By John A. Rumberger, PhD, MD, FACC

A recent publication [June 2014] in the British Journal The Lancet Diabetes & Endocrinology has reported that the presence of several specific gene mutations associated with a reduced metabolic synthesis of plasma vitamin D showed a causal relationship between low levels of vitamin D and high blood pressure [hypertension].

For every 10% increase in the blood concentration of vitamin D there was a small but real associated decrease in resting blood pressures and also 8% decrease in the odds of developing high blood pressure in the future. However as with all ‘observational’ investigations, a formal large study including use of vitamin D supplementation will need to be performed but is it possible that vitamin D supplementation may be effective in combating some cases of hypertension.

Another study recently published in February 2014 also noted increasing BMI [body mass index] as a causal factor in vitamin D deficiency. Increasing BMI is associated with obesity and at least ‘central’ obesity is associated with what is called a ‘metabolic syndrome’ commonly associated with abnormalities in cholesterol, high blood pressure, and abnormal blood sugar control. The later condition is commonly related to an ‘insulin resistance syndrome’ [pre-diabetes] and apparently low vitamin D levels contribute to the process.

We correctly avoid over exposure to the sun and freely use high SPF skin products; but this then reduces the amount of vitamin D produced in our sun exposed skin. Unfortunately, dietary sources of vitamin D [commonly ‘fortified’ in cereal, milk, orange juice, etc.] are poor and thus vitamin D deficiency is more common in the US than in the past. Vitamin D deficiency is a well-established factor in abnormal bone densities but it has also been suggested as a ‘modifiable’ risk factor for a variety of diseases including breast cancer, colon cancer, and even multiple-sclerosis.

Both hypertension and visceral obesity are important ‘risk factors’ in the development of heart disease.

Dr. John A. Rumberger comments: These two studies re-enforce my own experience in linking lowered bone densities and vitamin D deficiency with the increased incidence of coronary artery calcification and heart plaque formation.

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Fish Tacos with Watermelon

Fish Tacos with Watermelon (Yield: 4 servings)
The fish in this recipe is grilled and a great source of lean protein. Extra virgin olive oil and avocado contribute some healthy fats to this dish. This recipe also includes a watermelon salsa which is a great way to not only get more fruit into your diet, but to get in more vitamin C, magnesium, fiber, potassium and lycopene! This recipe is perfect for a warm weather cookout or picnic.
• 4 cups diced seedless watermelon
• 1/2 small red onion, finely diced
• 1/2 cup roughly chopped fresh cilantro
• Juice of 2 limes, plus lime wedges for serving
• 1 jalapeno pepper, seeded and finely diced
• 1 tablespoon plus 2 teaspoons extra-virgin olive oil, plus more for brushing
• Kosher salt
• 1 pound of skinless wild striped bass fillets
• 1 teaspoon chipotle chile powder
• 1 romaine lettuce heart, thinly sliced
• 8 corn tortillas
• 1 avocado, sliced
1. Make the watermelon salsa by combining the watermelon, red onion, cilantro, lime juice and jalapeno in a bowl. Toss with 1 tablespoon olive oil and ¼ teaspoon salt and set aside.
2. Preheat a grill to high. Drizzle both sides of the fish with the remaining 2 teaspoons of olive oil and sprinkle with chile powder. Brush the grill with olive oil, then add the fish and grill until marked and cooked through (4-5 minutes per side). Transfer the fish to a plate and break into bite-sized pieces.
3. Toss the lettuce with 2 tablespoons of the juices from the watermelon salsa. Warm the tortillas on the grill and fill with the fish, watermelon salsa, avocado and lettuce and serve with lime wedges.
Nutritional information (per serving): 437 calories, 18 grams of fat (3 grams saturated), 25 grams of protein, 45 grams total carbohydrate, 6 grams of fiber

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Tips to Staying Better Hydrated

By: Staci O’Connor
Tips to Staying Better Hydrated
As the temperature rises with the summer months, drinking enough is important whether you are playing a sport or going for a hike with your family, traveling for work or pleasure, or just sitting outside enjoying the warm sun (it certainly feels good after the winter some of us had). Water is critical to your health and it makes up 60 percent of your body weight. When you think about it, every system in your body depends on it! The lack of water can lead to dehydration, which can lead to headaches, and even life-threatening illnesses such as heat stroke.
What are my total fluid (water) needs?
You can either use the “8´8 rule” which is to drink eight 8-oz glasses of water per day (about 1.9 L). You also could state the rule as “drink eight 8-oz glasses of fluids a day,” because all fluids count toward the daily total. (Though this approach is not supported by scientific evidence, many people use this basic rule as a guideline for how much water and other fluids to drink.) Or you can use what the Institute of Medicine recommends which is: men consume 3 L (about 13 C) of total beverages per day and women consume 2.2 L (about 9 C) of total beverages per day.
Be sure to modify your total fluid intake from these recommended amounts depending on how active you are, what the climate is, your health status, and if you are pregnant or breastfeeding.
Try to make a conscious effort to stay well hydrated this summer and try to make water your beverage of choice! Try linking water with each meal and snack and even try to take a water break instead of a coffee break!
How can I naturally flavor my water?
1. Add citrus fruit: lemons, lime, oranges and even grapefruit.
2. Add ginger: Steep slices of ginger in hot water and then pour over ice.
3. Add cucumber slices and lemon: Just cut up and add to water.
4. Add some mint: Break apart the leaves and add to water.
5. Add a splash or two of unsweetened 100% fruit juice.
6. Try adding any fruit that you like for a different flavor each day of the week: strawberries, pineapple, peaches, apples, etc.
7. Let a sprig of lemongrass steep in a glass of water for a few hours.
8. Mix items up, for example: add ginger and lemon one day, add cucumber and lemon slices another day, or even try strawberries and mint for something completely different.

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Edamame & Carrot Salad – A Flavorful, Healthy Picnic Side Dish

This vegetarian, gluten free recipe is tasty, easy to prepare and packed full of nutrients. Edamame, boiled green soybeans, are high in fiber, protein, vitamins and minerals. A half-cup serving provides about 10% of the Daily Value for 2 key antioxidants, vitamins A and C. You can find frozen edamame in the freezer section of most grocery stores and it can be cooked in the microwave for this recipe. Try this dish to replace high calorie, high fat pasta and potato salads at your next event. Your body and your guests will thank you.

Edamame & Carrot Salad

3 cups shelled cooked edamame beans (soybeans)
4 medium carrots (about 12 ounces), peeled and coarsely grated
1/3 cup thinly sliced green onions
2 tablespoons rice vinegar
2 tablespoons fresh lemon juice
1 tablespoon canola oil
2 garlic cloves, minced

Preparation: Combine first 3 ingredients in medium bowl. Whisk vinegar, lemon juice, oil and garlic in small bowl to blend. Add to edamame mixture; toss to coat. Season with salt and pepper.

Nutrition Information: Serving size: ½ cup; Calories 110; Fat 4g; Sat Fat 0g; Sodium 55mg; Carbohydrate 12g; Fiber 4g; Protein 7g

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BBQ Basics for Weight Management

By Debbie Jeffery, RDN LD

Summer is BBQ time! But if you’re trying to lose weight, a buffet table filled with typical picnic foods can be tempting and the calorie count can easily get out of hand. However, following the below simple rules for smart summertime eating can put you in control.

  1. Bring a healthy dish with you. You’ll know that you’ll have at least one nutritious dish to enjoy. Fruit platters, raw veggie trays and steamed shrimp are all low calorie, healthy options.
  2. Pay attention to portions and your personal hunger level. Think about how hungry you are before you dig in. Start slowly and eat mindfully. When you get the feeling of fullness, stop eating – even if it means leaving food on your plate. Better to discard food than have it contribute excess calories to your body.
  3. Fill up on vegetables. Eat loads of green salad with lots of seasonal vegetables or crunch on the crudités but go easy on the dips.
  4. Have a little lean protein. Studies show that, gram for gram, lean proteins help you feel fuller than carbohydrates or fats, so enjoy what’s on the grill, a lean burger, skinless chicken, fish or even tofu.
  5. Balance your plate.   To keep a limit on calories, restrict yourself to 1 cup – total – of starchy side dishes, such as potato salads, pasta salads and bean dishes. As a reference point, visualize a tennis ball or baseball which is about 1 cup.  
  6. Prioritize your favorite food. If you really want a cheeseburger, go for it but balance your plate with a green salad or grilled vegetables and fruit as sides. If the chocolate brownies on the dessert table are too enticing, have grilled chicken or fish on top of a bed of greens to make room for the extra calories.
  7. Rethink your drink. Sangria, beer, wine and soda can easily add hundreds of unwanted calories. If you can’t resist, limit yourself to just one serving. You can also substitute low calorie fluids such as seltzer and a splash of juice, unsweetened iced tea or lemon water.
  8. When you’re finished eating, move away from the food and go play. Group games like volleyball and horse shoes are fun or you can enjoy a run or bike ride in the park. The important thing is to keep moving.
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5 Exercises to do in the Water

Working out in the pool provides resistance as well as provides a great cardiovascular exercise.  The water is easier on the joints but will still enable you to work on your balance, strength and endurance.  Below are 5 great exercises to do in your pool this summer!

1.  Water Jogging.  Jog for 1-3 minute intervals.  You can either jog at a waist high depth, or jog across the pool at a deeper depth making it more difficult since you will not be able to touch the ground.

2. Wall Climbs.  This will incorporate core balance, leg and back strength.  You will need to stabilize your body using your arms in a back and forth motion almost like treading water with your hands.  You will then walk your feet up the side of the pool at least 4 steps and back down.

3.  Planks.  You can do planks in the pool as long as you have a noodle or board.  You will press it into the water with both hands and keep it below the water.  Try to stay stable for 1-2 minutes.

4.  Leg Raises.  Holding on to the noodle or the side of the pool, raise leg straight to the back to work the hamstring and glutes, raise it to the outside to work the inner and outer thighs and lift the leg to the front to get a quad workout.  The water will act as resistance to make it more difficult.

5. Squat Jumps.  This will be the same as on land, but again, the water will provide more resistance to make this exercise more difficult.  Squat all the way down and then jump up and out of the water.

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Take Your Workout Outside

As the weather gets warmer, take a break from your normal indoor routine and take your workout outside.  Using nature and the resources around you, a total body routine can be accomplished!  Below are some example of different ways to workout outdoors!

Using a Park Bench:

1. Tricep Dips

2. Box Jumps

3. Decline Pushups

4. Single Leg Step Ups

5. Elevated Leg Lunges

6. Calf Raises

Using a Playground:

1. Pullups

2. Hanging Leg Raises

3. Supine Rows

4. Monkey Bars

You can also run sprints, bike ride, walk, roller blade, stand up paddle board or hike among many more fun outdoor activites!


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