Pear and Quinoa Salad

A pilot feeding study for adults with asthma: The healthy eating better breathing trial

Pear and Quinoa Salad | Johns Hopkins Medicine

Evidence from observational studies and to a lesser extent clinical trials suggest that a healthy diet may improve symptoms and lung function in patients with asthma. We conducted a pilot study to determine the feasibility of conducting a larger scale dietary trial and to provide preliminary evidence on the impact of a healthy diet on asthma outcomes.

In a randomized, two period cross-over trial, participants with asthma received a 4-week dietary intervention followed by a usual diet (or vice versa), separated by a 4-week washout. The dietary intervention was a healthy diet rich in unsaturated fat.

During the dietary intervention, participants ate three meals per week on site at the Johns Hopkins ProHealth Research Center. All remaining meals and snacks were provided for participants to consume off-site. During the control diet, participants were instructed to continue their usual dietary intake.

Relevant biomarkers and asthma clinical outcomes were assessed at 0, 2, and 4 weeks after starting each arm of the study.

Eleven participants were randomized, and seven completed the full study protocol. Among these seven participants, average age was 42 years, six were female, and six were African American.

Participant self-report of dietary intake revealed significant increases in fruit, vegetable, and omega-3 fatty acid intake with the dietary intervention compared to usual diet. Serum carotenoids (eg. lutein and beta-cryptoxanthin) increased in the intervention versus control.

Total cholesterol decreased in the intervention versus control diet. There was no consistent effect on asthma outcomes.

The findings suggest that a feeding trial in participants with asthma is feasible. Larger trials are needed to definitively assess the potential benefits of dietary interventions on pulmonary symptoms and function in patients with asthma.

Citation: Brigham EP, Matsui EC, Appel LJ, Bull DA, Curtin-Brosnan J, Zhai S, et al. (2017) A pilot feeding study for adults with asthma: The healthy eating better breathing trial. PLoS ONE 12(7): e0180068. https://doi.org/10.1371/journal.pone.0180068

Editor: Christophe Leroyer, Universite de Bretagne Occidentale, FRANCE

Received: November 9, 2016; Accepted: June 10, 2017; Published: July 13, 2017

Copyright: © 2017 Brigham et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: This work was supported by: National Institute of Environmental Health Sciences P50ES018176/Environmental Protection Agency RD83615201 (Nadia Hansel); 4KL2TR001077-04 (Emily Brigham); National Institute of Environmental Health Sciences P01ES018176/ Environmental Protection Agency RD83451001 (Greg Diette); National Institute of Environmental Health Sciences K23ES016819 (McCormack).

Competing interests: The authors have declared that no competing interests exist.

Observational studies have demonstrated harmful effects of the “Western” diet pattern in asthma and conversely a protective effect of healthier diets (such as a “Prudent” or Mediterranean diet pattern) [1–3].

“Western” diet patterns are characterized by high intake of processed meats and fast foods, whereas healthier diets such as the Mediterranean diet are characterized by higher intake of fruits, vegetables, whole grains, lean meats, fish, nuts, and omega-3 fatty acids.

Clinical trials are needed to confirm the effects, if any, of diet on lung symptoms and function in patients with asthma. A limited number of trials explore the effects of dietary counseling on asthma morbidity, with promising results [4–6].

However, no trial to date has investigated the effects of diet on lung symptoms and function using a feeding study design, i.e. providing all meals and snacks to study participants. This approach provides the strongest efficacy data to assess the effects of dietary changes on outcomes.

As such, we applied this rigorous study design, as has been done previously to investigate the effect of diet on cardiovascular disease risk factors [7–9].

One of the most widely-recognized feeding studies is the Dietary Approaches to Stop Hypertension (DASH) Trial.

A subsequent feeding study, termed the Optimal Macronutrient Intake Trial to Prevent Heart Disease (OmniHeart Trial), tested a DASH-style diet intervention which is rich in unsaturated fat and similar to a Mediterranean diet [7,10].

This diet features high fruit, vegetable, and low-fat dairy intake, with replacement of carbohydrates with olive oil, canola oil, and other monounsaturated fats [11].

The feasibility of testing this diet in adults with asthma is important and cannot be inferred from feeding studies in the general population, given a higher prevalence of food sensitization and food allergy among asthmatics [12,13]. Using a randomized, two period crossover trial of a four week “respiratory healthy” diet intervention versus usual diet as control, we investigated the feasibility of conducting a feeding study in adults with asthma (the Healthy Eating Better Breathing Trial).

Adults age 18–50 years with stable asthma were recruited via mailings, flyers in the community, and contacting participants in previous Johns Hopkins asthma studies. Eligibility was determined at a screening visit where informed consent was obtained and criteria included stable, active asthma.

Asthma was defined as self-reported physician diagnosis and treatment for asthma within the 12 months prior to enrollment, and stability was defined as no asthma exacerbation (emergency department visit, systemic steroid treatment, or urgent care visit) or respiratory infection in the 4 weeks prior to enrollment.

Participants were excluded if they were active smokers, pregnant or breastfeeding, used systemic corticosteroids or warfarin, had another major pulmonary diagnosis or significant systemic illness, reported high alcohol consumption (over 14 drinks per week or six or more drinks on one or more occasions per week), reported food allergy, weighed over 350 pounds or had changed weight by over ten pounds in the two months prior to screening, or reported so few symptoms at screening (Asthma Control Test score of 20 or more) that a change in symptoms was unly to be detected. To be eligible, individuals also had to agree to eat at least one meal per day at the study site, three to four days per week for four weeks during the intervention diet.

This pilot study used a randomized two period, two treatment crossover design. A four week washout separated the two diets, each of which lasted 4 weeks. A convenience sample of 12 participants was proposed for this feasibility trial. Participants were enrolled by a dedicated study coordinator between September and November of 2012.

Participants were randomized to begin with either the control or intervention diet. The random allocation sequence was generated by members of the data core and provided to research staff at the ProHealth facility.

During the intervention diet, participants were instructed to consume only foods provided by the study, which included three meals and one snack daily. Food during the intervention diet was prepared and provided by the nutritional staff in the research kitchen at the ProHealth facility.

Nutrient targets were the “diet rich in unsaturated fat” arm of the OmniHeart Trial, described in detail previously [7,10]. Sample menus can be found in the Online Supplement (Table A in S1 File). Supplied calories were adjusted to achieve stable weight, with anticipated daily caloric needs weight and estimated energy expenditure.

During the intervention diet, participants ate lunch at the ProHealth facility in Baltimore three to four times per week and received enough for the meals between the in-person visits. Additional meals and snacks were provided to cover unanticipated events (e.g.

weather delays) that may have resulted in schedule changes in order to ensure that participants always had access to study food. During the control diet and washout, participants were instructed to consume their typical diet; no meals were provided, and they were not required to visit the ProHealth facility for meals.

Prior to randomization, asthma status was reassessed, and a usual diet assessment was completed via three 24-hour diet recalls.

At 0, 2, and 4 weeks of each four-week diet, participants completed the following assessments: Asthma Control Test (ACT) questionnaire [14,15], Asthma-Specific Quality of Life Questionnaire (AQLQ-S) [16–18], Asthma Symptoms Utility Index (ASUI) [19,20], and spirometry and exhaled nitric oxide (eNO) measurements according to ATS guidelines [21,22]. Fasting blood samples were collected at these same timepoints for evaluation of serum carotenoids by high performance liquid chromatography (GENOX Labs) and lipids by spectrophotometry (Quest Diagnostics). To provide further insight into dietary change, participants completed three 24-hour diet recalls during each of the intervention and control diets.

Adherence to the dietary intervention was assessed via daily self-reported adherence to the diet, serum carotenoid levels, serum lipids, and 24-hour recalls of dietary intake. Outcomes relevant to asthma morbidity included the ACT, AQLQ, and ASUI questionnaires, spirometry [23], and eNO.

Given sample size and non-normality of sample population data, all summary statistics are presented as medians and interquartile ranges.

Biomarkers and asthma clinical outcomes are presented as change at week four (primary analysis) or week two (online supplement) from value obtained at week zero of each respective intervention or control diet.

As three 24 hour dietary recalls were performed during each of the screening, intervention diet, and control diet windows, the approach slightly differed; the three recalls were averaged for each week, and changes were presented as differences between the intervention or control diet and the screening week.

Individual estimates are graphically represented as change from screening to control and screening to intervention diet. The Wilcoxon signed rank test is used to provide pairwise comparisons of the change in data points across each of the control and intervention diets. A p-value of

Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180068

Organic baby food: It’s more expensive, but it may not be more nutritious. –

Pear and Quinoa Salad | Johns Hopkins Medicine

Squeezable pouches of organic baby food are as omnipresent on some American playgrounds as runny noses, diaper bags and overpriced strollers. Organic baby food can cost up to twice as much as conventionally grown baby food, and it comes in such gourmet blends as “blueberry, oats and quinoa” and ” spinach, apple and rutabaga.”

Parents go organic for a variety of reasons, including environmental concerns and a desire to avoid pesticide residue. And in some cases, they just want a status symbol. According to the consumer market research firm Mintel, organic baby food made up about 10 percent of the $1.4 billion U.S. baby food and snacks market in 2011.

But studies show that parents who are aiming to buy the best food for their infants may not need to spring for the expensive organics.

“The variety of foods and nutrients that babies take in will have a much larger impact on their health than whether they’re fed organic or not,” says Tiffani Hays, the director of pediatric nutrition at the Johns Hopkins Children’s Center. “Vitamins, minerals and fiber have much better research and documented health benefits than does choosing organic.”

A 2012 study in the Annals of Internal Medicine considered the question “Are Organic Foods Safer or Healthier Than Conventional Alternatives?” After analyzing hundreds of previous studies, including some that involved pregnant women and children, the authors found no strong evidence in favor of the organics.

No nutritional difference

Stanford University physician Crystal Smith-Spangler and her co-authors did not find consistent differences in nutrient levels between the two options. There was a 30 percent lower risk of pesticide contamination in organic than in conventional food, but it was rare for food from either group to exceed limits set by the Environmental Protection Agency, she said.

“Despite the widespread perception that organically produced foods are more nutritious than conventional alternatives, we did not find robust evidence supporting this perception,” the authors noted.

“The purpose of the study was not to tell people what to buy and eat, but to give people the information about the difference,” Smith-Spangler says. “I can see smart, rational people making different decisions. It’s a complex decision.”

A 2000 study, meanwhile, compared pesticide levels in three brands of baby food, two of them conventional and one organic. The authors didn’t detect pesticide residues in any of the samples.

Additives in food, such as dyes and preservatives, have been studied and found to be safe, though some parents still worry that there are negative effects, especially for infants and young children, Hays says.

Cancer, immune diseases, gastrointestinal symptoms and even behavioral problems such as attention-deficit hyperactivity disorder have all been blamed on food additives, she says, adding that there are no data behind these suspicions.

“These only remain concerns in theory, not something that has been documented and supported by controlled research studies or anything that,” she says.

The squeezable pouches of organic baby food hit the market about five years ago and have exploded in popularity since, according to organic baby food manufacturer Happy Family.

Parents love the pouches for the convenience: They can squirt the puree onto a spoon for the baby; when the child gets older, he or she can suck the food straight the pouch. There is very little mess. In the last few years, Gerber and other power players in the baby food market added pouches to their product lines, and not just for organics, according to Mintel.

And just as conventional baby foods come in pouches these days, some organics are sold in jars. (While the pouches are parent-friendly, they are not so planet-friendly. The plastic cap is the only part that’s recyclable.

The pouch is made of foil and plastic and is therefore headed for the landfill, according to Shazi Visram, the founder and chief executive of Happy Family.)

Paying a premium

Parents opting for organics pay a premium. At a Wegmans grocery in Fairfax recently, for example, a four-ounce jar of Gerber non-organic sweet potatoes cost 65 cents while the organic version, made by Earth’s Best, was 85 cents. A 4.2-ounce pouch of Earth’s Best sweet potato and apple puree cost $1.49. Yet Mintel reports that four in 10 mothers are willing to pay the premium for organics.

Jarred baby food is typically considered the domain of infants, but it’s common to see toddlers eating from pouches, and some companies have introduced squeeze pouches for adults.

Most babies need to eat super-smooth baby food for the first few weeks after introducing solids, Hays says. After that, she says, their oral motor skills advance quickly and parents should watch to see when their kids are ready to move from simple purees to more complex mixtures and eventually finger foods and table foods.

“Having a positive eating experience with a variety of foods, testing for allergic reactions and advancing textures are the most important parts of early feeding, not whether they’re getting organic or not,” Hays says.

How popular are the organic pouches? Visram started the company in 2006 with $115,000 in sales; by 2011, she said, she was up to $35 million. (“I pinch myself a lot,” she says.) The company’s top pouch is the spinach, mango and pear flavor, at 3.5 ounces and 60 calories.

Parents are smitten with the idea of getting their kids to eat spinach, “one of the holy-grail, top-10 foods you want your baby to develop a taste for,” Visram says.

While spinach is listed first on the front of the pouch, it’s actually the third ingredient listed in the official “Nutrition Facts” label on the back, behind pear and mango.

“Parents are looking for ways to get more vegetables into their children,” Visram says. “Our philosophy is: You do all you can, and it’s about repetition.”

Jessica Wolff, a Leesburg mother who works for a nonprofit medical society, feeds her 1-year-old daughter only organic food, though she and her husband eat conventional food. She’s hoping to keep pesticides and hormones her daughter’s diet.

“Across the board, everything for the baby has to be pure and good and better. I’m a little neurotic about it,” she says.

When her daughter started eating solids, Wolff bought organic foods at the farmers market and spent an entire day cooking them, pureeing it all and freezing some of the bounty in one-ounce portions. Once, when she tried to puree a free-range chicken, the baby food processor started to smoke. That was the end of “the whole horrible Sunday situation,” she says.

Now, her daughter eats prepackaged organic purees and meals from brands such as Ella’s, Plum Organics and Happy Family, sometimes mixed with organic yogurt, plus finger foods and fresh produce such as avocado.

“She has a really advanced palate, and I hope it sticks,” Wolff says. “It looks we have a food snob living in the house.”

The organic craze has gotten so intense that even parents of very sick children have been asking Hays and doctors at Johns Hopkins Children’s Center about replacing the hospital-provided liquids delivered by feeding tube with organic and homemade mixtures. “They couldn’t believe a liquid formula was as nutritious,” Hays says.

Paul Weiner, a Bethesda pediatrician, does not recommend organic baby food to patients because “there’s no definitive data that it’s better,” he says.

He has gotten a lot of questions about arsenic in rice ever since last fall, when Consumer Reports found “worrisome levels” of the element in a variety of products, including infant rice cereal. The report led the Food and Drug Administration to test about 200 food samples.

That produced similar results, but the agency did not recommend that consumers change their rice-eating habits. “We are not aware of any acute health risks linked with the consumption of infant rice in the U.S.,” the agency said in a message to consumers.

Weiner encourages parents to rotate rice cereal with barley cereal and oatmeal so that children don’t consume too much of it.

“If an adult were to eat that amount of arsenic, it wouldn’t necessarily be a problem, but for a baby’s small body size, it adds up,” he says.

Hays hopes that parents will refocus their good intentions for children’s nutrition.

“My hope is that any parent that is going to be diligent to make sure their child doesn’t get pesticides and hormones would be diligent that their child avoided obesity, because that effort would trump anything that we could do to avoid the side effects of additives,” Hays says.

Saslow is a former Post staff writer. 

Link to source article

 Link toLindlink to

Source: http://www.westendpedsnyc.com/blog/post/organic-baby-food-its-more-expensive-but-it-may-not-be-more-nutritious.html

The Cancer-Fighting Kitchen, Second Edition by Rebecca Katz, Mat Edelson

Pear and Quinoa Salad | Johns Hopkins Medicine

“Rebecca Katz has produced an invaluable resource. Instead of telling patients to ‘just eat a balanced diet,’ we can now show them how to control disease and optimize health with delicious, nourishing food from The Cancer-Fighting Kitchen. I recommend this book highly.”
Andrew Weil, MD

“Rebecca Katz brilliantly combines delicious recipes with nutritious ingredients to help promote and maintain a healthy lifestyle.

  I have shared The Cancer -Fighting Kitchen with my patients and their loved ones, and also with colleagues, family and friends.  Anyone concerned about their own health and well-being, and that of their loved ones, should buy this book.


—Vered Sterns, MD, professor of oncology and co-director of the breast and ovarian cancer program at Kimmel Cancer Center at Johns Hopkins

PRAISE FOR THE FIRST EDITION:

“Cancer treatments such as surgery, chemotherapy and radiation can be almost as hard on the body as the disease itself, and detailed nutrition advice is usually not on the program.

This informative guide to fighting cancer from the inside out…corrects that with a wealth of easy, immediate steps to speed up the healing process through diet.

…Katz’s experience with cancer patients and their long, often frustrating recovery lends authority to her wise, common-sense approach.”
Publishers Weekly, STARRED REVIEW

“If you or someone you love is battling this tough, tenacious illness, you’ll want to use every tool The Cancer-Fighting Kitchen provides.”
Energy Times

“An amazing book…with flavorful recipes…simply delicious.”
Washington Post“a must-have cookbook for learning how to cook and eat during treatment and after.”
—Kairol Rosenthal, author of Everything Changes: The Insider’s Guide to Cancer in Your 20s and 30s

“The Cancer-Fighting Kitchen is an incredibly rich and satisfying resource–it is a must for people living with and beyond cancer, and should be mandatory reading for all health care professionals.

This great gift will have a profound impact on the health and well-being of all who partake!”
—Donald Abrams, MD, chief of hematology and oncology at San Francisco General Hospital, integrative oncologist at the UCSF Osher Center for Integrative Medicine, and coauthor of Integrative Oncology

“If food is medicine, Rebecca Katz is one of the great healers. The Cancer-Fighting Kitchen is a book for anyone who wants to eat as if their life matters.”
—Rachel Naomi Remen, MD, author of Kitchen Table Wisdom and My Grandfather’s Blessings

“There is no substitute for eating healthfully, especially when diagnosed with cancer. This wonderful resource makes nutritious foods easy to prepare, attractive to look at, and tasty to eat.

It is the best I have seen.


—Joseph Pizzorno, ND, editor-in-chief of Integrative Medicine and coauthor of Encyclopedia of Natural Medicine and Natural Medicine for the Prevention and Treatment of Cancer

“A book to nourish loved ones. The Cancer-Fighting Kitchen: Nourishing, Big Flavor Recipes for Cancer Treatment and Recovery–This is a book I have added to my shelf and it will always be within reach.

I think this book could be called many things–a mother’s handbook to nourishing your loved ones or cooking to cure. I know my family and friends will benefit from my new favorite book the next time I need to cook something to make them feel better.


—Regina Charboneau for The Atlantic.com

Source: https://www.penguinrandomhouse.com/books/540809/the-cancer-fighting-kitchen-second-edition-by-rebecca-katz-with-mat-edelson/

Organic baby food more costly but not necessarily more nutritious

Pear and Quinoa Salad | Johns Hopkins Medicine
By Rachel Saslow, Special to The Washington Post •March 19, 2013 8:36 am

Squeezable pouches of organic baby food are as omnipresent on some American playgrounds as runny noses, diaper bags and overpriced strollers. Organic baby food can cost up to twice as much as conventionally grown baby food, and it comes in such gourmet blends as “blueberry, oats and quinoa” and ” spinach, apple and rutabaga.”

Parents go organic for a variety of reasons, including environmental concerns and a desire to avoid pesticide residue. And in some cases, they just want a status symbol. According to the consumer market research firm Mintel, organic baby food made up about 10 percent of the $1.4 billion U.S. baby food and snacks market in 2011.

But studies show that parents who are aiming to buy the best food for their infants may not need to spring for the expensive organics.

“The variety of foods and nutrients that babies take in will have a much larger impact on their health than whether they’re fed organic or not,” says Tiffani Hays, the director of pediatric nutrition at the Johns Hopkins Children’s Center. “Vitamins, minerals and fiber have much better research and documented health benefits than does choosing organic.”

A 2012 study in the Annals of Internal Medicine considered the question “Are Organic Foods Safer or Healthier Than Conventional Alternatives?” After analyzing hundreds of previous studies, including some that involved pregnant women and children, the authors found no strong evidence in favor of the organics.

— — —

Stanford University physician Crystal Smith-Spangler and her co-authors did not find consistent differences in nutrient levels between the two options. There was a 30 percent lower risk of pesticide contamination in organic than in conventional food, but it was rare for food from either group to exceed limits set by the Environmental Protection Agency, she said.

“Despite the widespread perception that organically produced foods are more nutritious than conventional alternatives, we did not find robust evidence supporting this perception,” the authors noted.

“The purpose of the study was not to tell people what to buy and eat, but to give people the information about the difference,” Smith-Spangler says. “I can see smart, rational people making different decisions. It’s a complex decision.”

A 2000 study, meanwhile, compared pesticide levels in three brands of baby food, two of them conventional and one organic. The authors didn’t detect pesticide residues in any of the samples.

Additives in food, such as dyes and preservatives, have been studied and found to be safe, though some parents still worry that there are negative effects, especially for infants and young children, Hays says.

Cancer, immune diseases, gastrointestinal symptoms and even behavioral problems such as attention-deficit hyperactivity disorder have all been blamed on food additives, she says, adding that there are no data behind these suspicions.

“These only remain concerns in theory, not something that has been documented and supported by controlled research studies or anything that,” she says.

The squeezable pouches of organic baby food hit the market about five years ago and have exploded in popularity since, according to organic baby food manufacturer Happy Family.

Parents love the pouches for the convenience: They can squirt the puree onto a spoon for the baby; when the child gets older, he or she can suck the food straight the pouch. There is very little mess. In the last few years, Gerber and other power players in the baby food market added pouches to their product lines, and not just for organics, according to Mintel.

And just as conventional baby foods come in pouches these days, some organics are sold in jars. (While the pouches are parent-friendly, they are not so planet-friendly. The plastic cap is the only part that’s recyclable.

The pouch is made of foil and plastic and is therefore headed for the landfill, according to Shazi Visram, the founder and chief executive of Happy Family.)

— — —

Parents opting for organics pay a premium. At a Wegmans grocery in Virginia recently, for example, a four-ounce jar of Gerber non-organic sweet potatoes cost 65 cents while the organic version, made by Earth’s Best, was 85 cents. A 4.2-ounce pouch of Earth’s Best sweet potato and apple puree cost $1.49. Yet Mintel reports that four in 10 mothers are willing to pay the premium for organics.

Jarred baby food is typically considered the domain of infants, but it’s common to see toddlers eating from pouches, and some companies have introduced squeeze pouches for adults.

Most babies need to eat super-smooth baby food for the first few weeks after introducing solids, Hays says. After that, she says, their oral motor skills advance quickly and parents should watch to see when their kids are ready to move from simple purees to more complex mixtures and eventually finger foods and table foods.

“Having a positive eating experience with a variety of foods, testing for allergic reactions and advancing textures are the most important parts of early feeding, not whether they’re getting organic or not,” Hays says.

How popular are the organic pouches? Visram started the company in 2006 with $115,000 in sales; by 2011, she said, she was up to $35 million. (“I pinch myself a lot,” she says.) The company’s top pouch is the spinach, mango and pear flavor. At 3.

5 ounces and 60 calories, parents are smitten with the idea of getting their kids to eat spinach, “one of the holy-grail, top-10 foods you want your baby to develop a taste for,” Visram says.

While spinach is listed first on the front of the pouch, it’s actually the third ingredient listed in the official “Nutrition Facts” label on the back, behind pear and mango.

“Parents are looking for ways to get more vegetables into their children,” Visram says. “Our philosophy is: You do all you can, and it’s about repetition.”

(Begin optional trim)

Source: https://bangordailynews.com/2013/03/19/health/organic-baby-food-more-costly-but-not-necessarily-more-nutritious/

Johns Hopkins Medicine

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Johns Hopkins Medicine

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Johns Hopkins Medicine unites physicians and scientists of the Johns Hopkins University School of Medicine with the organizations, health professionals and facilities of The Johns Hopkins Hospital and Health System.

Johns Hopkins Medicine's vision, “Together, we will deliver the promise of medicine,” is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care.

Diverse and inclusive, Johns Hopkins Medicine educates medical students, scientists, health care professionals and the public; conducts bio medical research; and provides patient-centered medicine to prevent, diagnose and treat human illness.

Each day in a hospital, staff members undertake complicated tasks caring for patients. Johns Hopkins Medicine's patient safety efforts aim to ensure that all of these steps work together to deliver high-quality, compassionate care to all patients across our health system.

Johns Hopkins Health System hospitals and services consistently receive awards and honors for patient safety and quality, including Top Performer on Key Quality Measures by the Joint Commission, Magnet designation for nursing, Home Care Elite and Delmarva Foundation Excellence Awards. The Johns Hopkins Hospital has been ranked No. 1 in the nation by U.S. News & World Report for 22 years of the survey's 25-year Acoustic Neuro Center

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Foods That Are Good for a Healthy Colon

Pear and Quinoa Salad | Johns Hopkins Medicine

Written by Paula Martinac; Updated December 02, 2018

Foods That Are Good for a Healthy Colon

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Part of your lower gastrointestinal system, the colon, or large intestine, plays a vital function in overall health by helping to move waste materials the body.

In the short term, a malfunctioning colon can result in constipation, with bloating, gas and general discomfort. But over time it can lead to even more serious problems.

You can keep your colon healthy with foods high in fiber and omega-3 fats.

An indigestible form of carbohydrate, fiber helps move food through your GI tract so you stay regular — and regular bowel movements keep your colon healthy. The Dietary Guidelines for Americans recommends adults get between 25 and 30 grams of fiber a day. If your diet has been low in fiber, be sure to drink plenty of water as you increase your fiber intake to avoid uncomfortable bloating.

Only plants contain fiber, so make sure you’re eating plenty of plant-based foods for colon health. Legumes supply significant amounts of fiber. Navy beans offer the most of all beans, with a whopping 10 grams of fiber per half-cup serving, or 33 to 40 percent of your daily needs. Other good choices, supplying at least 6 grams of fiber in a serving, include:

  • White beans
  • Adzuki beans
  • Chickpeas
  • Lentils
  • Pintos
  • Black beans
  • Great Northern beans

Fruits and vegetables are another good source of fiber. Fruits with high fiber counts per serving include pears and apples with the skin on, raspberries, blackberries, oranges and bananas. Sweet potato, white potato, winter squash, artichokes, collard greens, parsnips, Brussels sprouts, broccoli and spinach all offer at least 20 percent of the daily recommendation in a serving.

Stock up on whole grains to boost your fiber intake, too. Three-quarters of a cup of a ready-to-eat, high-bran cereal for breakfast supplies you with 14 grams of fiber; check the nutrient labels for the exact amount supplied by different brands. Other good cereal choices include shredded wheat and bran flakes. Whole grains offering at least 8 grams of fiber in a 1-cup serving include:

  • Spelt
  • Bulgur
  • Millet
  • Oats
  • Amaranth
  • Quinoa
  • Whole wheat
  • Wild rice 

In addition to fiber, make sure you’re getting plenty of omega-3 fatty acids in your diet. Johns Hopkins Medicine suggests eating fish up to three times a week to support the health of your colon. Anchovies, sardines, salmon, herring and mackerel are all excellent fatty fish choices; a serving is 3 to 4 ounces.

If you’re a vegetarian, some plant foods offer a type of omega-3 fats. Ground flaxseed and English walnuts are the best plant sources, but you’ll also find these fats in smaller amounts in other nuts and nut oils and in wheat germ. Some brands of eggs and soy products are fortified with omega-3s.

While upping your intake of foods with fiber and omega-3s, you’ll also want to limit consuming some foods that don’t promote colon health.

Johns Hopkins Medicine suggests cutting way back on your intake of red meat and other foods containing high amounts of saturated fat, certain kinds of dairy.

Avoid heavily-processed foods with a high sodium and sugar content to keep your colon — and the rest of your body — healthy.

Source: https://healthyeating.sfgate.com/foods-good-healthy-colon-3696.html

What Can You Eat for Breakfast With Gallbladder Disease?

Pear and Quinoa Salad | Johns Hopkins Medicine

Your gallbladder may be small, but when it's diseased, it causes mighty uncomfortable symptoms. A gallbladder disease diet can help ease or prevent the complications of the disease, including gallstones. A healthy, low-fat breakfast is part of a healthful pattern of eating.

Eat fruit for breakfast to help with gallbladder disease.

Image Credit: MirageC/Moment/GettyImages

Your gallbladder breakfast can include many tasty foods, but excludes typical fatty options such as sausage and bacon.

Gallbladder diet recipes for breakfast include low-fat gallbladder-friendly foods such as whole grains, fresh fruit and low-fat dairy products.

The gallbladder sits just under your liver and stores bile, a fluid used to digest fat. It's pear-shaped and relatively small.

After you eat, your stomach and intestines start to digest and process the food. Your gallbladder releases bile into the small intestine through a bile duct to help with food processing and breakdown.

If you have a block in the bile duct, you end up with pain in the gallbladder. Gallbladder disease describes infection, inflammation, blockage of the duct or stones. Conditions that can affect the gallbladder, as described by Johns Hopkins Medicine, include:

  • Cholecystitis, or inflammation of the gallbladder
  • Gallstones
  • Tumors in the form of cancer (rare)
  • Abscesses
  • Congenital defects
  • Irregular growths of tissue

Your doctor diagnoses gallbladder disease and can tell you more about treatment and management as well as prognosis. If gallbladder disease can't be managed, surgery may be necessary to remove the organ. Fortunately, bile has other ways of reaching the small intestine.

A healthy, nutrient-dense diet helps to keep your gallbladder in perfect health. What you eat can stimulate the gallbladder and provoke pain from disease and inflammation. As pointed out in a proposal for research published in the Cochrane Database of Systematic Reviews in March 2017, dietary fat, in particular, has an impact on gallbladder pain.

The authors also suggested the possibility that restricting fats can lower a person's cholesterol levels and, as a result, cholesterol in the bile. Cholesterol in the bile plays a role in the development of gallstones.

A low-fat diet essentially gives your gallbladder a rest, relieving the symptoms of inflammation.

Keeping your total calorie intake under control can also help ease gallbladder pain. A study of Iranian women diagnosed with gallbladder disease published in the_ Journal of Health, Population and Nutrition_ in March 2015 found that women who experienced rapid weight gain, consumed a high number of calories and had a diet described as “unhealthy” were more ly to develop the disease.

Foods that are aggravating to gallbladder disease are those that are high in fat, processed and contain lots of refined white flour, such as white breads and pasta. Fried foods, especially those prepared in vegetable or peanut oil, can also be aggravating.

Breakfast-specific foods you should avoid include sausage, bacon, cinnamon rolls and other high-fat baked treats, whole milk, processed cheese, egg yolks and butter. Even some healthy foods that are high in fat, such as avocado, nuts and nut butter, are best left off your gallbladder breakfast menu.

When you've been diagnosed with gallbladder disease, choose lower fat foods. You don't have to eliminate all fat, however, because a little fat is good for you.

Gallbladder-friendly foods include:

  • Lean meats, such as white fish and chicken or turkey breast
  • Plant-based proteins, such as lentils or tofu
  • Fat-free salad dressings, sour cream and cream cheese
  • Whole grains, such as oats, brown rice, quinoa and barley
  • Low-fat or no-fat dairy, such as yogurt, milk and cottage cheese
  • Fresh fruits and vegetables
  • Egg whites

The Health Systems of British Columbia suggests that, when you choose low-fat dairy, you should choose skim or 1-percent milk, lower fat yogurt with 2 percent or less milk fat and lower-fat cheese with 20 percent milk fat or less. If you do eat chicken or turkey, remove the skin. If you use sauces, make them with low-fat or nonfat plain yogurt or go for salsa or squeezed-on citrus juices.

High-fiber foods deter the formation of gallstones and inflammation in the gallbladder. Georgian Medical News published research in June 2014 demonstrating that a high-fiber diet showed statistically significant benefits for prevention of a sluggish bile duct, thus preventing gallbladder disease. High-fiber foods include leafy greens, whole grains and many fruits.

Alberta Health Systems of Canada suggests that people with gallbladder disease eat many small meals and snacks throughout the day.

At breakfast, for example, you might have just a banana and a low-fat yogurt at first and then a few hours later a slice of whole-grain toast with a smear of strawberry all-fruit jam.

Small meals make for easier digestion and don't overload your gallbladder.

Putting all these recommendations together into gallbladder-disease recipes can feel challenging, especially if you've always loved a big, hearty breakfast with lots of traditional, fatty foods. But, you still have lots of options.

Refine your eating habits. Breakfast ideas for gallbladder disease include:

  • Egg white omelet orfrittata with a variety of chopped vegetables cooked with a spritz of olive oil
  • Oatmeal with berries andlow-fat milk or almond/soy milk
  • Fresh fruit and low-fat yogurt
  • Whole-grain toast orbagel with fat-free cream cheese
  • Whole grainready-to-eat cereal with low-fat milk and banana
  • Tofu scramble cookedin a small amount of olive oil and made with soft tofu, black beans, freshherbs and tomato salsa
  • Ground white-meatturkey with fennel, oregano and black pepper, chopped bell pepper and onion formedinto patties and baked in the oven
  • Whole-grain toast withsliced tomato and melted low-fat cheese
  • Fruit smoothie madewith strawberries, banana, low-fat yogurt and ice

If you do add meat to your breakfast, even if it's lean, watch what meat you eat later in the day. Alberta Health Systems recommends eating not more than two to three servings of meat a day.

Source: https://www.livestrong.com/article/511519-what-can-you-eat-for-breakfast-with-gallbladder-disease/