Shop Smarter at the Grocery

You’ve heard the old excuse before: Healthy eating is expensive. I can confidently call my food choices healthy—at least most of the time—but I’m also a cheapskate at heart. Luckily, I manage to eat healthy on a budget, thanks to a few simple swaps—some of which save calories, too!

Too pricey: Fresh berries, Smart swap: Frozen berries
Fresh berries are often very expensive, especially when they are out of season. Frozen berries cost much less and they’re just as nutritious for you. Plus, with frozen berries, you don’t have to worry about eating them before they go bad. Throwing away rotten food is like wasting money!

Too pricey: Instant oatmeal, Smart swap: Quick oats
Instant oatmeal is great in a pinch, but buying a huge canister of quick oats is a much more cost-effective option. If you compare unit price on the two items, it’s much more economical to purchase the quick oats. For an on-the-go option, I portion out 1/2 cup of quick oats, put them in a Tupperware container, and add hot water when I get to my destination. Plus instant packets are often packed full of added sugars (and calories!). I prefer to sweeten my bowl with more natural options, like thawed frozen berries.

Too pricey: Vegetable chips, Smart swap: Kale chips
As a salty snack, homemade kale chips are a great swap to expensive veggie chips. And at less than 50 calories per cup, they’re just a fraction of the calories as the store-bought stuff. While they do require some prep work, kale chips are incredibly easy to make. Just spray washed kale with cooking spray, season with sea salt, and bake at 350° for about 15 minutes. They taste just like potato chips!

Too pricey: Fresh salmon fillet, Smart swap: Canned salmon
We all know we should eat more fish, as it is rich in omega-3s, but buying fresh fish is not always friendly on my wallet. Instead, I swap fresh salmon for canned salmon, which is much less expensive, and I am still able to get those healthy omega-3s in my diet. Plus, salmon salad makes an über-tasty packed lunch.

Too pricey: Whey protein powder, Smart swap: Tofu
Tofu sometimes gets a bad rap due to its mushy texture and bland taste, but swapping it with expensive whey protein powder in my smoothies saves me quite a few dollars. As a healthy, hunger-fighting protein source, tofu blends right into my smoothies, but for a fraction of the price.

Too pricey: Lärabars, Smart swap: Nuts and dried fruit
Lärabars are one of my favorites snacks, but buying them every week definitely takes a toll on my budget. Instead, I eat dried fruit, like dates and prunes, and nuts, like almonds and walnuts, and save my Lärabars for a special treat. Eating dried fruit and nuts together makes a very filling snack that also satisfies my sweet tooth.

More tips for saving at the grocery store
Plan a week ahead. Impulse buys occur most when you shop already hungry for your next bite. You’ll also be more aware of when you’ll be home for meals and will be less likely to overbuy.

Check your fridge and pantry before you head out the door. You’ll be surprised at the random ingredients you already have which might spur your creativity for the coming meals.

Don’t be afraid to buy bruised or discounted produce. Just be sure that you will use it within the next few days before the bruising worsens or before the food becomes overripe.

Buy staples in bulk when possible and store them correctly. Although many people advise creating a list and sticking to it, don’t overlook sales on frequently used items just because you don’t need them this week.

Courtesy of


Medical Vacations: Traveling for Surgery

When Godfrey Davies learned he needed surgery to remove polyps blocking his nasal airways, the self-described bargain shopper set out on a mission to find an affordable surgeon. He quickly learned a good deal is hard to find.

“The total numbers they were throwing at me were just incredible. I couldn’t believe it,” he says.

Davies, who is semiretired from his real estate business and uninsured, says he received estimates from two surgeons. When hospital, anesthesia and incidental fees were all tallied, the cheapest price he could find in Indianapolis, Indiana, was $33,127 — which he would need to pay out of pocket.

“I was speechless.” Davies recalls. “It was absolutely out of the question financially for me to have this done under those circumstances.”

Frustrated that his bargain shopping saved him so little, Davies called on family in the United Kingdom for assistance. When they told him they had found a private hospital in Wales that would perform the surgery for $2,930 [or £1,897], Davies didn’t think twice. He purchased a $768 round-trip ticket, and on March 18, he boarded a flight to the UK to have his polyps removed there at a savings of nearly $30,000.

Medical tourism on the rise
An estimated 878,000 Americans will travel internationally for a medical procedure this year, according to a report from the Deloitte Center for Health Solutions. That number is expected to nearly double by 2012.

The majority of medical tourists are uninsured; however, the cost of health care in this country has become so expensive that even some U.S. health insurance companies are coordinating with hospitals overseas. “It is curious to a number of folks as to why an established American health insurance company would be interested in medical tourism,” says David Boucher, president of Companion Global Healthcare, a subsidiary of Blue Cross Blue Shield.

His pilot program launched in 2007 as a “medical travel facilitator,” allowing participating employers to add an international option to the health care plans they offer to staff. The company has partnered with 29 hospitals in 14 countries and offers negotiated rates that are lower than those offered at hospitals domestically. Boucher says employers will sometimes waive co-pays or purchase airline tickets if an individual opts to travel abroad for expensive surgery because, ultimately, it benefits everyone.

“If you can save forty to fifty thousand on an employee’s surgery, it gets right to the company’s bottom line,” Boucher says.

So far, only a handful of insurance companies are offering this type of service, says Jessica Johnson, director of operations for the Medical Tourism Association, an international trade organization that acts as a liaison between patients and their international providers. She says even with insurance though, many Americans remain underinsured, so more people are educating themselves on the options.

“It’s all about affordability, quality and access,” Johnson says. “Something they don’t find as often here.”

Before you hop on a plane
Sure, the prices are affordable. But is it safe? Experts say before you hop on a plane, there are a few important things to take into consideration.

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Which is better: Getting Your Nutrients from Pills or Food?

To take the multivitamin or to not take the multivitamin: That is the question researchers are still trying to answer. New research on vitamins has offered conclusions that weren’t crystal clear. But researchers generally recommend getting vitamins from foods, not supplements, to boost your health.

Vitamin supplements and cancer
A study done on women in Puerto Rico, presented Sunday at the American Association for Cancer Research, found that multivitamin and calcium supplements have a protective effect against breast cancer. But a large Swedish study in the American Journal of Clinical Nutrition found that taking multivitamin supplements may increase the risk of breast cancer.

The Puerto Rican study, which was not published in a peer-reviewed journal, looked at the capacity of DNA to repair itself in the face of damage. A low DNA repair capacity has previously been linked to cancer risk, said Jaime Matta at the Ponce School of Medicine. Researchers surveyed 268 breast cancer patients and 457 healthy controls and took samples from them to analyze their DNA repair capacity. They found that participants who took multivitamin supplements reduced the odds of having breast cancer by 30 percent, and those who took calcium had a 40 percent decreased risk. Statistical analysis suggested that the calcium effect could be explained by the DNA repair capacity, but the vitamin effect was independent. Taking supplements of individual vitamins such as A, C and E had no effect, Matta said.

The Swedish study, which looked at more than 35,000 Swedish women, found that those who reported taking multivitamins were 19 percent more likely to develop breast cancer than those who said they didn’t take them.

Both studies should be looked at in the broader context of research on the subject, which has consistently found no association between multivitamins and cancer, said Joanne Dorgan, epidemiologist at Fox Chase Cancer Center in Philadelphia, Pennsylvania.

A 2009 study of more than 160,000 women in the U.S. Women’s Health Initiative found no link between multivitamin use and the likelihood of developing cancer or cardiovascular disease, or of dying. Other large-scale studies similarly have not found connections between breast cancer and multivitamin use.

The Swedish study, which also has a large sample, should be followed up, Dorgan said.

Although the Puerto Rican study is small, it generates a useful hypothesis about DNA repair capacity that should be looked into also, said Dr. Banu Arun, professor of medicine at University of Texas M.D. Anderson Cancer Center. It is important to explore why some people may benefit from vitamin intake more than others, and DNA repair capacity is a possible factor in that, she said.

Arun’s bottom line: “Don’t take all of these multivitamins with the intention that it will decrease breast cancer risk. Getting the vitamins and minerals from natural sources — food source — is the best.” Those with deficiencies because of genetics or chronic illnesses should compensate with supplements, she said.

Vitamins in diet and the heart
Getting nutrients from foods gets more support from a large Japanese study published in the Journal of the American Heart Association. Researchers looked at more than 23,000 men and 35,000 women, ages 40 to 79. They used questionnaires to assess how much folate, vitamin B-6 and vitamin B-12 participants had in their diets.

They found that greater intake of folate and vitamin B-6 was linked to fewer deaths from heart failure in men. These nutrients were also linked to fewer deaths from stroke, heart disease and overall cardiovascular diseases in women. When researchers controlled for cardiovascular risk factors and took out the participants who used supplements, the folate and vitamin B-6 continued to show these benefits.

Previous research has found that higher levels of homocysteine, an amino acid in the blood, may be related to blood clots and artery lining damage. B vitamins such as folic acid help break down homocysteine, but this study does not prove a direct cause.

The study represents a substantial source of data to further evaluate or expand upon dietary recommendations, said Linda Van Horn, nutrition researcher at Northwestern University Feinberg School of Medicine, who was not involved in the study. The large sample size and the standardized food frequency questionnaire give credence to the study, Van Horn said. “These particular nutrients — there’s no reason to think they wouldn’t be as important in an American population as they are in a Japanese population,” she said.

Still, the findings may not be entirely generalizable to the United States, as the Japanese dietary intake is different, and the country’s population is less obese as a whole. There should be a similar assessment in the United States to determine if the findings can be applied there, researchers said.

The message is to eat foods that contain B-vitamins, Van Horn said. These include dark green leafy vegetables such as spinach, broccoli, dried beans, peas, lentils and kidney beans, and chickpeas. Many cereals are also fortified with the vitamins.

Courtesy of CNN

Skin and Aging

It seems a paradox: The top layer of skin is replaced about once a month, so why does skin age? Part of the aging process is genetic. Just as your genetic makeup determines your eye color and whether your hair is curly or straight, genes also have some say in whether your skin retains a firm texture into your 60s and 70s, or begins to wrinkle and sag during your 40s. The breakdown of collagen and elastin that leads to droopy, lax skin occurs at different rates in different people.

Chronological Aging
Time takes its toll. As the years go by, skin undergoes a number of biochemical changes. Epidermal cells don’t slough off as easily, and the supportive fibers of collagen and elastin break down. Skin doesn’t retain as much moisture as it once did. The skin’s ability to fight infection, feel sensations, and regulate body temperature also diminishes. Over several decades of sending instructions for new cell production, the DNA can become damaged and allow cells to grow out of control, with skin cancer as the result.

The deterioration of collagen and elastin and the pull of gravity can result in some of the classic signs of aging skin: fine lines around the eyes, deepened expression lines at the corners of the mouth and across the forehead, and sagging skin. The nails usually become more brittle, and hair may begin to thin.

The single biggest cause of damage to skin as you age is not aging itself — it’s sun exposure. This damage is called photoaging. Over the years, sun exposure causes fine and coarse wrinkles; baggy skin with a yellow, leathery appearance; and dry, scaly skin. It also increases the risk for skin cancer. Because sun exposure diminishes collagen, which supports a network of blood vessels, photoaging can cause skin to bruise more easily.

You can easily distinguish the effects of photoaging from those of chronological aging. Look at the lines and pigmentation of the skin on your face and the back of your hands; feel its texture. Now do the same on a part of your body that hasn’t received much sun exposure, such as your lower abdomen or buttocks. The difference can be great, especially if you’ve been a sun worshipper throughout your life. People are spending billions of dollars annually to try to counteract the effects of photoaging (see “Skin rejuvenation procedures”).

Skin damage from sun exposure is caused by ultraviolet (UV) radiation. Not all the sun’s rays are created equal. Some wavelengths of UV radiation penetrate the skin more deeply than others. Realizing this difference has prompted researchers to question whether some types of UV rays mainly cause wrinkles and the brown spots (sometimes called “age spots” or “liver spots”) while others speed the development of skin cancer.

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Tar Heel Barbecue

For any of you with roots and/or family on the East Coast, you may know that North Carolina BBQ is one of the best regional meals you can find. Slow cooked pork with a light, spicy, vinegary sauce stands alone on a toasted bun; hopefully accompanied by a good slaw and some hushpuppies. Forget the heavy, sweet, or bottled sauces and the thought that dinner will only take 30 minutes to make. BBQ is as much about the company as it is about the food. If you’re in the Piedmont area try Allen and Son’s off of US 15/501 between Pittsboro and Chapel Hill and you’ll know what I’m talking about.

Assuming that you are a novice to the world of barbecuing pork and do not possess a charcoal grill, we will start with the basics. You will need the following:

1. A kettle-type charcoal grill (Weber is good)
2. One fire bucket or small charcoal grill
3. Fifteen pounds of hardwood charcoal (Kingsford is good)
4. One bag of hickory wood chunks
5. One small shovel or scoop
6. One pair of barbecue tongs
7. One pair of heavy rubber gloves
8. One sharp knife
9. One cutting board
10. One or two meat cleavers or chef knives
11. One stock pot (approx. 10-12 quart)
12. One roll of paper towels
13. One kitchen size waste can
14. One cup of salt
15. Charcoal lighter gel
16. A plastic water bottle with cap with holes (for fires)
17. A meat thermometer
18. One and a half quarts of barbecue sauce (recipe of your choice)

Salting the Meat and Preparing the Grill
Have your butcher prepare you an eight-to-nine-pound fresh pork shoulder Boston Butt. Rub the exposed side of the meat (not skin side) with a fair amount of salt. Set aside at room temperature. Place approximately half of a 10-pound bag of charcoal in a charcoal chimney, add dollop of ligher gel and light. Do not use lighter fluid, gas or other substance that might impart flavor to the charcoal. When the charcoal briquettes are lit and covered with light gray ash, transfer to kettle cooker. Arrange seven or eight briquettes in a circle at the center of the grill around the grate in the bottom and equally divide the remaining briquettes into piles positioned on opposing sides of the grill. Place several hickory wood chunks on top of each pile of briquettes. Arranging the briquettes in this fashion is the same principle employed by my grandfather and taught to me as a child. He called it “banking your fire.” It is the same principle of slow cooking meat with the fire around the edges that James Kirby imparted to Eddie Mitchell (Wilson). The wood chunks will soon begin to smoke. Put the cooking rack on the kettle (be sure the rack has been wire brushed, well cleaned and oiled with vegetable oil and dried).

Cooking the Meat
Set the pork butt, skin side up on the center of the grill above the circle of coals. Place the lid on the grill and leave the vent holes top and bottom open. Light another dozen or so briquettes in the charcoal chimney. When the briquettes in the chimney are covered with ash, add five or six briquettes to each pile on either side of the kettle grill. You do not have to replenish the circle of briquettes during the cooking process. Place a couple of hickory wood chunks on each of the two piles of charcoal. This process is repeated every 30 minutes from the time you initially place the meat on the grill. Try to replace the kettle grill lid quickly each time you add additional coals and wood to prevent the cooking fire from cooling. You do not need to check the meat between replenishing the charcoal briquettes and hickory chunks.

After meat has cooked for six-and-a-half to seven hours, turn the meat skin side down on the grill. If meat is cooking too quickly, only add four or five briquettes plus wood chunks to each side of the kettle grill each half hour for the next two-hour cooking period. If meat does not appear to brown, continue with adding six briquettes plus wood chunks every half-hour for the next two-hour cooking period. Cook meat skin side down for two hours. Entire cooking time should be eight to nine hours.

At this point if you are Phil Schenck (pit master at Bridges Barbecue Lodge) and have been cooking 60-90 shoulders per night, six nights a week for 19 years you can simply look at the meat, mash on it with a finger and know if it is cooked to perfection. Some people at this point wearing heavy rubber gloves, grasp the meat with both hands and squeeze it firmly. The meat should “give” if it is sufficiently done. I prefer to use a meat thermometer. The meat should have 170 degree internal temperature. If you do not feel “give” or the meat has not attained an internal temperature of 170 degrees, replace the meat on the grill, cook for another hour and try again. If you have kept your fire at a constant cooking temperature the meat should be done the first time you squeeze it or check with a meat thermometer.

Finishing the Meat
When the meat is done remove from the grill to the cutting board, remove skin, and trim away any fat. The meat is now ready to be pulled from the bone in chunks and chopped. After removing the meat from the bone, use cleaver(s) or sharp chef knives to chop the pork into the consistency you like. (I prefer coarsely chopped). You may wish to finely chop a tiny bit of fat (no gristle) and some crisp pork skin and mix with your chopped meat. Either or both of these additions add great flavor to your offering. Dowse meat lightly with sauce or dip and turn until all meat has some exposure to the sauce or dip. Do not over-sauce at this point. Guests can add additional sauce to suit their particular tastes. If you are not ready to serve at this point, place the meat in a warm stockpot and cover with heavy foil, keeping airtight. Do not set the stockpot on the grill, as the meat will continue to cook and the meat in the bottom of the pot will scorch.

Courtesy of the North Carolina Barbecue Society

Surprising Triggers of Heartburn

Heartburn is as American as apple pie; more than 60 million people experience it at least once a month. For those with gastroesophageal reflux disease or GERD, heartburn can be a constant companion. Some heartburn triggers are obvious: chili dogs, chocolate, Thanksgiving, but heartburn doesn’t stop and start with food alone. If you have constant heartburn, it’s time to track down the real culprit.

Here are some sneaky and often overlooked causes of heartburn.

As if anyone needed another reason to quit: Smoking makes GERD worse. Smoking can weaken the valve between the stomach and esophagus (so stomach acid flows back into the esophagus); cause fat-digesting bile salts to migrate from the small intestine to the stomach; and cut down on saliva, which normally flushes stomach acid out of the esophagus and contains a natural acid-fighter, bicarbonate. How do you spell heartburn relief? Q-U-I-T.

Prone to frequent headaches and heartburn? Think twice about reaching for the ibuprofen. When used regularly, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can trigger heartburn. Some prescription drugs can too, including antibiotics, calcium channel blockers (for high blood pressure), bronchodilators such as albuterol (for asthma and COPD), osteoporosis drugs, and some sedatives. Consult your doctor if you think your Rx is causing heartburn—don’t just decide to stop taking a drug on your own.

Fish Oil Supplements
Fish oil contains omega-3 fatty acids and has been hailed as a natural way to manage heart disease, depression, and countless other health conditions. However, it can also cause heartburn. The oil —not the fish — appears to be responsible for gastrointestinal side effects. Fish itself is low in fat and high in protein and is an excellent food for heartburn sufferers when used in a healthy, heartburn-soothing recipe.

Stress does seem to trigger heartburn, but the relationship is trickier than you might think. Stress does not cause an off-the-charts surge in stomach acid production. However, a study in the Journal of Psychosomatic Research suggests that a heartburn patient’s perception of his symptoms — and not the actual levels of stomach acid — are associated with stress. In other words, stressed people may be more aware of heartburn symptoms or the neurological effects of stress might ratchet up pain receptors in the esophagus.

Peppermint, like fish oil, is a double-edged sword when it comes to the stomach. Peppermint tea, peppermint-oil capsules, and even peppermint candies are often used to settle upset stomachs, but these remedies can backfire on people with GERD. The soothing and numbing effect of menthol tends to relax the valve that separates the stomach and esophagus (known as the lower esophageal sphincter), which can cause stomach acids to drift up the esophagus more easily, aggravating heartburn.

Being Overweight
The more you weigh, the more likely you are to have heartburn. A 2003 study in the Journal of the American Medical Association found that the risk of acid reflux symptoms increases along with body-mass index (BMI). The association seems to be stronger in women than men (especially premenopausal women). Explanations vary: poor diet, excess body fat in the abdomen, and chemicals released by body fat have all been cited as possible culprits.

Your Genes
Wondering what’s causing your heartburn? Take a look across the dinner table; your parents, not your plate, may be partly to blame. In recent years, twin studies have suggested that 30% to 45% of your risk for GERD is dependent on genetic factors. (The rest is up to you: what you eat, whether you smoke, whether you exercise.) Experts aren’t entirely sure what explains the hereditary nature of GERD. It could be due to inherited physical traits, such as abnormalities in stomach function or a hypersensitivity to stomach acids.

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Educate Grandchildren About Philanthropy

You don’t have to look far these days to find people in need of a helping hand. Earthquake survivors in Haiti, flood-ravaged communities in the United States, and other natural-disaster victims—all have an urgent need for large-scale, airlifted donations. At the same time, perhaps closer to home, the mortgage crisis and rising unemployment force families to seek help from local charitable groups, which in turn need their resources bolstered by individual contributions. So now is a good time to start teaching your grandchildren about the importance of charitable giving. Here are some tips to get you going.

Teach By Example
As with so many things in life, the best way to impart a lesson to your grandchildren about the importance of charity is to set a good example. That means being open with kids about the causes that matter to you, the volunteer work you do, and the money you donate. It also means involving them in your charitable efforts.

If you’re writing a check to your favorite cause, explain to your grandchildren why you’ve decided to support it. Visit the organization’s Web site together to show them how the group you’ve chosen helps others.
If you’re involved in a volunteer activity in which your grandchildren can participate, ask them to do so. I have one client who volunteers at a soup kitchen once a month and brings his granddaughter with him to help. Not only do they help feed hungry people in their community, they get to spend time together, too.

My own grandchildren know that giving money and time to charity is the norm in our family. I often talk with them about my involvement in various charities, and they see me heading off to meetings and events. But at the same time, I don’t make a big deal out of it, because I don’t want them to think there’s anything unusual about what we do. It’s simply the way we live.

Tap Into Their Interests
When you’re involved in causes that affect you personally, you can expect grandchildren to be eager to get involved themselves. But you can’t automatically assume that all of your favorite charities will become theirs. Sharing your own priorities for donations and support is a good way to introduce them to the concept of giving back to the community.

It’s also important as they grow up that their philanthropic projects come from their own interests. Pay attention to your grandchildren’s hobbies, to the topics that interest them most in school, and to items that catch their attention on the news. My own grandchildren spend hours watching nature shows on Animal Planet and the Discovery Channel, so we’ve spent time talking about the environment and global warming. I’ve encouraged the kids to think about making donations to groups that help with those concerns.

Start Early
Like teaching a foreign language, preparing your grandchildren for a lifetime of charitable giving starts ideally when they’re young. A picture of you pushing a baby grandchild or a toddler grandchild as you do a charity walkathon will make a great photo for the child’s baby book. Later, such experiences will become tales you can tell the kids of how they were active in charity even when they were little.

Age 6 or 7 is a good time to start involving your grandchildren directly in your charitable causes. A cause that’s close to home gives you a place to start. Many families, unfortunately, have a close relative who has some kind of serious health issue. You can show your grandchildren the Web site of an organization that helps people with that condition. You can also consider causes that are close to kids’ lives, such as schools, libraries, children’s hospitals, or religious institutions.

You can help grandchildren get on the road to giving back by at least partially funding their early charitable efforts. When my husband and I give our grandchildren money today, it always comes with a caveat: They can spend half on whatever they want, but the other half must go to a charity of their choice.

Charitable giving is its own reward—we know that it feels good to do good. By helping your grandchildren get involved in a cause, you’ll give them a gift of wisdom: the knowledge that each has the power to help make a difference and become a positive force in society.

Courtesy of AARP