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Widespread Hype Gives False Hope To Many Cancer Patients

After Michael Uvanni’s older brother, James, was diagnosed with a deadly form of skin cancer, it seemed as if everyone told the family what they wanted to hear: Have hope. You can beat this, and we are here to help.

The brothers met with doctors at a half-dozen of the country’s best hospitals, all with impressive credentials that inspired confidence.

Michael Uvanni was in awe when he visited the University of Texas MD Anderson Cancer Center in Houston, one of world’s most respected cancer hospitals. It was like seeing the Grand Canyon, said Uvanni, 66, of Rome, N.Y. “You never get used to the size and scope.”

Even the MD Anderson logo on buses and buildings — with “Cancer” crossed out in red, above the words “Making cancer history” — made the family’s battle seem winnable.

“I thought they were going to save him,” said Uvanni, an interior designer.

Patients and families are bombarded with the news that the country is winning the war against cancer. The news media hypes research results to attract readers. Drug companies promise “a chance to live longer” to boost sales. Hospitals woo paying customers with ads that appeal to patients’ fears and hopes.

“I’m starting to hear more and more that we are better than I think we really are,” said Dr. Otis Brawley, chief medical officer at the American Cancer Society. “We’re starting to believe our own bullshit.”

The consequences are real — and they can be deadly. Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.

“We have a lot of patients who spend their families into bankruptcy getting a hyped therapy that [many] know is worthless,” Brawley said. Some choose a medicine that “has a lot of hype around it and unfortunately lose their chance for a cure.”

Although scientists have made important strides in recent years, and many early-stage cancers can now be cured, most of those with advanced cancer eventually die of their disease.

For Uvanni, hope gave way to crushing disappointment when his brother’s health declined and he died from metastatic melanoma in 2014.

“You get your hopes up, and then you are dropped off the edge of a cliff,” said Uvanni. “That’s the worst thing in the world.”

Caregivers like Uvanni can suffer prolonged grief and guilt if their loved ones are riddled with side effects and don’t survive as long as the family expected, noted Holly Prigerson, co-director of the Center for Research on End-of-Life Care at Weill Cornell Medical College.

For decades, researchers have rolled out new cancer therapies with great fanfare, announcing that science has at last found a key to ending one of the world’s great plagues, said Dr. Vinay Prasad, an assistant professor of medicine at Oregon Health & Science University. When such efforts fail to live up to expectations, the cancer world simply moves on to the next big idea.

Hyping early scientific results — based on lab tests or animal studies — can attract investors that allow researchers to continue their work. Positive results can lead biotech firms to be bought out by larger drug companies.

“It’s in the interest of almost every stakeholder in the health system to be optimistic about these therapies,” said Dr. Walid Gellad, co-director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.

Of course, there is plenty of money to be made.

The U.S. spent nearly $88 billion treating cancer in 2014, with patients paying nearly $4 billion out-of-pocket, according to the American Cancer Society Cancer Action Network. Spending on cancer, a disease that most afflicts the aging, is predicted to soar as people live longer.

“While many people are trying to make patients’ lives healthier and longer and better, there are others that are exploiting their vulnerability,” said Dr. Leonard Saltz, chief of the gastrointestinal oncology service at New York’s Memorial Sloan Kettering Cancer Center.

Others argue that the excitement about cancer research is justified. A spokeswoman for the Pharmaceutical Research and Manufacturers of America, an industry group, said cancer patients have good reason for optimism.

“We continue to see great strides in identifying the genetic mutations and related factors that can drive the seemingly random formation of abnormal cells in cancer,” spokeswoman Holly Campbell said in a statement. “In the last decade, we’ve seen a number of scientific advances transform the landscape of many cancers.”

Promises To Cure Abound

Even the country’s top scientists sometimes get carried away.

In 1998, Nobel laureate James Watson — who co-discovered the structure of DNA — told The New York Times that scientists would “cure cancer in two years” using drugs that block tumor blood supplies. At that time, the drugs had succeeded only in mice.

In 2003, the director of the National Cancer Institute, Dr. Andrew von Eschenbach, announced a goal of “eliminating suffering and death due to cancer by 2015” by better understanding tumor genetics.

Last year, when President Barack Obama announced the Cancer Moonshot, which aims to accelerate and better coordinate research, he said, “Let’s make America the country that cures cancer once and for all.”

In a recent interview, von Eschenbach acknowledged he didn’t communicate his goal well.

“We all fall into that trap,” said von Eschenbach, now a senior fellow at the Milken Institute, a health and public policy think tank. “We’re offering what we have, but making it appear that it’s more than what it is.”

It’s easy to see how patients’ hopes are raised, said Timothy Turnham, former executive director at the Melanoma Research Foundation, an advocacy group. Researchers are frequently overly enthusiastic about early discoveries that have little chance of leading to a new drug.

“There is a disconnect between what researchers think is statistically significant and what is really significant for patients,” Turnham said. “Patients hear ‘progress,’ and they think that means they’re going to be cured.”

A Marketing Blitz

Uvanni said his brother’s experience was nothing like the sunny images in TV commercials, in which smiling cancer patients hug their grandchildren, hike in the mountains and lead dance classes.

A TV commercial for the Bristol-Myers Squibb drug Opdivo projects the words “a chance to live longer” on the side of skyscrapers, as a captivated crowd looks on. In much smaller type, a footnote reveals that lung cancer patients taking Opdivo lived just 3.2 months longer than others.

A TV ad for Merck’s Keytruda features reassuring images of a smiling, healthy patient hugging her family — not fighting for breath or struggling to walk. Although the commercial notes that the people in the ad are portrayed by actors, the commercial claims the drug provides “a chance for a longer life. It’s Tru.”

“Your heart sinks when you see those ads,” Uvanni said. Seeing the family depicted in the ad, he said “makes you wonder if they’re going down the same path that we did.”

The Keytruda ad notes that 71 percent of patients given the drug were alive “at the time of patient follow-up,” compared with 58 percent of those who received chemotherapy. The ad doesn’t mention that the “time of follow-up” was 11 months.

“It’s not false; it’s just incomplete,” said pharmacist Harold DeMonaco, a visiting scientist at the Massachusetts Institute of Technology in Boston. “They don’t give patients or the patients’ family enough information to make a reasonable decision.”

In an interview, Merck senior vice president Jill DeSimone said that the company aims to be responsible with its advertising, noting that the Keytruda ad reminds patients to talk to their doctors. “The physician is the ultimate decider on treatment,” DeSimone said.

In a statement, Bristol-Myers’ senior vice president Teresa Bitetti said that Opdivo ads play “an important role in educating patients about new treatment options and fostering informed conversations between patients and their doctors.”

Hospitals also have drawn criticism for overstating their success in treating cancer. In 1996, Cancer Treatment Centers of America, a for-profit chain, settled allegations from the Federal Trade Commission that “they made false and unsubstantiated claims in advertising and promoting their cancer treatments.”

The company’s current commercials — dozens of which are featured on their website — boast of offering “genomic testing” and “precision cancer treatment.”

The commercials don’t tell patients that these tests — which aim to pair cancer patients with drugs that target the specific mutations in their tumors — are rarely successful, Prasad said. In clinical trials, these tests have matched only 6.4 percent of patients with a drug, according to Prasad’s 2016 article in Nature. Because these drugs only manage to shrink a fraction of tumors, Prasad estimates that just 1.5 percent of patients actually benefit from precision oncology.

In a statement, Cancer Treatment Centers of America said, “We use national media to help educate cancer patients and their families about the latest diagnostic tools and treatment options. … All of our advertising undergoes meticulous review for clinical accuracy as well as legal approval to ensure we tell our story in an informative and responsible manner, and in compliance with federal guidelines.”

Spending on ads for hospitals that treat cancer soared 220 percent from $54 million in 2005 to $173 million in 2014, according to a 2016 article in JAMA Internal Medicine. Ads for Cancer Treatment Centers of America accounted for nearly 60 percent of all total cancer center advertising.

Targeting Melanoma

For more than a decade, the Food and Drug Administration approved no new treatments for metastatic melanoma. Patients typically died within a year of diagnosis.

Since 2011, however, the FDA has approved 11 new treatments, including several immunotherapies, which aim to harness the immune system to fight cancer. Last year, doctors leading a clinical trial announced that the median survival of patients taking the drug Keytruda had grown to two years. Forty percent of patients were alive three years later, according to the clinical trial, presented at the American Society of Clinical Oncology.

Researchers have tested immunotherapies against a variety of tumors, leading to approvals in lung cancer, kidney cancer, bladder cancer and others.

Such success has led doctors to label cancer immunotherapy as a “game changer.” N­­ewspapers and magazines call it a “breakthrough.” And hospitals laud them as “a miracle in the making.”

Yet these treatments — which were initially assumed to be gentler than chemotherapy — can provoke fatal immune system attacks on the lungs, kidneys, heart and other organs.

And there are no approved immunotherapies for tumors of the breast, colon, prostate and pancreas.

Only about 10 percent of all cancer patients can expect to benefit from immunotherapy, Prasad said.

Uvanni’s brother — who tried immunotherapy, as well as a number of other approved and experimental treatments — survived 3½ years after his diagnosis. That might lead many oncologists to describe his story as a success.

Uvanni sees no reason to celebrate. He wanted more than short-term survival for his brother.

“I thought we were going to have a treatment where we’d at least have a good block of quality time,” Uvanni said.

But treatments meant to control the cancer only made him sick. Some caused flu-like symptoms, with fever, chills and shakes. Others left him nauseated, unable to eat or move his bowels. Others caused dangerous infections that sent him to the emergency room.

“I hope that if something like that happens to me,” Uvanni said, “I would be strong enough to say no to treatment.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Negotiating Drug Prices: Should State Agencies Band Together?

Citing budget-busting drug costs, a California lawmaker wants state health programs to band together to negotiate better prices with drug companies.

Assemblymember David Chiu (D-San Francisco) has introduced a bill that would strengthen intra-agency collaboration on drug cost-saving strategies. Lawmakers will consider the bill at an Assembly Health Committee hearing on Tuesday.

“Californians and Americans are frustrated with the lack of progress around drug prices,” Chiu said, citing the uproar over EpiPen and hepatitis C medications.

He said state agencies should pool their efforts “so that we can leverage that consumer power and get the best deal for our money.”

While the proposed California Drug Costs Reduction Act does not mandate that various California health programs such as Medi-Cal or Covered California purchase drugs together, it would require administrators of those programs and 17 other state agencies to convene twice a year to strategize about ways to keep costs down.

Through the California Pharmaceutical Collaborative (CPC), state officials would consider a uniform state drug formulary and look at paying for drugs based on the value they bring to the health system.

A pharmaceutical collaborative by that name already exists within the California Department of General Services and purchases drugs for state prisons, hospitals and universities. This bill would expand on those efforts.

Chiu says it’s unclear what the current program is doing, and if it has been successful in bringing down drug costs. The 2002 legislation that created the collaborative required only a few agencies to participate, and only one report back to the legislature in 2005.

A 2005 report from the California State Auditor suggested the Department of General Services could do more to bring down pharmaceutical costs for California.

A more recent analysis from the nonpartisan Legislative Analyst’s Office showed spending by the Department of General Services has increased at a relatively high rate — about 20 percent annually between 2012 and 2016, although that trend may have been skewed by the release of high-cost hepatitis C drugs during that time.

“I haven’t had transparency about the work that’s happened,” Chiu said. During a February 2017 California legislative hearing about drug prices, the lawmaker expressed frustration about not being able to get information about the workings of the CPC.

Chiu’s bill would require annual reports from the pharmaceutical collaborative, which the lawmaker says would ensure more accountability.

A spokesman with the Department of General Services, Brian Ferguson, wrote in a statement that it has been meeting “regularly” to create a “roadmap” to cut drug costs.

The proposal so far has no registered opposition. Priscilla VanderVeer, a spokeswoman with the drug company trade association Pharmaceutical Research and Manufacturers of America (PhRMA) had no comment on the proposal.

Other states such as Massachusetts have bulk purchasing programs for drugs, according to the National Academy for State Health Policy. And Oregon and Washington have joined together to create a bulk purchasing program. It is one of five multi-state pharmaceutical programs in the country, according to the National Conference of State Legislatures.

About a third of Californians have health care coverage through Medi-Cal alone. Together with Covered California, and the California Public Employees’ Retirement System (CalPERS), these agencies insure more than 16 million people.

Experts say the diverse ways state programs pay for drugs would make it hard to implement an across-the-board prescription drug purchasing system in California.

Ben Johnson, fiscal and policy analyst with the Legislative Analyst’s Office said that the Medi-Cal program has different rules for payment and coverage than the state’s prison system. Medi-Cal is also entitled to deep drug discounts that other state agencies don’t receive.

“A lot of work would have to be done to be able to actually harmonize and create a uniform system of drug procurement in the state,” Johnson said. His agency does not take positions on legislation.

Advocates for AIDS patients and retired people support the bill. The California Public Interest Research Group (CALPIRG), which sponsored the initial legislation to create the collaborative in 2002, supports the current proposal as well. In a letter to the bill’s author, the group said the measure would provide “additional tools and direction” and increase accountability on the state government’s actions to reduce drug prices.

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Dad learns to walk again for his daughters' sake after doctors said he was paralyzed

Seven months after doctors told him he’d never be able to use his legs again, a man stood up and walked out of a rehabilitation center with his two young daughters at his side.

Cole Thomas, of Rochelle, Illinois, told “Today” that he shattered a vertebra in a September 2016 car crash.

>> Need something to lift your spirits? Read more uplifting news

“I realized I was hurt very badly,” the 34-year-old father of two said. “I looked down at my legs, and I couldn’t feel them, and I was like, ‘Oh, boy.'”

He later learned he shattered his L2 vertebra and had pieces of it embedded in his spinal cord. Doctors told him he was paralyzed from the waist down.

>> Read more trending news

Determined to walk his young daughters down the aisle someday, Thomas posted a video to Facebook from his hospital bed.

“They told me I will never walk again. I’m bound and determined to prove them wrong,” he said in the video.

He asked people for help connecting him to resources to help him learn how to walk. A relative reached out with information about the Shirley Ryan AbilityLab in Chicago.

He started therapy just eight days after the accident.

After months of hard work and determination, Thomas walked out of the rehabilitation center on Friday with his daughters by his side.

“I know I was going to have to give rehab and therapy 110 percent, just like I did my job. I have to walk again no matter what,” Thomas told “Today.” “I have to be the best I could be.”

Best and Worst Salad Toppings

A few years back I typed up a list of New Year’s resolutions on a small piece of cardstock, laminated it, and put it in my wallet. On that list was the resolution to eat a salad every day, simply because eating salad always made me feel like I was doing something good for myself. After all, salad provides several vitamins and can fill you up while reducing your caloric intake. What could be healthier than a big, fresh salad? Unfortunately, many things, as I later found out. Salads can run the gamut of healthiness, depending on what is in them. Although that big bowl of greens may be packed full of antioxidants and fiber, it can also be laden with fat, cholesterol, and sodium—not to mention an overabundance of calories. Some restaurant salads can even contain more calories than a cheeseburger! Luckily, like most things in life, a salad is the outcome of several small decisions. To make sure you don't sabotage your healthy diet unintentionally, choose wisely the next time you order a salad from a restaurant or visit the salad bar. When dining out, don't be afraid to ask questions, make special requests (extra veggies, dressing on the side, light cheese) and ask about substitutions (like grilled chicken for breaded). Most restaurants will be happy to accommodate you as long as their kitchen is stocked with the ingredients you want. Here’s how to choose wisely next time you're making a salad at home or choosing one from a menu. Lettuce The foundation of most salads, lettuce adds substance, crunch, water, and fiber for very few calories—only about 10 per cup. But if you want all that and vitamins, too, toss out the iceberg and toss in the romaine, mixed baby greens and spinach. While iceberg lettuce is lower in nutrients (and still makes a decent choice if it's the only thing available), these other greens are rich in vitamins A, C and K, manganese, and folate. Protein Adding protein, such as lean meat, tofu, eggs or beans, will help bulk up your salad and keep you full longer. Unfortunately, many protein toppings are deep-fried, breaded and greasy, which adds unnecessary calories plus cholesterol, sodium and fat to your salad. Skimp on fattier toppings such as bacon and fried (breaded) chicken strips, and go for lean proteins instead. Grilled chicken, canned beans of all kinds, chickpeas, tofu, hardboiled eggs (especially whites), or water-packed tuna are leaner choices. Nuts and seeds are popular in salads, too, and while they’re a healthy source of good fats and some protein, they’re not exactly low-cal. If you choose to add them, watch your portions (1/2 ounce contains more than 80 calories). Cheese Restaurants know that people love cheese, so they tend to pile on multiple servings of it on their salads. It might be tasty, but it sends the calorie counts sky high! While cheese is a nutritious food that adds flavor, calcium, and protein to a salad, enjoy it in moderation due to its high fat content. Just a half-cup of cheddar cheese (the amount on many large restaurant salads) contains 18 grams of fat and 225 calories. To keep calories in check, use a single serving of cheese (approximately 2 tablespoons). Choose low-fat varieties as much as possible to save on saturated fat and calories. A smaller amount of a stronger-flavored cheese, such as Brie, feta, chevre, gorgonzola, sharp cheddar or bleu cheese will go a long way in helping you cut down on your portions. Pile on the Veggies Vegetables like bell peppers, grated carrots, sugar snap peas, and tomatoes provide flavor, fiber, and vitamins for few calories. Grated carrots, for example, have only 45 calories in a whole cup, and there are only about 20 calories in an entire red bell pepper. When building your best salad, use as many veggies as possible for extra filling power—and a nice crunch! Practice moderation when it comes to starchy vegetable toppings like corn and potatoes, which are higher in calories. And remember to go for a variety of colors to ensure you're getting several different nutrients and antioxidants in your salad bowl. Don't Forget the Fruit Don't leave fruit on the sidelines! Fresh, canned and dried fruits add a sweetness that can help temper the slightly bitter taste of greens and veggies. They also provide color and texture (not to mention nutrition) to your salad bowl. Chopped apples, pears, grapes, or mandarin oranges (canned in juice—not syrup—and drained) are excellent salad toppers. Chewy dried fruits (cranberries, raisins) work well, too, but they are also high in calories (so only use a sprinkle!). Avocados (and the guacamole made from them) are creamy and nutritious thanks to their heart-healthy fats, but they're also a concentrated sources of calories. Keep your use of avocado to a minimum if you're watching your weight. Crunchy Toppings Sesame sticks, crispy noodles and croutons are salty and crunchy but conceal lot of hidden fat. Better options include water chestnuts, apple slivers, a small serving of nuts, crumbled whole-grain crackers, and homemade croutons. To make your own low-fat croutons, just slice a large clove of garlic and rub it over both sides of a piece of whole-grain bread. Cut the bread into cubes and then brown it in the toaster or conventional oven. Dressing A very healthy salad could go very wrong with one too many shakes of oil or dressing. The main issue with dressing is its fat and sodium content—and the fact that people have trouble controlling their portions. Two tablespoons is an appropriate serving of dressing, but most restaurants serve much more than that, whether mixed in to your salad or served on the side. Those calories add up fast. When dining out, always ask for dressing on the side and dip your fork into the dressing before picking up your bite of salad. Caesar, ranch and other cream-based dressings (when not specified as low-fat) are calorie bombs worth avoiding. Look for dressings specified as "low-fat" that contain no more than 60 calories per serving. You can also add flavor for minimal calories by using salsa, vinegar or lemon juice. Salad may be the symbol of healthy eating, but not every salad is healthful—or diet-friendly. The healthfulness of your next salad depends on the simple choices you make when topping or dressing it. Perhaps my greatest discovery about salads was that because you can customize them so easily, you could make a huge main-course salad for a very small amount of calories. Pile in the lettuce and veggies, add a moderate amount of lean protein, sprinkling some cheese and a little something crunchy and measure a portion-controlled side of dressing, and you’ve got a dinner that won’t leave you feeling hungry.Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1388

How to Meet Your Protein Needs without Meat

Eating a vegetarian diet can be very healthful and rewarding. However, most vegetarians—including soon-to-be vegetarians and their meat-eating loved ones—are concerned about getting adequate protein. Most people are accustomed to getting protein from meat, but what else contains protein? Aren't plant-based proteins "incomplete" or lower quality? Fortunately, with a bit of extra attention, you won't have any trouble meeting your protein needs just because you give up meat. There are so many protein-packed vegetarian options! Did you know that most foods, including vegetables, have some of the essential muscle-building nutrient? Without looking closely, it is easy to miss some great sources. (Who knew a cup of broccoli had 3 grams!) Nuts, seeds, soy products, cereal, eggs and dairy are all good meatless protein choices. These groups of food each contain different amino acids (the building blocks of proteins) and different levels of protein quality. There is no need to consume certain foods in special combinations as nutritionists once thought! When your diet includes a variety of each of these types of foods, you can rest assured that you're consuming all the amino acids you need for muscle growth and cell repair.  Pin this graphic for easy reference and scroll down for more details. Nuts Nuts provide a good dose of protein along with some heart-healthy fatty acids and antioxidants (vitamins A and E). They are also packed full of fiber. Take your pick! Many nuts have a significant source of protein ready to work for your body. Peanuts, almonds, pistachios, cashews, and pine nuts are among the highest in protein, while chestnuts and hazelnuts, although they do still have some protein, are the lowest. Think out of the box when you’re adding nuts to your diet. They can be grated, toasted, ground or eaten raw and are great when combined with salads, wraps, soups and stews and baked goods. But pay special attention to portion size! Nuts are a great source of many nutrients, but do come with a hefty dose of calories, thanks to the healthy fats they contain. A single serving is just 1 oz! Many nuts are best when stored in a refrigerator, which helps keep their fats from going rancid (for up to 6 months).   Nuts, 1/4 cup Protein Calories Fat Peanuts, raw 9 g 207 18 g Almonds, dry roasted 8 g 206 18 g Pistachios 6 g 171 14 g Hazelnuts 5 g 212 21 g Pine nuts 5 g 229 23 g Cashews, raw 5 g 197 16 g Walnuts 4 g 164 16 g Seeds Seeds are another great way to grab a few grams of protein and many other nutrients. Healthful unsaturated fats, as well as phytochemicals, make seeds a powerhouse for heart disease and cancer prevention. Just a quarter cup of pumpkin seeds (also called pepitas) has 8.5 grams of protein. Add this amount to a salad or eat them plain for a quick snack. Sunflower seeds are easy to add to pasta or salads, or sandwich wraps, while sesame seeds are easily ground and sprinkled onto steamed veggies for a protein dusting.   Seeds (1/4 cup) Protein Calories Fat Hemp seeds 15 g 232 18 g Pumpkin seeds, roasted 9 g 187 16 g Flaxseed 8 g 191 13 g Sunflower seeds, roasted 8 g 205 18 g Sesame seeds, roasted 6 g 206 18 g Legumes Dried peas, beans and lentils belong to a group of food known as "pulses" or "legumes." Aside from soybeans, these plants have a very similar nutrient content, which includes a good dose of protein. On average, they have about 15 grams of protein per cup, and tagging along with the essentials protein are fiber and iron. Adding beans, lentils and dried peas to your meals is a great way to replace meat (a beef burrito can easily become a black bean burrito, for example) while still getting your much needed protein. Add pulses to soups, salads, omelets, burritos, casseroles, pasta dishes, and more! Make bean dips (such as hummus, which is made from garbanzo beans, or black bean dip) to spread on sandwiches and use as protein-packed dips for veggies or snack foods.   Legumes, 1 cup cooked Protein Calories Fiber Soybeans 29 g 298 10 g Lentils 18 g 230 16 g Split peas 16 g 231 16 g Navy beans 16 g 258 12 g Garbanzo beans (chickpeas) 15 g 269 12 g Black beans 15 g 227 15 g Kidney beans 15 g 225 11 g Lima beans 15 g 216 13 g Pinto beans 14 g 234 15 g Soy Soybeans are a complete protein that is comparable in quality with animal proteins. Eating soybeans (and foods made from soybeans) has been growing trend in America for only five decades, but this protein-rich bean has been a staple in Asia for nearly 4,000 years! This plant powerhouse is used to create a variety of soy-based foods that are rich in protein: tofu, tempeh, textured vegetable protein (TVP, a convincing replacement for ground meat in recipes), soymilk and "meat analogs," such as vegetarian "chicken" or faux "ribs" are all becoming more popular as more Americans practice vegetarianism. To learn more about using tofu, read Tofu 101. To learn how soy may impact your health, click here.   Soy Foods Protein Calories Fat Soybeans, 1 cup cooked 29 g 298 10 g Tempeh, 4 oz cooked 21 g 223 13 g Edamame, 1 cup shelled 20 g 240 10 g TVP, 1/4 cup dry 12 g 80 0 g Soy nuts, 1/4 cup roasted 11 g 200 1 g Tofu, 4 oz raw 9 g 86 5 g Soy nut butter, 2 tablespoons 7 g 170 11 g Soymilk, 1 cup sweetened 7 g 100 0.5 g Soymilk, 1 cup unsweetened 7 g 80 0.5 g Grains In a culture that focuses largely on wheat, it's easy to overlook the many types of other grains available to us. Some of these grains are very high in protein and can be included in your diet for both whole-grain carbohydrates and muscle-building protein. Quinoa is unusually close to animal products in protein quality, making it an excellent grain to replace white rice or couscous. It can also be cooked and mixed with honey, berries and almonds in the morning for a protein-packed breakfast. Other grains high in protein include spelt, amaranth, oats and buckwheat. Choose whole-grain varieties of cereals, pastas, breads and rice for a more nutritious meal.   Grains Protein Calories Fiber Amaranth, 1 cup cooked 9 g 238 9 g Quinoa, 1 cup cooked 9 g 254 4 g Whole wheat pasta, 1 cup cooked 8 g 174 6 g Barley, 1 cup cooked 7 g 270 14 g Spelt, 4 oz cooked 6 g 144 4 g Oats, 1 cup cooked 6 g 147 4 g Bulgur, 1 cup cooked 6 g 151 8 g Buckwheat, 1 cup cooked 6 g 155 5 g Brown rice, 1 cup cooked 5 g 216 4 g Whole wheat bread, 1 slice 4 g 128 3 g Sprouted grain bread, 1 slice 4 g 80 3 g Dairy If you consume milk products, dairy is a great way to add some extra grams of protein to your day. Low-fat milk, cheese and yogurt are easily accessible, quick to pack and fun to incorporate into many meals and snacks. Whether you’re drinking a cup of skim milk with your dinner or grabbing some string cheese before you run errands, you can pack about 8 grams of protein into most servings of dairy. You’re also getting some bone-building calcium while you’re at it! Keep in mind that low-fat varieties of milk products are lower in calories and fat, but equal in calcium to the full-fat versions; low-fat varieties may also be higher in protein.   Dairy Protein Calories Fat Fat-free cottage cheese, 1 cup 31 g 160 1 g 2% cottage cheese, 1 cup 30 g 203 4 g 1% cottage cheese, 1 cup 28 g 163 2 g Fat-free plain yogurt, 1 cup 14 g 137 0 g Low-fat plain yogurt, 1 cup 13 g 155 4 g Parmesan cheese, 1 oz grated 12 g 129 9 g Whole milk yogurt, 1 cup 9 g 150 8 g Goat's milk, 1 cup 9 g 168 10 g 1% milk, 1 cup 8 g 102 2 g Swiss cheese, 1 oz 8 g 106 8 g 2% milk, 1 cup 8 g 121 7 g 3.25% (whole) milk, 1 cup 8 g 146 8 g Low-fat cheddar/Colby cheese, 1 oz 7 g 49 2 g Part-skim mozzarella cheese, 1 oz 7 g 72 5 g Provolone cheese, 1 oz 7 g 100 8 g Cheddar cheese, 1 oz 7 g 114 9 g Blue cheese, 1 oz 6 g 100 8 g American cheese, 1 oz 6 g 106 9 g Goat cheese, 1 oz 5 g 76 6 g Feta cheese, 1 oz 4 g 75 6 g Part-skim ricotta cheese, 1 oz 3 g 39 2 g Eggs Eggs contain the highest biologic value protein available. What this means is that an egg has a near perfect combination of amino acids within its shell; when assessing protein quality of all other foods (including meat), nutrition experts compare them to the egg. This doesn’t mean that all other sources of protein are less healthful or less important but does mean that an egg is an awesome way to get a few grams of protein. At 6 grams for one large egg, there are endless ways to add it to your diet. Salads, sandwiches, breakfasts or snack—an egg can fit in anytime!   Eggs Protein Calories Fat Egg, 1 boiled 6 g 68 5 g Egg white, 1 cooked 5 g 17 0 g Liquid egg substitute, 1.5 fl oz 5 g 23 0 g As you can see, protein is EVERYWHERE in our diet, and even without meat you can get enough every day; you just have to look in the right places! For more ideas for using these various plant-based proteins, check out our dailySpark series, Meat-Free Fridays for recipe and cooking ideas! Selected Sources Information Sheet: Protein from The Vegetarian Society (VegSoc.org) Various nutrient profiles from The World's Healthiest Foods (WHFoods.com) Want to learn more about going meatless? Check out SparkPeople's first e-book! It's packed with over 120 delicious meat-free recipes, plus tips and tricks for going meatless. Get it on Amazon for $2.99 and start cooking easy, wholesome veg-centric meals the whole family will love!Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=158

Umami: What You've Been Missing!

You've slimmed down your recipes, made healthy food swaps, and integrated vegetables into your meals. But do you ever feel like your food is missing something? When you finish eating, do you ever wonder why a meal just didn't hit the spot? You're probably missing umami. You've probably heard of the four basic tastes: bitter, sour, sweet and salty. Well, "umami," which means "yummy" in Japanese, is another distinct taste. Commonly found in fermented or aged foods, umami (pronounced ooh-mah-mee) adds that "mouth feel" to food. It makes your food feel richer, more delicious and more decadent. A key component in Chinese and Japanese cuisine, umami is starting to gain importance in Western cooking. American cooking tends to rely on fat or salt to get that feeling, but there are other, healthier ways to give your food and meals a little more oomph. Ever notice how parmesan makes pasta taste so much better? Or how much tastier ketchup makes your burgers? The parmesan, the tomatoes, and the beef all contain umami. Think about Japanese miso soup or almost any Chinese food. They're delicious and satisfying, thanks to umami-rich seaweed, fish, and soy sauce. Many foods are considered to have umami, including familiar foods like pepperoni pizza and hamburgers! And many condiments that seem to add "empty" calories (ketchup, steak sauce and Worcestershire sauce) actually help food feel more satisfying when you eat it. Here's a list of some umami rich foods:

By adding more of these foods to your meals, you can boost your satisfaction and potentially eat fewer calories overall and avoid overeating. A little goes a long way, and many foods rich in umami should be used as seasonings rather than main ingredients because they can be high in sodium and fat. Try adding a pinch of Romano cheese to steamed veggies or adding asparagus or mushrooms to your salad. If you're feeling decadent, put a pinch of crumbled bacon or a couple of sun-dried tomatoes in an egg white omelet. That could be just what hits the spot! Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1348

30 Ways to Revitalize Your Lunch Break

Lunchtime doesn't have to be bland or boring, just as it doesn't have to be a frenzied time to run errands or multitask. Our printable calendar provides 30 ideas to add a little adventure to your midday break. Click here to download and print your Adventurous Lunch Break Calendar. (You need Adobe Acrobat Reader to download this PDF.) If you think your friends or family members might benefit from these heart-healthy tips, share this calendar with them by clicking the "Share" button below.Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1336

Parents shed 'happy tears' after birth of baby without brain takes uplifting turn

An Oklahoma couple who decided to carry their baby without a brain to term in hopes of helping others has said "hello and goodbye" to their newborn daughter.

Royce Young shared the ups and downs of the couple’s emotional experience in a post on Medium on Thursday.

The Youngs learned in December that their second child had anencephaly, a rare birth defect that causes the frontal lobe of the brain to fail to develop. Children born with the condition usually die shortly after birth. Keri Young asked the doctor if she carried the baby to term, whether she could donate the baby's organs to help others. When the Youngs were told that it was possible, they decided to carry the baby to term.

Royce Young's Facebook post about his wife's reaction to learning their baby would be born without a brain went viral in February.

>> Read more trending news 

The couple named the baby Eva Grace. The baby stopped moving in the womb on April 16, prompting immediate medical attention. Doctors confirmed there was no fetal heartbeat. There would be no organ donations, not even an opportunity for fetal tissue research. Royce said he and his wife were devastated.

Doctors induced labor and Eva was born on April 17. At the same time, a call came from a LifeShare representative, an organization that manages organ donations in Oklahoma. The doctor told the Youngs the good news: They had a recipient for Eva’s eyes.

Royce said the couple shed happy tears upon hearing the news that Eva would still be an organ donor. Royce said he’s excited about Eva’s eyes being her “living legacy.”

 

25 Dinners With No Added Sugar That Help You Stick to Your #Goals

Think about it: That tablespoon of maple syrup in your salad dressing, the honey in your Asian-inspired stir-fry sauce, the generous drizzle of ketchup on your burger. Despite many people’s best efforts, that sugar still manages to creep into so many healthy dinner dishes. But meals can be just as tasty and easy to make without the slightest hint of added sweetener. We’ve rounded up 25 added-sugar-free dinners proving just that. 

Poultry 1. Healthy Orange Peel Chicken Photo: Lively Table In a welcome contrast to the honey-soaked restaurant version, this dish uses the actual peel and fresh juice of the orange for its fruity flavor and sweetness. It’s also all done in one pan, so it’s really only marginally harder than ordering in.  2. Creamy Buffalo Chicken Pasta Photo: Living Loving Paleo Instead of sugary ranch dressing for the “creamy” portion of this pasta, this recipe’s secret weapon is blended cashews, which make the dish incredibly rich in a much healthier way. If you use the coconut oil option instead of ghee, the dish also becomes entirely dairy-free. 3. Yogurt Chicken Curry Photo: Chef de Home Along with tang, plain yogurt adds some mild sweetness to this otherwise spicy curry. It’s so much better for you than the butter chicken you’d find in a traditional Indian restaurant, but just as tasty, especially paired with naan or rice.  4. Taco Stuffed Sweet Potato Photo: Spinach 4 Breakfast Get your taco the gluten-free way by stuffing your turkey mixture into a sweet potato. You get an extra serving of fiber and a touch of natural sweetness; plus, it’s a lot more fun to eat this way.   5. Chicken, Sweet Potato, and Coconut Stew Photo: Chew Out Loud There’s a lot that’s sweet about this recipe, but none of it has anything to do with sugar. It’s all from the sweet potatoes, the creamy coconut milk, and the freshly squeezed orange juice. Clean eating really doesn’t have to be hard or bland. 6. Easy 30-Minute Turkey Chili You’ll notice that the teaspoon of sugar in this chili is entirely optional—and it’s for good reason, since you won’t miss it at all if you omit it. With sweet bell peppers, mild turkey, cumin, and chili powder to spice things up, there’s already plenty of flavor going on.  Beef/Pork 7. Weeknight Sesame Steak Salad Photo: PDX Food Love A good steak salad shouldn’t just be a meal you order at a restaurant. It’s just as easy to re-create at home. As a bonus, you control everything that goes on to this plate, from the quality of the meat to the homemade dressing to the fun add-ins such as avocado and peanuts. 8. Peanut Broccoli and Pork Stir-Fry Photo: Nutritionist Reviews Asian-inspired food is delicious, but unfortunately, tends to use alarming amounts of added sugar, such as honey or sweetened sauces. This one gets its not-too-sweet flavor from a blend of rice vinegar and peanut powder (use peanut butter as an alternative)—it’s so good and so easy, you may want to bottle some of it for future stir-fries and salads. 9. One-Pot Beef and Tomato Macaroni Soup Photo: The Recipe Rebel Even canned soup can come loaded with sweeteners and additives. Ditch the store-bought stuff and whip up your own take on the classic beef and macaroni soup with a recipe that comes together in fewer than 30 minutes and uses all real food, including whole-wheat pasta. 10. Grandma's One-Pan Hamburger Helper Photo: The Seasoned Mom Packaged Hamburger Helper may save you a few minutes in the kitchen, but it isn’t doing a whole lot for your health with ingredients such as corn syrup, sugar, and MSG. This stovetop version packs in lean ground beef, whole-grain macaroni, and plenty of actual tomato sauce, and is hardly time-consuming to put together.  11. Spring Pea Risotto Photo: Kiwi and Carrot Who needs sugar when you have rich, creamy carbs that involve bacon? Not only is this recipe the ultimate savory comfort food, it also comes together in just 35 minutes—pretty much record timing for a risotto. 12. Yellow Rice Pork Chop Bake Photo: Food Done Light This foolproof rice recipe requires no stovetop stirring—the oven-baked method gets it just right. Plus the combination of saffron, paprika, and garlic powder will have your kitchen smelling heavenly.  Seafood 13. 20-Minute Baked Pesto Salmon Photo: Skinny Fitalicious With an avocado-based pesto slathered over salmon, this recipe is all about the “s” word—that is, superfoods, not sugar. Pair the fish with asparagus for a filling—not to mention, incredibly good-looking—plate.  14. Avocado Tuna Cakes Photo: Well Plated Get your protein and healthy fats in these neat little patties. Held together with egg and breadcrumbs then baked, they’re tasty and versatile. Serve them on a salad or with roasted veggies.   15. Pineapple Chipotle Salmon Tostadas Photo: Joyful Healthy Eats Fruit is a fantastic way to give a dish some all-natural sweetness, and a little goes a long way. These tostadas, piled high with spiced salmon and cooled off with a pineapple salsa, are a perfect example. 16. Cajun Shrimp and Rice Photo: Everyday Easy Eats No room for sugar in this spicy rice dish; Cajun seasonings, a squirt of lemon, and protein-packed shrimp do more than enough to make it tasty without the need for sweeteners, all-natural or otherwise.  17. Shrimp, Orzo, Spinach, and Feta Casserole Photo: The Straight Dish Next time anyone declares that seafood and cheese don’t mix, plate them up a big ol’ portion of this. The salty feta and shrimp go so perfectly with the garlicky pasta and sauce, you’ll no doubt be serving seconds. 18. Panfried Halibut With Grapefruit and Mango Salsa Photo: Cooks With Cocktails This dish packs in so many different flavors, you won’t even feel like you’re eating “light.” Simply seasoned halibut is pan-seared until flaky and topped with an herbed and slightly spicy fruit salsa. It’s refreshing and satisfying all at once. 19. Easy Tilapia Pomodoro Photo: My Life Cookbook Crusted in bread crumbs and Parmesan, and lightly browned—not fried—in a pan, this tilapia dish looks fancy, but requires just six ingredients. The easy tomato sauce makes for a tangy complement to the mild fish.  Meatless 20. Garlic Asparagus Artichoke Pasta Photo: Pumpkin and Peanut Butter While there’s no sugar in this recipe, it does use funky store-bought cubes of garlic, herbs, and ginger. If you can’t find them, just use regular garlic cloves and spices. This super-simple pasta will be just as delicious either way. 21. Pad Thai Zucchini Noodle Quinoa Salad Photo: Simply Quinoa Sugar is almost always included in an authentic pad Thai. This recipe departs from tradition, going for a loosely inspired version that not only skips sugar, but also uses zucchini “noodles” and adds quinoa for extra protein.  22. Quinoa Fried Rice Photo: Everyday Easy Eats Everyone needs a fried rice recipe in their arsenal, but give yours a superfood upgrade by using quinoa as a base instead. The fluffy kernels are chewy enough to hold up to the veggies and do a great job of absorbing the soy and Sriracha sauce. 23. Vegetable Samosa Bowl Photo: Kristin's Kitchen Who doesn’t love going to an Indian restaurant and starting off with a plate of crispy, deep-fried samosas? While that’s all well and good once in a while, try a healthier version at home. The veggie filling is piled on top of rice instead of wrapped in dough, and a spicy, cilantro sauce replaces the sugary tamarind one on the outside. 24. Easy Tempeh Fajitas Photo: B Brtinell Like tofu, tempeh soaks up whatever flavors you put on it. Here, it’s marinating in lime juice, garlic, and classic Mexican spices, then quickly sautéed with veggies for a fantastic weeknight fajita dinner.  25. Lentil Sloppy Joes Photo: Modern Little Victories Using lentils instead of meat for sloppy joes is a common vegetarian fix, but lots of recipes use brown sugar to sweeten the tomato sauce. This one nixes the sweetness, letting the tomato sauce and spices speak for themselves.  

 

15 Things Yogis Can’t Live Without

Sure, you have a yoga mat (you’re not doing your flow on a hard floor, right?), but if you really want to embrace your inner yogi, a mat is just the tip of the iceberg. We found more than a dozen irresistible products that all yoga lovers will be obsessed with. They range from the useful (yoga blocks and yoga bags) to the silly (namaste puns, anyone?). Having them around has been making us feel all sorts of zen.

1. Pinch Provisions Fitness Kit How many times have you walked into yoga class only to realize you don’t have a hair tie? This cute kit has you covered. You'll find the hair tie you were looking for, plus bobby pins, extra socks, ear buds, sample-size dry shampoo, deodorant towelettes, a foldable brush, a headband, a tampon, lip balm, blister balm, Band-Aids, safety pins, and breath mints. It's the definition of a lifesaver. ($22; shopspring.com) 2. Namast’ay in Bed Mug We all have that chipper friend who’s an unapologetic morning person and thinks it’s OK to say, “You sure you don’t want to sign up for a 7 a.m. flow this Sunday?” Just send them a selfie while sipping on some coffee (or booze—we’re not here to judge) from this cheeky mug. Problem solved. ($16.75; zazzle.com) 3. ClassPass We’re all about at-home yoga, but doing the same flow again and again gets boring. Classes are our favorite way to spice things up (Bikram, aerial, and beer yoga are all amazing), and ClassPass makes it so easy to sign up for the coolest yoga classes in your area. Bonus: They’re giving Greatist readers 70 percent off their first month.  (Price varies depending on location; classpass.com) 4. Yoga Joes G.I. Joe must be stiff from standing at attention for so long. You know what he needs? Yoga. These Yoga Joes flawlessly demonstrate nine moves, from child’s pose to warrior I (appropriate, right?). They'll be an awesome addition to any shelf or desk.  ($25; uncommongoods.com) 5. Sweaty Betty Yoga Block Unless you’re uber flexible, you’re going to need a yoga block at some point in your flow. Maybe you use it for support during triangle pose, or you grab two blocks to deepen your stretch in downward dog. You could purchase any old block, or you could get this one from Sweaty Betty. It might be made from the same foam, but it looks so much better. ($16; shopspring.com) 6. Quiver of Arrows Yoga Bag Embrace your inner Katniss Everdeen with this sweet yoga bag from Brogamats. It’s functional (a full-length zipper means you can fit all standard-size mats) and a great conversation starter. Next time you head to a new studio, bring this bag, and you’re pretty much guaranteed to make some new friends.  ($40; amazon.com)   7. Namast’op I Can’t Even T-Shirt You know those moments when you’re in a hot yoga class and you slip while easing into warrior II because you’re basically a puddle of sweat? The little voice in our head says what's printed on this t-shirt (plus an expletive or two). So obviously we need to be wearing it. ($35; shopbetches.com) 8. Bed of Nails Acupressure Mat and Pillow Twisting yourself into a pretzel in yoga class might work wonders to relieve muscle tension, but this mat takes it to the next level. Don’t let the name “bed of nails” scare you—there isn't anything you would find in a hardware store attached to this mat. Instead, the pointy acupressure plates stimulate blood flow to ease any lingering muscle soreness or pain.  ($39.95; amazon.com) 9. Athleta Get to Work Gym Bag Finding a fashionable gym bag that actually holds your yoga mat? We thought that was impossible until we came across this beauty from Athleta. The straps along the side of the bag are specially designed to hold your mat. And, on top of that, both the interior and the exterior have lots of pockets so this doesn't become the giant black hole that most gym bags are.  ($79; athleta.gap.com) 10. Yogitoes Yoga Mat Towel Call us skeptical, but every no-slip yoga mat we’ve tried hasn’t worked as advertised. At the beginning of class it appears to be doing its job, but the second we start sweating, our mat turns into a slip 'n slide. OK, fine. We're being a *little* dramatic, but you get the point. And that’s why these towels come in handy. They’re pricey, but washable. Put one over your yoga mat and never slip again—seriously.  ($59.01; amazon.com) 11. Every Body Yoga We wish we had someone like Jessamyn Stanley by our side when we started practicing yoga—someone to tell us to stop comparing ourselves to everyone else in class, someone to tell us how yoga can help us love our bodies. Her how-to book has 50 basic poses and 10 sequences, but it’s not just for beginners. We can all learn something from the way Stanley thinks (and talks) about yoga.  ($11.56; amazon.com) 12. Yummi Yogi Cutting Board Your charcuterie board has never looked so balanced! This adorable handmade cutting board is shaped like someone in tree pose, making it super Instagrammable when you’re using it to cut fruit or serve cheese and crackers.  ($50; etsy.com)  13. Pug Yoga Poster We’ll spare you the downward dog puns and just say this poster of pug poses is perfect for anyone who loves dogs or yoga—or both! And doesn’t that cover pretty much everyone out there?   ($24.88; society6.com) 14. The Mindfulness Coloring Book Feeling stressed? Chakras out of whack? Keep this mini coloring book in your bag or your back pocket—it really is small enough to fit. Its 70 designs range from flowers to butterflies to rolling waves, making them all a quick way to zen out on those days when you're too busy to take an hour-long yoga class.  ($6.45; amazon.com) 15. Hey What’s Up Let’s Flow T-Shirt We’re not sure if Fetty Wap does yoga, but it doesn't matter. This twist on the opening line in his song “Trap Queen” makes us laugh every time anyway. We know, we know—$50 is pricey for a tank top. But can you really put a price on telling the world, “Hey, I’m zen and on trend?” Didn't think so. ($50; y7-studio.com)

 

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