43. know how to eat well on the run. (continued)

here are few more things i’ve learned about eating well on the go.

1) plan ahead. i’m not much of a cook so pouring over recipes isn’t part of my routine. however, i do find that making a menu at the start of each week allows me to effectively utilize ingredients. whether i’ve just gone grocery shopping or i’m scrounging around in the fridge i like to make sure i don’t forget or waste anything. sticky notes are the easiest- use one per day. write out, specifically, the first couple of days’ foods, then add on different combinations of leftover ingredients. in my previous post, “eat well on the go” i explained that many ingredients can be multi-purposed, such as hummus and tortillas. for example: monday- taco as tortilla w/ lettuce, beans and salsa. tuesday- grapes, hummus with carrot sticks and corn chips. wednesday- quinoa with tomato and zucchini. thursday- salad with lettuce, tomatoes, avocado, zucchini, sunflower seeds. friday- grapes, salsa and beans with corn chips.

2) prepare now rather than later. no, you won’t actually get up early to cook something so do it now. besides- what if you oversleep? be sure all foods you’re packing are prepared (washed, peeled, etc.) in advance. also, you don’t want to spend your entire break chopping and boiling so whenever possible make a large batch of something, e.g. chili, soup, and freeze it in single servings. thaw them in the fridge as needed to supplement your menu. if you take them out of the freezer early in the week they should be ready by the week‘s end.

3) when you have food restrictions it can be tiresome to continually field questions like, “whoa- you don’t eat what?” however, it never hurts to show some consideration. once you get to know your coworkers, or fellow classmates you will all feel more comfortable having conversations about your diet. until then, we can’t help what connotations other people bring to the table (no pun intended) so let’s be sure we don’t give them a negative experience to associate with our particular diet. FYI:

banana peels and apple cores will attract flies if the trash isn’t emptied right away. consider bringing a bag or stuffing them in a discarded food wrapper from something else in your lunch.

no matter how good it tastes fish, including tuna, stinks. leave it at home- pack some nuts or a bean-based dish.

shitake mushrooms are very nutritious but smell like dirty diapers. leave them at home as well.

taking over the entire counter in the break room or the student commons is rude. minimize food prep or bring “instant” foods like grapes and carrot sticks.

hogging the microwave by bringing food that takes an excessively long time to heat up is also annoying. pre/partially cook food if you must bring something that can’t be eaten raw.

criticizing/ commenting on others’ lunches is obnoxious and doesn’t earn you any points. think about how it makes you feel when others say, “eeeew! you actually eat that?” or “really? you can’t have ____? how do you find anything to eat?” in time they will see how good you feel and how happy you are with your food choices. as the old saying goes, “the proof is in the pudding.”

42. eat well on the run.

i’m bAAAaaack! after a bit of a hiatus i’m firing up the old blog. i recently started a new job and went back to school. the ensuing craziness has inspired me to figure out how to eat on the go, or- even harder- on the run.

let’s start with the planning- write out your menu, preferably a week ahead. first, think about nutrition and major food groups. make sure you include protein in order to avoid fatigue as well as a headache. then figure out what beverage(s) to bring. next, consider what kind of packaging would be the most convenient. any job offers at least one break but not necessarily access to a kitchen. many schools do have a microwave but don’t allow food in the classroom. in this case you’ll need to bring several different items, one for each break.

finally, choose at least one ingredient that can serve double duty. for example, hummus makes a great dip for chips and/or raw veggies but it also tastes great on a veggie burger. additionally, it can be spread on a tortilla. tortillas are perfect for wrapping up scrambled eggs or veggies or fruit with cream cheese and can obviously be made into a taco. tortillas can also be smeared with some kind of nut/seed butter- even chocolate macadamia nut spread. sometimes i sprinkle a bit of cocoa powder over sweetened nut/seed butter.

now it’s time to go grocery shopping. (do not attempt this before figuring out exactly what you need.) for each item on the list think about the quantity you’ll need. is the food perishable… at all? if so, will you eat it all before it goes bad? if you’ve got a family or roommates this shouldn’t be a problem but when you’re buying for just yourself you don’t want too much left over; how many days in a row can you stand eating it? also, if you buy a large container you’ll need to prepare smaller portions in sandwich bags or plastic food saver containers. often it’s easiest to keep a small package in the car. for instance, i buy small tins of seasoned almonds, which are just the right size to fit in my cup holder.

when choosing a beverage it might be helpful to include a bottle of juice or a smoothie- sometimes you have to drink your nutrients. no matter what, water is a must. fill a reusable container, such as an exercise/hiking water bottle or simply bring bottled water and refill the container.

41. shop the perimeter of the supermarket.

i’ve heard that the perimeter of the supermarket is where the healthiest foods are. i suppose most people, whether they’ve got the munchies, need some last minute snacks for a party, or simply don’t care about nutrition, just want to get in and get out. they head straight for the center because it’s the shortest distance from the door. the more i thought about it i realized that the center is filled with starchy carbs, which are mostly processed foods full of salt and sugar. the produce and refrigerated sections are located around the perimeter. even when stores have a special diet section it’s located off towards the side.

since i’ve kept to the perimeter of my local chain grocery store i’ve discovered a previously-overlooked end cap of gluten-free products. i’ve also managed to locate a weekly sale isle in addition to a couple of carts that hold “distressed” merchandise where dented cans/boxes are discounted. recently i stocked up on some expensive organic tomato sauce. additionally, any time a brand changes its packaging the store must quickly get rid of all items with the old design. they’re still good, they just look different so the store has to discount them.

next time you shop start with the fruits and vegetables, then continue along the edges. if necessary, pop into an aisle to grab some quinoa pasta, salad dressing or granola bars. otherwise, don’t even bother browsing the chips and cookies- as the old saying goes: out of sight, out of mind.

40. know which questions to ask about clinical trials.

my previous posts (“fears and facts,” “pros and cons”) have explained the basics of drug trials. once you consider participating it’s important to know which questions to ask. most of these concerns should be addressed by whoever is conducting the survey, but answers to all of these questions must be provided upon request.

what experimental treatment is being tested?

has it been tested on humans before? if so, to what extent?

what is already known from earlier studies?

what is the intended purpose of the treatment?

what are the perceived risks? are there any known side effects or toxicities?

which company developed the treatment?

what is their track record for side effects, FDA approval and recalls?

who is conducting the market trial?

are they approved by the BBB (better business bureau)?

who funded the prior research? Who is funding the current study?

what is the duration of the clinical trial?

how often are study visits? what do they involve- will any invasive procedure be required?

what, if any, long-term follow-up will there be?

who should be contacted in case of problems?

this may all seem overwhelming but just like there are good dentists and bad dentists, trustworthy mechanics and deceptive repair people, effective teachers and lousy ones, there are safe clinical trials as well as dangerous ones. some treatments are helpful while others are harmful. though any study involves certain risks, this form of research isn’t necessarily negative- just be sure you know what you’re getting into.

39. hold medical researchers accountable.

as i’ve said in prior posts, doctors work for you because you pay them. you deserve compassion and respect, not to mention honesty. the medical community has many clear guidelines, which they are to follow- hold them to these principles! in 1947, the counsel for war crimes compiled a list of ten principles governing legitimate medical research on humans known as the nuremberg code. similarly, the WMA (world medical association) developed a set of principles for the medical community known as the declaration of helsinki. it emphasizes each patient’s right to make “informed decisions.” as for participation in research, “…the subject’s welfare must always take precedence over the interests of science and society, and ethical considerations must always take precedence over laws and regulations.” both the nuremberg code and the declaration of helsinki are the basis for the code of federal regulations issued by the united states’ department of health and human services. while these principles are generally accepted by much of the world unfortunately, not all countries (or states in the u.s.) have incorporated the nuremberg code into their laws.

now let’s examine the international code of medical ethics of the WMA. in 1949 they adopted a set of principles that specifically outlined the duties of doctors, which include:

  • “A doctor must practice his profession uninfluenced by motives of profit.”
  • “The following practices are deemed unethical: collaborating in any form of medical service in which the doctor does not have professional independence; receiving any money in connection with services rendered to a patient other than a proper professional fee, even with the knowledge of the patient.”
  • “A doctor is advised to use great caution in divulging discoveries or new techniques of treatment.”
  • “A doctor should certify or testify only to that which he has personally verified.”

after researching i’m less fearful of medical testing, as it is currently defined (see previously posted “fears and facts“). however, i’ve come across several disconcerting trends. first, many doctors receive monetary kick-backs from pharmaceutical companies. is this really promoting patient welfare? second, many medical schools receive funding from pharmaceutical companies. similarly, much clinical research is funded and/or conducted by drug companies. how objective can the findings be? third, is the prevalence of publication bias. research ethics committees around the globe (including sydney, australia; oxford, england; south africa; and the united states) have discovered that studies with statistically significant results are more likely to get published. for several decades, less than half to less than one-third of studies experienced a delay in publication. in fact, the increased likelihood of publication is attributed to researchers- certain studies are rated more highly because of the perceived importance of the results.

fortunately, as far back as 2003, JAMA (journal of the american medical association) has spoken out. “That it is not possible to find information about all initiated clinical trials is of international concern. This is a particular worry because scientists tend to publish their positive findings more often than their negative findings (publication bias).” not only that, many professionals within the medical field have urged their colleagues toward more ethical decisions; i have read a couple of journal articles to this effect. above all, the most influential factor is our support of those who adhere to the standards already set in place. no profession is safe from dishonesty and greed- why shouldn’t we hold medicine accountable?

38. know the pros and cons of clinical trials.

my previous post (“the facts and fears of clinical trials”) outlined the basics of market trials but there is still a lot to consider; it’s best not to make a hasty decision either way when deciding whether or not to participate. on one hand, you would be assisting with research, most of which experiences years of delay due to lack of participation in the testing process. on the other hand, there are risks and inconveniences, not to mention eligibility, to consider.

pros: participating in clinical trials will help to advance medical care and possibly help researchers find cures faster. cons: they require a time commitment and also may incur costs not covered by your healthcare plan. some trials require travel or even a hospital stay. pros: you will receive free drugs and frequent, intensive health monitoring. cons: you may not receive the experimental agent or it may not be effective. also, many medications have complex dosage requirements. pros: the satisfaction of helping others. cons: possible adverse side effects, such as life-threatening toxicities developed over time.

ultimately, whatever you decide should be based on facts and supported by research. know your options and your rights. be aware of what a particular study entails before you agree to participate. whether you accept or decline a request to join you will have peace of mind if you feel confident in your decision.

37. sort out the facts and fears of clinical trials.

chances are, especially if you have dietary restrictions, you have been asked to participate in medical research. clinical trials, also referred to as market trials, have been an integral part of the united states’ drug testing for decades. the FDA (food and drug administration) has been in charge of approving new drugs and medical devices* since the late 1930s but required no proof of the safety of new treatments until the early 1960s. today, anything new must go through several phases of trials before earning approval.

*dietary supplements are currently unregulated

phase I is the first time a particular treatment has been given to humans. it is administered in a low dose, which is increased if no side effects occur. in phase II the same treatment is given, though participants are randomly assigned different dosages given in different ways. phase III is usually offered by community-based oncologists simultaneously conducting studies around the country/the world. some participants receive the standard treatment, others receive additional dosages containing the new treatment. in phase IV the treatment is observed under “real world” conditions. researchers look for any long-term or previously unseen side effects, such as toxicity.

the most common concerns about clinical trials are possible side effects, the possibility of receiving a placebo (secretly empty treatment) and an overall lack of explanation/understanding. if you’re worried about side effects, there are always risks of any study. according to the american cancer society, placebos are rarely used alone in cancer research. the ACS claims that most trials simply compare new treatments against the current standard treatment. sometimes a new drug is added to the standard but everyone gets at least whatever standard treatment is currently available. as for explanation, we’ll further explore this issue over the next few weeks.