Drug-Induced Hypertension

by Diane, M.P.H, M.S.

Drug-induced hypertension: 

High blood pressure caused by using a chemical substance, drug, or medication

Drugs that can cause hypertension include:

  • Acetaminophen
  • Alcohol, amphetamines, ecstasy (MDMA and derivatives), and cocaine
  • Antidepressants (including venlafaxine, bupropion, and desipramine)
  • Caffeine (including the caffeine in coffee and energy drinks)
  • Corticosteroids
  • Cyclosporine
  • Erythropoietin
  • Estrogens (including birth control pills) and other hormones
  • Many over-the-counter medications such as cough/cold and asthma medications — particularly when the cough/cold medicine is taken with certain antidepressants like tranylcypromine or tricyclics
  • Migraine medications
  • Nasal decongestants
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

Alcohol’s effect on blood pressure is often taken for granted:

  • Drinking too much alcohol can increase your blood pressure.
  • The American Heart Association’s Guidelines state that if you drink alcohol, limit the amount to no more than 2 drinks a day for men, or 1 a day for women. They define a drink as one 12-ounce beer, 4 ounces of wine, 1.5 ounces of 80-proof spirits, or 1 ounce of 100-proof spirits.
  • If you are taking medication, note that alcohol magnifies the potency and risk of side effects from your dose of medication. Your liver and kidneys must work harder in the presence of alcohol, to metabolize and excrete various components of these drugs.

Rebound hypertension: This occurs when blood pressure rises after you stop taking, or lower the dose of, a drug (typically a high blood pressure medication).

To avoid medical problems, only take medications that are safe for people with high blood pressure:

  • Give a list of ALL medications you use, both prescription and over-the-counter, to each doctor you visit.
  • Read medication labels before buying over-the-counter products.
  • Make sure the medicine does not contain ingredients that could worsen your high blood pressure, such as NSAIDs or decongestants.
  • Talk to your doctor before using any over-the-counter medication, herbal preparation, vitamins, or other nutritional supplements.
  • Ask for alternatives to potentially harmful medicines.

References:

  1. “Medications and supplements that can raise your blood pressure: From acetaminophen to stimulants, know which drugs and supplements can affect your blood pressure.” Mayo Clinic staff. 2015. (Source: http://www.mayoclinic.com/health/blood-pressure/MY00256)
  2. “The Harvard Medical School Family Heath Guide: Don’t Let Decongestants Squeeze Your Heart.” © 2010 WebMD, LLC. All rights reserved. WebMD Medical Reference. Reviewed by Brunilda Nazario, MD on 10/19/11.
  3. “Hypertension/High Blood Pressure Health Center: Medications That Cause High Blood Pressure.” (Source: http://www.webmd.com/hypertension-high-blood-pressure/guide/medications-cause)

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What is Blood Pressure?

by Diane, M.P.H, M.S.

What is blood pressure?

  • Blood pressure is a measure of the force of blood pushing outwards on your arterial walls.
  • It is written as 2 numbers, such as 120/80 mm Hg.
  • Optimal blood pressure is less than 120 mm Hg systolic and 80 mm Hg diastolic.

Blood pressure is typically recorded with two numbers, written as a ratio:

  • Systolic: The top number, which is also the higher of the two numbers, measures pressure in the arteries when the heart beats (when the heart muscle contracts).
  • Diastolic: The bottom number, which is also the lower of the two numbers, measures pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood).

Blood pressure is determined by the:

  • Amount of blood the heart pumps
  • Condition of the heart valves
  • Pulse rate
  • Pumping power of the heart
  • Size and condition of the arteries

Other factors which also affect blood pressure:

  • Condition of kidneys, nervous system, and/or blood vessels
  • Genetics
  • Foods eaten, weight, and other body-related variables
  • Levels of various hormones in the body
  • Volume of water in the body

The cardiovascular system regulates blood pressure in various ways:

  • Specific hormones and autonomic nerve signals from the brain affect the rate and strength of heart contractions. Greater contractile force and heart rate lead to an increase in blood pressure.
  • Blood vessels can affect blood pressure:
    • Vasoconstriction decreases an artery’s diameter by contracting smooth muscle in the arterial wall. The sympathetic (fight or flight) division of the autonomic nervous system causes vasoconstriction, which leads to increases in blood pressure and decreases in blood flow in the constricted region.
    • Vasodilation is the expansion of an artery as smooth muscle in the arterial wall relaxes after a fight-or-flight response wears off or under the effect of certain hormones or chemicals in the blood.
  • Blood volume in the body affects blood pressure: A higher volume of blood in the body raises blood pressure by increasing the amount of blood pumped by each heartbeat.
  • Thicker, more viscous blood from clotting disorders can raise blood pressure.

High blood pressure: This occurs when pressure in your arteries is elevated

Types of high blood pressure: 

  • Essential hypertension has no obvious cause.
  • Secondary hypertension occurs due to another disorder.
  • Drug-induced hypertension is a form of secondary hypertension caused by a response to a medication, supplement, or other chemical substance.

 Blood pressure categories:

                                      Systolic        Diastolic

  • Normal (optimal)     <120                  <80
  • Prehypertension       120-139             80-89
  • Hypertension             >139                  >89

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Crustless Greek Spinach Pie

This delicious, nutritious, no-carb version of Greek spanakopita (without flour) is high in protein, calcium, folate, vitamin C, magnesium and potassium, and can be served hot or cold, as a side or meatless main dish:

Servings: 8-10 servings

Time: 1 hour 45 minutes

Ingredients:

  • 2 pounds raw greens such as fresh organic baby spinach, Swiss chard, collard, kale (or their frozen chopped versions, thawed and well drained)
  • 4 large onions, sliced or chopped
  • 1 bunch chopped scallions
  • 1/4 cup olive oil
  • 1 bunch chopped Italian parsley
  • 1 bunch chopped dill**
  • 4 or 5 eggs
  • 1/2 pound rinsed feta cheese, cut into small cubes or crumbled
  • 1/2 pound cottage cheese (I use organic, unsalted, low-fat cottage cheese, when available) or Farmer’s cheese or 5 ounces (about 2 cups) finely grated Parmesan cheese
  • Ground pepper to taste (salt is optional)***
  • Greek seasoning: Dried dill, mint, oregano, parsley, onion

Directions:

  1. Preheat oven to 375 degrees.
  2. Wash greens well, drain, and shake or blot dry with towel.
  3. Heat oil in a large heavy skillet over medium-high heat. Add onions and scallions and saute until softened, about 10 minutes.
  4. Add greens in batches, stirring until they become wilted.
  5. Squeeze and drain liquid from skillet and allow to cool.
  6. Stir in parsley, dill and pepper.
  7. In a large bowl, beat eggs until foamy. Combine beaten eggs, feta, and cottage cheese. Add to the greens/onion/herb mixture and stir to combine.
  8. Grease one shallow 3-quart baking dish or two 2-quart baking dishes with butter or olive oil.
  9. Pour in the spinach mixture, spreading evenly. Bake in 375 degree oven for about 60 minutes, until top begins to brown and spanakopita is bubbling all around.
  10. Allow to cool slightly before cutting into squares.
  11. Spanakopita is also delicious when served cold.

*Kefalotyri, or kefalotiri, is a very hard, salty, yellow cheese made from sheep milk and/or goat milk in Greece and Cyprus. It vaguely resembles Gruyere in taste, except it is harder and saltier. A popular, well-known cheese, Kefalotyri is widely believed to be the ancestor of hard cheeses in Greece with a history that dates back to the Byzantine era. Kefalotyri is used along with feta in many recipes for Spanakopita, where the recipe says to substitute romano or parmesan, if kefalotyri cannot be obtained. A similar cheese, Kefalograviera (also made from sheep and/or goat milk), is sometimes sold outside Greece and Cyprus as Kefalotyri. Young kefalotiri is aged for at least 2 months and has a milder flavor than aged cheese. The longer kefalotyri is aged, the stronger its flavor becomes. Substitutes for kefalotiri cheese are hard cheeses such as Romano or Parmesan, both of which have a similar sharp flavor and dry texture.

**Fresh herbs: Dill, fennel, parsley, mint, whatever you have or prefer; Italian parsley and dill are more traditional, but I’ve used various combinations, chopped finely, & all have worked.

***Cottage cheese, feta cheese, Kefalotiri, ricotta cheese, and Parmesan cheese all contain salt. Feta retains much salt, even after being rinsed!

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No Crust Greek Spinach & Feta Pie Recipe

Spanakopita (Modern Greek: σπανακόπιτα, from σπανάκι, spanáki, spinach, and πίτα, píta, pie), or spinach pie, is traditionally a Greek savory pie pastry baked with phyllo (filo) and a delicious filling of chopped spinach, leeks, chard, or sorrel, onions and/or scallions, feta cheese and eggs. In rural Greece, smaller amounts of spinach are used, with the missing part substituted with leeks, chard, and sorrel. Various white, fresh, preferably salted cheeses (ex. Kefalotiri*, cottage cheese, Farmer’s cheese, Parmesan cheese, Ricotta cheese) may be mixed with, or substituted for, the feta cheese. The filling is usually wrapped or layered in phyllo pastry with butter and/or olive oil, either in a large pan from which individual servings are cut, or rolled into individual triangular servings.

While the phyllo-dough recipe is most common, many recipes from the Greek islands call for a crust made of flour and water to form a crunchier, calzone-like exterior in place of the flaky phyllo dough. The pastry, enhanced by butter and egg yolk, becomes golden in color as it bakes.

Spanakopita is mostly eaten as a snack in Greece, and can be an alternative to tyropita (cheese pie). It can also be served as a side or main dish, straight from the oven or at room temperature. A “fasting”, or vegan, version of spanakopita, is often prepared during Great Lent and other religious fasts, composed of spinach, onions or green onions, other green herbs like dill, parsley, celery, olive oil and a little wheat flour, but without eggs or dairy products; the mixture is oven-baked until crisp. Non-traditional vegan versions are available that typically use tofu instead of cheese.

Servings: 14-18 servings

Time: 1 hour 45 minutes

Ingredients:

  • 3-4 pounds raw greens such as fresh organic baby spinach, Swiss chard, collard, kale (or their frozen versions)
  • 6-8 large onions, sliced or chopped
  • 2 bunches chopped scallions
  • 1/3 cup olive oil
  • 1 bunch chopped Italian parsley
  • 1 bunch dill**
  • 8-10 eggs
  • 1 pound rinsed feta cheese, cut into small cubes or crumbled
  • 1 pound cottage cheese (I use organic, unsalted, low-fat, cottage cheese, when available) or Farmer’s cheese or 5 ounces (about 2 cups) finely grated Parmesan cheese
  • Ground pepper to taste (salt is optional)***
  • Greek seasoning: Dried dill, mint, oregano, parsley, onion

Directions:

  1. Preheat oven to 375 degrees.
  2. Wash greens well, drain, and shake or blot dry with towel.
  3. Heat oil in a large heavy skillet over medium-high heat. Add onions and scallions and saute until softened, about 10 minutes.
  4. Add greens in batches, stirring until they become wilted.
  5. Squeeze and drain liquid from skillet and allow to cool.
  6. Stir in parsley, dill, and pepper.
  7. In a large bowl, beat eggs until foamy. Combine beaten eggs, feta, and cottage cheese. Add to the greens/onion/herb mixture and stir to combine.
  8. Grease one shallow 4-quart baking dish or two 3-quart baking dishes with butter or olive oil. (I use one 4-quart Pyrex casserole, but sometimes liquid leaks over the side. It’s best to use two 3-quart baking dishes.)
  9. Pour in the spinach mixture, spreading evenly. Bake in 375 degree oven for about 60 minutes, until top begins to brown and spanakopita is bubbling all around.
  10. Allow to cool slightly before cutting into squares.
  11. Spanakopita is also delicious when served cold.

*Kefalotyri, or kefalotiri, is a very hard, salty, yellow cheese made from sheep milk and/or goat milk in Greece and Cyprus. It vaguely resembles Gruyere in taste, except it is harder and saltier. A popular, well-known cheese, Kefalotyri is widely believed to be the ancestor of hard cheeses in Greece with a history that dates back to the Byzantine era. Kefalotyri is used along with feta in many recipes for Spanakopita, where the recipe says to substitute romano or parmesan, if kefalotyri cannot be obtained. A similar cheese, Kefalograviera (also made from sheep and/or goat milk), is sometimes sold outside Greece and Cyprus as Kefalotyri. Young kefalotiri is aged for at least 2 months and has a milder flavor than aged cheese. The longer kefalotyri is aged, the stronger its flavor becomes. Substitutes for kefalotiri cheese are hard cheeses such as Romano or Parmesan, both of which have a similar sharp flavor and dry texture.

**Fresh herbs: Dill, fennel, parsley, mint, whatever you have or prefer; Italian parsley and dill are more traditional, but I’ve used various combinations, chopped finely, & all have worked.

***Cottage cheese, feta cheese, Kefalotiri, ricotta cheese, and Parmesan cheese all contain salt. Feta retains much salt, even after being rinsed!

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Stacked Towels

How many times can you use a towel before having to wash it?

  • Consumer and environmental health agencies recommend that towels be washed after 3 or 4 uses, in order to reduce the risk of bacteria, mold, and viruses.
  • Towels used more often can actually breed bacteria and mold.
  • Hang towels and washcloths properly after each use by spreading them out on your towel rack, so they dry thoroughly.
  • Before taking a shower, open the bathroom door as much as possible for ventilation, unless it must stay closed for privacy.
  • If you have a bathroom fan, turn it on while bathing or showering, so the air is less humid.

Why should you wash towels frequently?

  • Every time you use a towel to dry yourself, dead skin cells are scraped off which can accumulate in the fibers of your towel. If you use the same towel for 10 days, 10 days’ worth of exfoliated cells will collect on that towel.
  • Also, your towel got wet when it dried off your body. Whenever fibers get wet, the opportunity to harbor bacteria and other germs is greatly increased.
  • Air drying makes a towel an unfriendly environment for bacteria, but only for so long.
  • If you use the same towel in the morning and night, the number of bacteria will increase exponentially each day! While we are relatively clean when we use a towel after showering, the combination of dead skin cells and moisture (i.e., a food source and water source) create the right conditions for bacteria and mold to grow.

How often should you wash your bathroom rug:

  • If your bathroom rug has a non-skid rubber backing, it will not tolerate being washed frequently: It is best to wash a bathroom rug on warm/hot. However, the rubber backing will deteriorate quickly, if it is washed on hot too many times. To maintain a bathroom rug with rubber backing, wash it only once every 3-4 weeks.
  • If your bathroom is used frequently, rugs should be washed weekly: If several showers are taken in the same bathroom on a daily basis, the rug gets damp multiple times. Since the rug is against a floor that doesn’t breathe well, if at all, it takes a long time to dry. Because of this poor drying between uses, mold and mildew grow easily.
  • In a bathroom where water is routinely splashed on the floor, the rug needs to be washed weekly as well: Again, the rug doesn’t have time to dry out well between uses and can harbor all kinds of fungi and mold. In a damp, warm bathroom, the fungi and mold will multiply.

Guide for washing bathroom rugs:

  • All bathroom rugs should be washed on at least a warm water setting. Hot water is best though, since it cleans items better than warm water.
  • If your rug has a non-skid rubber backing, it is best to let it hang dry over your shower or towel rod, a portable clothesline, or real clothesline if you have one. The rubber backing will stay intact much longer if not exposed to dryer heat.
  • If a bathroom rug does not have rubber backing, place it in the dryer.

Bedding:

  • Since bed sheets are typically in a dry environment, wash them each week or at least every other week.
  • If you sweat at night, wash your bed sheets weekly.
  • Pillows and comforters can be washed 2-3 times a year. An easy reminder: Wash them when the seasons change.
  • After someone has been sick, throw all their bed linens in the washer.

Kitchen towels:

  • Since these tend to be used more often than bath towels, try to change them every day, especially if they become damp.
  • Due to the presence of moisture, the handling of various foods, and bacteria in the average kitchen, the risk of cross-contamination is high.

Clothing:

  • Not everything you wear gets dirty after being worn once. Jackets, dresses, and jeans can be worn several times before they need a cleaning.
  • When denim jeans begin to lose their stretch, it’s time to wash them.
  • Toss your pajamas in the wash after sleeping in them for a few nights.

Reference:

Peterson, Dr. Keri. “How Many Times Can You Use a Bath Towel Before It Needs to be Washed?” Women’s Health. 05/31/15. (Keri Petersen, M.D., internal medicine, Lenox Hill Hospital, New York City).

 

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Delicious Ginger Cardamon Tea (Chai)

by Diane, M.P.H, M.S.

“If you are cold, tea will warm you.

If you are heated, it will cool you.

If you are depressed, it will cheer you.

If you are excited, it will calm you.”

William Ewart Gladstone: (1809-1898) Prominent nineteenth century British politician.

Chai is a delightful blend of tea, herbs, and spices which has been prepared for centuries in India to promote health and peace of mind, enhance digestion and immunity, as well as, reduce inflammation. This beverage has antioxidant properties and may also provide antibacterial and anti-cancer benefits, according to some studies. Chai is made in different ways, depending on the region where it is being consumed, but there are a number of standard ingredients: black tea, ginger, cardamom, cinnamon, fennel, clove and black pepper. When analyzing chai’s health benefits, it’s important to examine each ingredient in turn. Though they act synergistically to increase each other’s benefits, the separate botanical components have powerful health benefits on their own:

  • Black Tea: Black, green, white, oolong, and pu-erh teas are all derived from the Camellia sinensis plant, a shrub native to China and India. These teas are virtually calorie-free and contain many micronutrients, including vitamins and minerals (folate, trace amounts of choline, potassium, magnesium, and manganese), as well as, unique antioxidants called flavonoids and substances linked to a lower risk for heart disease, cancer, and diabetes. Research has shown that black tea may help reduce the risk of cardiovascular disease and stroke, protect lungs from damage due to exposure to cigarette smoke, and have anti-viral and anti-cancer properties. Black tea has the highest caffeine content and forms the basis for flavored teas like chai, along with some instant teas.
  • Ginger: An important root used in Eastern medicine, ginger aids digestion, reduces nausea, improves circulation and immunity, and reduces inflammation which can be especially helpful for people suffering from arthritis. Some research has shown that ginger offers antioxidant and anti-cancer properties.
  • Cardamom: A perennial plant native to the evergreen forests of southern India, cardamon is one of the oldest known spices and popular as a medicinal plant in Sri Lanka, India and the Near East. This peppery, citrusy spice is commonly used in Indian cuisine but has also been used in Ayurvedic medicine as a treatment for mouth ulcers, digestive problems, and even depression. Text of this ancient healing tradition (Ayurveda) indicate that cardamom tea has been used after meals to enhance digestion for about 5,000 years! Found in virtually every Tibetan medicine formula, cardamom aids digestion and immunity, helps detoxify the body, improves circulation, and may also fight respiratory allergies. The medicinally active components are found in the seeds, which can be dried and steeped in hot water to make cardamom tea.
  • Cinnamon: Provides fiber, manganese, and calcium, as well as, antibacterial, anti-inflammatory, and antioxidant support, and aids digestion. Cassia cinnamon may lower blood sugar in people with diabetes. Cinnaldehyde (also called cinnamic aldehyde) in cinnamon helps prevent unwanted clumping of blood platelets.
  • Clove: Offers antibacterial, anti-inflammatory, antioxidant support, aids digestion, and has analgesic (pain relieving) properties which may help alleviate ulcer pain.
  • Fennel: Provides antioxidants, Vitamin C, potassium and fiber, and has demonstrated some anti-cancer properties.
  • Black Pepper: Offers antibacterial and antioxidant support, promotes digestive health, and helps prevent formation of intestinal gas.

What Are the Benefits of Cardamom Tea?

Cardamom Photo Credit YelenaYemchuk/iStock/Getty Images

The following recipe is quite simple to prepare at home:

Servings: 2

Ingredients:

  • Milk – 1 cup
  • Water – 1 cup
  • Ginger – 1 teaspoon grated (or pounded with mortar and pestle) or 1/4 teaspoon ginger powder
  • Cardamom – 2 whole pods, pounded, or 1/2 teaspoon cardamom powder
  • Sugar, honey, or agave syrup – to taste
  • Tea – 2 teaspoons loose tea leaves or 2 tea bags

Directions:

  1. In a small pot, add water and grated ginger. Bring this to a boil.
  2. Add milk and allow it to come to a boil, stirring in between to prevent any sticking or burning.
  3. Stir in tea leaves and bring to a rolling boil.
  4. Turn off stove, add cardamom powder, cover pot with lid and allow tea to steep for 3-4 minutes.
  5. Add sugar to taste.
  6. If using loose tea, pour the tea through a strainer directly into the serving cups.
  7. Serve the hot chai or adrak chai with Indian snacks like pakoras, samosas, biscuits, or cookies.

Variations:

  1. You can vary the ratio of milk to water according to your preference.
  2. If you prefer a stronger tea, allow it to boil a little longer.
  3. For those of you who must limit your tea intake, note that this recipe is still healthful and delicious when prepared without tea.

Ginger Tea

 

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This bountiful dish is eaten for lunch every day by the world’s longest-lived family, the Melises. Traditionally, it is made with whatever is growing in the garden, but it always includes beans and fregula, a toasted pebble-size semolina pasta that is popular in Sardinia. Fregula can be purchased at Italian markets or online. If you can’t find fregula, any tiny pasta, such as Israeli couscous or acini di pepe, will do.

Cooking minestrone takes some time. A longer cooking time blends the flavors and enhances the bioavail­ability of various nutrients (lycopene in tomatoes, carotenoids in carrots, antioxidants, etc.) A shorter cooking time will create a tasty dish as well, but nutritionally inferior. Traditionally, the soup is served with slices of pane carasau, or Sardinian flat bread.

Servings: 4

Ingredients:

  • 1/2 cup dried peeled fava beans
  • 1/2 cup dried cranberry beans
  • 1⁄3 cup dried chickpeas
  • 7 tablespoons extra-virgin olive oil
  • 1 medium yellow or white onion, chopped (about 1 cup)
  • 2 medium carrots, peeled and chopped (about 2⁄3 cup)
  • 2 medium celery stalks, chopped (about 1/2 cup)
  • 2 teaspoons minced garlic
  • 1 (28-ounce) can crushed tomatoes (about 3½ cups)
  • 3 medium yellow potatoes, peeled and diced (about 1½ cups)
  • 1½ cups chopped fennel
  • 1/4 cup loosely packed fresh Italian flat-leaf parsley leaves, chopped
  • 2 tablespoons chopped fresh basil leaves
  • 2⁄3 cup of Sardinian fregula, Israeli couscous, or acini di pepe pasta
  • 1/2 teaspoon salt
  • 1/2 teaspoon freshly ground black pepper
  • 1/4 cup finely grated pecorino Romano (about 2 ounces)

Directions:

  1. Soak fava beans, cranberry beans, and chickpeas in a large bowl of water for at least 8 hours or up to 16 hours (that is, overnight). Drain in a colander set in the sink. Rinse well.
  2. Warm 3 tablespoons of olive oil in a large soup pot or Dutch oven set over medium-high heat. Add onion, carrots, and celery; cook, stirring often, until soft but not browned, about 5 minutes. Add garlic and cook until fragrant, about 20 seconds.
  3. Stir in tomatoes, potatoes, fennel, parsley, and basil, as well as drained beans and chickpeas. Add enough water (6 to 8 cups) so that everything is submerged by 1 inch.
  4. Raise heat to high and bring to a full boil. Reduce heat to low and simmer slowly, uncovered, until the beans are tender, adding more water as necessary if the mixture gets too thick, about 1½ hours.
  5.  Stir in pasta, salt, and pepper. Add up to 2 cups water if the soup seems too dry. Continue simmering, uncovered, until the pasta is tender, about 10 minutes.
  6. Pour 1 tablespoon of olive oil into each of four serving bowls. Divide the soup among them and top each with 1 tablespoon of the grated cheese.

Tips:

  • Vary the beans in the minestrone: pinto beans make a good substitute for cranberry beans; great northern or cannellini beans, for the favas.
  •  Use the stalks and fronds that come off a fennel bulb for the most intense flavor. No feathery fronds on the bulb? Add a teaspoon of fennel seeds to the aromatic vegetables you sauté to begin the dish.
  • Add other fresh vegetables from the garden or market, such as zucchini, cabbage, green beans, and cauliflower or broccoli florets.
  • For a stronger tomato taste, stir in a tablespoon or two of tomato paste.

Akentannos!

A Sardinian phrase meaning “until 100 years.”

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quinoa-porridge

Pumpkin Porridge with Quinoa 

A delicious, satisfying breakfast high in protein and fiber and heart-healthy meal for lunch or dinner with fresh fruit.

Oats are heart-healthy, nutritious whole grains with their bran intact and signicant fiber content. Half of their fiber is insoluble, aiding digestion, and the other half is soluble, lowering cholesterol.

While not really a grain, quinoa is cooked and eaten as one. Quinoa cooks quickly in 15 minutes or less, is high in minerals and one of the best sources of plant protein. Always rinse quinoa with cold, running water until the water  runs clear to remove any bitter saponins.

Pumpkin Porridge with Oatmeal

Prep time: 
Cook time: 
Total time: 
Servings: 4-8

Ingredients:

  • 1 15-ounce can or 16-ounce carton unsweetened pumpkin
  • 2 cups low-fat milk ( You may substitute almond, rice, soy, or coconut milk)
  • 2 cups water
  • 1 teaspoon ground cinnamon
  • 1/4 teaspoon ground nutmeg
  • 1/4 teaspoon ground cloves
  • 1/4 teaspoon salt (optional)
  • 2 cups quick cooking or Old Fashioned oatmeal (not instant)
  • 2 tablespoons raisins, chopped dates, figs
  • Honey or maple syrup for drizzling
  • Chopped (toasted or untoasted) almonds, peanuts, pecans, walnuts, pumpkin seeds, etc. (optional)

Directions:

  1. Whisk together pumpkin, milk, water, spices, and salt in a large saucepan set over high heat. Bring mixture to a boil.
  2. Add oats and lower heat. Stirring often, cook for 20 minutes, or until oats are tender and cooked through.
  3. Ladle porridge into bowls and drizzle with honey or maple syrup.
  4. Sprinkle with chopped nuts if desired.

Pumpkin Porridge with Quinoa: 

Prep time: 
Cook time: 
Total time: 
Servings: 2-4
Ingredients:
  • 1 cup dry quinoa, rinsed and drained
  • 1 3/4 cup water
  • ½ cup unsweetened pumpkin
  • 1 teaspoon ground cinnamon
  • ½ teaspoon ground ginger
  • 1/8 teaspoon ground cloves
  • 2-4 tablespoons honey or maple syrup
  • Organic raisins, chopped dates, figs
  • 1/4 cup chopped nuts (optional)
Directions:
  1. Place drained quinoa in a 2-quart saucepan over the stove and add 1 3/4 cup water. Bring mixture to a boil, then cover and reduce heat to low, allowing  quinoa to cook for up to 15 minutes, or until all of the liquid has been absorbed.
  2. Stir in pumpkin, cinnamon, ginger, cloves, honey or maple syrup, adjusting flavors to taste, if necessary.
  3. Serve warm with raisins, chopped dates, figs and/or chopped nuts sprinkled on top.

Variation: For creamier pudding, replace water with low-fat or non-fat milk, coconut or almond milk.

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This recipe is simple, has a delightful flavor and golden color due to wonderful Indian spices, and can be prepared with many combinations of vegetables.

Ingredients:

  • 1/4 cup extra virgin olive oil
  • 1 teaspoon ground coriander
  • 2 teaspoons fennel seeds
  • 1/4 teaspoon ground cumin (or 1 teaspoon cumin seeds)
  • 1/2-3/4 teaspoon curry powder
  • Freshly ground pepper to taste
  • Salt (optional)*
  • 1 large head cauliflower, cut into medium florets
  • 3 carrots, peeled and cut into circles or 1-inch chunks
  • 2-3 onions, each sliced into 8 wedges
  • 2-3 tablespoons chopped flat-leaf parsley (optional)

Directions:

  1. Preheat oven to 450 degrees.
  2. Arrange cauliflower, carrots, and onions in a 13 x 9 inch glass or ceramic baking dish or in a single layer on a baking sheet..
  3. In a small bowl, blend spices with olive oil thoroughly. Drizzle this mixture over vegetables in baking dish.
  4. Stir vegetables to coat them evenly with oil and spices.
  5. Roast vegetables on center rack of oven. After 12 minutes, turn over vegetables for even browning.
  6. Bake until browned and tender when pierced with a knife. When the tip goes in easily, remove vegetables from oven.
  7. Sprinkle with, or stir in, chopped parsley and serve.

*I always add more of the spices, instead of salt.

 Variation: Another Indian spice blend for vegetables is as follows:

  • 1 teaspoon mustard seeds
  • 1 teaspoon cumin seeds
  • 3/4 teaspoon curry powder
  • 1/2 teaspoon coarse salt

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The Effect of Smoking on Oral Health

by Diane, M.P.H, M.S.

Smoking increases the risk of many dental problems:

  • Bad breath
  • Tooth discoloration, especially yellowing
  • Inflammation of salivary gland openings on the roof of your mouth
  • Build-up of plaque and tartar on your teeth
  • Bone loss within the jaw
  • White patches inside the mouth (leukoplakia)
  • Periodontal (gum) disease, a leading cause of tooth loss
  • Delayed healing process following tooth extraction, periodontal treatment, or oral surgery
  • Lower success rate of dental implant procedures
  • Oral cancer: Smokers are up to 5 times more likely to develop mouth cancer than nonsmokers..

How does smoking or the use of tobacco products promote gum disease?

  • Tobacco products interfere with the normal function of gum tissue cells and attachment of bone and soft tissue to your teeth.
  • Users of tobacco products and smokers are more susceptible to infections, such as periodontal disease.
  • Blood flow to the gums becomes impaired, resulting in slower wound healing.

Does pipe and cigar smoking increase the risk of oral health problems?

Yes. Just like cigarettes, pipes and cigars can cause oral health problems. A 23-year long study published in the Journal of the American Dental Association found that cigar smokers experience tooth loss and alveolar bone loss (bone loss within the jawbone that anchors teeth) at rates equivalent to those of cigarette smokers. Pipe smokers have a similar risk of tooth loss as cigarette smokers. Pipe and cigar smokers are also at risk for oral and pharyngeal (throat) cancers even if they don’t inhale, as well as, bad breath, stained teeth, and increased risk of periodontal disease.

Are smokeless tobacco products safer?

  • No. Like cigars and cigarettes, smokeless tobacco products like snuff and chewing tobacco contain at least 28 chemicals that have been shown to increase the risk of oral, throat, and esophageal cancer. Furthermore, chewing tobacco contains higher levels of nicotine than cigarettes, making it harder to quit than cigarettes. One can of snuff delivers more nicotine than over 60 cigarettes!
  • Smokeless “Spit” tobacco contains over 2,000 chemicals, many of which have been directly related to causing cancer.
  • Smokeless tobacco can irritate your gum tissue, causing it to recede or pull away from your teeth. Once gum tissue recedes, teeth roots become exposed, creating an increased risk of tooth decay. Exposed roots are also more sensitive to hot and cold or other irritants, making eating and drinking uncomfortable.

Health effects of smokeless tobacco include:

  • Tooth abrasion: Grit and sand in smokeless tobacco products scratches teeth and wears away the hard surface or enamel. Premature loss of tooth enamel may increase sensitivity and require corrective treatment.
  • Gum recession: Constant irritation to the area in the mouth where a small wad of chewing tobacco is placed can result in permanent damage to periodontal tissue, as well as, the supporting bone structure. Injured gums pull away from teeth, exposing root surfaces and leaving teeth sensitive to heat and cold. Erosion of critical bone support leads to loosened teeth that can be permanently lost.
  • Increased tooth decay: Sugars are often added to smokeless tobacco during the curing and processing to improve its flavor. The sugars react with bacteria found naturally in the mouth, causing an acid reaction, which leads to decay. A study published in the Journal of the American Dental Association notes that chewing tobacco users were 4 times more likely than nonusers to develop tooth decay.
  • Tooth discoloration and bad breath: Very common in long-term smokeless tobacco users. The habit of continually spitting can also be both unsightly and offensive.
  • Nicotine dependence: Nicotine blood levels achieved by smokeless tobacco use are similar to those from cigarette smoking. Nicotine addiction can lead to an artificially increased heart rate and blood pressure. In addition, it can constrict the blood vessels that are necessary to carry oxygen-rich blood throughout the body. Athletic performance and endurance levels are decreased by this reaction.
  • Unhealthy eating habits: Chewing tobacco lessens a person’s sense of taste and ability to smell. As a result, users tend to eat more salty and sweet foods, both of which are harmful if consumed in excess.
  • Oral cancer: With the practice of “chewing” and “dipping,” tobacco and its irritating juices are left in contact with gums, cheeks and/or lips for prolonged periods of time. This can result in a condition called leukoplakia. Leukoplakia appears either as a smooth, white patch or as leathery-looking wrinkled skin. It results in cancer in 3-5 % of all cases.
  • Other cancers: All forms of smokeless tobacco contain high concentrations of cancer-causing agents. These substances subject users to increased cancer risk not only of the oral cavity, but also the pharynx, larynx and esophagus.

Quitting smoking lowers your risk for smoking-related diseases and can add years to your life.

If you currently use cigarettes, cigars, pipes, or smokeless tobacco, or have in the past, be aware of the early signs of oral cancer:

  • A sore that does not heal
  • A lump or white patch
  • A prolonged sore throat
  • Difficulty in chewing
  • Restricted movement of the tongue or jaws
  • A feeling of something in the throat

Pain is rarely an early symptom. For this reason, all tobacco users need regular dental check-ups.

Hookah water pipe smoking: May pose significant risks for oral health, since the water in the pipes does not filter out all of the harmful toxins.

Quit smoking to improve your appearance and overall health:

  • Regardless of how long you have used tobacco products, quitting now can greatly reduce risks to your circulatory and overall health.
  • Reducing the amount you smoke appears to help: One study found that smokers who reduced their smoking habit to less than half a pack a day had only 3 times the risk of developing gum disease compared with nonsmokers, which was significantly lower than the six times higher risk seen in those who smoked more than a pack and a half per day. Another study published in the Journal of the AmericanDental Association found that the mouth lesion leukoplakia completely resolved within 6 weeks of quitting in 97.5% of patients who used smokeless tobacco products.
  • As blood flow improves, your skin, gums and internal organs receive more oxygen and nutrients. This can provide a healthier complexion and improved immunity. If you stay tobacco-free, stains on your fingers and nails should disappear. 
  • When you quit smoking: Your skin becomes more resistant to premature aging. In just 20 minutes, blood pressure and heart rate return to normal. Within 24 hours, your lungs start to clear out smoking debris as tiny cilia help sweep irritants out of the lungs. After a year, your risk of a heart attack drops to half that of people who still smoke; after 15 years of being an ex-smoker, risk of a heart attack falls to that of someone who’s never smoked. After 10 smoke-free years, your lung cancer risk drops to half that of a smoker.
  • Quitting eliminates the pervasive smell of cigarettes in your breath, clothes, and hair: This smell is unattractive to nonsmokers and carries health hazards, too. The odor means that people around you are exposed to tobacco toxins (third-hand smoke). These toxins can be especially harmful to small children.

American Cancer Society statistics show why you should quit smoking:

  • About 90% of people with cancer of the mouth, lips, tongue, and throat use tobacco. The risk of developing these cancers increases with the amount smoked or chewed and the duration of the habit. Smokers are 6 times more likely than nonsmokers to develop these cancers.
  • About 37% of patients who persist in smoking after apparent cure of their cancer will develop second cancers of the mouth, lips, tongue, and throat, compared with only 6% of those who stop smoking.

To help you stop using tobacco:

  • Your dentist or doctor may be able to help you calm nicotine cravings with medication, such as nicotine gum and patches. Some of these products can be purchased over the counter; others require a prescription. Other medications such as Zyban require a prescription.
  • Smoking cessation classes and support groups are often used in tandem with drug therapy. These programs are offered through local hospitals in your community and sometimes through your employer or health insurance company. Ask your doctor or dentist for information on similar programs they may be familiar with.
  • Herbal remedies, as well as hypnosis and acupuncture, are other treatments that may help you stop the habit.
  • Engage in new activities, classes, or seek support from family and friends.

References:

  1. American Dental Association. WebMD Medical Reference. Reviewed by Michael Friedman, DDS on May 22, 2014. WebMD, LLC.
  2. Effects of tobacco on oral tissue: Using Smokeless Tobacco is gambling with your health! (Source: www.mintsnuff.com/gamblingwithyourhealth.htm).-
  3. “Health Effects of Cigarette Smoking: Quitting smoking lowers your risk for smoking-related diseases and can add years to your life.” The United States Centers for Disease Control and Prevention: Tables, Charts and Graphs-Smoking and Tobacco Use. (Source: www. cdc.gov/…/ta…) 02/06/14.

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