Beauty Health for Life

Please welcome Michele Laikowski, actress, voiceover artist, mom to the cutest boy in the Tri-State, and forever friend of CHG. And today on Serious Eats: Shredded Beet, Apple, and Currant Salad with Apple Vinaigrette. I made, ate, and loved dried fruit in a salad. Is that a horseman, I see?

Hi CHG readers! The last time I was here, my son was 7 months old and I was discovering ways to make baby food. Actually, I discussed making pureed peas and lamented the lack of space in my Brooklyn apartment.

Well, now, we’re at the stage in his life where he eats big-people food, and he wants to eat it NOW. That leaves a working mom, who picks up her kid at 6 pm, trying to figure out how to distract him for as long as possible while cooking a nutritious and healthy meal. (Thirty minutes is the longest I’ve ever distracted him. It’s in shame I tell you that I use The Wiggles.) What’s a Working Girl to do?

If you said, Harrison Ford, you are only partially correct. OK, you aren’t correct at all! But you guys, remember in the movie when he explains how he got the cut on his chin*? How cute was he? Well, dreamy, actually. Kris, I’m sorry but Harrison Ford showed George Clooney how to be a great big sexy star! Now, I know what I’m doing this weekend. I am watching Working Girl. I’m cooking ahead.

During the week, while I slave for The Man, I think about what my kiddo will eat and what my husband and I will also enjoy. Many times, its pork chops, rice, and frozen spinach (I mean, I totally heat it). That takes almost exactly 20 minutes with prep and everything. So, that’s good—but it’s also labor intensive. Please don’t laugh, but when you’ve got an almost-2-year-old pulling on your leg not wanting to just watch The Wiggles but actually interact with you, you really want to comply. And you especially do not want your kid with you while you’re near a stove. (TODDLERS ARE CRAZY AND WANT TO TOUCH EVERYTHING.)

So, here’s a meal that is toddler- and daddy-approved: Broccoli Quiche. You can make it on Saturday, and it will hang out in your fridge for about four days. Or you can make two and freeze one for the future.

I’ve adapted Mark Bittman’s recipe from How to Cook Everything; and by adapted, I mean I added broccoli. I make it while the kiddo is napping or when the other working person in my house and life, the daddy, has taken him outside to chalk up the sidewalk. Then on Monday, Tuesday, and/or Wednesday I can pull it out of the fridge and reheat it in my oven for 20 minutes.

This is probably not your go-to for really healthy, but for a toddler, it’s pretty darn good. And for your *ahem*-year-old mom and dad, it’s something you want to eat occasionally. That being said, you can totally healthy this up by using low-fat cheese, 2% milk, and/or cutting out a few of the egg yolks.

My husband, a real man, fought against this quiche. Now, he asks for it.


* Interesting (to me) fact: they also explain that scar in Indiana Jones.

~~~

If you like this recipe, you may also enjoy:
Mark Bittman’s Baked Eggs in a Dish
Crustless Spinach Quiche
Tofu Veggie Scramble

~~~

Broccoli Quiche

Photo: Melissa Sanders via Flickr

Adapted from How to Cook Everything by Mark Bittman
Yields 8 servings

Ingredients
6 eggs, room temperature
1 1/2 cups cheddar cheese, grated
3/4 cup broccoli (frozen and defrosted or fresh)
1 1/2 cups milk, heated gently until just warm
1/2 tsp salt
1/4 tsp cayenne (or to taste)
frozen pie shell (or homemade, if you’re ambitious)

Instructions

1. Heat the oven to 325º and set the rack in the middle. Set out the frozen pie crust that you bought because you’re me and can only really tackle pie crusts on holidays. If you make your own pie crust, I bow to you—just remember to leave out sugar.

2. Beat the eggs with a fork or whisk. Stir in the milk, and add the cheese, broccoli, salt, and cayenne. Stir until well blended.

3. Put the pie crust on a baking sheet and pour in the egg mixture. When you put it in, you MAY have a little left over. I’m sorry, I add broccoli and Mark doesn’t. Scramble up the remainder in a pan to hold the kiddo tight until the quiche is ready.

4. Bake for 30 to 40 min, or until almost firm (it should still jiggle just a little in the middle) and lightly browned on top; reduce the oven heat if the shell’s edges are darkening too quickly. Cool on a rack for at least 30 minutes before wrapping it in plastic wrap, or it will get wet on top. (It may anyway, but the cooler the better.) Put quiche in fridge.

5. When you’re ready to eat it, take it out of the fridge and reheat at 325 for 20 – 30 min. If you guys are making it in the next couple weeks and live in the Northeast, serve with a honey crisp apple. They are the bomb right now.

Approximate Calories, Fat, Fiber, Protein, and Price per Serving
251 calories, 17.3g fat, .6g fiber, 12.4g protein, $2.07

Calculations
6 eggs: 426 calories, 30g fat, 0g fiber, 36g protein, $1.25
1 1/2 cups cheddar cheese cheese: 682.5 calories, 55.5g fat, 0g fiber, 42g protein, $1.39
3/4 cup broccoli: 30.75 calories, 0g fat, 3.75g fiber, 3g protein, $0.25
1 1/2 cups milk: 219 calories, 12g fat, 0g fiber, 12g protein, $0.43
1/2 tsp salt: negligible calories, fat, fiber, protein, $.02
1/4 tsp cayenne: negligible calories, fat, fiber, protein, $.02
frozen pie shell: 649 calories, 41g fat, 1g fiber, 6g protein, $2.48
TOTALS: 2007 calories, 138.5g fat, 4.75g fiber, 99 protein, $12.46
PER SERVING (totals/8): 251 calories, 17.3g fat, .6g fiber, 12.4g protein, $2.07

It isnt just carbohydrates people with diabetes need to be vigilant about. Its the fat too.

A new study from the Joslin Clinic in Boston found that patients with type 1 diabetes required more insulin coverage for a higher-fat meal compared to a lower-fat meal. The meals were prepared in the Clinics kitchen and had identical carbohydrate and protein, but different fat content - 60 grams vs. 10 grams. The carbohydrates in the meals had similar glycemic indexes.

Dietary Fat Acutely Increases Glucose Concentrations and Insulin Requirements in Patients With Type 1 Diabetes, Diabetes Care, April 2013

It was a small study of crossover design, meaning each participant consumed both the high-fat meal and the low-fat meal.

"RESULTS Seven patients with type 1 diabetes (age, 55 ± 12 years; A1C 7.2 ± 0.8%) successfully completed the protocol. [The high-fat] dinner required more insulin than [the low-fat] dinner (12.6 ± 1.9 units vs. 9.0 ± 1.3 units; P = 0.01) and, despite the additional insulin, caused more hyperglycemia.

CONCLUSIONS This evidence that dietary fat increases glucose levels and insulin requirements highlights the limitations of the current carbohydrate-based approach to bolus dose calculation. These findings point to the need for alternative insulin dosing algorithms for higher-fat meals and suggest that dietary fat intake is an important nutritional consideration for glycemic control in individuals with type 1 diabetes."

Joslin accompanied their study with this short video:

"When people ate a higher fat meal, their blood sugars were higher for longer and required more insulin."

Why does dietary fat lead to higher blood glucose? It is thought that fat contributes to insulin resistance:

"Dietary fat and free fatty acids (FFAs) are known to impair insulin sensitivity and to enhance hepatic glucose production. ... Interventions that lower [free fatty acid] levels in nondiabetic and type 2 diabetic individuals lead to both improved insulin sensitivity and glucose tolerance."

Saturated fat may be more problematic:

"Studies in nondiabetic individuals indicate that saturated fats cause more profound insulin resistance than monounsaturated and polyunsaturated fats. By design, the [high-fat] dinner meal in the current study was predominantly saturated fat."

And:

"Pizza is widely recognized to cause marked late postprandial hyperglycemia in patients with type 1 diabetes."

________

My fasting glucose at diagnosis, versus currently.

All around us there are people who are struggling or living with challenging health conditions or diseases. Some are very visual, and apparent, and some are not. For those with apparent health conditions or diseases, we feel an immediate sense of empathy. However, it is not so easy for us to empathize with those whose needs we cannot openly see. We may assume a person is exaggerating (they really dont have it that bad), is being wimpy (they should just shut up and deal with it), or is simply lying.

Type 2 diabetes is one of these misunderstood diseases; it is a hidden illness and people with hidden illnesses often end up being judged as if they had no needs, or should be restricted in needs. These attitudes often end up in discrimination, particularly from employers, health insurance companies, and some health care providers and agencies. The problem becomes compounded because type 2 diabetes is also a silent disease. It is a disease which can remain silent (not showing very many outward signs of its presence) for many years, even decades. Hence, many people will often ignore their condition because they feel fine and healthy, and the condition does not seem real to them. Because there is NOTHING telling them they are sick, they feel a certain sense of invincibility... until they get their blood glucose level tested with a finger prick.  Persons with type 2 diabetes must check their blood glucose levels regularly if they are to be kept constantly aware that they a.) have a serious medical condition, and b.) that they need to adjust their food intake according to what their glucose levels are. A person with type 2 diabetes needs to be able to eat to their meter in order to be able to manage their disease.

If the medical establishment (who are constantly preaching on the diabetes pandemic, and how serious this matter is, and how the condition is costing our governments, worldwide, billions of dollars) had any inkling of the issue at hand, or indeed, if they believed their own warnings, they would realize that in order to reduce the risk of type 2 diabetes, and to control the health of those with current type 2 diabetes diagnoses, we need...

• Educated clinicians: Clinicians who are not trivializing the condition to their patients, but which strive to understand the condition, its potential risks and dangers, and who are committed to empowering their patients and properly educating them as to what the condition is; and
• Access to Proper Tools and Medicines: Sufficient glucose testing strips to make appropriate nutritional decisions, from day to day, to help control glucose levels, as well as access to necessary medications -- including insulin. 

Currently, the OHP provides 100 test strips every 90 days, but a new plan would severely restrict access to strips for type 2 patients unless they are newly diagnosed, take insulin, or meet a few other special requirements. For people not taking insulin – which covers the vast majority, about 70% of all type 2 patients – those with an A1c above 8.0% would be entitled to one test strip per week, while those with an A1c below 8.0% would not be provided with any test strips at all.

This is obscene!! One test strip a week tells NOTHING to a patient with type 2 diabetes! Tests need to be done in pairs so that we can see the cause and effect of things like meals, exercise, illness or periods, or even overnight sleep. Patients with type 2 diabetes are practically being PUNISHED for having good control, and being told that their health is not important enough to merit an educated management of their disease. Besides that, patients are supposed to work hard to keep an A1C which is at or below 6.5%. Telling a person that they will only get strips if they have higher A1C levels is not only not a good recommendation, but it is also unconscionable. It is the testing that keeps me at a lower A1C! Im not psychic, for crying out loud. As of yet, there is no magical Glucose Level 8-Ball.

We need to stand together as a type 2 community against these kinds of things, or we will continue to be bullied by the medical establishment. If we are to stem the tide of unfortunate complications, and type 2 diabetes diagnoses, then we need to stand up for our rights as patients. We DESERVE education, quality treatment, tools, and medications, to manage our condition and lead healthy lives.

Really... whatever happened to the Hippocratic Oath?

DO NO HARM. 

We have very little time... Please sign the petition, here: Dont Restrict Test Strips for People with Diabetes.  

A chemical found in red wine remains effective at fighting cancer even after the bodys metabolism has converted it into other compounds.

This is an important finding in a new paper published in the journal Science Translational Medicine by Cancer Research UK-funded researchers at the University of Leicesters Department of Cancer Studies and Molecular Medicine.

The paper reveals that resveratrol – a compound extracted from the skins of red grapes – is not rendered ineffective once it is metabolised by the body.

This is an important development, as resveratrol is metabolised very quickly – and it had previously been thought that levels of the extracted chemical drop too quickly to make it usable in clinical trials.

The new research shows that the chemical can still be taken into cells after it has been metabolised into resveratrol sulfates.

Enzymes within cells are then able to break it down into resveratrol again – meaning that levels of resveratrol in the cells are higher than was previously thought.

In fact, the results appear to show resveratrol may be more effective once it has been generated from resveratrol sulfate than it is if it has never been metabolised because the concentrations achieved are higher.

The team, led by University of Leicester translational cancer research expert Professor Karen Brown, administered resveratrol sulfate to mice models.

They were subsequently able to detect free resveratrol in plasma and a variety of tissues in the mice.

This is the first direct sign that resveratrol can be formed from resveratrol sulfate in live animals, and the researchers think it may help to show how resveratrol is able to have beneficial effects in animals.

The study also showed that resveratrol generated from resveratrol sulfate is able to slow the growth of cancer cells by causing them to digest their own internal constituents and stopping them from dividing.

Professor Karen Brown said: "There is a lot of strong evidence from laboratory models that resveratrol can do a whole host of beneficial things – from protecting against a variety of cancers and heart disease to extending lifespan.

"It has been known for many years that resveratrol is rapidly converted to sulfate and glucuronide metabolites in humans and animals – meaning the plasma concentrations of resveratrol itself quickly become very low after administration.

"It has always been difficult to understand how resveratrol is able to have activity in animal models when the concentrations present are so low, and it has made some people skeptical about whether it might have any effects in humans.

"Researchers have hypothesized for a long time that resveratrol might be regenerated from its major metabolites in whole animals but it has never been proven.

"Our study was the first to show that resveratrol can be regenerated from sulfate metabolites in cells and that this resveratrol can then have biological activity that could be useful in a wide variety of diseases in humans.

"Importantly, we did all our work with clinically achievable concentrations so we are hopeful that our findings will translate to humans.

"Overall, I think our findings are very encouraging for all types of medical research on resveratrol. They help to justify future clinical trials where, previously, it may have been difficult to argue that resveratrol can be useful in humans because of the low detectable concentrations.

"There is considerable commercial interest in developing new forms of resveratrol that can resist or overcome the issue of rapid metabolism. Our results suggest such products may not actually be necessary to deliver biologically active doses of resveratrol to people."

Heres the latest bit of research on the use of cinnamon to help control blood glucose:

Effect of Cinnamon on Glucose Control and Lipid Parameters

It appeared in this months issue of Diabetes Care. Researchers performed a meta-analysis (a study of studies) of five randomized placebo-controlled trials using cinnamon. Their conclusion:

"Cinnamon does not appear to improve A1C, fasting blood glucose, or lipid parameters in patients with type 1 or type 2 diabetes."

This is not a new investigation, but an analysis of older studies.

NutraIngredients.com has a good run-down:
Meta-Analysis Questions Cinnamons Diabetes Benefits
________

Since the Disease Management Care Blog not only wants to be informative but also helpful to its readers, it has developed a seven point generic physician employment inquiry response and recruitment letter.  It is available below. 

The DMCB is confident that those smaller physician-owned private practices that remain independent will find this form letter very helpful in the coming years.  The DMCB releases this to the public domain and its colleagues are welcome to copy, paste, distribute, share, alter, modify or adapt all or some of the document as it becomes necessary.

Dear [insert name of physician here]:

Thank you for your recent [select: tweet, email, Facebook posting or VM] inquiry about leaving your current salaried position and joining our practice.  Thanks to widespread patient dissatisfaction with the institutions that were spawned by "health orm," our small business has experienced tremendous growth. We are constantly on the lookout for new talent that complements our projected demand.  Maybe you can join our team!

As you are undoubtedly aware, many of our colleagues nationwide have been lured into full time employed positions involving large complicated corporate practice arrangements, many of which were set up to be ACOs. Savings havent materialized and many of these organizations have responded by demanding more patient "throughput" from their employed physicians and imposing cutbacks in vital support services.

In contrast to those organizations, our practice offers you:

1) a completely transparent compensation arrangement that equitably divides our net revenue income among the owner-physicians.   No more having to deal with an unwieldy administration that allocates salary amounts based on some opaque budget of anticipated revenues and upside savings minus overhead and capital allocations that you have no say in.

2) a team-based environment that not only relies on your expertise but knows whos boss.  Unlike those other complicated practice settings with layers of middle management, our office personnel report directly to you, period.

3) a patient population that is not only grateful for our high "same day" service standards and efficient and compassionate practice style, but who also recognize that unnecessarily calling at the end of the business day or repeatedly while were on night call is reason to be assisted in finding another physician.  We have caully cultivated a very loyal following of patients who genuinely partner with us.

4) a highly trained and motivated administrative support and care management staff that not only uses state-of-the-art approaches to deal with private managed care commercial insurers, but uses a "3A" approach of Anticipating, Automating and Appealing any service that requires prior authorization from you.  Youll only get involved in these matters when its necessary.

5) a stable practice environment. Speaking of managed care insurers, they comprise the bulk of our business. While they are far from perfect, Medicare and Medicaid they are not.  They dont threaten us with arbitrary fee schedule cuts, audits, and payment delays.  We firmly believe patients and taxpayers should get what they pay for.  Its not our fault if they havent paid for our level of clinical and consumer excellence. 

6) an EHR system is not only low cost and user-friendly, its modular and cloud-based.  Our vendor has agreed to performance guarantees, there are no one-sided "hold-harmless" clauses and its seamlessly compatible with any hand held device of your choice any time and any where.

7) a unique market niche that sits in that "sweet spot" between a local employer community that likes us, insurers that respect us, specialist physicians work with us and a multispecialty ACO close by that welcomes our errals.

Once again, thank you for contacting us.  Please send your CV to [insert P.O Box address here] where we will store it in strictest confidence along with dozens of your colleaques CVs.  We promise you that when we get to it in the coming months, we will contact you. 

Best regards,

This is one of the most popular cocktail choices on Souzas Caipirinha menu at Bar Veloso in São Paulo, Brazil. While Souza normally makes it with sake, he sometimes uses the more traditional cachaça upon request.

1 3/4 oz. sake
1 starfruit, cut into cubes except for one star-shaped “round” reserved for garnish
1 tsp. sugar
5 fresh basil leaves
Cracked or cubed ice
Tools: muddler, barspoon
Glass: Old Fashioned
Garnish: remaining “round” of starfruit

Muddle starfruit and sugar in glass. Add ice, sake and basil. Stir well and garnish.

Hi team CHG,

Thank you very much for your emails and posts. Were all okay - just on a break. Hope youre having good summers, and eating well!

Kris

HOW much for the PCMH?!*

According to Drs. Gill and Bagley, writing in the Annals of Family Medicine, the costs of transforming a primary care practice to a Patient Centered Medical Home should be generously borne by "payers."

While wishful thinking about payers deep pockets is not new, the article has some eye-opening data (with Disease Management Care Blog provided links) on just how much some or all of the elements of a PCMH cost:

a) $1850 per month per practice or $17,000 per physician,

b) $5,600 start-up then $2,200 per year related to the costs of reporting outcomes,

c) $117,000 per physician per year, and

d) up to approximately $15,000 per practice per year for a management facilitator. 

No wonder the DMCBs friends in academia want someone else to pay for it.

In the meantime, companies like this continue to offer a different business model. Instead of rebuilding and equipping an entire primary care practice for a croup-to-guts "transformation," population health (definition here) service providers focus on those patients who are at highest risk and provide a modular combination of in as well as outsourced services. While there is no head-to-head cost comparison of PH vs. PCMH, it would appear that the per patient approach of PH has a competitive pricing advantage.

Stocking up for allergy season

And speaking of outsourced services, the DMCB joins its other colleagues in looking forward to EHRs "meaningful use" criteria go from being meaningless to being truly meaningful.

For an under-recognized example of just how meaningful things will become, check out this interesting blog posting that describes the use of cloud-based EHR-data to follow U.S. allergy statistics.

While the information is interesting on its own merits, think how these data could be used by savvy providers to match allergy "market demand" by "stocking" a "just-in-time" "inventory" of allergy-care services such as patient reminder campaigns (for those with allergy-provoked asthma, "be sure to use your peak flow meter!") extra condition-specific appointments ("your provider with allergy expertise can see you this morning!"), treatments slots (nebulizers and immunotherapy ready to go) and medications (OTCs and prescription meds for the in-house pharmacy).


*Image from Wikipedia

Which salads are highest in calories and fat -– and which are lowest?

When youre looking to order something relatively healthy from a fast-food menu, you probably go for a salad. But did you know some fast-food salads are as high in calories and fat as a double Quarter Pounder with Cheese (740 calories, 42 grams of fat)?

Two key ingredients can make or break your fast food salad: chicken (specifically, whether you choose "grilled" or "crispy" style) and salad dressing. Although some fat helps make salad dressing taste good, many fast-food dressings go too far. A serving of blue cheese dressing at Carl’s Jr., for example, adds 320 calories and 34 grams of fat to your salad.


Below are my picks for some of the best and worst salad options at the 10 top fast food chains. The "best" salads were those with the most fiber and the least saturated fat; the “worst” salads had the highest levels of saturated fat, total fat, and/or calories.
Best Fast Food Salads

All these fast food entrée salads have less than 5 grams of saturated fat, and most have less than 15 grams of total fat. Those with more than 15 grams of fat feature nuts, which are nutrient-rich and contribute "smart" fats (monounsaturated fat and polyunsaturated fat). Because of the fat and sodium content of many fast-food salad dressings, Ive suggested using only half a pack of dressing with some of these salads. That should be plenty for most people.

   1. Taco Bell Chicken Ranch Taco Salad (Fresco Style). This salad has 240 calories, 6 grams total fat; 1 gram saturated fat; 1,110 milligrams sodium, 6 grams fiber, and 23 grams protein. Ingredients: beans, fiesta salsa, lettuce, rice, southwest chicken, tomato.

   2. Taco Bell Chipotle Steak Taco Salad (Fresco Style): 220 calories; 7g total fat; 2g saturated fat; 960 mg sodium; 6g fiber; 41g protein. Ingredients: beans, fiesta salsa, lettuce, rice, steak, tomato.

   3. McDonald’s Premium Southwest Salad with Grilled Chicken (with 1/2 packet Southwest dressing): 370 calories; 12g total fat; 3.5g saturated fat; 1,130 mg sodium; 6g fiber; 30g protein. Ingredients: Mixed greens, oven-roasted tomatoes, fire-roasted corn, black beans, poblano peppers, cheddar & jack cheeses, and tortilla strips.

   4. Chick-fil-A Chargrilled Chicken Garden Salad (with Fat Free Honey Mustard): 390 calories; 15g total fat; 4.5g saturated fat; 1065mg sodium; 5g fiber; 25g protein. Ingredients: Lettuce, carrots, grape tomatoes, broccoli florets, Jack and cheddar cheeses, grilled chicken, garlic and butter croutons, honey-roasted sunflower kernels.

   5. Wendy’s Mandarin Chicken Salad (with 1/2 packet Oriental Sesame Dressing but without crispy noodles): 395 calories; 18g total fat; 2.3g saturated fat; 880 mg sodium, 4g fiber; 29g protein. Ingredients: Salad greens, grilled chicken fillet, mandarin oranges, toasted almonds.

   6. Chick-fil-A Chargrilled Chicken & Fruit Salad (with Reduced Fat Berry Balsamic Vinaigrette): Calories: 360; 10g total fat; 3.5g saturated fat; 810mg sodium; 4g fiber; 23g protein. Ingredients: Lettuce, carrots, Jack and cheddar cheeses, grilled chicken, fresh fruit medley, Harvest Nut granola.

   7. Jack in the Box Grilled Chicken Salad (with Low-fat Balsamic dressing): 286 calories; 10.5 g total fat; 4g saturated fat; 1,140mg sodium; 4g fiber; 28g protein. Ingredients: Mixed salad greens, grilled chicken tenders, cheddar cheese, grape tomatoes, red onions, cucumbers, carrots.

   8. Carl’s Jr. Cranberry Apple Walnut Grilled Chicken Salad (with 1/2 packet Raspberry Vinaigrette): 380 calories; 17g total fat; 4.5g saturated fat; 915 mg sodium; 4g fiber; 26g protein. Ingredients: Mixed salad greens, grilled chicken, feta cheese, apple slices, dried cranberries, glazed walnuts.

   9. KFC Grilled Chicken BLT Salad (with Hidden Valley Ranch Fat Free dressing: 255 calories; 7g total fat; 2.5g saturated fat; 1,160 mg sodium; 3g fiber; 36g protein. Ingredients: lettuce, oven-roasted chicken, diced tomatoes, bacon bits.

  10. Carl’s Jr. Original Grilled Chicken Salad (with Low Fat Balsamic Vinaigrette): 235 calories; 7.5g fat; 3g saturated fat; 1,090 mg sodium; 3g fiber; 24g protein. Ingredients: Mixed greens, grilled chicken, red onions, shredded cheese, tomatoes, and cucumber slices.

Worst Fast Food Salads

Most of these entrée salads have more than 10 grams of saturated fat, 35-59 grams of total fat, and up to 900 calories. Some have more sodium than most U.S. adults should consume in an entire day (1,500 mg), as recommended by the CDC.

   1. Wendy’s Chicken BLT Salad (with Honey Dijon dressing): 790 calories; 53.5g total fat; 13.5g saturated fat; 1,665 mg sodium; 3g fiber; 38g protein. Ingredients: Salad greens, fried chicken filet, grape tomatoes, bacon, shredded cheddar, garlic croutons.

   2. Arby’s Chopped Farmhouse Chicken Salad, Crispy (with Buttermilk Ranch dressing): 670 calories; 48g total fat; 12.5g saturated fat; 1,470 mg sodium; 4g fiber; 33g protein. Ingredients: Salad greens, popcorn chicken, pepper bacon, cheddar cheese.

   3. Jack in the Box Chicken Club Salad (with Bacon Ranch dressing): 866 calories; 59g total fat; 12g saturated fat; 2,168 mg sodium; 5g fiber; 38g protein. Ingredients: Mixed salad greens, crispy chicken, bacon, cheese, seasoned croutons.

   4. Carl’s Jr. Southwest Grilled Chicken Salad (with Chipotle Caesar dressing): 710 calories, 50g total fat; 12g saturated fat; 1,960 mg sodium; 6g fiber; 37g protein. Ingredients: Spring salad mix, grilled chicken, roasted corn, black bean salsa, red onions, shredded cheese, bacon bits, and tortilla strips.

   5. Taco Bell Chipotle Steak Taco Salad: 900 calories, 57g fat, 11g saturated fat, 1,700 mg sodium, 8g fiber, 28g protein. Ingredients: crispy tortilla "bowl," steak, beans, cheddar, rice, lettuce, tomatoes, tortilla strips, reduced-fat sour cream, chipotle dressing.

   6. KFC Crispy Chicken Caesar Salad (with Creamy Parmesan Caesar dressing): 650 calories; 48g total fat; 11g saturated fat; 1,340 mg sodium; 4g fiber; 32g protein. Ingredients: Lettuce, crispy chicken, Parmesan cheese, Parmesan garlic croutons.

   7. Chick-fil-A Chick-n-Strips Salad (with Buttermilk Ranch dressing): 780 calories; 49g fat; 10g fat; 1,825 mg sodium; 5g fiber; 43g protein. Ingredients: Lettuce, carrots, grape tomatoes, broccoli florets, Jack and cheddar cheeses, fried chicken strips, garlic and butter croutons, honey-roasted sunflower kernels.

   8. Burger King TenderCrisp Chicken Garden Salad (with Ranch dressing): 680 calories; 46g total fat; 9g saturated fat; 1570 mg sodium; 4g fiber; 28g protein. Ingredients: Lettuce, carrots, tomatoes, cheese, crispy chicken.

   9. Sonic Drive-In Crispy Chicken Salad (with regular Ranch dressing): 534 calories; 37.6g fat; 8.5g saturated fat; 1,334 mg sodium; 5g fiber; 21g protein. Ingredients: Lettuce, crispy chicken, carrots, jack cheese, grape tomatoes, red cabbage, croutons.

  10. McDonalds Premium Bacon Ranch Salad with Crispy Chicken (with Ranch dressing): 540 calories; 35g total fat; 8.5g saturated fat; 1,500 mg sodium; 3g fiber; 30g protein. Ingredients: Mixed Greens, grape tomatoes, carrots, jack and cheddar cheeses, bacon, crispy chicken.

Yesterday, we asked you readers for the best deals at the major big box stores - CostCo, BJs Wholesale Club, and Sams Club. Your responses were comprehensive and, excuse my language, pretty farging great. (Quinoa! Who knew?)

Wiki Ken Hammond

Last night, I compiled those responses into this, a master list of Big Box Bargains – like a cheat sheet - which should help you find the best deals next time you visit a glorious warehouse. (For me, see: tonight.) Its useful! Its extensive! Its pretty!

About the process: Every product mention got one vote. (So, if three different commenters wrote "mushrooms," it got three votes.) Some things, like mattresses, elicited one clear vote and were easy to tally. Others, like cheese, were much more varied, producing several similar-but-not-exactly-alike answers. In those cases, I tallied the category as a whole, and then elaborated on individual responses within parentheses. (Um … if that makes sense, which it only kind of does. But youll see.)

Enjoy!

17 VOTES
Cheese (2 votes feta, 2 votes Tillamook)
Paper products (10 votes toilet paper, 4 votes paper towels)

16 VOTES
Spices (5 votes cinnamon, 3 votes pepper)

13 VOTES
Olive Oil

8 VOTES
Yeast (reader Jennifer: “Literally 100x cheaper than the envelopes”)

7 VOTES
Nuts (2 votes almonds)

6 VOTES
Pet food & supplies (3 votes dog food, 2 votes supplies, 1 vote cat food)
Salad greens (4 votes organic)

5 VOTES
Butter
Canned tomatoes (1 vote organic)
Dried fruit (2 Craisin votes)
Eggs (2 votes organic)
Milk (1 vote organic)
Quinoa

4 VOTES
Baby supplies (2 votes diapers, 2 votes wipes)
Bread (2 votes "fancy bread")
Chips
Electronics/big appliances (camera, elliptical, computer, etc.)
Gas
Vanilla Extract

3 VOTES
Alcohol (wine, bourbon, etc.)
Baking soda
Bananas
Cleaning products
Movie tickets
Mushrooms
Oatmeal
Peanut butter (1 vote organic)
Produce
Rice (1 vote Basmati)
Sabra Hummus
Soap
Yogurt (1 vote Greek-style)

2 VOTES
Almond butter, Bagels, Beans, Cereal (1 vote Kashi), Clif bars, Coffee, Contact lens solution, Drugs (Kirkland brand Advil, Zyrtec, etc.), Frozen berries, Frozen chicken, Ground turkey, Gum, Kids clothes, Laundry detergent, Lettuce, Maple syrup, Soy milk, Tissues, Toothbrushes/toothpaste, Tortillas, Vinegar, Potatoes, Tomatoes

1 VOTE
Bacon (Kirkland brand), Better than Bouillon chicken base, Bisquick, Books, Breathe-right nose strips, Brita filters, Brown sugar, Canned pineapple, Canned tuna/salmon, Cars (!), Checks, Chicken breasts, Chicken broth, Chicken thighs, Coconut Milk, Cornstarch, Crackers, Cutting boards, Dairy, Dental floss, Deodorant, Dish detergent, Dr. Pepper, Dried onions, Floss, Flour, Food court items, Fresh meats, Frozen edamame, Frozen hamburger patties, Frozen salmon fillets, Frozen shrimp, Frozen strawberries, Frozen vegetables, G2, Garlic, Gelato, Gift card deals (restaurants, movie theaters, etc.), Glasses, Goldfish, Grains, Granulated garlic, Ground flaxmeal, Honey, Hot dogs, Hot sauce, Green chiles, Janitorial supplies, Jarred roasted red peppers, Larabars, Marinated shrimp, Magazines, Marinated artichoke hearts, Mattresses, Nutella, Onions, Organic, Organic apples, Organic carrots, Organic frozen fruit, Organic hamburger, Popcorn (the kind you pop on the stove), Popcorn salt, Prescriptions, Printer paper, Ramen, Rotel, Rotisserie chicken, Salmon, Salmon burgers, Salsa, Shampoo, Shaving gel, Smuckers strawberry jam, Store-brand fish oil, Store-brand naprosyn, Sugar, Strawberries, Sun-dried tomatoes, Sweet potatoes, Tires, Toiletries, Tuna, Tupperware, Udis granola, Veggie burgers

Fun comments:

• Commenter Aryn writes: “Beware the giant box o pens. My husband and I bought 200 pens when we started grad school thinking wed use them up quickly. Its been seven years. We still have about 180 of those pens.” (Aryn! I totally did this once, too, for a friends promotional event. Maybe we can have a pen party?)
• Commenter Ami writes: "I tend to shop with my mom and we split items that neither of us can use in a week - we also split the cost of membership with makes it even more worthwhile."
• Also of note: Readers loved CostCo’s return policy, especially on appliances and electronics.

And thats it! Sweet readers, do you agree/disagree/have anything to add? The comment section is wide open.

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