Common Signs and Symptoms of Stroke

• Sudden numbness or weakness of the face, arm, or leg—especially on one side of the body.
• Sudden confusion, trouble speaking or understanding.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance or coordination.
• Sudden severe headache with no known cause.

If these symptoms occur seek medical attention immediately as this may reduce the risk for disability or death.

References:
Centers for Disease Control and Prevention. Stroke Fact Sheet. Available at: http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_stroke.htm
Million Hearts. About Heart Disease and Stroke. Available at: http://millionhearts.hhs.gov/abouthds/overview.html
National Institute of Neurological Disorders and Stroke. NINDS Stroke Information page. Available at: http://www.ninds.nih.gov/disorders/stroke/stroke.htm

Pharmacist Jameson’s California Salsa Recipe
½ medium onion
1 jalapeno pepper, seeds and membranes removed
¼ cup fresh cilantro
1 teaspoon fresh lemon juice
1 teaspoon salt (optional)
1 clove of garlic, minced (optional)
3 ripe Roma tomatoes, quartered
3 ripe Roma tomatoes, finely chopped

Place onion, peppers, cilantro, lemon juice, garlic, and the quartered tomatoes in a blender. Blend well (15-20 seconds) on low speed. Add the chopped tomatoes. Blend for about 10 seconds on medium speed until salsa reaches desired consistency. Be careful not to over mix (Hint: If your mixture turns soupy, you know you’ve over mixed). Note: A salsa maker works well as does a good knife and skilled hand (if you’re feeling ambitious).

We generally think of losing weight as being healthy, but gaining lean body mass can be incredibly beneficial to people of all ages and can lead to healthier living.  Strength training can help increase bone mineral density and prevent osteoporosis as well as reduce the risk for injury.  Think you just need to burn calories?  Building muscle can increase the amount of calories you burn both at rest and after a workout.  Additionally, gaining and retaining muscle as we age can lead to increased quality of life and independence as well as prevent falls. To build lean body mass without gaining additional fat, a couple of key nutrition and exercise principles should be followed:

1)  The first principle is to consume enough calories to maintain and gain bodyweight.  The body is an adaptive machine and always tries to maintain balance.  For this reason, the body will not build muscle when it does not receive adequate calories- those calories will be used to maintain other bodily processes.  Only when the body is receiving enough calories to maintain normal bodily processes will it consider using some extra calories to build muscle.  Therefore the most important concept in building muscle is ingesting adequate calories and a little more (300-500 calories) to support the addition of muscle.  The Mifflin-St Jeor equation is a great way to estimate calorie needs. For more information on how this can be determined, please contact one of our dietitians.

2)  Muscles are made from the amino acids we consume found in protein.  To support an increase in muscle, protein must be consumed to supply amino acids to the new muscle.  The recommendation for protein for a healthy adult is .8 g/kg.  This means approximately 55g of protein should be consumed for a 150 pound person.  If a person performs consistent, intensive resistance exercise with the purpose of gaining muscle needs can increase to 1.2-1.7 g/kg or 80-115g protein for a 150 pound person.  While this number may seem like a lot, the average American consumes close to this amount of protein per day.  The real key here is to spread out the protein in smaller, more frequent doses.  The standard American diet is lowest in protein in breakfast and excessively high at dinner time.  Try adding some eggs for breakfast.  If you’re in a rush, yogurt or a glass of milk is an easy way to get some protein in during the morning.

3)  Do you really need protein supplements to gain muscle?  A lot of supplement companies make it sound like you really do.  But the reality of the matter is that protein powder is no more effective at building muscle than the protein found in regular food.  Use protein powder when it is convenient, but try to rely on whole food sources at all other times.

4)  Eating after exercise helps take the body out of catabolic state (breaking down nutrients for energy) and into an anabolic state (using nutrients for building muscle).  Try to get in both carbohydrate and protein within 30-60 minutes after your workout.  20g of protein has been previously been shown to be the highest amount of protein beneficial for building muscle at one meal.  The optimal ratio of protein: carbohydrate after a hard workout lasting 45 minutes or longer is 1:3-4.  This means that if you consume 20g of protein, you should also take in 60g-80g of carbohydrate. A protein supplement can be beneficial post-exercise, but carbohydrate should be added to ensure optimal recovery and adequate caloric intake to support muscle growth.  Adding some fruit or a Gatorade can help serve this purpose.  If you want a one-stop-shop for both carbohydrate and protein, try chocolate milk, yogurt, or a smoothie made with protein powder or Greek yogurt.

5)  Resistance exercise is vital in building lean body mass.  Without the stimulus resistance exercise provides, the extra calories you consume will just be stored as fat.  Resistance exercise doesn’t just mean lifting weights- bodyweight exercises such as pushups, squats or TRX suspension training and resistance bands can be used to build muscle. Just remember compound, whole body movements are always the most effective.  Stick to moderately difficult resistance exercise and contract your muscles with intention, keeping your body as tight as possible during the exercise.

References|
Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;13:1510–30.
Zelman, Kathleen. “10 Ways to Boost Your Metabolism.” . WebMD, 3 26 2012. Web. 9 May 2013. http://www.webmd.com/diet/ss/slideshow-boost-your-metabolism.
Kerksick C, Harvey T, Stout J, Campbell B, Wilborn C, Kreider R, Kalman D, Ziegenfuss T, Lopez H, Landis J, Ivy JL, Antonio J.  Internationational society of sports nutrition position stand: nutrient timing. J Int Soc Sports Nutr. 2008;5:17
Moore DR, Robinson MJ, Fry JL, Tang JE, Glover EI, Wilkinson SB, Prior T, Tarnopolsky MA, Phillips SM. Ingested protein dose response of muscle and albumin protein synthesis after resistance exercise in young men. Am J Clin Nutr. 2009;89(1):161–8
Rodriguez NR, Di Marco NM, Langley S.  American College of Sports Medicine position stand.  Nutrition and athletic performance. Med Sci Sports Exerc. 2009;41(3):709–731.

Serving Tip: Try asparagus cold!

You’ll need:

• Asparagus
• Olive oil
• 1 lemon
• Salt
• Small container of Greek yogurt

Sauté asparagus with a little olive oil on medium-high heat for a couple minutes, until al dente. Splash with juice from half a lemon and a little salt. Transfer to plate to cool. While asparagus is cooling, mix up plain Greek yogurt with a teaspoon of lemon zest and juice from the second half of the lemon. Once asparagus is cool, top with lemon yogurt dip. This makes a great appetizer or finger food.

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Strawberry Orange Mascarpone Crepe
Ingredients
2 cups strawberries, sliced
1 cup orange slices
8 oz. Mascarpone cheese
1 1/2 cup heavy cream, whipped to med stiff peek
1 tablespoons vanilla bean paste
1/4 cup sugar
1 package of prepared crepes
Mint sprigs for garnish

Instructions
In a medium bowl combined strawberries slices, orange slices and sugar (save some of the strawberries and oranges for garnishing).
Set aside and allow to marinate.
Combine mascarpone cheese and vanilla bean paste.
Mix until smooth.
Fold in 1/2 of the whipped cream.
Fold in strawberries and oranges.
Lay out prepared crepe. Spoon filling on 1/3 of crepe then roll up.
Place in baking pan and repeat with all crepe shells.
Bake at 350 degrees for 5 minutes, just to warm slightly.
Serve with a dollop or two of whipped cream, a strawberry, three orange slices and mint sprig.

Bacon and Potato Medley Hash Browns
Ingredients
1/2 lb. Harmon’s Bacon, cut in ribbons
1 lb. tri-color potatoes
1 lb. sweet potatoes and yams
2 eggs
1-tablespoon flour
1 shallot
3 garlic cloves
2 tablespoons sunflower oil (if needed)
Salt and pepper to taste
Dollop of crème fresh or sour cream and minced chives to garnish

Instructions:
Peel potatoes and shred with food processor or grater.
Shred shallot and garlic.
Combined potatoes, shallot, garlic, eggs and flour in a bowl and season with salt and pepper. Don’t over mix.
In large skillet cook bacon ribbons until they start to get crispy.
Remove from pan leaving bacon bits and oil in pan.
Fold bacon into potato mixture.
Heat skillet back up to medium heat, adjust oil do that it coats the bottom of the pan.
Add bacon potato mixture to cover surface of pan, careful not to overload.
Cook for 4-5 minutes or until brown and crisp.
Flip and cook other side (approximately 3 minutes).
Turn out onto cutting board and slice like pizza.
Serve with dollop of crème fresh and sprinkle with chives.

Ingredients
2         cups strawberries, sliced
1          cup orange slices
8  oz.  Mascarpone cheese
1 1/2   cup heavy cream, whipped to med stiff peek
1          TBLS . vanilla bean paste
1/4      cup sugar
1          package of prepared crepes
Mint sprigs for garnish

Directions:
In med bowl combined strawberries slices, orange slices and sugar.  (keep some of the strawberries and oranges for garnishing)
Set aside and allow to marinate.
Combined mascarpone and vanilla bean paste, mix until smooth.
Fold in 1/2 of the whipped cream. Then fold in strawberries and oranges.
Lay out prepared crepe. Spoon filling on 1/3 of crepe then roll up.
Lay in baking pan and repeat with all crepe shells.
Bake at 350 degrees for 5 minutes, just to warm slightly.
Serve with a dollop or two of whipped cream, a strawberry, three orange slices and mint sprig.

Laura, Registered Dietitian

A busy week culminated late yesterday afternoon in a mess of frustration, stress, and an overall no-good-very-bad mood.  So I did what I had been putting off all week – I jumped on my bike and rode up Emigration Canyon.  Just what I needed.  I left as a grumpy pants and came back 90 minutes later cheery and refreshed.  Magic, right?

Well, depending on your definition of magic, yes.  Exercise has been shown to improve mood and reduce depression in multiple studies over the last few decades.  One study measured the mood of 80 dance class participants before and after an hour long class.  The researchers found that exercise improved mood—especially in those who had depressed feelings before the class.

Feeling moody and down after a long day or week is one thing, but the benefits of exercise goes even farther.  It may also improve symptoms of clinical depression.  A 2009 review article concluded that exercise can be as effective as anti-depressive medications and cognitive behavior therapy (counseling).  This is great news, but please talk to your doctor about the best care plan for you.

To decrease symptoms of depression and enhance mood, 30 minutes of exercise 3-5 times a week is recommended by The Institute of Clinical Symptoms.  Notice that this is in line with the recommendations for general health and prevention of high blood pressure, diabetes, and obesity.  Also, any exercise is beneficial (even if it is broken up into 10 minutes segments), but a mix of aerobic and resistance exercise is most effective.  Meditative type exercise such as tai chi and yoga also works.

How exercise improves mood is less clear.  The Mayo Clinic suggests these factors are behind exercise’s mood-enhancing effects:

• Releases “feel-good” brain chemicals such as neurotransmitters and endorphins.
• Increases body temperature which may help calm us down.
• Helps us gain confidence.
• Distracts us from our worries and things that cause us anxiety.
• Offers an opportunity for social interaction (if you exercise with others).
• Provides a healthy way to cope with negative feelings.

This is just another reason to stop sulking and thinking up more excuses.  Get out there and move!  Your body and mind (and maybe your family and friends too) will thank you.

References:
Lane, AM and Lovejoy, DJ.  The effects of exercise on mood changes: the moderating effect of depressed mood. J Sports Med Phys Fitness. 2001; 41:539-45.
Mead GE, et al. Exercise for depression. Cochrane Database of Systematic Reviews. 2009; CD004366
http://www.jfponline.com/Pages.asp?AID=8921
http://www.mayoclinic.com/health/depression-and-exercise/MH00043
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6217a2.htm?s_cid=mm6217a2_w

There’s no describing Bob and Randy’s “festiveness” – you just have to watch. Make sure you watch all three segments to catch the three recipes and get the full Bob and Randy effect.

Click the image to watch video on KSL

Fish Tacos

Jicama Slaw

Tres Leches Cake

Chef Evan’s Chilled Cucumber Tomato Soup
Serves 4

• 2 English (hothouse) cucumbers, sliced
• 1 red onion, sliced
• 4 Roma tomatoes, sliced
• 3 cloves garlic, chopped
• 2 roasted red peppers, chopped
• 1 cup tomato juice
• ½ cup no-sodium added chicken or vegetable stock
• 3 tablespoons red wine vinegar
• 1 tablespoon parsley, chopped
• 1 tablespoon fennel, chopped
• 1 tablespoon mint, chopped
• 4 ounces Chevre

In a large container add all ingredients and refrigerate overnight. The next day, puree all of the ingredients in a blender and strain to desired consistency (you can use a mesh sieve or cheesecloth in a colander for this step). Season with salt and pepper and crumble 1 ounce of Chevre onto each serving.