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How To Eat Healthy At An Italian restaurant

8/31/2017

 
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Italian food is one of the most beloved foods across the world - and for good reason! It is based on using super fresh ingredients with plenty of olive oil and herbs.
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However, Italian food is also known for its heavy pasta and cream based dishes which are definitely not helpful for staying healthy and fit. As with any restaurant, it is all about making the right choices and choosing the dishes that will fuel your body and not work against you.


Here is how to order healthy at an Italian restaurant:


Appetizer

  • Minestrone soup - This soup is broth based with lots of vegetables, and tends to pack a ton of flavor with not a lot of calories. Soup is great to start with because the liquid will fill up space in your stomach, meaning less chance of overeating later.
  • Charcuterie - This is a mix of different meats which makes this a high protein and high fat appetizer and will make you feel satisfied and help to fill you up a bit before the main course.
  • Antipasto - This is a mix of meats, cheese, vegetables, and olive oil, and  is a great high protein and high fat starter.
  • Carpaccio - Another high protein, high fat appetizer, this consists of thin slices of raw fish with olive oil.
  • Roasted vegetables - Super fresh vegetables are a staple of Italian food, starting with vegetables will give you some fiber to fill you up a bit before the main course.
  • Caprese salad - This salad is traditionally composed of tomatoes, basil and mozzarella which is great high fat starter. Eating high fat to start will prevent you from overeating at the main dish. Note: If dairy tends to upset your stomach, you should probably skip the mozzarella because this type of cheese is typically harder to digest due to the higher lactose content.
  • Grilled calamari - Aka squid, calamari is a another great protein choice, just make sure to get grilled and not fried or crusted.


Pasta Main Course

Choose pasta only if you are if you are looking for a high carb meal, such as after heavy exercise or a carb-refeed day. Otherwise, pasta in general is not a good choice for your waist-line. 
  • Pasta primavera - This dish is made with lots of vegetables and the sauce is usually olive oil based with tomato.
  • Spaghetti with pesto - If you are really craving a fatty pasta with more of flavor profile than just plain olive oil, get it with pesto rather than cream. Pesto is made with basil, garlic, olive oil and pine nuts, and is much better for you than heavy cream based sauces such as with Alfredo.


Low Carb Main Course

  • Pollo alla Diavola - This is typically roasted chicken with vegetables, olive oil, and herbs -  can't get much healthier than that! Just ask to make sure it is not battered or crusted
  • Soup and salad - When in doubt, go for a soup and salad from the appetizer menu. The soup will fill you up along with the fiber from the salad. Add protein to the salad and use olive oil as the salad dressing - most Italian restaurants should have great olive oil.
  • Fish - There will likely be salmon or Branzino on the menu, any grilled or baked fish with a side of vegetables is a perfect order. 


Drink

  • Red wine - Go for dry red wine (dry means low in sugar) such as Pinot Noir, Cabernet Sauvignon, and Merlot.
  • Dry white wine - This is great with light meals such as salad or fish. Order a dry white wine such as Sauvignon Blanc .
  • ​Scotch or whiskey on the rocks - If you are not a wine drinker, go for one of these which tend to pair well with heavier meals and will be low in calories when served on the rocks or water.


About the author: Sarah-Kate Rems is an Ivy-league trained Board-Certified Family Nurse Practitioner licensed in California and New York State with an expertise in preventative healthcare. She considers nutrition and exercise to be the basis of well-being and is a strong advocate for daily physical activity and maintaining a healthy diet. Sarah-Kate is also a co-founder of The Mindful Tech Lab


What To Order At The Mexican Restaurant

7/27/2017

 
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I get questions from patients all the time about how to eat at a restaurant without derailing their diet. Of course cooking your own food is best because you can control everything that goes into it (not to mention you save a lot of money!) but when you want to be social and go to dinner that’s ok too!

​Here is what you should order when eating at a Mexican restaurant:


Appetizer:
  • Guacamole - Carve out 2-3 spoon fulls onto your plate and dig in or add some salsa on top. Guacamole is full of healthy fats with zero carbs and will keep you much better satisfied than a basket of chips.
  • Ceviche - This consists of raw fish (normally sushi grade) in citrus with maybe some diced tomatoes - you can’t get much healthier than that! This is a light, tasty, and low carb way to start your meal.

Main Course:
  • Fajitas - With lots of grilled vegetables, pico de gallo, and salsa as a topping to add flavor. Skip the rice and tortillas and see if they can substitute in extra veggies instead. If you are going to keep the beans go for black beans rather than refried because they have gone through less processing and contain more fiber. If you are low carb, skip the beans and ask for a side of avocado or guacamole instead.
  • Grilled chicken - With lots of vegetables. Skip the rice here as well, instead add add a side of avocado or black beans.
  • Grilled fish - With lots of vegetables. Skip the rice here as well. Top with salsa or consider adding a side of avocado or black beans.

​Drink:
  • Tequila on the rocks - A shot of tequila has around 70 calories and will take a longer time to sip.
  • Skinny margarita - Tequila w/ soda and lime is great because you get the bubbles from the soda water and a hint of lime to pair with the tequila. This will also be easier to sip rather than a sugar bomb of a margarita - a margarita can have a whole days worth of sugar and calories! 
  • Light beer - If you can’t see yourself not ordering a Mexican beer with your Mexican food, then go for a light version such as corona light.

Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

IN With the Fat, OUT With the Carbs for a Healthy Heart

7/7/2017

 
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Obesity, diabetes, and heart disease have skyrocketed and continue to increase since the government’s recommendation for low-fat diet for a healthy heart starting in the 1970s. When we take a closer look at the evidence connecting saturated fat and heart disease, the evidence presented is pretty weak, and more and more evidence is mounting and getting recognition against the long term belief that saturated fat intake leads to cardiovascular disease and death.
 
The low-fat mantra all started in the 1950s with a scientist named Ancel Keys. He performed a couple of highly flawed studies where he "cherry-picked" data to show that saturuated fat intake caused heart disease. The government and food industry locked onto this idea, despite data and numerous studies that have flooded in to debunk this theory. I highly recommend the books Eat Fat Get Thin by Mark Hyman, MD, and  Why We Get Fat by Gary Taubes, for more information and citations of this.

Here are 5 reasons that saturated fats are not going to increase your risk for heart disease or death:
 
1. Low-fat diets are NOT effective at preventing heart disease
No study has been able to prove that a low fat diet will decrease risk of cardiovascular mortality. Plenty of studies show that saturated fat can increase total cholesterol, and then make the simplified conclusion that saturated fats lead to heart disease. But this is highly misleading because yes, saturated fat will increase total cholesterol because it increases HDL cholesterol (good cholesterol), as well as the good type of LDL cholesterol (more on this below); however,  no study can show a direct link between saturated fat intake and cardiovascular related death. Again, there are more studies then I could ever reference, but here are a couple good ones:

In 2010, an analysis of 21 quality studies that looked at roughly 350,000 individuals up to a 21 year period found no risk of saturated fat intake with cardiovascular disease or stroke 
 
And lastly, one of the largest and most expensive and long term clinical trials called the Women’s Health Inititiative(WHI) was meant to show the benefit of a low-fat diet for lowering cholesterol and heart disease. After eight yearsof this study, the women on low-fat diet had lowered their total and LDL cholesterol, however, there was no beneficial effect on heart disease, stroke, or cancer found from eating a low fat diet.
 
2. Fat increases your HDL cholesterol (good cholesterol) 
Low HDL cholesterol has been found to be a far greater risk factor of having a heart attack than a high LDL cholesterol . When you replace fat in your diet (including saturated fat), with carbohydrate, this lowers your HDL cholesterol. A study by The New England Journal of Medicine explains that a low HDL cholesterol is a “biomarker for dietary carbohydrate.” Saturated fats have been shown to increase your HDL cholesterol (good cholesterol), and to have either no effect on your triglyceride cholesterol or to reduce this (another type of bad cholesterol). 

In practice, when I get a patient's labs back and I see a low HDL cholesterol level with high triglycerides, this is an indicator to me that this individual is eating a high carb, low fat diet. 
 
3. Fat increases large LDL particles (good type) and decrease small LDL particles (bad type)
Yes, to make things more confusing there are different types of LDL, large "fluffy" type (think cotton balls), small dense type (think rocks), and many other sizes in between. We want more of the large LDL particles to small dense LDL particles because the small dense LDL particles are much easier to lodge themselves into the walls of your arteries causing your arteries to narrow which leads to decreased blood flow (ie oxygen to your heart). These small dense LDL particles also are known to oxidize which leads to rancidity and inflammation in the blood vessels. Saturated fats will increase large LDL and decrease small LDL which in effect will cut your risk of heart disease. 
 
4. Replacing saturated fats with carbohydrates increases bad cholesterol
This is more of a summary of the above, but I want to reiterate that replacing saturated fats for carbohydrates makes your cholesterol profile much worse. Carbohydrates have been shown to decrease your good HDL cholesterol while increasing small particle LDL bad cholesterol, as well as inceasing your triglyceride cholesterol. As mentioned above, heart disease is most associated with a low HDL cholesterol and high triglyceride cholesterol. LDL is a little harder to predict with heart disease because of the varying sizes and conflicting evidence. 
 
5. Prevents "Diabesity"
Cutting back on fat almost enevitably means you are going to add carbohydrates to your diet, and high  carbohydrate intake is what leads to diabetes as well as obesity - this is something that is not disputed. Obesity is a risk factor in itself for heart disease, as is diabetes, put these two major risk factos together and you are talking about a massive increase in your chance of cardiovascular disease (think heart attack).  
 
Just as guidelines have changed in terms of cholesterol containing foods (in case you didn’t know, cholesterol containing foods do not raise bad cholesterol and this has finally been recognized by the American Heart Association (AHA) and the United States Department of Agriculture (USDA)) I have a hunch that there will be new guidelines for saturated fats in the near future. 

​Be sure to increase your intake of good saturated fats such as organic eggs, organic grass-fed beef, coconut oil, and dark chocolate.

​Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

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