A New Kind of Egg Replacement By Leslie Rusch-Bayer, RD, LDN, CPT

Screenshot 2016-08-25 13.59.30Many of my patients have found they have severe egg yolk and egg white sensitivities. While avoiding egg dishes like omelets, soufflés and deviled eggs is relatively easy, it is harder to eliminate foods like quick breads, noodles or many processed foods that are made with eggs.

Recent egg replacements have included prunes, bananas, applesauce and chia seeds. However, typical egg replacers do not provide any help when trying to make some recipes, especially meringues or mayonnaise.

Let me introduce a rather unknown egg replacing option: aquafaba. Derived from the Latin words for water and bean, aquafaba is made from the water that tofu, peas, lentils and especially chickpeas are soaked in. During the soaking process, starches and many vitamins and minerals are leached into the water. It is made of about ninety percent water and ten percent protein. Aquafaba can be used as a thickener, binder, emulsifier or foaming agent. Understand that chickpeas create the best aquafaba and if tofu or lentil “water” is used you may have different results.

Aquafaba is made the same as meringue. Once placed in a bowl, use a whisk or electric hand mixer to whip the “water” until stiff white peaks form. This could take between 1-2 minutes. The peaks of aquafaba are long-lived. The slight “beany” aroma that you may notice in the bowl will disappear when cooked.

A nutritional analysis showed that per one tablespoon there are about three calories.

Meringue and mayonnaise have been successfully made using aquafaba.

If you have sensitivities to egg yolk or egg whites, I encourage you to Google ‘aquafaba recipes’ for more options. Be courageous and try a few new recipes. Aquafaba is affordable and inexpensive.

 

Roasted Onion, Squash & Fig Salad With Maple Mustard Balsamic Dressing

 

Screenshot 2016-08-22 09.35.57Serves: 4

INGREDIENTS

Salad

  • 1 butternut squash, peeled, seeded and cut into ½-inch cubes
  • 1 large sweet onion, halved and sliced into ½-inch ribbons
  • 1 tbsp olive oil or avocado oil
  • ½ tsp sea salt
  • ¼ tsp ground black pepper
  • 8 cups mixed greens
  • 1 cup crumbled fresh goat cheese
  • ½ cup walnuts, chopped
  • 4 dried figs, slices

Maple Mustard Balsamic Dressing

  • ¼ cup extra-virgin olive oil
  • 2 tbsp balsamic vinegar
  • 1 tbsp lemon juice
  • 1 tbsp whole grain mustard
  • 1 clove garlic, minced
  • 2 tsp maple syrup
  • ¼ tsp sea salt
  • Ground pepper, to taste

DIRECTIONS

To Make the Roasted Onions & Squash:

  • Preheat oven to 400F. Toss squash and onion with olive oil or avocado oil, salt, and pepper. Roast for 35 minutes. Meanwhile, prepare remaining components.

To Make the Dressing:

  • Whisk together all ingredients in a small bowl or shake together in a glass jar. Set aside until ready to use.

To Assemble the Salad:

In a large bowl, toss the greens with ¾ of the dressing. Divide evenly between 4 bowls or present this in one large salad bowl. Top with roasted squash, onions, walnuts, goat cheese, and figs. Drizzle each bowl with remaining dressing. Serve immediately.  Enjoy!

Couri Center patient, Jamie shares her personal journey with TLC™

newsletter tlc testimonial graphicWhen you first came to Dr. Couri, what was your motivation?   My husband and I have been trying to start a family for over 5 years with no luck.  I did a ton of research online and had been told by a few doctors that I needed to lose weight to have a better chance.  We had done a few cycles with the fertility drugs but had not had any luck.  I was starting to feel like the more I tried to lose weight the more I gained.  I tried other programs (Weight Watchers, Beach Body, Atkins, and even meal delivery) and I would be really successful for the first month or two.  Then I would gain back everything I lost, plus another 10-15 lbs. extra.! I didn’t feel like I was able to stick with anything.  I felt like my will power was gone.  Plus I was scared of becoming obsessed with the scale.  When I was a teenager I struggled with body image and an eating disorder.  Even though that was more than 20 years ago, I have always been scared of falling back into that hole.   For the longest time, I have wanted to ask for help but I never did.  I have always felt that I needed to do it on my own.  I told myself I knew how to lose weight, I’d done it before.  I made excuses for my weight, my lack of exercise, and for my unhealthy habits.

So, when I went in for my regular appointment with Dr. Couri, I had no real intention of asking her for weight loss advice.  We were finishing up the appointment with a little small talk and she asked me if there was anything else I had a question on.  My mouth asked the question before my brain could even think about it.  I asked her about weight loss pills and if there are any out there that really work.  I figured she would say no there are no short cuts- just diet and exercise-which is what she said, but then Dr. Couri asked me a question:  “Are you serious about changing your habits?”  I said yes, but didn’t really expect anything.  Even when she set me up with a free TLC™ consultation, I did not expect anything to come of it.  I figured I would not be able to stick with any plan she gave me, but hey the appointment was free so why not.

In one word, how would you describe the way you felt on a regular basis before TLC™? One word is hard for me…tired I guess.

Before the program, did you think you had a choice about feeling this way or did you think: “this is just the way it is”? I was always tired and had frequent migraines but I figured that was my normal.  I felt like I had tried everything with zero results. I was just tired of trying and failing over and over again.  I was tired of being broken.

What are some of the most valuable things you have learned during the TLC™ program?

  • Trust in the small changes.  I was always trying to go straight into the big changes and never was one for starting small, but I was never able to stick with the big changes.  So, the biggest thing I learned is that small changes make a HUGE difference.
  • Asking for help is not a weakness.  I still struggle with this and probably always will.

How have you changed since TLC™? I lost 14.5 lbs. and 11 inches off my body in 12 weeks.  I went down a jean size, but that is not the biggest change.  I was on my way to being a diabetic.  My dad was diabetic, my grandpa was a diabetic, and my brother is diabetic.  I always figured it was only a matter of time before I was one too.  My 12-week labs say otherwise.  I am not anywhere near where I want to end up, but I feel like a death sentence has been lifted off my head.  I have so much more energy and motivation to just be healthier.   I am far from perfect with my food but I don’t let one bad food choice send me into a spiral of bad choices anymore.

We all know change is hard. Was it worth it? Describe how these changes have impacted your life and your future.  The hardest part for me was learning to say no, not just to myself but to others as well.  Food is always present at every event from birthday parties to funerals.  Food has always controlled my life in some way or another…Am I eating too much? What am I going to eat? Eat more …Eat less…Don’t eat that…etc.   During the detox week I would think why am I doing this?  I’m not going to stick with this program and it’s going to be another waste of money, but by the end of that first week, I felt amazing.  I couldn’t believe how much better I felt.  It was totally worth it.  I wasn’t bloated.  My migraines are few and far between now.

What does your future look like now?  I see myself being more active and just nicer to be around.

If the “new you” could talk to the “old you,” what conversation would you have?  I would tell the old me to trust the program, trust the small changes, and to trust myself.

If you were recommending the TLC program to a total stranger, what would you say?  This is something I don’t have to imagine.  I have recommended this program to anyone who will listen.  I struggled and still have struggles but every second was worth it.  It feels like a huge commitment on the first day.  The lab work, blood drawls, weekly appointments may seem like a lot of work but I noticed a huge difference the first week.   I tell people that I went into the program thinking it was a weight loss program but it ended up being so much more for me.  Somewhere in the middle my focus shifted from the number on the scale to focusing on my overall health.

-Jamie R, August 2016

 

 

 

 

 

A Candid Interview with Renee

Renee Newsletter PostMeet Renee Alwan Percell, MMS, PA-C, and the newest addition to the Couri Center! Take a peek at some of her favorite things and get to know her a little better…

Do you have siblings? // Yes: a younger sister Carolyn and younger brother Michael

Any pets? // We had a cat, Judah, that my husband and I got when we were in the Peace Corps.  He is in cat heaven now.  We just acquired a bunny that my son named Pikachu.

College // Marquette University   Major // Biomedical Sciences

Favorite healthy snack? // Almonds, although I found out I have a sensitivity to them!

Favorite fruit? // It’s a tie between watermelon and cantaloupe

Least favorite fruit? // Grapefruit

Favorite veggie? // Green Beans

Least favorite vegetable ?// Brussels sprouts

Favorite workout? // Vinnitsa Yoga

Least favorite workout? // Biking

Favorite band? // Coldplay

Favorite color? // Blue

Favorite animal? // Tortoise turtles, if I could have one roam in my back yard, I’d be a happy girl!

When you get free time, what’s your favorite thing to do? // I have 3 kiddos that keep me very busy.  If I actually have a few minutes, I take the time to breath and rest my mind.  I love gardening too so often times will let the kids run around outside and I can play in the garden.  Win for all!

If you could throw any type of party, what would it be and whom would it be for? // I’m planning a huge benefit for the kid’s school right now.  We are starting an annual auction.  It’s a big task but I love it.

What is one of your favorite quotes? // I love Maya Angelou.  Here’s my top 2 from her:

“If you don’t like something, change it. If you can’t change it, change your attitude.”

“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

How many pairs of shoes do you own? // In the summer I have 2 pairs of shoes, flip-flops and running shoes.  But in the winter I have too many boots to count!

What did you want to be when you were small? // Marine Biologist

What motivates you?  My family and God

If you could meet anyone, living or dead, who would you meet? // This is a tricky one!  Mother Teresa.

Favorite movie? // The Little Mermaid.  My boys refuse to watch it with me!  I will just have to wait until my daughter is old enough to want to watch it!

Favorite book? // Top 3:

  • The Red Tent by Anita Diamont
  • The Bluest Eye by Toni Morrison
  • The Poisonwood Bible by Barbara Kingsolver

Favorite television show? // I apologize in advance- The Walking Dead!  People are shocked when I admit to that one!  A more normal favorite is Fixer Upper on HG TV.

Biggest fear? // Being stuck in a small space.

What chore do you absolutely hate doing? // Any chore that is smelly.  I’ve made an agreement with my husband that he gets the stinky jobs and he has graciously accepted.

Mountains or beach? // That’s tough because my husband is from CO so we visit there often and love the mountains.  We met on the island of St. Lucia so love the beach too!  I guess if I had to choose, I think I’d go with beach!

Weakness?//ANYTHING chocolate

Guilty pleasure ?// watching reality TV shows

Favorite original recipe?// Fish tacos

Worst recipe flop? // Brownies made from scratch.  I forgot to add the Cocoa!  Coops!

Favorite part about your job?// I love being able to help women out whether it be answering questions during an annual exam or figuring out a specific problem.  I love working at the Couri Center because all of the providers take the time to listen to patients.  We are here for our patients.  In today’s changing world of medicine that is not always the case, sadly.  I feel so fortunate to have this opportunity to provide care to the women in our community.

 

 

 

 

 

 

 

 

 

 

Excess Pounds Means Higher Cancer Risks By Michele Couri, MD, FACOG, ABIHM

Screenshot 2016-08-25 13.51.13

As a physician, I have seen first-hand the significant rise in obesity rates among patients both young and old. Currently in the United States, about 70% of all adults are considered overweight and 36% are obese according to the World Health Organization. These staggering statistics make the U.S. one of the countries with the highest prevalence of obesity. This persistent and steady rise in obesity rates seen over the past decades remains a grave public health concern.

As we probably are all well aware, obesity increases the risk of cardiovascular disease, diabetes, joint related disorders and infectious complications. However, it is now clear based on medical studies that obesity increases the risk of developing cancer. I recently ran across a study that caught my attention and sparked my interest to share with you as a newsletter article. The study entitled “Duration of Adulthood Overweight, Obesity, and Cancer Risk in the Women’s Health Initiative: A Longitudinal Study from the United States” was published August 16, 2016. This particular study looked at 79,913 women ages 50 to 79. They studied these women for 12.6 years, examining how the timing, duration, and intensity of overweight and obesity during adulthood impacts cancer risk, taking into account other factors such as physical activity, diet, smoking, hormone use, and diabetes history. During the 12 years that this study spanned, there were 6,301 obesity-related cancers diagnosed among the women. What they found was impressive– for every 10 years of being overweight as an adult, there was an associated 7% increase in the risk for all obesity-related cancers. More specifically, the risk was highest for cancer of the uterus (endometrial cancer) (17%) and kidney cancer (16%). For breast cancer, the risk was 5%. What is even more bothersome is that after adjusting for the intensity of overweight and obesity (i.e. how overweight individuals were), these figures rose to 8% for postmenopausal breast cancer and 37% for endometrial cancer (for every ten years spent with body mass index ten units above normal weight).

Endometrial cancer is the most commonly diagnosed gynecologic cancer in the United States. From 2007 to 2011, the incidence of endometrial cancer has increased by 2.4% each year, and death rates have increased by 1.9% each year. Rising obesity rates in the U.S. represent the greatest risk factor. Endometrial cancer is most commonly diagnosed in postmenopausal women, and the most common presenting symptom is postmenopausal bleeding or spotting. The link between obesity and endometrial cancer is related to the fact that adipose tissue is a repository for excess estrogen. Excess estrogen stimulates the lining of the uterus, and without proper progesterone balance, the estrogen can cause cellular proliferation and cancer development. This stimulation of tissue from excess estrogen could partly explain the link between obesity and increased rates of breast cancer. Obesity also is associated with higher levels of chronic inflammation, insulin resistance, DNA damage and changes in hormone metabolism, which are all key mechanisms in increasing the risk of cancer.

Adults are not the only ones at increased risk of developing cancer if they carry excess weight. A recent study showed that male teenagers who carry a lot of excess weight are more than twice as likely to develop colorectal cancer (CRC) by middle age, according to a large cohort study. Those with a high level of systemic inflammation are also at increased risk. The study published May 26th in the journal Gut, is noteworthy as one of the few to evaluate the association between teenage body mass index (BMI) and bowel cancer in adulthood.  In addition, girls who are overweight as young children and teens may face increased risk for colorectal cancer decades later, suggests a new study published in Cancer Epidemiology Biomarkers and Prevention.

In summary, how much of their adolescent and adult lives women are overweight and how overweight they are plays important roles in cancer risk. This finding highlights the importance of obesity prevention at all ages and from early onset. Lifestyle medicine is critical in helping women achieve optimal health including sustainable weight loss. At the Couri Center, we have devoted our time and efforts in creating programs designed to facilitate successful achievement of long-term health goals. The TLC™ program, our lifestyle program run by our Registered Dietician/Exercise Physiologist Leslie Rusch-Bayer and overseen by myself, is an excellent way to learn and implement lifestyle changes in addition to losing weight. This program, now in its 5th year, has changed hundreds of patients’ lives for the better.   We have helped patients reverse diabetes, eliminate their cholesterol medications, crush inflammation through identifying food sensitivities and the list goes on and on. But now, after reading this study, I firmly believe that by helping women lose weight and keep it off, we have significantly decreased their risk of developing cancer. That, my friends, is a beautiful thing.

To Your Health,

Dr. Couri

 

 

 

 

Genitourinary Syndrome of Menopause By Terry Polanin, MSN, APN, Family Nurse Practitioner

Screenshot 2016-08-25 15.05.41This summer I had the opportunity of attend the National Nurse Practitioner Symposium in Keystone, Colorado. Aside from the beauty and serenity of the mountains and time with a good friend, I attended many informative sessions. One session that caught my attention was the “Genitourinary Syndrome of Menopause.” As you may know, much of our time at the Couri Center is spent with women who experience this syndrome and need our help. I gained valuable insight into “opening the door” for women to discuss this personal topic-which is often avoided by women or their health care providers. GSM (Genitourinary Syndrome of Menopause) is a new name for a condition formerly referred to as vulvovaginal atrophy or atrophic vaginitis. GSM describes the conditions associated with low estrogen levels due to menopause after the ovarian function diminishes. An estimated 6,000 women enter menopause daily and we are living longer, with the current life expectancy at 83 years in the USA. Actually, almost 40% of a woman’s life is spent in the post-menopause years.

The symptoms of GSM include vulvar burning, irritation, urinary urgency, burning with urination with or without urinary tract infection, vaginal dryness, and painful intercourse. As estrogen declines in the years prior to and after a woman stops having periods, these tissues undergo significant changes. One may see shrinking of the labia, narrowing of the opening of the vagina, loss of elasticity, changes in the vaginal pH balance which can lead to vaginal infections, dryness and possibly injury to the tissues, which can cause bleeding, and discomfort. The emotional impact of GSM is also significant causing women to avoid sexual relations, which can impact a relationship. In a research study from 2014 (North American Menopause Society), over 30% of North American partners interviewed have discontinued sexual intimacy related to symptoms of GSM and reported relationship deterioration. Of those partnered women who sought and were treated with vaginal estrogen therapy, they reported improved relationship and intimacy.

GSM symptoms can be mistaken for other problems so careful screening by your health care provider is advised. And especially any post-menopausal vaginal bleeding must be evaluated at once. Women with breast or uterine cancer would also be advised specific to their relative history. However, a number of treatment options exist for women with GSM.

Non-hormonal Options:

  • Vaginal moisturizers such as long acting Replens, over the counter.
  • Organic coconut oil (tested on your arm before applying to the genitalia)
  • Lubricants such as Astroglide® or KY® Jelly Liquid with sexual activity (avoid ones with perfumes or warming properties that may be irritating)
  • Avoid perfumed soaps, laundry detergents, lotions, fabric dryer sheets or other possible irritants or allergy-potential products that are drying to the skin
  • Stop smoking
  • MonaLisa Touch™, is a non-hormonal therapy using a CO2 laser. Statistically significant improvement was noted after three laser treatments six weeks apart. This is an excellent non-hormonal option for women and Dr. Couri is the first in the greater Peoria, IL area to offer this in-office, 5-minute treatment. We are having regular classes about this procedure if you would like to enroll http://www.couricenter.com/event/septemberbeautyfromwithin/

Other options were mentioned, but the most common treatment advocated was the low – dose vaginal estrogen preparations. They have been widely researched and documented for safety and effectiveness. The 2013 North American Menopause Society statement included low-dose estrogen and ospemifene medication as effective alternatives for GSM. Topical forms of low dose estradiol, plant based preferably, were advocated such as Estrace® cream or Vagifem® vaginal tablets and did not elevate blood levels of estrogen, indicating they mainly impacted the vulvo-vaginal tissues.

Other natural therapies such as DHEA, Hyaluronic Acid, Vaginal pH balanced gel, oxytocin, and vaginal microbiota are available and some being more thoroughly tested but no data for effectiveness available at this time.

GSM is a common problem. Symptoms impact more than just the vagina. It can have a significant impact on the quality of life for women and for their partners. If you are bothered by this problem, please make an appointment to discuss the evaluation and treatment options available to you at the Couri Center.

Have a happy, healthy fall!

Terry Polanin, MSN, APN

Family Nurse Practitioner