On Being Healthy: Setting Goals

It is a new year and with new years come resolutions. For many years, the most common NY resolution has been to change to a healthy lifestyle, either by losing weight, improving diet, or exercising. Goals without plans of execution are destined to fail. So no matter what your goal is, whether it is to lose weight, exercise, read more, make new friends, do a daily devotional, or find a new hobby, you must have a plan.

1.) Setting Realistic Goals

Goals must be attainable and realistic. When I counsel patients on obesity, they usually have some unrealistic expectation for weight loss. Women especially! (Women, just face the fact that you will not lose weight as fast as your male counterparts. God designed us to hold on to calories in order to continue the human race in the event of famine. So… if you get marooned on an island, you will out live your husband.)

  • So what is a realistic goal? For weight loss centered on lifestyle change, 2-4 pounds a month averaged over several months, for there will be plateaus and dips. For those wanting to read more, start with 1 book if you read 0 last year. If you read 10 last year, increase it to 12. For those wanting to improve diet, pick one thing you will REMOVE and one thing to ADD to your diet.
  • Start small. Accomplish the small goals. Count the victories. THEN improve upon those results. Did you lose 5 pounds in a month? Great! Lets do it again next month. Did you go 1 month without a soda? Great! Now see if you can go 1 month without soda and dessert. Did you get to your book goal by June? Awesome! Double it by December. No one was ever discouraged by meeting goals early, but I have seen many people set too lofty of goals and get discouraged and quit. You must know yourself. Do you have the will power to push yourself to lofty goals or do you need tiny victories to help encourage you along the way?

2.) Be specific.

Do not be vague with your goals. Don’t say “Lose Weight”, instead say “Lose 15 pounds by June”. Don’t say “Read more”, say “Read 5 books this year.” Don’t say “Exercise more”, say “Walk/run/swim/bike 3 times a week for 30 minutes.” Know exactly what you are striving for so that you can celebrate when you achieve that milestone.

3.) Making a Plan

So you set your goal… Now what? You need to come up with a way to get from point A to point B.

  • So you decided to lose weight. Are you going to do that by exercising? Dieting? Both? See below for further specifics.
  • You want to try to eat healthier. What are you going to do? Weight watchers? A fad diet? Paleo? Keto? Whole 30? South Beach? Does heart disease run in your family? Do you need to think about low fat/cholesterol diet plans? What about osteoporosis? Do you need to increase your dietary calcium?
  • You decided to exercise. What type of exercise do you think you will enjoy? When are you going to exercise? Where are you going to exercise? If it is outside, what is your indoor contingency plan?
  • You want to do a daily devotional or quiet time. Are you going to do a guided devotion plan on the Bible app? Are you going to use a Bible reading plan? Will you journal your findings and prayers? Will you do this in the morning or evening? How are you going to adjust your schedule to make time for this?
  • You want to find a new hobby. What are you going to try first? Do your friends have any hobbies you find appealing? What hobbies fit into your lifestyle- budget and time?

4.) Accomplishing the Goal

Celebrate! Do not be ashamed to tell your friends or family. Be proud of what you accomplished. That 5 pounds is great! That one book is a milestone! Walking 30 minutes 2 times a week is an improvement for you!
Do not compare yourself to others because that will rob you of joy or plant a seed of envy.

5.) In the Event of Failure

If you do not meet your goals, take time to reflect to see why you failed. Then alter your plan and try again!

  • You didn’t meet your weight loss goal… So did you cheat on your diet? Fail to stick to your exercise schedule? Did you have some health problems that hindered your ability to exercise? Did your metabolism come to a screeching halt because of menopause? Are you getting empty calories somewhere that you don’t realize? Are your portion sizes too big? Is your lifestyle to sedentary?
  • You didn’t reach your book goal… Did one book bog you down because it wasn’t enjoyable? Did you have a hard time finding time to sit down and read a physical book? Would it benefit you to start reading on a kindle book since you will always have it with you? (Waiting rooms and car pool lines are great for reading instead of browsing Facebook) or listening to audio books on your commute (mine is only 12 minutes and I listened to 60 audio books last year)?
  • You didn’t find a hobby… Did you make time to try several activities? Did you go with a friend? Did you give each activity more than one try? Sit back and reflect on what you truly enjoy. Do you like to be active, still, creative, indoors, outdoors, interactive, reflective? Have you considered things that are not traditionally considered hobbies? Vacation planning, tutoring, volunteering, meditation, yoga, trivia night, board games, wine/craft beer tasting, cooking, yard work/gardening.

Mexican Stuffed Bell Peppers

This is one of my favorite meals. It’s easy to make and can be kept fairly healthy. Any time you see red, yellow, or orange bell peppers on sale, you can bet my family will be eating them within the week!

To make this diabetic friendly: leave out the corn.

To make this DASH diet friendly: do not use jarred tomato sauce. Use fresh cut tomatoes.

This is pretty low in cholesterol, but leaving out the cheese would be even better.

Ingredients:

  • 4-5 bell peppers, any combination of red, yellow, and orange
  • 1 medium yellow onion, diced
  • 1 pound of ground turkey
  • 1 can of mexi-corn, drained
  • 1 can of black beans, drained and washed
  • 1 can of tomato sauce
  • 1 tbsp of onion powder
  • 1 tbsp of garlic powder
  • 2 tsp of ground cumin
  • Mexican style shredded cheese (Monterrey jack or cheddar will work too)
  • Optional: 1 can of diced tomatoes (with or without green chilies) or salsa

Directions:

  1. Preheat oven to 350F.
  2. Brown turkey and drain.
  3. Cut the tops off the peppers. Remove the stem and dice the top of the pepper into small pieces. Remove the seeds from inside the peppers.
  4. Sauté the diced onion and peppers together until soft.
  5. Mix browned turkey, peppers, onions, beans, corn, and spices.
  6. Pour 1/3 tomato sauce into the bottom of a Pyrex dish. Pour the rest into the meat mixture. Also add your tomatoes or salsa at this time if you would like.
  7. Stuff peppers with the mixture, then top with cheese. (We always put remaining mixture around the peppers in the dish.)
  8. Bake at 350F for about 25-30 minutes.

The stuffing makes great nachos or tacos, so serve the excess up with tortillas or chips!

An Apple A Day: Wellness Exams

Preventative medicine is one of the most undervalued parts of medicine. How can one measure the value of not having a disease? The bible tells us that our days are numbered yet we don’t know how many of them we have. The Bible, science, and history all have warned us of the things that can rob days from us: tobacco use, alcoholism, uncontrolled cholesterol, diabetes, hypertension, slothfulness, gluttony, pneumonia, and cancer.

This post is about what you should have done depending on your age and stage of life. Keep in mind that insurance plans vary and all that is recommended may not be covered by your plan. Also, different specialty societies (such as the American College of Gynecology or American College of Physicians or American Urologic Association) may have different recommendations than the US Preventative Task Force. I have compiled the recommendations that I feel are most useful, and even these can vary depending on patient’s medical and family history. It is important that you consult with your primary care physician to discuss the screenings and vaccines that are appropriate for you.

General Wellness:

Each year:

  • Body Mass Index (BMI)
  • Blood pressure
  • Cholesterol
  • Diabetes
  • Alcohol misuse
  • Depression
  • Tobacco use
  • Flu shot
  • Lung cancer screening  (low-dose computed tomography (LDCT) in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years)

Every other year:

  • Vision (starting at age 40)

Every 10 years:

  • Colonoscopy (at age 50 or earlier if indicated by family history)
  • Tetanus vaccination (Tdap once in adulthood- also given to women during pregnancy and immediate family of infants)
  • Hepatitis C (1-time screening for HCV infection to adults born between 1945 and 1965)
  • Shingles vaccine (recommended to those 50 or older who have not had singles in past 6 months)
  • Pneumonia vaccines (2 different vaccinations needed after age 65 or earlier if patient is at risk due to conditions such as asthma, COPD, diabetes)

Women’s Wellness:

Each year:

  • Mammogram starting at age  40 (earlier if indicated by family history)

Every other year:

  •  Bone density starting at 65 years old (starting at age 60 if risk factors present)

Every 3 years:

  • Pap smears starting at age 21; after age 30, women can opt for every 5 years if done with HPV co-testing; discuss with your OB/GYN what is the best for you

Men’s Wellness:

Each year:

  • Prostate specific antigen, also known as  PSA starting at age 55
    • *Prostate cancer screening is highly debated topic right now. The US Preventative Task force state that men between 55-69 should discuss the benefits of this test with their physician before having it done. Often times men have to pay out of pocket because some insurance plans no longer cover it.

Once:

  •  Abdominal aortic aneurysm screening (between the age of 65-75 if smoked >100 cigarettes during lifetime)

Trick or Treat: Peanut Allergies

Halloween is such a fun time. Costumes, pumpkin carving, cooler temperatures, and sugar highs for days on end. While it is a time of celebration for most, for some parents, it is a time of significant anxiety. The incidence of food allergies has increased in recent decades, and the parents of kids who have food allergies live in fear of their kid accidentally getting some piece of candy that unknown to them, may have an allergen in it with devastating consequences. While there are many allergies, peanut allergies are the ones I am focusing on today.

I have a guest blogger today, Dr. Lindsay McMullan, who is an allergist at the Asthma and Allergy Clinic of Hattiesburg. She is a board certified allergist and immunologist and she is also board certified in internal medicine. She did her residency and fellowship at the University of Mississippi Medical Center. She is married and has 3 beautiful children.

What is the teal pumpkin project?

The Teal Pumpkin Project raises awareness for food allergy and encourages non-food treats for Halloween marked by a teal colored pumpkin in front of the venue where treats are being distributed. Participants can mark their location on the project map and also visit the site for treat ideas.

The point is to help ease the stress and increase the fun of Halloween for food allergy families. One of their biggest resources: FARE  (Food Allergy Resource & Education), has instituted the Teal Pumpkin Project. Resources are available for a variety of Halloween celebrations. What a great way to show support for friends and family with food allergies!

To learn more about the Teal Pumpkin Project visit: https://www.foodallergy.org/education-awareness/teal-pumpkin-project

What happens to a kid when they eat peanuts and have a peanut allergy?

Peanut allergy can cause symptoms such as hives or whelps, swelling including: lips, tongue, and throat, asthma attacks, and stomach symptoms. They can also be so severe that they threaten someone’s life. We call severe reactions anaphylaxis.

How can you be sure that candy or foods do not have peanuts in it?

Peanuts are required to be listed as a possible allergen on the ingredient label if the food contains peanuts.  We talk to our allergy patients about reading every label.  If foods are not labeled, you can ask the person who prepared the food if it contains peanuts or has been contaminated by peanuts (such as cooked on the same surface).

Why are food allergies becoming more common?

There is not one answer to this question. It involves many factors. Some problems with food are different from an actual allergy but can still make you feel bad. So it is important to be sure your diagnosis is correct because instructions and risks can be different.  A test by itself does not diagnose a food allergy.  There are also tests available that are advertised as allergy tests but do not actually check for any allergy.  Your primary care physician can refer you to a board certified allergy specialist if a food allergy is suspected.

When is the appropriate age to introduce peanuts? Also milk, eggs, etc?

Food introduction should not be delayed out of concern for allergy. In fact, earlier introduction for peanuts helps to decrease the likelihood of allergy in many patients. (link to information about this).  During infancy, when other foods are introduced, is ok to introduce peanuts and eggs. Milk is not introduced until after the age of 1 due to other concerns, though milk containing products such as cheese may be introduced before then.  Some children such as those with severe eczema or a known egg allergy may need additional caution before introducing peanuts. Board certified pediatricians and family medicine physicians can help parents navigate food introduction for infants and also help refer to board certified allergists when assistance is needed.

Is peanut allergy the same as tree nut allergy?

No. Peanuts are actually legumes and grow in the ground.  Many peanut allergic people are not allergic to tree nuts, just as many tree nut allergic people can eat peanuts. There are people who are allergic to both. An allergist can help a person figure out if they are allergic to peanuts, tree nuts, or both.

How can I be more considerate of those with food allergies?

This is a GREAT question.  At Halloween, offering non-food treats such as stickers or other items is helpful. You can use a Teal Pumpkin (link that was in first paragraph for the project) to notify trick-or-treaters that you have non-food treats.  Educating your children, grandchildren, and friends to be kind and not bully those with food allergies is also important. Finally, if you are hosting an event, or preparing food for an event, checking for possible food allergies is great. If this is not possible, labeling your food with ingredients goes a LONG way towards helping those with food allergies know what is safe.

Chipotle Roasted Sweet Potatoes

These sweet potatoes are incredible. They are a staple at our house!

**These are not appropriate for a diabetic diet. I would leave out or significantly decrease the amount of brown sugar in these if you are diabetic. If you are trying to lose weight or cut your cholesterol, try substituting the butter for olive oil. Honey may also be an option instead of brown sugar. If you have high blood pressure, leave out the salt.

sweet potatoes

Ingredients

  • 6 sweet potatoes, peeled and quartered
  • 5 tablespoons butter, melted
  • 3 tablespoons brown sugar, or more to taste
  • 1 tablespoon onion powder
  •  1 tablespoon garlic powder
  • 1 tablespoon chipotle chili powder, or more to taste
  • 1 1/2 teaspoons salt
  • 1 teaspoon ground black pepper

 

Directions

  1. Preheat oven to 400 degrees F. Line a baking sheet with parchment paper (don’t skip this! Clean up is difficult if paper is not used!).
  2. Whisk brown sugar, onion powder, garlic powder, chili powder, salt, and black pepper together with the melted butter in a small bowl.
  3.  Toss sweet potatoes and butter mixture together in a large bowl. Toss until evenly coated. Pour potatoes in a single layer onto the prepared baking sheet.
  4. Roast in the preheated oven until potatoes are tender, usually 30 to 45 minutes.

I usually try to stir the potatoes halfway through so the bottoms don’t burn. The sugary butter mix can make them turn crispy quickly!

*Side note: sweet potatoes do not keep well if you try and prep them in advance. They tend to dry out in the fridge. I learned this the hard way!

Trick or Treat: Flu Season Safety

As my previous post mentioned, the flu shot is not 100% effective. Just because you get the flu shot, does not mean that you are Ironman. You may be safer than those who are not immunized, but you are still at risk. So how do we keep safe?

WASH YOUR HANDS

Soap and water. Keep them clean! I avoid shaking hands with my patients during flu season. I wipe down my grocery carts with the sanitizing wipes like a crazy person. I make my kids wipe down the cart as we drive through Kroger. I bathe them in hand sanitizer quite frequently in parking lots. I’m kidding, sort of.

Also, for my athletes (specifically you basketball players): don’t share water bottles. Get your own and put your name on it. The quickest way to lose the conference title is to give the whole team the flu during tournament time!

DO NOT GO TO SCHOOL OR WORK WITH FEVER

Or church. Or Kroger. Or Chuck E. Cheese. Stay home! Please be fever free for at least 24 hours before coming back into the public sector. We do not want your germs.

It is NOT OK to put mix Motrin and juice in your kids sippy cup and send them to school so they will be fever free until at least noon just so you can cross a few things off your to do list.

EAT A HEALTHY DIET

Eat a diet that is well rounded. Make sure you’re getting plenty of vitamin C! Fruits and veggies are important. Potatoes do not count as veggies!

GET PLENTY OF SLEEP

Your body needs sleep to function properly, even your immune system!

IF YOU HAVE BEEN EXPOSED TO SOMEONE WITH THE FLU

Call your primary care physician to see if you should be treated prophylactically against the flu.

IF YOU THINK YOU HAVE THE FLU

Call your primary care physician to discuss your symptoms or get an appointment.

I personally like to put my febrile patients immediately into a room to prevent infecting the rest of the patients who are in my waiting room.

Greek Chicken Pasta

This is one of my favorite dishes to cook. It is also my family’s favorite dish to eat. People think I’m crazy when I tell them my 4 year old will eat artichokes.

This technically fits in to the Mediterranean diet if you use whole wheat pasta (which we don’t). It is also a very quick dish to make. I prep the chicken and veggies while the noodles boil. Give it a try! Mom and kid approved!

Ingredients

1 (16 ounce) package linguine pasta

1/2 cup chopped red onion

1 tablespoon olive oil

2 cloves garlic, crushed

1 pound skinless, boneless chicken breast meat – cut into bite-size pieces

1 (14 ounce) can marinated artichoke hearts, drained and chopped

1 large tomato, chopped

1/2 cup crumbled feta cheese

3 tablespoons chopped fresh parsley

2 tablespoons lemon juice

2 teaspoons dried oregano

salt and pepper to taste

2 lemons, wedged, for garnish

Directions:

1) Bring a large pot of lightly salted water to a boil. Cook pasta in boiling water until tender yet firm to the bit, 8 to 10 minutes; drain.

2) Heat olive oil in a large skillet over medium-high heat. Add onion and garlic; saute until fragrant, about 2 minutes. Stir in the chicken and cook, stirring occasionally, until chicken is no longer pink in the center and the juices run clear, about 5 to 6 minutes.

3) Reduce heat to medium-low; add artichoke hearts, tomato, feta cheese, parsley, lemon juice, oregano, and cooked pasta. Cook and stir until heated through, about 2 to 3 minutes. Remove from heat, season with salt and pepper, and garnish with lemon wedges.

I got this recipe free from Allrecipes.com, which is a great source for free recipes with many reviews!

Full nutritional info can be found on the webpage:

https://www.allrecipes.com/recipe/12072/greek-chicken-pasta/?internalSource=streams&referringId=16704&referringContentType=recipe%20hub&clickId=st_trending_s

Silent Killers: Cholesterol

The second topic in the series of Silent Killers is cholesterol. Luckily, my very good friend and partner, J. Kevin Bridges MD is one of two certified Lipidologists in the state of Mississippi. JKB knows A LOT about cholesterol, so who better to be my first guest blogger?! The words below are straight from the lipid guru himself.

Bridges 13

What is high cholesterol?

• Cholesterol is made by your body normally, and it is also consumed in the foods you eat.

• Your body needs cholesterol for proper cellular function.

• When we say your cholesterol is high that can mean several things, as there are other parts of your cholesterol panel (aka lipid panel) that we use to determine your cardiovascular risk. Examples are triglycerides and different lipoproteins (LDL, HDL, etc).

• Each of these components can be “high” when compared to the rest of the population, so it’s not always as simple as saying your cholesterol is high.

Why does it matter if my cholesterol is high?

• What we know for certain now is that if certain parts of your cholesterol/lipid panel are high, then it increases your risk for cardiovascular events like heart attack and stroke.

• We have proven that by reducing some components of your lipid panel, that there are significant reductions in the risk of heart attack and stroke.

What number is the most important number?

• There has been a lot of discussion and confusion about this over the past few years. The best evidence shows that the most important number in your lipid panel that we can use to predict your cardiovascular risk is a value called “non-HDL.” This number is your total cholesterol minus HDL (high density lipoprotein).

• In reality, this number confuses some people, so it is generally easier to focus on LDL (low density lipoprotein).  LDL is what makes up the majority of non-HDL so it is generally accepted that LDL is an easier target of focus for patients and physicians to discuss.

What about my “good” cholesterol?

• HDL (high density lipoprotein) has been described as “good cholesterol”.

• In the past we thought that if we increased HDL with medications that it would reduce your risk of a heart attack or stroke. We know now that this is not true.

• If does seem that many who have a higher HDL naturally have less incidence of cardiovascular events when compared to those who have a low HDL, but this is not universal, as there are certain groups of people who have extremely low HDL and yet they do not have heart attacks or strokes.

• Bottom line about HDL is that we don’t yet fully understand its role in determining cardiovascular risk.

Ok, my cholesterol is high. What can I do to lower it and reduce my risk of a heart attack or stroke?

• The first thing that everyone should do is to re-evaluate your lifestyle (diet and physical activity. Most of us can improve on the foods we eat.

• The latest evidence shows that if we use a 9 inch plate to help with portion control, and if ½ of our plate non-starchy vegetables of a variety of colors, ¼ of our plate is lean protein (fish or chicken), and about ¼ of our plate in whole grains and starchy vegetables, then this is the best overall dietary change one could make to help reduce their risk.

• If you are overweight, you need to lose weight by not only dietary changes, but you need to start doing some moderate aerobic exercise (brisk walking will do). The current recommendation by the American Heart Association is 30 minutes per day, 5 days per week. You may not be able to start off doing this much, but work your way toward this goal.

• If you are smoking, make up our mind that you need to stop and ask your primary care physician to help you achieve this goal, possibly with medications if you struggle to quit on your own

• Once you’ve made lifestyle changes, there are medications that have been proven to lower your LDL (bad cholesterol), while reducing your cardiovascular risk. This is a discussion that you could start with your primary care physician.

Ok doc, I’ve heard about those cholesterol medications and I’ve heard that they are bad. What’s the deal?

• There is a lot of urban legend out there about cholesterol medications. There have been multiple studies that have proven the safety of the drugs that we use today.

• Looking at every one of the landmark clinical trials that have looked at statins in particular, they have all demonstrated a very low incidence of side effects and all have shown to reduce LDL, and subsequently a reduction in cardiovascular events.

• Because of this tremendous amount of data that shows that statins are safe, and they are very effective in lowering LDL (again, this lowers your risk of a heart attack or stroke), statins should be first line drug therapy for someone who has a high LDL and is considered to be at an increased risk for cardiovascular events. Again, you should talk to your doctor about this.

But, I’ve heard that statins make you hurt. I don’t want to hurt.

• There was a study done that put people into 2 groups. One group of people was given the maximum dose of atorvastatin (a statin drug), and the other group was given a placebo (just a fake pill). Neither group knew which pill they received. The study was intended to see if there was a difference in the two groups regarding muscle/joint pain. The study showed that the group that received the statin had about 9% of the people in that group with those reported side effects. The placebo group reported about 6% of their group with the same symptoms. There was not enough difference in the two groups to help demonstrate why the people in the study had these symptoms.

• There is a very small risk of statins causing myalgia (muscle pain) and in very rare cases, myonecrosis (muscle tissue damage). Understand that these are potential adverse effects. This does not mean that you will have these issues. This is not unlike the potential adverse effect of severe liver damage when one takes Tylenol (which millions of people take every day).

• Bottom line is that if you are at an elevated risk for cardiovascular events due to an elevated LDL, then you should not reject the idea of a taking a statin based on what you’ve heard others say. Have that discussion with your primary care physician.

Are there other medications that can help lower my cholesterol, other than statins?

• Yes. It depends on your situation, but there are other medications to help lower your cholesterol; however, you want to make sure that the medication that you are going to take has actually been shown to reduce your risk of cardiovascular events in the case of a high LDL. Regardless, because of their documented safety and cardiovascular risk reduction, statins should be the first drug therapy that should be considered in almost every case. Again, you should discuss this with your primary care physician.

What do I do if my primary care physician and I have difficulty coming up with an effective way to lower my cholesterol?

• There are other resources that you can use to help. You can seek out a clinical lipidologist (someone who specializes in managing complex lipid disorders) with the American Board of Clinical Lipidology at lipidboard.org or with the National Lipid Association at lipid.org

• You could also seek out a cardiologist or endocrinologist interested in managing lipid disorders.

Dr. J. Kevin Bridges MD is one of two board certified lipidologists (one who specializes in cholesterol metabolism) in the state. He received his undergraduate degree in Biology at Mississippi College, completed medical school at the University of Mississippi School of Medicine, then went on and did his Internal Medicine residency at the University of Mississippi Medical Center. He was awarded the Gold Humanism award, which honors students and residents with excellent bedside manner and clinical skills. He was also awarded Evers Society Resident of the Year by the medical students during his third year of residency.

He is also a pretty decent baby sitter.

DASH diet: Dietary Approaches to Stop Hypertension

This diet can have a significant impact on those who are hypertensive or pre-hypertensive. This is a diet that is rich in fruits, vegetables, legumes, fiber, and low-fat dairy products. It is low in sweets, meats, bread, and fat. The diet also aims to keep sodium (or salt) consumption below 2 grams per day. If you come in to my office with elevated blood pressures, you will leave with this diet in hand. I prescribe it before medications are initiated or along with medications.

How can I reduce the salt in my diet?

– Do not add salt to your food.

– Avoid eating packaged or processed foods. (Look at the sodium content on the back of the box. Do not forget to look at the serving size.)

– Avoid canned food. Yes, even the reduced sodium labels. Go for fresh or frozen produced.

– Avoid eating out. Restaurants usually use a lot of salt to season food.

Things to avoid:

– Meats: anchovies, sardines, bacon, ham, sausage, chitterlings, chipped beef, corned beef, fatback, hot dogs, lunch meats

– Milk products: butter, cheese spreads, condensed milk, ice cream, sherbet, processed cheese

– Vegetables: canned soups, pickles, olives, pickled beets, sauerkraut, tomato juice

– Snacks: corn chips, potato chips, pretzels, salted nuts, salted popcorn, soda crackers

– Seasonings: baking powder, baking soda, bouillon, ketchup, chili sauce, garlic salt, horseradish, meat tenderizer, monosodium glutamate, mustard, soy sauce

Things that are good:

– Fruits: apples, apricots, avocado, banana, cantaloupe, dates, grapefruit, honeydew melon, nectarine, prunes, raisins, watermelon, apple juice, grape fruit juice, prune juice, orange juice

– Vegetables: asparagus, beans, broccoli, brussel sprouts, cabbage (cooked), cauliflower (cooked), corn on the cob, eggplant (cooked), lima beans, green peas, peppers, potatoes (baked or broiled), radish, squash (cooked)

Seasonings to try:

– Basil, bay leaves, brown sugar, chives, cinnamon, cloves, chopped onion, dill seed, dry mustard, fruit, ginger, green pepper, lemon juice, mint, mace, marjoram, nutmeg, oregano, parsley, paprika, pepper, pepper sauce, rosemary, sage, thyme, vinegar

– Do not use a salt substitute!

What I always tell my patient is eat things that grow from the ground. Eat fruits and vegetables. Season your food with things that grow. Tony Chachere’s and Worcestershire sauce do not grow!