The LILI Letter — August 2025

August,

One of the things I like about this month is how the light begins to change. It softens. Fall is just around the corner, which is fine by me, with the cooler temperatures. Hopefully we have all had a fun vacation or two by this time. August is a singular month for the fact we don’t celebrate any holidays, other than the kids going back to school. 😊 My friends, enjoy all that summer has to offer while we still have the chance. 

In good health,
Jennifer James

Success story

Throughout my career as a dietitian, several patients have told me that their cancer diagnosis, heart attack/open-heart surgery, or diabetes diagnosis was “the best thing that ever happened to me”. Huh?

They have undergone a transformation. As one patient of mine recently put it, “I thought cancer was bad, but it has made me stronger and given me back my family”. Another patient said that his heart attack and subsequent open-heart surgery were his wake-up call. His priorities had shifted, and he decided to not work so hard and spend more time with his wife and kids. He had been given a second chance at life, and he was not going to mess it up. Yet another patient decided that their diabetes diagnosis was a gift. It forced him to re-evaluate his life, realized he did not have unlimited time, and decided to take much better care of himself by improving his diet and exercise habits. He wanted to be around to see his grandkids graduate from high school.

You might be scratching your head over this. We may all view any major health change as a very negative thing. Each instance held a beautiful gift for these people, and they embraced it. No matter what happens to us, as bad as it might be, there is usually a gold nugget surprise if we are willing to be open to it. 

As for everything else that may happen to us in life, let’s try to look at any traumatic event with fresh eyes. What may look like a very bad thing initially, may actually be a very good thing in disguise. Indeed.

Have you tried…tofu?

I have been writing this newsletter for 12 years. I hesitated about featuring tofu, but not today. It is really quite versatile and delicious, depending on how you prepare it. It is made from concentrated soy milk, that is curdled to varying degrees, and pressed into molds. It is a complete protein and can be substituted for meat, poultry and fish in many recipes. Thought to have been accidentally created a hundred years BCE, it has become a main protein staple on the Asian continent. The Western world is using it more, and I cook with it regularly. Don’t be shy about trying this versatile, plant-based, and highly nutritious food.

Problem? No problem!

As I mused on our lives as human beings, I came to the realization that we will always have some sort of problem. Problems with our house, vehicle, health, personal relationships, finances, neighbors, the weather and on and on. The delusion is thinking life is supposed to be without problems. The ancient philosophers and religions figured this out. So why do we think our lives should always be smooth sailing? And get annoyed when they don’t go that way? Our lives so rarely go that way, yet we continue to think they should. Crazy-making! 

I watched a random video on YouTube about someone’s near-death experience (NDE) a short time ago. What struck me was the particular person’s “take-home message” from the NDE. They were told to “breathe, and don’t resist. I really like that. If we are not happy with our current set of problems, just breathe (relax) and don’t resist (go with it). Very wise advice.

One of the great tragedies of our lives is believing that the here and now is inferior to how we think it should be. I have looked back on times in my life with nostalgia, even though at that particular time I wasn’t that excited about what was happening. I had thought at the time it should be different or somehow “better”, not full of problems. 

Can we all make peace with the fact that there will always be problems? Of one form or another? And that the here and now is just fine the way it is? Yes, we can improve our lives, but most of the things that confront us we really have no power over. Rather, let us all breathe, and not resist, even when life hands us one problem after another. 

Eating smoke

We all know that smoking tobacco products is harmful. What about smoking meat, chicken, fish and other foods, and then eating them? With our backyard barbecues in full swing, and the Traegers smoking away on the briskets, one might wonder if all that smoked meat is good for us.

During a fire, smoke inhalation damages the heart, lungs and other organs. Smoke is also full of carcinogens. So, if we are subjecting our food to this process, what will this do to us? According to the Cleveland Clinic, anytime we smoke food, we add contaminants to it. I will not disagree that food tastes pretty wonderful when smoked. But is it worth it? Smoking food creates a number of harmful substances, namely, polycyclic aromatic hydrocarbons, (PAHs) and heterocyclic amines, (HCAs). These substances are also created when we cook meat at very high temperatures. They are considered carcinogens, and interact with our DNA to cause mutations, possibly putting us at risk for cancer. The gut is most at risk from these mutations, with colon and stomach cancers, especially with a high intake of smoked meats. Other possible health risks from eating smoked meat include strokes, heart disease and other forms of cancer. Obviously, eating smoked meat (or other smoked foods) on a regular basis is not in our best interest. 

If we like smoked meat, what should we do? The Cleveland Clinic recommends the following:

• Limit red meat in general, smoked or otherwise. The Mediterranean diet I teach to our cardiac rehab patients allows red meat (beef, pork, or lamb) in a small portion once a week (3-4 ounces).
• Smoke turkey or chicken instead of red meat.
• Use hardwoods, like hickory instead of softer woods. Softer woods contain more resin, which creates more smoke with an unpleasant smell.
• Use leaner meats, since the fat dripping off the meats onto the heat source creates the harmful compounds.
• Don’t smoke fish, it is probably already contaminated, and has a greater surface area which picks up more carcinogens.
• Don’t burn or char the food either.
• As a compromise, marinate meats or poultry in liquid smoke for the flavor and then grill, rather than smoking it.

Please don’t shoot the messenger. Now we know the possible harms from eating a steady diet of smoked meat and other foods. What you do with the information is up to you. 😊

Are smoked meats bad for your health?

Not all weight loss is good

I work with a wide variety of patients. I work with cancer patients one day a week. I also see post-surgical cardiac patients, and a conglomeration of outpatients, including those with lung disease. Many of these people lose weight, unintentionally, which is not necessarily a good thing.

There are several instances where unintentional weight loss is common. When a person has cancer, the rate at which the body burns calories increases. This is from a number of factors, one being how our immune system responds to the tumor, with substances that cause inflammation and speed up the rate at which we burn calories. Cancer treatment often decreases appetite through side effects from chemotherapy and radiation, including nausea, vomiting, taste changes, fatigue and pain. Lung disease increases the work of breathing, which increases calorie expenditure, and often causes unintentional weight loss. Post-surgical patients may not have an appetite either, just when their bodies need more food for recovery. Eating less than 1000 calories a day won’t even support a toddler! More muscle mass is lost in all cases.

Often, patients are thrilled with this weight loss if they have been overweight. I have to break the bad news to them that this is not the type of weight loss that is healthy. I will show them photos of different parts of the body and how malnutrition manifests, such as the shrinking fat pads around our eyes and under our cheek bones. I have seen examples of malnutrition in my office, and the patient didn’t think it was a problem until I had the “tough-love” talk with them. They finally realized they were harming themselves.

The new class of medications, the GLP-1 RA’s can cause marked weight loss as well, since the person doesn’t have their normal hunger cues and feels full very quickly. If a person eats adequate protein and calories, does regular strength training and monitors their food intake to make sure they are meeting their needs, it will lessen the tendency to lose muscle tissue. Unfortunately, not everyone on these medications will do these things.

Weight is basically how much gravity pulls on us. Drink two cups of water and see how the scale changes. If you urinate or have a bowel movement, it will affect the scale. Put on work boots and step on the scale. If we are retaining water from eating too many salty foods, that will increase our weight. Building muscle can increase weight as well.

Frankly, I think we focus too much on weight. We should be more concerned with our overall health, how our clothes fit, our strength, flexibility and stamina. If you, or someone you know, looks like they have lost weight without trying, without changing their diet or exercising more, please have them see a doctor. If we lose more than two pounds a week, and our family members are telling us we need to eat more, we are likely not eating adequately. Loss of significant muscle is NOT good weight loss. Trust me on this one. (Please know that any weight loss, healthy or otherwise, involves some loss of muscle. More muscle lost, more of a concern).

Cancer cachexia

Sesame tofu

This is one of many ways to prepare tofu. It takes on the flavor of the other ingredients and can be substituted for meat, poultry or fish in recipes.

• 1-pound block of extra firm tofu, cut into 1-inch pieces
• 2 Tbsp. sesame seeds, black and white
• 1-1/2 Tbsp. canola oil
• 2 green onions, sliced
• 3 Tbsp. reduced-sodium soy sauce
• Juice from half a lime
• 2 tsp. honey or brown sugar
• 1 minced garlic clove
• 1 tsp. minced fresh ginger
• ¼ tsp. toasted sesame oil
• 3 Tbsp. water

For the sauce, mix the soy sauce, lime juice, honey, ginger, garlic, sesame oil and water until well blended. Set aside.

Heat the oil in a large skillet over medium-high heat. Add the tofu. Cook for 8-10 minutes until golden brown, tossing frequently to lightly brown the pieces evenly. Turn down the heat to medium. Pour the sauce over the tofu, bring to a boil, then turn down to a simmer. Let it simmer and bubble until reduced and absorbed, turning the pieces often to evenly absorb the sauce. Remove to a plate. Pour any remaining sauce over the tofu. 

Serve over hot cooked rice. Sprinkle with sesame seeds and sliced green onions.

Enjoy! Serves 4.

Calories for ¼ recipe with 2/3 cup brown rice: 355 calories, sodium 443 mg

August support groups

Mondays, 2-3 p.m.

Heart Center Conference Room, Suite #200

ORMC Medical Plaza

Free to graduates of ORMC weight loss classes

(We will not meet on Labor Day, Sept. 1)

“Every problem is a gift. Without problems, we would not grow.”

— Anthony J D’Angelo