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Tuesday, June 26, 2018

ONE frequent hyperlink between SIX lead causes of demise

Stress

If this provides you psychological photos of late uni essays, prolonged site visitors jams, and awkward first dates, you’re fully regular.

Here’s one factor that may shock you: Stress isn’t inherently evil.

A LONG time prior to now – a time when folks would truly hunt for meals as a substitute of driving to Coles – stress may have saved you from a monstrous, raging bear. Or worse.

The as soon as useful battle or flight survival mechanism that saved our ancestors alive, has developed proper right into a grotesque model of its former self.

Studies have confirmed that power stress is the frequent hyperlink between the six most important causes of demise: coronary heart illness, most cancers, lung illnesses, accidents, cirrhosis of the liver and suicide.

So how has this evolutionary characteristic turn into one factor that is truly KILLING us?

To perceive learn to efficiently combat stress, we have now to first understand WHY stress is so prevalent all via our fashionable society.

A survey of better than 3000 regularly adults by the American Psychological Association confirmed typical grownup charges their stress diploma at 4.9 out of 10 all through regularly life. (1 being your non secular yoga teacher and 10 being the offended outdated man on the site visitors lights this morning.)

But critically, lengthy work hours, poor sleep patterns, massive quantities of stress from work and a meals routine consisting of ice espresso and servo pies can have a crucial affect on every psychological and bodily well being.

Everyone is conscious of the feeling of stress, nevertheless just a few know learn to efficiently counteract the implications.

So proper right here’s the good news…

By learning the best way to actively reduce your stress by the use of regularly routines and practices, you could improve your psychological well-being whereas concurrently decreasing the prospect of sickness and illness.

Retreats are a helpful technique to chop again stress and unplug out of your loopy, rushed life.

Imagine this: Wake as much as an hour of guided-meditation at daybreak, actually really feel your muscle pressure float away with a calming yoga class, adopted by a dip throughout the magnesium pool. This tranquil setting offers you a chance to rest your thoughts and floor your self again to your pure state.

Numerous scientific analysis present the clear benefits of meditation and yoga, ranging from diminished stress, improved focus, flexibility, immune well being and slowed rising older. The record goes on and on.

Due to the fast-paced rush of up to date life, it’s normally easy to not realise HOW harassed you actually are. It isn’t until you take a few days of self-care to actually really feel the burden lifted off your shoulders.

Just a quick preserve at a retreat will not solely go away you refreshed and rejuvenated nevertheless can have long-lasting benefits. Qualified therapeutic therapeutic massage therapists, motivational audio system, beauticians, yoga academics and physique motion practitioners put collectively an expertise that teaches you self-care practices and routines that you could be apply to your private life to chop again stress and anxiousness.

 

WARNING: Upon ending your keep at a retreat, likelihood is you will actually really feel a way of calmness and readability. These uncomfortable unwanted side effects are NOT short-term and will lead to an improved prime quality of life.



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Monday, June 18, 2018

Fitness Influencer Nadia Murdock Talks Benefits Of Barre And Shares Her Go-To Moves

Healthy Fit Care:

Barre changed my life. Literally changed my life! When I decided to get certified in barre I had no idea what life had in store for me. I had already fallen in love with barre as a student and was looking to broaden my expertise as a fitness instructor. Upon completing my certification I learned that I was expecting and I couldn’t have been happier.

It’s funny how things work out: I wound up teaching through my entire pregnancy (up until a week before delivering!) and the experience really helped me to have a greater appreciation for movement and my changing body both pre- and post-pregnancy.

What is barre?

Many people who have taken my class assume walking into the studio that barre will be an easy workout. Before we begin, some even consider it their light day for working out. The response I have gotten post workout, however, is actually the exact opposite. Barre is a challenge and definitely transforms the body! Mores specifically, the textbook definition of barre is “ballet-inspired workouts that utilize a ballet barre.”

Now what is barre to me? I consider it a dynamic and challenging way to engage the entire body not just physically, but mentally too. The most amazing thing about this style of fitness is that it can be taught in so many different ways. I like to teach my classes with a bit of a challenge and intensity. Women (and men) who may not have considered utilizing unique fitness tools like the gliders and resistance bands I introduce in my classes to shake things up become hooked!

Barre challenges the body in a unique way, zeroing in on those smaller muscle groups.

The majority of classes mix elements of pilates, dance, yoga, and functional training, all with motivating music. It also offers a sense of community and built-in accountability partners. I have even found students bonding with one another as they count through the reps with me. Friends are made before my eyes. It’s actually a beautiful thing to see.

Mind and Body Benefits

Body Confidence

The amount of confidence that I have seen shine through some of my students is incredible! I often hear things like:

  • I work out all the time and I don’t see a difference, but barre is my game changer.
  • Barre has helped me set personal goals like wearing a sexy dress to my next high school reunion.
  • I couldn’t fit into this dress before but your barre classes helped me! Look!

No matter what the goal, big or small, many of my students are on their way to achieving what they have set in mind and are feeling good about themselves while doing it!

Functional Fitness

As we age, we overlook the simple daily tasks that can potentially become difficult without proper exercise and nutrition. I have a 50 plus grandmother who takes my classes religiously. She couldn’t do a sit up or hold a plank before taking barre as she suffers from back pain and vertigo. Now she is one of the strongest individuals in my class. She is proof that through consistency and truly pushing yourself each session you will see your strength change.

Active Mom

Personally speaking, I was blessed to be able to teach barre my entire pregnancy and because of that I have been an active mom since day one. It was important to me to be able to be out and about with my son, showing him the importance of being physically active and enjoying fresh air regularly. Barre allowed me to transition back to a regular fitness routine effortlessly and increased my postpartum strength immediately. I even do resistance band workouts at home and find my son looking with amazement and curiosity, which motivates me daily. I always want to set a good example of maintaining a healthy lifestyle for my son and his future, and my involvement with barre is helping me do that.

My Top 4 Go-To Barre Moves

1. Relieve Bicep Curls

This traditional move offers so many benefits and can easily be spiced up with relieves! Using two- to three-pound hand weights, the class will perform a series of bicep curls while remaining in relieve (on toe). This takes a lot of concentration and focus, really tapping into the idea of mind over matter. Perform this move for 3 sets of 8 to 12 reps.

2. Planks with Resistance Band Tap Outs

This is one of my favorite moves! During the ab portion of my class I have students perform traditional planks but add a bit of variety by including resistance bands. After holding the plank for a specific duration of time, I have them perform alternating tap outs with resistance bands around their ankles. Planks can be done anytime, anywhere—it’s one of the reasons I love this move so much! Hold the planks for 30 seconds, performing 15 tap outs between each set. Do this for three sets.

3. Ballet Jacks

For cardio bursts, this is my go-to move! Starting in grand plie, the class will jack their feet in and out while keeping their arms straight out to the side at shoulder height. With each jack in, the hands come in to meet the chest. This helps to warm up the body and get an extra burn! Perform 8 to 12 reps for 3 to 5 sets depending on your experience level.

4. Grand Plie with Heel Raises

This is another traditional move that can be done with or without a barre, making it great for at-home workouts! While standing in grand plie (second position) your legs are wide with your knees turned out with a slight bend. I have my students lower the body to the point where they feel the muscles working. Once that is found, they begin to alternate their heels with with raise into relieve. (I even throw in few pulses and bands from time to time!) Execute this move for 8 to 12 reps for 3 sets.


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Fitness Influencer Nadia Murdock Talks Benefits Of Barre And Shares Her Go-To Moves

Healthy Fit Care:

Barre changed my life. Literally changed my life! When I decided to get certified in barre I had no idea what life had in store for me. I had already fallen in love with barre as a student and was looking to broaden my expertise as a fitness instructor. Upon completing my certification I learned that I was expecting and I couldn’t have been happier.

It’s funny how things work out: I wound up teaching through my entire pregnancy (up until a week before delivering!) and the experience really helped me to have a greater appreciation for movement and my changing body both pre- and post-pregnancy.

What is barre?

Many people who have taken my class assume walking into the studio that barre will be an easy workout. Before we begin, some even consider it their light day for working out. The response I have gotten post workout, however, is actually the exact opposite. Barre is a challenge and definitely transforms the body! Mores specifically, the textbook definition of barre is “ballet-inspired workouts that utilize a ballet barre.”

Now what is barre to me? I consider it a dynamic and challenging way to engage the entire body not just physically, but mentally too. The most amazing thing about this style of fitness is that it can be taught in so many different ways. I like to teach my classes with a bit of a challenge and intensity. Women (and men) who may not have considered utilizing unique fitness tools like the gliders and resistance bands I introduce in my classes to shake things up become hooked!

Barre challenges the body in a unique way, zeroing in on those smaller muscle groups.

The majority of classes mix elements of pilates, dance, yoga, and functional training, all with motivating music. It also offers a sense of community and built-in accountability partners. I have even found students bonding with one another as they count through the reps with me. Friends are made before my eyes. It’s actually a beautiful thing to see.

Mind and Body Benefits

Body Confidence

The amount of confidence that I have seen shine through some of my students is incredible! I often hear things like:

  • I work out all the time and I don’t see a difference, but barre is my game changer.
  • Barre has helped me set personal goals like wearing a sexy dress to my next high school reunion.
  • I couldn’t fit into this dress before but your barre classes helped me! Look!

No matter what the goal, big or small, many of my students are on their way to achieving what they have set in mind and are feeling good about themselves while doing it!

Functional Fitness

As we age, we overlook the simple daily tasks that can potentially become difficult without proper exercise and nutrition. I have a 50 plus grandmother who takes my classes religiously. She couldn’t do a sit up or hold a plank before taking barre as she suffers from back pain and vertigo. Now she is one of the strongest individuals in my class. She is proof that through consistency and truly pushing yourself each session you will see your strength change.

Active Mom

Personally speaking, I was blessed to be able to teach barre my entire pregnancy and because of that I have been an active mom since day one. It was important to me to be able to be out and about with my son, showing him the importance of being physically active and enjoying fresh air regularly. Barre allowed me to transition back to a regular fitness routine effortlessly and increased my postpartum strength immediately. I even do resistance band workouts at home and find my son looking with amazement and curiosity, which motivates me daily. I always want to set a good example of maintaining a healthy lifestyle for my son and his future, and my involvement with barre is helping me do that.

My Top 4 Go-To Barre Moves

1. Relieve Bicep Curls

This traditional move offers so many benefits and can easily be spiced up with relieves! Using two- to three-pound hand weights, the class will perform a series of bicep curls while remaining in relieve (on toe). This takes a lot of concentration and focus, really tapping into the idea of mind over matter. Perform this move for 3 sets of 8 to 12 reps.

2. Planks with Resistance Band Tap Outs

This is one of my favorite moves! During the ab portion of my class I have students perform traditional planks but add a bit of variety by including resistance bands. After holding the plank for a specific duration of time, I have them perform alternating tap outs with resistance bands around their ankles. Planks can be done anytime, anywhere—it’s one of the reasons I love this move so much! Hold the planks for 30 seconds, performing 15 tap outs between each set. Do this for three sets.

3. Ballet Jacks

For cardio bursts, this is my go-to move! Starting in grand plie, the class will jack their feet in and out while keeping their arms straight out to the side at shoulder height. With each jack in, the hands come in to meet the chest. This helps to warm up the body and get an extra burn! Perform 8 to 12 reps for 3 to 5 sets depending on your experience level.

4. Grand Plie with Heel Raises

This is another traditional move that can be done with or without a barre, making it great for at-home workouts! While standing in grand plie (second position) your legs are wide with your knees turned out with a slight bend. I have my students lower the body to the point where they feel the muscles working. Once that is found, they begin to alternate their heels with with raise into relieve. (I even throw in few pulses and bands from time to time!) Execute this move for 8 to 12 reps for 3 sets.


Source link



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https://ift.tt/eA8V8J

Sunday, June 17, 2018

Learn How To Cook Salmon Like A Pro (Just In Time For Summer!)

Healthy Fit Care:

Cooking salmon is one of those things that sounds harder than it actually is. Is it different from cooking meat? Yes, completely. Will you find yourself making salmon multiple times a week once you’ve tried these methods? Absolutely! The cooking methods in this article are perfect for beginners because they require very little in terms of ingredients, equipment, and time. The first step? A visit to the fish counter!

The Fish Counter (the Beginning of a Beautiful Friendship)

Your local fish shop or fish counter at the grocery store will almost always have the freshest salmon. The salmon on display should smell fresh and faintly briny; an overly fishy smell indicates that it’s past its prime. Don’t be afraid to ask questions! Fishmongers are more than happy to give you cooking tips and prep suggestions, and they can help make your life easier by removing bones and skin (especially if you call ahead to place your order).

Farmed vs. Wild Salmon

As a general rule, it’s the safest bet to opt for wild salmon over farmed salmon. Farmed salmon has a mixed reputation. Critics say that salmon farms have been shown to have detrimental effects on both the fish themselves and the ocean at large.

Farmed salmon is more likely to carry diseases (and to potentially spread those diseases to wild salmon if they escape their pens). There are also environmental concerns about the chemicals that are used to treat farmed salmon.

That said, as farming methods have changed, some varieties are considered safer than others.

And not everyone has access to wild salmon, so buying farmed fish may be the only option in some areas.

A Quick Reminder of How Nutritious Salmon Really Is

An incredibly versatile protein, salmon is high in heart-healthy omega-3 fatty acids (which are thought to contribute to healthy brain and cardiovascular function). Salmon is also a good source of vitamin B12, selenium, and niacin.

Vitamin B12, found most commonly in animal-based proteins, is essential for blood cell and nerve health and the production of DNA. Selenium, a trace mineral, is crucial for healthy thyroid function. Niacin lowers cholesterol levels and cardiovascular risks.

Prepping Salmon for Cooking

The best practice when cooking salmon is to either cook from a fresh fillet that hasn’t been frozen or to cook directly from frozen form. Since salmon is so perishable, it can be risky to attempt defrosting before cooking. Use fish tweezers (such as these Kotobuki Japanese fish bone tweezers) to remove any pin bones left in the flesh.

Resist the urge to rinse fresh salmon under cold water, as this can potentially splash bacteria all over the fish—or even contaminate your sink or other items in your kitchen. Use a paper towel to pat the fish dry; the drier the surface of the salmon the better for searing over high heat. Once the salmon has been thoroughly dried, it’s time to get cooking!

Avoiding Overcooking Salmon

Overcooking is often the biggest fear people have when it comes to learning how to cook salmon. Although it’s true that salmon overcooks easily, the trick is to remove it from the heat just before you think it’s done. LaDonna Rose Gundersen, an Alaskan fisherwoman and author of My Tiny Alaskan Oven, Salmon, Desserts & Friends, and The Little Alaskan Salmon Cookbook, offers these words of advice for beginners: “Do not overcook salmon, and remember it continues to cook when you remove it from the heat. Better to undercook it slightly than to overcook it.”

Salmon is cooked when it reaches an internal temperature of 145° F. Aim to take it off the heat at 140° F and let the residual heat do the cooking in the last few minutes before you check the internal temperature again. Salmon that has been properly cooked will be opaque throughout and will flake easily with a fork.

Sides and Wine: What goes with salmon?

Diane Morgan is the author of the best-selling cookbook Salmon: Everything You Need to Know + 45 Recipes and a huge fan of this versatile fish. When it comes to pairing with wine, it’s all about what’s in season at any given moment.

Wine-wise, salmon and pinot noir are a lovely pairing, as is true for a Beaujolais. That said, an Austrian grüner veltliner is terrific if the fish will have a smoky flavor. When tomatoes are at their peak, I pan roast salmon and serve it with sautéed green beans, yellow pear tomatoes, and drizzle it with a homemade basil oil. That dish is grand with a French white Burgundy or Orvieto.

Salmon is so versatile that it can also take on Asian flavors, creamy sauces like an aioli, or Mexican accents as in grilled salmon tacos with a chipotle sauce.

Gundersen likes to pair salmon with classic comfort food. “This sounds crazy, and yet simple baked beans pair well with [pan-seared] salmon. …Or, a nice Caesar salad or asparagus roasted alongside the salmon.” Wine and beer that is slightly acidic can stand up to salmon’s assertive flavor, while buttery wines like chardonnay complement salmon’s milder flavors.

How to Cook Salmon

Pan Searing Salmon in a Skillet

Whether you pan sear salmon in a skillet exclusively or you finish the fillet in the oven, the secret to crispy skin remains the same: plenty of heat and patience.

Yields:

2 servings

Ingredients:

  • 2 center-cut fillets about 1” thick (use fillets with a uniform thickness for best results)
  • 2 Tbsp. grapeseed oil (or another neutral oil with a fairly high smoke point)
  • Kosher salt
  • Freshly cracked black pepper

Special equipment:

  • Paper towel
  • Sharp chef’s knife
  • Heavy skillet (either cast iron or stainless steel; it should be oven safe if you choose to finish the salmon in the oven)
  • Long-handled tongs
  • Fish spatula/turner (we love this OXO Good Grips Fish Turner)

Pan-sear method:

  1. Remove the salmon fillets from the fridge 15 minutes before cooking. Carefully pat all sides down with a paper towel—the drier the salmon the crispier the skin.
  2. Using a sharp chef’s knife, make four shallow cuts (aim for a depth of ¼”) diagonally across the salmon skin. Repeat in the opposite direction so that you end up with a crosshatch pattern. This extra step will allow the salmon to lie flat over high heat and on your plate (otherwise the skin has a tendency to curl under).
  3. Generously season the salmon fillets with kosher salt and freshly cracked pepper.
  4. Add the oil to the pan and heat over medium-heat high until the oil is just beginning to shimmer. Resist the temptation to add the salmon before the pan preheats!
  5. Using long-handled tongs, carefully add the salmon fillets skin-side down to the pan. Cook the salmon for 4 minutes undisturbed (again, resist the temptation to move the fillets around in the pan or flip them after only a moment or two).
  6. Carefully flip the salmon fillets over using a fish spatula and cook for another 3 minutes. The salmon should feel firm but not dried out. Remember, it’s always a good idea to remove the salmon from its heat source just before it’s done, as the residual heat will continue cooking the fish.
  7. Serve the salmon fillets with the skin on while still hot.

From skillet to oven method:

  1. Preheat the oven to 350° F.
  2. Follow steps 1 to 4 exactly as described above.
  3. Gently place the salmon fillets in the hot oil skin-side down and cook for 2 minutes. Carefully turn the fish skin-side up with a spatula and cook for 2 more minutes.
  4. Transfer the hot skillet to the preheated oven and cook the salmon for another 8 to 10 minutes or until the fish flakes easily and has turned opaque.

Perfect pairing:

Pan-seared salmon is a great match for a crunchy broccoli slaw dressed with soy sauce, sesame oil, and rice vinegar. A bottle of cold, crisp lager with an optional squeeze of lime is all that’s needed to round out the meal.

How to Poach Salmon on the Stovetop

Poaching is an elegant, easy cooking method that results in perfectly flaky, coral-colored salmon. This method uses white wine, but feel free to use water or fish stock in its place.

Yields:

2 servings

Ingredients:

  • 1 large salmon fillet (¾–1 lb)
  • Kosher salt
  • 1 cup dry pinot gris
  • Small handful of fresh dill, stems included
  • 1–2 sprigs Italian parsley, stems included
  • 2 scallions, white and pale green parts only
  • 2 thin slices of lemon
  • Freshly cracked pepper

Special equipment:

Method:

  1. Lightly season the salmon fillet with kosher salt. The skin can be left on or removed (many fish counters will do this free of charge).
  2. Add the wine, dill, parsley, scallions, and lemon slices to the sauté pan along with an extra teaspoon of salt.
  3. Set the salmon fillet on top of the aromatics and fill the rest of pan with cold water so that it just covers the salmon.
  4. Bring the poaching liquid to a rolling simmer over medium-high heat. Immediately turn down the heat to medium-low and place the lid over the salmon.
  5. Allow the salmon to gently simmer in the poaching liquid for 5 minutes. Check to make sure the salmon is opaque (give it another 30 to 45 seconds if not) and carefully remove with a fish spatula.

Perfect pairing:

Poached salmon can be served hot or at room temperature and tastes particularly delicious when served with steamed snap peas and asparagus. Poached salmon can also be served chilled as part of a green salad or cold grain dish. Enjoy the rest of that pinot gris used in the poaching liquid; its slight acidity is a fantastic match with oily fish.

How to Grill Salmon on a Plank

Morgan is a huge fan of grilling salmon using the plank method. In fact, it’s the only method she’ll use for grilling salmon. “If I had to name my absolute favorite way, it would be to grill salmon a la plancha* or on a cedar or alder plank. I never grill salmon directly on the grill grates because the delicate flesh inevitably sticks to the grill,” she says.

To get started with this method you’ll need a wooden plank (preferably cedar) that has been soaked in cold water for several hours.

Yields:

2–4 servings

Ingredients:

  • 1–2 large salmon fillets, ~1 lb each.
  • Olive oil
  • Kosher salt
  • Freshly cracked pepper

Special equipment:

  • Wooden grilling plank (like these cedar grilling planks from Grill Gourmet)
  • Grill (gas or charcoal)
  • Fish spatula/turner
  1. Soak the grilling plank for 2 to 4 hours in cold water.
  2. Heat the grill to medium heat and arrange the pre-soaked grilling plank directly on the grill rack.
  3. Brush the salmon with olive oil and season generously with salt and pepper.
  4. Carefully place the salmon on the grilling plank. Close the lid and cook the salmon for 12 to 15 minutes, depending on the size of the fillet.
  5. Remove the cooked salmon from the plank. It should separate easily from the skin. Serve while hot.

*A la plancha is a Spanish cooking technique seldom seen in North America. It involves cooking food on a flat-top metal grill that resembles a griddle.

Perfect pairing:

Classic barbecue sides like corn on the cob and grilled veggies are right at home next to salmon cooked via the plank method. A mellow lightly chilled pinot noir will complement the salmon’s buttery flavor.


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Learn How To Cook Salmon Like A Pro (Just In Time For Summer!)

Healthy Fit Care:

Cooking salmon is one of those things that sounds harder than it actually is. Is it different from cooking meat? Yes, completely. Will you find yourself making salmon multiple times a week once you’ve tried these methods? Absolutely! The cooking methods in this article are perfect for beginners because they require very little in terms of ingredients, equipment, and time. The first step? A visit to the fish counter!

The Fish Counter (the Beginning of a Beautiful Friendship)

Your local fish shop or fish counter at the grocery store will almost always have the freshest salmon. The salmon on display should smell fresh and faintly briny; an overly fishy smell indicates that it’s past its prime. Don’t be afraid to ask questions! Fishmongers are more than happy to give you cooking tips and prep suggestions, and they can help make your life easier by removing bones and skin (especially if you call ahead to place your order).

Farmed vs. Wild Salmon

As a general rule, it’s the safest bet to opt for wild salmon over farmed salmon. Farmed salmon has a mixed reputation. Critics say that salmon farms have been shown to have detrimental effects on both the fish themselves and the ocean at large.

Farmed salmon is more likely to carry diseases (and to potentially spread those diseases to wild salmon if they escape their pens). There are also environmental concerns about the chemicals that are used to treat farmed salmon.

That said, as farming methods have changed, some varieties are considered safer than others.

And not everyone has access to wild salmon, so buying farmed fish may be the only option in some areas.

A Quick Reminder of How Nutritious Salmon Really Is

An incredibly versatile protein, salmon is high in heart-healthy omega-3 fatty acids (which are thought to contribute to healthy brain and cardiovascular function). Salmon is also a good source of vitamin B12, selenium, and niacin.

Vitamin B12, found most commonly in animal-based proteins, is essential for blood cell and nerve health and the production of DNA. Selenium, a trace mineral, is crucial for healthy thyroid function. Niacin lowers cholesterol levels and cardiovascular risks.

Prepping Salmon for Cooking

The best practice when cooking salmon is to either cook from a fresh fillet that hasn’t been frozen or to cook directly from frozen form. Since salmon is so perishable, it can be risky to attempt defrosting before cooking. Use fish tweezers (such as these Kotobuki Japanese fish bone tweezers) to remove any pin bones left in the flesh.

Resist the urge to rinse fresh salmon under cold water, as this can potentially splash bacteria all over the fish—or even contaminate your sink or other items in your kitchen. Use a paper towel to pat the fish dry; the drier the surface of the salmon the better for searing over high heat. Once the salmon has been thoroughly dried, it’s time to get cooking!

Avoiding Overcooking Salmon

Overcooking is often the biggest fear people have when it comes to learning how to cook salmon. Although it’s true that salmon overcooks easily, the trick is to remove it from the heat just before you think it’s done. LaDonna Rose Gundersen, an Alaskan fisherwoman and author of My Tiny Alaskan Oven, Salmon, Desserts & Friends, and The Little Alaskan Salmon Cookbook, offers these words of advice for beginners: “Do not overcook salmon, and remember it continues to cook when you remove it from the heat. Better to undercook it slightly than to overcook it.”

Salmon is cooked when it reaches an internal temperature of 145° F. Aim to take it off the heat at 140° F and let the residual heat do the cooking in the last few minutes before you check the internal temperature again. Salmon that has been properly cooked will be opaque throughout and will flake easily with a fork.

Sides and Wine: What goes with salmon?

Diane Morgan is the author of the best-selling cookbook Salmon: Everything You Need to Know + 45 Recipes and a huge fan of this versatile fish. When it comes to pairing with wine, it’s all about what’s in season at any given moment.

Wine-wise, salmon and pinot noir are a lovely pairing, as is true for a Beaujolais. That said, an Austrian grüner veltliner is terrific if the fish will have a smoky flavor. When tomatoes are at their peak, I pan roast salmon and serve it with sautéed green beans, yellow pear tomatoes, and drizzle it with a homemade basil oil. That dish is grand with a French white Burgundy or Orvieto.

Salmon is so versatile that it can also take on Asian flavors, creamy sauces like an aioli, or Mexican accents as in grilled salmon tacos with a chipotle sauce.

Gundersen likes to pair salmon with classic comfort food. “This sounds crazy, and yet simple baked beans pair well with [pan-seared] salmon. …Or, a nice Caesar salad or asparagus roasted alongside the salmon.” Wine and beer that is slightly acidic can stand up to salmon’s assertive flavor, while buttery wines like chardonnay complement salmon’s milder flavors.

How to Cook Salmon

Pan Searing Salmon in a Skillet

Whether you pan sear salmon in a skillet exclusively or you finish the fillet in the oven, the secret to crispy skin remains the same: plenty of heat and patience.

Yields:

2 servings

Ingredients:

  • 2 center-cut fillets about 1” thick (use fillets with a uniform thickness for best results)
  • 2 Tbsp. grapeseed oil (or another neutral oil with a fairly high smoke point)
  • Kosher salt
  • Freshly cracked black pepper

Special equipment:

  • Paper towel
  • Sharp chef’s knife
  • Heavy skillet (either cast iron or stainless steel; it should be oven safe if you choose to finish the salmon in the oven)
  • Long-handled tongs
  • Fish spatula/turner (we love this OXO Good Grips Fish Turner)

Pan-sear method:

  1. Remove the salmon fillets from the fridge 15 minutes before cooking. Carefully pat all sides down with a paper towel—the drier the salmon the crispier the skin.
  2. Using a sharp chef’s knife, make four shallow cuts (aim for a depth of ¼”) diagonally across the salmon skin. Repeat in the opposite direction so that you end up with a crosshatch pattern. This extra step will allow the salmon to lie flat over high heat and on your plate (otherwise the skin has a tendency to curl under).
  3. Generously season the salmon fillets with kosher salt and freshly cracked pepper.
  4. Add the oil to the pan and heat over medium-heat high until the oil is just beginning to shimmer. Resist the temptation to add the salmon before the pan preheats!
  5. Using long-handled tongs, carefully add the salmon fillets skin-side down to the pan. Cook the salmon for 4 minutes undisturbed (again, resist the temptation to move the fillets around in the pan or flip them after only a moment or two).
  6. Carefully flip the salmon fillets over using a fish spatula and cook for another 3 minutes. The salmon should feel firm but not dried out. Remember, it’s always a good idea to remove the salmon from its heat source just before it’s done, as the residual heat will continue cooking the fish.
  7. Serve the salmon fillets with the skin on while still hot.

From skillet to oven method:

  1. Preheat the oven to 350° F.
  2. Follow steps 1 to 4 exactly as described above.
  3. Gently place the salmon fillets in the hot oil skin-side down and cook for 2 minutes. Carefully turn the fish skin-side up with a spatula and cook for 2 more minutes.
  4. Transfer the hot skillet to the preheated oven and cook the salmon for another 8 to 10 minutes or until the fish flakes easily and has turned opaque.

Perfect pairing:

Pan-seared salmon is a great match for a crunchy broccoli slaw dressed with soy sauce, sesame oil, and rice vinegar. A bottle of cold, crisp lager with an optional squeeze of lime is all that’s needed to round out the meal.

How to Poach Salmon on the Stovetop

Poaching is an elegant, easy cooking method that results in perfectly flaky, coral-colored salmon. This method uses white wine, but feel free to use water or fish stock in its place.

Yields:

2 servings

Ingredients:

  • 1 large salmon fillet (¾–1 lb)
  • Kosher salt
  • 1 cup dry pinot gris
  • Small handful of fresh dill, stems included
  • 1–2 sprigs Italian parsley, stems included
  • 2 scallions, white and pale green parts only
  • 2 thin slices of lemon
  • Freshly cracked pepper

Special equipment:

Method:

  1. Lightly season the salmon fillet with kosher salt. The skin can be left on or removed (many fish counters will do this free of charge).
  2. Add the wine, dill, parsley, scallions, and lemon slices to the sauté pan along with an extra teaspoon of salt.
  3. Set the salmon fillet on top of the aromatics and fill the rest of pan with cold water so that it just covers the salmon.
  4. Bring the poaching liquid to a rolling simmer over medium-high heat. Immediately turn down the heat to medium-low and place the lid over the salmon.
  5. Allow the salmon to gently simmer in the poaching liquid for 5 minutes. Check to make sure the salmon is opaque (give it another 30 to 45 seconds if not) and carefully remove with a fish spatula.

Perfect pairing:

Poached salmon can be served hot or at room temperature and tastes particularly delicious when served with steamed snap peas and asparagus. Poached salmon can also be served chilled as part of a green salad or cold grain dish. Enjoy the rest of that pinot gris used in the poaching liquid; its slight acidity is a fantastic match with oily fish.

How to Grill Salmon on a Plank

Morgan is a huge fan of grilling salmon using the plank method. In fact, it’s the only method she’ll use for grilling salmon. “If I had to name my absolute favorite way, it would be to grill salmon a la plancha* or on a cedar or alder plank. I never grill salmon directly on the grill grates because the delicate flesh inevitably sticks to the grill,” she says.

To get started with this method you’ll need a wooden plank (preferably cedar) that has been soaked in cold water for several hours.

Yields:

2–4 servings

Ingredients:

  • 1–2 large salmon fillets, ~1 lb each.
  • Olive oil
  • Kosher salt
  • Freshly cracked pepper

Special equipment:

  • Wooden grilling plank (like these cedar grilling planks from Grill Gourmet)
  • Grill (gas or charcoal)
  • Fish spatula/turner
  1. Soak the grilling plank for 2 to 4 hours in cold water.
  2. Heat the grill to medium heat and arrange the pre-soaked grilling plank directly on the grill rack.
  3. Brush the salmon with olive oil and season generously with salt and pepper.
  4. Carefully place the salmon on the grilling plank. Close the lid and cook the salmon for 12 to 15 minutes, depending on the size of the fillet.
  5. Remove the cooked salmon from the plank. It should separate easily from the skin. Serve while hot.

*A la plancha is a Spanish cooking technique seldom seen in North America. It involves cooking food on a flat-top metal grill that resembles a griddle.

Perfect pairing:

Classic barbecue sides like corn on the cob and grilled veggies are right at home next to salmon cooked via the plank method. A mellow lightly chilled pinot noir will complement the salmon’s buttery flavor.


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Saturday, June 16, 2018

How Boss Bs Fuel Their Workdays

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Healthy Fit Care:

Whether it’s athletic performance, mental stamina, or emotional well-being, there’s no denying the impact of food. It’s no wonder, then, that so many badass women prioritize meals that work for them, choosing foods that will bring them the energy, nutrition, and satisfaction to continue in their badass ways.

Of course, health doesn’t have to—and often should not—look like the menu from an elite detox retreat. Happiness, balance, and success almost always look less glamorous than they appear on Instagram. (Artful rose latte made from raw dairy, coconut nectar, bee pollen, and crushed rose petals, anyone?)

To paint a clearer picture of the diverse ways go-getter women are fueling their workdays, HealthyWay asked for a peek into the menus powering the daily grinds of a fitness trainer and model in Toronto, a mother and pastry chef in Little Rock, and an Olympic athlete and consultant in New York City.

[Editorial note: These interviews have been edited for length and clarity.]

Edith Werbel

Edith Werbel is a Toronto-based certified personal and group fitness trainer, model, entrepreneur, and “crazy cat lady” with a very informative fitness blog and a BootyFull training program that promises a more shapely backside in eight weeks.

How long have you worked as a fitness trainer and a model?

My first job out of university was an office job—and I hated it. I thought to myself “what’s the opposite of this s**t?” And that’s how I became a trainer! I’ve been a full-time trainer for about eight years now, and I’ve modeled for more than 15 years. I started as a fashion model in my teens and have since transitioned to more fitness modeling.

How would you describe what you do?

The pros: I practically get paid to stay fit, have fun, and hang out with cool clients all day. And what’s more, I feel I genuinely help people, and it’s incredibly rewarding.

The cons: The hours are long, the work unstable, and it’s very tiring in more than one way.

What are you most proud of accomplishing so far?

I think the one thing I’m most proud of is my BootyFull eight-week glute training program that I sell on my site. Glutes are my area of specialty, and I’ve helped shaped many a beautiful backside. I’m proud of this program I’ve put together that is both popular and effective and helps pull in some extra passive income.

What are three terms that pop in your mind when you think of your eating philosophy?

Intuitive, enjoyable, and healthy

Edith’s Daily Grind Menu

Breakfast

I start each morning with a coffee protein shake: coffee, coconut water, half a banana, and a scoop of vanilla protein powder. It’s a pretty light breakfast. I look forward to it every day and it keeps me fueled for a workout.

Lunch

Lunch is usually after my workout and usually consists of a salad with chicken.

Dinner

And dinner again is often a protein with some roasted vegetables. I eat healthy and moderately most of the time, without overly obsessing or restricting myself. Once a week, I have a properly dirty meal of something like a burger and fries.

Zara Abbasi

Zara Abbasi is a lawyer, pastry chef, entrepreneur, and mother of three living in Little Rock.

How long have you been a lawyer, pastry chef, mother (and any other amazing things you are up to)?

I graduated from law school in 2013 and have been a pastry chef for five years. I have not had any professional training in the culinary department so I feel like maybe the title of pastry chef may be too important for me.

I have been a mother for nine years now, and out of all the hats I wear, that is by far my favorite. I do all these “amazing” things for my kids so that they can believe in the positivity of this world and can see that someone who works hard can achieve anything.

How would you describe what you do?

I’m a Jane of all trades. I love working different positions and learning about the world through the different challenges placed before me. But if I had to describe who I am at heart, it’s an entrepreneur.

What are you most proud of accomplishing so far, and what do you hope to someday accomplish?

Professionally, I’m really proud of finishing law school and passing the bar. I had two of my kids while I was in school and there were days I felt I would never pull through. I love being on the other side of that feeling, seeing how all the hard work paid off.

Creatively, I’m so proud to have made a name for myself in our small city by throwing caution to the wind and following through with my creative visions. It’s been remarkable to see how supportive people can be when you put yourself out there.

Physically, I’m proud of taking care of myself. I used to put my health and well-being last like most women do. But this year, I’ve made it a priority to get enough sleep, drink plenty of water, exercise, and most importantly, say “no” and guard my mental energy.

What I hope to accomplish: I hope that the hard work I’ve put forth in my business venture really pays off and I’m able to create a sustainable line of products that makes the business successful.

What are three terms that pop in your mind when you think of your eating philosophy?

Balanced, fun, homemade

Zara’s Daily Grind Menu

Breakfast

I have a pretty erratic schedule. I have a small 10-month-old baby, so I tend to follow her lead on the day sometimes. Breakfast usually consists of a cup of chai, first and foremost. I feel it has the same effect on me as does a cup of coffee on most other people. I find that I cannot start my day without it.

When I have my first cup of chai, it’s usually when I’m making some breakfast for the baby and simultaneously checking emails and messages. When it is my turn to eat, I usually stick to pretty basic breakfast staples such as oatmeal, eggs, and a fruit. I change up the type of eggs based on my mood but find that I like a healthy combo of both protein and carbs.

Lunch

For lunch, I usually have more time to myself, because it usually coincides with the baby’s nap. This is where I really like to take care of myself. I usually make myself a salad of some sort. I’ve been known to stock my pantry and fridge with ingredients to make no less than seven varieties of salad at any given time. It makes lunch less boring, and [having] the staples on hand keeps me from noshing on things I probably shouldn’t. I follow up my lunch with plain Greek yogurt (FAGE is my absolute favorite) with a little brown sugar sprinkled on top.

Snack

I usually snack in between lunch and dinner and head to our dry pantry for those snacks. I find myself going to pretzels, cheddar popcorn, and roasted nuts around that time because I find I need something salty before I need anything sweet.

Dinner

For dinner, I like to plan pretty elaborate meals sometimes. Some nights we’ll have handmade pasta and meatballs, other nights we’ll have a full French three-course meal including coq au vin, roasted vegetables, and crème brûlée. And then on other nights, we will have something simple like chicken and dumplings or a pot of chili. We like to keep dinner interactive with the kids and keep it rotating so we don’t fall into meal ruts.

Nzingha Prescod

Nzingha Prescod is a foil fencer—a 2012 and 2016 U.S. Olympian, a 2015 Senior World Championships bronze medalist, and four-time world champion—and a consultant for a Big Four accounting firm in New York City.

How long have you been a professional athlete?

I have been on the senior national team for nine years—through high school, college, and right now as I balance my athlete life with a career in business. I’m a consultant at EY [formerly Ernst & Young], so my schedule is a bit packed. As the games approach, I’m looking to dedicate more time to fencing and everything that comes with it (speaking engagements, photo shoots, clinics, etc.).

How would you describe what you do?

Consulting is really mastering learning on the job. I am aligned to the data analytics practice so I’m primarily assigned to projects where my team helps the business structure their data and report/present it in the most intelligible way. Every client has different data and systems, so each engagement requires different skills!

What are you most proud of accomplishing so far and what do you hope to someday accomplish?

I’m most proud at any moment I overcome self-doubt, especially in uncomfortable situations, i.e., competitions! Every time me or my team has medaled at world championships, I’ve been able to affirm to myself for the entire day that I am capable. I hope to continue sharing what I’ve learned through sport and opening doors for children to have similar opportunities and experiences as I did.

What are three terms that pop in your mind when you think of your eating philosophy?

Balance, moderation, and experimenting!

Nzingha’s Daily Grind Menu

Breakfast

If I have time to eat a bowl of cereal I’ll have Alpen and Honey Bunches of Oats with skim milk. I always add in a couple of walnuts and coconut flakes so my bites are more exciting. I really look forward to it most days when I wake up. If I am heading in to the office, I’ll get a bowl of oatmeal with peanut butter, granola, blueberries, brown sugar, raisins, and coconuts flakes in the cafeteria. If I’m looking for something more savory, I’ll have bacon, egg whites, and pepper jack cheese on multigrain bread.

If I have an early workout and need some sustenance quickly, I’ll have Belvita breakfast cookies with Greek yogurt. Whatever I’m having, I make sure it’s balanced between protein and carbs. I switch my carb intake for breakfast depending on my activity for the day. So I’ll have less cereal or only one slice of toast if I’m not as active that day.

Snack

If my meal was more than two or three hours before my workout, I’ll have a snack like apple or banana with peanut butter, seed crackers with hummus, or piece of banana bread. If my meals aren’t awkwardly spaced I may just have some fruit to snack on throughout the day. Post strenuous workouts, I’ll have a scoop of protein powder with skim milk to promote recovery and prevent soreness.

Lunch/Dinner

For lunch and dinner I try to have some form of vegetables in both meals. I aim for half a plate of veggies, quarter protein, quarter carbs. This isn’t always the case, but whenever a meal is heavier on one spectrum, I try to even it out later in the day!

Dessert

I have been eating a lot of Oreos (no cream) and milk!

Takeaways: Protein, Veggies, Enjoyment, Balance

As you can see, there are a handful of common threads running through the menus. All of these women prioritize protein and vegetables, they consume fruit in at least one of their meals, they talk about enjoying something that they eat every day, and they aim for balance, whether between macronutrients like carbohydrates and protein or nutrient-dense foods and “junk” foods. Most of them also mention hydration and regular exercise.

This is smart living. As we know, water is literally life, and the benefits of exercise are as infinite as the internet.

It’s smart nutrition, too. “Protein is essential for building and maintenance throughout the body,” registered dietitian Christeena Haynes (full disclosure: also my sister) tells HealthyWay. “Vegetables, fruits, and other complex carbohydrates are the body’s largest source of energy and provide fiber, vitamins, and minerals the body needs to keep things running smoothly. Fiber and protein also help you stay fuller longer, meaning you’re less likely to overeat and fill your body with empty calories.”

This balancing of proteins and carbs mentioned gives “your body what it needs to function well…so you’re not overeating carbs, which affect blood sugar levels more,” says Haynes. What’s more, some research suggests that the combo may be better suited to improving athletic performance and recovery than carbs alone.

The fulfillment these women seek in their noms is also good practice. “If you don’t enjoy what you’re eating, just from my own experience, you’re probably not going to maintain what you’re doing,” says Haynes.

Beyond the intuitive component of eating bites you find exciting, it also makes physiological sense. In his book The Gospel of Food: Everything You Think You Know About Food Is Wrong, sociologist Barry Glassner references a study from the 1970s that suggests we might actually absorb more nutrients from foods that please us.

“In one of my favorite studies, Swedish and Thai women were fed a Thai dish that the Swedes found overly spicy,” Glassner wrote. “The Thai women, who liked the dish, absorbed more iron from the meal. When the researchers reversed the experiment and served hamburger, potatoes, and beans, the Swedes, who like this food, absorbed more iron. Most telling was a third variation of the experiment, in which both the Swedes and the Thais were given food that was high in nutrients but consisted of a sticky, savorless paste. In this case, neither group absorbed much iron.”

We’d love to see a more recent reproduction of the above study, but until then, we’ll stand by one takeaway: Pursue pleasure in your diet.

It’s easy to let the prescriptiveness of “healthy eating” erase desire. Nutrition does not equal dull and flavorless meals. The way food looks and smells, its taste and texture in your mouth, how it makes you feel after you eat it, and the rituals surrounding mealtime—these are part of living, and they’re worth your attention.

Stay hungry, boss Bs.


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Rainbow Babies: Navigating Pregnancy After Loss

Healthy Fit Care: Rainbow Babies Navigating Pregnancy After Loss

When she was seven weeks pregnant, Uma (who’s asked that we use a pseudonym) started spotting. She was prescribed bed rest, but the spotting soon became real bleeding. It felt like she was having menstrual cramps, but she soon miscarried in the middle of the night, over the toilet. “I remember trying desperately to keep it in,” she says.

The first doctor she saw after the loss was “unspeakably cruel.” He refused to confirm that she’d miscarried, insisting she go to another facility although he clearly had the equipment to examine her. “It was winter, with lots of snow on the ground,” she says, “and I remember walking past heaps of it on the pavement and crying.”

When she returned two weeks later for a follow-up, she lost it on the tram going to work. “My colleague held me for a long time at the tram stop without asking me what had happened. And then I went to a shopping mall stairwell and cried for another couple of hours. It did make me realize one thing, though: I actually really wanted a baby.”

Two months later, she got pregnant with her son—her so-called rainbow baby—who is now 8.

For some, however, a subsequent pregnancy doesn’t come so quickly (or at all): Keely Mitchell lost a pregnancy at eight weeks and another two years later at between six and eight weeks.  “When I discovered I was pregnant, everything in my world stopped and shifted. Suddenly I was planning for a whole new future,” she says. “Once I learned I had miscarried, it was all over. In a moment, my future just went back to where it had been. It was a strange and complicated mental shift. I felt lost.”

Although she didn’t really grieve for the first loss, the second hit her hard. “We had been hoping to get pregnant again for two years, so I was excited and ready. I felt attached to this potential child, and I was devastated to lose them. The physical pain and visual proof of all the blood were so upsetting. And I knew I wanted to try again, but I was scared of losing another pregnancy. I just couldn’t fathom how much more of this grief I could take.”

Five months later, however, she got pregnant with a girl, who is now 3.

What’s a rainbow baby?

“Rainbow baby” is a relatively new term coined for a baby born soon after a pregnancy loss: either a miscarriage or stillbirth. The term comes from the nature of rainbows—that they appear after a scary, dark storm and bring renewal and beauty back to the world. Without erasing the tumult that has come before, they bring new life and light to the world.

Many women have found great comfort in the term—it feels truly miraculous.

Although pregnancy loss is all too common—10 to 25 percent of clinically recognized pregnancies result in a loss—not every mom loves the term “rainbow baby.”

“I associate rainbows with unicorns and light and fluffy things,” says Uma. “And what’s come before isn’t light and fluffy.” Mitchell agrees: “It feels too saccharine for me.”

What’s it like to be pregnant after a loss?

“During the second pregnancy, we were on tenterhooks,” says Uma. She had the same bleeding at eight weeks, but this time she went to a gynecologist who prescribed progesterone suppositories (progesterone supplements have been shown to decrease miscarriages).

Although this pregnancy did not end in loss, it was not without struggle. “I did feel the loss of innocence. When I got the Down syndrome test back, it was quite a high percentage, and the doctor said I could do an amnio, but we didn’t because of the chance of miscarriage.” (Her son was not born with Down syndrome.)

She also learned that you can hold two difficult truths at the same time: “That you lost something that would’ve turned into a person of endless possibilities and imaginings (for me, I think about if it was a girl). And that if that she had been allowed to develop fully, that your present child—with the real possibilities and imaginings—wouldn’t exist. Both hold equal weight.”

For her part, Mitchell says, I was not able to feel much emotionally about my third pregnancy until I had made it through the first trimester. I was reluctant to get attached or have any hopes or dreams about the future until I felt I was through that window of likely miscarriage. I really didn’t get excited or think of the fetus as my child until I had my 20-week anatomy scan and saw my beautiful daughter moving on the ultrasound screen. When I saw her spine, I suddenly saw her future.”

But you may not see that future until you are holding the baby in your arms, and that’s okay, too. “You may need to protect yourself emotionally,” says Mitchell. “If you can help it, don’t worry constantly about miscarriage again, though. I know that’s difficult, but it doesn’t really help. It can be tempting to read into things that are the same or different from the lost pregnancy—like you don’t feel morning sickness this time—but since every pregnancy can be so different, these things mean very little, and it is not terribly helpful for your state of mind.”

Many women feel like they don’t have a right to be sad about a loss at six or eight weeks, but it’s important to grieve the loss, no matter how early it came. “It’s also okay to still grieve the loss even as you have your new child in your arms,” says Mitchell. “It can be a very confusing feeling to feel grief and excitement simultaneously.”

She adds, however, that it’s okay to not grieve those past losses and just be excited about this new pregnancy. “If you are struggling with your feelings,” she says, “find someone you can talk to.”

How can I help a friend who is dealing with loss?

The most important thing you can do for a friend who is dealing with loss—and possibly a subsequent pregnancy or “rainbow baby”—is to follow her lead. She might want to talk and talk and talk. If so, let her. (Read: Do not advise or tell her how she should feel. Simply listen.) I felt much closer to women I’d known for ages but never known they’d had miscarriages,” says Uma. “When I opened up to them, they opened up to me.”

Or she may not want to talk at all. “A woman who is pregnant after a loss might not want to hear your excitement because she isn’t excited yet, and it makes her nervous about the pregnancy,” Mitchell says. She may not want to talk about the pregnancy at all. In fact, I had a friend who suffered a miscarriage and then a late-term loss whose subsequent pregnancy went completely unmentioned until she was almost 30 weeks along (and unmistakably pregnant).

On the other hand, a friend might need your vocal support and excitement. “Ask her, if you need to!” advises Mitchell. “If the pregnant person in your life has a partner, they might have completely different feelings about the past loss and current pregnancy. Ask them what they need, too.”

What do I do if I want to keep my pregnancy after loss a secret?

Many women save sharing news of a pregnancy until the end of the first trimester, when the risk of loss is lower. You may be someone who needs more support—telling your mother, sister, and friends as soon as you pee on a stick—but you may also want to keep the news between you and your partner for as long as you possibly can. That doesn’t mean you need to be alone in your worry and excitement. “An anonymous online pregnancy forum can be really helpful,” says Mitchell. “I found a lot of support in those groups, people I could talk to about how I was feeling or what I was worried about, or even just read their stories and not feel alone.”


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Why more men are delaying prostate cancer treatment

Healthy Fit Care:

When Ben Pfeiffer was diagnosed with prostate cancer in April, his urologist noted in the biopsy report that he was leaning toward recommending that Pfeiffer have his prostate surgically removed.

But Pfeiffer, 58, a married construction supervisor from Las Vegas with two grown daughters, said his wife insisted that he get a second opinion.

It’s a good thing she did.

The doctors Pfeiffer subsequently visited at the University of California Los Angeles (UCLA) and the University of California San Francisco (UCSF) did not believe surgery was needed.

Pfeiffer said the results of the tests, which included genomic testing, showed he had a nonaggressive cancer that made him a good candidate for something called active surveillance, also known as “watchful waiting.”

In other words: No need for surgery or radiation at this time. And perhaps never.

This may sound counterintuitive if you haven’t kept up with the latest advances in prostate cancer research.

Less than a decade ago, the standard response from a doctor when a man was given a prostate cancer diagnosis was to schedule a surgery to have the organ removed.

When some members of Pfeiffer’s family heard the news of his cancer, they asked him when he was going to get the prostate removed.

“I told them I was considering not doing the surgery, and they said, ‘What? You need to get this out, you need to get rid of it,’” Pfeiffer told Healthline. “But that is the old way of thinking. Cancer scares people, but they don’t understand active surveillance. A lot of people don’t.”

Watching and waiting

Doctors examine the results of a prostate cancer biopsy using something called a Gleason Score.

Generally speaking, cancers with lower Gleason scores (2 – 4) tend to be less aggressive, while cancers with higher Gleason scores (7 – 10) tend to be more aggressive, according to the Prostate Cancer Foundation (PCF).

Pfeiffer, who had a Gleason Grade 6, said the doctors he saw after the visit to his initial doctor suggested he keep a close eye on his cancer with regular follow-up checkups with no treatment unless and until it is deemed necessary.

“There are times for some prostate cancer patients when watchful waiting is by far the best option,” Pfeiffer said.

Study of veterans

Pfeiffer is not alone.

Watchful waiting is an increasingly common option for prostate cancer patients.

nationwide study published last month in the Journal of the American Medical Association (JAMA) revealed that the idea of watchful waiting is now particularly popular by America’s veterans.

In the study, researchers at the New York University School of Medicine and the Manhattan campus of the Department of Veterans Affairs New York Harbor Healthcare System looked at 125,000 veterans diagnosed with nonaggressive prostate cancer between 2005 and 2015.

The researchers discovered that in 2005, only 27 percent of men under 65 opted for watchful waiting to keep track of their tumors.

By 2015, the situation had reversed, with 72 percent choosing to monitor but not treat.

The study was aided by a look at new genetic testing that enables doctors to give patients a far more specific diagnosis for their cancer.

Researchers concluded that low-risk prostate cancer has a favorable prognosis without treatment.

Current guidelines recommend watchful waiting as the preferred approach for low-risk patients.

However, studies show that this approach, while embraced by the VA, is underutilized in the United States compared with other countries.

“About 20 to 40 percent of newly diagnosed prostate cancer patients should consider watchful waiting and holding off on any treatment,” Jonathan Simons, president and chief executive officer of the Prostate Cancer Foundation, which helped fund the study, told Healthline.

Simons, an oncologist and leader in prostate cancer research, said that when it comes to prostate cancer, the outcomes for patients are better in VA hospitals than in the rest of American medicine.

Simons said watchful waiting is neither irresponsible nor dangerous, as long as patients communicate closely with their doctors and receive regular check-ups.

Trying to spread the word

For study coordinator Stacy Loeb, this research hits home.

“My grandfather was a veteran who died from prostate cancer,” said Loeb, an assistant professor in the urology and population health departments at NYU School of Medicine and an attending urologist at VA New York Harbor Healthcare System.

“I’m passionate about veterans and prostate cancer care in the veteran population,” Loeb told Healthline.

She, along with Simons, is exploring ways to improve public awareness of the viability of watchful waiting for some prostate cancer patients.

“We’re trying to improve prostate cancer care by sending out educational materials, working with the PCF, and just describing to the public what watchful waiting is,” said Loeb.

She noted that at private clinics in the United States, as many as two-thirds of prostate cancer patients at low risk are still unnecessarily undergoing early aggressive treatment.

The National Cancer Institute estimates that 29,000 American men will die from prostate cancer in 2018, with 164,000 new cases diagnosed.

And most of these cancer diagnoses are in the earliest stages.

At the VA, however, the numbers of patients with nonaggressive prostate cancer who opt for watchful waiting “compare favorably” with patients outside the VA.

“The VA is leading in terms of providing good prostate cancer care,” said Loeb.

Leading the charge

Prostate cancer is the number one cancer for men who seek healthcare at the VA.

The person who spearheaded the drive to improve care at VA for prostate cancer patients is former VA Secretary David Shulkin.

“Our objective at VA was to build the most contemporary and advanced approach to prostate cancer,” said Shulkin, a medical doctor who was a hospital administrator before President Obama appointed him to the VA.

“This incorporates a personalized approach that begins with a full assessment of the veteran, including genomic testing,” Shulkin explained.

“For some veterans, this will mean targeted chemotherapies and advanced cellular therapies, for some it will mean surgery or radiation, and for others it may mean watchful waiting and avoiding unnecessary comorbidities associated with therapies,” Shulkin told Healthline.

Shulkin said he “jump-started” the precision oncology program at the VA.

“It was a major focus I had. The program was run by Dr. Michael Kelly out of our Durham VA,” said Shulkin, who also advanced the VA partnership with the Prostate Cancer Foundation.

“This led to a $50 million collaboration on precision oncology for prostate cancer,” he said. “Second, we brought in IBM Watson to help with the genomic analyses. And third, we began a cancer survivorship genomic analysis program with Sanford Health.”

Finally, he said, “We prioritized our Million Veteran Program to boost data collection, partnerships with industry and other federal agencies like the NIH and DOE, and we accelerated research projects using this unique data source.”

VA could help find cures

Simons said the VA public-private partnerships could lead to major medical breakthroughs.

“I don’t think most American fully understand that VA is a potential resource for cures,” he said. “This study involved more than 125,000 men with prostate cancer. It is the largest study of its kind.”

Simons said he is focused on getting his research to men and women who have served their country, and becoming a model for how precision oncology should be practiced.

“We’re working hard to have another launchpad meeting to bring nonprofits in to discuss what we can do for veterans with cancer,” he said. “This is all about President Lincoln’s idea of caring for those who ‘shall have borne the battle.’”

Not just for prostate cancer

Is watchful waiting a legitimate and responsible strategy for patients with other cancers besides prostate cancer?

Yes, Simons said, although he cautions more research is needed.

Simons said follicular non-Hodgkin’s lymphoma, specifically, as well as some types of early-stage breast cancer and an uncommon form of bladder cancer are just a few of the cancer types that can potentially benefit from the active surveillance approach.

There is also a growing interest for a type of uterine cancer that might not need treatment.

“This area of active surveillance and management is a new form of oncology,” said Simons.

He noted this has a lot to do with the progress made in recent years in the genome and the testing of an individual person’s genetics.

“For now, we see no active surveillance for colon or pancreatic cancer or glioblastoma, but we know that follicular lymphoma, a low-growing, low-grade cancer, does overlap with nonaggressive prostate cancer,” Simons said.

Singer’s widow spreading awareness

Acclaimed singer-songwriter-musician Dan Fogelberg (“Leader of the Band,” Part of the Plan,” “Same Old Lang Syne”) died of advanced prostate cancer in 2007.

According to his widow, Jean Fogelberg, a musician, artist, and now passionate advocate for prostate cancer patients and their families, her husband got “mild symptoms” and went to a clinic and was tested by an on-call doctor he didn’t know.

“We were never notified of the results of those tests, so we just assumed he was OK, and we went on with our lives,” Fogelberg told Healthline in an exclusive interview about her husband’s cancer.

Two years later, she said, when her husband went to his regular doctor for a checkup, he learned that his prostate cancer had dramatically advanced.

“By the time he went in for the physical for the PSA, it was 151, then within a week it was 364,” Fogelberg said.

Since her husband’s death, Fogelberg has dedicated much of her life to supporting prostate cancer patients as well as cancer caregivers.

“I try to do it with grace, I try not to make any missteps,” she said.

Fogelberg hopes more prostate cancer patients will consider active surveillance rather than surgery if it isn’t necessary.

“I encourage people to get second opinions and learn about all their options,” she said.

Fogelberg also wants people to know how courageously her husband fought his prostate cancer.

“He was so brave, he put up such a graceful fight,” she said. “He made me feel like the smartest, funniest, prettiest person on the planet. Whatever I did, he was there for me with advice and support.”

But it’s still not easy to talk about her husband, she admitted, because it is a reminder of what could have been had they heard from the on-call physician and if he had survived long enough to see some of the latest research reach the clinic.

“There are new treatments now, so much progress has been made, and that is great,” she said. “But talking about this is of course bittersweet.”

This article first appeared on HealthLine.com.


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