Quick meal ideas from Connie

Connie is an entrant in the 6-week challenge and sent me this email:

I don't like the creamy dressings so this fits the bill for me.I boil some red beets and save the juice.   Mix the juice with favorite vinegar and about a quarter cup of pure fruit juice.  I used apple-grape.   I have used pomegranate.   Pour that over the beets.  I add sliced onions, a few whole cloves, a verysmall clove of garlic tooI then add a bit of water to cover.  Pickled beets from my youth.  I love the juice so much that I use it for my salads.The other quicky is I put a package of frozen organic - no salt - veggies with a container of no salt organic veggie broth.  I added what spices I had on hand and other left over frig veggies. In about fifteen min we had a great dinner.  Sure beats not eating right when you are in a hurry.  Fast hot soup on a cold evening.  

This sounds interesting to me.   I will give it a try.  

The 100% club

We often discuss on the Fuhrman forums whether it's better for us to go 90% or 100% nutritarian.  Dr. Fuhrman's life plan allows for 10% excursions once you attain health and appropriate weight.   I don't think he intends for that 10% to be the worst foods like cheese and ice cream, but even those are allowed rarely.   I really think this is an individual choice.  For some people, making foods forbidden makes them more desirable, and increases the cravings.  For others, eating just a little bit opens the floodgates.  It probably depends a lot on how you look at it.   For me, both those feelings can occur.   Overall though, for me, it seems 100% is much easier than 90%.  There is much less deciding involved, and studies have shown that having too much choice and making too many decisions is exhausting and weakens your willpower.  Now 90% might make life easier for other people I interact with and might make me more sociable and less of a standout.  But I don't think I can handle it.  It is easier for me to go 100%.  Plus, I've found people don't care as much as you think when you do funny things like not eat, or top a plate of lettuce with your own fixings, or bring your own food.  Also, if I'm 100% most of the time, on a daily basis, then if something really unusual comes up, it's no big deal if I decide to partake.  I just have to remember that these unusual events need to be limited to only a few times a year (and that remembering is kind of a hassle so again, it's easier to just stay on plan and have fewer decisions and fewer things to remember!).  Like I said, this is a very individual choice.  My main point is that even though it might seem counterintuitive, 100% is easier for me than 90% and I'm kind of surprised by that as much as anyone else.  Emily discusses something like this in her latest Diseaseproof post.

Sept. 30

Day 30, last day of September, only 12 days left of the Challenge, and then someone wins a vita-mix.  I'm hoping it will be waiting for me when I arrive home tomorrow.

Just an aside, it's 9 pm, I finished dinner a while ago, cleaned up the "kitchen" and closed it down (turned out the lights), brushed my teeth, am not the least bit hungry, and yet, I'm sitting next to someone who is eating gorp, coke, and chips.  It's not the food itself than makes me want to eat, but the fact that someone else is eating makes me want to eat too, even though I'm not hungry at all.  I wish everyone would just eat 3 meals a day and stop tempting us nutritarians!   oh well, this too shall pass, as soon as the crunching stops.  :)

Anyway, tomorrow's food is same as today's except the jicama is kind of rotten so I threw it away.  I must have picked a bad one.  Anyway, I had a little more of everything else so it ended up being about the same number of calories for tomorrow.  It's kind of weird how I pick the right amount of calories.  I guess over time you get good at it.

total calories 1461, protein 66 g (14%), fat 22 g (13%), carbs 280 g (73%), fiber 87 g.

PEERtrainer advice

I get PEERtrainer's tip of the day in email and I often find them very interesting.  Today's email said that daily logging of food is a key to successful, longterm weightloss.  It doesn't matter how you do it, doesn't have to be fancy or calorie counting, just logging what you ate.  It helps you from deceiving yourself and shows you your potential pitfalls.   The email is posted here.

That reminds me that another thing they recommend is daily weigh-ins.  They admit it's controversial but they find it works for a lot of people.  I don't recall where I saw that posted, sorry.

Day 29

Today I got to squeeze in one last, and of course fantastic, mountain bike ride before leaving Moab.  That made us late getting to our destination, so after preparing tomorrow's meals and showering, I'm ready for bed.  We stopped at a Whole Foods in Denver.  wow, I do love my fresh produce.  It's expensive, but it sure is good. I got enough for the next two days which will get us home.  I also got some sugar snap peas and carrots that I ate tonight--I updated yesterday's post with the new numbers.  Here's tomorrow's meals:

I guess I didn't feel like oatmeal.  It's all salads again.  Starting from the bottom:  romaine lettuce, cabbage, balsamic vinegar, broccoli, jicama, red kidney beans, banana, figs, strawberries, nuts and seeds.  and a pound of carrots divided between the three meals.

Total calories 1472, protein 58 g (12%), fat 21 g (12%), carbs 288 g (75%), fiber 98 g.

Day 28

Today was a fantastic day of hiking, mountain biking and sight seeing.  I'm whipped so will write this quickly and get to bed!  Tomorrow we start driving home again, so no more mountain biking, very sad.  I could spend a month here mountain biking.  This is the mecca (Moab).  I was hungrier than usual tonight, after all the exercising so bought some sugar snap peas at the grocery store.  They were crisp so I was hopeful but they had a funny taste.  I was hungry so I ate a few handfuls and then threw the rest away.  The local produce lovers must get their produce from the farmer's markets.  I got a pomegranate yesterday that turned out to be half-rotten.  However, they have some organic honeycrisp apples that are really good.  I'll finished those along with all my produce tomorrow.  I got a giant head of romaine and a giant jicama, and had bigger than normal portions of cabbage and cauliflower left so I just made salads for all three meals tomorrow.  They consist of romaine lettuce, cauliflower, cabbage, balsamic vinegar, lime juice, cilantro, spring mix lettuce, 2 giant apples, a giant jicama, nuts and seeds, and black soy beans.   The giant things brought up the calories to something reasonable.  [Edited the next day:  I got some carrots and sugar snap peas at Whole Foods and enjoyed them immensely before eating my late dinner, so here is an updated calorie intake]:

Total calories 1567, protein 68.5 g (14%), fat 21 g (11%), carbs 302 g (75%), fiber 113 g.  wow, lots of fiber, 41g just from from that giant jicama.

Tomorrow we will hit a Whole Foods in Denver.  I'm looking forward to getting some good produce there.

Day 27

Hi all, not much new to report.   same old, same old.  Had an awesome mountain bike ride in Moab.  Hope to repeat tomorrow along with a nice hike in Arches.  fun!

Today I supplemented what I had planned to eat with an apple and peach, increasing my calories to 1455.  That made me feel much better--I was very hungry this morning and it makes it harder for me to sleep.  Clearly 1272 calories is not enough for me.  1400-1600 seems about right.  Tomorrow's meals are almost a repeat of today's.  The best fruit in the local store to me looks to be the honeycrisp apples so that's what I'm eating.   Surprisingly the store had jicama so I got to include that again in tomorrow's meals.  It's a gigantic one.  I think the bigger ones aren't as sweet.  But it's still good.  My broccoli went bad so I threw it out.  I tried some conventional carrots from the store and didn't like them.  So I haven't got a good carrot since California.  Whole Foods may be expensive but their produce really does taste better.  I wonder if most people in the US have never tasted a good carrot.  They don't know what they are missing.  Okay, after that blathering here are tomorrow's meals.

brekky:  oatmeal with apple and raisins and nuts and seeds.  mmmm, can't wait.

lunch and dinner:  salad with romaine, spring greens, cabbage, cauliflower, jicama, lime juice, cilantro, apple, nuts and seeds, chickpeas.

snack/emergency food for mountain bike ride:  small handful of raisins.  I almost never feel a need to eat during exercise, but since I'm in the desert riding alone I may as well be a little cautious and bring a little food.  Water seems to me to be way more important and I will bring a lot of that.  But the food could give me a boost if I'm feeling tired on the way back.

yikes, time flies, time for bed.   let me know how things are going for you.  oh, here's tomorrow's food summary [edited later to reflect the extra sugar snap peas I had after dinner, and I had forgotten to add in the romaine]:

total calories 1585, fat 26 g (14%), protein 58 g (12%), carbs 305 g (74%), fiber 84 g

Day 26

Hi everyone!  I have a good internet connection tonight.  Still on vacation, still makin' my salads.   The grocery stores I've been to the last few days have not featured large produce sections.  The organic produce is pretty limp so I've been choosing conventional.  Today's lettuce was very good.  I chose organic carrots because they looked reasonably fresh but they are tasteless and I don't feel like eating them.   Apparently organic produce varies a lot in quality too.  Maybe I'll try some conventional carrots and see if they taste good.   Or just stick with the apples.  Most stores are stocking the fresh honeycrisp apples and they are very good.  Here's tomorrow's meals.

brekky:  oatmeal and apple and nuts and seeds mixture (walnuts, sunflower seeds, pumpkin seeds, hemp seeds).   The oats and chopped apple are soaking in water overnight.  A few minutes in the microwave and then sitting for a while, will make it luscious.  As usual, I will eat in the car while companion drives.

lunch and dinner:  salad made from:  green lettuce, cabbage, broccoli, jicama, big honeycrisp apple, cilantro, lime, nuts & seed mixture, can of red kidney beans, 1/2 avocado.   Tonight I used my last jicama.  I will miss those.  I love them!

Total calories planned for tomorrow is only 1272; fat 27 g (18%); protein 54 g (14%); carbs 225 g (68%), fiber 70 g.   This is similar to the amount of calories I had today and I suspect it's not enough.  I would have had more today but I didn't like the carrots.  I'm just driving today and tomorrow so pretty sedentary.  If I get hungry I'll eat an apple.  

Guest Commentary: Spending More Resources on Preventive Services is our Common Strategy

Akira Babazono, MS, MD, PhD**
Chair and Professor
Department of Health Care Administration and Management
Graduate School of Medical Sciences, Kyushu University, Japan


Dr. Saito and I visited JSPH to meet most faculty members, with the help of. Dr. Nash, this past August. We thanked them to have given precious information concerning healthcare problems. We are very happy to agree that we need more resources on primary care, including prevention, rather than for specialized care in developed countries where chronic diseases are prevalent.

Lifestyle-related diseases account for about 60% of deaths and we spend majority of health care expenditure on treatment for those diseases in Japan. The Japanese government has mandated insurers to provide health examinations and guidance related to metabolic syndrome since 2010. Insurers have to determine the risk for metabolic syndrome, including level of obesity (abdominal circumference and BMI), blood glucose and lipid levels, blood pressure, and the presence or absence of a smoking habit for every insured person aged 40 and over. Then, insurers are obliged to offer health guidance interventions according to the degree of risk of each insured person.

There are several studies that have reported favorable outcomes. The health examinations and guidance program would be productive because it is the efficient way to motivate patients to continue to maintain a healthy lifestyle in order to prevent chronic diseases.

I hear that the Patient Protection and Affordable Care Act mandates insurers to make co-payments on cancer screening free and to give subsidies to the insured to participate in fitness programs. I believe that we are on the right track because chronic diseases, which cannot always be cured by procedures, are preventable.


** Dr. Babazono and his colleague, Dr. Takao Saito, MD, PhD, attended the Tenth Quality Colloquium at Harvard in August, 2011 and spent the following week at JSPH. This is Dr. Babazono’s 3rd visit with JSPH.

day 25

Slow internet connection here.   will try to post once and then be done.  Yesterday’s food described in my previous post was very yummy.  The oatmeal was my best ever.  Unfortunately today and tomorrow’s hotel doesn’t have a microwave so no oatmeal for a few days.  Fortunately, I like my salads just fine.   Today’s salads have lettuce, cabbage, jicama, a big pear, nectarine, banana, can of chickpeas, cherry tomatoes, 1 oz nuts and seeds (walnuts, hemp, sunflower, and pumpkin seeds), lime and cilantro.  No rhyme or reason, just the produce I liked best from the grocery store.  I’ll be running out of the good California produce in a few days, but I’m seeing honeycrisp apples in the grocery stores so I think I’ll stock up on some of those yummy fruits.

I had a couple of entertaining thoughts yesterday.  One was about the Food channel.  I like watching the food channel.  I like how they turn cooking and eating into entertainment with contests and silly races and exciting plots and music.  It cracks me up.  I was thinking, wouldn’t it be fun if they had nutritarian shows?  We could have several segments on being a nutritarian road warrier.  I’d be willing to do a show.  Haha.  But everyone does it differently and it’d be fun to see how different people do it.  We’d learn so much from each other and we’d be portrayed as cool dudes and dudettes and feel like role models instead of weirdos.  (I care less and less about that as time goes on!).  

My other thought was that I have a couple of security blankets and I secured both of mine yesterday.  My two security blankets are my food scale and carrots.  I feel safe and content when I measure my food.  Then I know I’ll be getting enough calories.  Is that goofy or what?!  I also really love my carrots.  Total goofiness.  The reason for this neurotic behavior is my weird nutritarian diet, which requires planning and preparing most of my meals from scratch even when on the road.  I want to feel I will have enough food tomorrow.  When I feel I will, I relax and I’m happy with the quantities.  Very silly but if it works, I’m not going to worry about it.  

So yesterday I saw a kitchen store and stopped in and got a food scale.  will post my calories when my internet connection is fast again.  buh-bye

Humans on a Cafeteria Diet

In the 1970s, as the modern obesity epidemic was just getting started, investigators were searching for new animal models of diet-induced obesity.  They tried all sorts of things, from sugar to various types of fats, but none of them caused obesity as rapidly and reproducibly as desired*.  1976, Anthony Sclafani tried something new, and disarmingly simple, which he called the "supermarket diet": he gave his rats access to a variety of palatable human foods, in addition to standard rodent chow.  They immediately ignored the chow, instead gorging on the palatable food and rapidly becoming obese (1).  Later renamed the "cafeteria diet", it remains the most rapid and effective way of producing dietary obesity and metabolic syndrome in rodents using solid food (2).

Read more »

Sept. 23 = Day 23

Again, hardly any time to post, quick update.  I've been overeating the delicious local fruit and nuts here in the agriculture valley of California.  I'm relearning the phrase Dr. Fuhrman often states, "No excuses."  oops.  I've been making excuses--it's fresh, it's local, I never can get fresh pumpkin seeds or brazil nuts in Wisconsin!  Wow, fresh nectarines, fresh grapes, so good!  Well, it doesn't mean you overeat them.  gotta remember, no excuses.  Besides that bump in the road, having a great time.  Here is tomorrow's food:

Brekky will be oatmeal with nectarine, banana, hemp seeds, pumpkin seeds, sunflower seeds (1/3 oz total).  I hope it tastes as good as I'm imagining!  I'm soaking it overnight so I just have to heat it in the microwave for 1-2 minutes I hope.   

Lunch and dinner:  salad consisting of romaine lettuce, jicama, cherry tomatoes, black beans, cilantro, lime juice, and more of the seeds (2/3 oz).   If I need more food than this I have more fruit and carrots.

Tomorrow we move on to a new location.  Goodbye to fresh local produce of every kind and Whole Foods, spectacular scenery and traffic jams.  Hello to mountain biking!

Guest Commentary: Population Health on the World Stage: The UN High Level Conference on Non-Communicable Diseases (NCDs)

Rob Simmons, DrPH, MPH, MCHES, CPH

Director, MPH Program

Jefferson School of Population Health

For only the second time in its 66-year history, the first being in 2001 on HIV/AIDS, the United Nations held a high level (Heads of State and Ministries of Health) meeting of the General Assembly on a population health topic.

Jefferson School of Population Health (JSPH) was one of only eight US university schools to be invited to participate in this historic meeting representing the Civil Society and the NCD Alliance on the health and economic impact of non-communicable diseases (chronic diseases). Along with our colleague, Global Health Specialist Dr. Lucille Pilling, , I was honored to represent JSPH at this event in New York earlier this week.

The five major NCDs are those we are all familiar with in the U.S.: cardiovascular diseases (CVDs), cancers, chronic respiratory diseases (CRDs), diabetes, and mental illness. The major NCD risk factors include poor diet and physical inactivity, tobacco use, and excessive alcohol use.

Currently, more than 60% of all deaths worldwide stem from NCDs. It is estimated that 80% of all NCD deaths occur in low and middle-income nations, up sharply from just under, 40% just twenty years ago.

NCDs have been established as a clear threat not only to human health, but also to development and economic growth. Once considered “diseases of affluence”, NCD’s have now encroached on developing countries, most of whom have limited health, education, and economic infrastructure to address the changing demographics in their countries.

A global analysis of the economic impact of NCDs recently released by the World Economic Forum and the Harvard School of Public Health reported that cumulative economic losses to low and middle-income countries are estimated to surpass US $7 trillion over the fifteen year period of 2011-2025 (an average of $500 billion per year). This yearly loss is equivalent to approximately 4% of these countries’ current annual output. The negative health and economic impact will put a major strain on the budgets of every country around the globe, especially low and middle-income nations.

For these reasons, world leaders came together for this two-day meeting to ratify a series of policies and action steps to address the burden of NCDs. Highlights included presentations from UN Secretary General Ban Ki-moon, Dr. Margaret Chan, Director General of the World Health Organization, 19 “Heads of State,” and leaders from a range of public and private foundations. Throughout the conference, collaboration between the public and private sectors of society was emphasized as the only viable, sustainable platform to reduce the growing and potentially devastating burden of NCDs around the world.

The UN High Level Conference on NCDs was only the first step in a multiple decades-long endeavor to avert a global health and economic crisis. Each nation, multi-national and national public and private organizations, and global business leaders were asked to pledge their political and economic support (to the best of their ability) to this global health initiative. Hopefully, over the next decade and beyond, we will be able to look back at this seminal event and recognize the importance of population health being on the world stage at this place in time.

To learn more about the UN High Level Meeting on NCDs and the global health NCD initiatives, here are some websites regarding the event and actions taken:

http://www.un.org/en/ga/ncdmeeting2011/

http://www.un.org/en/ga/president/65/issues/ncdiseases.shtml

http://www.who.int/nmh/events/un_ncd_summit2011/qa_hlm.pdf

http://www.un.org/apps/news/story.asp?NewsID=39642&Cr=non-communicable+diseases&Cr1=

Some just released resources on NCDs include:

“The Global Economic Burden of Non-communicable Diseases”, Harvard School of Public Health, World Economic Council, September, 2011

“Scaling Up Action Against Non-communicable Diseases: How Much Will It Cost”, World Health Organization, 2011

“From Burden to “Best Buys”: Reducing the Economic Impact of Non-communicable Disease in Low- and Middle-Income Countries”, World Health Organization, World Economic Forum, 2011

“NCDs: Time for Change”, Global Health, Issue 12, Fall, 2011, Global Health Council

“A Call to Action on Health Promotion Approaches to Non-Communicable Disease Prevention”, International Union for Health Promotion and Education”, September, 2011

Day 22

Long day of driving, nice scenery, great fruit at a fruit stand, best grapes I ever had (both fresh and ripe, not a combination I usually get in Wisconsin).   Now it's time for bed.   How was your day?

Day 21

Hi everyone, I know some of you are doing well, others not so well, on the 6-week challenge.   I feel for the strugglers.  I made some mistakes today and will try to learn from them.  Here's today's lunch at "Cafe Glacier Point" (we're sitting on very comfortable rocks, not in a real cafe).    

I couldn't finish it because I was full, because....we stopped at this fruit stand, and got some really good fruit.  and some fresh brazil nuts, and some dates!   uh-oh!   Here I am already digging into the grapes, which were yummy.  

So were the peaches.   Unfortunately I ate too many brazil nuts and dates.  I rationalized the nuts saying I don't eat as much nuts as Dr. Fuhrman recommends so it's okay to eat more today, and they are fresh and not rancid like the ones I often get in Wisconsin.  Okay, that actually made some sense (I'm a clever girl).  Dr. Fuhrman recommends at least 1 oz of nuts per day.  I usually prefer eating less most of the time and then more on occasions.  For the dates, I was rationalizing that they might be fresher in California.   As it turned out, the nuts were better than the ones I get in Wisconsin and the dates were pretty much the same, as they are dried fruit after all.   Anyway, once I started eating them, it was hard to stop.

So what should I have done differently?  hmmm.  The nuts were great, I don't regret eating them but I ate too many, past fullness.  One or two dates would have been enough but I ate several more.  I'm not that huge a date fan because they are almost too sweet for my tastes.  On the other hand, eating them makes me feel like I got a treat and that's a nice feeling.  So how do I prevent myself from overeating them next time?   Maybe I should decide how much I will eat before I start eating them, dole them out, and put the rest away.  And maybe I should wait until mealtime to eat them.  Then it's more of a ritual.  I do like Dr. Fuhrman's idea of eating only at meal times.  Well, I'd like to think I'll do better next time so I'll give it a try!

Primal Docs

Chris Armstrong, creator of the website Celiac Handbook, has designed a new non-commercial website called Primal Docs to help people connect with ancestral health-oriented physicians.  It's currently fairly small, but as more physicians join, it will become more useful.  If you are a patient looking for such a physician in your area, or an ancestral health-oriented physician looking for more exposure, it's worth having a look at his site:

Primal Docs

Update 9/22: apparently there is already another website that serves a similar purpose and has many more physicians enrolled: Paleo Physicians Network.

Day 20!

Hi everyone, it's Sept. 20 which means day 20 of the 6-week challenge!  I'm on vacation and have very little time to post.  I'm still eating my salads as posted a few days ago.  Only the last two days I've been using cherry tomatoes, jicama, and fresh figs as my "fruit" on the salad.  Oh man it's good.   I stop at a Whole Foods every night and get excellent fresh produce.  I'm in California so most of the produce is fresh and local.   I'm getting great fresh baby carrots, along with everything else.   Tonight I thought I got some blackberries but they never showed up in my bag or receipt, so somewhere they got lost.  bummer.  Well, tomorrow I can get some.  Okay, I have to go and prepare tomorrow's food and then get to bed!  We're visiting Yosemite this week and didn't get a place in the park so we have long drives every day.  Not very good for the environment...

How are you doing?   Tomorrow is the half-way point!    That's plenty of time to get back on track if you struggled, or to keep the momentum going if you are doing well.  If you are doing well and can keep this up for an entire 6 weeks you can really learn to change your habits and preferences this way.

Have a great day today and tomorrow!

Day 18

Today I overate a bit, with that second sweet potato after dinner.  I got more hungry than usual before lunch and dinner and I think it made me overeat at dinner.  The sweet potatoes were pretty small so it's no big deal.  I'm not sure I like sweet potatoes in my salad and I also prefer them baked in the oven to steamed in the microwave.   So I think I'll drop the sweet potatoes and save them for when I get back home.  My salads were same as yesterday.  Tomorrow we arrive at our destination and will have Whole Foods nearby all week so there will be no problem getting healthy food.

Here's a picture of me and my yummy salad at Great Basin National park:

How are you doing?

BACK on the ROAD AGAIN

As the School of Population Health officially starts its second full academic year I want to take a moment to thank our entire team---the faculty and staff who make it possible for us to bring first-rate "in person and online content" to so many students around the nation. Right now we have more than 310 students taking at least one 3-credit course with us, either in person or online, across our 5 degree programs. It is thrilling for me to report these numbers to you!

On another note, I have been "back on the road again" preaching the gospel, if you would, of health reform through improvement, leadership, waste reduction, and care coordination. Everything that our school stands for and teaches. My message has been very well received...

This past week I was in Colorado Springs for the Fall meeting of the Governance Institute--I have served on their faculty for nearly 20 years and now I generally headline the opening day event. I spoke to almost 300 leaders from hospitals across the nation about the role of good governance in promoting quality and safety. The next day, I led the AHA Center for Governance Meeting in Boston, MA. I reiterated my message to this group and then led 2 workshops where we dug into the details about the structure and function of a good Board Committee on Quality.

Later in the week I attended the National Quality Forum Annual Awards Dinner and meeting in Washington, DC, and was in attendance when Norton Healthcare won the 2011 Annual Award. I am especially proud of Norton as they are partners with Humana in a successful Accountable Care Organization model in Louisville, KY. More on that another time.

I capped off the week with the closing plenary for the South Carolina Hospital Association at their meeting in Hilton Head Island. Here, I emphasized the need for care coordination and the creation of a physician leadership class. I also had the wonderful experience of signing scores of copies of my latest book, Demand Better.

Finally, I am especially proud of my ongoing affiliation with the Main Line Health System in suburban Philadelphia where I chair the Board Committee on Quality. In case you missed it, MLH was named by the Joint Commission as one of the very top systems in the entire country. Kudos should go to the leaders of MLH including Jack Lynch, Don Arthur, and Denise Murphy.

What are you doing to be a part of the solution for health care? DAVID NASH

Day 17 of the 6-week challenge

Hi folks,

I'm on vacation so don't spend much time online.  We're having a fabulous time.   Today was a fabulous mountain bike ride and hike in Salt Lake City.  We've been here 2 nights with a Whole Foods near our hotel.  I was thinking today that I should take advantage of Whole Foods.  They have a "Health Starts Here" program based on a whole foods plant based diet!   In their prepared food section, anything labeled as "Health Starts Here" is vegan with no oil, and less salt (hopefully).  I was thinking today, I could save time and get a lot of meals from there.  Then I ate my salad.  It was soooo good.  That is the problem.  I love my salads so much.   I brought oatmeal with me and I haven't eaten it yet because I prefer the salads! Here is tomorrow's:

This has, let's see if I can remember, cabbage, romaine lettuce, baby bok choy; some veggies cooked in the microwave:  broccoli, sweet potato, zucchini, and mushrooms; cucumber, seed mixture, chickpeas, jicama, strawberries, blackberries, pear, balsamic vinegar.  I've heard of jicama for a while and finally saw some in this Whole Foods.  I love it!  It's less sweet than most fruits and more sweet than most veggies.  I also nibbled on really good fresh sugar snap peas while prepping.  I've been eating tons of carrots so I actually got tired of them and won't have any tomorrow.   I'll probably be craving them again when I get to the next Whole Foods.

I hope you are doing well, and if not, it only takes 4 days to get back on track!

Day 15!

Two weeks down for most of you.

It's only day 2 of vacation and we're having a great time already.  Yesterday was a long drive but I slept and ate my meals as a passenger, and listened to audio tapes while driving.  It was very relaxing.  Today we had a shorter drive, and lots of fun mountain biking and hiking in between rain showers.   We stopped at the end of the day at a co-op which didn't have great produce except for a giant bag of spinach so I got that.  That's enough to get me through until tomorrow.  We walked by a vegetarian restaurant that looked fun.  I'd eat there for a treat.  But it was late and we just wanted to get to the hotel and relax.  And I"d actually like to eat really clean during this 6-week challenge, and save my treats for later.

I'll post tomorrow's food which is similar's to today's food but I remember it better because I just made it. Tonight we're in a mini-suite with a great work area:

Here's tomorrow's salads:

That's lots of cabbage, lots of spinach; some broccoli, zucchini and mushrooms cooked up in the microwave, a red bell pepper, apple, pear, peach, nectarine, seed mixture, and red kidney beans.  I think that was it.  And that is the end of my food except for carrots and a little cabbage.  Tomorrow we'll be near a Whole Foods so I'm looking forward to a whole new batch of produce.

How is your day going?

Guest Commentary: RECs – Help for Ambulatory Care Physicians in Implementing EHRs

Richard Jacoby, MD
Clinical Associate Professor
Jefferson School of Population Health

Over the past year, states across the country have developed Regional Extension Centers (RECs) to support the electronic health record (EHR) initiative passed as part of the American Recovery and Reinvestment Act (ARRA) of 2009. Why is this important? With benefit of a little background information, the answer is pretty clear.

The evidence suggests -- and it is generally believed -- that adoption of EHRs by physicians and other health care providers is a critical first step in enhancing the quality and value of health care delivered in the U. S. However, adoption of electronic health records by physicians has been painfully slow in this country. How many of you still have to fill out a paper form when you visit your doctor?

The Health Information Technology for Economic and Clinical Health (HITECH) Act was included as part of ARRA to provide incentives for physicians and other health care providers to adopt and use EHRs in a meaningful way. By meeting HITECH criteria for “meaningful use”, physicians and other providers can qualify for up to $44,000 from Medicare and/or $63,750 from Medicaid to offset their EHR purchase costs. However, there is a stick to go along with the carrot. Beginning in 2015, CMS will impose financial penalties on providers who do not engage in meaningful use of health information technology.

But adopting and utilizing a new technology can be a daunting task – especially when the technology is implemented in the context of health care provider practices. Recognizing this, the HITECH act established and partially funded RECs to act as consultants – i.e. to support priority primary care providers and certain critical access hospitals in making choices, adopting, and “meaningfully using” EHRs.

RECs assist providers in evaluating the available EHR systems offered by different vendors and selecting one that meets the needs and budget of the practice. Next comes the really hard part – providers must re-engineer the way care is delivered in the practice to coincide with the new technology! It requires a detailed analysis of the practice workflow pre-and post-EHR implementation -- i.e., understanding what each employee currently does, and what that employee will do post-implementation, from the moment a patient enters the office until the time he/she leaves.

Once the practice is up and running with the new technology in place, challenges remain. Providers must understand and comply with specific rules in order for the practice to qualify for incentive payments. If all goes as planned, RECs may play an important role in helping with the transition from paper-based to electronic systems.

The Jefferson School of Population Health is providing services to physicians as part of the REC effort in Pennsylvania. For more information, contact Richard Jacoby, M.D. at richard.jacoby@jefferson.edu.

The Big List of No Oil Salad Dressings

This is a great resource from Healthy Girl's Kitchen:  Her big list of no oil salad dressings includes recipes for all of them!

Day 14 of the 6-week Challenge

Two weeks into the challenge, and the first day of my vacation.  I forgot to bring my food scale.  At first I was disappointed, then glad.  I'm tired of measuring my food.   I know how much to eat.   If you aren't sure, you can measure your food.   I think it's great to do for 2-3 weeks if you've never done it before.  If you are trying to lose weight, it gives you an idea where most of the calories come from; and if you are trying to build muscle by working out (the only way to do it), it helps you see where the higher protein foods are (green veggies, beans and nuts, not fruit).

Now everyone handles food on vacation differently.   I prefer making my own food to trying to find something in restaurants, and my travel companion doesn't want to waste time in the restaurants either.  You can make good time on the road by eating in the car.  So it's sort of like camping only we'll be staying in hotels this trip.  Here's my food for a few days.  At right is an electric cooler, which plugs into the car electrical outlet.  Picnic basket has utensils.  The other bags (insulated) have today's food and some extra food that didn't fit into the cooler.

Oh, and can't forget the beans:

Today's meals were

Brekky:  salad and baked sweet potato.  That's the last of the sweet potatoes for this trip because I won't be cooking, except maybe oatmeal.   The salad was: cabbage, kale, bok choy (a bit too strong tasting), lettuce,  broccolini, sweet red pepper, pear, peach, apple, zucchini, mushrooms, edamame, peas, seed mixture, and that really expensive sweet balsamic vinegar.  That's like sugar, definitely something to eat in small quantities.  I made a giant batch and split it into 3 big bowls (8 cup size!) for each meal.  Here's my breakfast:

Lunch was salad and carrots.  Dinner was the same.    That's kinda how it's going to be on this vacation, the same old thing every meal.  But the salad fixings will vary.  In fact, it's fun to see what I can make up from the different stores I visit.   

Fat Tissue Insulin Sensitivity and Obesity

In this post, I'll discuss a few more facts pertaining to the idea that elevated insulin promotes the accumulation of fat mass.  

Insulin Action on Fat Cells Over the Course of Fat Gain

The idea that insulin acts on fat cells to promote obesity requires that insulin suppress fat release in people with more fat (or people who are gaining fat) to a greater extent than in lean people.  As I have written before, this is not the case, and in fact the reverse is true.  The fat tissue of obese people fails to normally suppress fatty acid release in response to an increase in insulin caused by a meal or an insulin injection, indicating that insulin's ability to suppress fat release is impaired in obesity (1, 2, 3).  The reason for that is simple: the fat tissue of obese people is insulin resistant.

There has been some question around the blogosphere about when insulin resistance in fat tissue occurs.  Is it only observed in obese people, or does it occur to a lesser extent in people who carry less excess fat mass and are perhaps on a trajectory of fat gain?  To answer this question, let's turn the clocks back to 1968, a year before Neil Armstrong first set foot on the moon. 

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Day 13

I don't have much time to post, packing for my vacation.  Yeah, I know I shouldn't advertise that I'm going on vacation.  Well, someone will be staying at my house.  Does that ward off the burglars? 

I'm hearing from people doing well today.  Way to go!  

Today's food was

Brekky, after exercise and dentist:  sweet potato, lots of raw carrots while prepping lunch and dinner.

Lunch:  my usual salad as of late:  cabbage, kale, summer squash, Italian fry peppers (best red peppers I've ever eaten), peach, pear, apple, seed mixture, balsamic vinegar.  I did more taste tests on the vinegar.   I now have 4 bottles.  As it turns out, the most expensive is to die for, the cheapest is pretty lame.  The taste correlates with price (darn!).  Looking at the label, so do the calories and sugars.  So that all makes sense!  The really expensive bottle is awesome.  In might start buying that as my reward for good behavior.  I suppose that means I have to use the cheap bottle after I misbehave.   Anyway, the salad was luscious with the expensive vinegar and the ripe fruits.  Everything on the salad except the vinegar and seeds is local and tastes really good.   I also had some greens and beans.

Dinner:  same as lunch, salad, greens and beans.  and a small box of blackberries.  a few cherries, a few carrots.

Total calories 1501, protein 49 g (10%), fat 17 g (10%), carbs 315 g (80%), fiber 80 g.

Vitamix has shipped!

Soon the vitamix will be in my hot little hands.  Then I'll ship it off to one of you.  Getting excited?

Day 12

Hi everyone, darn it, just got some disappointing news about a family member's diagnosis.  so I'm bummed right now.  I guess I was counting on better news.  Here's what I ate today:

brekky:  sugar snap peas, beans and greens.  I was in the mood for beans and greens after a hard workout.  I was already a weakling before I broke my elbow last winter, but I am even more so now.  But I'm happy to be doing something about it.  I harvested a ton of collards from the garden since I'll be gone for a few weeks.  I froze a bunch and used the rest in my beans and greens.  For the beans and greens, I cooked up the collards, an onion, and eggplant from the garden, some basil, then added a serving of beans and grains from the freezer (thawed in the microwave), a can of (garden) tomatoes and some no-salt seasoning.  Really good.   here's the collards:

smashed down into ziplock bags for freezing:

Lunch:  I hit a home run with this salad I invented the other day.  wowsa.  Today's was even better.  kale, chopped and massaged (in my hands), marinated in really expensive balsamic vinegar (and boy is it good--I'm still having fun taste testing vinegars, got a few new bottles today), add cabbage, yellow summer squash, red bell pepper (these are just what's local and in season right now), and the part that makes it really really good:  fresh ripe local peach and fresh ripe local pear.  YUMMMMMMMM.   Had that with my last 1.5 ears of sweet corn for 2011.  I savored every bite.

Dinner:  the rest of the beans and greens.  the rest of the salad.  a bowl of frozen mango (didn't need it, but wanted it and it was good).  One more chore to do, harvest the basil leaves and freeze like the collards:

Okay, the garden can grow back while I'm gone and I'll be ready to eat more fresh kale and collards when I get back.

Total calories:  1626, protein 65 g (12%), fat 12 g (6%), carbs 351 g (82%), fiber 87 g.   

Forgot my nuts and seeds again, oops.  I had more calories than usual which was a surprise.  I was thinking it was fairly low-calorie food but I did eat a lot of it.  I could have held off on that second serving of beans and greens at dinner.  oh well, no big deal I don't feel overfull.  Notice the higher percentage of protein compared to yesterday when I had more fruit.

Guest Commentary: Revisiting Managed Care – 10 Years On

David Woods, PhD, FCPP
CEO, Health Care Media International
Adjunct Faculty, Jefferson College of Graduate Studies

More than decade ago I wrote a book for the Economist Intelligence Unit, The Future of the Managed Care Industry and its International Implications.

What's changed about managed care in 10 years? Well, certainly not public perception. In fact, in a poll at that time a solid majority of respondents believed that the quality of medical care would be harmed rather than improved by the trend toward more managed care.

Yet, despite subsequent studies showing that quality of care has not been demonstrably compromised under managed care, it is hard to find many friends of the system. The media cite horror stories about denial of care; and TV series featured doctors trying to do good despite managed care’s strictures.

Today, more than 80% of Americans insured by their employers are in some sort of managed care plan -- as are the overwhelming majority of doctors.

Alain Enthoven, PhD, a professor at Stanford University and a leading authority on healthcare systems and policy, defines managed care as a strategy used by purchasers of healthcare. Four essential principles of managed care are: selective provider contracting; utilization management; negotiated payment; and quality management.

The principal objection of patients to managed care was the prospect of being thrown out of the hospital within hours of major surgery. They also disliked the necessity of having to go through gatekeepers, typically primary care doctors, before being allowed to see a specialist.

One thing I certainly got wrong in the book was my contention that if managed care has achieved anything, it has slowed the breakneck speed at which US healthcare costs were growing. In fact, those costs have now reached a stratospheric $2.3 trillion a year.

So, according to the premise of my book’s title, I asked the question: What is the future for managed care? I answered it by saying that managed care will not only survive but thrive in the US. I also suggested that managed care would need to get away from the perception that its main function is to restrict care, but rather to supply a service to members that should include such care as is needed.

Managed care plans are seeking to rebuild damaged relationships with providers... and they're looking to shift more responsibility for payment on to users. As they move into less restrictive products they lose their ability to control costs, a fact that is likely to contribute to further premium increases, which in turn could put additional pressure on public programs.

In a recent interview, Dr Alain Enthoven told me that despite deficiencies in managed care that tend to favor fee-for-service delivery, Kaiser Permanente has prospered, he says, mainly because it has rolled out an electronic health record that has led to a cultural change both for patients and for physicians. What has impeded managed care’s progress, he says, is that employers continue to offer fee-for-service care and many have still not even tried managed care. And while managed care companies have made steady progress, employers still don't provide employees with incentives to choose economical healthcare.

Despite changes in managed care over the years, some of the original ambitious goals have not been achieved, including cost containment and universality. Some of the challenges of managed care might be obviated by passage of the Affordable Care Act. Unless the Act is significantly diluted it is perhaps the most significant change in healthcare delivery over the past decade. Gone will be denial of care for pre-existing conditions; and, for any type of insurance to work, the requirement that there be 100% enrollment is central.

Day 11, 31 to go

I'm in pre-vacation mode, which means, eat what needs to be eaten before vacation.  So I started out with some frozen bananas that for some reason I think should be eaten now and not later (maybe I really just wanted them).  I had those and frozen cherries, chopped up, for brekky.   Wow was that ever good, like ice cream:

I also had some chopped cabbage and carrots because I'm so used to having salad or cooked greens with a meal.  I'm actually not a big fan of fruit only for brekky despite my having had it the last few days in a row.  

Today and tomorrow are the final days of sweet corn.  So I bought six and shared 3 with housemate, so we each had 1.5 ears for lunch and will have the rest tomorrow.   Then the corn stand will be gone.  I savored those corns.  It is so good.  I also had a salad made from cabbage, sweet red pepper, summer squash, edamame, peas, and vinegar.  I also had a peach.

Dinner was a yummy baked oriental yam topped with pumpkin pie spice and more salad.  Then...I couldn't resist the bananas and cherries so had another bowl.  Good thing I ran out of bananas. 

Total calories 1509, protein 40 g (8%), fat 11 g (6%), carbs 347 g (86%), fiber 67 g.

I wouldn't call this a maximally optimized nutritarian day, but I tend to allow that one day a week.  I didn't eat any nuts or seeds.  tsk tsk.  Notice how the protein is lower since I ate relatively higher proportions of fruit, less beans and no nuts or seeds.  My fat is quite a bit lower too without the seeds.  I'll have some tomorrow.

How to lose a lot of Weight

Just got this email from PeerTrainer on what to do when you need to lose 50 or more lbs.  Might be useful to some of you.

If you are struggling

I tried to do Dr. Fuhrman's 6-week challenge last Nov and tanked almost immediately.  Something about the challenge sent me off in the wrong direction.  Maybe it was my Miss Behaving streak.  I suspect that this has happened to some of you on this challenge.  Here is a suggestion, I'm not sure if it's helpful but here you go.  What if you change your goal to:  get back on track.  Use the next 32 days to learn how to do this right, to try it out in all situations, experience the obstacles, figure out the solution, get better, and by the end of this you know what to do.  We can start a new 6-week challenge when this is over and you can roll into it ready to go and knowing what to do and enjoying doing it.  Anyone have a vita-mix they want to donate?  haha.

Day 10 of the Challenge

Hi everyone, this is actually my 2-week point in the challenge since I started early.  I notice that I might appear to be pretty strict with my 6 week challenge.  Part of the reason is time--it takes less time to make simple meals from beans and greens and salads.  The other part is I guess I am looking to reset and seal my healthy habits.  Dr. Fuhrman says it takes 12 weeks to change habits and break addictions so I am looking to do this for 12 weeks (well, hopefully forever).  I want to lose my desire for SAD sweets so am even avoiding the sweet nutritarian food, except fruit.  But I should think about making some nice dishes when I get back from vacation.  I came across a nice spaghetti recipe when I was looking for a pesto recipe in my last post.   I have a ton of recipes on this site and then there's Dr. Fuhrman's recipe site. So when I get back from vacation, I should try to start making a nice meal on the weekends.  Since it will be winter by then I won't have mountain biking and kayaking to distract me.

Here's what I ate today.

Brekky:  small bowl of frozen fruit--banana, cherry, mango--before yoga class (was out of fresh, went grocery shopping after yoga).   carrots and cabbage when I got home to tide me over to lunch.

Lunch:  2 giant corn on the cobs, delicious as usual.  Tomorrow is probably the last day for fresh sweet corn so I'll do a repeat then.  sliced tomato from the garden.   some more carrots.

Dinner:  giant salad with kale, collards (massaged), cabbage, cilantro, parsley, yellow squash, fantastic local red bell pepper, cucumber, edamame, mango, and balsamic vinegar.  more carrots.

total calories 1400, protein 47 g (9%), fat 18 g (11%), carbs 301 g (80%), fiber 68 g.

Easier than Pesto

I've got two giant basil plants in the garden and winter is coming, so it's time to start harvesting them.  I used to make pesto but that was work.  Today I just brought in half of one plant, shown here,

pulled the leaves out, stuffed them into a plastic bag,

and put them in the freezer.  If it's like spinach and other greens, you can crumble them while they are frozen and it even saves time chopping.   So hopefully I'll have fresh-frozen basil throughout the winter.

Sleeping on the Job

Since I don't do caffeine, I occasionally desire a nap--fortunately that doesn't happen too often.  It's amazing what a 10-15 minute nap can do to revive a girl.  I have a yoga pad, blanket, pillow, eye mask, and earplugs at my office.  Okay, that is overkill.  Minimum equipment needed is just a yoga mat and you can nap anywhere with a floor.

Preparing for vacation

18 cans of beans.  hee hee.

Yummy Salad

I make salad every day and this one was so good I want to remember it.  It includes kale and collards because I'm going on vacation next week and want to trim down the plants in my garden before leaving.  I think what makes the salad good are the combination of pears and mango and the kale and cabbage.  It's a great combo.  Apples would probably work in place of pears.

Ingredients for 3 salads:

cabbage, 277 g or 3 cups chopped

kale, 168 g or 2-3 cups chopped  (or however much you want, this is just how much I picked from the garden)

collards, 41 g, or 2 big leaves (or however much you want)

1 medium cucumber chopped

1 medium yellow summer squash, chopped

1 large pear or 2 small

1 cup chopped mango (I used frozen)

3 Tbsp balsamic or fruit infused vinegar (not sour)

1 oz seed mixture or chopped nuts

How easy is that?  combine everything.  I made this the night before because I don't have time in the mornings.   Well, that's okay for the kale and collards because they marinate overnight and are more tender.  Oh, and an important thing I do with the kale and collards is I mashed them, or massage them, with my hands after chopping them--that helps tenderize them also.  Oh, you de-stem them too before chopping.

Day 9 of the 6-week challenge.

Woo hoo, day 9 starts to feel substantial, almost into double digits.  If you lasted this long you've probably lost toxic hunger, and are feeling good.  Your taste buds have probably re-sensitized and fruit and veggies are starting to taste really good.   Just think, it really only takes about a week of truly healthy eating to start feeling good.   So if you are struggling, maybe you should reset right now, and in a week you'll be right there with the rest of us.

Today I had the same old thing but my salad was really good!  Wowsa, I'm making this again.  I think I will have to post this as a separate recipe, which I'll do next.

Brekky:  greens and beans, salad (after exercise).

lunch:  baked sweet potato, salad.

snack*:  carrots and sugar snap peas.

dinner:  greens and beans, salad.

*egads, I had a snack.   Dr. Fuhrman doesn't recommend snacks!   Well, tough noodles.   I was much happier riding my bike home at 7 pm having had the snack then I have been the last few weeks.  I eat lunch at noon and don't get dinner until 8 pm.  Lately my bike ride home has been tired and hungry.  Tonight I was back to day dreaming on my bike and enjoying the ride.  Plus this way I don't have to stuff myself at lunch in order to make it until dinner.  I'm not going to worry about this "transgression."

I didn't weight my carrots and sugar snap peas so my calories are just a guess but they are probably within 100 of correct.  By the way, I don't eat just a few carrots, I eat about a pound.  We're getting local carrots again (hopefully for the next 8 months) and I just really like them.

Total calories:  1392,  protein 50.5 g (11%), fat 16 g (10%), carbs 288 (79%), fiber 68 g.

Day 8

Today I switched to my Fall schedule:  food prep the night before, exercise before work, breakfast when I get into work.  So I eat a more substantial breakfast.  Here's what I ate today.

Brekky:  greens and beans, salad made from cabbage, spinach, lettuce, red bell pepper, cucumber, yellow squash, peaches, apples, seed mixture, balsamic vinegar.

Lunch:  baked sweet potato and salad.

Dinner:  greens and beans, salad.   carrots, sugar snap peas, and kohlrabi while prepping tomorrow's meals.

I'm running low on fresh fruit so my total calories were a little low.  I feel satisfied right now, hopefully won't wake up early hungry.

Total calories 1352, protein 55 g (12%), fat 21 g (13%), carbs 265 (75%), fiber 70 g.

People often ask me how I get my protein:  from vegetables, beans, and nuts and seeds.  In Dr. Fuhrman's Healthy Times newsletter #42, Fueling the Vegan Athlete, he gives a table of estimates of protein requirements.  The estimates are about  0.7-0.8 g/kg/day for sedentary individuals, 1.5 g/kg/day for endurance athletes, and closer to 2 g/kg/day for strength athletes.  That is grams of protein per kg of body weight per day.  My body weight is 125 lbs or 56.8 kg.  So today I had about 1g/kg of protein.  Another estimate of protein requirements from the table gives 12-15% of calories for all individuals from sedentary to strength athletes--note that athletes will naturally increase their protein intake by eating more calories.  I had 12% today.   I've read elsewhere that 5-10% of calories is sufficient (World health organization maybe?).   I think I get enough.  I exercise daily but I'm not an athlete (I am just a wannabe).

I hope your day was successful!

Day 7 of the 6-week challenge

One week down!   Here's what I ate today

Brekky: a bowl of frozen fruit while making a bunch of smoothies for housemate:  banana, blueberries, mangos.  and a ripe peach.  and some sugar snap peas and carrots.  and cherry tomatoes from the garden.  and some tastes of smoothies.

Lunch:   oriental yam and salad (cabbage, salad greens, spinach, cucumber, yellow bell pepper, apple, seed mixture).  I actually didn't have time for lunch, ate the yam right before a meeting and the salad had to wait until about 4:30 pm.

Snack:  I was surprised to see fruit at a presentation where we usually just have cookies and cake.  I didn't even consider if I was hungry and just had some but in fact I kinda was since I hadn't eaten my salad yet, so that was fine.    Then I had my salad after the presentation

Dinner:  greens and beans, and salad, some carrots and sugar snap peas.

total calories 1463, protein 47.5 g (10%), fat 16.5 g (10%), carbs 311 g (80%), fiber 68 g.

The last few days had some emotional turmoil and some situations where in the past I might have strayed off plan or overeaten but the 6 week challenge has me happily focussed on reaching my goals.  My desire for that is higher than any triggering desire to stray.  Let's hope it stays that way.  One day at a time!

Tejas' update

Here's an update on the progress of one of the Challenge participants, Tejas:

For almost one week, I stayed good to my plan till dinner time. Even dinner time was much better.  The good thing is that we are doing this s family.   We have green smoothie.
In past 10 years, I gained 25 lbs.
I never liked SAD food and I used to eat lacto vegetarian diet (except that cooking oil was so cheap in US that I think I started to overuse it).Worst part of this weight gain was that I thought it is natural. I am already eating very healthy food and it is part of aging process (to get fat) and motherhood.I had really high triglyceride (wheat and rice and large portion size)  In back of my mind, I was bothered by my extra weight but had no strong resolve. I tried for a week or so few times but would give up very soon.In beginning of this year, I got smart phone. I started to read many blogs related to food, well being etc.First four months I was blown away by information shared by various doctors and bloggers. Intellectually I knew that I need to do something but blogs finally motivated me enough to move on from my previous experience of fear of failure.I started to incorporate more and more raw food in diet. I would loose weight very fast but I can easily gain 5 lbs on Saturday party food.
As I started to learn more about my body, I started to work with my family as well. I am fortunate that I do not have any health issues in my family and I would like to keep it that way.In past 3 to 4 months, I lost only 15 lbs, but my lipid panel report shows much better numbers.My kids drink green smoothie at least 3 to 4 times per week.Our salad consumption is gone up 4 times and oil consumption is gone way down.
I am happy with progress we made as whole family.My typical day has no grain or oil till 6 pm. During dinner, I do eat very little wheat or rice (2 or 3 spoons) .My only problem is that I want to eat after 9 pm (some fried snack).I have these snacks for kids (school, day care)./ these are healthy crackers or bars, but they are still something that I should not eat.
I am participating in this 6 week challenge to get rid of 10 lbs and that will put me in my ideal weight range.In addition to all the blogs I follow and read, I also stumbled upon this book.  Does anyone else know about “Dr. Richard Fleming”?Please do share your experience and story. 

Thanks Tejas!  If you want me to post your progress report, let me know.  It's not a requirement, you can just add a comment to the blog occasionally.

Day 6

Here's what I ate today.  You can kind of see a pattern developing.  The corn season is ending, but I'm still loving the oriental yams.  Soon it will be pomegranate season!

Brekky:  frozen fruit (mangos, sweet and sour cherries), fresh ripe local peach (yum), big handful of spinach.  carrots and sugar snap peas while prepping lunch and dinner.

Lunch:  baked oriental yam, salad like yesterday's (cabbage, salad mix, spinach, apple, patty pan squash, red bell pepper, broccoli, scallions, seed mixture, cilantro, orange juice).  

Dinner:  greens and beans, same salad as lunch except I got to the store and got some balsamic vinegar.  much better with vinegar!  Not only that, I did a taste test.  

On the left is Lucini balsamic vinegar of modena which I think cost $1.76/oz (I didn't keep the receipt). On the right is Spectrum Organic balsamic vinegar of modena coming in at $0.38/oz.   I'm surprised to report I preferred the cheap one.  It had a more fruity, tangy flavor though it was just a slight bit vinegary.  I don't like vinegary balsamic vinegar (sorry if that makes no sense).  The lucini was very not-vinegary which I really like in a balsamic vinegar.  It describes itself as full-bodied and balanced which I agree with, but it seemed to lack flavor to me.   My tastes may vary day to day so I'll try the comparison again.  Also it might be that the spectrum brand goes better with apples.  Lucini might go better with tomatoes.  I'm going to buy some more vinegars and keep playing with this.  It is fun.  I'll have no trouble consuming all of them as long as they taste okay.

I had some kohlrabi for dessert.

Total calories 1501, protein 59 g (12%), fat 20 g (11%), carbs 300 g (77%), fiber  79 g.

Hyperinsulinemia: Cause or Effect of Obesity?

Is Elevated Insulin the Cause or Effect of Obesity?

The carbohydrate hypothesis, in its most popular current incarnation, states that elevated insulin acts on fat cells to cause fat storage, leading to obesity.  This is due to its ability to increase the activity of lipoprotein lipase and decrease the activity of hormone-sensitive lipase, thus creating a net flux of fat into fat cells.  I'm still not sure why this would be the case, considering that fat tissue becomes more insulin resistant as body fat accumulates, therefore insulin action on it is not necessarily increased.  Total fat release from fat tissue increases with total fat mass (1), demonstrating that insulin is not able to do its job of suppressing fat release as effectively in people who carry excess fat.  But let's put that problem aside for the moment and keep trucking.

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A Helpful Realization for Me

I hope that I learned something useful about myself recently.  I could wait six months to verify that it works and then post it if it's successful, but I'll go ahead and share now and then if it doesn't work, I'll have to submit a correction post.

This year, on the occasions that I strayed from healthy eating and then came back, I wondered: why was it so easy for me to be a vegan for the last 6 years but it is sometimes difficult to be a nutritarian?  Both involve denying myself a category of foods.  In fact, being vegan involved a complete 100% abstinence from certain foods whereas being a nutritarian just involves mostly abstaining (that turned out to be a clue).   Interestingly, this year, I strayed for the first time in 5.5 years from veganism, about 3 times.  That's because I gave myself permission, since Dr. Fuhrman allows for a small amount of animal products.  I didn't follow his advice as he intended since I ate ice cream, one of the worst foods you could eat.  But that straying clued me in to something.

Before I strayed from veganism (first time Nov. 2010), my vegan logic when choosing food was, 1) is it vegan?  2) if not, what's something vegan I can eat?  I have a clever clever brain (as do you) and all of my cleverness was applied to finding something vegan to eat.

As a nutritarian, because there is some leeway and you can eat an occasional cookie and still be healthy, sometimes my clever clever brain, which loves sugar, will go all out to argue why it's justified.  It is a powerful force when my clever clever brain goes all out to convince me of something.  It is too smart for me.  It will just keep on arguing until I am convinced.

If I were to decide that for me being a nutritarian means eating only health-promoting food, then maybe my decision process will be like the vegan one.  1)  Is it nutritarian?  2) if not, what's something nutritarian I can eat.  no arguments.  And then my clever clever brain, which is a powerful force, can go all out applying itself to finding me good nutritarian food to eat.

So I decided I want to be vegan and nutritarian, which for me means, no animal products, and no disease-promoting foods (that is, 100% healthy foods instead of 90, 95, 98%).  It's just easier that way.

I'm not saying I'll always be vegan and nutritarian but I want to be now and I hope I will be forever.