Kerry Neville – HealthStylz

Embrace the Exotic With These Funky Fruits

Kerry Neville — Mon, 27 Feb 2017 12:37:24 +0000

Beyond common apples and oranges, there’s a whole world of weird and wonderful fruits to explore. Exotic and unique-looking produce is mostly native to tropical and sub-tropical regions of places such as Southeast Asia, New Zealand and South America, but now is grown in warm regions of other countries, too, including the United States.

While you might find some of these fresh fruits in your regular supermarket on occasion, they’re more widely available at Asian, Latin and gourmet supermarkets, or from online specialty produce purveyors. Growing seasons vary by location and fruit, with some growing year-round in temperate or tropical climates. Canned, jarred and dried fruits are available year-round, as are products made from these fruits, such as jellies and jams. Like other fruits, exotic options are typically good sources of vitamins A and C, potassium and fiber. Inside and out, their vivid colors, varying textures and sweet to tart tastes may be a pleasant surprise.

Their curious appearance may be one reason why specialty fruits are among six of the top 10 fastest growing categories in grocery stores, according to a 2015 Nielsen study. And Nielsen’s previous report found that dollar sales of fresh global and exotic items grew 9 percent in 2014. That’s not surprising, given the culinary trend of fusion cuisine and a desire to eat healthier. Restaurant chefs are looking for ways to infuse unique and unexpected flavors into their dishes — and once chefs jump on a trend, consumers typically follow.

Showcasing exotic fruits on television cooking shows also has helped introduce them more broadly to audiences who might otherwise never know what a dragon fruit looks like, for example. Traveling is another way consumers become familiar with foreign fruits; once they try it on vacation, they may look for the fruit upon returning home. It’s hard to remember, but mangoes and kiwis once were considered “exotic” and now they’re everyday staples in many people’s grocery carts.

Finger Lime

Not a true lime, yet a member of the citrus family, finger limes are native to Australia and also are known as “caviar limes.” Filled with juicy greenish-white or pink sacs that burst when bitten, they have a perfume-y flavor reminiscent of lemon, lime and a hint of fresh herbs. Usually eaten fresh, finger limes also can be made into marmalade.

Mangosteen

Although similar in name, mangosteen is not related to the mango. Its white, juicy, segmented flesh is more similar to a tangerine, with a sweet-tart flavor that melts in your mouth. Its hard, thick and tough dark rind is difficult to open but worth the effort.

Longan

A smaller relative of the lychee, longans have a translucent white, soft pulp that surrounds a large black seed. When cut in half, it resembles an eyeball, earning this fruit its nickname: dragon’s eye. In China, longans are sometimes dried and added to tea for special occasions.

Dragon Fruit

This grenade-shaped member of the cactus family (also called “pitaya”) has a leathery exterior ranging from yellow to bright pink with lime-green spiny tips. Flecked with tiny black seeds, its juicy flesh can be white or red and has a refreshing and light flavor.

Rambutan

Similar to lychees but not as juicy, the rambutan got its name from the Malay word for hair because its rind is covered in dark, soft bristles. It has a single seed surrounded by flesh that is grape-like in texture, with a sweet, delicate flavor.

Loquat

Native to China and widely grown in Japan, loquats are picked ripe, so they spoil quickly and bruise easily; therefore, they’re usually found fresh only in areas where they’re grown. U.S. loquats are harvested from March to June in coastal areas, including Santa Barbara and San Diego. Dried or canned loquats are available at many Asian markets.

Guava

Several varieties of guava are available varying in size (small egg to apple), shape (round or pear-shaped), texture (rough or smooth- skinned) and color (yellow, green, red or purple-black, with flesh that is pale yellow to bright red), and with small edible seeds or seedless. To eat fresh, guava should be very ripe.

Horned Melon

Known also as a “kiwano” or African horned cucumber, this bright yellow-orange fruit has horns that make it look like a small spacecraft. Its jellylike interior has a mild flavor that tastes like a combination of banana and cucumber.

Cherimoya

Native to Peru and more recently grown in Spain and California, among other places, cherimoya’s green, leathery, scaly skin is reminiscent of a globe artichoke, while its white, custardy flesh is peppered with black seeds. Cherimoya has a delicate flavor suggestive of banana and pineapple. Serve it chilled and halved for scooping.

Jackfruit

A relative of the breadfruit and fig, jackfruit is the world’s largest fruit — it can weigh up to 100 pounds. Inside, its many edible starchy seeds are encased in irregular clumps of yellow flesh that can be eaten raw, cooked, dried or pickled. Jackfruit has gained popularity as a meat replacement for vegetarian versions of foods such as tacos and pulled pork.

Passion Fruit

This edible fruit from the passion flower is also known as “granadilla.” The most common variety looks like a purple egg and has a sweet-tart flavor and strong tropical scent. Since there is only a small amount of golden, jelly-like filling, passion fruit often is used as a flavoring.

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Sardines Are Tiny Fish That Are Big on Flavor

Kerry Neville — Thu, 28 Apr 2016 21:22:59 +0000

Iridescent, tiny and flavorful, sardines are actually several different types of small fish — not a species, as some people think.

Sardines swim in huge schools near the water's surface and are easily caught by net, mainly at night. The fish feed by straining plankton from seawater as they swim, ranking them low on the aquatic food chain — and low in heavy metal contaminants, such as mercury. Although typically just a few inches long, sardines can grow longer than a foot.

Found in oceans around the world, sardines are a culinary mainstay in many European countries. They are fish that rapidly reproduce, but due to overfishing, ineffective regulations and environmental impact, Monterey Bay Aquarium's Seafood Watch program has labeled Atlantic sardines from the Mediterranean region as "Avoid." As of April, most sardine fishing off the U.S. West Coast also is banned for the second year in a row due to plunging sardine populations. The good news is canned sardines packed before the bans are available.

Cooking with Sardines

While fresh sardines are occasionally available during summer months at some markets, they’re more commonly found canned, either whole or as fillets, with or without skin and bones. Both the skin and bones are edible, but can be removed based on preference. The canning procedure involves washing sardines, removing the heads, cooking, drying and then packing them in water, oil or sauces such as tomato, chili or mustard. Sardines are sometimes smoked or salted, too.

With a full, rich flavor, sardines are considered by many to be the ultimate convenience food. Their appeal spans the socioeconomic ladder, enticing thrifty shoppers and food connoisseurs alike. In fact, there are vintage sardine collectors — similar to wine collectors — who have opinions on the best brands, years and maturity periods of tinned sardines.

Enjoy canned sardines plain, straight from the tin, or mashed with mustard and onions as a spread on crackers or toast for a light lunch. Add sardines to salads and sauces or sauté them with herbs to top pasta.

Nutritional Qualities of Sardines

Sardines are one of the new "it" fish, thanks to their impressive nutrition profile and status as a low-mercury option. Depending on their size, there are typically one to two sardines in a one-ounce serving of canned sardines. They’re a good source of protein and vitamin D. Thanks to their soft, edible bones, canned Atlantic sardines are a good source of calcium, too (Pacific sardines, on a per-ounce basis, fall a bit short at 68 milligrams).

Their sodium content varies depending on the liquid used in canning. The American Heart Association recommends sardines in its list of fish rich in heart-healthy omega-3 fatty acids, which research shows may decrease the risk of heart arrhythmias and triglyceride levels and may slightly lower blood pressure.

Using Sardines in Foodservice

In the U.S., restaurant menus may feature grilled, broiled or deep-fried sardines during their short summer season. In Europe, the small fish hold a special place in cultures, particularly along coastal regions, and freshly grilled sardines are standard summer fare. Fresh sardines may be tough to find and are quite perishable. Frozen sardines are available in 20- or 50-pound boxes from select seafood purveyors.

Canned sardines are not typically found on menus in restaurants or foodservice establishments; if anything, they may be used in appetizers. Large quantities of canned sardines are available in tins that range from two to 15 ounces and are packed by the case. Once opened, tins of sardines can be refrigerated for three to four days.

Kerry Neville, MS, RD, is principal of MIX, a food and nutrition communications firm based in Seattle.

Sardine-Stuffed Grape Leaves

Recipe by Brittany Peterson

Ingredients

[10 grams] 1 tablespoon dried currants
[35 grams] ¼ cup yellow onion, finely diced
[25 grams] 1½ tablespoons (22 milliliters) olive oil, divided
[30 grams] ¼ cup walnuts, chopped
[70 grams] ⅓ cup brown rice, dry
[1 gram] ¼ teaspoon salt
[<1 gram] ¼ teaspoon freshly ground black pepper
[240 grams] 1 cup (240 milliliters) water
[15 grams] ¼ cup fresh dill, chopped
[8 grams] 2 tablespoons fresh parsley, chopped
[6 grams] 2 tablespoons fresh mint, chopped
[50 grams] 10 large preserved grape leaves
[250 grams] 20 small fresh sardines, heads and spines removed, then cleaned
[110 grams] 1 large lemon, cut into wedges

Directions

Line baking tray with parchment paper or aluminum foil.
Place currants in a small bowl and cover with ½ cup warm water to rehydrate for about 5 minutes, then drain.
In a small, nonstick saucepan over medium-low heat, sauté onion in ½ tablespoon olive oil until soft.
Add walnuts and brown rice, and cook for 1 minute. Mix in salt, pepper, drained currants and 1 cup water. Bring to a simmer, cover with lid and cook over low heat until rice is cooked, about 25 minutes.
Remove from heat and stir in dill, parsley and mint. Set rice aside while preparing grape leaves.
Remove grape leaves from jar, place in a large bowl and submerge in cold water to help unwrap and flatten them. Drain water, then cover leaves with almost-boiling hot water to remove some saltiness. Allow to sit in hot water for 1 minute, then drain. Remove stems and slice in half symmetrically down the center. Cut extra in case some rip.
Place one grape leaf half on a flat work surface, and place sardine fillet at the wider end of the leaf. Stuff sardine with a small spoonful of rice mixture, then fold fish over the rice to enclose it. Roll fish tightly into the grape leaf. Place each rolled grape leaf onto the lined baking tray, allowing at least a finger-width distance between the pieces. Repeat until all fish is used.
Turn broiler to low. Brush the tops of the grape leaves lightly with remaining tablespoon of olive oil and place under the broiler for 8 minutes until the grape leaves are darkened but not charred. Remove and use tongs to carefully turn grape leaves. Return to broiler for an additional 8 minutes. Check for doneness by cutting through the center of a roll to ensure fish is white and flaky.
Serve hot with fresh lemon wedges to squeeze over the top. Serves 4.

Cooking Note

If fresh sardines are not available, use canned sardines and omit salt from recipe.

Nutrition Information
SERVING SIZE: 5 pieces (80 grams)
CALORIES 327; TOTAL FAT 19g; SAT. FAT 3g; CHOL. 52mg; SODIUM 587mg; CARB. 22g; FIBER 4g; SUGARS 4g; PROTEIN 19g; POTASSIUM 509mg; PHOSPHORUS 299mg

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Olives are Mediterranean Marvels

Kerry Neville — Fri, 18 Dec 2015 16:26:32 +0000

Unlike many fruits, olives have a bitter taste and are rarely eaten raw. Often, they must be cured in order to be palatable. Oleuropein, which gives olives their bitterness, is drawn out during the curing process. Depending on the type of olive and the region where it is grown, several curing methods are used.

Water curing requires months of repeated soaking and rinsing of olives.
Brine curing involves immersing olives in a water and salt solution for one to six months. Sometimes lactic, citric or ascorbic acid is added.
Dry curing means olives are layered with salt and placed in drums that are rolled weekly to aid dehydration. After bitter compounds are removed, olives are rinsed and coated with olive oil.
Oil curing refers to soaking olives in oil for several months. Sometimes “oil-cured” is used in reference to the final stage of the dry curing process.
Lye curing involves washing unripe olives in a lye solution to speed the de-bittering process. Olives are then rinsed and soaked in a brine solution. The variety of colors among table olives is mainly due to their stage of ripeness at the time of harvest. Like many fruits, olives start off green in color and, as they mature, become deeper shades or different hues entirely. Olives may be picked either immature or ripe, depending on the variety.

Olive color can be affected by oxidation during fermentation, which can turn olives brown or black, or the addition of food-grade dyes or compounds such as ferrous gluconate. Flavor and texture are primarily determined by the olive’s oil content, size, ripeness and growing region — as well as how it ferments through curing. Dressings, herbs or other ingredients added to olives also affect flavor.

Nutritionally speaking, olives provide mainly monounsaturated fat, which research shows may help reduce LDL cholesterol and lower risk of heart disease and stroke. The amount of fat, calories and polyphenols varies among olives. On the branch, they are a low-sodium food; however, the curing process not only removes many natural polyphenols, but also increases sodium content.

Alfonso

From the Tacna province of Peru, these ovoid-shaped olives range in color from deep violet to eggplant purple due to soaking in red wine or red wine vinegar after brining. Their soft, juicy flesh and distinct vinegary, slightly sour taste sets them apart.

Amfissa

Golden, green or naturally ripened black, this olive’s color depends on its maturity. Brine-cured and often pitted, this Greek olive has a soft flesh and a mildly sweet, mellow flavor.

Beldi

Dry-cured in salt, then washed and packed in olive oil, these intensely flavored, small and wrinkly olives come from Morocco. They often are used in tagines and salads or eaten on their own, sprinkled with olive oil and hot pepper.

Castelvetrano

A Sicilian favorite that’s popular as a snack, Castelvetranos have a green-apple color, meaty texture and buttery flavor. Keep these olives in brine until ready to serve; they oxidize quickly and lose their bright color.

Cerignola

Harvested in the Puglia region of Italy, these large green or black olives are about the size of a walnut, crisp to the bite and have a mild, buttery flavor. Served whole or pitted and stuffed with garlic, salami, sundried tomatoes or cheese, Cerignolas are frequently found on antipasti platters.

Gaeta

With a tart and citrusy taste, these small, purplish-brown to black beauties from Puglia are the most popular Italian table olives. They can be dry-cured, which gives them a shriveled, wrinkly skin, or brine-cured and dipped in olive oil so they’re plump and juicy.

Gordal

If this green beauty looks familiar, it’s because it’s the jumbo version of Manzanilla and Spanish Queen. Grown in the Seville province of southern Spain, Gordal — which translates to “fat one” — has a firm, meaty bite and a light fruity and peppery flavor.

Kalamata

These popular Greek olives have a distinct almond shape, shiny, dark-purple skin and a smoky, fruity flavor. During the curing process, they’re often slit to allow red wine vinegar to penetrate the flesh.

Liguria

Tiny olives with big flavor, Ligurias — sometimes called Taggiasca olives — are grown in Italy near the French border. Similar to Niçoise olives, they’re cured in brine, sometimes with stems attached, then packed in olive oil and aromatics such as bay leaves, thyme and rosemary.

Manzanilla

With a crisp bite and slightly smoky, almond flavor, these brine-cured Spanish olives are often stuffed with pimiento. Well-known for garnishing a martini, they’re also used in olive-loaf deli meat and the Spanish rice dish, arroz con pollo.

Mission

These black olives are actually green olives made black through a combination of lye-curing, oxygenation and the addition of ferrous gluconate (a type of iron). Unlike other olives, they are not fermented and are typically processed within a week. These familiar canned olives have a mild flavor and semi-firm texture.

Niçoise

Small and oval with a purplish-brown hue, Niçoise olives are a signature ingredient in French dishes, such as Niçoise salad and tapenade. Their light flavor also makes them enjoyable to eat on their own.

Nyon

Dry-cured in salt and then aged in brine, these tiny olives from the south of France are jet-black with a wrinkly texture. Nyons have a mild, salty and bitter taste and a plump, meaty texture. They’re often tossed with traditional herbes de Provence.

Picholine

Crisp and crunchy with a nutty flavor and slight licorice undertone, these French olives are harvested while green and brine-cured. They’re commonly eaten as a snack or hors d’oeuvre and used in martinis and cocktails.

Spanish Queen

Processed through a method known as the “Spanish Cure,” these green olives are washed in lye for de-bittering, then rinsed and fermented in brine. Like Manzanillas, they often are stuffed with pimiento, but also are available whole, pitted or stuffed with ingredients such as almonds, garlic, jalapeños or blue cheese.

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Today’s Look at Yesterday’s Deli

Kerry Neville — Fri, 30 Oct 2015 14:26:08 +0000

Move over, fried chicken strips, mayo-laden potato salad and overstuffed meat sandwiches. Today's supermarket deli food offerings are an improved trifecta of taste, variety and nutrition. Alongside traditional deli meats and cheeses in the "prepared foods department," consumers now can find an array of diverse and delicious freshly prepared foods that rival restaurant meals.

Available options include ready-to-eat, heat-and-eat or partially prepared meals that require minimal finishing time at home. Consumers can order from a display case at the counter, grab ready-to-go items from self-service refrigerated shelves, help themselves to salad, soup and hot food bars, or even customize made-to-order meals at ethnic food kiosks — all in the convenient setting of their local grocery store. This new prepared-foods format has become so popular that it has earned the moniker "grocerant" — the intersection between grocery store and restaurant.

Big and Growing Bigger

With a $26 billion market, prepared foods are a huge growth category for retailers. This has the restaurant industry worried, as more consumers in search of quick and healthy meals at a good value look to prepared foods as an alternative to quick-service and fast-casual restaurants.

In fact, sales of prepared foods — for both in-store eating and takeout dining — have increased 30 percent since 2008, compared to a 10-percent increase for the foodservice industry overall. Still, visits to the prepared foods department are not yet routine for most shoppers, with less than half of shoppers saying they regularly visit this department.

When asked, consumers most often say they buy prepared foods because they don't want to cook that evening — so it's not surprising that dinner is the most popular meal for the prepared foods department. Other reasons why consumers purchase prepared foods include convenience (already at the store), cost (cheaper than eating out) and simplicity (easier than preparing foods from scratch). And the most frequent buyers, Millennials, are looking for convenient options that offer high-quality, fresh foods to fit their busy lifestyles.

Feeling Fresh and Nutritious

Conveying freshness is critical to a successful prepared foods department. Attractive displays, a "made-on-site" look, frequent item rotation, clear packaging, local sourcing of ingredients, use of "made today" labels, and labeling that shows when an item was made versus an expiration date all add to the feeling of freshness that customers want.

Fresh is where stores such as Whole Foods Market excel. Jess Kolko, RDN, LD, senior research analyst on the Global Perishable Purchasing team at Whole Foods, spends part of her time working with chefs on the "healthification" of menu items in the prepared foods area, boosting the nutritional value of Whole Foods' dishes where possible. This is in addition to Kolko's responsibilities of sharing nutrition and ingredient information about Whole Foods' prepared foods with customers. The quality standards for the foods Whole Foods sells in stores extends to those sold in the prepared foods department, so items

are free of artificial preservatives, colors, flavors, sweeteners and hydrogenated fats; meats meet the company's internal animal welfare standards; and wild-caught seafood is certified sustainable, while farmed seafood meets strict internal quality criteria. Locally grown produce is used whenever possible.

"Transparency of ingredients is important to our customers, and it's important to us," Kolko says. That syncs with survey findings among prepared foods shoppers, who say they want 100-percent natural foods that are free from artificial ingredients, low in sodium, low in sugar, free from trans fats and low in calories. Nearly one-quarter also say they want hormone-free animal products.

Beyond ingredients, shoppers of the prepared foods department are interested in health and nutrition information for foods they buy, and this information will soon become the standard for most chains selling prepared foods. Yet, some have made that leap early.

Mariano's, with stores in the Chicago area, offers online nutrition information for prepared food items. Likewise, the New York-based chain Wegmans lists nutrition information for its popular dishes as part of an Eat Well, Live Well program. At Whole Foods, consumers can find the Health Starts Here emblem on prepared dishes and salad and hot bar selections that meet its criteria for healthy options — which are items made using whole foods, contain only healthy fats and are "plant-strong" and nutrient-dense.

At Kowalski's Markets, a small, high-end chain in the Twin Cities, a "Good Foods for Good Health" emblem is found on deli salads that meet specific nutrition criteria, as well as a "Made with Gluten Free Ingredients" designation to help those on a gluten-free diet find options more easily.

Now Trending

Rotisserie chicken has been standard deli fare for years. But nowadays, consumers will find more ethnic options, from Vietnamese pho to Cuban sandwiches, as well as regional favorites such as slow-cooked barbecue and seafood chowders.

Many stores feature "gourmet homestyle" dishes that are rooted in comfort food but revamped as an upgraded version that consumers wouldn't typically prepare themselves — either because the dishes require too much time or use more expensive premium ingredients. This comfort food fare is particularly popular at Kowalski's Markets, says corporate nutritionist Susan Moores, MS, RDN, but dishes with trendier ingredients, such as ancient grains, are top-sellers, too.

Whole Foods looks at global culinary trends and explores new menu items, Kolko says, and a big focus is on innovative ways to use plant foods. Similarly, Wegmans places a strong emphasis on creative vegetable main and side dish offerings in its prepared foods department.

"Our $6 meals feature our 'Half-Plate Healthy' initiative," says Kirby Branciforte, RD, a Wegmans nutritionist. With this program, consumers are encouraged to fill half their plate with two servings of vegetable side dishes, fruit or a combination of both, and the other half with their choice of an entrée.

Retailers and restaurants continue to compete for a share of consumer food dollars. However, consumers' desire for more nutritious and convenient food options offers grocery stores an opportunity to increase sales by promoting choices in their ever-evolving prepared foods departments.

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Spectacular Stone Fruits

Kerry Neville — Wed, 29 Apr 2015 03:34:14 +0000

Nothing says summer quite like the sweet, juicy flavors of stone fruits. Whether you prefer peaches, plums, nectarines, apricots or cherries — or any of their hybrids — act quickly: Unlike apples or pears, fresh stone fruits don't store well.

"Stone fruit" is more of a culinary term than a botanical one. It comes from the stone-hard covering found around the single large seed at the fruit's core. The stone supports the fruit as it hangs off the tree branch by its stem and provides a passage for nutrients to flow from the tree to the growing fruit.

Stone fruits are species of Prunus, members of the large rose family. A surprising stone fruit is the almond. On the tree, almonds look like small, hard, green peaches; an almond shell (found inside the green peach-like hull that's removed after the almond is plucked from the tree) looks similar to a peach pit, and the kernel — which is what we eat — is the fruit's seed. Culinary experts often point to a slight almond flavor in stone fruits, and that's one reason why cherries, peaches and apricots pair so well with almonds in recipes.

Peaches, nectarines, apricots, plums and their hybrids are best ripened at room temperature, stem-end down. Don't refrigerate fruit before it's ripe, or it may develop unappetizing wrinkled skin and mealy flesh. Ripe fruit is soft, has a sweet aroma and can be stored in the refrigerator for a few days. Cherries are ready to eat when purchased and can be kept in the refrigerator, loosely covered, for up to three days.

Stone fruits are delicious simply eaten as is, when they're at their peak of ripeness. But they also can be roasted, poached or sautéed, baked into pies and crumbles, tossed into salads, made into jams or used as a sauce or topping for both savory and sweet dishes.

Apricots

Apricots are rich in pectin, which provides their creamy texture when eaten ripe and their meatiness when dried. This delicate fruit is most often canned or dried. Dried apricots often are treated with sulfur dioxide to help preserve their naturally light color. Unsulfured apricots are browner with a slightly cooked taste.

Apriums

Like pluots, apriums are an apricot-plum hybrid, but with more apricot characteristics than plum. While apriums look, smell and taste more like apricots, they are juicier and have a slightly firmer flesh.

Cherries

Sweet or sour, cherries are a good source of vitamin C and potassium. Since they must be picked ripe, cherries are a fragile crop. Sweet cherries, including Bing, Rainier and Sweetheart varieties, mainly are sold fresh, but most cherries grown are sour varieties and typically are canned, frozen or dried.

Nectarines

Genetically speaking, nectarines and peaches are not very different, except nectarines have a smooth skin while peaches have fuzz. Like peaches, a nectarine's flesh may be white or yellow. These cousins can be used interchangeably in recipes, but nectarines offer the advantage of having no skin to peel.

Peaches

Peaches come in clingstone and freestone varieties. As the name implies, a clingstone's fruit doesn't fall off its pit, making it fine for eating but a chore for slicing. However, a freestone's fruit easily separates from its pit. You can't tell whether a peach is a clingstone or freestone by its looks, but clingstones typically arrive first at farmers markets, followed by freestones.

Plums

Most plums fall into two main types: Asian and European. Asian plums are larger and rounder than their smaller, oval-shaped European counterparts. Asian plums are almost always eaten fresh; European varieties usually are dried or made into preserves. Fresh plums are a good source of vitamin C, while dried plums — also known as prunes — provide fiber and vitamin A, and may be puréed and substituted for fat in cakes, quickbreads or muffins.

Pluots

Akin to the aprium, the pluot boasts more plum parentage than apricot. Without a plum's bitter skin, smooth-skinned pluots have a more complex aroma. Plumcots are similar to pluots, but this hybrid is comprised of equal parts plum and apricot.

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Not Always Better Together: Herbs, Spices and Medication Interactions

Kerry Neville — Tue, 03 Mar 2015 02:57:16 +0000

A teaspoon here, a dash there… For people who regularly take medications, could drugs interact with the spices and herbs used in recipes?

After all, it can happen with food. If an individual takes certain statin drugs to lower blood cholesterol levels and also drinks a lot of grapefruit juice, too much of the statin may stay in his or her body, increasing the risk of liver damage and kidney failure. On the flip side, grapefruit and other juices have been shown to decrease the effectiveness of some medication in treating allergy symptoms.

Ginger is thought to quell nausea and upset stomach, while garlic is often used to help prevent heart disease and cancer. But research shows that both may slow blood clotting in combination with anticoagulant drugs, so caution is warranted when eating ginger or garlic, or taking supplements containing them.

However, little research has been published on the potential for drug interactions when herbs and spices are used for culinary purposes instead of supplements. "It's likely a different story when spices and herbs are used in cooking and baking since the amount is smaller, compared to their use as a supplement," says Forrest Batz, PharmD, associate professor in the department of pharmacy practice at the University of Hawaii at Hilo. "Interactions may exist, but the bigger question is whether or not those interactions are clinically relevant. And so far, that doesn't seem to be the case."

Roy Upton, RH, DAyu, executive director of American Herbal Pharmacopoeia and expert advisory board member to the American Herbal Products Association's Botanical Safety Handbook, says that while there is research on specific compounds in spices and herbs, studies use concentrated preparations of the compounds, not the spice or herb in culinary amounts. For example, piperine, an alkaloid found in black pepper, has been shown to increase the bioavailability of several drugs, but Upton says no interactions have been noted with use of pepper as a spice. Scientific reviews of other spices — including anise, fennel, cayenne, parsley and several Indian spices — also show no reports of clinically relevant interactions.

Dean Elbe, PharmD, BCPP, co-author of the handbook Food Medication Interactions and a clinical pharmacy specialist at British Columbia Children's Hospital in Canada, agrees — adding that research in food and medication reactions is complicated in general. "There are many other variables that need to be considered aside from the amount of an herb or spice," Elbe says. "The specific varietal of the herb or spice, its potency, how much might be contributed throughout the day through different foods, even the specific genetics of an individual dictate how a person metabolizes medications and might affect the interaction between the herb or spice and drug."

To paraphrase the 16th-century physician Paracelsus, it may be a case of "the dose makes the poison." Mixing a few teaspoons of cinnamon into a recipe for two dozen cookies or stirring chopped garlic into pasta sauce is not a likely cause for concern over drug interactions. However, before taking a dietary supplement, as more than two-thirds of U.S. adults do, speaking with a pharmacist or a registered dietitian nutritionist about potential interactions is recommended.

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Breaking Bread around the World

Kerry Neville — Mon, 27 Oct 2014 16:45:21 +0000

Whether it’s naan in India, baguettes in France, tortillas in Mexico or lavash in the Middle East, the breaking of bread brings people together throughout the world.

Bread is a significant symbol in many religions, with numerous nods to it in the Old and New testaments. It even inspires poetry. Omar Khayyám, 11th century Persian mathematician and astronomer, included the well-known verse, “A jug of wine, a loaf of bread, and thou,” in one of his poems.

There also are a number of secular connotations for the word. For example, “bread” (as well as “dough”) is slang for money. A “bread line” refers to people waiting for food from a charitable organization or public agency – akin to today’s soup kitchen or food bank. A person’s “bread and butter” refers to one’s main source of income. The “breaking of bread” means to eat a meal with others. And bread is called the “staff of life” because it’s considered a mainstay of the diet throughout history, all over the world.

Bread is one of mankind’s first “processed” foods. In pre-historic times, a mix of ground grains and water could be cooked on hot stones, making a type of flatbread. Ancient Egyptians are believed to have cultivated wheat and developed a grinding stone called a quern, which crushed grains into coarse flour. The first leavened bread likely happened by accident, when yeast from the air mixed with the combination of flour and water; however, yeast production became a profession in itself in ancient Egypt. Archeological digs have excavated bread ovens and tools, and bread loaves of varying shapes and sizes have been unearthed in tombs and burial sites.

White breads were especially popular among the ancient Romans and Greeks, for whom a lighter color bread indicated higher quality. Over time, milk, eggs and butter were sometimes added to the dough, along with fruit, sweeteners and other ingredients. The art of baking was held in high regard; a representative of the Guild of Bakers held a seat in the Roman Senate.

By the Middle Ages, bread had spread into Asia and the rest of Europe, with different cultures using whichever grains were common in their regions. For example, the Vikings mainly made bread from rye, while China’s steamed breads were often made from rice, sorghum and other indigenous grain flours. Kings and landlords employed staff solely dedicated to baking bread, while poorer people typically brought their dough to a communal oven.

The Industrial Age ushered in the beginning of today’s commercial breads. Mass production of yeast began and Charles Fleischman started selling yeast to bakers, and then to the public, within a few short years. Flour mills appeared in Europe and America, and bread moved from being a homemade product to a commercially produced staple. In 1930, Wonder Bread — that soft, white bread in the famous white package with red, blue and yellow circles — became the first commercially-produced sliced bread. In the 1940s, thiamin, niacin, riboflavin and iron were added to enriched flour and hence, into breads, in a public health campaign to ward off nutrient deficiency diseases such as beriberi and pellagra. In 1998, folic acid was added to the list of required nutrients to enrich commercial breads to help prevent birth defects.

Today, many bread manufacturers are expanding product lines made with gluten-free flours or starches, xanthan gum and emulsifiers to mimic breads containing gluten, while others are exploring reduced-sodium formulas. Consumers are also looking for breads that offer bonus nutrition, such as added fiber, calcium and vitamin D. On the flip side, bread is the No. 1 source of sodium in the American diet. While its per-serving sodium (80 mg to 230 mg per slice) pales in comparison to that of other foods, people tend to eat multiple servings of bread throughout the day.

But while Americans sure o love their bread, research indicates we’re on the pathway to making healthier choices when it comes to navigating the bread aisle. A recent survey indicated that 56 percent of consumers are cutting back on white bread, while more consumers are seeking whole-grain and multi-grain breads. Could bread manufacturing and consumption be coming full circle to its humbler, simpler beginnings?

Do Know Your Loaves?

Despite their different textures, shapes and flavors, breads can generally be classified into three categories: yeast breads, flat breads and quick breads. Here are samples from around the world of each type:

Yeast Breads

Yeast breads use yeast as the leavening agent to help dough rise. Some examples include: brioche (rich French bread); baguette (long, thin loaf French bread with crispy crust); bauernbrot (German sourdough bread); challah (braided Jewish Sabbath bread); cherniy hleb (Russian black bread); kulich (Eastern Orthodox sweet Easter bread); and pan de jamón (Venezuelan stuffed bread of ham, raisin and olive bread).

Flat Breads
Flat breads are thin and flat breads, as the name implies. Some may be leavened (such as Italian foccacia, Greek pita or Native American frybread, that are cooked in oil), while others do not include a leavening agent of any sort. Examples of other flat breads include: naan (Indian tandoor-baked bread); lavash (Middle Eastern thin flatbread); tortillas (corn or wheat Mexican round flatbread); bammy (Jamaican cassava flatbread); lefse (Norwegian potato flatbread); and matzah (Jewish cracker-type bread).

Quick Breads
These breads do not require kneading or rising time, since a leavening agent (baking powder or baking soda, for example), helps the dough rise quickly when it’s combined with a liquid. Eggs may also help leaven quick breads. Examples of quick breads include popovers (American version of the English Yorkshire pudding that is a hollow, light and airy roll); buttermilk biscuits (Southern American favorite that uses buttermilk); soda bread (Irish soda-leavened bread); cornbread (American quick bread that contains corn meal. Other variations include Johnnycakes, corn pone and hushpuppies); and Boston brown bread (early American steamed bread traditionally baked in a can and sweetened with molasses).

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Besting Breastfeeding Bullies: A Case for Supporting, Not Shaming

Kerry Neville — Tue, 26 Aug 2014 15:15:18 +0000

"Breast is best" has long been the mantra to new mothers and is a favorite among many registered dietitian nutritionists.

There's no shortage of good reasons for moms to breastfeed their infants; numerous studies point to the nutritional and health benefits of breast milk, including reduced risk of ear infections, sudden infant death syndrome, obesity and respiratory illness, as well as improved maternal outcomes such as a reduced risk of ovarian and breast cancer, Type 2 diabetes and postpartum depression.

For some mothers, however, breastfeeding isn't an option — either because they can't breastfeed or they choose to formula-feed instead. And many of these moms report feeling shame and guilt about their situation.

Has the "breast is best" mantra gone too far in perpetuating these feelings among women who cannot, or choose not, to breastfeed?

Too Much Pressure?
"Bullies" may be a strong label to those who passionately believe that breast milk is the best food for babies — and in most cases, it is likely an unfair depiction of many breastfeeding advocates.

La Leche, an organization that fervently promotes breastfeeding via mother-to-mother support, is sometimes cited as one of the "extremist" breastfeeding groups. Although its approach may seem dogmatic to some, La Leche was founded in 1956 when formula was the go-to choice for mothers, and has dedicated the past 58 years to promoting the benefits of breastfeeding.

Over the years, campaigns and programs to boost breastfeeding among new mothers have been largely successful.

Research from the Centers for Disease Control and Prevention's 2014 Breastfeeding Report Card shows that more than three-quarters of moms begin breastfeeding their infant. Yet despite these promising stats, a study published in 2013 in Pediatrics found first-time moms who report problems and concerns with breastfeeding during the first few days after giving birth are nearly 10 times as likely to quit breastfeeding within two months.

Those findings aren't surprising to Ginger Carney, MPH, RD, LDN, IBCLC, FILCA, FAND, director of clinical nutrition and lactation consultant at St. Jude Children's Research Hospital in Memphis. "It takes a village for a woman to successfully breastfeed," says Carney, noting there are many barriers that make breastfeeding more difficult than it has to be.

"Some of these barriers start in the birth hospital when moms and babies are separated, or when formula is provided to mothers who are breastfeeding," she says. "Other barriers that occur later include unwelcome looks when moms try to feed their babies in public or when new moms return to work and need to find a private place to pump."

Much of Carney's work with new mothers is centered on dispelling myths and providing women with the education and tools to work around these barriers.

Katie Mulligan, MS, RDN, LDN, is an extension service dietitian at the University of Rhode Island whose own experience changed her perspective of formula. Trying to "do the right thing" by breastfeeding resulted in the hospitalization of her 5-day-old daughter while Mulligan waited for her milk to come in. With the help of a lactation consultant, Mulligan used formula to supplement her breast milk. "You think that breastfeeding is natural. No one tells you that breastfeeding can be incredibly hard and heart-wrenching, and that you feel like the world's worst mom when it doesn't work out," Mulligan says.

Many other new moms agree; a 2012 study found that 43 percent of first-time mothers feel guilty about using formula instead of breastfeeding. "My opinion was definitely different before I had a child," Mulligan says. "Now I am much more open to formula as a perfectly good option for babies."

Less Judgment, More Support
Babies not latching on properly, concerns over quantity of breast milk and pain during breastfeeding are typical situations that certified lactation consultant Freda Rosenfeld, IBCLC, encounters in her work with new moms. "I'd say that in 80 percent of cases, I'm successful in helping women achieve their nursing goals," says Rosenfeld, adding that the operative phrase is their nursing goals.

While in an ideal world all women might exclusively nurse, Rosenfeld is also pragmatic: Medical conditions, use of medications, returning to work, fatigue and other factors influence how much, how long and if ever a woman can breastfeed, or if the addition of formula is needed. Each mother's goals, options and situations are different; important points for RDNs to consider and remember when counseling new mothers.

"My belief is that every woman should first and foremost be educated about breastfeeding, and those who want to breastfeed should be helped to be successful," Rosenfeld says. "But no one should ever be made to feel guilty about their choice or circumstance."

Elizabeth Ward, MS, RD, author of Expect the Best: Your Guide to Healthy Eating Before, During & After Pregnancy (Wiley 2009) couldn't agree more. "Women need support for their decisions, not pressure or shame," says Ward. "Being happy is the greatest gift you can give your baby, and if that means no breastfeeding and using formula instead, then that's the best choice."

But sometimes, that's easier said than done. Like many moms-to-be, Massachusetts-based dietitian Dianne Rishikof, MS, RDN, LDN, always assumed that she would breastfeed, but medical issues thwarted her plans. A conversation with her cousin — a pediatrician who holds a strong "breast milk only" stance — left her devastated and feeling like a failure. While reassurance from both her own doctor and pediatrician that using formula would not harm her baby's health helped ease her worries and anxiety, the seesaw feelings of guilt continued for months, perpetuated in part by parenting books she read.

Only after her son turned 6 months old and it was clear that he was nourished, healthy and attached to her did Rishikof come to terms with her circumstances. "I am at peace with this choice that was taken away from me, but I still feel like I need to say 'for medical reasons' whenever I talk about bottle feeding my kids," says Rishikof. "And that need for defensive justification speaks volumes to the pressure or judgment that I must still feel."

Mulligan has spoken out against the pressures mothers face feeling like they are failures if they don't breastfeed and has found support among fellow RDNs, for the most part. However, she says, "There are dietitians who think we should 'warn mothers of the dangers of formula' — that's an exact quote — and that type of thinking does nothing but harm, to the mother and to you, as a health professional."

Using formula to feed a baby is sometimes a conscious choice and other times a decision that's out of a mother's control. Either way, health professionals' roles are to provide less judgment and more support and encouragement — and, of course, science-based nutrition education free from personal bias.

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Plantains: A Tropical Staple for Sweet or Savory Fare

Kerry Neville — Tue, 01 Jul 2014 02:26:17 +0000

A staple in many tropical cultures, the plantain is a surprisingly versatile fruit that appears in everything from appetizers to desserts. Plantains may resemble bananas, but their starchy flesh is less sweet, more like that of a potato, and plantains must be cooked before eating.

Often sold individually instead of in a bunch like bananas, plantains have thick skins that range in color from green to yellow to black. Plantains can be used at any stage of ripeness. Green plantains are bland and best fried, grilled or broiled in savory recipes. Yellow ones are sweeter and softer; they are delicious grilled or baked into savory or savory-sweet recipes. Black plantains are the sweetest variety and are ideal for desserts.

To peel plantains, cut off both tips. Make a slit down the full length of the peel and pull off the skin in one piece. While green plantains are the most difficult to peel, yellow and black plantains may peel more easily – but still not as simple as unzipping a banana.

Ripen plantains by storing them at room temperature out of direct sunlight and turning them daily. It takes seven to 10 days for green plantains to fully ripen.

A medium raw plantain provides 218 calories with no fat, and is a good source of fiber. It's also an excellent source of potassium and vitamins A, C and B6. Although allergies are uncommon, some people are allergic to plantains and bananas. Those with a latex allergy may develop a reaction when eating bananas or plantains, since they cross-react with latex.

Cooking and Eating Plantains Around the World

Walk into any Latin or Caribbean restaurant and you're almost guaranteed to find plantains on the menu. Plantains also appear in some African, Asian and Indian cuisines.

Whether it's mangú, pureed plantains topped with sautéed onions (a popular breakfast item in the Dominican Republic) or pastelón, a lasagna-like dish made with plantains from Puerto Rico, it's hard to go wrong. Dodo is Nigeria's rendition of fried plantains, often served with rice, beans or eggs. An Indian stir-fry, aratikaya vepudu pairs plantains with ginger, turmeric and other spices.

Tostones, which go by many different names depending on the country, are twice-fried green plantains. They're similar to potato chips in that they're sliced and fried, but they can also be shaped into mini-bowls to hold a variety of fillings. To make tostones, the plantain chips are fried once, then a saucer is placed on top or a mallet is used to pound them until the chip is thin and flat. The chip then is fried again. A tostonera is a hinged, two-part tool sold in many Latin supermarkets that can be used to flatten the slices. To make a bowl shape instead of a chip, use a shot glass to form a bowl after the first frying and once shaped, fry it again.

Tostones can be topped or filled with avocado salad, ceviche or marinated, cooked chicken. They're also delicious served with a dip or simply on their own.

Pre-sliced, diced and mashed plantains, which save untold time in the kitchen, are available frozen in foodservice quantities and in varying stages of ripeness. Frozen tostones in chip form or bowls, also are available.

Contributing Editor Kerry Neville, MS, RD, is a nutrition communications consultant based in Seattle.

Spicy Pork and Plantain Dry Curry

Recipe by Tram Le, MS, RD

Ingredients

3 tablespoons canola oil, divided
2 medium green plantains (1 pound total), peeled and sliced in ½-inch slices
½ teaspoon kosher salt, divided
2 carrots, peeled and sliced in ½-inch slices
½ medium onion, diced into 1-inch cubes
2 cloves garlic, minced
1¼ pound pork tenderloin, cut in 1-inch cubes, fat trimmed
2 teaspoons curry powder
¼ teaspoon ground turmeric
¼ teaspoon red chili pepper flakes
¼ teaspoon freshly ground black pepper
⅓ cup chicken broth
2 tablespoons chopped cilantro

Directions

Over medium heat, add 2 tablespoons canola oil to a 3.5-quart French oven (or other cast-iron pot). When the oil is shimmering, add the plantain slices. Add ⅛ teaspoon of kosher salt, and frequently turn the plantains, frying them for 6 minutes, or until lightly browned. Take the plantains out and set aside in a clean, medium bowl.
Using the same pot, turn the heat down to medium-low, and add 1 teaspoon canola oil. Add the carrots, onion and garlic, and another ⅛ teaspoon of kosher salt, sauteing and stirring often.
When the onions soften (about 5 minutes), add the plantains back in and cook, covered, for another 5 minutes. Remove contents and set aside in a medium bowl.
In a separate medium bowl, toss the cubes of pork with ¼ teaspoon kosher salt, curry powder, ground turmeric, red chili pepper flakes and black pepper. Add 2 teaspoons canola oil to the same pot, increase heat to medium, and saute pork, stirring often, for about 6 minutes, until browned.
Add in all vegetables and pour in chicken broth, mixing all ingredients together, and then cover. Continue to cook for another 8 minutes, until the meat is cooked through and carrots are tender.
Garnish with chopped cilantro.

Nutrition Information

Serves 4
Serving Size: 3 ounces pork, ¾ cup vegetables

Calories 419; Total fat 20g; Sat. Fat 4g; Chol. 97mg; Sodium 408mg; Carb. 30g; Fiber 3g; Sugars 14g; Protein 33g; Potassium 1018mg; Phosphorus 351mg

Tram Le, MS, RD, is based in Annapolis, Md. She is a Stone Soup blogger and the author of This Veg Life.

Oven-Baked Plantains with Chipotle Black Beans and Cilantro Salsa

Recipe by Jamie Stolarz, MS, RDN, LDN

Ingredients

2 large (10-inch) ripe, black plantains
2 tablespoons extra-virgin olive oil
½ teaspoon garlic sea salt*
¼ teaspoon freshly ground black peppercorns
1 cup canned low-sodium black beans, rinsed
1 canned chipotle pepper in adobo sauce
¼ cup finely-minced sweet yellow onion
1 cup fresh cilantro, large stems removed, cut with kitchen shears

Directions

Preheat oven to 375°F.
Cut off plaintain tips and peel. Bias-cut each plantain into 8 wedges by slicing each plantain on the diagonal into approximately 2-inch pieces. Repeat with second plantain to form a total of 16 wedges.
Place plantain wedges in a shallow, 8×11-inch glass baking dish. Drizzle plantains with extra-virgin olive oil. Toss to evenly coat. Sprinkle with garlic sea salt and freshly ground pepper. Toss to coat and bake for 35 minutes, or until light golden brown.
Meanwhile, rinse and drain black beans. Place in a small bowl. Use a paring knife to thinly slice chipotle pepper horizontally to form circles, reserving seeds and sauce.
With a spoon, gently mix pepper, seeds and sauce into beans. In a second small bowl, mix onion and cilantro.
Use a spatula to flip cooked plantains. Pour beans and chipotle over plantains. Use a spatula to gently combine. Bake an additional 5 minutes or until beans are warm.
Divide cilantro-onion mixture among four plates. Top each plate with four plantains and ¼ cup of chipotle beans.

Cooking Note

Garlic sea salt can be substituted with 1⁄4 teaspoon garlic powder and 1⁄8 teaspoon salt.

Nutrition Information

Serves 4
Serving Size: 4 plantain wedges, ¼ cup black beans, ¼ cup cilantro-onion salsa

Calories 237; Total fat 7g; Sat. Fat 1g; Chol. 0mg; Sodium 338mg; Carb. 41g; Fiber 6g; Sugars 14g; Protein 5g

Jamie Stolarz, MS, RDN, LDN, is based in Brandon, Fla. She is a Stone Soup blogger and author of TwoSistersOneKitchen.com.

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In the Matter of Milk

Kerry Neville — Tue, 01 Jul 2014 02:16:28 +0000

From rumors of hormones in milk causing early puberty in girls to lurking residues of antibiotic and cancer-causing agents, milk's wholesome reputation has been rattled in recent years — giving rise to the organic milk sector and leading some consumers to ditch dairy milk altogether. Are the alarms based in fact or fiction?

Antibiotic Use among Dairy Herds

The topic of antibiotics in dairy production reflects concerns about general overuse of antibiotics in livestock. According to a recent World Health Organization report on antimicrobial resistance, half the countries in the world may mass-administer antibacterial drugs to food-producing animals.

In the U.S., antibiotics are not used as preventive guards against illness or to boost growth or milk production in dairy cows, according to Tom Overton, PhD, professor of dairy management at Cornell University. If a dairy cow is sick, a veterinarian might administer antibiotics — but only for specific infections and when other means of managing the illness don't work. "The percentage of cows who might need antibiotics at any one time is very small, typically 2 percent or less of the herd," says Overton.

And since milk from cows taking antibiotics cannot be sold, farmers have an economic incentive to avoid using antibiotics unless absolutely necessary. "On our farm, if a cow is sick or is being treated with antibiotics, she is moved to a separate group," says Heidi Wells, RD, LD, a private practice dietitian whose family owns a dairy farm in Kansas. A cow that falls ill is relocated from the healthy "A" group to the "B" group. Cows in the "B" group are milked while on antibiotics, but their milk is discarded. After the cow finishes her course of antibiotics and returns to good health, her milk is tested after each milking session. Only after there is no evidence of antibiotic residues in her milk will she move back into the "A" group.

Farmers are typically careful about this because the financial repercussions are hefty. Every tanker truck of milk that arrives at a dairy processing plant is tested for antibiotic residue — accounting for about 99 percent of the milk produced in this country, according to Sebastian Cianci with the U.S. Food and Drug Administration.

A tanker of antibiotic-laced milk can be traced back to the farm of origin, which must pay for not only its own wasted milk, but also for the milk from any other farms in that load. Repeat violations jeopardize the farm's ability to sell milk at all.

In 2013, the National Milk Drug Residue Data Base, a voluntary industry reporting program, found that 99.987 percent of bulk milk from tankers tested negative for residues of 10 different groups of drugs, including antibiotics, and 100 percent of all pasteurized fluid milk and milk products were negative for drug residues. Still, while milk in America may be antibiotic-free, critics say dairy farms use practices that potentially promote anti-bacterial resistance, particularly since dairy farms are where disease-susceptible calves typically are raised for veal.

"Calves may be given a medicated milk replacer that contains sub-therapeutic doses of antibiotics in an effort to stave off scours (diarrhea)," says Stacia Clinton, RD, LDN, New England regional director of the Healthy Food in Health Care program, adding that considerations beyond antibiotic residue in food include a potential emergence of antibiotic-resistant bacteria, which can be passed through direct contact or even through animal waste, dust or dirt in the air and through water streams.

"There is no legislation requiring farms to disclose prophylactic use of antibiotics unless there is a prescription from a veterinarian," says Clinton. "The real issue is about transparency."

Hormones and Milk Production

"There are six anabolic hormones, including progesterone, prostaglandins and oxytocin, that may be used to maintain healthy reproduction and lactation cycles [of dairy cows], under the care of a licensed veterinarian," says FDA'S Cianci. No steroid hormones are approved for production purposes in dairy cows — although commercial milk sold in the U.S. is fortified with vitamin D (calciferol), which functions primarily like a steroid hormone.

Arguably the most widely known hormone associated with dairy foods is recombinant bovine somatotropin, or rbST. A synthetic form of the natural protein hormone bovine somatotropin already produced in cows, rbST helps mammary glands take up more nutrients from the bloodstream, thereby producing more milk (approximately one gallon per day more than a cow not given rbST).

While there are environmental benefits to increased milk production per cow — fewer cows are needed to produce a given quantity of milk, resulting in less feed, manure and methane gas — European and Canadian bans on both rbST itself and products from cows treated with rbST strained trade agreements with the United States in the 1990s. This, coupled with boycotts by consumers and retailers, led some manufactures to voluntarily label their products as "rbST-free." Today, the USDA estimates less than 9 percent of cows were treated with rbST in 2010.

Controversy about rbST use in milk production have ranged from whether it increases cows' risk of mastitis, an infection of the mammary glands (it doesn't, according to a 2014 meta-analysis published in the Journal of Dairy Science), to its potential effect on human health.

All milk — conventional or organic — contains very small quantities of bST, and cows treated with rbST are within tiny variations of the natural bST hormone. There is no test that can differentiate between naturally occurring bST and rbST in milk, and most of it is denatured through the pasteurization process. Like a vast majority of proteins, bST and rbST break down into individual amino acids and peptide fragments during digestion. Hormonal activity is destroyed, rendering bST and rbST biologically inactive in humans. Even if the hormones survived digestion, because they are bovine forms of somatotropin and are speciesspecific to cows, they are not recognized by any human cell receptors.

Another criticism hinges on studies that have shown milk from rbST-treated cows to have slightly higher levels of the hormone insulin-like growth factor, known as IGF-1. How this hormone might affect cancer risk is unclear; early studies found a relationship between blood levels of IGF-1 and colorectal, prostate and breast cancers, although later studies either have not confirmed these findings or have found weaker relationships.

But drinking milk from cows treated with rbST likely would not affect IGF-1 levels in a person's blood anyway, according to Overton, since it would be degraded in the digestive tract. Even if it were absorbed intact, it's estimated that an adult would need to drink the equivalent of more than 39 gallons of milk per day to equal the amount of IGF-1 that's naturally secreted in a person's GI tract, says Overton.

Patty Lovera, assistant director at consumer advocacy group Food & Water Watch, disagrees — saying research indicates most IGF-1 actually survives digestion since it binds to casein, the main protein in milk, and may be absorbed into the human bloodstream with it. "The initial concerns we had about rbST and IGF-1 levels are still concerns. The issue of rbST among the public has receded somewhat because of the reduction in how widely it's used by dairy farmers, not because there is any new evidence of its safety," Lovera says.

Healthy Farm Management Practices

The average cow makes about 2,500 gallons of milk a year, says Overton, but this can vary significantly among cows. While rbST can boost milk production, it is just one tool — and not the most important one — that dairy farmers use. "[It] is not a magic substance that automatically increases milk production," says Overton. "If a cow isn't healthy or doesn't eat a good diet, rbST will not override those factors to help increase her milk. In fact, if you examine the data from 1993 (when rbST was introduced) to today, you will not see a huge blip skyward in milk production. Cows in the U.S. continue to increase production because of genetic improvement and other factors that relate to the quality of management in many areas of the dairy farm."

Wells' family farm, which has a milking herd of 165 cows, does not use rbST because there was not a great enough increase in milk production to warrant its expense compared to other ways they care for their cows. Proper animal husbandry is the biggest piece of the milk production puzzle — and nutrition plays a significant role, according to Wells. An animal nutritionist visits monthly to monitor and optimize the feed ration for their cows. Dry, comfortable bedding and a relaxed environment are also important. "It may sound funny, but cows really do sense nervousness and tension," says Wells. "When you are gentle and calm in the milk barn, the cows stay calm, making it easier to express milk."

Clinton agrees, saying that changes in animal production methods could help reduce the need for use of antibiotics and added hormones such as rbST in the first place. "With topics like these, if you look at them singularly — in this case, only within the milk and dairy industry — they may not seem like much of an issue," says Clinton. "But we really need to examine all facets in an approach that is systemic and comprehensive in order to have a full picture."

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