Planet-friendly, plant-based home cooking

Originally Posted Here: https://www.health.harvard.edu/blog/planet-friendly-plant-based-home-cooking-2019021215990

With all the news about the health and environmental advantages of eating less meat, many people are trying to eat more plant-based meals. But where do you begin?

Instead of trying to cook an entire vegetarian meal from scratch, start with one small step and build from there, says Dr. Rani Polak, founding director of the Culinary Healthcare Education Fundamentals (CHEF) coaching program at Harvard’s Institute of Lifestyle Medicine. “For example, buy some canned beans. You can then make a simple bean salad with a little olive oil and lemon juice. Or if you have a favorite recipe for beef stew, try swapping in beans for some of the meat,” he says.

A trained chef, Dr. Polak is committed to encouraging people to cook at home rather than relying on restaurant or processed food. “With home-cooked meals, people tend to eat smaller portions, fewer calories, and less fat, salt, and sugar,” he says. And people who eat more home-cooked meals tend to weigh less and have healthier cholesterol and blood sugar values compared with people who eat out frequently. Following are Dr. Polak’s suggestions for buying and preparing the building blocks of a plant-based diet: legumes, whole grains, and vegetables.

Legumes

Botanically speaking, legumes are the edible seeds from pods you can split in half. Familiar examples include the wide array of beans — black, fava, garbanzo, kidney, and pinto, to name just a few. Lentils, peas, and peanuts are also legumes.

Nutrition-wise, legumes are hard to beat. They’re a good source of protein, starch, fiber, and other nutrients, including iron, zinc, and folate. They don’t contain any unhealthy saturated fat. Plus, they’re inexpensive and widely available, they can be stored for long periods, and they are easy to prepare.

If you use canned beans, choose salt-free versions when possible, or rinse them before using, which can remove about a third of the added sodium. Cooking dried beans is simple. Just soak several cups of beans in cold water overnight. The next day, drain, cover with water, and boil until tender. Do this once or twice a week to have a convenient source of plant-based protein around which you can build a meal. “If you come home at 6 p.m., tired from a busy day, it’s good to have a ready-to-use source of protein such as beans available,” says Dr. Polak.

Whole grains

Whole grains are seeds or kernels that contain key nutrients such as protein, B vitamins, antioxidants, minerals, and unsaturated fats. All whole grains — such as barley, rye, and wheat — are also excellent sources of fiber, which helps lower cholesterol and control blood sugar. Some popular examples you’re likely to find in supermarkets include cracked wheat (bulgur), brown rice, and steel-cut oats or oatmeal. Some stores also sell more exotic whole grains, such as amaranth, farro, and millet.

As with legumes, whole grains are easy to cook, especially bulgur, another of Dr. Polak’s favorites. Just add equal parts boiling water and medium-coarse bulgur to a bowl, stir, and cover with a plate for five minutes. For brown rice and other grains that take longer to cook, use the batch cooking method.

Vegetables

Few Americans eat the recommended 2 to 2 1/2 cups of vegetables per day. The reasons for that shortfall likely vary, but shopping-related issues are often to blame. Even if you pick up plenty of produce at the store, sometimes it spoils before you get around to using it. Try these tips:

If you shop weekly, use tender produce such as salad greens and spinach early in the week; save harder vegetables such as broccoli and carrots for later. Buy frozen vegetables, which are just as nutritious as fresh. Choose pre-cut vegetables, such as butternut squash, to save time and effort. Putting it all together

Dr. Polak’s simple formula for a filling, nutrient-packed main dish is to combine a legume, a cooked whole grain, and chopped vegetables, which can be raw, steamed, sautéed, or roasted. There are endless variations, including warm or cold versions, to which you can also add dried or fresh fruit, spices, and fresh herbs. For recipe ideas, see the American College of Preventive Medicine’s recipes and instructional videos.

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Integrative approaches to reduce IBS symptoms

Originally Posted Here: https://www.health.harvard.edu/blog/integrative-approaches-to-reduce-ibs-symptoms-2019021115918

Irritable bowel syndrome (IBS), a gastrointestinal condition that involves abdominal pain and altered bowel habits (constipation, diarrhea, or both), affects over 10% of Americans. Though some find the condition merely a nuisance, for many individuals it can be quite bothersome and disruptive. While medications can sometimes offer relief, some individuals do not respond to medications or find the side effects intolerable. Fortunately, there are several well-studied, nondrug, integrative approaches that can help to reduce IBS-related symptoms and restore a sense of control over one’s life.

Stress reduction

IBS is well known to be aggravated by stress. Moreover, the symptoms and the disruption they cause can themselves become a source of stress, creating a vicious cycle of stress and discomfort. How does stress affect the gastrointestinal system? It turns out that the largest concentration of neurons outside of the brain and spinal cord is in the gastrointestinal tract, making it particularly susceptible to stress and creating a strong brain-gut connection. Stress hormones can alter movement through the gastrointestinal tract (speeding it up or slowing it down) and cause the muscles in the intestines to spasm and cause pain. Thus, for people who experience a lot of stress in their lives, learning stress-reduction techniques can be instrumental in reducing the frequency and severity of IBS-related symptoms.

Several clinical trials have demonstrated that two stress-reduction techniques — meditation and mindfulness-based interventions — can significantly reduce abdominal pain and improve bowel habits. To be most effective, these tools should be practiced daily, as over time they retrain the nervous system and reduce the amount of time that it operates in the stress (fight-or-flight) response. It’s important to remember that meditation and similar techniques are learned skills that take time and practice to build, so you are unlikely to notice an immediate improvement in IBS-related symptoms after the first or second try. There are many meditation apps, internet tutorials, and even evidence-based courses offered through major hospitals that offer opportunities to learn these invaluable skills.

Other stress-reducing approaches have also shown benefit for IBS-related symptoms. These include gut-directed hypnotherapy (a popular protocol in Europe), cognitive behavioral therapy, and possibly yoga.

Special diets

Studies have shown that foods high in FODMAPs (dietary sugars known as fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) can exacerbate IBS-related symptoms by providing fuel for certain bacteria in the gastrointestinal system. The byproducts from these bacteria can cause pain and bloating. On the other hand, low-FODMAP diets can reduce the abdominal pain, bloating, diarrhea, and constipation associated with IBS. Although safe to follow for short-term use, there are no long-term studies of this diet, and sustaining this eating pattern can be challenging.

For some patients with diarrhea-predominant IBS, reducing intake of gluten, a protein found in wheat, rye, and barley, can help. This may be the case even if you do not have celiac disease, as gluten can modify the barrier function of the gut lining.

Supplements

For individuals with constipation-predominant IBS, a soluble fiber supplement (Metamucil or others containing psyllium) can be helpful. Large amounts of fiber can hinder the absorption of medications, so take your medications one to two hours before the fiber supplement. Soluble fiber is also found in foods such as beans, avocados, oats, and dried prunes. Be sure to consume plenty of water with fiber to avoid worsening the constipation.

A recent analysis of nearly 1,800 patients from multiple studies demonstrated that probiotics reduce pain and symptom severity in IBS compared to placebo. Probiotics are “good” bacteria touted to help maintain digestive health. However, given the variety of different probiotics that have been studied, it is difficult to know exactly which ones are most useful or how much to take.

Finally, peppermint oil is well known for its ability to relax the smooth muscles of the gastrointestinal system, and can help reduce the abdominal pain associated with IBS. To reduce the potential for heartburn, enteric-coated capsules (typically containing 0.2 milliliters or 181 milligrams of peppermint oil) are recommended. The dose for adults is one to two capsules up to three times per day.

Mind-body tools, a low-FODMAP diet, and some supplements can help relieve IBS-related symptoms and are generally safe for most people. They can also be used in combination with most IBS medications. If you have IBS, talk with your healthcare professional, as he or she may be able to provide you with resources to help you implement these tools in your life.

Follow me on Twitter @DrCalm123

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Tackling parent-teacher conferences: The early years

Originally Posted Here: https://www.health.harvard.edu/blog/tackling-parent-teacher-conferences-the-early-years-2019020815961

Coming into December, my wife Jenny and I had been through two parent-teacher conferences and were batting .500. The first, during my oldest son’s last year of preschool, opened with a list of stuff that didn’t shock us but his teachers weren’t too thrilled with: knocking over blocks, interrupting, not sitting still for circle time.

Milo was 4.

Unfortunately, there was no eventual, “Enough of that. He’s 4. Here’s why he’s great.” We left feeling they didn’t like him. Milo was doomed and we had failed. We decided that they were full of it, or at least that was our hope.

A year later came parent-teacher conference No. 2. His kindergarten teacher, a 30-year veteran, told us most of the class was in the middle of a bell curve, and everyone was still getting to know each other. She apologized for starting with academics. We asked how much of a concern an earlier note home was. “None,” she said.

It was a good and needed counterbalance.

A learning curve for the parent-teacher conference

I wasn’t worried going into our first-grade conference in early December. Milo’s teacher is open and quick to respond by email. I could see his progress with homework, and I have the chance to help out in class. Of course, there was more to know. But every school conference presents a numbers challenge. We had 20 minutes. Milo’s teacher had 20-plus conferences to do. I needed advice, so I asked two experts.

Dr. J. Stuart Ablon is associate professor of adolescent psychiatry at Harvard Medical School and director of Think: Kids at Massachusetts General Hospital. Julia G. Thompson is a former 40-year public school teacher and author of The First Year Teacher’s Survival Guide. They agreed on this:

You need a plan. No one has time to waste. Academics shouldn’t dominate, although they often do, so you have to ask a few pointed questions to find out about skills like collaborating, multitasking, and flexibility. But before you tackle any of that, shut up for the opening 10 minutes. “You want to see how the teacher gets your kid,” Ablon says.

Expect holes in the picture. It was only December. Not everything can be known by then. Fill in the blank spots by talking about your child’s strengths. Teachers use them to overcome weaknesses, and now you’ve clued them in, Thompson says.

Focus on a few key questions. With whatever time remains, try asking:

How does my child handle frustration? This touches on willingness to ask for help and problem-solve, Ablon says. How does my child fit in? This gets at how children are interacting, whether they’re leaders or followers, what they’re excited about, and how they spend their free time. A good follow-up is so obvious, it’s rarely considered: Does my child look happy? “If they are, school is stress-free, and they’re engaging and appropriately challenged,” Thompson says. How well does my child settle down for work? This is about tuning out distractions, being tolerant, but also meeting expectations. Along with the teacher understanding your kid, you want to understand what the teacher wants, Ablon says. Here’s how our parent-teacher conference played out

I quickly re-learned that 20 minutes isn’t long. Side conversations constantly present themselves, offering the chance to eat up even more time. It’s also not a scripted event. Milo’s teacher started by asking what questions we had. A tempting offer, but we threw it back to her. Whenever she asked something, I answered just the question, then stopped talking. When I shared, it was to add to her understanding. I was always conscious of the clock and constantly fighting my natural tendency to chat. But it paid off. We got her take and got in our questions.

The conference isn’t meant to be exhaustive or solve every issue –– save that for a follow-up meeting. It’s about learning, and hopefully leaving with a sense of comfort.

“You should feel that the teacher is knowledgeable and in control of themselves, which means they’re in control of the class,” Thompson says. “[Also] that they care about and value your child, and that they want to work with you.”

We know each year can change. We’ll take this victory and our .667 batting average.

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