surgery, and other dietary factors—so make sure you have tried to identify the problem first.

  1. Are you lactose intolerant? A person can be newly lactose intolerant at any age. Sometimes after trauma to the gut or a long course of antibiotics, a person can become lactose intolerant.  If you are, or think you are, there are lactose free milks, lactose free yogurts, lactose free ice cream, lactose free cottage cheese and lactase enzyme supplements to take when you eat lactose-containing foods.
    Lactose intolerance can be a temporary problem or it can be a permanent problem. People can be slightly lactose intolerant, moderately intolerant or severely lactose intolerant. Sometimes we just need to wait it out and see how long it lasts over time.
    There is a test to determine if you are lactose intolerant, however, if you are, the test will give you bad gas and diarrhea for several hours. Because of that, many people can make the diagnosis themselves, with the proper information for testing it.
  1. Are you eating too much fiber? Yes, too much? When people have diarrhea, they need to decrease their fiber intake to decrease stimulation to the colon. Try to eat less than 10-15 grams of fiber/day. Avoid the most laxative fibers like wheat bran, bran cereals and raw vegetables. Eat white rice, white bread, peeled fruits, peeled and cooked vegetables until you see an improvement in the diarrhea.
    It may sound strange for me to tell you to eat less fiber–when you hear everyone saying people should eat more fiber. But, in the case of diarrhea, it is always best to lower your fiber intake.
    Dietary fiber is actually the sum of two fibers: soluble and insoluble fiber.  It is the insoluble fiber that can make diarrhea worse, like what is found in the skin of fruits and vegetables and the fiber in wheat bran.
    Soluble  fiber actually slows the intestines. Soluble fiber can slow stomach emptying and slow movement in the gut–most notably the soluble fiber “pectin.” Historically, pectin is part of “Kaopectate” which is an old remedy for diarrhea. Peeled apples, applesauce and a peeled potatoes have pectin in them and they do help control diarrhea. Unfortunately, food labels do not tell you how much soluble fiber is in a food–but most registered dietitians can help you get that information.
  1. Consider taking a calcium supplement—not for the calcium for your bones—but for the calcium that does not get absorbed. Calcium supplements are very constipating—so you can safely use that to your advantage.  You may need to take 1000-1500 mg calcium/day to get help. Take calcium carbonate because it is the least absorbed form of calcium.
    Many people take Tums for this–they are made from calcium carbonate. Tums have 400-1000 mg of calcium per tablet, depending on the product. Note: you do not want to take a magnesium-based antacid because magnesium has a laxative effect.
  1. Do not drink fruit juice or eat too much fruit. A glass of fruit juice has the equivalent of several pieces of fruit in it and is known for its laxative effect. The skin of fruit is the most laxative part of the fruit—so peel all the fruit you eat. Bananas, melons and peeled apples are the least laxative of the fruits—so eat those rather than plums, peaches, nectarines, and apricots—which are more laxative fruits. Cooking the peeled fruit also makes it easier on the gut. Eat only 1-2 servings of peeled/cooked fruit/day until the diarrhea is more controllable.
  1. Consider taking a probiotic—especially one that has been shown to help control diarrhea, such as Lactobacillus reuteri (or L. reuteri). Ideally, you should take it daily for several weeks to determine if it is helpful. You may want to take it every day if you have a chronic diarrhea problem. Eating yogurt is another way to get probiotics, but if you are also lactose intolerant, be sure to eat a “lactose free” yogurt product like:

    Taking a probiotic will help to reestablish a more favorable type of microflora/microorganism to grow in your large intestines–one that is less likely to trigger diarrhea.

  2. When diet changes do not help control your diarrhea, try medication. You should not “put up” with diarrhea or “let it run its course.” There are over-the-counter and prescription drugs for controlling diarrhea, including Imodium (loperamide) and Lomotil (diphenoxylate hydrochloride and atropine sulfate)–and many others. If one drug does not work for you, don’t give up, please try another one. They all work by different methods and may affect you differently.

If you have any questions or comments about this subject, please feel free to contact me.

© 2012 Ann M. Del Tredici, MS, RD, CDE

Posted in Calcium Supplements, Diarrhea, Fiber, Lactose Intolerance, Lactose-free Foods, Probiotics, Uncategorized | Leave a comment

Nausea: How to Minimize and Treat It

Nausea: Sometimes Hard to Treat

Nausea can be due to a lot of different metabolic problems, often having something to do with the gastrointestinal tract, but not always. Chronic nausea is most likely to occur between the ages of 15 and 30. Pregnancy is a common reason for nausea—known as part of morning sickness. Sometimes people vomit with their nausea, sometimes not.

Common reasons for nausea: Low blood sugar, diabetes (diabetic ketoacidosis), pancreatitis, hepatitis and other liver diseases, gall stones and gall bladder disease, ulcer, overeating, bulimia, motion sickness, vertigo, appendicitis, small bowel obstruction, dehydration, a concussion or brain tumor, angina or heart disease or a heart attack, Addison’s disease and carbon monoxide poisoning can all have nausea as a symptom.

Certain medications can also cause nausea—and of course, most chemotherapy drugs cause nausea.

Treatment for nausea:

  • Rehydration with an electrolyte solution, such as Pedialyte, diluted juice, 50/50 dilution of Gatorade with water or Gatorade G2 (low sugar) or plain water. You don’t want something with too high a concentration of sugar or electrolytes. Sometimes carbonated beverages help, sometimes not.

  • Small, frequent feeding of bland, low fat foods, such as saltines and chicken broth, dry toast. Avoid strongly-flavored or spicy foods.
  • Eating frequently keeps the blood sugar from coming down too low (which is a trigger for nausea) and keeps the stomach from being over-stretched, which can involve the vagus nerve, resulting in nausea, vomitting and diarrhea.
  • Do not over-fill the stomach with any meals or liquids
  • Avoid foods known to trigger nausea. If you really want to eat the food, try eating in the later half of the day, when people generally have less nausea. Foods with strong flavors or smells may bother you; fried foods and high fat foods may cause nausea, especially with gall bladder disease.
  • Meclizine, sold as generic or Bonine®, over-the-counter, non-drowsy medication, 25-100 mg per day, taken as needed.

    Over-the-counter meclizine: Bonine®

  • Medical Marijuana has been shown to decrease nausea, especially in patients on chemotherapy.

© 2012 Ann M. Del Tredici, MS, RD, CDE

Posted in Nausea, Uncategorized | Leave a comment

Protein Quality of Foods

Some sources of high quality protein  (photo: orchinorthodontics.com)

Dairy~milk, eggs and cheese (photo by orchinorthodontics.com )

The quality of a protein refers to its amino acid content. Specifically, how well will a protein source meet my needs for essential amino acids, the ones that my body cannot make itself.

When we eat the muscle, tissue, eggs or milk from another animal, it will have all of the amino acids we humans need—because we all have the same kind of tissues and protein needs.  When we eat a plant protein, however, that is not the case. The plant does not need to make muscle cells or milk for the lactation of infants–so its amino acid composition will be different.  A plant needs to make proteins for structure, enzyme functions and seed and nut production—so there will be some significant differences in amino acid content.

Milk and eggs are very high quality proteins because developing animals are capable of solely surviving and developing on the milk from their mothers. Eggs solely feed the development of the embryos of the poultry laying the eggs.

Chicken eggs, blue, brown and ecru (Photo © 2012 Ann M. Del Tredici, MS, RD, CDE)

A variety of beans and lentils (photo by foods-healing-power.com)

Ranking of the Protein Quality of Foods

From highest to lowest protein quality:

  1. Milk from any mammal, cheese, yogurt and other products made from that milk, including whey and whey powder; also lactose-free dairy products and lactose free yogurts. It includes the milk from cows, goats, yaks–and from any other mammal you can get milk from. (This category does not include soy milk, rice milk or almond milk–all of which are low quality protein sources.)
  1. Eggs from any land animal, usually from chicken and poultry, but also from fish and shellfish; any food made from eggs, like omelettes, custards, quiche, for example, and fish and shellfish eggs, such as caviar (sturgeon),  salmon roe, trout roe, lobster roe, scallop roe.
  1. Protein from animals of the sea: fish,  shellfish and mollusks, including salmon, cod, catfish, shrimp, lobster, scallops, mussels and clams, for example.
  1. Protein from land animals: cows, chickens, pigs, lamb and other poultry–the list is long, but it is beef in any form, chicken, pork, lamb, duck, Cornish hen, and turkey, as examples.
  1. Soybeans and products made from them, including tofu, miso, tempeh and soy milk and soy protein powder
  1. Beans other than soybeans and foods made from them, lentils and peas, hummus, kidney beans, fava beans, pinto beans, red beans, black-eyed peas, just to name a few.
  1. Nuts and seeds, including peanuts, almonds, walnuts, pecans, hazelnuts, peanut butter, almond butter, sesame seeds and tahini, sunflower seeds, pumpkin seeds, and many more. Almond milk is down here–quite low in protein amount and low in protein quality.
  1. Quinoa and other grains and foods made from them, including bread, tortillas, rice, noodles, and pasta to name the most common ones. Rice milk is way down here in the lower quality protein sources–it is no match for cow or goat milk.
  1. Starchy vegetables, then leafy vegetables–such as potatoes, corn, parsnips, sweet potato; leafy vegetables include artichoke, asparagus, carrots, cauliflower, collards, salad greens, sprouts, mushrooms, chard, tomatoes and turnips, to name some of them.

Whole grain cereals and breads (photo by anthonycolpo.com )

Lots of vegetables! (photo by motherearthproducts.com )

© 2012 Ann M. Del Tredici, MS, RD, CDE

Posted in Animal Protein, Dairy, Eggs, Food, Home-grown Eggs, Lactose-free Foods, Protein, Uncategorized, Vegetables | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Carbohydrates and Diabetics

This is a link to an article I wrote recently for the physician members of the Marin Medical Society. It tries to help explain how much carbohydrate should be eaten by people–both by diabetics and by non-diabetics.

These days there is a “phobic” environment about carbohydrates–people are afraid to eat them–and that is not right. We humans are designed to eat carbohydrates–in relatively large amounts. The trick is knowing how much to eat and what kind of carbohydrates to eat.

For diabetics, I discuss how to monitor if they are eating too much carbohydrate or not. Some basic explanations about carbohydrates are also included. Almost every diabetic patient needs some help determining how much carbohydrate to eat–and it is a do-able and satisfying task when they are ready to try finding out how to do it.

Link to article: “Carbohydrates for Diabetics

http://www.marinmedicalsociety.org/magazine/articles/?articleid=514

Text: © 2012 Ann M. Del Tredici, MS, RD, CDE

Photo credits:  First photo: bonfirehealth.com; Second photo: acupuncturetoday.com; Third photo (below) : dreamstime.com

A fruit stand on a street in Siena, Italy

Posted in Carbohydrates, Diabetes, Uncategorized | Leave a comment