The LILI Letter - August 2023

August,

Time to slip in the final summer vacations, get the kids ready for school, and enjoy the garden produce. I hope your summer is going well and you have taken advantage of the great outdoors to play and relax. Although all that outdoor fun probably needs to take place before 9 a.m.!!

In good health,
Jennifer James

Success story

We have a cardiac rehab patient this month with a fantastic “Success Story”.

“P” writes:

“I had a major heart attack in April and survived. I then started rehab a couple of weeks later. Since then I have been attending the Cardiac Wellness Center and classes to regain my strength and return to my normal routine. At first, I was depressed and discouraged. I felt as if there was no hope in my future. The staff here have been very helpful and supportive. Their encouragement has helped me regain my strength and I now realize I have a future. They have taught me the value of exercise and good nutrition. I am very thankful that I am attending Cardiac Rehab and have the association with the wonderful staff here. I appreciate their dedication, support and care they give to all of us who are working so hard to get better.”

This is Jennifer now. “P” is being modest. She has lost 20 pounds, 10 before and 10 after her heart attack. How did she do this? She gave up the margaritas and caramel macchiatos, started eating more fish and salad and followed the Mediterranean diet. She even meditates regularly. What I love about her story is she wasn’t trying to lose weight. She was taking better care of herself. She looks great and really works up a sweat during her rehab workouts. She is a wonderful example of doing things the right way, not letting the scale dictate her every move. Great job “P”!! You rock!

Do you really know…zucchini?

This vegetable is probably the most prolific (and therefore gifted) garden vegetable. Its history is quite interesting. Zucchini is part of a group of summer squash that originated in Mexico and South America 7,000 years ago. The variety we grow and eat today was actually cultivated in Milan, Italy in the late 1800’s after New World explorers took it back to Europe. Who knew? Now you do. Zucchini is high in vitamin A, C and the minerals manganese and potassium. Try the recipe below for something different.

• VegetableFacts.net

Be calm and eat your dinner

I see many folks with digestive issues. These range from bacteria growing in the small intestine (where it doesn’t belong), to reflux, irritable and inflammatory bowel disease, and so on. If we don’t tolerate a particular food consistently, then wisely avoid that food. If tomatoes always give us heartburn, avoid tomatoes! What has been eye-opening for me, is that many people with digestive issues can tolerate a food on some days, but not tolerate the same food on other days. The food hasn’t changed, they have. So, what gives? From my experience, these folks tend to be tightly wound and/or are frequently stressed. Maybe all of us are pretty stressed these days, and this is just a coincidence, but I think not.

One branch of our central nervous system, the involuntary, or autonomic branch, is responsible for running things that are outside of conscious control. Digestion, maintaining our body heat, breathing, and other functions are the responsibility of this branch. It consists of two opposing sides. One side, the sympathetic nervous system, is activated when we perceive a threat, which could just be an anxious thought, or a real threat, like a fire. Our stress response, or the “fight or flight” response, kicks in. It is very powerful, and increases our odds for survival. In fact, specific nerves in the spinal cord are activated that dilate our pupils (so we can see the threat), increase our blood sugar (to give our running or fighting muscles more energy), and increase our blood pressure and breathing rate (so our muscles get more oxygen). The nerves that stimulate digestion (and rest) are completely different, and are activated when there is no threat, or “all is well”. The parasympathetic nervous system, responsible for the “rest and digest” response, manages our peristalsis, (the rhythmic contraction of our gut that moves food along), salivation, and secretions from our gall bladder and pancreas. All designed to digest a meal. If we are running for our lives, the rest and digest response is “offline”. This is why we often feel gut pain if we try to eat when stressed. Our digestion cannot fully function, because the opposing set of nerves is engaged.

Which brings me to how important it is to relax, especially if there is no real threat. Learning to meditate can help. If we are not in danger of dying, whatever is bothering us needs to be demoted to “not a real threat”. Amazon sending us the red widget instead of the blue widget is not a real threat. Calming ourselves regularly engages the “all is well/rest and digest” response. It really should be our default mode, not 24/7 stress. Our body’s healing and repair occur in this mode. Expressing gratitude or taking some deep breaths before a meal can calm us. If we experience gut pain when eating, notice how stressed we feel throughout the day, and especially when we eat. It could be the culprit.

The keto diet revisited

This diet is a high fat (75-80% of calories), moderate protein (15-20%), and low carbohydrate (5%) diet. It was originally designed in the 1920’s to manage drug-resistant epilepsy in children. Many who follow it love the fact they lose weight quickly. The pounds just seem to drop off while the dieter can eat unlimited amounts of palatable high-fat foods such as bacon, butter, steak and cheese. It eliminates the highly processed carbohydrate-rich foods, such as cookies and pastries, (a good thing), but also the healthy high-carbohydrate foods, like whole fruit, whole grains and dried beans. People are often not very hungry on this diet, and the variety of food is very limited, so meal planning becomes easier. They usually eat more vegetables, another good thing. Blood sugar can improve and many folks feel great on the diet.

But, and this is a big but, there are possible long-term negative health effects. I have seen multiple people in my office who have lost significant amounts of weight on this diet, but they are sick and tired of it. It is difficult to sustain. Diarrhea may be a problem, since our gallbladder releases bile when we eat fat. Bile has a laxative effect, and when our diet is very high in fat, diarrhea can occur. Constipation is also common, due to a low intake of dietary fiber (only found in plant foods, which contain carbs). Many lose lean muscle mass in their arms and legs. This is because our body does need some carbohydrate on a regular basis, and if we don’t obtain enough from food, it turns to our muscle tissue. This is a concern because these are the muscles that help us walk, lift things, and go about our day. Often, people who have had trouble losing weight on other diets are not bothered by this. They are finally losing weight! One can hardly blame them.

The American Heart Association, the American Cancer Society and other cancer groups do not endorse this diet. It contains foods that increase our risk of colon cancer and heart disease (processed meats, fatty meats, cheese, butter, coconut oil, desserts made with coconut oil, etc.), and omits many foods that are protective. It is not recommended for pregnant women. The fetus needs at least 175 grams of carbohydrate per day for proper development.

Our bodies run on both carbohydrate (glucose) and fat. A very low carbohydrate intake forces our body into the back-up mode for burning energy, in this case using ketone bodies, made by the liver from fat tissue. Our bodies use the same system during actual starvation. Carb binges can occur on this diet due to a substance building up in the brain, neuropeptide-Y, which tells our body we need more carbs. We gain weight afterwards as our body stores carbs in the form of glycogen, and glycogen is stored with water, in a 1:3 ratio. Water is very heavy, as we all know. We think the weight gain is from fat, which it’s not.

I analyzed a typical day of a person eating the keto diet. The calories were around the 1500-mark, which could help many lose weight, regardless of where the calories came from. What I noticed was that the meals came up short on many nutrients, such as thiamine, magnesium, manganese, vitamin A, vitamin C and dietary fiber. Of course, one could take a multivitamin/mineral and a fiber supplement to make up the difference, but these would not be from actual food.

We can also lose weight eating a healthy, balanced diet, such as the Mediterranean or DASH diets that include whole grains, dried beans, and whole fruit. It may take longer, but it is more sustainable. For a compromise, if you are on the keto diet, consider adding back small amounts of healthy carbs, such as steel cut oats, plain popcorn, black beans and lentils, along with whole fruit. The Recommended Dietary Allowance for carbohydrate is 130 grams a day, primarily for our brain to function optimally. ALL nutrients can be obtained from food if we are smart about it. I’ve seen it with my own diet. Try Cronometer’s website, or download the app, and see how your vitamins and minerals stack up on a typical day on the keto diet. You may be surprised.

• Helms. N. (2023, January 3). Ketogenic diet: what are the risks? University of Chicago Medicine blog.
• Taylor, MG. (2023, January 31). 11 typical keto side effects, according to experts. Prevention. 
• Nelson, M. (2018, September 17). Ketogenic diet and cancer treatment. American Institute for Cancer Research.
• American Heart Association News. (2023, April 27). Here’s how 10 popular diets scored for heart health. The American Heart Association blog. 

Comma-dy,,,,,,,

This bit has nothing to do with nutrition, but everything to do with communication and living a happy life. So, on to the topic… Most of us text. It is not my preferred form of communication. In fact, 93% of personal communication is NOT what is said (or texted), but body language, voice, tone and cadence. We miss facial expressions and the overall energy of the person. How we interpret these texts and emails depends on our mood, relationship with the person who sent it, assumptions and expectations. It gets complicated. Throw in poor punctuation, and voila! Hurt feelings and misunderstandings.

A title of a book I find quite funny is “Eats, Shoots and Leaves”, by Lynne Truss. Is this about an angry restaurant patron?? Removing the comma changes it to “Eats Shoots and Leaves”, and brings to mind a hungry panda. One comma completely changes the meaning of the sentence. Hence, her book about the importance of proper punctuation.

Case in point, I wanted to speak to someone on the phone, but was going to shower and then eat dinner. The text message back to me was “no choking”. Which I understood as, “don’t choke while eating”. I said I didn’t mind eating during my dinner, (they would likely do most of the talking). Their next reply was, “I’ll be fine”. I interpreted that as, “I really want to talk to you, but because you are going to shower and eat, we won’t talk, even though I really want to”. Again, I said it was ok to call, but they refused. Well. Come to find out THEY were actually choking, quite badly, and could not talk on the phone. They were peeved at my lack of concern, I was peeved at their refusal to talk on the phone. Lordy. One little comma, “no, choking”, would have cleared it all up. And yes, we are still speaking.

So, my friends, when we text (and email) people, let’s all be mindful of the punctuation and tone. Better yet, just call the person. I prefer phone calls, unless it is just a short message, or one of us is choking. Our relationships will be the better for it. For better electronic communication, visit this website:

• Why Is There So Much Miscommunication Via Email and Text? | Psychology Today.
• Koutoujian, M. (2023, May 23). Cultivating relational flow through the practice of being skills. [Webinar]. Wellcoaches.

Greek zucchini pie

This is my version of a recipe found at heart.org. It uses phyllo dough for the pastry, which is much easier to work with, and much lower in fat and calories than a traditional pie crust. After an 8-hour power outage I had to toss the first one. It was worth making a second time.

• 2 small-medium zucchinis, thinly sliced
• 5 green onions, trimmed and chopped
• 10 ounces of fresh baby spinach
• 2 cloves minced garlic
• 1 Tbsp. of canola or other oil
• Juice from ½ medium lemon
• 1/2 tsp. minced lemon zest
• 2 Tbsp. fresh oregano, minced, or 2 tsp. dried
• Freshly ground black pepper
• 1/8 tsp. ground nutmeg
• ¼ tsp. salt, optional
• 2 eggs
• 1 cup of nonfat evaporated milk
• 1.5 ounces crumbled feta cheese
• 6 sheets of thawed phyllo dough
• Cooking spray

1. Preheat the oven to 375 degrees.
2. Spray a pie pan with cooking spray. Set aside.
3. Heat the oil in a large non-stick skillet over medium heat. Sauté the green onions until soft, about 2-3 minutes. Add the zucchini and cook for 5 minutes. Add the spinach in batches, folding to incorporate until wilted. Add the oregano, lemon juice and zest, pepper, nutmeg and salt (if using). Stir to combine. Turn off the heat.
4. Lightly beat the eggs in a separate bowl and add the milk.
5. Layer the phyllo sheets in a crisscross pattern in the pie pan, letting the edges hang over the sides, pressing into the pie pan.
6. Add the vegetable mixture to the pie pan, pour in the egg mixture. Sprinkle with the feta. Fold up the phyllo sheets, leaving the center uncovered. Lightly spray the phyllo with cooking spray.
7. Bake for 30-35 minutes, or until the feta starts to lightly brown. Remove and let sit for 15 minutes. Serve warm.

This is best served fresh. The phyllo loses its crispness if refrigerated.

Enjoy!

Calories:

• 1/4 pie: 230
• 1/6 pie: 155

Next “Losing It & Loving It” weight loss class…

September 14-December 7

Thursdays, 6:00pm-7:00pm (first class 6:00pm-7:30pm)
Heart Center Conference Room
ORMC Medical Plaza, 425 E. 5350 S., Suite #200
Cost: $150

To register: OgdenRegional.com or call (866) 887-3999

Questions: Email
(801) 479-2133

August support groups

Mondays, 2:00pm-3:00pm

Heart Center Conference Room

ORMC Medical Plaza
Suite #200
Free to LILI graduates

“The single biggest problem in communication is the illusion it has taken place.”

George Bernard Shaw