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Faculty & Staff

“Soy” What?

As a dietitian I am often asked questions about soy foods acting like estrogen in the body, are they safe? Do they contribute to causing breast cancer? I will admit over the years the information has been varied, but for the past several years researchers have found more and more information confirming that eating soy in moderation even as a breast cancer survivor is not a problem.

Since it is breast cancer awareness month I decided to do some additional research and explain for you in more detail.

First of all let’s think about where you might find soy in the diet, the following is a list of dietary sources:

·         edamame (raw soy beans),

·         soy milk, soy cheeses, soy yogurts

·         tofu (which is made from the bean curd)

·         tempeh (fermented soy)

·         miso (a Japanese flavoring made from fermented soybeans)

·         vegetarian foods like veggies burgers

The parts of the soy bean that are in question when it comes to breast cancer are the phytoestrogens (estrogen hormone-similar chemicals found in plants) known as isoflavones. There are two types of isoflavones in soy, genestein and daidzen. It is important to know that although these compounds can act like estrogen, they are only slightly as potent as the real stuff.

Large population studies of healthy women who reported details about their usual diet and were followed for many years, have shown no association between moderate soy intake and breast cancer rates.  Studies in Asian women have found a lower risk of breast cancer rates with higher soy consumption (4 or more servings per day), whereas studies in the U.S. have not found any association between how much soy a woman consumes and her risk of breast cancer.   Other things to consider are lifelong dietary and lifestyle patterns not noted in these studies.

What about soy intake for breast cancer surviviors? There are studies that show that small amounts of soy are safe and may be protective for surviors. However the best advice is to discuss the pros and cons with your health care provider until more conslusive data is available.

When it comes to taking supplements research is finding mixed results, basically the jury is out and the recommendation is to “avoid concentrated sources of soy such as soy-containing pills or powders, or supplements containing high amounts of isoflavones.” (American Cancer Society).

When making the decision to consume soy or not, remember that tofu and other soy foods have considerable health benefits and are linked to lower rates of heart disease. Because they are excellent sources of protein, soy foods may replace other less healthy foods in the diet and therefore help lower cholesterol. Also soy is an excellent good quality protein alternative for those who follow a vegetarian or vegan diet.

Bottom line: avoid pill and powdered soy supplements and enjoy soy foods in moderation.

Resources:

The American Institute of Cancer Research (www.aicr.org) and The American Cancer Society (www.cancer.org)

 

 

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Not Insignificant

We had just wrapped up at the Istanbul Archaeology Museum, drained from taking in all the incredible history exhibited in the museum’s three buildings. The consensus was to take the tram to a spot for lunch, then hop on it again to find a baklava shop we’d heard is amazing. The tram is one of several fantastic methods of public transportation used by what feels like everyone (at the same time) in the city of Istanbul. A seat on the bus, metro, or tram is a highly coveted spot that is not easily attained. In fact, sometimes just getting on any of these vehicles is a nearly impossible feat because they are so crowded. “Maximum Capacity” doesn’t seem to be a concept as firmly held here as it is in the U.S. As we approached the tram, desperately seeking nourishment after an exhausting outing of museum-going, we discovered hoards of other people on the platform who we would soon have to fight for a spot. The tram arrived and its doors opened, the poor passengers inside desperately trying to escape before being trampled by the masses boarding. Amidst this commotion, while trying to edge my way in without elbowing an elderly woman in the face, I felt a hand squeezing my butt. Suffering some sensory overload from the experience of getting on the tram, it took me a few seconds to realize this was happening, and to notice that the hand had not let go. When I did finally realize, I whipped around—no easy task when one has no more than a half-inch radius of personal space around her—and attempted to identify to whom the brazen hand belonged. My friend had witnessed this all go down, and pointed to a short, middle-aged man in a blue dress shirt and grey slacks who was holding a briefcase. He had turned to face the door, but looked over his shoulder a few times at me as I glared at him and shared some choice words I wish I knew how to say in Turkish. Our stop came soon after my futile attempt to give him a piece of my mind, and he was quickly lost in the crowd of passengers exiting.

The incident, his subsequent looks of complete indifference at me as I uselessly berated him, and the absence of a reaction from any of the passengers nearby who’d also watched it all happen brought me to the disturbing realization that what I had just experienced was, in a word, insignificant. I felt violated and uncomfortable in my own skin. The members of our group did their best to console me, through belatedly cursing the perpetrator or sharing their own stories of being publicly groped by strangers. I was overwhelmed with fury, but social etiquette urged me to stifle my anger and attempt to distract myself until I could be alone and reflect.

I never thought I would feel more like a compilation of body parts, assembled solely for the purpose of being assessed, criticized, and used by men, than at a Duke fraternity party—until I came to Turkey. I was warned, of course. Both of my parents effectively told me to put my feminist identity on hold during my time in Turkey, reminding me constantly that my views would not be received well in a country whose deputy prime minister told women they shouldn’t laugh out loud in public. They and many others warned me that life would be different as an American woman in Turkey—especially one who does not look Turkish in the slightest—and I would be expected to adapt. I’m okay with adapting. I want to be challenged. I enjoy exploring beyond my comfort zone. Being transformed against my will into a walking piece of meat for men to invade with their stares and debase with their words, among other things, does not fall into any of those categories. Nor does being expected to accept it as normal.

Throughout my first month and a half here, I have already met several incredibly intelligent, outspoken, headstrong Turkish women whose respective brilliances inspire me. Simultaneously, I have seen how the day-to-day culture of male entitlement, especially as expressed through street harassment, treats these women and all women as disposable objects. My experience on the tram was insignificant—to be expected, even. Because, from my western point of view, if you identify as a woman in Turkey, you automatically forfeit the basic human right of being treated as an equal to someone who identifies as a man.

The realization that the previous sentence requires no “in Turkey” to be true is an incredibly uncomfortable truth to accept. The idea of women as objects—to be owned, to be used, to be disposed of, to be replaced—is certainly not unique to this country. As I mentioned, the most objectified I’ve ever felt prior to coming to Turkey is when in attendance at a frat party at Duke. I have realized how easy it is to sit on the high horse of a westernized perspective and criticize other countries for the inequalities they are enforcing and perpetuating. It is far more unsettling to recognize the fact that, though it may manifest itself in different ways, gender inequality is as much a constant in our society as it is anywhere else. Being violated by a stranger on the tram was a blatant reminder that I am living in a man’s world, a world in which my womanhood renders my rights, my experiences, and my value insignificant.

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Student Health Closed Saturday 10/11

The Student Health Center will be closed on Saturday, 10/11, for Fall Break. We will re-open with normal operating hours on Monday, October 13th, at 8:30am.

For after hours health care options, please call us at 919-681-9355.

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Service Information for Alexander Rickabaugh and Kaila Brown

Student Affairs will be arranging transportation to the funeral and memorial services of Alexander Rickabaugh. We hope to accommodate all students who would like to attend these services via chartered bus.  In order to meet transportation demands please complete the following questions to reserve a spot:
https://duke.qualtrics.com/SE/?SID=SV_dhBDLU8uCZJY9KJ

We are working out options for food on the bus for the way out and back, but if you have specific dietary needs, please bring food with you.

Services will be held Friday, Saturday and Sunday. Details below.

Friday, September 26th:
The funeral service will be held at Centenary United Methodist Church in Winston-Salem (646 W. 5th St., Winston-Salem, NC 27101). The family will receive friends following the service.

The schedule will be as follows:

  • Bus staged at 4:00pm
  • Bus departure time from the West Campus Bus Stop at 4:45pm
  • Funeral at Centenary United Methodist Church in Winston-Salem at 7:00pm
  • Bus leaves from Winston-Salem at approximately 9:00pm
  • Bus returns after the funeral to the West Campus Bus Stop at approximately 10:30pm

Saturday, September 27th:
Memorial program at Forsyth Country Day School in Lewisville, NC
If you would like to attend this memorial program please note the following. Bus transportation will be provided for students interested in attending, leaving from the West Campus Bus Stop at 8:00am.

The schedule will be as follows:

  • Bus staged at 7:30am
  • Bus leaves at 8:00am
  • Memorial Service at Forsyth Country Day (5501 Shallowford Rd., Lewisville, NC 27023) 10:00am
  • Bus leaves from Forsyth Country Day at 11:30am
  • Bus arrives back on West Campus at approximately 1:30pm

Sunday, September 28:
Additionally, On Sunday morning at the start of the 11am worship service in Duke Chapel there will be a silent procession of roses for Alex and Kaila. This is a way of remembering them, honoring their lives and providing a space for community grief in the midst of Duke’s weekly Chapel service.

We have not yet heard anything more about memorial plans for Kaila Brown. I'll be sure to let you know if we do.

We will continue to do all we can to offer support and comfort to all. I urge each of you to take advantage of all opportunities for care should you or anyone you know be in distress. All students can contact Counseling and Psychological Services (CAPS) at 919-660-1000 and in an emergency, please call Duke Police at 919-684-2444 or by dialing 911.

You can also contact DukeReach (http://studentaffairs.duke.edu/dukereach1) at 919-681-2455 or at dukereach@duke.edu.

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Take Your Nutrition News with a Grain of Salt

In the past few days, news of a recent study praising the health benefits of a low-carb diet has spread like wildfire through headlines and across the Internet.  Good Morning America featured a segment entitled, “Low-Carb May Trump Low-Fat in Diet Wars” and urged listeners to “back away from the bagel” if they were watching their figures.  TIME magazine exclaimed, “If you’re trying to lose weight, fat might be your friend” and was joined in the lipid lauding frenzy by National Public Radio whose online article leads with “Turns out, eating foods with fat…doesn’t make us fat.”  The New York Times, where I and many other students I know turn for breaking news, issued “A Call for a Low-Carb Diet” and it quickly became the most emailed story on the day of its publication.  But before we as readers get too caught up by these attention-grabbing statements, it’s important to investigate what’s really lying beneath the headlines. 

 

To start, I’ll summarize my take-aways after reading the New York Times article on this breaking nutrition news.  The article presented the findings of a study published in the September 2014 volume of the Annals of Internal Medicine and funded by the National Institutes of Health – already, this is sounding highly credible with such big names on board.  The study looked at a “racially diverse group of 150 men and women” (yay for generalizability!) who were split into two groups that each received different dietary guidelines.  The low-fat group was instructed to limit their total fat intake to less than 30% of their daily calories as recommended by the federal government guidelines – seems reasonable.  The low-carb/high-fat group upped their fat intake to more than 40% of their daily calories and were told to eat mostly foods like fish, olive oil, nuts, cheese, and red meat.  Both were encouraged to eat veggies and neither group had to watch their calories nor change levels of physical activity.  At the end of a year, the low-carb group lost an average of eight pounds more than the low-fat group, had greater reductions in body fat and greater increases in lean muscle mass, and significantly lowered their heart attack risk.  Seems simple, sign me up!  I can lose weight, build muscle, and have a healthy heart just by eating my eggs and bacon, no exercise or calorie counting required. 

 

Now before you order up that next cheeseburger without its bun, it’s important to step back from the media and critically assess what the research is really telling us.  David L. Katz, a doctor and director of the Yale University Prevention Research Center, published an insightful response article to the low-carb craze headlines, bringing to light some crucial caveats of the study that nearly all news articles are glossing over.  First, not all fats or carbohydrates are created equal so it’s inaccurate and counterproductive to talk about diets in such umbrella terms like low-fat or low-carb.  Secondly, it needs to be known that all study participants had BMIs categorizing them as obese, making the results not nearly as generalizable as they have been portrayed.  Lastly, the true diet conditions for the low-carb and low-fat groups in the study have been very poorly communicated to the public.  Comparing the diet guidelines given in the study with the participants’ pre-study diets reveals that the low-fat group only reduced fat intake by 5%, while the low-carb group reduced carbohydrate intake by nearly 75%.  In light of this evidence, it makes sense that the much more restrictive diet would result in greater weight loss. 

 

To conclude, Katz leads us away from the trendy diet fads and recommends eating whole foods in sensible quantities.  He also recommends that we approach health headlines with a more careful eye to see past the sensationalism that can make a good story, but not the best lifestyle advice.  It’s important to be aware that not all of the facts surrounding a research study’s methods and findings make their way into the media’s presentations.  But, that doesn’t mean that we need to write off all health and wellness news as nonsense – if a headline does make your head turn, dig a little deeper, seek out more details from primary sources, and look at what other experts and critical voices in the field have to say.  With a little extra effort, you’ll find the news that’s really worth your attention.      

 

Note of Interest: A few days after this initial media firestorm, the New York Times re-published the article with a new headline, “A Call for a Low-Carb Diet that Embraces Fat.”   

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The Inevitable Adventures of the Day

Hey Dukies! I'm back in the Dirty D and it feels so good. As one of the few juniors who has remained in Durham for the Fall, I have to say that I'm pumped to be part of the elite few who elected for “Duke in Durham” this semester.

This past summer, I lived in rural Nepal for 3 months working for the United Nations. Though Duke was instrumental in giving me that experience, the experience itself was largely Duke-less. I woke up most mornings wondering how I, on my own, was going to navigate the inevitable adventures of the day. (Care for the details? I blogged there, too. Here's the link: http://thelifeperipatetic.tumblr.com) And though this past summer was one of the most rewarding of my life, I'm glad I'm back at Duke. Because I've realized, to tweak that familiar saying, that you can take the Duke student out of Duke, but you can't (by the time she's a rising junior) take Duke out of the student.

I'm still trying to figure out why. Maybe some people would argue that it's due to the trauma of successive mid-term seasons. But I have a few other ideas... Like the fact that more and more, you realize that the people you find yourself missing are the ones not from your home state, but from the Gothic Wonderland. It is because you get up at 1:45am Nepali time to watch the World Cup finals live, because you're craving some stadium spirit that rivals Duke's. It is getting off the plane into the US after months abroad, and realizing that you want your first meal to be the baked oatmeal from the Div Cafe. Nothing else will do.

Bottom line—my months away from Duke (and Duke's people) has helped me appreciate and admit my attachment to this place. This blog is one way to try and do that attachment justice. So, if you're interested for another year of my (attempted) witticisms, observations, and reflections, stay tuned!

Thanks for reading.

Elizabeth

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Student Health Closed on 9/1

The Student Health Center will be closed on Monday, 9/1, in observance of the Labor Day holiday.

We will re-open with normal operating hours on Tuesday, 9/2, at 8:30am.

For after-hours care and nurse advice, please call 919-681-9355.

 
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