Monthly Archives: October 2009

Foodie Friday: Quinoa

Oct 2009 001Well, it hasn’t been the best week here in The Doctors’ Rheum, food-wise. A busy week, travel and erratic schedule led to too much takeout and restaurant eating. I have no recipe to feature this week, so I thought I’d talk about a food find quite popular on the blogs. I knew about quinoa as a gluten-free “grain,” but have learned it is especially popular among vegetarians and vegans due to its protein content. Note the following from Wikipedia:

In contemporary times, this crop has become highly appreciated for its nutritional value, as its protein content is very high (12%–18%), making it a healthful choice for vegetarians and vegans. Unlike wheat or rice (which are low in lysine), quinoa contains a balanced set of essential amino acids for humans, making it an unusually complete protein source.[4] It is a good source of dietary fiber and phosphorus and is high in magnesium and iron. Quinoa is gluten-free and considered easy to digest.Oct 2009 006

What to do with it? It is very quick and easy to cook. I tend to like sweet flavors and have made a wonderful “pilaf” type of dish using pantry items. To cooked quinoa, I added caramelized onions, toasted pine nuts, sauteed garlic, golden raisins and crumbled feta. This could be a good side dish or filling enough as a main dish with some salad. I have also tried this recipe from epicurious using corn and mint. More a summer dish, though. Maybe this quinoa stuffing recipe would work for Thanksgiving? You can substitute quinoa for rice, couscous or even oatmeal. I would love to have this fruit and nut quinoa for breakfast! (That site with the breakfast quinoa,, has multiple other quinoa recipes). I think “Foodie Friday” has served a purpose already . . . after writing this post I’m excited to get back in the kitchen and make a new quinoa dish!


Fish Oil for RA

1Korea Trip 177My daily briefing email from the ACR (American College of Rheumatology) led with a story on fish oil in RA. More info can be found on the Health Day and UK Telegraph sites. The actual article was published in the journal Nature 461, 1287-1291 (29 October 2009). This site requires a paid registration to read the article, entitled “Resolvin D2 is a potent regulator of leukocytes and controls microbial sepsis.” Sounds fascinating, huh? Well, I could get the full article from the hospital library tomorrow but I think I’ll be OK with the Editor’s Summary on Nature’s site:

Resolvins, locally acting factors derived from omega-3 fatty acids, have been recognized as inflammation-resolving mediators. Experiments in a mouse abdominal sepsis model now show that resolvin D2 (RvD2) inhibits neutrophil trafficking to inflammatory sites and decreases leukocyte interactions with endothelial cells in a nitric oxide-dependent manner. RvD2’s cellular and molecular actions translated to a dramatic increased survival. This work points to RvD2 as a potent anti-inflammatory agent and suggests new therapeutic approaches that do not compromise host defences.

So, what does this mean? Fish oils may have a beneficial effect on inflammatory conditions, like RA. It appears that this happens because a substance in fish oils stops white blood cells from sticking to the walls of blood vessels. The article specifically talks about fish oil, but the vegetarians among us will be interested in other sources of omega-3 fatty acids, like flax seeds, walnuts and chia seeds. Many of my patients take these supplements and they are fairly well tolerated, aside from the occasional “fish belching” that some experience. Apparently taking the supplements with meals can decrease it, although a certain family member of mine unfortunately hasn’t found a tolerable brand yet! I should emphasize that the conclusions have been that these supplements may help symptoms of RA and may be part of a comprehensive treatment plan. Certainly no one is suggesting this as a treatment or in any way disease-modifying.

More Vitamin D

A reader recently asked about vitamin D related to RA (rheumatoid arthritis). This is interesting, and something we’re learning more and more about. Vitamin D sure is a hot topic in health news lately. One reason may be that the recommended daily intake was set long ago and actually may not be enough. Another reason may be all the sunscreen we wear, although this has been disputed. In terms of autoimmune illnesses, we do know that the cells of the immune system have vitamin D receptors. Some studies have suggested low vitamin D levels could cause a flare of autoimmune diseases, but other studies have not found this to be true. Either way, your doctor can talk with you about your specific requirements and check a vitamin D level if needed.

True Confessions


I love this pic. I took it years ago and it always makes me laugh. But now when I look at it, I think about it as a representation of my health goals, including eating less processed foods. Due to a busy schedule (meeting, patient care, meeting, presentation during lunch so I didn’t eat, rounds, appointment, office) I had to make a quick drive-thru pit stop somewhere and had McD’s fries for the first time in months! Tasty. Hot, crispy. Way too salty. A little GERD. Will be back again when the taste memory fades . . .

Dig Your Bones?

I just laughed out loud at this osteoporosis PSA on CBS. It’s great, though.

Aching Knees?

[picapp src=”0295/ebf12727-476a-4e70-a07c-1dffab9332d3.jpg?adImageId=6650510&imageId=298916″ width=”234″ height=”347″ /]I walked a LOT today. First, I completed week 2 day 2 of the “Couch to 5K” program, which is designed to get you up to running 5K over about 2 months. I did this before, about 7 or 8 years ago, and then ran a few 5Ks. The running bug didn’t really stick, but I’ve decided to give it another try. After doing the 30 min run/walk session, I grabbed the dog and took her on a 40 minute walk. (She didn’t seem to like the erratic stops and starts when I tried to take her on a training run in week 1). Later in the day I went shopping. Slow walking around stores, but on my feet a couple hours, then my mom wanted to do some hilly neighborhood walking. Fast forward to now and I’m feeling a little tight in the legs. In addition, slap me on the hand I did not really stretch. Classic “do as I say, not as I do.” I see ibuprofen in the near future.

A common cause of knee pain in patellofemoral syndrome. This is a frequent cause of knee pain in younger people and may be due to overuse, underdevelopment of certain parts of the quadriceps (thigh) muscles, the way feet over or under pronate (turn too far in or out). I frequently refer patients to this handout from (Of course, this is after I’ve evaluated and diagnosed them. If you are reading this as a knee pain sufferer, make sure you see your doctor). I think it is has a good set of exercises with simple instructions. However, I often recommend physical therapy assessment and treatment as well. A recent article in BMJ discussed exercise in patellofemoral syndrome. Anyone interested in a summary can look here and the original article here.  So now I’m off to do some stretching.

Are you up to date?

Health care professionals likely know and use the online resource UpToDate. I have been using it since I was a resident, and maybe even as a med student. At any rate, I remember when it was on CDs. And I remember when there were no online resources and we had to look up journal articles in an index book, but I digress. . .

We have an institutional subscription at my office and hospital and I use this resource frequently. I have just learned over at 33 charts that there is now a patient site online. Find the patient information site here.