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Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: dignacassens@...

Date: Thu, 1 Sep 2011 19:24:57 -0700

Subject: RE: coumadin

Because I LOVE cilantro, and it’s “the” Mexican flavor. I didn’t include

the spices I use, such as the hot peppers of which I use a variety for different

flavors as well as spiciness that reaches deep into your flavor and sensitivity

spectrum.

From: rd-usa [mailto:rd-usa ] On Behalf Of

Schoneweis

Sent: Thursday, September 01, 2011 6:55 PM

To: rd-usa

Subject: RE: coumadin

How much cilantro?? :) Why ruin it with cilantro anyway? :)

susan

> From: Judith Holle <jholle@... <mailto:jholle%40swcp.com> >

> Subject: RE: coumadin

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> Date: Thursday, September 1, 2011, 10:53 PM

> My thoughts exactly re

> guacamole!!!! 40 X no way …. even if they packed a

> home measuring cup solid instead of

> using metric weight. Not happening

> Everyone makes guacamole differently I use Hass avocados,

> garlic, onion,

> lime juice, green chile or the juice from the frozen

> roasted green or

> reconstituted dried red chile or charred

> jalapeno , cilantro , a tiny

> tiny dash of soy sauce ( not Mexican I know) and

> maybe chopped fresh

> tomatoes No mayo here though. I am sure some

> will chime in with their

> recipe But I cannot fathom what anyone would

> add that would turn this into

> a high K(40X) guacamole or what lead the Coumadin Cookbook

> to state that .I

> even went back to PT.INR.com to reread

> statement.

>

>

>

> How much mayo do you put in Dave? 1Tbs (14g) only has 5.9

> mcg I cannot

> imagine anyone using so much mayo that you end up with a

> high K guacamole

> colored green mayo Ball parking it. If 28 g ( 1

> oz) of avocado has 6.0 and

> 28g(2Tbs) mayo has 11.8, we are not looking at an end

> product of 40X Even if

> you wander around the mayo types I do not see it

> Commercial products

> always a mystery But cannot see that in a cookbook

>

>

>

> Jacqui You have the cookbook. What’s the word from

> the printed page? Is

> there a recipe?

>

>

>

> Again here too, it is the RD that has the applied

> knowledge to ask how do

> you prepare your food and then calculate and tailor .

>

> Soap box off

>

>

>

> Judy

>

>

>

>

>

>

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ]

> On Behalf Of

> Rowell,

> Sent: Thursday, September 01, 2011 11:22 AM

> To: 'rd-usa <mailto:%27rd-usa%40yahoogroups.com> '

> Subject: RE: coumadin

>

>

>

>

>

> Most guacamole is jut squished avocado with a little hot

> sauce and mayo in

> it. Can't possibly be " 40 times more K " than plain

> avocadoes!

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com> ] On Behalf

> Of Judith Holle

> Sent: Thursday, September 01, 2011 11:48 AM

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> Subject: RE: coumadin

>

> Hi Dave,

>

> Who could forget an icon ??

>

> My question would be how old is old The " keep greens

> consistent " sounds a

> bit more evolved than the avoid all greens, alcohol , herbs

> ,current

> lifestyle etc But the avoid avocados is a puzzle I do not

> think " back then "

> we knew of the impact of vit E or C on INR But here too

> avocado is not that

> rich in either one .( E .56 in 28.35 and C 2.5-4.9 in

> 28.35) I would think

> you would have to eat waaaay mucho avocados before danger

> danger danger My

> Food Medication Interaction Data base book is somewhere in

> a box .Is there

> a reference stated ? Intriguing

>

> PT.INR .com stated that in the Lancet (1991) avocados

> brought " possible "

> antagonistic affects in 1 pt. oooooh They had a a quote

> from Coumadin

> Cookbook (2003)that avocados are relatively high in K

> especially if skins

> are eaten( UGH) and that guacamole has as much as 40 times

> the amount of K

> as avocado I do not have the Cookbook (I honestly do not

> use cookbooks) But

> this sounds like a question of volume to volume density.

> How sad the

> Cookbook did not include experts such as RD, RD/chef, food

> scientist ,chef

> etc

>

> Science based evidence(6.0 milligrams K in 28.35 grams and

> minimal E and C )

> has yet to put the black hat on the yummy avocado

>

> To take a side trip, Medscape has a number of articles re

> the food med

> interaction in the new anticoagulants . Warfarin

> " replacements " for some But

> not those of us with artificial mitral valves. We need to

> become educated

> on this new class of meds

>

> Stay safe

>

> Judy

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>] On

> Behalf Of

> Rowell,

> Sent: Thursday, September 01, 2011 8:42 AM

> To: 'rd-usa <mailto:%27rd-usa%40yahoogroups.com>

> <mailto:%27rd-usa%40yahoogroups.com>

> <mailto:%27rd-usa%40yahoogroups.com>'

> Subject: RE: coumadin

>

> Thanks, Judith. Do you really remember me from my NM days?

> My main interest

> in this topic is why the old drug/nutrient book said " keep

> greens

> consistent " , but " avoid avocadoes " back then.

>

> W. Rowell, RD, LN, CLT

> Montana State Hospital

> Long Term Care Consultant

> InfoSites:

> www.elk-hunting-tips.net<http://www.elk-hunting-tips.net>

> www.benefits-of-massage-therapy.com<http://www.benefits-of-massage-therapy.c

> om>

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com> ] On

> Behalf

> Of Judith Holle

> Sent: Wednesday, August 31, 2011 3:08 PM

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> Subject: RE: coumadin

>

> Hi Dave,

>

> A voice from the shadows of your past in Albuquerque

>

> Simple answer >no need to avoid

>

> People on coumadin do not really really have to avoid

> anything...

> particularly

> food IF intake is consistent. Therein lies the key.

> Consistency But not of

> the food. Consistency in vit K intake As professionals we

> need to get past

> the old restricted do not eat/avoid mentality As a

> professional nutrition

> expert with an artificial valve since 1998 on a stable(same

> ol same ol )

> warfarin sodium dose and an boringly stable INR of between

> 3.0 -3.5, there

> is nothing I cannot eat (if I want the morsel). Key is

> moderation within

> overall Vit K consistency and awareness of Coumadin ½

> life.

>

> I love food... green leafy food, occasional grapefruit

> juice, occasional

> cranberry cocktail(who drinks straight cranberry juice

> anyway (eeeeooow)etc.

> With science-based knowledge and taking responsibility for

> my own health

> outcome I can continue my love affair quite well. I use

> www.ars.usda.gov/services/docs<http://www.ars.usda.gov/services/docs> for

> nutrient data base. I keep my K food

> at about 120mg +/-because I want some coverage for bone and

> cardio health

> But that is me .

>

> There is nothing more yummy that a spinach(144

> milligrams/30g), roasted

> green chile(3.4/26g), avocado(6.0 milligrams/28.35g and

> tomato(9.7/123 g)

> salad with a fine glass of wineJJ I do not however munch

> that the same day I

> eat fresh roasted Brussels sprouts with garlic.

>

> Warfarin Sodium or Coumadin is a fickle med As my MD says

> seek not justice

> from Coumadin That being said there are a lot more drug

> drug interactions

> than food drug interactions that can unsettle the INR. It

> does not play well

> with others

>

> A bit more of an answer than " no need to Dave " I still get

> a bit

> passionate about what we as RDs should know and do. We sooo

> need to educate

> clients more. Each client will have a different lifestyle

> and health

> profile. As professionals we need to provide our clients

> with the

> individually tailored tools to avoid that high level of

> non-compliance .

>

> Stepping off my soapbox

>

> I have now moved to Oregon where I have a selection of fine

> wine/craft

> beers and great food But I as you would suspect I am

> importing the NM

> green

> stay safe, Dave

>

> Judy Holle

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>] On

> Behalf Of

> Rowell,

> Sent: Wednesday, August 31, 2011 10:57 AM

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> <mailto:rd-usa%40yahoogroups.com>

> Subject: coumadin

>

> Should people on Coumadin avoid avocado? I see it on an

> older Food

> Medication Interactions book, but not on newer resources,

> although I do not

> have a newer FMI.

>

> W. Rowell, RD, LN, CLT

> Long Term Care Consulting

> Montana State Hospital

> Montana Developmental Center

> Certified LEAP Therapist

> Owner, InfoSites

> www.elk-hunting-tips.net<http://www.elk-hunting-tips.net>

> www.benefits-of-massage-therapy.com<http://www.benefits-of-massage-therapy.c

> om>

>

>

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