Category Archives: Registered Dietitians

Don’t Forget About Walnuts!

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I can’t seems to get enough of one of my favorite winter foods: Walnut Stuffed Figs. It’s a Portuguese favorite my mother used to make when I was a little girl.
Here’s the recipe:
Take a dried, but not too dry, fig (Kadota or Calimyrna, I guess.) Cut the fig in half and press as many walnuts as you can into each half. Put the fig sandwich together and mash it down with the heel of your hand. Roll it sugar (this part is unnecessary unless you have a sweet tooth like me but, rest assured, no more than ¼ teaspoon of sugar sticks to each fig) and eat. How simple is that?

I’ve been eating two Walnut Stuffed Figs with a Greek yogurt for breakfast, or lunch, or whatchamacallit. (I’m not the structured type.)  At 110 calories each, they’re quite filling and mad nutritious, full of calcium, copper, potassium, manganese, iron, selenium and zinc, niacin, pyridoxine, folate, and pantothenic acid, as well as alpha-linolenic acid (an omega-3), anti-oxidants, and nutrition pigments. (You can skip your supplement for the day.)  Walnut stuffed figs may be wrapped in bacon or topped with Gorgonzola cheese, which is not for everyday, but here are the recipes:

Remember Walnuts!

Full disclosure: the California Walnut Commission has wined and dined me a few times this year. Those guys know how to host a classy event!  It’s hard to believe that walnuts need a promo because who could have a problem with walnuts? But I guess people forget about them and they don’t know how nutritious walnuts are. That’s too bad because walnuts have anti-inflammatory properties that protect against heart disease and diabetes, and they maintain sperm quality, with fewer chromosomal abnormalities, in older men. (I mention this because I know a lot of late 20- and early 30-somethings who are delaying childbearing and, so, guys, take it from me, keep eating walnuts.) Dr. Wendie Robbins, from the UCLA School of Public Health, presented her walnuts-fertility research in Philadelphia at a FNCE dinner hosted by California Walnuts held at Supper, the wonderful ‘New American’ restaurant. Nom nom nom, walnuts with every course.

You must visit the California Walnuts Commission’s recipe page for inspiration. I recommend these two recipes only because I’ve made them and they are seasonal:

Random walnut fact: Do you know the name of the “classic walnut,” the principal variety marketed inshell? It’s the Hartley Walnut, the only variety that can stand vertically!

Your thoughts: How do you eat walnuts? Got a walnut recipe to share?

Whoa! That’s a Lot of Brands

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The dietitian’s Food & Nutrition Conference & Expo last week overwhelmed me. Between them, FitBloggin, the Editor’s Cooking & Entertaining Showcase, and other food events in Manhattan, I am up to my neck in swag, branded promotional gifts. I have seen around 500 vendors in 17 days. Did I say I am overwhelmed?  Some products are fantastic (hello, Tupperware~) and others are unexpectedly cool (more about them later) but, overall, none was necessary. But someone, somewhere, has some job.

All in all, the food industry is about developing niche products out of something we already have. Take salt, for instance, simple and necessary. A biblical food. At one end, I met Real Salt, very nice people selling salt harvested from an ancient sea bed unrefined with 60 trace minerals. At the other end is Soda-Lo, also very nice people, who use nanotechnology to recrystalize salt into microscopic hollow crystals that are meant to reduce the salt in processed foods. Both brands (and others) claim to deliver an intense salty taste immediately and so, we need less to register a salty taste. Both companies seem to be telling the truth, as is my man, Alton Brown, who explains the taste of salt.

None of this matters to a body that can utilize salt in any form, from any source, and excrete the excess (when we are in good health.)  As for the teeny bit of 60 trace minerals? I get them in my wholesome food and vitamin-mineral supplement. And the nano-salt? I don’t eat much processed food and I guess nanos are okay….

I have to say that too many brands in too few days messed up my chi, but I am breathing in to restore peace. In the end, the experience left me seriously craving cabbage.

This is My Pledge to you: I will never write about a product unless I truly love it and I actually use it. And if I am paid to write to endorse anything, I will disclose it, and you may never know how I really feel. Full disclosure: No one paid me to mention cabbage.

Your thoughts:  What do you think about having so many brands on the market?

An Over-Extended Family’s Dream

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That would be a visit from me. :)

Meet the Sharkey family, a working couple with two small children. I helped them to make over their family diet. They were in “damage control” mode and they couldn’t see the forest from the trees. I teased out the issues and then recommended small, simple, specific changes that added up to something significant. Now, they are practicing forever. (Join the club.)

You can read about the Sharkey family intervention, “Hectic to Wholesome,” in Consumer Reports Food & Fitness, a magazine devoted to family health. See my lifestyle suggestions, product recommendations, and “kid friendly” recipes.

Want to schedule an appointment with me? Read about my services.

Your thoughts: Can you relate to the Sharkey family?

My Mondays Are Meatless

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Here it is the second Monday after the commotion started when a USDA headquarters interoffice newsletter encouraged employees to choose meatless meals on Mondays in the company cafeteria.

“Meatless Monday” is a worldwide public health campaign to go meatless for health one day a week. A New York City ad man from Don Draper days working with Johns Hopkins Bloomberg School of Public Health and other big-league players started the crusade. (It shows the power of working across silos.) The USDA newsletter article was not an official position, but it offended the National Cattleman’s Beef Association and a few Republican senators, and so the USDA retracted the statement, removed the newsletter, and apologized to the beef industry. The Meatless Monday folks were not directly involved, but free publicity is good.

It’s All About the Cooking 

Volumes of research show the vegetarian diet is much healthier than a diet full of meat. Not that I’m against meat, a little is nice, but I learned how to be a vegetarian back in my hippie days, and so beans, grains, nuts and seeds, tons of vegetables, and eggs and cheese are simply my staple ingredients. Being a vegetarian is not about “Choose My Plate” with segmented meals, meat-and-potatoes style. Vegetarians tend to eat mixed dishes where grains, beans and cheese become a full meal salad or dish for the first time around and for leftovers.

A recent survey showed that 28% of Americans don’t know how to cook. (I wonder what the others call “cooking.”) Since that 28% is just starting out, they should learn how to cook vegetarian-style. I can attest to the long range health benefits. Here are three meatless recipes that I am cooking this week: Mary’s Wild Rice Salad (bring it to a party); Skillet Gnocchi with Chard & White Beans (impossible to stop eating); Mollie Katzen’s Moosewood Cookbook Zucchini Feta Pancakes (a summer classic). In August, I try to serve every dish with tomatoes and sweet corn on the side.

Your thoughts: Were you aware of Meatless Mondays? Do you take part?

How Sugar-free Peeps Saved the Day

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Aunt Jean: “You have to call your Aunt Pauline. They told her to eat white bread. What’s going on? She doesn’t know what to eat. ”

Mary: “Her kidneys are failing and so she can’t have much potassium. Brown breads have a little more potassium. I’ll visit.”

You would think we dietitians always preach the conventional paradigm of healthy eating, but that is not the case. When the body’s major organ systems fail, we modify our advice.  For example, my Aunt Pauline’s kidneys are on the fritz. She can’t remove excess potassium, so the level builds up. Too much can cause an irregular heartbeat and even sudden death. And so, Aunt Pauline was prescribed a low potassium diet, also low in sodium for swelling, without excessive protein for the kidneys again, with her blood glucose levels in mind for diabetes, well controlled on pills.

Aunt Pauline had two low-potassium diet sheets listing what to and what not to eat. Both sheets were a little different and, on my laptop, another sheet from the National Kidney Foundation was a little different still. The lists agreed upon the very high and very low potassium foods, but the middle range was questionable. Cooked cabbage? Maybe yes, maybe no. The same was true for whole wheat bread. Believe me, I know what it’s like to make those lists. The results depend on the makeup of the committee and the time of day.

For breakfast, according to the lists, Pauline could choose oatmeal, puffed rice, a bagel, or white toast. Oatmeal is fine, but every day? What about other cereals? The paper didn’t say. That’s when we had to look at the real numbers and make decisions case-by-case. The rule: be wary of foods with more than 250 mg of potassium per serving. Puffed rice, 6 mg of potassium, 1 mg of sodium (“too bland”); raisin bran, 357 mg of potassium (not an option); yada-yada, try this and that, and then bingo! Rice Krispies, 30 mg of potassium, 190 mg of sodium. That will do. And food-by-food, we went down the list. How much, how often, what’s it worth to you? It’s the only way to get buy-in to the diet therapy.

And, to keep life sweet, we make room for indulgences, also a personal thing.
Mary: “Check it out: Marshmallows have zero potassium and 6 mg of sodium; I’ve seen sugar-free marshmallows made with sugar alcohols. You could make Rice Krispies Treats.”
Aunt Pauline: “Really? I would like that…But what I’d really like is Peeps.”
Mary: “I’ve seen sugar-free Peeps made with sugar alcohols. You can have those too.”
Aunt Pauline: “This diet isn’t so bad after all.”

Sugar-free Peeps save the day, junk food that they are.

Your thoughts: Do you know someone who is confused by his/her medical diet?

Vitamin D3 and Me

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I finally found a vitamin D3 supplement that I am willing to take for my presumed deficiency. I say presumed because I haven’t actually had my 25-Hydroxyvitamin D serum levels tested. I’m skipping that step because the values haven’t been standardized and, besides, I’d have to self-pay.

But, why wouldn’t I have low vitamin D levels? The most recent National Health and Nutrition Examination Survey (NHANES) estimated that 25% to 57% of adults have insufficient levels of vitamin D. Other studies set the number as high as 70% for some segments of the population.

Vitamin D is made when the sun’s ultraviolet B (UVB) rays hit the skin. There are many reasons why I wouldn’t get enough. I work indoors (UVB rays don’t penetrate glass), live in the northern latitude, often wear sunscreen, and I’m getting older. Those factors push me towards the brittle bones that are conclusively related to a lack of vitamin D. Less conclusive are the links to cancers, heart disease, autoimmune conditions, and, it seems, to whatever else ails you including colds and flu and forgetfulness.

The RDA for vitamin D is set at 600 International Units (IUs) per day from food. That amount meets the needs of 98% of healthy people. But Americans don’t eat nearly enough vitamin D. According to NHANES, average intake is 204 to 288 IU/day for males, and for females, the range is 144 to 276 IU/day. Vitamin D is found in only a few foods: oily fish and cod liver oil are the most important sources, followed by egg yolks, liver, and mushrooms. And while 3-ounces of cooked salmon supplies 477 IUs, one egg has only 40. Milk has been fortified with vitamin D since the 1930s, but 16 ounces supplies a little more than half of the RDA. Some brands of orange juice, yogurt, cheese, margarine, and breakfast cereals are also fortified. Scroll down to see the vitamin D content of selected foods.

I’m Covered

I thought I should take some vitamin D, but I couldn’t stomach another pill. I take a multivitamin, a prescription med, two fish oil capsules, a curcumin capsule, and a calcium tablet sometimes. But then the folks from Nature Made invited me to look at a few of their products, and I accepted the offer because they are big on scientific research and purity, and because we met at 250 Greenwich Street, the new World Trade Center Tower 7. I’m a sucker for a skyscraper with a fantastic view.

Nature Made’s vitamin D3 (the active form) comes in a grape-flavored chewable tablet that tastes like a sweet tart. Each tablet supplies 1,000 IUs, the daily amount commonly advised. The leading vitamin D scholar, Dr. Michael Holick, recommends taking up to 2,000 IU per day (4,000 IUs is the Tolerable Upper Limit.)  And so now, if I get about 250 IUs from milk, 500 IUs in my multivitamin, and 1,000 IUs in one sweet-tart. I am covered.

 Your thoughts: How do you manage to get enough vitamin D?

Talking About Oxtails in Brooklyn

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I recently went to the new restaurant, Bar Corvo, on Washington Avenue in Brooklyn. It got fantastic reviews even before it opened – and it is 200 feet from my apartment. Sweet. I went with my lifelong friend, pediatric dietitian Barbara Robinson. (Readers of my blog might remember when we traveled on the BQE back from Rhode Island to New York.)

Everything was perfect at Bar Corvo. We had the Lentil Soup, Warm Farro Salad (with roasted cauliflower, Brussels sprouts, goat cheese, red onion, hazelnuts, and warm sherry vinaigrette), Focaccia, and Trebiano D’Abruzzo wine. It didn’t seem like much food for two people, but we couldn’t finish it all. I can still conjure up the aromas and flavors. A lasting experience is all I ask from a restaurant.

Barbara and I were both surprised by the relatively large number of unusual foods on the menu. Besides lentils and farro, there were dandelion greens, fava bean puree, oxtail ragu’, octopus confit, and roast Amish chickens (wearing little bonnets singing, ’tis the gift to be simple) to pleasure the palates of the foodies on the Brooklyn culinary scene.

Barbara:  “What exactly is an oxtail?”
Mary:  “I guess it’s the tail of an ox.”

That’s a pretty lame conversation for two veteran dietitians, and so I Goggled oxtails; here’s the poop: ox tails are actually tails – bony and muscular – from cows (there are no oxen left around here.) Oxtails are among  the offals, the internal parts of an animal – the heart, liver, tongue, tripe, brain, kidneys, etc. – that are edible, but not commonly eaten in America today. They are traditionally braised gently and slowly to made an intensely-flavored gelatinous stew. The stew is served in Roman trattorias (like Bar Corvo) and in Jamaican and African restaurants. A few doors down at The Islands, a Caribbean restaurant, the oxtail stew is a very popular dish. In fact, New York City seems to be crazy about oxtails. There are 402 comments at Yelp, New York, Oxtail Soup! I guess it’s only a matter of time before I try them.  I’ll be sure to report back.

Your thoughts: Have you eaten oxtails? Would you?

My Intuitive Eating “Aha” Moment

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On LinkedIn, I am a member of the Intuitive Eating Professionals Group, where Evelyn Tribole, MS, RD, group founder, asks us to “share something…that is not included in your profile, perhaps an “aha” moment in your career.”  I am inspired to share my “aha” moment after attending the BEDA (Binge Eating Disorder Association) national conference on Saturday, where I learned that, treatment-wise, not much has changed over the years.

In 1985, I worked in a large gastroenterology practice affiliated with a teaching hospital. I saw lots of eating disordered patients because one of the docs did medical evaluations of patients with bulimia and AN. At the same time, another gastroenterologist performed a procedure with a device called the Garren-Edwards Gastric Bubble. A deflated ‘bubble’ made of stretchable plastic (like a pool toy) was placed by endoscopy in the stomach of a severely overweight patient.  With the pull of a cannula, the bubble was inflated and left in place to fill the stomach while the patient followed a low-calorie diet. That’s where I came in. The bubble was developed by a team at Johns Hopkins. It was all above the board. The hospital asked us to do the procedure, but we stopped after a patient got a small bowel obstruction from the bubble. Those were interesting days. My patients’ eating patterns were all over the map.

But my “aha’ moment came by way of a patient referred by an internist for a simple weight loss diet.  She was a favorite patient, a young woman of my age, overweight but far from obese, with my mother’s maiden name. We were doing the balanced, flexible diet thing with a focus on behaviors when one day, she looked at me and said, “Mary, you don’t understand. I peek behind the curtain, and when my husband drives away, I make a batch of scalloped potatoes, and I eat the whole thing.” Aha! I thought, “they didn’t teach us this in school.” And then I thought, “this is really real.”

I was lucky because psychologists who specialized in EDs would stop into  the office. They turned me on to Susie Orbach, Fat Is a Feminist Issue (1978); Geneen Roth, Feeding the Hungry Heart (1982) and Breaking Free from Compulsive Eating (1986) and, of course, Hilde Bruch. Evelyn’s book, Intuitive Eating (1995), wasn’t published yet and there was no Gurze catalogue. But, I read and read and saw lots of patients, and attended Geneen’s workshops,  consulted with therapists, and taught others how to do it. And now it’s wonderful to see so many dietitians espouse the non-diet approach. But, after all those years, the pills, shakes, meals, stomach stapling (but not swallowing pool toys) are all still here.

Your thoughts: Why don’t more people give up dieting and follow a non-diet approach?

When ‘My Plate’ is a Bowl

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Today is the first of March and the start of National Nutrition Month. That’s when my professional association, The Academy of Nutrition and Dietetics (formerly the American Dietetic Association), turns up the volume on eating healthy. This year, their theme is “Get Your Plate in Shape” in keeping with “Choose My Plate,” Michelle Obama’s USDA campaign.

And so, Diets in Review asked several of us nutrition and fitness professionals to share a picture and some words about our own plates. Read their article today, Mary Hartley’s Plate for National Nutrition Month. I kick off the month-long series.

Now, I’ve explained that I don’t take pictures of my food. Like tattoos, it’s a generational thing. And my only camera is the one in my iPhone, which is not the best. And then, wouldn’t you know it, Michelle Obama forgive me, but my typical plate is a bowl. In the article, I deconstruct the contents and reassemble them, so to speak, back onto a plate, and say more about the nutritional content. Read it and see.

The My Plate campaign is made to guide eaters of the “Standard American Diet” –  a supper of meat/chicken, with a starch and a vegetable on the side.  I almost never eat like that. When I was a young adult and learning how to cook, I was a vegetarian and those habits stuck. I love to say, in all my years, I have never cooked a steak. Not that I don’t eat steak because I do every few years, but an 8-ounce petite filet lasts me for three yummy meals. I’m just a happy Flexitarian. And my dietitian friends are mostly Flexitarian too, and they are mostly slim and healthy and free of pills.

Here are the recipes for Gypsy Soup and Cheesy Cornbread. The soup is very healthy (thank you Mollie Katzen and the Moosewood Cookbook) and the second is not quite as, but both taste out of this world.  Enjoy!

Your thoughts: What do you think of this year’s National Nutrition Month message?

Dr. Oz + Raspberry Ketones = TV Hype

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Gee whiz, I just dissed Dr. Oz as TV hype in an article today, Dr. Oz’s Raspberry Ketones Dismissed by Dietitian as TV Hype. (I’m the dietitian.) It’s an opinion piece for Diets In Review about a product Dr. Oz endorsed, raspberry ketones, a ‘fat blaster you’ve never heard of.’  I called Dr. Oz more showman than doctor. Read my article and see if you agree. But, hey, he’s in the medical info-tainment field. ‘Nuf said.

Show Time

In 2009 when Dr. Oz was first on the air, I went to a show. In New York City, the studio was close to where I worked in the windowless office, and I just had to get away.  On that show, he talked about zinc deficiency, a problem that most Americans do not have. That’s when I saw that Dr. Oz (or rather, his staff) liked food-and-nutrition games. The segment was presented as a game in which three audience members each picked a box, small, medium or large, that contained a high-zinc food and, in one, a special gift. In the small box, the contestant found beef liver with 4.45 mg of zinc in a 3-ounce serving (adults need 8-11 mg of zinc/day), and in the medium box, was 1 cup of sauerkraut, with only 0.27 mg of zinc. (What’s up with that?)  But in the large box, there was a huge pile of king crab with 6.48 mg per 3-ounce serving – along with a cruise to Alaska. The first two contestants had doubly bad luck because Dr. Oz made them eat their selections. Incidentally, oysters have the most zinc with 76.3 mg per 3-ounce serving.

Three years later, Dr. Oz is still playing games. In the segment reviewed, Revolutionary Metabolism Boosters that Blast Fat, ‘fat’ contestants ‘blast’ through a paper curtain to introduce a new product that may or may not work. That’s how info-tainment happens here in New York City.  Perhaps if I’m outrageous enough, I can get on the show.

Your thoughts: What do you think of Dr.Oz and raspberry ketones?