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Quiche with a Spaghetti Squash Crust!

>> Monday, April 14, 2014

In pie-style foods, it is often the butter-laden and carb-heavy crust that comes with most of the caloric burden, while the contents can often be quite healthy.  I love this solution to make quiche easier on the waistline - using spaghetti squash to make the crust!  

I've taken the original recipe and modified to lose the egg yolks and I've cut down on the milk a bit as well, as I like to use lots of veggies and the extra moisture requires a little less fluid in the recipe. You can also try a leaner cheese, though the kick of the swiss cheese really tastes great.


  • 1 lb Asparagus
  • ½  of a small yellow onion
  • 2 cloves of garlic
  • 1 teaspoon olive oil
  •   1 cup of egg whites
  • 3/4 cups skim milk
  • 1 cup swiss cheese
  • ½ teaspoons salt
  • ¼ teaspoons pepper
  • 3 cups cooked spaghetti squash (about 1 small squash)
(You can cook your spaghetti squash by preheating your oven to 400ºF, lining a baking sheet with foil or parchment paper, slicing the squash in half, placing it face down and putting it the oven for about 20 minutes. Or if you are in a pinch, you can cook it in the microwave - but take it from me, that's a whole lot messier!)


1.  Preheat oven to 400ºF.

2.  Cut off the woody ends of the asparagus. Chop the onion, mince the garlic, and cut the asparagus spears into 1-inch pieces. Heat the olive oil in a pan over medium heat, and saute onion and garlic for several minutes, until the onion is soft. Add the asparagus and continue to saute until the asparagus has turned bright green and is soft but not limp.

3.  Whisk together the egg whites, milk, cheese, salt, and pepper.

4.  Grease a pie pan. Press the cooked spaghetti squash to the sides and bottom of the pan, forming an even crust. Pour the egg mixture into the pan. Add the asparagus, onion, and garlic on top of the egg mixture; be sure it sinks in.

5.  Bake for 40 minutes until quiche is firm. Enjoy!

Makes 6 servings.  Per serving, approx:
  • Calories: 135
  • Fat: 6g
  • carbs: 9g
  • protein: 11g

Thanks to my brother in law's mom (and my dear friend) Bridgette for the heads' up on this awesome recipe!

Follow me on twitter: @drsuepedersen © 2014


Landmark Study Shows Physical Activity Decreases Heart Attack Risk

>> Monday, April 7, 2014

We have all heard before that physical activity is important for overall health.  Believe it or not, it is now for the first time that we have solid evidence to prove that being more active in daily life decreases the risk of cardiovascular events (eg heart attacks) in particular.

The study, recently published in Lancet, assessed pedometer data (recording # steps per day) in over 9,000 people with prediabetes from 40 countries around the world.  They examined how many steps per day each person took at the beginning of the study and again at 1 year, and then followed them up for an additional 6 years.  They found that:

  • people who were more active at baseline (start of the study) had a lower risk of cardiovascular events
  • people who became more active over the course of a year had a lower risk of cardiovascular events at 6 years
  • for every 2,000 steps/day increase in activity over a year (about one mile or 1.6 km), there was an 8% decrease in cardiovascular events!

Prior to this study, the studies suggesting that being more active decreases the risk of cardiovascular events have been based on less rigorous data and study design.  Also, previous studies have generally been based on self reported data (ie the person in the study gauges how active they are), whereas this study objectively measured number of steps per day with pedometers.  For these reasons, this study is considered a landmark trial in that it has shown us, very objectively and in a high quality study design, that being active really does decrease heart risk in a group of high risk individuals.

See if you can find ways to take more steps in your day!

Follow me on twitter: @drsuepedersen © 2014


The Low Down on Electronic Cigarettes

>> Monday, March 31, 2014

For many Canadians (and Canadian doctors), e-cigarettes are an enigma wrapped in a mystery.  Though they are not regulated or approved for sale in Canada, they seem to be finding their way across the border in increasing quantities.  The Canadian Medical Association Journal published a couple of great articles about them in a recent issue to teach Canadian doctors what e-cigarettes are all about.   Here are some key points:

1.  What are e-cigarettes?

They are canisters shaped like cigarettes, which release vapor containing flavoring agents, other chemicals, and sometimes nicotine.  They are intended to simulate smoking without exposure to as many chemicals as tobacco.

2.  Are e-cigarettes safer than smoking regular cigarettes?

Hard to say.  Some studies show that e-cigarettes contain some impurities and carcinogens; also, the ones that contain nicotine still promote the nicotine dependence that keeps people addicted to smoking.  Even worse, smoking e-cigarettes could induce an addiction in someone who was previously a nonsmoker.

3.  Are e-cigarettes useful to help someone stop smoking?

Again, hard to say, as they have not been well studied. One randomized controlled clinical trial was not able to show superiority compared to nicotine patches. Contrast this with several other medication and behavioral approaches to smoking cessation which have been proven effective in clinical trials (the list is available here).  Also, I would add to this discussion that stopping the physical behavior of smoking is an important component of stopping smoking as a habit - in other words, the action of e-smoking may be too close to actual smoking to actually help a person to break the behavior.

A concern in the US is that e-cigarette companies are free to tempt American youth with fruit flavored e-cigarettes and celebrity endorsements, effectively resurrecting marketing campaigns that the tobacco industry used to use.  Thus, there is a fear that the e-cigarette industry could lure young people (or anyone for that matter) into nicotine addiction and possibly subsequent tobacco use.

So, while e-cigarettes may seem like a good idea on the surface, they have a dark side: those that contain nicotine propagate the addiction and may not effectively help people quit smoking; and even worse, they may lure non smokers into the dangerous world of smoking addiction.

Follow me on twitter: @drsuepedersen © 2014


#1 Top Post Of All Time on DrSue.Ca - Never Trust A Skinny Chef

>> Friday, March 28, 2014

As much as everyone enjoys eating out, it can really be hazardous for someone trying to lose weight, as restaurant meals are a notorious source of hidden calories and huge portions. As such, research is being done to try to figure out how best to cut back on those calories, while preserving the experience and taste sensation of eating out.

Research presented by Dr. Barbara Rolls and colleagues at the recent Obesity Society meeting asked chefs how they thought the industry could best help out to shave calories in light of the obesity epidemic.

These chefs were more interested in creating new inventions for calorie-savvy customers, rather than changing their existing dishes: 67% thought that introducing a new reduced-calorie item would sell well, whereas only 44% felt reducing the calories in an existing item would be successful.

They were also divided on whether putting calorie information on the menu would hurt or help sales. Interestingly, a separate study from New York examined the effects of mandatory calorie labeling, which went into effect in fast food restaurants in their city in July 2008. It was found that although some people said they were purchasing fewer calories based on this information, there was actually no difference in the average number of calories people purchased before vs after the implementation.

In a previous survey study, chefs also admitted that they ladle up serving sizes that are two to four times the size of recommended servings!

Where does this leave us? Well, it is unlikely that restaurant food will ever be uniformly 'safe' to eat from a dieters' point of view, regardless of how many reduced calorie options show up at your favorite spot. The definition of 'reduced calorie' or 'reduced fat' remains somewhat nebulous, and remember that low fat dishes often replace the missing fat with sugar, which can bring the calorie count right back up to equal or exceed the high fat version! The best thing to do when eating out, is to bring the following principles with you:

  • Cut your portions in half. Ask your waiter to bring half your meal in a take away container before it even hits your plate.
  • Do look for options labelled as 'reduced calorie' or 'low fat' on the menu, as they are probably better options - but cut your portion in half as well. Ask your waitress what changes were made in the dish to make it healthier.
  • Opt for the dishes heavy in fresh greens, such as salads. Get your dressing on the side!
  • Give the menu back to the waiter as soon as you have ordered, to avoid the temptation to order dessert!
  • Choose restaurants that specialize in fresh food - this can be anything from sushi to Subway! It is harder to hide calories (eg cooking oils, sauces) in food that is fresh.

Gone are the days where we should say "Never trust a skinny chef!"

Dr. Sue © 2009 


#2 Top Post of All Time on DrSue.Ca - Metabolic Syndrome in College Football Linemen

>> Thursday, March 27, 2014

While elite athletes are typically thought of as representing the pinnacle of fitness and health, this may not always be the case.  A recent Canadian study reports that amongst college (American) football linemen, there may be particular concerns regarding metabolic health.

The study, published in the Canadian Journal of Diabetes, looked at the prevalence of metabolic syndrome on the University of Saskatchewan's Huskie football team, which is one of the most prestigious University football programs in Canada.

Metabolic syndrome is defined by a constellation of several criteria, including waist circumference, blood pressure, blood sugar, and cholesterol measurements (both triglyceride levels, and the 'good cholesterol' called HDL).  Meeting three of the five criteria makes the diagnosis of metabolic syndrome.   It is associated with an increased risk of diabetes, heart disease, and a long list of other potential medical complications.

The study found that amongst the Huskies studied,  18 of 21 linemen had at least 1 feature of metabolic syndrome, compared to only 4 of the 18 non-linemen studied.  Three of 21 linemen had the full blown metabolic syndrome, whereas none of the non-lineman had the diagnosis.  Not surprisingly, linemen were also substantially taller, heavier, and had a much higher Body Mass Index (35.6) than the non-linemen (26.4).

Higher body mass is viewed as an advantage for athletes who play the position of linemen, but the health consequences as seen in this study are a serious concern.  The age at which children begin playing football has decreased over the last decade, suggesting that progressively younger children may be being encouraged to pack on the pounds to play the position of lineman more effectively.  As the authors point out, when these young athletes retire from the sport, their longstanding eating patterns may be difficult to break, putting them at even higher risk of significant health consequences of obesity.

As the authors conclude, "much work is necessary to inform policy and to educate on the long term consequences of increased body size" in these young athletes.

Article:  Mannsell K et al.  Prevalence of metabolic syndrome among college football linemen. Can J Diab 2011; 35(5):497.

Dr Sue Pedersen © 2012

Follow me on Twitter for daily tips! @drsuepedersen 



I am excited that you have arrived at my site, and I hope you are too - consider this the first step towards a Healthier New You!! As a medical doctor, Endocrinologist, and obesity specialist, I am absolutely passionate about helping people with weight management. Though there is certainly no magic cure for obesity, there IS a successful treatment plan out there for you - it is all about understanding the elements that contribute to your personal weight struggle, and then finding the treatment plan that suits your needs and your lifestyle. The way to finding your personal solution is to learn as much as you can about obesity: how our toxic environment has shaped us into an overweight society; the diversity of contributors to obesity; and what the treatment options out there are really all about. Knowledge Is Power!!

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