Yuppies vs. Millenials: Health Policy Implications

In this post, the Population Health Blog distinguished between yuppies' desires and the millennials' expectations.

To further help its savvy health policy savant-readers distinguish between the two, the PHB is happy to provide examples in the table below:

Health Care Topic               Yuppies                     Millennials

Preferred Encounter:         Appointment              Text message

Appointment
Opener:               "Thank you for seeing me"  "Thank me for seeing me"

Preferred
Encounter Outcome:    Specialist referral          Complimentary latte

Likes:                                   Pills                              Pixels

Long Term
Health Goal:                      Live forever               Live well forever

Plans to Live
Well Involve....                  Testosterone                  iPhone

Opinion on
MD vs. RN
vs. NP vs. PA                    Very important               "What?"

Remote Care
Management                      Know more                   No brainer

HEALTHY AND FIT IS NOT ROCKET SCIENCE

When it comes to getting a healthy fit body, it is not about making it complicated, extreme, and it is far from a science project.  There are so many confusing messages hitting us square in the face about the “right” diet and the “right” fitness fad exercise program to create what we so long to become.  Even further, people rush in droves overspending on pills, powders, gimmicks, videos, extreme fitness programs, and anything that promises a smoking hot body in two weeks or less.  Sadder still, there is no consideration of the negative effects on the body when such choices are made.  It is the dive blind and hope for the best philosophy and that would scare the crap out of me.

Think about the word health and what that means to you personally. I live a life of health and fitness and teach it as a lifestyle of quality that includes eating healthy foods, exercise and stretch on a regular basis.  It is also important to reduce pain in our bodies, and stress in our lives overall.  Lastly, I touch on the areas of emotional and spiritual health and wrap health up in a balanced package of physical, nutritional, emotional and spiritual well-being. There is nothing blind about the correct approach to adopting a healthy lifestyle and achieving that smoking hot body.

We all have the potential to create our best healthy body, but fall short when we slip through the cracks of empty promises and seek out the quick fixes that are never guaranteed.  What is guaranteed and will provide the results of good health and fitness are our individual choices to live a healthy life each day. This process is not rocket science but getting back to the basics of simple living.  Eating healthy has become such a complicated subject of what to eat, when to eat, why to eat and the same is true with exercise as everyone preaches the “my way is the only way” agendas. 

Let’s consider how to make healthy simple and work for each of us.  I like to start by writing down healthy foods that I enjoy eating: lean chicken, fish, peaches, plums, raw nuts, fresh vegetables, yogurts, and chocolate for example. I do the same thing with my exercise programs: ARC trainer, HIIT programs, dancing, stretching, and weight training to name a few.  I keep my cooking simple and healthy using olive and coconut oils, lots of spices, and herbs.  I exercise for no more than an hour 4 to 5 times per week, and make it a goal to get plenty of rest.  There is nothing magic about what works for me and I create my healthy lifestyle around what I enjoy.  If the focus is on simple, healthy, and fun, the results of that lifestyle will be seen on the outside as well as the inside.

Adopting a physical healthy lifestyle is not extreme, is not meant to hurt our bodies but a gift of moving our bodies in a way to challenge and build a stronger self.  There has been some trial and error as I have walked through the types of exercises that work best for my body, that continue to challenge me, but eliminate or greatly reduce risk of injury.  I may try something and feel aggravation and not that good sore that occurs from a great workout, and that is my body’s way of telling me not to do that move.  I simply remove what does not work for me, and keep what does.  My workouts will not be your workouts, and I do not buy into that philosophy of there is only one right way. Life and health does not work like that and I say run from any fitness professional who preaches that agenda. 

The same goes with adopting a healthy eating routine.  There is never a “one-size-fit” all program, we all have different tastes, and I hope we are all steering clear of foods that upset our systems. Our bodies are wonderful machines that know exactly what to do with the food we consume, and honestly, we are all adults with common sense enough to know that if we continue to eat like crap, we will feel like crap, and our bodies will be wearing the consequences.  There are no pills, potions, or exercise programs that will take away the results of poor eating habits.  It is important to realize that although science is at work in our bodies every day, when it comes to adopting a healthy lifestyle, let’s leave the rocket science where it belongs and get real with keeping it simple.

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FIT AT 50!

Thanks for stopping by my Blog, hope you enjoy the content, and if you have not become a follower yet, I would love to see your face on my friend's list.  If you are inspired, LIKE my entry, leave a comment and I look forward to responding!

"Necessity is the Mother of Innovation": Here's the Four That Need It

Actually, the Population Health Blog wishes it had coined that adage.

While a quick internet search indicates that the quote is on a host of business websites, the PHB only just discovered it on this post on disruptive health care innovation.

While there's a lot of management jargon, the author makes a good point about health reform's four necessities.  Any health technology provider, clinical enterprise, population health vendor, pharma company, health insurer, research outfit or government entity that can solve just one will have our collective gratitude. 

1) Millions of new Medicaid enrollees who are struggling with the twin burdens of poor health status and socioeconomic challenges.  If there is a clinical-technology platform that can provide care for this population, now is the time for it to step forward.

2) An influx of healthy millennials who, instead of having "needs" (that was their grandparents' problem) or "desires" (that was their parents' problem), have expectations that they believe can be significantly met with their handhelds.

3) Tens of millions of chronically ill persons who need to have a higher value medical home model scaled up, while we find even better industrial-based approaches to get them to self-manage.  At home.

4) High deductibles: if we can get money out of a checking account in Idaho while visiting Istanbul, there's got to be a way to minimize the disparate impact of high out of pocket expenses with increased transparency, value-based purchasing, tax sheltered accounts and other cloud-based financial tools.

Can Physician Loyalty to Their Profession Be Superseded by Loyalty to their Employer?

Whenever the Population Health Blog heard the "value-not-volume" health policy operatives drone on about "provider alignment of incentives," it wondered.... really wondered.... if this Kool-Aid had completely convinced the ACO Adminosphere's inhabitants that their physicians' loyalty to their profession could be superseded by loyalty to their employer.

Sure, running a private-practice sucks and Obamacare's economics favor consolidation, but that's not necessarily enough to capture hearts and minds.  The PHB recently heard a local ACO executive explain that her long-employed physicians were still (yes, still) challenged with EHR implementation, teaming, shared savings, quality metrics, practice management, joint ventures and the role of patient educators. 

Other than that, Mrs. Lincoln, how was the ACO play?

And then there's a tweet from @VinceKuraitis on how a group of St. Louis cardiologists are "leaving" hospital employment and striking out on their own. Vince asks if this is a random blip or start of a trend.

Good question.

If this does turn out to be the start of a trend, don't be surprised. As someone very wise pointed out millennia ago, people do not live by bread alone.

Image from Wikipedia

Credble Numbers on Obamacare: And Why is the 16.3% Prevalence of Persons Without Health Insurance Good News?

The signed Affordable Care Act

We finally have some credible numbers on what's happened to insurance enrollment under Obamacare. The paper can be found here.

The authors used the ongoing Gallup-Healthways survey that questions representative samples of the U.S. population about their health insurance status. Since it began, this repeat survey has assessed changes in the coverage of adults 18 to 64 years of age. The authors used these data to assess the trends in insurance status that were associated with the roll-out of Obamacare between January 2012 to June 2014.

For all of 2012 and the first part of 2013, the nation's uninsured rate was 20% to 21%.  Following the star-crossed open enrollment period that began in the fall of 2013, the uninsured rate began to drop.  By April of 2014, it fell to 16.3%. 

Depending on the underlying statistical assumptions, the absolute percent increase in Americans with insurance ranged between 4.2% to 7.1%. States that took the Feds up on their offer to underwrite Medicaid expansion saw a absolute decline of 6%  of low-income Americans having no insurance.

The Population Health Blog predicted that the 2014 outcomes from Obamacare would have something for everyone.  For the news outlets (like this and this) with a reputation of being sympathetic to the Administration, positive spin abounded. In the meantime, more skeptical reporters tried to poke some holes in the data, saying the increase in insurance coverage was really thanks to gains in employment or was in reality a lousy deal thanks to narrow networks.

The PHB's take?

It's struck by the relatively modest decline in the percent of uninsured Americans. Considering the heavy price we've paid, that lingering 16.3% rate is a lot.

That price?  It includes not only the hit to our national fisc, but paralyzing partisan rancor, endless and unpredictable litigation and the precedents of White House 'pen and phone' fiat by regulation. The latter will almost certainly be used by a future Presidents on both sides of the aisle.

And so it goes.

Care Management: What a Bargain

They did it again!

Sound familiar?

Patients' intake into the program was initiated with a face-to face meeting with a nurse care manager.  After a physician-approved care plan was in place, the patients were telephoned and engaged in the protocol.  The patients could then use a voice-activated system or a website to report disease status.  Outbound nurse calls were prompted if the patients requested it, reported a problem, didn't have adequate disease control, if the medications were not being taken as prescribed or if there were side effects.  After 12 months, patients in the care management program, compared to a control group, had clinically and statistically significant improvements in the control of their condition .

To the Population Health Blog, this narrative has been repeated dozens of times involving numerous chronic health conditions.  In this latest example, Dr. Kroeknke and colleagues randomly allocated 250 patients with three months or more of chronic musculoskeletal pain to either a) state-of-the-art pain care or b) state-of-the-art pain care plus nurse led care management. 

Twelve months later (and after only one drop-out), patients in the first group rated their pain as having dropped from a baseline of 5.1 to 4.6 out of ten (zero is no pain, 10 is awful), while the second care management group rated their pain as having dropped from 5.3 to 3.6.  Total time spent by the care manager averaged 3-4 hours per patient.

While patients in the care management group were taking more medications, there was no difference between the two groups in narcotic use.  There was also no difference in health care utilization.

The PHB's take:

While the authors credited the care plans that triggered increases in medications that were tailored to patient preferences, the PHB wonders if a greater sense of control combined with the perceived support of a sympathetic listener also contributed to the greater improvement in pain.

Once again, there wasn't hard "savings" or a "return on investment."  However, the expense of only three to four hours of nurse care manager time to achieve a one-point improvement on a 0-10 scale of pain not only seems like a wise investment, it's a comparative bargain.

Help Fund High-Quality Research on Diet and Health

University of California, San Francisco researcher Dr. Ashley Mason has asked me to spread the word about a diet-health study she's preparing to conduct in collaboration with Dr. Lynda Frassetto.  Dr. Frassetto is a widely recognized expert on mineral metabolism and bone health, and also one of the few researchers who has managed to wrangle funding to study the health impacts of a Paleolithic-style diet.  Her findings have been quite provocative.  

Together with their collaborators, Drs. Mason and Frassetto are preparing another diet-health trial to study the impact of two different diets on polycystic ovary syndrome, or PCOS.  PCOS is a common hormonal disorder among reproductive-age women, and its signs and symptoms include ovarian cysts, excess hair growth, menstrual irregularity or absence, infertility, and obesity.  Its causes are unknown, but insulin resistance is a core characteristic of it and is thought to play an important role.  PCOS is thought to be influenced by diet and lifestyle. 

A research team including Drs. Frassetto and Mason, as well as Drs. Umesh Masharani, Heather Huddleston, and Michael Cohn will test a Paleolithic-style diet and an American Diabetes Asssociation diet to see if either or both improves insulin resistance and menstrual cycle regularity for women with PCOS.  Each diet will likely have beneficial effects, however it remains unknown which will be more effective at treating PCOS.

Currently, it's exceedingly difficult for researchers to land funding from the National Institutes of Health (NIH) to do nutrition-related research in the context of disease treatment or management, particularly if it involves a Paleo diet. Recognizing the important potential of fleshing out the relationship between diet and health, researchers are looking for other ways to fund their work.  This study will give them the early data they need to start large, truly definitive studies of the links between diet and insulin resistance, and you can help make it happen.

Please check out their crowdfunding website to learn more about the study, the researchers, and make tax-deductible donations to support their work. And, if you're attending the Ancestral Health Symposium, one of the "backer" rewards is having lunch with the researchers.

Click here to see their crowdfunding site! 


This post was prepared in part using content provided by Dr. Mason.

Favorite Salad Bowls and Food Travel Bag

One thing that makes healthy eating more pleasurable is the way the meal is plated and served.  Although I am guilty of eating a meal in my car when I have to, I much prefer to sit down to a pretty table (a simple placemat and fresh bunch of flowers) with some care taken in how the food is presented.  My girlfriend, Karen, turned me on to the best salad bowls ever and I'm hooked on them!  They are the Blanc Porcelain Bowls from  Sur La Table and they are so perfect because they are wide (9 inches) and shallow.  You can see all the beautiful components of your dish in this bowl and have lots of room to mix things up. A pasta or noodle dish is also perfect in this bowl, but I think it's too big to use as a cereal bowl. The bowls are expensive ($9.99 each) but so worth it.  You can microwave them and even cook up to 500 degrees in the oven, and of course, they are dishwasher safe.  A set of 4 made a nice "thank you" gift for my trainer after the bikini competition too.  

The other kitchen item I can't live without now is my insulated World Market Jane Lunch Bag.  It's insulated and I use it probably once a day if I have to take a meal with me on the go to eat later.  I can actually fit quite a bit in there- a tupperware meal for me, one for my son, an icepack, and a juice box! There are pockets on the sides that I use to put plastic silverware and napkins.  The bag is $12.99.

What kitchen item can you not live without?  Please share! 

New Insights on Big Data

Say hello to big data!

This week's The Economist discusses some of the implications of "big data."

Population Health Blog readers may recall the Facebook kerfuffle when it was revealed that the company had been "experimenting" on its users.  While this is another timely reminder that Facebook users are not customers but a product, what's far more interesting is how the company used its vast utilization data to monetize the changes of a hundredth of single percent in its users' behavior. 

These weenie changes can add up to additional ad revenue.  Ditto for the techy Google's search, Amazon's placements and Facebook's ads which, according to Schumpeter, are getting a return on investment from "every pixel" of the monitor screen you're using to read this blog.

Unfortunately, says The Economist, this big data approach has been more difficult for the for the traditional "bricks and mortar" businesses, which have traditionally been fixated on traditional accounting measures.  But, as these businesses tether their infrastructure increasingly to information technology, they're getting there: UPS is monitoring 60,000 delivery vans, retailers are assessing how in-store placements generate the most revenue and businesses are measuring how the mix of different types of employees relates to productivity.

The PHB would rate most health care providers as being in the bricks and mortar category than in the technology space.  They have a way to go.

Two lessons:

1) Big data doesn't replace traditional business monitoring of revenue and expense, balance sheets, averages and standard deviations, it adds to it.  And yes, that ceaseless tinkering adds cost that - in the right hands - should have a return on investment.

2) The "tinkering" has its share of failures in addition to successes.  While The Economist can point to some wins, the landscape is probably littered with losses.

Speaking of the right hands and minimizing losses from big data, the PHB is proud to link this article appearing in the NACD Directorship Magazine.  While a password is necessary, the bottom line is that corporate boards can do ten things to help their companies successfully achieve a big data return on investment:

1. Provide analytic leeway;

2. Be clear on who is responsible;

3. Set realistic budgets;

4. Assess how big data is fitting into the pre-existing culture;

5. Be skeptical;

6. Link it to Enterprise Risk Management;

7. Task the Audit Committee with some oversight;

8. Assure privacy;

9. Reduce inappropriate incentives;

10. Get a big data expert on the Board.

Image from Wikipedia

MAD AT MENOPAUSE

Just thinking about the title is bringing on a hot flash.  I am mad at menopause and although I am excited about being in the 50 club, I am not enjoying the hormonal changes that my body is experiencing right now.    I will be talking very candidly about my experience with hormone changes and my body in this blog, and this is not meant to offend anyone, but this is a subject that many are afraid to discuss out of embarrassment, fear, and the belief that these things are to be the “kept secret” of women.  I say bullshit to that.  Health involves discussing all things as it relates to the human body and aging, and I for one am all about sharing, learning, and getting feedback from others on the subject.

LIFE SAVER

I have been frantically researching hormone imbalance for a few years now, have tried supplementation, herbals, transdermal creams, and natural moisturizers at an attempt to restore balance in my body.  I am very aware of the foods that help with hormone balance and eat my share of raw pumpkin seeds and watermelon.  Being a trainer and walking the talk of my profession and passion, I exercise consistently which is another way to help with the stresses of hormone imbalance.  Some women may sail right through without a hitch in the get along, but not this girl, and through my research I have discovered I am not alone in a big way with those that are suffering. 

I began experiencing night sweats years ago, which I easily managed with a transdermal OTC progesterone cream, and that seemed to be the biggest drag of my premenopausal time.  However and for a few years now, my periods began to dictate when they would come, or not, and if I would need super plus everything or not.  I do not know from one month to the next if I am in full menopause.   According to my doctor, I am required to not have a cycle for one full year.  Also, I enjoy my gynecologist and have to say she is easy to talk to, and I respect her opinion and am able to share my desire to go through this process as natural as possible.  The thing about most western medicine doctors is non-support of bio-identical hormones, and they are generally not covered by insurance.  So be prepared for such roadblocks, but also do not be afraid to be yourself and cover every concern with your doctor.

Menopause has been a thief of my womanhood, has plagued me with sleepless nights, is cooking me from the inside out, caused frequent UTIs, and the worst part … a broken “ya-ya”.  This may sound funny, but I am at the point of frustration and working very hard at making the best decisions for me and my body.  I am sure that many can relate to what I am sharing and I am hoping for lots of comments so that we can all support and share what has worked or not worked.  This can no longer be a hide behind the door subject, but as women, it is important to be brave, embrace who we are, what we are going through, and create a voice for answers.  I will get off my soap box now and dive right into my journey of being mad at menopause.

The dreaded hot flash comes at all hours of the day and night, and for some reason, I am bothered most at night.  It is so frustrating to not get a full night sleep and that alone can really put me on edge.  I have discovered that I am best under a light sheet with one leg covered and one leg exposed.  I also sleep with the ceiling fan going which seems to help.  Lord help me if I have a glass of wine in the evening as that will trigger a hot flash before I finish the glass and will definitely haunt me during sleep time, so the key is to stay away from the triggers. What has helped, and with my doctor’s recommendation, with many of my symptoms is Maca Root powder, an herbal that I mix in my green shake each day.  Before taking the product, I put in the necessary research of pros and cons, and decided to give it a go.  What I am sharing has worked and not worked for me, and it is important for each of us to be our own health care advocates and not jump into the “try this” without putting in the research time.  Do not take my word as gospel, as my body is different than yours, and what I share is helpful and informative, and hopefully a motivation to start your own journey of research.  

Moving on to other mad at menopause symptoms: decreased sexual sensitivity, increased bladder discomfort and UTIs, and the dreaded “dry vagina” or what I like to call the broken ya-ya.  Talk about the worst of the worst and are you kidding me??  This has got to be the most unfair situation ever as sex is a very important part of a healthy marital relationship, and we as women need to feel confident about our bodies, our abilities, and not feel guarded about the act because our minds get so focused on things like:   “will I orgasm, am I too dry, will it hurt too much, it is too much trouble … and the list can go on and on”.  Personally, I refuse to be a woman on the edge with the inability to get over the fence and I am referring to orgasm here.  I enjoy this part of my life in a very positive way so research focused in this area has been very thorough.  I have discovered a new vaginal suppository with a coconut oil and vitamin E makeup that works better than most of the OTC products out there.  I use ½ a suppository daily and that keeps me naturally moisturized for the day and into the evening.  My goal is to prevent vaginal atrophy and yes this is what occurs during menopause and in laymen terms, we women start drying up like a prune with a sandpaper interior that clearly states “do not enter or else”.  I refuse to allow any such nonsense to happen, and am fighting for my sexual right as a woman and wife.

Decreased sensitivity during sex can also occur as the body no longer carries the blood supply to the vaginal tissue and clitoris.  Research sent me to L-arginine supplementation which is an amino acid naturally occurring in our body, and studies have shown help with blood supply and flow to the sex organs.  Well, this turned out to be a huge waist of my time, and contributed to cold sores which I can be prone and my research lead me to discover that although it may assist with increased blood supply, L-arginine use also stimulates the virus causing cold sores and so that really ticked me off.  I tossed that out and refused to walk around with a mouth full of hurt in order to supply my other lips. Thank goodness I also keep a supply of Lysine, an immunity boosting amino acid which works to prevent cold sores and I increased the dose to counter act the negative side effects of the L-arginine.  L-arginine will not be a part of my program. 

Another unfortunate menopause related problem that occurs with me has been severe bouts of UTI (urinary tract infection) type symptoms that will wake me in the middle of the night, send me to the floor, and in a fetal position.  I have a low-dose antibiotic on standby when these events occur, OTC Cystex, and cranberry supplements.  I found that a heating pad also helps along with OTC pain reliever like Aleve.  Also, I begin a protocol of increased water and additional 100% cranberry juice to flush out my system.  I am very in tune to my body and can feel when this starts coming on so many of the times I do catch it early and am able to not lose too much time or days off work.  The night may suck getting the symptoms calmed down, but once manageable, I can function pretty well at work and in general. 

I have also looked into HRT (hormone replacement therapy), and currently researching bio-identicals which is still HRT, but with hormone closely related to our own body production.  I have decided I will not take any systemic estrogen by mouth because I do not want the hormone to metabolize through my liver and into my bloodstream.  The incidence of cancer is greater with such therapy so this door is forever closed for me.  I am trying a vaginal insert pill of very low dose estrogen which is localized to the vaginal tissues and in an effort to plump up and restore natural vaginal lubrication and reduction of UTI issues.  I even had doubts and fears regarding cancer with the vaginal insert, but after discussion with natural doctors, and those doctors prescribing bio-identical hormone, their first course of treatment is this very thing: vaginal cream, pill, or ring.  My online research also reduced my fears, and I am willing to give it a go for a few months and am hoping for a positive outcome.  I will need to report back with my personal findings.  I do welcome feedback from women, or husbands whose wives are currently using vaginal insert low estrogen and how it has been helpful or not. 

I have had many discussions with women going through the same issues from menopause and that alone is a help that I am not alone.  It can feel like such a desperate and frustrating time not knowing the best course of action to take, and most important not to subject ourselves to cancer or other disease in the process of discovery.  It feels unfair that very little research and clinical studies into women’s dysfunction caused by menopause have not been completed so that we may have more options, and feel more confident in our decision making.  If anything, I hope my personal share on the subject has been helpful, and provides a comfort that you are not alone in your frustration.  Keep up the research and find what works best for you and your body.  We are all on this journey of life and the transitions along the way and all we can do is our best.  Take good care and Stay Healthy!

I dedicate this Blog to my fabulous husband who is always supportive and understanding.  Thanks Don for your patience, and always knowing the right words to say at just the right times.  I love you forever and a day!

Enjoy my new recipe index page where my recipes are now by category, have their own link, are printable, and comment receivable. 

Thanks for stopping by my Blog, hope you enjoy the content, and if you have not become a follower yet, I would love to see your face on my friend's list.  If you are inspired, LIKE my entry, leave a comment and I look forward to responding!

Stay Healthy!

Darla

Mustard Lemon Chicken with Thyme

If you've been following along this blog for long, y'all know how much chicken we eat around here. Last week, I shared how we typically grill up a bunch of chicken and then add it to our salads throughout the week.  I'm keeping chicken on my menu, but I wanted to find more interesting ways to prepare it.  I'm sure you know how boring chicken breasts can be if they're not salted, flavored with herbs and spices, or added to a salad with dressing.  Today, I'm sharing a recipe for Mustard Lemon Chicken with Fresh Thyme as a healthy alternative to salting the heck out of your chicken.  I've partnered with Sunkist Lemons on this post and if you want more info about sodium and reduced-sodium recipes, check out their website. 

I practically cut sodium out of my diet these last few months, and truthfully, I don't miss it.  I do use salt-free seasonings, but here, a little bit of lemon goes a long way toward brightening and adding flavor to this dish.  

And something about using lemons in the summer feels so fresh.  Aren't they pretty?!

This recipe couldn't be simpler.  You just make the mustard-lemon sauce for the chicken, then bake it in the oven.  This recipe would pair well with rice or pasta and fresh veggies. 

DIRECTIONS

Preheat the oven to 350 degrees.  Place the chicken breasts onto a baking sheet. Make the sauce below and spoon it on top of the chicken.  Add some cracked pepper on top and a few sprigs of thyme, along with lemon wedges.  Bake the chicken for about 35 minutes or until the internal temperature reaches 170 degrees.  Remove from the oven and let rest about 10 minutes. 

INGREDIENTS

Chicken (boneless, skinless breasts)- 6 

Lemon (2) - zest of 1 lemon and it's juice (1 more for in the baking dish and/or garnish)

Garlic - 4 cloves minced 

Dijon mustard - 2 tablespoons

Olive oil - 2 tablespoons 

Thyme - 1 tablespoon + more for garnish

Parsley - enough for garnish

Fresh cracked pepper - to taste

Thank you for supporting Honey We're Healthy by visiting my sponsors! 

Naturally Sweetened Super Crunchy Buckwheat and Cardamom Granola

Naturally Sweetened Super Crunchy Buckwheat and Cardamom Granola

¼ cup flax seeds

½ cup raw buckwheat groats (not Kasha)

1 cup rolled oats

1 tsp ground cardamom

1 cup quite tightly packed dates (17 small, fresh dates)

2 tbsp coconut oil

Preheat your oven to 150^oC/300^oF and line a medium-sized baking tray. 

You'll need a bigger bowl than this one ;)

Place all dry ingredients in a rather big bowl and stir well. Put the dates and coconut oil in a separate bowl and blend with a hand blender until the mixture is smooth. You might want to add 1-2 tbsp of water for the right consistency. Then pour the date paste over the grains and stir until everything’s well coated.

Spread the granola out on the baking tray and bake for about 30-35 minutes. Remove the tray from the oven to give it a quick stir every ten minutes or so, we don’t want the top or edges to burn! (Confession: Mine was slightly burnt but it actually gave it a pretty nice and toasty flavor. I did have to throw some away though so make sure to watch it while it's in the oven!)

Once the cooking time has elapsed, turn the oven off but leave the granola in there to dry out (unless it already feels crunchy enough). I like to make this at night and then take it out of the oven the morning after. Store in an airtight container and keep in the pantry.

Crunch away!

Tilda

Thai Steak Salad with Peanut Sauce

I'm so happy to share a recipe featuring steak!!!  And this is a really good cut of meat, specifically, beef tenderloin.  I haven't had one of those in ages and I didn't want to mess up the cooking, so my husband cooked that part of this Thai Steak Salad for me.  He got it just right too!

Because this meal is a salad, all you have to do is prepare the marinade, and then be patient while the meat marinates at least four hours, or up to overnight.  It's easy to throw the cold salad ingredients together, then I take a short-cut and top the salad with my store-bought peanut dressing!  

INGREDIENTS

(ingredient portions depend on how many people you are feeding and what you like in your salad).

Beef tenderloin or flank steak- 1 pound 

Romaine lettuce

Cabbage

Tomato

Red onion

Avocado 

Mango

Cashews (optional)

Sesame seeds (optional)

Basil and/or cilantro (optional)

*Bangkok Padang Peanut Sauce (or other peanut sauce) 

MARINADE 

Juice of 1 lime

Low sodium soy sauce- 3 tablespoons

Canola oil- 3 tablespoons

Brown sugar- 2 tablespoons

Minced garlic- 1 tablespoon

Red curry paste- 1 teaspoon

To make the marinate, combine the above ingredients into a large plastic ziploc bag. 

Pat the meat dry with paper towels and add to the bag with the marinade.  Marinate in the refrigerator for at least 4 hours or overnight.  I did 4 hours and it was great. 

To cook the steak, spray a grill pan with cooking spray and heat pan to medium-high heat.  Cook for about five minutes per side until medium rare, or longer for more doneness.  Let rest until room temperature and then slice thinly. 

Assemble the salads by adding the romaine, cabbage, onion, avocado, and mango.  You can also add fresh herbs and cashes if desired.  

I love this peanut sauce, but it's a little spicy, so I pour it into a bowl and thin it with a bit of water and add lime juice to it.  It you like some kick, it's great on it's own.  

This salad is so good!  Especially when you mix everything up and all the flavors meld together.  

I'm sure this will be in our dinner rotation again in the near future!