Making Healthy Choices™

Written by
Don Hall DrPH, CHES
Founder of Wellsource, Inc.

• Dietary Fiber and Blood Pressure

• Feelings of Energy and Fatigue

• Weight Gain and Risk of Kidney Stones

• Linoleic Acid and Cardiovascular Mortality

• Meat Consumption and Risk of Colorectal Cancer

• Meat Intake and Risk of Gout

• Unhealthy Alcohol Use

• QuickFacts

• Downloadable Power Point Slides

• Featured Health Links

• Healthy Recipes

• What's New? Las Vegas Wellness Seminar, May 16-17, 2005

• About this Newsletter

Dietary Fiber and Blood Pressure

Dietary fiber is an important part of a healthy diet and is protective to the cardiovascular system. Dietary fiber is a collective name for a variety of plant substances that are resistant to digestion. The structural fibers of plants (cellulose, lignin, and hemicellulose) are insoluble fiber whereas the natural gel-forming fibers (pectin, gum, and mucilage) are soluble. The insoluble fiber comes primarily from whole grains and the soluble fiber from fruits, vegetables, legumes (peas and beans), seeds, and oats.

In a recent meta-analysis of 21 placebo controlled trials, dietary fiber was found to lower blood pressure. Both soluble and insoluble fiber are protective to the health but soluble fiber seems to be especially good for the cardiovascular system.

• Dietary fiber, especially soluble fiber, reduces the glycemic index of foods thus lowering the insulin response. High insulin levels play a role in raising blood pressure.

• Foods high in dietary fiber have also been shown to enhance insulin sensitivity and improve vascular endothelial function.

• Insoluble fiber improves mineral absorption in the gastrointestinal system which may have an indirect favorable effect on blood pressure (higher magnesium and potassium levels improve blood pressure levels).

• Apart from fiber’s effect on blood pressure, soluble fiber improves blood lipids. One study found that a one-gram increase in soluble fiber reduced blood LDL cholesterol levels by 2 mg/dL.

• High intakes of dietary fiber also have been linked to lower risk of type 2 diabetes.

In the Health Professional Follow-up Study of 30,681 men, dietary fiber was an independent risk factor for reduced risk of high blood pressure. The intake of dietary fiber in the United States and other Western countries is low. Less than half of these populations meet the recommended intake of fiber. The Institute of Medicine set the dietary recommended intake (DRI) of fiber at 26 g daily for women and 38 g daily for men. The National Hearth, Lung, and Blood Institute of NIH recommends 10g to 25g of soluble fiber daily for a therapeutic effect on heart health. The recent Dietary Guidelines for Americans provides the following table of foods high in soluble fiber.

Source: USDA Home and Garden Bulletin No. 72, Nutritive Value of Foods.

Bottom line: The researchers concluded their article with this recommendation, “Increasing fiber intake in the general population may contribute to the prevention of hypertension.”

Reference: Streppel MT, et al. Dietary fiber and blood pressure: a meta-analysis of randomized placebo-controlled trials. Arch Intern Med. 2005; 165:150-156.

Feelings of Energy and Fatigue

Feeling energetic (vigor or vitality) is a positive feeling affecting the capacity to complete mental or physical activities. Fatigue is a negative feeling resulting in reduced capacity to complete mental or physical activities. Feelings of low energy and fatigue are quite common, affecting about one-fourth of the population.

In a review of this topic researchers looked at conditions that affected feelings of fatigue – obesity, smoking, heavy drinking, and presence of certain diseases such as arthritis, diabetes, high blood pressure, and depression. They also looked at the role of physical activity in promoting feelings of energy in 7 large population studies, and 15 experimental studies. Each of these studies showed that the higher the level of physical activity, the more energy people had.

One large study in Australia included 39,532 women. Researchers calculated an activity score for each woman based on their reported exercise program. Possible scores ranged from 0 to 80 with 0 being the least active (no regular activity) and 80 the most active. The women also reported their feelings of energy or fatigue on an “energy-vitality scale.” Sedentary women reported the most frequent feelings of low energy and fatigue. As women reported more weekly physical activity, they also reported more frequent feelings of high energy. The biggest improvement in feelings of energy came from those initially doing no exercise who started doing some regular exercise.

Activity and Energy Level slides (2 slides).

Another study included 1,758 people followed for 2 years. Their activity level and feelings of energy were evaluated twice during the 2 years. Researchers found that the total time spent exercising at the beginning of the study was a significant predictor of who would report feeling more energetic at the end of the 2-year study even after adjusting for potential confounders including age, BMI, education, gender, ethnicity, smoking, drinking, disease conditions, and poverty. Interestingly, exercise had the greatest benefit in increased energy for those who had health problems such as high blood pressure, diabetes, heart failure, and depression.

Exercise trial studies show similar increases in feelings of energy. One intervention study was made with depressed seniors. They exercised 45 minutes 3 times per week for 10 weeks. A control group didn’t exercise but received health education on depression for an hour twice a week. After 10 weeks the exercise group showed a large increase in feelings of energy. The increase was 1.3 standard deviations, nearly a doubling of their reported energy levels. The control group, however, made no significant improvement in energy levels (see chart above).

In one study, heart failure patients who were sedentary started a 3-hour per week stepping exercise program. After 12 weeks the exercising heart patients showed a significant (1 standard deviation) improvement in energy levels.

All of the intervention trials showed uniformly positive improvements in energy even in those persons with health problems and chronic illness. The authors summarize their findings; “Sedentary people who feel fatigued are likely to experience a moderate to large increase in feelings of energy if they become regularly physically active.”

What kind of exercise is best for improving energy levels? The study authors point out that for most people, and especially people who are older or have chronic health problems, moderate aerobic exercise (walking, stepping machine, stationary bicycling, etc.) is best, -- 30 minutes 3-5 times weekly will show good results. Also, choose exercises you enjoy (exercise to music, golf, active gardening, walking in the park, etc.). Keep in mind that excessive exercise (too much too soon) may actually increase feelings of tiredness and fatigue, especially in persons not used to regular exercise.

The bottom line is clear. If you want to enjoy more energy in your life, regular, moderate physical activity is a key ingredient. As always, if you have health problems, get your doctor’s guidance as needed in developing a safe, effective activity program.

Reference: O’Connor PJ et al. Chronic physical activity and feelings of energy and fatigue. MedSciSportsExerc.2005; 37:299-305.

Weight Gain and Risk of Kidney Stones

If you’ve ever passed a kidney stone or known someone who has, you know it is a very painful and serious event anyone would like to prevent. In a large study of 50,000 men and 194,000 women, researchers found a link between weight gain and kidney stones.

Men who gained 35+ pounds since age 21, compared to those who maintained their weight, were 39% more likely to develop kidney stones. Women who gained a similar weight were 70% to 80% more likely to develop kidney stones. Women with a BMI of 30+ doubled their risk of kidney stones.

Kidney Stones and Excess Weight (2 slides).

If you want to prevent kidney stones, drink plenty of water and maintain a healthy body weight.

Reference: Taylor EN et al. Obesity, weight gain, and the risk of kidney stonesJAMA. 2005; 293:455-462.

Linoleic Acid and Cardiovascular Mortality

The role of fat in the diet has been closely linked to cardiovascular mortality. Early studies emphasized saturated fat as the primary culprit so low fat diets and low saturated fat diets were recommended for heart health. More recent studies are finding that polyunsaturated fats, primarily linoleic and alpha-linolenic, are strongly protective against cardiovascular disease. To cut these fats out of the diet would raise the risk for cardiovascular disease. Current thinking is that fat quality (the kind of fat) is more important for heart health than fat quantity. New research on polyunsaturated fat confirms this concept.

Polyunsaturated Fats and Cardiovascular Disease (8 slides).

A study in Finland carefully looked at the eating habits of 1551 middle-aged men for 15 years who were free of heart disease, diabetes, or cancer. Deaths from cardiovascular disease (CVD) and all cause mortality were tracked and compared to dietary records and serum levels of fats in the blood. Here is what researchers found:

• Men who ate the most linoleic acid, the top one-third, were 61% less likely to die from cardiovascular disease compared to men in the bottom one-third of linoleic acid intake.

• Men who ate the most alpha-linolenic fatty acid, the top one-third, were 30% to 42% less likely to die of CVD than their counterparts who ate the lowest amount, bottom one-third.

• Intake of total fat in the diet was not associated with CVD.

• The intake of linoleic acid was a stronger indicator of coronary risk (protecting against CVD) than was total fat, saturated fat, monounsaturated fat, or dietary cholesterol.

• Dietary polyunsaturated fat (including linoleic and alpha-linolenic) intake in the upper third was associated with a 62% lower risk of CVD mortality compared to persons in the lower one-third of intake. This means that those men eating the most polyunsaturated fat had nearly a two-thirds decrease in risk of death from cardiovascular disease.

• Dietary linoleic acid decreased total mortality (death from any cause) by 34% when comparing upper one-third intake with lower one-third. Alpha-linolenic also lowered the risk for all deaths by 15% to 33% (upper one-third vs lower one-third intake).

• Comparing serum fatty acids showed similar decreases in mortality and were even stronger predictors of CVD mortality.

This study shows the strong protective effect of polyunsaturated fats against CVD (heart attacks and strokes). Men in the upper one-third intake of polyunsaturated fats were up to 3 times less likely to die of CVD than those in the bottom one-third of polyunsaturated fat intake! But remember, total fat intake was not linked to CVD deaths.

The authors conclude by stating, “Carrying out recommendations to replace saturated fat with polyunsaturated fat in the primary prevention of CVD may substantially decrease cardiovascular disease and to a lesser degree overall mortality.”

What are the best sources of polyunsaturated fats? Vegetable oils are the best sources of linoleic acid—such oils as soy, corn, sesame, and sunflower. Walnuts, whole grains, and soy foods (soy milk, tofu, etc) are also good sources. All whole plant foods, other than palm and coconut oils, contribute polyunsaturated fats to the diet. Most animal fats lack or are very low in linoleic acid but are high in saturated fat. For heart health, choose primarily whole plant foods and non-hydrogenated vegetable oils that supply linoleic and alpha-linolenic fatty acids.

Reference
Laaksonen DE et al. Prediction of cardiovascular mortality in middle-aged men by dietary and serum linoleic and polyunsaturated fatty acids. ArchInternMed. 2005; 165:193-99.

Meat Consumption and Risk of Colorectal Cancer

The Cancer Prevention II study continues to yield good information to help reduce the risk of cancer. The latest report found a relationship between red meat intake and an increased risk of colon cancer.

The study includes 148,610 adults followed for more than 10 years. Researchers divided people into three groups based on how much red meat they ate. Those in the top one-third of processed meat intake had a 50% increased in risk of colon cancer. A high ratio of red meat to chicken and fish also showed a 53% increased risk of colon cancer, and high red meat intake increased the risk of rectal cancer by 43%. The World Health Organization states that about 30% of all cancers in Western countries are caused by dietary factors.

Red Meat and Colorectal Cancer (4 slides).

In non-smokers, diet is the most important factor in preventing cancer. This study suggests that a diet high in red meat increases the risk for cancer. Other studies indicate that diets high in fruits and vegetables decrease the risk for many cancers. If you are interested in preventing cancer, shifting toward a whole plant based diet is an effective strategy. It is also one of the best ways to reduce the risk of coronary heart disease.

Reference: Chao A et al. Meat consumption and risk of colorectal cancer. JAMA. 2005; 293:172-182.

Meat Intake and Risk of Gout

Gout is the most common form of inflammatory arthritis in men and affects more than 3.4 million people yearly. Gout is caused by the buildup of uric acid in the joints. It most commonly causes pain and tenderness in the joints of the big toe, ankle, and knees but it can occur in any joint. Gout also affects women but usually only after menopause. Gout can be very painful and impair walking. The best therapy for gout is prevention!

A recent study reported in the March 11, 2004 issue of the New England Journal of Medicine found certain dietary practices linked to gout. The study included 47,000 healthy men studied for 12 years to see who would develop gout. Here is what they found:

• Those men eating the most meat (beef, lamb, or pork) were 41% more likely to develop gout compared to those eating a low intake (see chart below).

• Those eating the most sea food had 51% higher risk of developing gout.

• Those drinking 2 glasses of non-fat milk daily had 41% lower risk of developing gout compared to those drinking less than 1 glass of milk daily. Nonfat milk appears to be protective against gout.

• A higher intake of vegetable proteins did not increase the risk of gout and neither did a moderate intake of purine-rich vegetables.

• Persons who drank alcohol had a higher risk of gout.

• Overweight men were more likely to develop gout.

Preventing Gout ( 10 slides).

To summarize, if you want to prevent gout:

• Maintain a healthy weight, or lose weight if overweight.

• Avoid or limit your alcohol intake.

• Eat primarily a plant-based diet, use nonfat milk and dairy products, and avoid or limit meats and seafoods.

• Drink plenty of water.

• Exercise moderately daily.

• See you doctor if needed – medications can help.

Reference : Choi HK et al. Purine-rich foods, dairy, and protein intake, and the risk of gout in men. NEJM. 2004; 350:1093-1103.

Unhealthy Alcohol Use

The adverse effects of alcohol were highlighted in a recent issue of the New England Journal of Medicine (NEJM)(Feb. 10, 2005 issue). Each year in the United States 85,000 deaths are attributed to unhealthy alcohol use in addition to the substantial disability due to alcohol related injuries, depression, social problems, and dependency issues. The adverse economic impact of alcohol use exceeds $185 billion annually.

Helping people be aware of the dangers of unhealthy alcohol use can save health care expense and lives. Current estimates are that about 30% of the population is defined as “risky” users of alcohol and 5% are “harmful” users which results in serious physical, mental, or legal consequences. Some of the most common health problems caused by drinking are:

• High blood pressure

• Depression

• Insomnia

• Liver disease and cirrhosis

• Heart burn

• Anemia

• Cardiomyopathy (damage to heart muscle)

• Pancreatitis

• Cancers of the esophagus, larynx, mouth, and breast

• Injury from accidents

• Missed work due to hangovers

• Mental and social health problems

Moderate alcohol use may decrease heart disease in older persons but generally increases mortality in young adults. Nondrinkers have the lowest mortality rates for all men less than age 34 and all women less than age 45. In older individuals, mortality rates are lowest when alcohol intake is kept very low: no more than 2 drinks per week for women and no more than 5 drinks per week for men. If you choose to drink, keep intake low.

If you are concerned about your drinking, talk to your doctor for advice. The CAGE questions are recommended for use by doctors to screen all drinking patients for problem drinking. It goes like this (mark yes or no):

1. Have you ever felt you should cut down on your drinking?

2. Have people annoyed you by criticizing your drinking?

3. Have you ever felt bad or guilty about your drinking?

4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?

If you mark 1-2 or more of these questions with a positive response, you are likely involved in unhealthy alcohol use and you should seek help from a doctor of counselor. The full article in NEJM also gives practical suggestions for counseling persons with unhealthy alcohol use and recommends treatment guidelines.

Reference: Saitz R. Unhealthy alcohol use. NEJM. 2005; 352:596-607.

QuickFacts Important health facts you need to know and share.

Blood Sugar and Cancer Risk. A high blood glucose level increases the risk for cancer says in a new study from Korea. In a very large study including 1.3 million men and women followed for 10 years, researchers found that as blood glucose levels went up, so did the risk for several major cancers. Cancers related to higher blood sugar levels included pancreatic (relative risk 1.9 for men and 2.05 for women), esophageal, liver, colon, rectum, and cervix.

It appears that the obesity epidemic contributes to insulin resistance, higher blood sugar levels, and higher risk of cancer. Overall, men with fasting blood glucose levels of 140 mg/dL or higher had 37% more cancer, and women 23% more cancer than persons with fasting glucose levels less than 90 mg/dL. Source: JAMA. 2005; 293:194-202.

Healthcare Costs 2005. Healthcare spending is projected to reach $1.9 trillion in 2005. This represents 15.5% of the gross domestic product of the United States. This means that one out of every $6 to $7 we spend in the United States goes for health care.

The amount spent on healthcare in the United States is double the amount spent on education and 3.6 times more than the amount spent on defense. The question is: are we getting our money’s worth? Spending more on “sickness care” does little to improve the health of the nation. More emphasis needs to be put on health and wellness care, promoting healthy eating, physical activity, maintaining a healthy weight, and developing good mental health habits.

The high cost of ill health is a tax on all Americans and is hurting our economy. General Motors (GM) now estimates that the cost of health care for their workers increases the price of every car by $1,500. This puts the U.S. at a competitive disadvantage compared to other countries according to GM’s CEO Richard Wagoner. High healthcare costs threaten the health and global competitiveness of our nation. It’s time for every organization and every individual to take responsibility for improving the health of our nation and reducing healthcare costs. Quality healthcare and prevention must become a national priority if we expect to bring this problem into line. Sources: Health Benefit News, Feb. 10, 2005, and the Washington Post, Feb. 11, 2005.

Incentives Increase Participation in Wellness Programs. More companies are offering financial incentives to increase employee participation in wellness activities. For example, Union Pacific (UP) offered $200 this year to their managers who took a wellness assessment and didn’t smoke or who started a program to stop smoking. Over 3,500 mangers (46%) enrolled in this plan. UP offered this incentive, they said, because healthier employees make better decisions about their medical care and help hold down rising healthcare costs. Source: Employee Benefit News, Feb. 15, 2005.

Air Pollution Damages Chromosomes in Babies of Expectant Mothers. A new study of 60 newborns in New York City reveals that exposure of expectant mothers to exhaust pollutants may alter their baby’s chromosomes. These pollutants are prevalent in all large urban areas and can cross the placenta and reach the fetus.

When researchers tested the blood from the umbilical cord, they found twice as many abnormalities in the chromosomes of white blood cells in mothers living in high pollution areas compared to those living in low pollution areas. This evidence that air pollution can alter chromosomes in utero is troubling since other studies have validated this type of genetic alteration as a biomarker of cancer risk. Clean air is essential to good health for mothers and unborn babies. Source: NIH News, Feb. 15, 2005.

Stop Smoking Intervention Cuts Death Rates in Half. A National Institutes of Health (NIH) study looked at how effective a stop smoking intervention could be on a group of 5,900 middle-aged smokers who were all in good health at the start of the study. Half were assigned to a stop smoking intervention and half were left to normal medical care (were not enrolled in a stop smoking program).

After 14.5 years, researchers looked at the difference in death rates between the two groups. Sustained quitters had one-third fewer heart attacks and strokes and half the overall death rate of those who continued to smoke. That’s great news for smokers! If you smoke now but stop, you may cut your risk of dying in the next 15 years in half!

NIH points out that smoking is still the single most avoidable cause of disease, disability, and death in the United States. Currently about 22.5% of adults (46 million) still smoke. Smoking contributes to 440,000 deaths per year. The trend for the future doesn’t look too bright when you also realize that 26% of high school seniors currently smoke. There is still much to be done to encourage smokers to stop and young people not to start smoking. Source: NIH News, Feb. 14, 2005

Folic Acid Helps Prevent High Blood Pressure. High blood pressure is currently one of the most common and serious health problems. It affects an estimated 65 million people in the U.S., about 1 out of every 4 to 5 adults. New research from the Nurse’s Health Study II shows that young women who get enough folic acid, at least 1,000 mcg a day, have a 46% lower risk of getting high blood pressure compared to other young women who have a low intake (less than 200 mcg/day). The recommended daily intake (RDI) for folic acid is 400 mcg/day for adults.

Good dietary sources of folic acid include: beans and legumes, citrus fruit and juices, wheat bran and other whole grains, and dark leafy greens. It is also readily available in vitamin supplements. Folic acid is effective in reducing birth defects, colon cancer, coronary heart disease (by reducing homocysteine levels), and now high blood pressure. Getting adequate folic acid daily is practicing good preventive care! Source: JAMA. 293:320-329 Jan. 19, 2005.

Power Point Slides

You can download these slides and use them in your health presentations. To save a file click on 'Files' (top, left hand side of browser), click on 'Save As', specify your folder to save it in, type in a file name, and save it. To view the slide you need Microsoft Power Point software program or the MS PP Viewer, free from Microsoft.

You can download these slides and use them in your health presentations.

- Daily Life Activity and Hypertension. - Daily life activity should be considered an important measure for the prevention of hypertension
- Physical Activity and Metabolic Measures. Postmenopausal overweight women saw the following metabolic improvements with increasing level of daily energy expenditure
- Folic Acid and Blood Pressure Higher total folic acid intake was associated with lower hypertension

Featured Health Links

A Parent's Guide to Healthy Eating and Physical Activity. Developed by the Preventive Medicine Institute/Strang Cancer Prevention Center with support from MetLife Foundation. It is in pdf format (4.4 MB) and is 102 pages so allow time for the download. It is loaded with good information in working with young people on nutrition and health.

Year of the Healthy Child. The U.S. Surgeon General has committed to making 2005 "The Year of the Healthy Child." You can read about this goal on the home page of the Surgeon General. Throughout this year they will announce child health initiatives. Check this site periodically to see new programs to improve the health of our children. The two first reports are new "Folic Acid Guidelines for Women", and a new advisory on "Alcohol Use in Pregnancy." Fetal alcohol syndrome (FAS) is the leading preventable birth defect with associated mental and behavioral impairment. For every baby born with FAS, 3 additional children are born who still experience brain and functional deficits due to mothers drinking alcohol that affect learning and behavior.

High Blood Cholesterol -- What You Need to Know. This is a new 6 page handout developed by the National Cholesterol Education Program (NCEP). It is an excellent guide explaining high cholesterol and what steps you can take to reduce your cholesterol level.

Coronary Artery Disease. A new web site provided by the National Heart Lung, and Blood Institute that explains heart disease and what you can do to help prevent or control a heart problem.

Diabetes Statistics. Interested in the newest diabetes statistics? Diabetes is one of the fastest growing diseases in the United States and also one of the most costly. An estimated 18 million Americans now have diabetes. That's one in every 12 Americans over the age of 20. Over the age of 60 on out of every 5 or 6 people has diabetes (18.3%). The cost of diabetes is estimated at $132 billion every year. Statistics provided by NIH, National Diabetes Information Clearinghouse.

Health Savings Accounts (HSA). Health-savings accounts will become the most popular type of health insurance for small businesses in a few years, insurance experts say. HSAs provide a financial incentive for people to stay well. Those who live more healthfully and stay well can keep money that would normally go to the insurance company. HSAs should provide a big boost to the health promotion industry. Learn what companies are saying about HSAs. A new HSA web portal is now available for following this new trend in health care financing. Use this site to keep in touch with new information on HSAs.

Hypothermia. A NIH news release on hypothermia points out that 600 people die of hypothermia each year in the United States. Learn the symptoms and signs of hypothermia and how to prevent it.

Finding Your Way to a Healthier You -- a brochure explaining the new (2005) dietary guidelines. Designed for the consumer (12 page PDF). A web site for more detailed information for health professionals is also available. A third site lists the science base for the new guidelines. This site is a rich source of nutrition information for the health professional wanting more background and scientific information substantiating the guidelines.

Active at Any Size. Here is an excellent site on exercise guidelines for individuals who are very overweight. Developed by WIN (the Weight Control Information Network by HHS).

Healthy Recipes

Here are some new ideas to try in your home.

Recipes. Tomato Salsa with Avocado and Onion. Try this great home made salsa! Recipe provided by Good House Keeping.

Recipes that Lower Risk of Diabetes and Heart Disease. Legumes such as beans, lentils, peas, and chickpeas are versatile and tasty foods. When eaten regularly, legumes help maintain favorable blood sugar levels and blood cholesterol levels.

Canadian and Australian growers of legumes or pulses have a website at http://www.passionforpulses.com with recipes based on beans and peas. They also summarize research outcomes of the disease-lowering effects of pulses for diabetes and heart disease.

For example, people eating test diets that included as little as 2.5 to 5 oz a day of canned beans (69 - 150 g/day) or 2.6 to 7 oz a day of cooked dry legumes (75 - 200 g/day) lowered their cholesterol levels 10% or more within two to three weeks. A reduction this size can lower the risk of coronary heart disease by 20%. You can find their summary of research findings about the amount of legumes consumed and the beneficial effects reported at http://www.passionforpulses.com/amount.html.

The website suggests that if you want the benefits of beans without the flatulence often associated with them try eating legumes regularly in small amounts. Gradually build up to consistently larger amounts. This gives your body time to adjust to the increased fiber and other components of beans. You may want to try these three interesting recipes.

• Italian Chickpea Stew
  http://www.passionforpulses.com/recipes/nonna.html

• Chickpea Salad with Sundried Tomatoes
  http://www.passionforpulses.com/recipes/suntomatoes.html

• Sicilian Broad Beans with Mint – serve hot or cold
  http://www.passionforpulses.com/recipes/broadbeans.html

Passion for Pulses , published by Tuart House, an imprint of UWA Press, with support from CLIMA and GRDC, brings together sweet and savoury recipes from around the world, from favorites such as Hommous, Dhal and Chilli Con Carne to the more exotic French Cassoulet, Thai-style Green Beans and Pork, Wattleseed Shortbread and Crab and Chickpea Curry.

The recipes are separated into easy-to-follow sections covering seven regions of the world - Australia, Northern Europe, Southern Europe, the Middle East, Asia, the Indian subcontinent and the Americas - with soups and starters, mains and sweets under each section.

Every recipe is vividly illustrated with full-color photographs taken by award-winning photographer, Brad Rimmer. Whether you are looking for a quick dish to make at the end of a long day or something to impress for a special occasion, you will find it in Passion for Pulses.

Specific information about legumes (pulses) and diabetes is at http://www.passionforpulses.com/diabetes.html

Additional studies about legumes (pulses) and heart disease is reported at http://www.passionforpulses.com/heartdisease.html

Las Vegas Wellness Marketing Seminar

The Successful Health Management Systems™ Seminar, by Wellsource, Inc.,the leader in population health management applications, will teach health professionals and others how to develop and market wellness programs or improve an existing program. The next seminar will be held May 16-17, 2005 at the Excalibur Hotel Casino in Las Vegas, Nevada.

The seminar provides professionals in the healthcare and wellness industry with the opportunity to network with peers and share successes and challenges. The learning experience is facilitated with interactive workshops that encourage participation. For a program schedule and registration form. Register early to receive discounted registration and hotel rates.

For further information on the Wellness Marketing Seminars, visit our website www.wellsource.com, call a Director of Business Development at 1-800-533-9355, or e-mail well@wellsource.com.

Wellsource Inc.
15431 SE 82nd Dr.
Portland, OR 97015
(503) 656-7446

About Making Healthy Choices

Making Healthy Choices is written by Don Hall, DrPH, CHES president of Wellsource Inc. with contribution from associated health professionals. It is available as a resource to Wellsource clients and other select organizations involved in promoting health.

Content is general health information from evidence based research. Its purpose is not to treat disease but to promote healthy lifestyles. Persons with health problems should consult their physician for specific guidance.

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