Good afternoon, all! Tomorrow marks my first test of the spring semester in medical nutrition therapy. In the past, you all have expressed interest in reading about what I’m learning in my nutrition coursework (see the ABCs of Energy Needs and Multi-Tasker). So today I present you with a little lesson in Food & Drug Interactions.

When discussing interactions in the body, they can be classified into three general categories:

• Drugs with food
• Drugs with supplements
• Drugs with drugs

The focus of today’s discussion will be centered around interactions involving drugs and food.

Most drugs enter the cytochrome P450 pathway in order to be metabolized. There are hundreds of variations of how this metabolic pathway is precisely carried out, meaning that there is significant variation among individuals. For example, a certain food might cause a drug-related interaction in some people, while others do not have the same experience. Thus, it is difficult to predict how the foods listed below might affect someone taking the indicated medication.

1. Black tea demonstrates powerful inhibitory effects on the cP450 pathway. Single-ingredient teas (such as St. John’s wort or cat’s claw) have less of an impact on the enzymes in the pathway than blended varieties. Herbal teas also have an inhibitory effect—so if you’re taking a medication, perhaps you should think twice about chugging gallons of tea.

2. Broccoli, spinach, and kale are all rich in vitamin K, a nutrient best known for its ability to enhance blood clotting. For those taking a blood-thinner such as Coumadin, a high vitamin K intake may cancel out the drug’s effect, thereby putting them in a potentially life-threatening condition. Coumadin dosing can be adjusted to suit your vitamin K intake—so don’t use it as an excuse to skip eating those leafy greens!

3. Grapefruit juice contains a molecule called bergamottin that inactivates drug-metabolizing enzymes in the liver, which in turn may lead to a build-up of a drug in the bloodstream. The most common class of drugs for which grapefruit consumption is a concern is statins, but it might also affect certain blood pressure lowering drugs, anti-anxiety medications, and anti-malaria medications. (Side note: a new hybrid grapefruit has been developed that would circumvent this problem).

4. Licorice contains a compound called glycyrrhizin that may increase the risk of toxicity for Lanoxin, a medication used to treat congestive heart failure. However, it is worth noting that most licorice sold in the US in made with artificial flavoring; it is only natural licorice that contains the compound. So if you happen to have a wicked Twizzler habit and take Lanoxin, you don’t have to worry much about the interaction.

This is natural licorice. Check out my review of Panda Licorice from 2010.

5. Aged cheese, brewer’s yeast, chocolate, beer, avocado, red wine, fava beans, and fermented foods all contain a monoamine compound called tyramine. Monoamine oxidase inhibitors (used to treat depression) block monoamine oxidase, an enzyme that helps break down tyramine. Thus, if you eat high-tyramine foods, the substance can build up in the body and cause severe spikes in blood pressure.

And with that, I conclude today’s study session. Wish me luck…

Filed under: list, Study Session, Uncategorized | 4 Comments »

The 80-20 rule. Cheat meals. Dessert shots.

Aside from their common foundation in weight loss culture, all these things share something else: an emphasis on moderation. Indeed, one of the main tenets of healthy eating doctrine is that a healthy diet is a diet of neither deprivation nor indulgence.

Moderation in the diet can be achieved in any of several ways, such as portion control or limiting the frequency of treats. However, I prefer to use the “fifty-fifty” method in which I combine a food with its healthier alternative in equal proportions. What follows are a few examples of how I use the fifty-fifty method in my everyday cooking.

Sugar

If you’ve taken a stroll down the cereal aisle lately, you’re likely well aware of the overwhelming variety available these days. When selecting which box to toss in the cart, I primarily consider dietary fiber and sugar. It can be a tad difficult to find a high-fiber, low-sugar cereal…that doesn’t taste like cardboard. So I like to compromise by buying a box each of the sweetened and unsweetened versions of a cereal.

If I use 1/2 cup sweetened shredded wheat for every 1/2 cup unsweetened shredded wheat, I get a savings of 5.5 grams of sugar. This way, I can enjoy a hint of sweetness while still keeping the sugar content of my breakfast under control.

This trick also works well with Cheerios!

Try it:

Sodium

As odd as it may sound, one of my favorite beverages in the whole world is tomato juice. Any time I get ready for air travel, I excitedly await my in-flight snack of Bloody Mary Mix + peanuts. Although tomato juice does provide some valuable nutrients, it typically also contains significant amounts of sodium—think upwards of 700 mg sodium per cup. Accordingly, I’ve come to a compromise that pleases my taste-buds: I use 1 part low-sodium spicy V8 to 1 part regular V8. This little trick cuts the sodium content in half.

Try it:

*Note: V8 is often put on a BOGO sale at my grocery store, PLUS there is an abundance of coupons available for Campbell’s products, so buying two bottles at once can be quite affordable!

Calories and Fat

Remember Mission Mayonnaise? Clearly, it’s no easy task to find an affordable and chemical-free mayonnaise with a reasonable amount of Calories and fat. While I am perfectly content using Greek yogurt in place of mayonnaise most of the time, occasionally I still crave a little of that distinctive mayonnaise creaminess. Use a dab of the real thing and mix with Greek yogurt, and you’ve got a means of saving hundreds of Calories per recipe!

+

Try it:

 

Cholesterol

Most cholesterol recommendations suggest that individuals consume no more than 200-220 milligrams of cholesterol per day, and a single egg has 180-200 milligrams of cholesterol. There are some complexities to cholesterol metabolism, but if you have been diagnosed with high cholesterol, your doctor will likely tell you to limit your consumption of egg yolks. Some opt to cut out the yolks completely and consume only egg whites. However, as I’ve explained before, egg yolks contain quite an array of valuable nutrients. So my rule of thumb is two whites for every yolk. That way you get all those fat-soluble vitamins from the yolk as well as the high-quality protein from the whites.

Try it:

How do you practice moderation in your life?

Filed under: How To | 7 Comments »

Poor whole wheat pasta. It seems that every day someone comes up with a new excuse not to eat it:

“It tastes like cardboard!”

“It’s high in carbs!”

“It has gluten!”

Let’s address each of these accusations individually, shall we?

Years ago, when whole wheat pasta first became available, many brands did have an unmistakable tough texture. Indeed, you might as well have been eating the box in which the noodles were packaged. However, pasta-making technology has progressed such that the final product is much smoother and, well, less cardboard-like.

A standard serving of  whole wheat pasta (1 cup cooked) contains approximately 37 grams of carbohydrate. While that may seem like a lot, it’s important to remember that the carbohydrates present in whole wheat pasta are complex. Because whole grains contain all parts of the grain—the bran, germ, and starchy endosperm—they contain valuable fiber, vitamins, and minerals that their refined counterparts do not. Because of this difference in composition, whole grains have a very different effect on the body; they are digested more slowly and actually aid in the prevention of chronic disease.

Source

Just like any wheat product, whole wheat pasta does contain gluten. This fact is a problem only if you happen to have an allergy or sensitivity to gluten. As described above, whole wheat pasta provides a variety of nutritional benefits, so it is not recommended that individuals eliminate wheat products unless medically necessary.

So now that I’ve extolled the virtues of whole wheat pasta, let’s get onto actually eating it. For this week’s Pantry Makeover recipe, I present you with Whole Wheat Penne with Avocado-Edamame Pesto.

Whole Wheat Penne with Avocado-Edamame Pesto

Serves 2

Ingredients

• 4 oz dry whole wheat penne
• 1 medium avocado
• 1 handful fresh basil leaves
• 1 garlic clove minced
• juice of 1 large lime
• 1 cup shelled edamame, steamed
• salt to taste
• 1/2 cup grape or cherry tomatoes, halved

Method

1. Cook pasta according to package directions until pasta reaches an al dente texture.

2. Meanwhile, combine avocado, basil, garlic, lime juice, edamame, and salt in a food processor or blender. Blend until smooth. (Note: at this point, the pesto may be used as a dip rather than a sauce; it has a thick texture that makes it perfectly dippable).

3. Once pasta is cooked, drain and combine with pesto and tomatoes. It may be served hot or chilled.

Nutrition per 1/2 recipe: 388 Calories, 11.6g fat, 220mg sodium, 10.7g fiber, 17.3g protein

PS This recipe is Margot-approved.

Filed under: Recipe | 8 Comments »