Author Archives: suemah

Research Recap: Dietary Protein Amounts and the Risk of Type 2 Diabetes

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various protein foods such as fish, meat, eggs and milkGetting enough protein is important for good health. But can too little or too much affect your risk for Type 2 Diabetes?

Background

According to the International Diabetes Federation, China has the largest population with diabetes in the world, and almost half of them are undiagnosed. Researchers from the School of Public Health and Fudan University in Shanghai China were interested in exploring the link between protein intake and the risk of Type 2 Diabetes.

The researchers studied 29,517 adults who did not have diabetes. The average age of the participant was 55 years. The study lasted 5½  years from 2017 to 2022. Each of the participants recorded their usual food intake using a validated food frequency questionnaire.

What the study found

After the 5½ years, 5.1% of the study participants (1511 participants) developed Type 2 Diabetes. Those who developed Type 2 Diabetes tended to be older, had high blood pressure, carried excess weight and / or had a family history of diabetes.

Interestingly, the researchers found a U-shaped association between the risk of developing Type 2 Diabetes and the percent of energy (total daily calories) consumed from protein. In other words, people who ate either too little or too much protein had higher chances of developing Type 2 Diabetes.

Let’s look at this scientific graph, taken from the research paper.

A graph showing a flat U shaped curve relationship between risk of developing Type 2 diabetes (Hazard ratio) versus percent of calories consumed as protein (% energy from protein)

 

 

 

 

 

 

 

 

 

 

 

 

Along the vertical axis is the “Hazard ratio” with a 95% Confidence Interval. The hazard ratio measures the relative risk of something happening, in this case, the risk of developing Type 2 Diabetes. A hazard ratio of 1 (shown as the dotted black line in the graph) means that there is no difference in risk. A hazard ratio higher than 1 means increased risk, and lower than 1 means a decreased risk.

The horizontal axis of the graph is the “Energy from protein” – this is the percent of energy (total daily calories) from protein that a person eats. When protein made up between 12.20% to 16.85% of a person’s total daily calories, the risk of developing Type 2 Diabetes has a hazard ratio of less than 1. This is shown as the bottom part of the letter “U” under the dotted black line in the curve. The risk for developing Type 2 Diabetes increased by up to 1½ times when people ate less than 12.20% or more than 16.85% of their daily total calories from protein. The lowest risk of developing Type 2 Diabetes was observed when protein intake was 14.53% of the daily total calories.

How you can use this info

Protein is an important nutrient for many reasons, including bone health, muscle health and immunity. This research, published in Nutrition Diabetes (June 2025) suggests that eating a certain amount of protein may also lower your chances of developing Type 2 Diabetes.

The study found that eating 12.20% to 16.85% of your total daily calories from protein can be protective against developing Type 2 diabetes. Use this range as a guide.

Here’s a sample calculation showing how you would convert these percentages to grams of protein. The average adult eats about 2000 calories a day. So let’s use that number for this sample calculation.

  • For 12.20% of 2000 calories, multiply 0.1220 x 2000 to get 244 calories. One gram of protein contains 4 calories. So divide 244 by 4 to get 61 grams of protein per day.
  • For 16.85% of 2000 calories, multiply 0.1685 x 2000 to get 337 calories. One gram of protein contains 4 calories. So divide 337 by 4 to get 84.25 grams of protein per day.
  • Among the study participants, the lowest risk for developing Type 2 Diabetes occurred when protein comprised 14.53% of the total daily calories. Let’s do the math again. Multiply 0.1453 x 2000 to get 290.6 calories. One gram of protein contains 4 calories. So divide 290.6 by 4 to get 72.65 grams of protein per day.

In general, if you’re eating about 2000 calories a day, you can aim to eat between 61-84 grams of protein. And the lowest risk for developing Type 2 Diabetes in this study group was found among those who ate 72.65 grams of protein per day. Overall, this translates to eating about 20-25 grams of protein at each meal, which is what I generally recommend for muscle health.

Limitations of this study

  • Keep in mind that this study was done on a select group of adults in one specific country. The types of foods consumed by the participants may differ from the foods you typically consume. For example, more than half of the protein eaten by the study participants was plant protein such as soybeans, tofu and nuts.
  • Your protein needs may vary depending on other factors such as your health conditions, bone health, physical activity and strength training.
  • Diet is just one risk factor for Type 2 Diabetes. Your risk of developing diabetes varies with various factors including family history, diet, physical inactivity, high blood pressure, medications and ethnicity.
  • Always check in with your health care provider or a dietitian for personalized advice. Remember, this information is for educational purposes only and is not intended to replace the advice of your health care provider.

 

Research cited: Xu M, Zheng J, Ying T, Zhu Y, Du J, Li F, Chen B, Liu Y, He G. Dietary protein and risk of type 2 diabetes: findings from a registry-based cohort study and a meta-analysis of prospective cohort studies. Nutr Diabetes. 2025 Jun 3;15(1):25. doi: 10.1038/s41387-025-00380-z. PMID: 40461516; PMCID: PMC12134278.  https://pubmed.ncbi.nlm.nih.gov/40461516/

Ask a Dietitian: What is Resistant Starch…and how can it benefit your health?

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Text on a backdrop image of cooked pasta, cooked potatoes and cooked riceResistant starch is a type of fibre that resists digestion in the small intestine, and it can have health benefits.

One way to create resistant starch is to cook and then cool / refrigerate certain types of carbohydrates, such as potatoes, pasta and rice. This process (called “retrogradation”) changes the structure of some of the original starch to create a resistant starch that doesn’t get digested. The amount of resistant starch doesn’t change significantly when the food is reheated.

Here are a few health benefits of resistant starch:

  • Blood sugar control: Usually, starchy carbohydrates are digested and broken down into glucose which can raise your blood sugar levels. Since resistant starch is not digested, it doesn’t have this effect, so it can be beneficial for controlling your blood sugar levels.
  • Gut health: Resistant starch travels to the large intestine where it acts as food for the good bacteria in our gut. In other words, resistant starch is a prebiotic! When the resistant starch is fermented in the large intestine, it produces beneficial, short chain fatty acids.
  • More gut health: Since resistant starch is fermented slowly in the large intestine, it may cause less gas and bloating than other fibre-rich foods.
  • Satiety: Eating foods with resistant starch can help you feel full for longer.

Here’s what you can do:

  • Pasta: Cook pasta to al dente. Once cooled, store the pasta in the refrigerator. The longer it is refrigerated, the more resistant starch is formed. Eat the pasta cold in a pasta salad like my Caprese Pasta Salad, add to a soup, or reheat the pasta and enjoy it with a sauce. Bonus tip: Cook pasta to al dente – it will have a lower glycemic index than mushy pasta and create a slower rise in your blood sugar levels.
  • Potatoes: Boil, roast or bake the potatoes. When cool, store the potatoes in the refrigerator for at least a few hours, preferably overnight. Eat the potatoes cold in a potato salad or reheat them in your favourite recipe.
  • Rice: Cook rice as you normally would. Allow the rice to cool at room temperature and then refrigerate for at least 12 hours. Use the rice to make Best Shrimp Fried Rice or simply enjoy the reheated rice as a side dish. The amount of resistant starch does not change much after reheating cooked and cooled rice, pasta or potatoes.

 

Copycat Shake and Bake Chicken

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A plate of breaded chicken drumsticks

Copycat Shake and Bake Chicken

Do you remember Shake and Bake? This homemade breadcrumb and spice mix tastes just like the real deal! This recipe makes enough for 2-3 meals of baked chicken. Store any extra breadcrumb mixture in the fridge.
Print Recipe
Course Dinner
Servings 4

Ingredients
  

  • 1 1/2 cups breadcrumbs, plain
  • 1/2 tbsp salt
  • 1 1/2 tsp paprika
  • 1 tsp sugar
  • 1/2 tsp garlic powder
  • 1/2 tsp black pepper
  • 1/4 tsp cayenne pepper
  • 1/4 tsp dried parsley
  • 1/4 tsp dried basil
  • 1/4 tsp dried oregano
  • 2 tbsp canola oil
  • 8 chicken thighs or chicken drumsticks, skin on

Instructions
 

  • Mix all ingredients (except the oil and chicken) in large bowl. Add the canola oil and mix well.
  • Preheat oven to 400 F. Put about 1 cup of the breadcrumb mixture onto a large plate. Press one piece of chicken, skin side down, into the breadcrumb mixture. (Alternatively, for the authentic shake and bake method: put about 1 cup of the breadcrumb mixture into a large plastic bag. Add one piece of chicken at a time. Seal and shake the bag so that the chicken is nicely coated with the breadcrumb mixture.)
  • Place the chicken piece on a foil lined baking sheet. Repeat with remaining pieces of chicken. Add more breadcrumb mixture to the plate or plastic bag, if needed, using a clean spoon.
  • Bake in preheated oven for about 45 minutes or until internal temperature is 165 F.
  • Discard any breadcrumb mixture that has touched the raw chicken. Store remaining breadcrumb mixture in a mason jar or container in the fridge.
Keyword Baked Chicken, Chicken, Shake 'n Bake Chicken

Research Recap: Surprising Findings about Grocery Flyers in Canada

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A red grocery basket filled with foods in a grocery store aisleDo you look at grocery flyers? If yes, the findings of a recent Canadian study may surprise you!

Background

A group of researchers from Saint Mary’s University, Dalhousie University and the University of Waterloo looked at 53 grocery flyers from both discount and regular banner stores across Canada in 2014, 2017 and 2021.

The flyers were collected at least twice each year and not during calendar holidays such as Halloween, Christmas, Valentine’s Day or Easter since theme-related foods tend to be advertised at these times.

In total, 8790 foods and beverages were reviewed for their nutritional quality.

What the study found

Baked products were the largest category of foods advertised in food flyers, making up on average 11% of the entire flyer. Next were non-alcoholic beverages (excluding milk) at 10.7% and then milk / dairy products at 10.2% of the total items found in the flyers.

Vegetables and fruits only comprised 8.3% and 6.5% respectively of the foods advertised in the flyers. Meat products came in at 7.2% and snacks at 5.1%.

When reviewing the nutritional value of the foods / beverages in the flyer, more than half of the items advertised were considered ultra-processed and did not align with Canada’s Food Guide. About one-third of the items in the flyer were unprocessed or minimally processed.

Interestingly, the foods items shown on the flyer cover page were consistently more likely to follow the advice of Canada’s Food Guide. This observation was noticed in both discount and regular banner store flyers located in Ontario, Quebec and Atlantic Canada, but not for Western Canada. (The research authors didn’t explain why this wasn’t noted in Western Canada.)

The bottom line

This was the first nationwide observational study of grocery flyers in Canada and the first to analyze multiple years of flyer data.

As a dietitian, I often suggest planning your weekly meals based on the foods that are on sale. Since the healthier foods are typically found on the first page of the flyer, spend more time looking there and then scan the rest of the flyer for additional items to round out your grocery list.

 

Research cited: Alisson Dykeman MAHSR, Gabriella Luongo PhD, Leia Minaker PhD, Emily Jago MHK, and Catherine L. Mah MD, PhD . Ultra-processed Foods Frequently Promoted in Canada’s Grocery Flyers from 2014, 2017, and 2021, with Healthier Cover Pages. Canadian Journal of Dietetic Practice and Research (2025, July 14). https://doi.org/10.3148/cjdpr-2025-017

Supplements and Bone Health

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A plain white supplements bottleIn September, I presented a webinar in partnership with Osteoporosis Canada – Supplements and Bone Health. You can watch the webinar recording here (about 50 minutes).

Below is a summary of the key messages from the presentation. (This information is for educational purposes only and not intended to replace the advice of your health care professional.)

Calcium

  • Calcium helps build and maintain strong bones.
  • Get 1000-1200 mg/day, ideally from food first.
  • If you’re not able to get enough calcium from food, then you can take a calcium supplement.
  • Look at the amount of elemental calcium per tablet. Take no more than 500-600 mg of elemental calcium at a time.
  • Find a form of calcium that works best for you (tablet, chewable, soft gel, effervescent tablet).
  • Take calcium carbonate with meals or right after eating. Take calcium citrate anytime.
  • Talk to your health care professional about possible interactions between calcium supplements and any medications you may be taking.

 Vitamin D

  • Vitamin D helps our body absorb calcium.
  • Our body can make vitamin D when our skin is exposed to sunlight, but this is affected by the season, our age, sun screen and limited skin exposure to the sun.
  • If you’re under the age of 70, get 600 IU/day (15 micrograms/day) of vitamin D.
  • If you’re over the age of 70, get 800 IU/day (20 micrograms/day).
  • Not many foods contain vitamin D. Under new regulations by Health Canada, the vitamin D content in milk, goat’s milk and margarine will be almost doubled by December 31, 2025. Vitamin D can also be added to yogurt and kefir.
  • Health Canada recommends taking a vitamin D supplement if you’re over the age of 50 – take 400 IU/day, every day (not just during the winter months). You may need a higher supplement dose if you’re at risk for vitamin D deficiency. At the same time, eat foods that are rich in vitamin D such as milk, fortified plant-based beverages, eggs, yogurt and fatty fish like salmon and sardines.
  •  Most vitamin D supplements are most commonly in the form of vitamin D3. Take the supplement with a meal or snack that contains fat since vitamin D is a fat soluble vitamin.
  • Talk to your health care professional about how much vitamin D you may need. Don’t take more than you need since too much vitamin D can be harmful.

Protein, Vitamin K, Magnesium

Use the Nutrient Calculator on the Osteoporosis Canada website to see if you’re getting enough bone building nutrients like calcium, vitamin D, protein, vitamin K and magnesium. Talk to your health care professional or a Registered Dietitian if you’re not getting enough of these key nutrients.

 

 

 

 

Easy Quinoa Salad

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A bowl with quinoa, cucumbers, red peppers, red onion and feta cheese

Easy Quinoa Salad

My kid says "Mom, this is better than Costco's!" I agree - it's a delicious salad that is super easy to make!
Print Recipe Pin Recipe
Course Lunch, Salad, Side Dish
Servings 6

Ingredients
  

  • 1 cup dry quinoa
  • 1/2 cucumber, diced
  • 1/2 red pepper, diced
  • 1/2 small red onion, diced
  • 1 cup feta cheese, crumbled or diced
  • 1 clove garlic, minced
  • 1 1/2 tbsp olive oil
  • 1/2 tbsp balsamic vinegar
  • salt and pepper to taste

Instructions
 

  • Cook quinoa according to package instructions. Let cool.
  • In a large bowl, add cooked quinoa, cucumber, red pepper, red onion and feta cheese.
  • Make the salad dressing. In a small bowl or jar, whisk garlic, olive oil, balsamic vinegar, salt and pepper.
  • Drizzle salad dressing over salad and toss gently to coat. Enjoy!
Keyword quinoa, quinoa salad

What is Fibremaxxing…and should you try it?

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Background of fibre rich foods such as beans, nuts, oats and fruit

Fibremaxxing is the latest nutrition trend on social media. Should you try it?

What is fibremaxxing?

Fibremaxxing isn’t a medical term. In fact, my computer’s spellcheck doesn’t even accept the word (haha!).

Fibremaxxing essentially encourages you to maximize your fibre intake in meals and snacks throughout the day, to promote your overall wellness and digestive health. The aim of fibremaxxing is to meet or exceed the Recommended Dietary Intake for fibre, which is between 25 to 38 grams for adults. Most of us are only eating about half the amount of fibre that we need.

Why do we need fibre?

Fibre has many health benefits. First of all, there are generally two main types of fibre:

Soluble fibre – this is the type of fibre that can help lower blood cholesterol levels and control your blood sugar. It’s found in foods like apples, oranges, carrots, oats, barley, beans and lentils.

Insoluble fibre – this is the type of fibre that helps you stay regular and prevent constipation. It’s found in foods like berries, broccoli, carrots, potatoes, bran and whole grains.

Eating fibre also helps reduce your chances of developing heart disease, type 2 diabetes and colon cancer. Plus, fibre promotes gut health.

Should you try fibremaxxing?

Yes, you could try it, but with some very important cautions!

1. Focus on meeting, not exceeding the fibre recommendations. Too much of a good thing is not better for your health. Read the Nutrition Facts information to find the fibre content of packaged foods and check out the list of fibre rich foods below.

2. Add more fibre gradually. If you pump up the fibre too quickly, your gut will tell you – aka hello bloating, constipation or diarrhea. Aim to add a few grams of fibre every couple of days and build up to 25-38 grams daily.

3. Build sustainable habits. Try adding an extra veggie at dinner, having a bean-based meal or snacking on nuts.

4. Get plenty of fluids.  Fluids help fibre move through your body.

5. Reach for food first. Food is the most delicious way to get fibre. Only use fibre supplements / powders if needed and check with your healthcare professional first.

Note that extra fibre may not be recommended if you have / had irritable bowel issues, surgery, or are preparing for tests such as a colonoscopy. Always check with your healthcare professional.

Here are some top foods for fibre.

Fruits

Apple with skin  – 5 g

Avocado ½ – 7 g

Banana – 2 g

Blackberry ½ cup – 4 g

Blueberry ½ cup – 2 g

Pear with skin  – 5.3 g

Persimmon – 6 g

Pomegranate ½ – 5.6

Prunes, dried ¼ cup – 4 g

Raspberries ½ cup – 4 g

Vegetables

Artichoke hearts ½ cup – 7.6 g

Broccoli ½ cup – 2.9 g

Brussels sprouts ½ cup – 3.4 g

Butternut squash ½ cup – 3.5 g

Carrot ½ cup – 2.5 g

Cauliflower ½ cup – 2.6 g

Corn ½ cup – 3.6 g

Green peas ½ cup – 5.6 g

Mushrooms ½ cup raw – 0.5 g

Sweet potato, mashed ½ cup – 4.3 g

Grains

All Bran Buds cereal 1/3 cup – 11 g (not sponsored; this is a cereal I enjoy)

Barley ½ cup cooked – 3.7 g

Brown rice ½ cup cooked – 2.0 g

Multigrain bread 1 slice – 2.8 g

Quinoa ½ cup cooked – 2.7 g

Whole wheat pasta ½ cup cooked – 2.2 g

Nuts & Seeds

Almonds ¼ cup – 4.5 g

Chia seeds 1 Tbsp – 3.5 g

Chickpeas ¾ cup – 8 g

Edamame (soybeans) ½ cup – 5.7 g

Hemp seeds 1 Tbsp – 0.5 g

Kidney beans ¾ cup –12 g

Lentils ¾ cup – 6.2 g

Sesame seeds 1 Tbsp – 1.1 g

Sunflower seeds ¼ cup – 3 g

Nuts ¼ cup – 2.7 g

Source: Canadian Nutrient File

Chicken Pesto Pasta

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Chicken Pesto Pasta

A hearty meal made with savoury pesto sauce and a chef's tip for the most tender chicken ever! Recipe by Sue Mah, NutritionSolutions.ca
Print Recipe Pin Recipe
Course Dinner
Servings 6

Ingredients
  

  • 1 lb chicken (about 4-5 chicken thighs or 2 chicken breasts), cut into 1-inch pieces
  • 2 tsp light soy sauce
  • 1 1/2 tsp cornstarch
  • 3 tbsp canola oil, divided (1 tbsp + 2 tbsp)
  • 2 cups sliced mushrooms (about 6-8 large mushrooms)
  • 1 box 410 grams of dried pasta (e.g. penne, farfalle, rotini, gemeilli) [Or substitute with about 7 cups cooked pasta]
  • 1 cup pesto [For convenience, I use store bought jars of De Cecco Pesto (not sponsored)]
  • 1/3 cup sundried tomatoes, drained, sliced
  • salt and pepper to taste
  • fresh basil or parsley for garnish

Instructions
 

  • Prepare the chicken: Add the diced chicken to a bowl. Season with soy sauce and cornstarch. (This is a tip I learned from my chef Dad. The cornstarch and soy sauce help to tenderize the meat. Cornstarch also keeps the meat soft and velvety.) Toss to coat and allow to rest while cooking the pasta and mushrooms.
  • Cook the pasta: Cook pasta according to pasta directions. Reserve 1/2 cup of the cooking water. Drain the pasta, cover and set aside.
  • Cook the mushrooms: Heat 1 Tbsp oil in a large skillet over medium high heat. Sauté the mushrooms for a few minutes. Add salt and pepper to taste. Toss the mushrooms and continue cooking until lightly browned. Remove from pan.
  • Cook the chicken: Heat the remaining oil in the skillet. Add the chicken and cook, stirring occasionally for 7-8 minutes or until the internal temperature reaches 165 F.
  • Make the meal: Turn heat to medium low. Toss pasta and mushrooms into the skillet and toss with the chicken. Stir in the pesto sauce until pasta is heated throughout. Toss in the sundried tomatoes. Add a splash of reserved cooking water or oil from sundried tomatoes if needed or if the pasta seems dry. Season with salt and pepper to taste. Garnish with fresh basil or parsley.
Keyword Chicken Pesto Pasta, Chicken recipes, Pasta, Pesto Pasta

Ask a Dietitian: What is Coconut Cloud Coffee?

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Headshot of Sue with a glass of cloud coffee and coconut in the backgroundWith summer on the horizon, beverages are trending again, especially coffee beverages. Do you remember the Dalgona Coffee craze back in 2020? Now, Coconut Cloud Coffee is taking over social media.

What’s in it?

Recipes may vary, but essentially the ingredients include 3 Tbsp whipping cream, 1 tsp vanilla syrup and 2 shots of espresso – all whisked together until it doubles or triples in volume to form a frothy “cloud”. This is then poured over ice cubes and coconut water to look as if a cloud is floating on top of the drink.

Are there any benefits to drinking Coconut Cloud Coffee?

Proponents claim that coconut water is a healthier option than water because of its electrolytes. True, coconut water does contain electrolytes such as potassium and magnesium, though in small amounts especially if there is added water in the ingredients list. Note that coconut water (even unsweetened versions) contains natural sugars and some brands have added sugars. The total amount of sugars in a cup of coconut water can be up to 18 grams which is equivalent to 4.5 tsp of white sugar. And if you make Coconut Cloud Coffee, remember that there’s even more added sugars from the vanilla syrup in the recipe.

The bottom line

Think of Coconut Cloud Coffee as a treat or dessert. When made with whipping cream, it’s in the range of about 200 calories per cup. If you’re looking for electrolytes in food, try having a medium banana or ¾ cup of white beans or 2 cups of raw spinach.

 

Cottage Cheese Bagels

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Baked bagels on a wire rack

Cottage Cheese Bagels

You can make your own bagels with a few simple ingredients! Cottage cheese adds a boost of protein! Recipe by Sue Mah, NutritionSolutions.ca
Print Recipe Pin Recipe
Course Breakfast, Snack
Servings 4

Ingredients
  

  • 1 cup all purpose flour
  • 2 tsp baking powder
  • 1/2 tsp salt
  • 1 1/4 cup plain cottage cheese Strain 1 1/4 cup of cottage cheese to remove some of the moisture. This should yield about 1 cup of strained cottage cheese.
  • 1 egg + 1 tsp water
  • Toppings: sesame seeds, poppy seeds, everything bagel seasoning

Instructions
 

  • In a large bowl, whisk together flour, baking powder and salt.
  • Add strained cottage cheese to flour mixture.Stir with a fork to combine and form a shaggy dough. (Straining the cottage cheese prevents the dough from becoming too sticky.)
  • Knead the dough on a lightly floured surface and shape into a ball. Allow the dough to rest for about 10 minutes. (This allows the gluten to relax, making it easier to stretch the dough.)
  • Cut dough into 4 pieces. Shape each piece into a ball. Use your thumb to poke a hole in the ball and stretch the hole to about 1 1/2 nches as it will shrink upon baking.
  • Beat egg with 1 tsp water to create an egg-wash. Brush a small amount of egg wash on the top and sides of each bagel.(This helps the toppings stick to the bagel.)
  • Invert bagel and dip into a plate of toppings.
  • Cook bagels in the air fryer: Spray air fryer basket with oil. Bake the bagels at 275ºF for about 15 minutes or until golden brown. There is no need to flip the bagels. Allow bagels to cool for 15 minutes before cutting or eating.
  • Cook bagels in the oven: Preheat oven to 375ºF. Line a baking sheet with parchment paper. Spray parchment paper with oil. Bake bagels on the top rack of the oven for about 25 minutes or until golden brown. Allow bagels to cool for 15 minutes before cutting or eating.

Notes

Baked bagels on a wire rack
Keyword bagel, cottage cheese, cottage cheese bagels