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California Proposes Stringent Cap On Toxic Chemical In Drinking Water

California regulators are proposing a strict limit on a toxic man-made chemical that has contaminated water supplies throughout the state, particularly in its vast agricultural heartland.

California would be only the second state, after Hawaii, to establish a threshold for the former pesticide ingredient and industrial solvent known as TCP (1,2,3-trichloropropane) in drinking water. The chemical compound, identified in California as a human carcinogen, is no longer in wide use but has leached over the years into many wells and reservoirs.

The problem extends well beyond California and Hawaii, environmental advocates say, but the chemical is not regulated by the federal government. Citing federal data, the Environmental Working Group, a Washington, D.C.-based advocacy organization, says the chemical also has been detected in water supplies of a dozen other states, including New York, Pennsylvania and New Jersey, as well as Puerto Rico.

Once TCP gets into the groundwater, it “persists for centuries,” according to the EWG’s April report.

The California State Water Resources Control Board’s proposal would set the maximum allowable amount of TCP in public tap water at five parts per trillion — the lowest level that existing filtration systems can reliably detect and far lower than Hawaii’s.

It “is a top priority for the state water board,” said board spokesman Andrew DiLuccia.

TCP taints water systems serving nearly a million people from Sacramento to San Diego, according to the state water board. The compound is present at levels above the proposed limit in 562 wells, reservoirs and other sources belonging to 94 public water systems, according to 2016 data. Those numbers do not include private wells.

In California, the contamination exists in many urban areas, including in Los Angeles, San Bernardino and San Mateo counties. Though the source in those more populated regions is not known, the pollution is believed to come from industrial and hazardous waste sites.

“Los Angeles has quite a bit of contamination,” said Andria Ventura, toxics program manager for the environmental advocacy group Clean Water Action. “It’s hard for water providers to pinpoint where it came from.”

But California’s most serious and widespread TCP contamination is in the agricultural counties of the Central Valley, where the chemical was an ingredient in soil fumigants sold by the Shell Oil and Dow Chemical companies from at least the 1950s into the 1980s.

During that period, farmers who grew potatoes, sugar beets and other vegetables used the fumigants to kill tiny, soil-dwelling worms called nematodes. Dozens of municipalities and public water suppliers across the state have filed lawsuits against Shell and Dow, alleging that the companies knew — or should have known — that the TCP in their soil-fumigating pesticides would migrate into groundwater and pose a serious health hazard.

Shell and Dow have denied wrongdoing. Shell quit selling its product, known as D-D, in the mid-1980s. About the same time, Dow opted to reformulate its fumigant, known as Telone, after which TCP declined to “generally undetectable” levels, according to company spokesman Jarrod Erpelding. He declined to comment further, citing pending litigation.

Shell sent an email response: “The former Shell agricultural product, last manufactured more than 30 years ago, contained trace amounts of 1,2,3 trichloropropane (TCP). It was used to control microscopic worms that attacked crops causing millions of dollars a year of crop loss for farmers, and was approved for use by the U.S. government and the State of California.”

Environmental advocates say the adoption of a regulatory limit for TCP is a crucial step to help cash-strapped, rural water districts pay for the cleanup of their drinking water.

“It allows the districts when they go into court to be very specific and say to the judge, ‘We’re going to need exactly this amount of money to purchase this kind of system to meet the state standards,’” said Bill Walker, managing editor at the Environmental Working Group and co-author of its report on the role of Shell and Dow in California’s TCP drinking water problem.

“It doesn’t guarantee they’ll win,” he said, “but it increases their leverage.”

At a public hearing on April 19, water board members heard testimony and received written comments on the proposed limit. Now the board is reviewing the input it received and will likely vote on the plan by summer, DiLuccia said.

The regulation would require water utilities to test their supplies for TCP and remove it from any public drinking water source that exceeded the threshold, starting in 2018.

The proposed limit is more stringent than Hawaii’s because it is as close as California could get to meeting its stated “public health goal” for TCP set in 2009, officials say.

Though it is difficult to know how long the California cleanup might take, the cost of TCP testing and subsequent cleanup could reach nearly $500 million over 20 years, according to one water board estimate.

TCP contamination “disproportionately impacts poor communities and communities of color,” said Jenny Rempel, of Community Water Center, a Visalia, Calif.-based advocacy group. “This is a problem where the cost should not be borne by taxpayers.”

Todd E. Robins, a San Francisco attorney who is representing more than two dozen of the water suppliers that are suing Shell and Dow, argues that the companies included TCP in their worm-killing pesticides to get rid of the compound without having to pay for proper disposal. It was a byproduct of unrelated manufacturing processes and, according to the suits, played no role in killing the plant-damaging worms.

“The TCP that we find today in groundwater is the result of past use of soil fumigants that contained TCP as an unnecessary ingredient,” Robins said. “Instead of paying for disposal costs, they started getting farmers to pay for them.”

“The saddest part of the story,” Robins added, “is that the … actual active ingredient breaks down in the soil after a matter of days and has rarely been detected in anyone’s groundwater.”

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One of the lawsuits filed by Robins, on behalf of the Del Rey Community Service District in Fresno County, says the companies knew they could remove or reduce the amount of TCP in their pesticides without compromising its effectiveness but failed to do so.

The complaint calls TCP a “hazardous waste” — a byproduct created in the manufacturing of a different chemical, allyl chloride, that Shell and Dow used to make plastics and other commercial products.

An internal Shell memo uncovered in Robins’ litigation cites $3.2 million in savings from “cost avoidance for disposal” related to the allyl chloride operations. The memo is dated Jan. 20, 1983 — a year before the company stopped producing the TCP-laced pesticide.

In addition to the pending cases, which also name distributors and marketers as defendants, Robins said he has settled eight cases against both Shell and Dow since 2010. He said he cannot disclose the amounts because of confidentiality agreements.

Last December, in a case tried by a different lawyer, a Fresno Superior Court jury awarded the city of Clovis $22 million against Shell to clean up its TCP-tainted drinking water.

In 2010, in a case brought by the city of Redlands, Shell won. The company argued that a nearby aerospace plant was the source of the toxin. Moreover, the wells in question were used for irrigation, and the jury didn’t believe they’d ever be used for drinking water.

As the lawsuits proceed, some California residents do what they can to protest the toxic chemicals in their water supply. Bartolo Chavez, 57, took time off his job in a juice packing house to testify at the recent hearing in Sacramento.

“We talk about the contaminants and the danger,” said Chavez, who has lived for 21 years in the Central Valley town of Arvin, Calif. “And [that] we’re exposed.”

He said he gets tokens from the water district to get free filtered water — not just because of TCP but because of other contaminants as well, such as arsenic and chromium-6.

“But the tokens aren’t enough,” Chavez said, speaking through a Spanish-language interpreter. “So in addition, we buy bottled water at Costco.”

Chavez and his wife, a hotel worker, pay about $50 a month for that water — a price they say they can ill afford. But leaving Arvin isn’t an option either, Chavez said.

“I have thought about moving, but it’s not so easy to find work in other places, especially when you’re older,” he said. “Our house is almost paid off, and to move would be to start over again, so it’s almost impossible.”

California Healthline Managing Editor Bernard Wolfson contributed to this report.  This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

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

5 Healthier Mac and Cheese Recipes

Macaroni and cheese is a comfort food staple, but let's face it: With all the cream, butter, and cheese (and artificial ingredients, if you're making the boxed variety), it's not the healthiest. But there's good news: With just a few swaps and additions, mac and cheese can get way healthier. Here's how.

1. Buffalo Chickpea Mac and Cheese This vegan macaroni dish is a little unconventional, but the additions are definitely worth the effort. The noodles are topped with crunchy romaine lettuce, spicy Buffalo roasted chickpeas, and creamy (non-dairy) ranch-style dressing. 2. Creamy Butternut Squash Mac and Cheese Butternut squash and Greek yogurt make this pasta dish super creamy and comforting without, you know, cream. A sprinkle of whole-wheat breadcrumbs on top adds some delicious crunch, and (bonus!) it freezes perfectly for last-minute dinners.  3. Broccoli-Basil Mac and Cheese This healthy casserole is topped with breadcrumbs made of (wait for it... ) broccoli. The cheesy sauce includes butternut squash, cherry tomatoes, and Greek yogurt. So it practically has more veggies than noodles, making it a dish you can feel good about chowing down on.   4. Vegan Gluten-Free Mac and Cheese The gluten-free, vegan "cheese" sauce this recipe uses gets its cheesy texture from nutritional yeast, making it a super healthy alternative to a classic roux. It also calls for lots of roasted garlic, so the end result is so flavorful, no one will know they're eating vegan and gluten-free—unless you tell them. 5. Bacon and Pea Macaroni and Cheese In this smokey, bacon-y mac and cheese recipe, bright green peas add some much-needed vegetables while creamy Greek yogurt replaces some of the cheese. It's a healthier option on pretty much all fronts. Naturally, we love it.

Originally published November 2014. Updated April 2017.

14 Ways to Cook Fish This Summer If You Don't Have a Grill

Nothing says summer like slapping fresh fish on the grill and enjoying a cold one with your friends on a patio. No grill, you say? Not to worry. There are plenty of ways to make a tasty summer meal with the kitchen equipment you already have, and we’ll prove it with these 14 recipes. From crisp salmon to juicy shrimp, fire up anything but the grill and get cookin’.

1. Broiled Striped Bass You can still get color and char on fish by popping that pan in the broiler. Essentially an upside-down grill, the broiler is our No. 1 solution to making fish taste just like you cooked it outside on your deck. This simple striped bass is covered in sweet tomatoes and briny olives. 2. Cajun Mahi Mahi With Mango Salsa This sweet and spicy fish gets its kick from Cajun seasoning, balanced out by a pineapple-mango salsa. Searing mahi mahi gives it a crispy exterior, and best of all, the whole meal takes 15 minutes, tops. Summer dinners are about to be easy AF. 3. Seared Salmon Searing is a quick way to get some color and crispy crust on a piece of fish. Plop a piece of salmon in a pan and let it cook without flipping for longer than you think. Serve with a warm lemon butter cream sauce. 4. Poached Cod in Tomato Sauce Poaching fish sounds tricky, but it’s another one of those simple cooking methods you need to try this summer. This mild cod dish is cooked in bubbling tomato sauce until tender. 5. Coconut Fried Pineapple Snapper As far as fried food goes, this snapper dish is fairly light thanks to just six ingredients. Dredge snapper in flour, dip in an egg-and-pineapple-juice mixture, then coat in coconut flakes. Serve with a side of roasted veggies, cauliflower rice, or a healthy fruit salad. 6. Oven-Fried Catfish A fish fry seems like classic summer food, but try making it a little healthyish next time by oven-frying. You’ll still get that crispy, battered coating, yet there’s no grease from deep-fried oil. 7. Baked Shrimp Boil A seafood boil just sounds like summer, but if you’re not in the position to cook outdoors, the answer is to throw everything on a sheet tray. Seriously, when have shrimp, sausage, potatoes, and corn ever steered you wrong? 8. Broiled Miso Cod With Asparagus Satisfy a craving for Japanese food sans takeout with this miso cod recipe. Veggies get tossed in a sesame oil sauce, and the fish is coated in a miso glaze. Make sure to factor in time to let the fish marinate for maximum flavor. 9. Braised Catfish Steaks Even if you don’t have a traditional Korean stone pot you can braise fish like a pro. Lug out any thick pan or dutch oven to make these sweet and spicy catfish steaks. 10. Steamed Red Snapper Like grilling, steaming is a simple cooking method—which gives you more time to focus on the gorgeous weather. This Jamaican-style red snapper is steamed in a spicy broth and served with tender veg. 11. Superfood Baked Salmon One pan, Whole30 approved, and 20 minutes from start to finish? We’re sold. Add salmon, Brussels sprouts, lemon slices, and a blueberry-balsamic mixture to a sheet pan, and bake for 15 minutes. Pro tip: Heat them under a broiler for 2 minutes to make everything extra crispy. 12. Poached White Fish in Tomato Basil Sauce Frozen white fish fillets sound meh, but with just a few extra ingredients, they’re practically a gourmet meal. Cook the fillets in chicken stock, white wine, and garlic, and throw in cherry tomatoes and fresh basil… 30 minutes on the stove and you’re good to go. 13. Baked Lemon Butter Tilapia Tilapia is a pretty mild fish, so consider this your go-to summer party staple—even picky eaters will enjoy it. Mix butter, lemon juice and zest, and garlic, then drizzle the mixture over tilapia. With a quick garnish of salt, pepper, and parsley, the fish comes out light, flaky, and just a little tangy. 14. Baked Honey Cilantro Lime Salmon Dress up your usual oven-baked salmon recipe with garlic and a honey-lime glaze. Once you dress the fish, all you have to do is pop the sheet pan in the oven for 25 minutes. Go ahead, pour yourself a drink while you wait.

 

11 Epic Fitness Retreats That Belong on Your 2017 Calendar

Day-to-day workouts are fun and all, but sometimes you need to couple that sweat session with a little extra culture, music and, uh, wine. That’s why fitness retreats and festivals exist—they’re all about balance, meeting like-minded people that turn into lifelong friends, and having a helluva good time. (After all, you’re still on vacation.) These are the ones to book this year, whether you’re looking for a quick one-day getaway or an epic multiday sleepover. If you do sign up (and you should!), just be sure to warn your friends and followers that you're about to serve up a serious dose of FOMO.  East Coast 
Surf Yoga Beer When: July 14-16Where: Hunter Mountain, NYWhat: Just a two-hour drive from New York City sits Hunter Mountain, where you and a group of friends (because yes, they will be your BFFs by the end of the weekend) will kick off a "detox-to-retox cycle," as SYB likes to call it. You’ll do as much as you can outside, including swimming in the lake, yoga on the lawn, and hiking (maybe even ziplining) in the woods. And since you’re on vacation, you'll have ample opportunity to imbibe a few beers—because, you know, balance. You’ll even head back home feeling more centered: There are presentations on things such as "how to chill out about food" and creating healthy habits, so you can get in the groove of starting the day with a glass of lemon water or taking deep breaths in times of stress. When the weekend is over, start saving your pennies for SYB’s international getaways in drool-worthy destinations like the Amalfi Coast and San Pedro, Belize. Swoon. Prices start at $400; surfyogabeer.com Glamping Yoga Retreat When: June 30-July 2Location: Finger Lakes, NY What: Hiking. Nature. Yoga. If those things sound right up your alley—but roughing it in a sleeping bag, eh, not so much—then this retreat is for you. While nestled in the Finger Lakes region of Central New York, you’ll flow through four yoga classes (three vinyasa style and one restorative) and set off on scenic hikes through Ithaca’s Buttermilk Falls State Park. Rather than returning to a not-so-comfy campsite, you’ll sip wine under the stars, eat s’mores by the campfire, and sleep in fully furnished safari tents with beds and plush robes (!). When it’s time to refuel and recover, expect farm-to-table dining and complimentary access to saunas and a steam room at August Spa by Firelight Camps. You know, everything that ~summer dreams~ are made of. Prices start at $648; fingerlakesyogascapes.com Spartan Week When: May 14-21Where: Miami, FL What: OK, we know this one’s a bit of an investment, but it’s worth it for you CrossFit diehards and obstacle race gurus. For one week, 1 Hotel South Beach will host the first-ever Spartan Week and challenge you on everything from Spartan obstacles to unleashing your meditative potential. Created in partnership with Joe Di, director of fitness and training for Spartan Race, you’ll choose between a three- and four-night stay and participate in a range of activities—even morning Hurricane Heats are available—and follow it up with recovery classes and post-training meditation. When all’s said and done, you’ll walk away with a Spartan Week medal and custom t-shirt so you can proudly sport your accomplishments on the flight home (or at your next Spartan Race). Prices start at $1,500; 1hotels.com 
Midwest 
Adventure Mindful Running Retreat When: August 10-13, August 17-20Where: Boulder, CO What: For those ready to hone their trail-running skills—and get a taste of training at altitude—this retreat in Boulder, CO, is pretty badass. Organized by professional trail runner Timothy Olson, two-time winner and record holder of Western States 100-mile race, you’ll not only learn how to effectively navigate trails without burning out your energy but also spiff up your healthy eating, yoga, and meditation skills (and walk away with a sweet swag bag). If you ever thought running was boring before, your mind will be forever changed after this trip. Prices start at $650; adventuremindful.com Soul Camp When: June 24 Where: Chicago, ILWhat: While most fitness retreats focus on a specific sport or activity—yoga, hiking, biking, etc.—Soul Camp looks at you from a 360-degree perspective, which is pretty awesome because, well, we’re not just what we do. So when you sign up for either a day-only or sleepaway camp, just know you’ll be taking a whole range of classes: nutrition, yoga, meditation, mindfulness, public speaking, social activism, fitness, and more. Each day there’ll be about 30 teachers, speakers, and instructors to learn from, and each night there’s a host of talent shows, late night discos, s’mores, and live entertainment. It really is like summer camp for grown-up kids. Just don’t be surprised if you walk away feeling refreshed and ready to take on the world. Prices start at $99; soul.camp Yoga on the Mountain You might also like {{displayTitle}} READ When: August 11-13Where: Snowmass, CO What: Yoga, yoga, and more yoga. That’s what you can expect at this new, three-day boutique yoga festival from Power Yoga Retreats set in Snowmass, CO, just a short 20-minute drive from Aspen. There are more than 60 classes to choose from, including basics like introduction to Ayurveda and more complex options like hypnotic flow. When you’re not moving through sun salutations—or, LBH, enjoying that savasana—there’s live music, meditation, hiking and, yes, even a party or two. Because finding your zen includes letting loose a little, right?Prices start at $150; gosnowmass.com Soulstice When:  July 13-16Where: Sundance, UTWhat: Tucked away in Utah's Wasatch mountains, Sundance Mountain Resort is everything you ever imagined a rustic cabin weekend could be, and Soulstice isn't your average fitness retreat. This four-day, three-night, all-inclusive trip has unique fitness activities such as outdoor aerial yoga, stand-up paddleboard yoga in a geothermal spring crater, reformer Pilates, BOSU fitness classes, and sunrise vinyasa on the mountaintop. It's the kind of experience that gives off those feel-good vibes you only get when surrounded by your soul sisters—whether you've known them your whole life or you just met them. Sure, it's on the pricey side, but bonus offerings such as floral arrangement classes, salt spa experiences, glam touch-ups pre-garden party, and live music (among others) make it worth it. Trust us, you'll never regret taking a good-for-your-soul getaway. Prices start at $1,250, soulstice.com
West Coast 
REI Outessa When: July 14-16, August 18-20, September 22-24Where: Kirkwood, CA; Mt. Hood, OR; Waterville Valley, NH What: Adventurous ladies, put your hands up. REI has launched a three-day outdoor adventure program designed to get women outside without worrying about who’s judging them, which means no boys allowed. (Hey, sometimes you just need your girls to create a supportive learning environment.) You’ll customize the long weekend from start to finish, starting with accommodations (anything from resort condos to glamping with a concierge to DIY camping) and activities. So whether you’re into trail running, rock climbing, paddleboarding, or one of the other 200 options available, you’re pretty much guaranteed to find someone else with similar interests—and an REI professional guide to help you learn more. In your downtime, there are plenty of chef-prepared meals, adult bevvies, inspirational speakers, and evening entertainment to go around. Plus, you’ll walk away with a sweet goodie bag packed with products and gear.Prices start at $799; outessa.com Wanderlust Squaw Valley When: July 20-23Where: North Lake Tahoe, CA What: You may think you’re going to Wanderlust for the yoga, and while that’s great and all, you’ll walk away with so much more than an improved downward dog. When you’re not flowing through various yoga styles—including aerial and stand-up paddleboard versions—there’s a whole range of activities to choose from. Kayaking, river rafting, mountain biking, slacklining—you name it, and it’s all available in the scenic mountains of Squaw Valley. Of course, there’s plenty of food (hello, delicious barbecue), wine, and live music to be enjoyed as well. Prices start at $104; wanderlust.com Virgin Festival of Sport When: October 13-14Where: San Francisco, CA What: This San Francisco retreat calls itself the "Coachella of sport,” so you know it’s going to be one heck of a good time. It’s one of four festivals Virgin Sport is hosting around the world (find the others in East London, Westminster, and Oxford), and each one is customized to the host city. For those staying stateside, expect a lot of those infamous San Fran hills on your distance and short runs. You won’t just be running, though—there’s plenty of group training, local food, music, art, and culture to be discovered too. You may even find some cycling and boot camp-style classes to sign up for because it's all about challenging yourself here. Prices start at $79; virginsport.com

 

Dog food recalled after samples test positive for euthanasia drug

A dog food company has issued a nationwide recall after some samples tested positive for the euthanasia drug pentobarbital.

Party Animal said in a recent news release that it is recalling two lots of its Cocolicious dog food after a Texas retailer said a customer had brought samples of the food to a testing lab, which detected the drug.

The affected products, manufactured in 2015, include 13-ounce cans of Cocolicious Beef & Turkey dog food (Lot #0136E15204 04, best by July 2019) and Cocolicious Chicken & Beef dog food (Lot #0134E15 237 13, best by August 2019).

>> Read more trending news

"The safety of pets is and always will be our first priority," Party Animal said in a statement. "We sincerely regret the reports of the discomfort experienced by the pet who consumed this food."

Customers who have the recalled products "should return them to the place of purchase and will of course receive a full refund," the company said.

"Party Animal wishes to emphasize that we have submitted many recent lots of our beef flavors for testing and all have tested negative for any pentobarbital," the company added. "We have also had extensive discussions with our manufacturer regarding the potential cause of the reported contamination of the 2015 lots, and we will continue with such discussions even as we await testing results for the 2015 lots. In order to ensure adherence to our commitment to the safety of pets, we are also actively re-examining our manufacturing processes."

Read more here.

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.

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