The following is a guest post (from my husband´s website medicosmba.com) that I found very interesting for us food and nutrition practitioners. Check it out!

When I think how healthcare has change with Google, the first thought that comes to my mind is how useful searching is for keeping up to date and easily learn new things. Well, Google’s mission is to organize the world’s information and make it universally accessible and useful. However, this is just the beginning: there are lots of things that healthcare should look up into Google’s ways. Let me show you why…

Google has been one of the fastest growing companies in the world. Let’s just mention their some financial data: FY ending 2013 reported revenue for almost USD 60B and a net income of almost 13B. Both revenue and net income have steadily increased in the last few years. What Google has done to achieve this impressive results?

You might be able to resume everything with the first statement of Google’s beliefs: “Focus on the user and all else will follow”. Just think of how many things we do everyday with Google’s services and how almost everything is for free: searching, email, docs, analytics, maps and so on. Also, user experience with each one of these products is great. There are designed to solve some aspect of our everyday life. So, how does Google make any money? Advertising is the answer. It’s kind of making money from the back door. Google reinvented advertising, it charges for performance (what is called pay-per-click) and not any more for time or space.

So, where are the healthcare links here? First, think about this “focus on the user and all else will follow”. Focusing in the patient is the key. It seems so obvious, but how many times we rush with things that so little have to do with our medical practice? Most of us studied medicine to care for patients, right?  So, here’s the first thing: just care about the patient and do what you think is best right thing for him.

Let’s go one step further: data that is accessible and transparent. Google has made it possible for everyone to find almost everything on the web. If a client had a bad experience with a brand, you’ll find it. Healthcare has just begun the journey of opening data up. It is common among doctors to be jealous about our knowledge and more often than not, data is kept and not shared. This is especially true when the results are not good ones: how much common is to hear about the great results of some surgery than about the complications. You can learn much more from the cases that didn’t go that well, than from the straightforward case. Why should we private ourselves from this kind of learning? It’s a fact that many hospitals started to show their data and made it accessible for everyone. However, this doesn’t happen everywhere and some parts of the world are even far from starting with initiatives like this. Why a patient that comes to visit me shouldn’t be aware of how many patients I treated with his condition? Or what my complication rate is?

Lastly, another Google’s statement: “Great just isn’t good enough”. As health care practitioners, its necessary to be great but clearly this is not enough to surpass yourself. And when it comes to do the best for our patients that extra mile always counts.


Guest post from Sebastian Defranchi, MD -  MedicosMBA

In Argentina and many other Latin American countries, Catholicism is the main religion and is very common the avoidance of meats (other than fish) on Holy Friday.  So, based fish dishes such as “Empanadas de vigilia” (vigil empanadas) are very popular at this time of the year. Also “Rosca de Pascua” (a Passover breadroll) is traditional sweet bread originated in Italy with simple ingredients (flour, milk and egg) to compete with the traditional eggs. Chocolate eggs are a must! You can find them in all sizes, colors and filled with a wide variety of candy or mini pieces of chocolate. The tradition of exchanging eggs originated in Europe as eggs are a symbol of fertility in coincidence with Easter occurring during spring. So, Christianity sees eggs as symbol of resurrection. Easter eggs weren’t made from chocolate at first! Now we have chocolate eggs themed with kids favorites cartoons (Mickey Mouse Clubhouse, Hello Kitty, Barbie, etc.) and also personalized eggs. The U.S. traditional Easter egg hunt is uncommon in our country. In Argentina, people (specially kids) exchange decorated chocolate eggs and eat them on Easter Sunday. 

As Holy Thursday and Friday are holiday in our country, many people uses these days for tourism. 

How is Easter celebrated in your area? Do you have any traditional recipe to share?

To culminate this NNM, themed Enjoy the taste of healthy eating, I´d like to share two aspects of Argentina´s food culture: family meals and simplicity:

Family meals 

In Argentina, we usually take the time to sit and have a meal. In the big cities, many people have lunch at work but they do share the other mealtimes with family. It has been shown that shared mealtimes makes family members feel loved, confident and happy. Also, homemade food in Argentina includes many preparations from scratch with few processed ingredients. Sharing mealtimes with your kids and involve them in the cooking process will make them have better eating habits since childhood.

Simplicity

Enjoying food prepared with fresh and minimally processed real ingredients is a national tradition. When you visit the supermarket you will see that there is not much variety of frozen meals or processed food boxes. Supermarkets aisles are not that overwhelming like in other parts of the world. Another example of simplicity: in Argentina the typical salad dressing is oil and vinegar (commonly olive oil and balsamic vinegar). That’s what the waiter will bring you to season your salad if you are eating out. And, don’t look for salad dressings in the supermarket, you won’t find much. Some of the typical condiments are mayonnaise, mustard, ketchup and salsa golf (an Argentinean creation that resembles Thousand Island dressing). Just make your own dressings and toppings with real ingredients and bring in simplicity to your dinner table!

Meats are also lightly seasoned with just a pinch of salt and pepper (and sometimes chimichurri). No one puts butter or other toppings on a grilled steak, there is no need.  And, recently, the province of Buenos Aires banned the salt shaker from restaurant tables in an effort to combat high blood pressure. It will be available upon request, but only after the guest have tasted the food. The new restaurant trend in Argentina is to get back to basics, value regional meals and natural ingredients. 

Healthy eating doesn´t have to be boring. This year´s NNM theme remind us to enjoy food. What I like to do is to experience food ingredients from other cultures and take healthy and tasty ideas from each one. For example, it is known that many Americans don´t eat very well...but not all is wrong. For example, in the US I´ve learn to have dinner earlier (usual dinner time in Argentina is 9pm) and have a better digestion before going to bed. Also, I´ve seen that many Americans respect seasonality of fresh fruits and vegetables, making certain dishes at certain times of the year. Seasonal produce is less expensive, more nutritious, taste better and is more natural. When I was in Brazil, I took from them the idea of having fresh fruits at all meals. From Mexico, I took the idea of adding onions and peppers (even the spicy ones) to many recipes reducing the amount of salt when cooking, as well as adding avocado to many dishes. There are many other examples. Like Japanese, one of the healthiest cuisine, with sushi (most sushi is low in fat and has lots of fresh ingredients). Another pretty healthy cuisine is Greek, with its dark leafy veggies, fresh fruit, high-fiber beans, lentils, yogurt, olive oil, and omega-3-rich fish. 
As an Italian (my dad was born in Calabria), I´ve learn to eat lots of vegetables and mainly the pleasure of food. Because of the Italian immigration, this was an influence in the Argentinean food culture too. Meal times are moments without any rush, where you can share with family and friends while enjoying food. 
I use to take one day of the week (Fridays work for me) to enjoy a different ethnic meal. Sometimes I have to tweek ingredients that are not available here, but it´s fine and FUN! 

-Romina 

Tomorrow, March 12th, is Registered Dietitian (RD) in the United States. It is a day to celebrate, share and congratulate dietitians for they work. As I said in the previous post, there was no RD day prior to 2008. This is the 6th time that is celebrated in the US. But, what about other countries? Some have a long tradition celebrating dietitian-nutritionist day like Argentina. In Argentina nutritionist day is every August 11th to commemorate Dr. Pedro Escudero, the father of the profession in the country and Latin America. We don´t have nutrition month in Argentina.

A few days ago, we were having an online conversation with colleagues in the American Overseas Dietetic Association (AODA), the international affiliate of the Academy of Nutrition and Dietetics, when we found out that many countries don´t have dietitian day.  We thought that this is a great opportunity for dietitians abroad to promote a dietitian day, maybe using the American one.  Here are some examples about dietitian or nutritionist (name of the credential may vary in each country):

Argentina: August 11 th

Australia: March 14 th

Brazil: August 31th

Costa Rica: No dietitian day

Germany: No dietitian day

Hong Kong: No dietitian day. AODA members adhere to US dietitian day

Venezuela: October 2nd

Singapore: No dietitian day

South Korea: No dietitian day. Celebrates Nutrition Day

 

If you need more information about the profession in other countries, I always recommend to visit the International Confederation of Dietetics Associations (ICDA). Click here: http://www.internationaldietetics.org/NDAs.aspx

 

I want to congratulate also my DTR (Dietetic Technician Registered) colleagues for the wonderful job they do every day. Let’s all celebrate and make our contributions visible to the world!

 

HAPPY DIETITIAN´S DAY!!!

 

Romina

March is the National Nutrition Month ® in the United States, where Registered Dietitian Nutritionist day is celebrated on March 12th. It was 2008 (while I was working in the US as a DTR) when the Academy (back then the American Dietetic Association) created this tradition (2008) to commemorate the dedication of RDs and DTRs as well. Then moved back to Argentina where I work as a dietitian. The nutritionist/dietitian day here in Argentina is celebrated every August 11th.
It doesn´t matter that March is not nutrition month here. But because I love to share what dietitians are doing around the world to advance the profession, I will be blogging each week of March about NNM. Thank you Academy for inspiring us bloggers! So,  don´t miss upcoming post in Global Dietitians:
-       Dietitian/Nutritionist´s Day in other countries: how colleagues from around the world celebrate
-       Enjoying the taste of eating: take the best of ethnic foods.
-       Keep it simple: real food, real taste.

I really like this year theme  “Enjoy the taste of healthy eating”. I believe that it´s essential to let people know that healthy eating doesn´t have to be boring or tasteless. If you don´t enjoy doing something it´s probably that sooner or later you quit. We, as food and nutrition experts, are specially positioned to educate people on how to make food enjoyable and eat well all life long! 

Find NNM catalog, handouts and other resources at www.eatright.org/nnm.

Happy Nutrition Month!
-Romina

This week is the RAWFEST in Buenos Aires, an event dedicated to promote the philosophy of “raw food”. It will be located in the Faena Hotel from February 18th to 22th and is organized by the Hippocrates Health Institute from Florida, USA. The event will have conferences with international speakers, workshops, free samples and live music. This event inspired me to write this post and to get the raw food diet naked. 

·         What is raw food diet? Also called "live food diet" or vegan raw, people that follow this diet eat fresh vegetables and fruits, nuts and algae, all cultivated without agrochemical processes and without heating them to more that 107ºF, to supposedly preserve their nutrients and boost energy and vitality production and to promote mental and physical health. Raw food diet followers believe that heat “kills” foods reducing their nutrients, making them toxic and less digestible. Foods are consumed raw, dried with low temperatures or fermented.

·         Mith: heat destroys nutrients. It is true that fresh fruits and vegetables are very nutritive. But, heat destroys cells walls and fibers increasing the disponibility and digestibility of several nutrients. For example, cooked tomate has more lycopene available or cooked carrots have more beta-carotene available than raw. We should eat both raw and cooked vegetables to get the best of both groups.
·         Mith: cooking destroys food enzymes. This is true. Heat destroys enzymes, but is doesn´t matter because the body produces their own enzymes to digest food. Even more, raw food enzymes are destroyed by stomach acid.  And, if raw food had their own enzymes to help digestion they would autodigest before we can eat them!

·         Another crash diet? Raw food is a tendency that growths globally and we as food experts must be well aware of it. Celebrities like Natalie Portman, Demi Moore y Robbie Williams are raw food diet followers. Now, I wonder whether in Argentina this is a culinary trend or another crash diet that we will forget about in the next few months. Some have already seen the business aspect and several restaurants in Buenos Aires started to commercialize raw foods like Kensho y Buenos Aires Verde, Buenos Aires Raw Club. Others restaurants like Experimental Raw Bar y Verde Llama went out of business. 

·       Raw vs. Asado. It´s kind of difficult to follow this diet 100% (adherents try to consume 50-100% of all foods raw) , specially in Argentina....First, our food culture is way different from a algae and pea´s sprouts salad (Argentina is the country with the highest beef consumption in the world). Second, some raw recipes are time consuming even with no “cooking”. And, some food are really costly here in Argentina (if you can get them). On the other hand, this diet has to be well designed with professional help to prevent nutrition deficiencies. It is not recommended for kids because inadequacy of some nutrients. Depending on personal preferences some people include raw milk and raw meats like in ceviche, carpacchio or sushi.  
What is good about this diet is that promote the consumption of healthy vegetables and fruits. But their rational seems to be more philosophic than scientific. I truly respect their followers, but as a nutritionist I think that it has some risks and has to be well planned. What do you think?

 Romina

Like I said in last week post, this month is dedicated to the heart as it’s the American Heart Month (don´t forget Wear Red this Friday!) and also St. Valentine´s Day, celebrated on Friday 14th. The day is named after St. Valentine, a third century priest who tradition says was martyred on February 14, 270. St. Valentine is known for conducting weddings contrary to the decree of Emperor Claudius II.  This religious celebration turned to be a more pagan event especially in English-speaking countries. Over the last century many countries beyond western culture started to celebrate Valentine´s Day with their own versions. (Please share Valentine´s Day traditions in your country!)  
In Latin America, February 14th it´s also the day of love and friendship.  In Argentina, Valentine´s Day is becoming more and more popular. In general, lovers give each other a small present like chocolates, candies, flowers, etc. Eating out is also common, as special menus are offered at local restaurants.  Like in all celebrations, food has a protagonist role.  I think that worldwide, the most popular food in Valentine´s Day is chocolate.  And, speaking about love and sweethearts chocolate is good for HEART health! 
Why? Dark chocolate is high in flavonoids (e.g. cacao polyphenol) which are antioxidants and may lower blood pressure and improve the blood flow to the heart. White chocolate has no flavonoids and milk chocolate has very little (plus, saturated fats and high sugar). The highest cocoa content the higher the benefits. It is thought that chocolate flavonoids increases body's production of nitric oxide, a powerful substance that causes blood vessels to relax and dilate. This, in turn, causes an increase in blood flow to the heart and a decrease in blood pressure. Nitric oxide is also stimulated by drugs such as Viagra,  that may be one of the reasons why chocolate has had a long reputation as an aphrodisiac (although there is no proof of that). Chocolate also contains phenylethylamine, which research suggests is a stimulant that releases endorphins giving us a sense of well being and pleasure.  Many other benefits have been linked with chocolate like stroke prevention, reduction of diabetes prevalence, support of cognitive function, etc. 

So, this Valentine’s, choose a good quality dark chocolate to give to your loved one or just to indulge yourself (and your HEART!).  Don’t forget that chocolate is high in fat and calories, so moderation is key.  Just a square of a chocolate bar can provide all the benefits. 

Happy Valentine´s Day!!
Romina  

January is almost gone and I just realized that February, the “red month”, is just around the corner. February is the heart month not only for Valentine´s Day on Feb 14th but also for the American Heart Month (and the Wear Red Day this Friday 7th). Here in Argentina we don´t have this tradition which is celebrated in the United States every year to increase awareness on women heart disease, the number one killer (more than all type of cancers combined!). The Go Read For Women campaign will celebrate its 10th anniversary this Friday 7th.  The web page of the American Heart Association is now full of resources not only in English but also in Spanish, Chinese and Vietnamese. The website has alsoj a very nice interactive library with animated explanation of popular heart topics. The AHA has lots of programs, I love the one that promote Jump Rope for the Heart for kids and adults to increase physical activity.

The AHA recommends these healthy habits to prevent heart disease:

·         Quite smoking

·         Consistent exercise: 30-60 minutes most days of the week

·         Manage stress: check stress management resources

·          Eat healthy: Eat more fruits, vegetables, whole grains, low-fat dairy, poultry, fish and nuts. Avoid sugary and processed foods and foods high in sodium

Are you ready for this Go Red? You have 9 days to prepare your outfit and remember that offices and buildings can be decorated with red too!

This past weekend we went to Mar del Plata with all the family. Mar del Plata is a beach front city from the Buenos Aires Province and is a classic destination for Argentineans in the summer. This trip brought to me lots of memories from my childhood, specially the typical foods we eat on the beach. These are the 10 foods you don’t want to miss from the Argentinean beach:

1.       Mate: this is an herbal infusion made from Yerba Mate leaves and it´s a must on the beach. You can have it hot or cold (called tereré), or add citrus peel for extra flavor. Even hot it´s a good option to satisfy your thirst. Better without sugar or with calorie free sweetener to save on calories.

2.       Facturas (sweet pastry): I don´t know why but facturas taste better on the beach. Maybe is the water used on the dough or maybe because they sell lots of them I end up buying always fresh and warm from the oven. Croissants or medialunas (sweet or salted), pastries with dulce de leche, with fruit jam or custard cream…delicious..but an important source of saturated fat and sugar. Not healthy at all..How many calories? About 180-200 cal. each one and  medialunas a little less (125 cals)

3.        Churros: one could say that churros are the argentinean  “doughnuts”, because they are made from a fried dough, with sugar and different filllings like dulce de leche (my favourite), chocolate and custard cream. Churros came from the Spanish colonization and they are also traditional in other Latin American countries.  They are made in churrerias (there is one very famous) and sold by beach vendors. How many calories for 1 churro? About 190 (filled with dulce de leche)

4.       Alfajores: these are typical Argentinean sandwich cookies filled with dulce de leche and covered with chocolate. Alfajores from Mar del Plata are the best!  There are also with fruit jam, chocolate mouse, nuts, with sugar frosting, etc. Each alfajor have about  200 calories.

5.       Choclo: choclo is a corn on the cob, very popular on the beach. You can buy it from food stands on the beach or from walking corn vendors. We eat them just with salt and butter. (175 calories each). At least it´s a veggie with lots of fiber and vitamins.  

6.       Sandwichs: the most typical sándwich is made with sliced bread with ham and cheese or milanesa sandwich (milanesa is a thin steak breaded and fried). Many people made sandwichs at home. Here we have to be careful with food safety and make sure that cold food stays cold using an appropriate insulated container. This option is healthier if we use whole wheat bread, low fat cheeses and meats and adding vegetables like lettuce, tomato, arugula, avocado, etc.  

7.       Ice cream: beach vendors offer ice cream screaming: “heladoooo, palito, bombón heladoooooo” (meaning ice cream, stick ice cream). And most people can´t resist to that call. Specially kids! Stick to sorbets, which are a better option compared with creamy ice cream.

8.       Sodas and water: with the extreme hot weather we are having the bottles don´t last much and soft drink vendors are everywhere. They are much costly on the beach than on the grocery store. Stay with water or sugar free sodas.

9.       Fruit: it´s very common to see fresh frui t or fruit salads on the beach. Again, here we have to be careful with food safety as cut fruit have lots of manipulation and hot temps turn that “healthy “fruit salad in a risky food. It would be better to bring your own whole fruit or make sure that the fruit salad was always cold.

10.   Barquillos: this sweet snack is another food from Spanish heritage. It is a thin dough like a biscuit with a ship (barco) kind of shape. Usually barquilleros are the food vendors, but you don´t see them often these days. Each one has 120 calories.

As you can see, it´s easy to put up some weight during summer vacations.

So, on the beach we should try to eat:

·         Varied sandwiches  (with whole wheat bread, vegetables, low fat meats and cheeses) light vegetable quiches (tartas) or salads (with greens, tomatoes, whole rice, low fat meats, egg, etc)

·         For dessert: fresh seasonal fruit, fruit salad, fruit sorbets

·         Drink plenty of water!

·         And for afternoon snack (merienda) lots of sugar free mate with 1 medialuna or 5 crackers or bread sticks or 1 alfajor once and then.  

Important! Make sure to keep cold foods cold when you bring food to the beach.  

Moderation is key as well as physical activity on the beach like walking, volleyball, soccer, etc. Exercise keeps us busy and is good for you!

What is your favorite food to eat on the beach?