Wednesday, February 27, 2013

Eat Right, Your Way, Everyday

It’s that time of year again, National Nutrition Month!  I have a sneaking suspicion that the only people who get excited about NNM are dietitians (and some may argue that many of them do not see the big deal either!) but I wanted to post for the occasion anyway.  The theme for 2013 (we have a theme every year-great isn’t it?!?!) is Eat Right, Your Way, Everyday.  Some years I really like the theme and other years I could take it or leave it.  This year’s theme really appeals to me.  After several years of working in the field of dietetics I have discovered that every person does things his or her way no matter what you tell them.  This is not a bad thing at all but it has taught me a great deal about working with individuals to improve their diet and health.  There are so many recommendations out there and many of them are not necessarily the best advice for everyone.  The following tips relate to just about everyone, aside from these recommendations I advise that you do what the month’s theme says.

1.)   Eat every day.  This sounds like a no-brainer but I mean it.  There are many diets out there that suggest fasting every other day or at least 2 days per week.  This is not a good idea.  It is fine to allow your body to go without food for approximately 12 hours but after that get the engine going and throw a little fuel on the fire…EAT.

2.)   Exercise every day.  Exercise means something different to everyone but what I am talking about here is to MOVE.  Studies have shown that even people who fidgit weight less than people who don’t. Take a walk at lunch, stand while on the phone, take a walk after dinner.  No matter what it is, move your body.

3.)   Eat a minimum of 1200 calories.  You may have heard this one and it is no fad.  If you do not meet the minimum requirements for calories the odds of you meeting all of you nutritional needs is greatly reduced.  Be sure to eat the minimum and to choose whole foods most of the time.

4.)   Eat colorfully.  This may sound odd but it is important that the food choices you make have a variety of color.  As I tell all of my patients, students and clients each color indicates a different concentration of vitamins, mineral and antioxidants.  It’s okay if you don’t like broccoli, eat okra instead but eat your colors every day!
5.)   Take care of you.  This is especially important for those folks who are busy everyday taking care of people at work or at home.  Whether it is your patients, co-workers, friends or family make sure that you set aside time to care for yourself.  You will be more help to others when you are at your best.

For more tips visit to see how you can improve your health.

Friday, December 28, 2012

New Year’s Resolutions That Stick

Vision Boards can be a great way to help you visualize your goals
We all do it, we make a resolution at New Year’s to do something and by January 3rd we are already neglecting it.  Oftentimes by February 1st we forget that we even had a New Year’s resolution to begin with.  Surveys show that most New Year's Eve Resolutions never become realized goals.  Here are a few tips to stick to your resolutions and reach your goals in 2013.
1.       Be sure to be specific as to what you want and make it something you can achieve.  Many people will say “I want to lose weight” but few will say “I will to lose 15# by April when my daughter gets married.”  Be sure to be specific whether it is so many pounds by a certain date or going to the gym/working out a minimum of 3 days per week.  Create a vision board, buy a journal, write an “end of the year letter” or create a list of things you want to accomplish in the coming year.  Use powerful statements such as "I am going to" or "I will" instead of "I want to."

2.      Once you have decided on something specific, create a timeline for your goal and outline specific tasks and actions that you will need to take.  Do you need to clean out the fridge on January 1st or pay that gym membership fee?  Do it.  Figure out what resources you will need and get them together before the first of the year if possible.

3.      Start early.  The biggest mistake people make in regards to New Year’s Resolutions is that they believe that they will magically wake up on January 1st and be motivated to achieve their goals.  This is (unfortunately) not true as that day is just like today or any other day for that matter.  Start on those resolutions THIS WEEKEND if you can. 

4.      Tell people about it!  That’s right, when you tell others about the goals you want to accomplish you are more likely to stick to them.  So post your vision board on a blog (like I did!) or post something on Facebook or Twitter or just tell a friend.  If you feel like you need, ask them to keep you accountable to reaching your goal.
5.      Track your progress.  It is important that you track how well you are doing.  Remember that falling off of the wagon today does not undo any previous progress made.  Getting off track is normal but keeping track on a regular basis helps you get back on task.  Do this with a daily journal or a weekly check-in note.  There are many Smartphone applications (such as for money, Noon Coach for weight loss and Evernote for keeping notes) to help you.  Look at how far you have come to see how far you can go!

Tuesday, October 2, 2012

Fall Snack Recipes

 F all is my favorite season of the year.  I have always loved the fall and have missed the changing of the seasons since I have moved to the southwest. However the local stores, including those where I buy my groceries, are reminding me that fall is here. There are so many great snack ideas that help me to take in the different fall flavors of the season and I love returning to them each October. Some of my favorite foods to use are pumpkin and pumpkin seeds, apples, winter squash (such as Butternut), pecans, almonds and sweet potatoes. When you add the fall spices like cinnamon, nutmeg, vanilla and brown sugar to that you have one tasty season. These are also foods that many people, myself included, tend to forget about the rest of the year. Following are a few of my favorite recipes and snack ideas for fall.  Happy Fall snacking!!

Greek Pumpkin Yogurt

1 cup plain, low fat or fat free Greek yogurt (any brand will do)
1/3 to 1/2 cup pumpkin puree (I usually use canned)
1/8 to 1/4 teaspoon pumpkin pie spice
1/2 teaspoon sugar or artifical sweetener (such as Splenda or Truvia)
1/2 Tablespoon pumpkin seeds (roasted, unsalted)
Cinnamon-to taste
1. Mix pumpkin puree and pumpkin pie spice and sugar (or sweetener) together with wire wisk
2. Mix Greek yogurt and pumpkin puree together with wire wisk (I find that the wisk works well but a blender would probably work as well)
3. Sprinkle a the roasted (unsalted) pumpkin seeds and cinnamon over top for a crunch

Baked Apples

5 Tablespoons of Maple syrup (may be sugar free)
1/2 cup low fat milk or Non-dairy milk
1/3 cup of Oatmeal
1 teaspoon Vanilla
1/2 teaspoon Cinnamon
1/4 teaspoon Nutmeg
3 Apples, sliced
1/4 to 1/2c chopped pecans

1. Preheat oven to 350 degrees. Mix all ingredients, except apples, pecans and 1 T of maple syrup, in a large bowl. Add apples and toss until well coated.
2. Pour into a 9×9 baking dish and cover with foil. Bake for 20 minutes. Remove foil, stir once and bake for 20 more minutes.
3. Toss pecans in maple syrup and sprinkle on top of the apples during the last 5 minutes of baking.

Mashed Sweet Potatoes

                      2-3 Medium sweet potatoes
                      1/2 cup low fat milk or Non-dairy milk
                      1 Tablespoon Cinnamon
                      1/2 Tablespoon nutmeg
                      1/4 cup brown sugar or Splenda brown sugar artificial sweetener
                      1/4 cup melted margarine or canola oil
                      1/2 cup slivered roasted almonds
1. Peel and chop sweet potatoes in small cubes and boil until soft.
2. Once cooked through, drain pototoes and mash with a potato masher
3. Add in other ingredients and mix together (I use an electric hand mixer)
4. Top with slivered roasted almonds and serve
Butternut Squash Soup

                     2 onions, diced
                     6 cloves garlic, peeled
                     3 pounds butternut squash, peeled, de-seeded, and cut into 1-inch cubes
                     1 tablespoon fresh ginger, minced
                     1 bay leaf
                     7 cups vegetable stock or water
                     1 teaspoon cinnamon
                     1/2 teaspoon nutmeg

1. In a large pot, combine the onions, garlic, squash, ginger, bay leaf and stock. Bring to a boil and then simmer gently for about 30 minutes. When the squash is tender, add the cinnamon,
and nutmeg. Simmer another 5 minutes.
2. Remove the Bay leaf and puree with an immersion blender or place in a blender jar and process until smooth. Transfer back to the pot, season with salt and pepper to taste, and re-heat.
Hint: Some stores sell peeled, chopped, winter squash in bags, both fresh and/or frozen which cuts down on preparation time.

Monday, August 13, 2012

Shop Smart and Read the Label

Smart Shopping and Label Reading
            These days it seems as if the simple act of shopping for food has become just another task on the busy to-do list.  Add to that the barrage of advertisements (in store and not) and mixed messages that the media is touting and you have some pretty confused folks wondering the supermarket trying to make heads of tails of it all.  I have put together a grocery shopping guide to use when you head out to the store.  Always be sure to avoid shopping on an empty stomach and plan ahead what you are going to buy and prepare for the week ahead.  The best advice overall is to choose whole foods.
1.      When you get into the store be sure to get the size of cart that you are going to need.  If you need a few items from a list be sure to just grab a basket or small cart.  If you are shopping for a large family and buying for one week or more go for the bigger cart.  The reason is that if you have more room to store items you may end up buying more items than you need.
2.      Begin with the perimeter.  The most important foods are found in the perimeter (fruits, vegetables, meats, dairy, etc).  Start by stocking up on the fresh fruits and vegetables that you know you will be able to use within a week or so.  Then head onto meats and diary and buy enough for the week or buy some meats and freeze them for the month.  Try to plan your meals around these food groups.  Keep in mind that juices often are mostly water and sugar (even some of the better brands) so stick to whole fruits and vegetables as much as possible.
3.      Head to the isles after you finish the perimeter.  This is where the packaged items will be found.  These items are more likely to be processed, canned, and have additives that are unnecessary for your body (but necessary for long-term storage).  Choose wisely when shopping in these isles.  Try to avoid foods that are canned and those that are heavily processed (check your ingredient list-the first ingredient is the highest percentage of that food and so on down the list).  Choose whole grain cereals, breads and pastas and whole wheat crackers without added fats.  Grab some mixed, unsalted nuts as a snack.
4.      End with the freezer section where you can choose dairy foods, meats and frozen fruits and vegetables that may remain in your freezer for longer than one week.  This is where you want to check the labels carefully to avoid trans-fats and sugars at greater than 10-12g per serving.  Be sure to check the ingredient list of fruits and vegetables for additives that are unnecessary (for example-frozen broccoli should say broccoli, nothing more).
Label Reading Tips
1.      Start at the top with serving size and servings per container.  If you plan to eat more than one serving you will need to multiply everything else on the list by that number of servings to know how much you are actually eating.
2.      Try to avoid foods with greater than 3g of total fat per serving (unless it is nuts, oils and margarine or avocado).  Packaged foods (even foods such as bread and cereal) may contain added fats (and sugars and salt).
3.      Limit the sugar content.  A breakfast cereal with more than 6-10g of sugar is a dessert, not a breakfast.  Also keep in mind that sugar alcohol and sugar are pretty much the same (in the way that they act in your body) so do not be fooled.  Avoid sugar alcohols the way that you avoid sugar.
4.      Watch out for those fat-free and sugar-free lines on packages.  When a product has the fat taken out, often either sugar or salt is added.  Additionally, when a sugar or salt are removed fat is often added.
5.      Limit salt content.  Sodium is in virtually everything that is processed (as it acts as a great preservative).  In fact recent studies indicate that many Americans are getting most of their daily sodium from the bread that they eat.  Limit sodium (aka salt) to 1,500-2,000mg per day.
Remember that whole foods are foods that can be readily found in nature and/or are minimally processed before you eat them.  A good example is an apple vs. apple juice or carrot sticks vs. cheese flavored crackers.  Choose whole foods first.  Try not to buy items that you may find tempting when in your home.  If you have trouble eating only a few cookies then don’t buy a big package and keep it at home.  Every once and a while you can always stop by a store for a small package and enjoy the smaller portion.

Tuesday, June 12, 2012

Five Things You Can Do Today for Better Health

Oftentimes life keeps us pretty busy and focusing on healthy behaviors can drop down the priority list.  Stress is a major contributor to unhealthy habits which can lead to poorer health and lower quality of life.  The good news is that oftentimes all that we need is to make a few good choices during the day to accomplish our health goals and get back on track.  Remember that healthy living is made up of every choice that you make throughout the day, every day.  Try making these five choices today to start improving your quality of life.
1.       Eat breakfast.  I know that you hear this often but starting the day out with a solid breakfast will be a key factor in how you feel for the rest of the day.  Skip the bagel and doughnuts though and grab some berries, yogurt, whole grain cereal or an egg white omelet instead. 
2.      Drink water.  Summer is officially here and that means that you are much more likely to become dehydrated.  Our bodies need a minimum amount of water daily to function properly and dehydration can make you feel tired and run down all day.
3.      Go for a walk.  Whether it is 15 min during your lunch break, 20min before work or 30min or more after work head outside and go for a stroll.  We often think that exercise means sweating and exerting a lot of energy but all activity throughout the day counts.  Vigorous exercise is definitely recommended at least twice a week but those little walks really add up to better health at the end of the day.
4.      Catch up with someone today.  It can be as simple as a phone call, chatting via the computer or having coffee with a friend but personal relationships add to our quality of life.  Call someone you have been meaning to talk to or have lunch or dinner with your co-worker or significant other to just chat about your day. 
5.      Go to bed early.  Sleeping less than 7-8 hours a night can lead to tiredness the next day and for many people a higher intake of calories.  When our bodies don’t get enough sleep we don’t have enough energy to get through the day.  So have a cup of (non-caffeinated) tea and hit the hay early tonight for a better tomorrow.

Tuesday, May 15, 2012

Make Exercise More Meaningful

    To be honest I have always been an active person.  I played outside most of the time as a child and was on a little league team by the age of 5.  I swam 3 years in high school and was on the track and field and tennis teams and even swam one year in college.  I have felt that I kind of need to be doing a sport in order to stay active.  Sure sometimes I will go to the gym and take a cycling class or jump on the Arch trainer but that cannot be the only thing I do.  As an adult I have undertaken the sport of triathlon and I have to admit that I really enjoy it.  People look at me like I am a lunatic when I say that I do it because there is the misconception that it’s “hard.”  Honestly as long as you train for it and you at least somewhat enjoy each sport triathlon is great!  I would argue that multi-sports are better than single ones as they get you doing different activities (and since boredom, routine and “regular” exercise are not really my forte it is perfect for me).  I have found that training for my next race is a huge motivator to exercise when I am not feeling up to it.  It also keeps me more focused on my diet as good nutrition is very important for athletic performance.  Whenever I am discussing exercise with someone, this is the advice that I give when deciding what it best for you.
·         Find something that you enjoy.  This seems like a no brainer but you would not believe how many people tell me that they will pick up running only later on to admit that they hate to run.  This is not a wise plan when trying to choose a behavior that fits into your lifestyle FOR LIFE!
·         Try different activities.  This is pretty easy and I highly suggest it to avoid boredom and to find out exactly what it is that you enjoy.  I have tried a number of activities including skiing, ice skating, windsurfing, hiking and dance classes.  The key here is to try new things that at least sound like fun and stick with those that you enjoy the most.
·         Mix it up!  Once you find one thing you like, start looking for others.  Have a plan B activity for those days when you are unable to do your favorite.  Also, mixing up you exercise routine prevents your body from getting too used to the activity.  When we get too used to an activity we need to work harder at it to continue to be challenged.
·         Try out a sport if it is your thing.  Okay so you won’t be joining the high school football team again but look for recreational sports at places like the local YMCA.  You can also train for an upcoming 5K run or 20K bike ride or join a master’s swim class at a local University.
·         Eat like an athlete.  When you decide to become more active it is time to eat more like an athlete.  Starvation dieting will not work if you plan to take on an activity on a regular basis.  Eat enough food and eat plenty of nutrient rich foods (whole grains, fruits, vegetables and legumes) every day.  Time your meals around your exercise/activity to see what works best for you.
·         Challenge yourself.  This is one really big reason why I do cycling classes and train for triathlon.  Moderate exercise is good but vigorous is important too.  In fact you are likely to feel hungry after moderate exercise but less likely to be hungry after vigorous exercise so push yourself!
·         Don’t forget strength training.  This can be as simple as a $10 workout DVD or as much as a class at your gym.  Building muscle is important for strong bones and a faster metabolism.  Resistance training can also decrease the loss of lean muscle mass if you are losing weight (along with eating plenty of food).
The last most important thing is to find other people who are enjoying your activities.  Exercise is always more fun with other people plus you are more likely to push yourself and each other in a group.  Join a running or cycling club or a hiking meetup group.  Take your family or find a workout buddy to go to the gym with .  Having some support and making it a social activity will increase the likelyhood that you will continue to do it longterm. 

Monday, April 23, 2012

A Dietitian's Top Ten List of Foods to Include in a Heart Healthy Diet

May, which is Older American’s Month, is fast approaching and as an early tribute to Americans over the age of 65 years I wanted to touch on the topic of heart disease.  I don’t want to do this because these Americans are more likely to have or die from the disease but because heart disease is the reason that my father never made to be and “older American.”  Heart disease has been nicknamed the “silent killer” because in many cases it takes someone’s life quickly and without previous warnings.  Heart disease can affect people of younger ages so it is important to know your risk and do your best to prevent this disease.  For the record my father was 36 when he had his first (known) heart attack after which he had a double bypass coronary graph and he was 53 years old when he died.  His father, my paternal grandfather, only lived until age 63 before he succumbed to complications of heart disease.
While heart disease is the most common chronic disease facing Americans right now it is usually accompanied by type 2 diabetes, high blood pressure and obesity.  For many of us, including myself, our genetic background and family history paint a grim picture of a future without proper self care and early detection.  For many others who lack a substantial family history don’t dismiss your risk either.  Just from what I see in my clinic on a monthly basis I encounter patients with absolutely no family history of the disease.  In fact while that can increase your chances of getting the disease that risk factor pales in comparison to diet and lifestyle.  I used to think that having a family history of the disease was a terrible burden to bear but as it turns out it has been pivotal in motivating me to know my numbers (lipid panel and glucose) and maintain a healthy lifestyle.  The good news is that with early detection and lifestyle modification the disease can be prevented, controlled and some cases reversed (for more information on reversal see Dr. Dean Ornish’s work).
Before getting into the important nutrition component I feel compelled to touch upon some of the lifestyle factors that can lead to the disease.  This includes smoking (please quit-my father died with a pack in his pocket), being overweight, uncontrolled diabetes and a sedentary lifestyle.  Basically it means don’t smoke or quit smoking, control your blood sugars if you have diabetes and use exercise as one tool in helping keep your heart strong and maintain a healthy weight.   The other main tool in losing weight is good nutrition.  My favorite handout to give my patients is a top 10 list which highlights the most important foods to add to your diet.  Ideally by adding in healthy foods you will find that less healthy food just doesn’t have as much room in your diet and limiting them feels more natural and less like deprivation.
1.      Considering all of the benefits that we hear about soy it should be no surprise to find it on the list.  However you only get the benefits  by swapping out soy products for meat and dairy choices (such as milk).  So if you have never tried Soy milk or soy beans you may be surprised what you are missing out on.

2.      Nuts and seeds-I can’t count the number of times over the years that I have had to tell the wife of one of my patients to let her husband have his peanut butter and cashews!  Go for unsalted, raw nuts and eat a variety.

3.      Fish Oil-First let me suggest starting out by adding in foods and if you feel compelled to use a supplement I would say that you need to discuss it with your doctor.  You will find high amounts in trout, salmon, mackerel, albacore tuna and herring.

4.      Monounsaturated fats-A typical Western diet provides too much Polyunsaturated and saturated fats without the much needed balance of these oils.  Go Mediterranean by using olive oil as a dressing and throw some walnuts on your salad.

5.      Spices-Especially garlic, are good for your heart.  Try to use a variety of spices (such as turmeric, cinnamon, curry, ginger, etc) and use them whenever possible.  Use them in place of salt when you can.

6.      Whole fruits and vegetables-This seems like a no brainer I know, but it really is important.  Fresh fruits and veggies are best followed by frozen ones.  When you cook them be sure to leave a little crunch in the food which means more fiber.

7.      Water-This is an important nutrient for everyone unless you are on a fluid restriction.  While it may seem counterintuitive, the best way to avoid collecting fluid (especially around the heart and lungs as seen in congestive heart failure) is to drink more water.  You can also benefit your heart by drinking black and green teas (which should be decaffeinated).

8.     Fiber-Fiber is found in fresh fruits, vegetables, legumes and whole grains primarily.  Every meal should be providing fiber.   On average we need 25-30g per day.  One way to get a little extra is to use a fiber supplements such as Metamucil or Benefiber.

9.      Whole grains-How do we know when we are buying whole grains?  Read your ingredient list and look at the first ingredient which should say-whole grain.  If it doesn’t see if there are better options for you.  A rule of thumb; each slice of bread should have at least 2 grams of fiber.

10.  Chocolate-I bet you didn’t expect to see this on my list-did you?  That’s right dark chocolate and baker’s cocoa are very good for the heart.  The best way to get it into your diet is by cooking or baking with cocoa or dipping fresh fruit into melted dark chocolate as a treat.