Monthly Archive

Metrowest Nutrition

From Our Blog

Nutrition to Beat Breast Cancer

Wednesday, October 15, 2014

As women, we are constantly bombarded with messages about maintaining a healthy weight.  While it can be difficult to face, we know that carrying around excess weight isn’t good for many reasons.  Increased risk of heart disease, diabetes and stroke are just a few of the health risks that are connected with weight gain as we age.  Achieving and maintaining a weight can help protect you from these diseases but did you know that it may also protect you from breast cancer?

As an oncology dietitian I work with women who either have breast cancer or have a strong family history of the disease. Weight gain in adulthood puts many women at increased risk of hormone-related breast cancer due to higher amounts of estrogen present in their bodies, produced by fat tissue. Women who are overweight or obese have higher levels of estrogen than thinner women because they have more fat tissue to produce the hormone. When you lose weight, you decrease your stores of fat tissue and therefore lower the amounts of estrogen circulating in your body. This can be beneficial for lowering risk of hormone-related cancers.

Studies show that weight gain, particularly after menopause, is the most troublesome for increased risk of hormone-related breast cancer however many women are unaware of this connection. The good news is that you don’t have to feel powerless. Researchers point out that even small weight loss can make a big impact on reductions in risk. You don’t have to lose 40 or 50 pounds to see a benefit. If you are overweight, reducing your body weight by just 10% will lower your risks.

Where to start? When I meet individually with patients, we start first by talking about healthful choices. From a cancer-prevention and weight loss perspective, my first priority is always to work with my clients on increasing their intake of plant-based foods and then we proceed from there. My baseline nutrition recommendations are listed below:

1.  Start with for 5 servings of fruits/veggies daily (at least!). We all can benefit from eating more fruits and vegetables. Period. From a weight-loss point of view, it is important to watch portions of starchy vegetables like potato, winter squash and corn and think of these foods more like bread or pasta on your plate. Although they are healthful options, calories in starchy vegetables can add up more quickly than with their less starchy counterparts. On the flip side, it is really hard to overeat carrots, greens, tomatoes, peppers, asparagus, summer squash, broccoli, Brussel sprouts, etc. so have heaping servings of these whenever you can. Brightly colored fruits and veggies are packed with beneficial nutrients so aim to have lots of different colors represented on your plate. 

2.  Choose whole grains as often as possible. Think brown rice, whole grain breads, oatmeal, whole wheat pasta, etc. Whole grains have more fiber and nutrients than refined versions. The additional fiber will help you feel fuller and more satisfied when eating, in addition to keeping your GI tract healthy.
3.  Cut back on packaged foods. Aim to eat more whole foods to reduce your intake of sodium and preservatives. When choosing packaged goods, look for those with the fewest ingredients listed and pick those with recognizable ingredients.

4.  Limit sugary drinks. Choose beverages that are naturally calorie-free.

5.  If you eat meat, choose lean poultry or beef. Organic options will further reduce your exposure to hormones which may be beneficial. Include fish often. Portion size should be 1/3 of your plate or less. Emphasis should be on the plant foods on your plate, not the animal protein. Aim to have at least one vegetarian meal each week and include things like beans and tofu.

6.  Limit alcohol. For women, reducing intake to 1 drink per day or less is associated with the lowest risk of cancer and other diseases. 1 drink = 5 ounces of wine, 12 ounces of beer or 1.5 ounces of liquor. 

Of course, it's always important to individualize nutrition and lifestyle goals and determine what a healthy weight is for you -- this is not a "one size fits all" scenario.  Behavior change is difficult and takes time.  Small, gradual changes work best.  A registered dietitian (RD) can help you through this process.  If you have survived breast cancer or have a strong genetic risk for it, consider reaching out to an RD to get some support around healthy changes you can make.  Be proactive and take charge of your health!

All information is in keeping with current recommendations from the American Cancer Society and American Institute for Cancer Research. To see more information from these groups, visit or

Blog written by Leslie Judge, MS, RD, COD

Pregnant & Feeling the Burn? Helpful Tips for Heartburn.

Wednesday, September 17, 2014

Every pregnant woman has her share of discomforts but I would argue that none are quite as annoying or uncomfortable as heartburn. I say this because many other things that plague pregnant women (morning sickness, back pain, swollen feet, sleepless nights) usually don’t last the entire pregnancy. Heartburn, on the other hand, can often start at the beginning and last right on through until your little one is born. There are a host of factors that contribute to heartburn in pregnancy. Hormones and the pressure your growing baby puts on your stomach are the biggest causes. Clearly, there is not much pregnant mommas can do to avoid these things. If you are blessed enough to be heartburn-free during your pregnancy, thank your lucky stars. You have no idea how much fun you are missing. If you are experiencing heartburn, be sure to speak to your doctor about taking some over the counter antacid medications. Most doctors readily give you the green light on things like Rolaids, Tums and even Zantac – but check in just the same before taking these. Here are some additional tips to help manage your heartburn:

  • Slow it down: Eat slowly and chew foods well. When you eat quickly you end up gulping more air which only increases heartburn and gas.
  • Size matters: Have smaller meals more frequently throughout the day. Five or six mini-meals will be easier on your system than the traditional three. Avoid sitting down to large meals which can stay longer in your stomach (and make heartburn worse).
  • Avoid the main offenders: Spicy, fatty and/or greasy foods, chocolate, peppermint, carbonated drinks, citrus fruits/juices (orange, lemon, grapefruit) and tomato-based sauces/juices.
  • Keep liquids and foods separate: Drink liquids separately from your meals to avoid overfilling your belly. Small sips with meals are fine but avoid downing large amounts when eating.
  • Loosey Goosey: Choose clothes that aren’t too tight on your belly. Extra pressure in this area does nothing to help lessen heartburn.
  • Keep it up(right): Don’t lie down too soon after eating. Remain in an upright position (sitting or propped up with pillows) for at least two hours after eating. Sleeping with your head elevated may also help you avoid heartburn.

Leslie Judge MS, RD, CSO, LDN

NEW! Foods to Fight Cancer Workshop

Tuesday, September 16, 2014

Join oncology nutrition specialist, Leslie Judge for a workshop on nutrition for cancer prevention and survivorship.  Whether you are concerned about risk or reoccurance, this workshop will help separate fact from fiction regarding the food and cancer.  You can purchase tickets online here or contact Leslie for more information: 617-332-2282 or

Is it normal fatigue or pregnancy anemia?

Wednesday, September 10, 2014

Many women struggle with anemia during pregnancy. Although it’s a common thing for expectant moms to have low iron levels, it will be something that your doctor wants to address. In most cases, even given your best efforts, a pregnant woman couldn’t eat enough high-iron foods to take care of the problem without taking a supplement. Your doctor will likely prescribe some sort of supplemental iron regimen (and a note here, you should never take additional iron unless a doctor or medical professional tells you to – toxicity could be very dangerous).In addition to taking an iron pill, eating a high-iron diet is also very important and will have the added benefit of increasing your body’s absorption of the supplemental iron. Here’s what you need to know:

Iron-containing foods:


Iron content

Foods to try


* beef heart                                    * leeks

* clams                                           * liver

* chicken/turkey giblet                   * oysters

* fortified cereals

* lean pork, ham or beef


* beet greens                                  * salmon

* dandelion greens                          * sardines

* eggs                                              * spinach

* enriched breads/cereals               * swiss chard

* kale                                               * whole grains

* mustard greens                            








* asparagus                                    * molasses

* blueberries                                   * nuts

* broccoli                                         * peaches

* Brussels sprouts                           * peanut butter

* collard greens                               * potato

* dark green lettuce                         * raspberries

* dried fruits (apricots, dates, raisins, prunes)

* escarole                                        * sweet potato

* green beans and peas                  * wheat germ


Tips to increase iron absorption:

  1. Your body will absorb iron from meats more easily than from plant sources.  Eat iron-containing plant foods (in the ‘high’ and ‘good’ columns above) with meats (in the ‘highest’ column) to maximize absorption.
  2. Foods high in Vitamin C will help your body better absorb the iron in foods. Eat any of the following foods with any of the iron foods listed above for better absorption.
    • Oranges and orange juice
    • Leafy green vegetables
    • Berries
    • Potatoes
    • Turnips
    • Tomatoes
    • Bell peppers
    • Broccoli
    • Cauliflower
  3. When drinking tea or coffee, drink it at least 1 hour before or 2 hours after your iron-containing foods. Coffee and tea contain substances that interfere with the way iron is absorbed in the body.
  4. Cook foods in cast iron pans and skillets.
  5. Only take iron supplements if instructed to do so by your health care team. Too much iron in the form of supplements can be harmful.
  6. If you do take iron supplements, take them with foods high in Vitamin C (see list above) and separate them from your prenatal vitamin and any calcium supplement you may be taking by 2 hours or more.

Leslie Judge MS, RD, CSO, LDN

NEW! 'Yoga of Eating' Session Starting Soon.

Friday, September 05, 2014

Don't wait, this class will fill up!  We got such rave reviews when we held this group in June that we've decided to run it again.  This time, based on demand, we're doing 6 weeks instead of 4.  Join us in our new, larger office space in Newton Centre and learn how to truly make peace with food.  Develop awareness of internal appetite regulation while learning ways to incorporate mindfulness into your everyday life.  The class starts with a relaxation exercise including breathing and yoga followed by a mindful meal and finishing with a topic for discussion.  There will be plenty of time to share and reflect along the way -- most participants find the insight and support from others in the group equally as valuable as the class itself.  Please register here or contact Liz Fayram at 617-332-2282x2 for more information.

We had a waiting list for the last session and since we are limited to six participants, so again, definitely sign up soon if you're interested. 


Remaking Your Fall Baking

Wednesday, September 03, 2014

It just isn’t fall without apple pie, warm apple cider donuts and pumpkin bread.  Let’s face it, the cooler whether puts us in the mood for good, old-fashioned comfort food.  While it may be tempting to grab some off the bakery shelf in the grocery store, it’s more nourishing for the body and the soul to bake them in your own kitchen.  Plus, you can add an extra nutrition boost that you won't find in that Entemann's box (although there's a place for that too!).  There are many creative ways to shape up your recipes.  Following are some tips for common ingredients.

Sugar Alternatives: 

Sugar is getting a lot of bad press these days.  And while I agree, it is something we need to eat in moderation, it's not quite the villain it's made out to be.  That sweet taste provides us with one of life's greatest pleasures.  However, if you have a health condition like diabetes that precludes you from eating sugar or you find your body feels better with less, here are some great ways to ease up on it in recipes without sacrificing flavor.

  • Agave nectar:  It’s debatable whether this is actually a “better” alternative.  While it has a lower glycemic index and you can use less of it for the same sweetness, it does contain a high concentration of fructose.  A recent brain study showed fructose increases appetite more than glucose.  However there is no evidence that fructose is worse than sucrose found in sugar -- basically, we should try to limit both.  That being said, if you want to shave off some of the calories from sugar with the same amount of sweetness, use this conversion:  for every 1 cup of sugar in a recipe, use 2/3 cup of agave nectar and reduce the liquid by 1/4 to 1/3 cup.  You can also use agave crystals if liquid is not desired.
  • Stevia:  Stevia is an extremely sweet, non-caloric herb, native to Paraguay.  It has been used for centuries as sweetener and flavor enhancer but only recently in the U.S.  Here is a stevia conversion chart.

Note:  There is really no difference between sugar, high fructose corn syrup, maple syrup, coconut crystals or even honey (although honey has other immuno-preventative properties) in terms of sucrose & fructose contribution to the diet. 

Baking soda:  Did you know that most baking soda contains aluminum?  Aluminum is a common additive in most processed foods and many personal hygiene products like deodorant.  So, it must be safe, right?  Yes, in certain amounts but it’s a heavy metal that can accumulate in our bodies over time.  Aluminum has been linked to neurological disorders including Alzheimer’s.  Make sure to read the label and look for “aluminum-free” varieties.  Choosing organic baking soda ensures there is purely bicarbonate of soda, what baking soda is intended to be.

Flour:  Many recipes call for All Purpose Flour (APF).  For a gluten-free (GF) APF, mix a ratio of 2:1:1 rice flour: tapioca starch: potato starch or look for a premixed version at the grocery store.  For extra fiber, consider substituting whole wheat flour but make sure to add an additional 2TBS-1/4c of liquid ingredient.  Almond, coconut and bean flours have great nutritional properties like additional protein and can provide nice flavor and texture to baked goods.  With the popularity of gluten-free eating and paleo diet, you can find oodles of recipes with these flours on the web.  One more tip here; chia flour can add some extra structure or “glue” to gluten-free recipes and also pack in some extra protein and fiber.  Try substituting 1/4 of the main flour (i.e. rice in the case of GF) with chia powder for a recipe you’ve already tried and see what you think.

Shortening:  Shortening is vegetable oil (soy or corn) that is chemically processed to remain somewhat solid at room temperature.  It contains a large amount of trans-fat which we now know is worse than saturated fat for heart health. Companies including Crisco, removed (most) trans-fat from their recipes in 2006 when FDA required it be shown on label and last year, categorized it as an “illegal food additive”.  Unsalted butter is a better alternative to shortening.  An even healthier option is Spectrum® organic palm oil.  Palm oil is one of few vegetable oils that is highly saturated and semi-solid at room temperature and maintains the properties of shortening.  You may also consider coconut oil which has revealed a number of health benefits recently.  It works wonderfully in frosting recipes too.  Just be for-warned, your food will have a slight coconut taste.

Eggs:  Choose organic, free range eggs that also have omega-3 fatty acids.  Free-range means the chicken was able to roam outside eating grass and getting plenty of exposure to sunlight (hint: vitamin D).  The omega-3 comes from the feed, often containing flax meal.  Organic eggs do not contain any hormones and receive organic feed.  Don’t assume that if an egg is free-range and/or contains omega-3 that it is automatically organic.  Read the label carefully.

Milk:  Choose 1% or skim milk in recipes.  If you want to ensure some of the properties the full fat milk provides, replace the milk equivalent with ½ skim milk and ½ yogurt (see the next section).  You may also want to experiment with almond or coconut milk which have fewer calories but contain some unsaturated “healthy” fat as well.

Replace Mayonnaise, Buttermilk or Heavy Cream with Nonfat Yogurt:  Mayonnaise, buttermilk and cream offer wonderful properties to baked goods.  They offer fat to create the moist texture we love.  Buttermilk contains acid which activates baking powder and baking soda.  The bad news is they also contain a lot of saturated fat which is linked to heart disease.  The good news is you can cut down or eliminate this fat but replacing some or all of the ingredient with yogurt.  It’s simple, 1 cup yogurt = 1 cup sour cream, buttermilk, heavy cream or mayo.   See Stoneyfield’s website for some great recipes using yogurt .

Check out the blog healthy seasonal recipes  for even more great fall recipe ideas and healthy baking tips.

And last, but most certainly not least, here's Eating Well's yummy, healthy version of the all-time fall favorite, apple pie!  And if you're a stickler for your mom's version, that's fine too.  So am I!  Whatever treat you choose, make sure to enjoy it.

Post-Partum Nutrition Survival Guide

Tuesday, September 02, 2014

The first six weeks after the arrival of a new baby are nothing less than hectic to say the least. All women experience this period differently but I think it’s safe to say that we all get our fair share of extreme fatigue and wide-swinging emotions. Whether you are a first-time momma or an experienced pro, taking care of your nutrition during this period is key to boosting your energy and allowing your body to heal after delivery.

Although the importance of feeding yourself can seem like a no-brainer, when you tack on exhaustion, frequent feedings, diapers, a mounting hill of laundry and perhaps an older child to take care of, you may find that caring of yourself takes a back seat to taking care of your little one(s). Here are a few quick tips on nutrition survival during the first six weeks. 

1. Quality. When your body is tired it is natural for cravings for sweets and starchy comfort foods (mac & cheese, pizza, etc...) to increase. Your body is simply looking for a quick supply of energy. Although these foods are fine in moderation, they often don’t keep your energy up in the long-term and will cause a ‘crash’ a few hours after eating. Although the double chocolate chip muffin may be calling your name, try to maximize your intake of options that will fuel your body (think whole grain toast with peanut butter OR yogurt topped with fruit and nuts). Selections like these combine protein and carbohydrate which will help your tired body feel energized for longer periods of time.

2. Reality. At the risk of now sounding contradictory, don’t go overboard and become crazed about the every meal you eat. Do your best to eat as nutritiously as possible but cut yourself some slack. If you are managing a small meal or snack every 3-4 hours, you are doing a great job. Keep easy and nutritious options handy: yogurt, fruit, cheese sticks, granola bars, whole grain crackers, nuts, cut veggies & hummus, hard-boiled eggs, etc. 

3. Protein.  Whether you had your baby vaginally or via C-section, you’ve got some healing to do. Your body utilizes protein to repair wounds so don’t skimp here. Aim to have a 4-5 oz. serving of protein at each meal (or at least 3 times daily). Protein options include: chicken, beef, fish, milk, soy milk, yogurt, cheese, nuts, seeds, beans, lentils and tofu. 

4. Vitamin C.  In keeping with the theme of healing, vitamin C is crucial to tissue as it repairs itself. No need to seek out vitamin C supplements - It’s always better to get vitamins through foods anyways. Vitamin C can be found in fruits (citrus, berries, kiwi) and vegetables (leafy greens, bell peppers, broccoli). 

5. Fluid.  Keep yourself hydrated with non-caffeinated, non-alcoholic beverages. Becoming dehydrated can make fatigue worse which is definitely not a bonus these days so aim to get a minimum of 6-8 cups (48-64 oz.) each day. 

6. Vitamins? If you are breastfeeding, definitely keep up with your prenatal vitamins in the post-partum period. If you aren’t breastfeeding, check in with your doctor on what he/she recommends. If you were taking extra iron during pregnancy for anemia, also check with your doctor about whether or not to continue this – many docs will have you continue with the additional iron until your 6-week check-up. 

7. Caffeine. It may be tempting to jack yourself up on caffeine if you are tired. If you are breastfeeding this is not a good idea because it could make your baby jittery and/or sleepless (horror!).  Even if you aren’t breastfeeding, too much caffeine should be avoided because it provides little nutritional value and can wind up keeping you from catching those zzz’s that you desperately need. 

Leslie Judge MS, RD, CSO, LDN

Eat Your Fat Folks!

Thursday, August 07, 2014

For years, health practitioners led by USDA guidelines, have been encouraging people to cut out fat.  The result has been an influx of highly processed, low fat options that are higher in sugar and/or simple carbohydrates.  We've also led on the assumption that a calorie, is a calorie, is a calorie.  Hence, if calories in are less than calories out, weight loss is guaranteed, right?  This mentality has failed many of my clients.   

The reality is we now know that cutting out fat is detrimental to weight management.  Fat is essential for satiety, the feeling of fullness we get after a meal.  It staves off hunger much longer than carbohydrates and even protein.  We are learning more about how genetics and our microbiome (gut environment) impact weight and overall health.  It's not simply about calories or fat OR perhaps even saturated fat.  Research does support opting for cardio-protective, mono-unsaturated fats such as olive oil, those found in fatty fish, avocado, etc.  However, it seems villainizing fat has led to increased consumption of simple carbs and sugar which are more likely to lead to weight gain, diabetes and related health conditions.

This is a great clip from a recent Time Magazine piece entitled "Eat Butter".


The EWG's 2014 Shopper's Guide to Pesticides in Produce

Tuesday, August 05, 2014
Every year, the Environmental Working Group (EWG) puts out a list of foods containing the highest amount of pesticide, "the dirty dozen" and those containing the least, "the clean fifteen" to help guide consumer choices.   The EWG is a non-profit, non-partisan organization dedicated to using the power of information to protect human health and the environment. 

These lists help inform shoppers about which vegetables and fruits to prioritize as organic and which they can save a little money on by opting for the conventional variety. 

Here are some reasons to consider limiting pesticides in the diet and in skin products:

  • They accumulate in our fat cells;  major organs such as the liver, kidneys and brain; in our glands such as the thyroid and adrenals; and throughout our central nervous system.  
  • The liver and kidneys become less efficient at removing them from the body as we age
  • The longer pesticides stay in the body, the more likely they are to build up to levels that may cause injury
  • Chemicals and pesticides can react in the body in unexpected ways

Read about how pesticide intake may impact children's IQ here.  On a more positive note, research has shown that removing pesticides from the diet decreases pesticides in the body by 98% in two weeks.  Informing yourself about the clean fifteen and dirty dozen can help reduce pesticide intake in your family.

Move over big agriculture, there's a new (old) farmer in town!

Monday, August 04, 2014

Farming is hot and farmers are cool!  Who would've thought twenty years ago that farming would be fashionable?  When I was in college (yes, I'm dating myself I know) one of my dorm mates was majoring in horticulture and agriculture and it seemed so obscure to me at the time.  It made sense for her having grown up on a farm and as she put it "being a hick" and all but there was no way that farming was going to compete with computer science and at the time, I was completely unaware of how closely it tied to my own discipline.

Nowadays,  with more insight into farming practices and how they impact the food we eat, we're becoming more selective in our food choices.  Specifically, we want to know where and how food is grown and what happens after.  Organic farming in particular has exploded.  On May 15th, an article appeared in the Wall Street Journal indicating that "organic farming is not sustainable".  Here's a great response to that article by the Cornucopia Institute.

Many young college grads and professionals are forgoing the rat race in pursuit of a more bucolic, rustic life on the farm.  Don't be fooled though, this lifestyle is anything but "less work".  It is however a different kind of work; a lifestyle that keeps you fit and healthy and connected to the earth.  In recent history, big agriculture took the place of small, family run farms.  However, we seem to be reverting to our original small scale farming efforts in favor of better quality and in hopes to preserve our land for generations to come.  Interested in becoming a farmer?  Check out this great site, sustainable-live-work-play

Boston Web Designer