Saturday, September 9, 2017

September at a Glance



September at a Glance

It’s almost been two months that I’ve been at my new job.  Talk about time flying!  I mean it feels like it was just yesterday that I was starting to get adjusted to my new schedule, new co-workers, and new job duties.  To say that I have been happy is an understatement.  I'm doing what I love and loving what I do and I have amazing co-workers - really truly family oriented.  But I think one thing that stands out with my new job is the ability to control my schedule - I feel blessed.  I’m not dependent on a patient showing up late anymore and there’s no late night charting after the full slate of patients in a day.  I work my 40 hours a week (not 50 or 60) and again have the ability to work 6 hours one day if the next entails 10 hours – it’s all dependent on our programs and events happening for the week.  Planning and organizing is key – but I’m good at that (I’d like to think).  And the reason why I mention the timing part is that was what I’ve mentioned on the blog here and here – I wasn’t balancing my work and home life well at all.  How could I when I was consumed with work?  Not to mention my social life was effected.  I wasn’t practicing the very thing that I would tell my patients and I was walking around stressed out – not good for my health and unfortunately not good for my co-workers at the time.  The transition to the new job has been good.  I’m doing what I love – teaching nutrition in a group setting.  Just last week I did a supermarket tour.  Everyone came with such great questions and being right there where all the products are really made it hit home with some of the participants about how to make the healthier choice.  Call me a nutrition nerd, but how fun!  I love passing on the message of how to eat healthy and learn to decipher what products to buy.

NEWtrition Facts Labels

In May 2016, the Food and Drug Administration finished its overhaul of the Nutrition Facts labels, giving larger companies a July 2018 deadline to put them on packages.  Not trying to talk politics here, but in June the Trump administration postponed the deadline (ugh).  However, some companies have updated their labels even with Trump’s postponement (woohoo)!  Here is a new label to see what’s different:
The new labels distinguish between natural and added sugars.  This will be an eye opener for some in seeing how much sugar they are actually taking in.  The recommended amount is just 6 teaspoons/day (~25g) for women and children and just 9 tsp/day (~36g) for men.  It can get confusing at times, but the truth of the matter is that we need to start cutting back on our total amount of sugar – start by adding up how much you are currently consuming with the intent to cut back.  Yogurt would be your first area –
Trader Joe’s avocado-citrus – has 12g of added sugar (that would be half my days' worth) in a 5 oz. cup in addition to 3g of naturally occurring milk sugar, lactose.  My advice, opt for plain yogurts and add in your own fruit to have naturally occurring sugar provide the sweetness.  Remember the intent is to start where you are at and begin to cut back.  Yogurt, a seemingly "healthy" food loaded with sugar.  Glad the added sugars have now been added to the labels.

Quaker Orchard Peach Oats – You might think you’re doing well eating oatmeal, when in fact you’re eating ½ your day’s added sugar ladies!  The orchard peach flavor has 13g (3 teaspoons) of added sugar.  Gah!  4g is from the actual peaches and that’s why the total shows 17g.  I’m here to tell you that yes, I know adding in some sugar or maple syrup will make it taste better and maybe you are doing better by eating oatmeal than before when you were eating pancakes and syrup in the morning.  Point taken.  But it’s astounding to me how much they add in to these products and now are having to out themselves.  As an educator, my hope is that as people become more aware they can begin to now lessen the amount they are taking in.  Try doing your own overnight oats – here's a recipe example here - it's a simple ratio, equal oats to equal milk.  Just be careful with the sweetener you're using, aim to use as little as possible and add in fruit to naturally add the sweetness.  Flavor combinations are endless!


Izze sparkling grapefruit juice – Not to confuse you, but let’s face it, it is confusing.  Their exact words from their website –
70% pure fruit juice and a splash of sparkling water. That’s it. No added sugar, no high-fructose corn syrup, no preservatives, no caffeine, and no evil sciency chemical concoctions. Because at IZZE, we believe juice should be pure with a splash of sparkle.”  
Juice is juice (I don’t care that they diluted it with water).  This 12 oz. bottle has 29g of sugar from apple, white grape, orange, and grapefruit juice.  No juice sugars don’t count as added sugar, but the truth?  No one needs to drink juice even if advertisers say you should and it looks natural.  Sorry not sorry.  Eat a piece of fruit and get the added benefit of fiber in your diet.
Kind Fruit/Nut Delight bar – has 4g (1 teaspoon) of added sugar.  For a nut/fruit bar, that’s actually not too bad.  3g is coming from the actual fruit – they’re using an added sugar to help the nuts and fruit bind together - a better grab and go option.  Just be careful with some of the KIND bars as they do use palm kernel oil to help them bind - this particular “Fruit and Nut” bar doesn’t but many of their other products do. 


Keep in mind the FDA is basing the Daily Value on “added sugar” to be 50g.  The American Heart Association recommends what I stated earlier – 6 tsp/day (25g) for women and 9 teaspoons/day for men – way less than the FDA’s recommended amount.  This is one area I would not recommend looking at the percentages for – definitely look at the grams of added sugar and aim for as little added sugar as possible.



My new job title is “Wellness Dietitian”.  The department I work for is called Community Health and I do just that – educate out and about in the community.  But it bodes the question what is wellness?  It’s a more commonly used term within different health professionals, but within nutrition what is it really?  How are you well with nutrition?  The dictionary definition of wellness:

noun

1.

the quality or state of being healthy in body and mind, especially as the result of deliberate effort.

2.

an approach to healthcare that emphasizes preventing illness and prolonging life, as opposed to emphasizing treating diseases.

I’ve always wanted people to prevent diseases rather than have to treat them (after the fact).  I think sometimes I live in a nutrition la la land.  But the truth is many times people don’t change their eating habits until after they’ve had a diagnosis made.  So back to this wellness definition, recently people have been talking about how to connect all 6 dimensions of wellness – physical, social, intellectual, spiritual, emotional, and occupational. 
The other night I did a presentation where I talked about the “Hunger Fullness Scale” I think this is a good example of combining different components of wellness – are you actually hungry?  Are you eating because you’re bored?  Anxious? Or are you simply eating out of habit?  All of this pertains to one’s nutrition and why we eat, but the truth of the matter is we need to hone in on our actual hunger cues (the physical sign) where we sometimes don’t pay attention to.  We do often eat based on our emotions (the emotional) even when we know better (intellectual).  And sometimes we’re eating just because others are eating (social).  Nutrition can get complicated.  Many people “live to eat” rather than “eat to live”.  We should be mindful (spiritual) of this in helping ourselves to have nourishing meals that sustain us and provide us the nourishment we need.  It doesn’t always work this way, but that’s the goal and what we should aim to do.  My yoga teacher recently wrote an article on what “wellness” means - Seven Simple Rituals for Creating Wellness in Your World
I think the definition can be intermixed and it’s still evolving, but the truth of the matter is that in order for us to be mind-body-spirit connected, we really need to know ourselves and be present in the moment (as much as we can).


September is National Childhood Obesity Awareness Month - The statistics are startling.  1 in 6 (17%) children in the United States are obese.  Children with obesity are at a higher risk for having other major chronic health conditions and diseases - asthma, sleep apnea, type 2 diabetes.  They also have more risk factors for heart disease:  high blood pressure and high cholesterol.  Children with obesity are also more likely to be bullied and teased more so than their normal weight peers.  This can lead to social isolation, depression, and lower self-esteem.  Children with obesity are more likely to be obese as adults.  This can lead to lifelong physical and mental health problems - type 2 diabetes, heart disease, and many types of cancer. 

Childhood obesity is influenced by many factors:  eating and physical activity behaviors, genetics, metabolism, family and home environment, and community and social factors.  Obesity may also be influenced by:  too much time being inactive, lack of sleep, lack of places to go for physical activity, lack of access to affordable, healthier foods. 

How can you as a parent help prevent obesity and support healthy growth?  There are many things parents can do to help their children achieve a healthy weight and maintain it.  
  • Be aware of your child's growth.
  • Provide nutritious, healthy foods in place of foods that are high in added sugar and fat.  Aim to serve more fruits and vegetables at meals - even if they kick, scream, and cry when veggies are being served.
  • Make sure water is available and limit sugary beverages (sodas, teas, punches, juice, etc.)
  • Help kids get active - this could be helpful for parents too!  Aim to have them move more.
  • Be a role model.  When you're eating healthy meals and snacks, they will too!  If you're not eating vegetables, odds are they won't want to.  Try to find a new veggie each week to prepare and trial.  Keep in mind it might take up to 10 introductions (or more!) before a child will be willing to try a new food.  Be patient & keep experimenting!
Veggie Transformation - Broccoli Stems - http://withfoodandlove.com/broccoli-stem-salad/
The goal is to raise awareness in regards to childhood obesity.  Start where you are at and aim to implement healthy habits, one at a time.

September is also officially National Yoga Month.  It's a national observance designated by the Department of Health & Human Services designed to educate people about the health benefits of yoga and to inspire a healthy lifestyle.  If you've never practiced yoga, I invite you to try. 

Yoga is unique because you connect the movement of your body and the fluctuations of your mind to the rhythm of your breath.  Connecting the mind, body, and breath helps us to direct our attention inward.  Through this process of inward attention, you can learn to recognize your habitual thought patterns without labeling them, judging them, or trying to change them.  You become more aware of your experiences from moment to moment.  The awareness that you cultivate is what makes yoga a practice, rather than a task or goal to be completed.  Your body will most likely become much more flexible by doing yoga, and so will your mind.

Writing my blog a day early - one because I have the time and two because we are bracing for Hurricane Irma here in Miami.  While this week has been one of anticipation, stress, and preparation, the storm has ultimately moved west.  We will get tropical storm/hurricane strength wind and rain from the bands of the storm (so there may be power outages), but we are not getting a direct hit or "the big storm" of the century as had been expected.  While I am grateful for this shift in the storm's path, I do not wish this storm on anyone.  We just saw the devastation from Hurricane Harvey and now are all waiting to see the wrath of Irma.  Prepare as much as you can (evacuate if necessary) and stay safe, Florida!

Sunday, August 20, 2017

Not Sponsored. And Definitely Not An Ad...Just here to educate


I debated on whether or not to write this post.  Some dietitians will agree with me and some will obviously not.  That’s the beauty of opinions. So here goes…Recently the trend has been for food manufacturers to have food bloggers promote their products.  On the pictures the food bloggers will write #ad #sponsored so it’s well apparent that they are promoting a product.  This is the state of social media these days, hashtags help promote.  Add that to a popular food blogger and people are out buying their products.   The food manufacturer’s win and win big $$.  How much are the food bloggers paid?  I don’t know and I really don’t care.  What I as a dietitian care about is for people to be healthy. And let’s be honest all these products that are being promoted are not healthy.  Food bloggers are not all dietitians, so I don’t hold it against them to know any better.  And as I said, if you see your favorite food blogger making a yogurt parfait with some sugar laden yogurt (or whole-milk based yogurt), you are going to go buy that product.  You want to make exactly what the food blogger is making.  I’ve been there – if it looks good, I’m immediately at the store buying the ingredients.  Yes, I’m addicted to cooking and baking and all things food.  But the product endorsement these days is now involving dietitians.  Yes our underpaid selves are now accepting sponsorships from questionable products.  I’d love to say that all dietitians are picking healthy products/brands, but the truth of the matter is they are not.  I scroll through enough Instagram pictures to know that I do not have sugar laden yogurt in my refrigerator.  It’s a mixed message when you promote that and people believe it is something they should go eat.  So when does it cross the line between profiting yet promoting health?  This is just one of the reasons why I think dietitians should be paid more as a profession (the age old debate)…maybe then we wouldn’t have to get sponsorships.  I’m all about preventing disease, but in the nutrition world that’s an ideal world to live in.  People do not think about prevention, but rather start paying attention once there is an illness.  I hope through my blog I’m able to show people that healthy can taste delicious…I think my pictures are proof.
As a dietitian, patients ask me all the time, “what product should I buy?”  I try to stay as impartial as I can be – educate the patient as to what key words to look for on the label and from there be able to choose whichever brand that may be.  Because at the end of the day they are not always going to have you (the dietitian) in their back pocket.  Teaching them how to make these decisions is critical, because let’s face it the supermarket is overwhelming.  I forget the stat at how many new items come in to the store on a weekly basis, but it’s hard even for me to know some of the latest products.  Enter, teaching how to read the label to patients so they can now make the better choice.  My co-worker leads a “Navigating the Supermarket” tour here in Miami (and I’ll be doing them soon too!) but it’s inevitable that the question comes up “which brand should I buy?”  Education is key in making the healthier choice.  Re-directing the patients to be able to see that they now can read the label and make the best choice for them (and their family).  It’s empowering.  Peanut butter really should only list as the ingredients, peanuts, salt, and that’s it.  Yes, that’s it.  I don’t care what brand you buy, but the bottom line is anything else added in is either sugar or an unhealthy trans fat that no one needs.  It’s hard to navigate with all the marketing strategies and not feel like you’re being deceived.  I get it.  Just know that they do want you to buy their product – “double fiber” bread I see you.  We’re all working to improve how we eat.  Figure out what your goals are (as they are different than mine) and begin to change one thing at a time and build as you go.  It won’t seem so overwhelming that way.  Promise.
The following are products that I use in my kitchen – no I am not sponsored and these are not ads.  It’s just what I eat.  And while this might seem like a product endorsement, I like to see it as I discussed, a teaching moment.  Read on to see what I say about the items and again, forget the brand, buy whichever brand you want that fits the bill of what I describe.  Because in Florida the brand might be Publix, where in California it might be Ralph’s or Kroger’s. 
Whole Grains.  Oats.  Quinoa.  Bulgur.  Farro.  Sorghum. (featured in the picture, but there are more grains – wheat, rice, spelt, buckwheat, couscous and more!)  They are all different varieties of grains.  But are they whole? It can get confusing when you’re at the store.  Are they added in with spinach powder or inulin (extra fiber) or are they just one ingredient on the label?  I’ve been challenging myself recently to rotate the whole grains that I’m eating.  I get in a rut and eat brown rice on repeat.  The truth is that half of your grains should be whole.  And with those grains, there should be a variety.  That’s the goal anyways.  Aim to find some whole grains you are able to include and stray from the enriched grains – think white flour that’s been stripped of the vitamins, minerals, and fiber, that they then try to add it back in.  If you’re not into quinoa, that’s fine.  The idea is to find a few whole grains to incorporate into the mix and lessen the amount of enriched grains we are eating.  P.S. if you’re not into quinoa, try this recipe and then let me know if you’re not into quinoa.
My absolute favorite way to eat quinoa!

Keeping with the theme of whole grains.  It’s hard to find a whole grain cracker in the store.  Period.  Here’s one that I recently found that doesn’t taste like cardboard.  I would love to say that I make my own crackers, but the truth is I need something quick sometimes.  These have been in the rotation.  I love their picture they added on the front for a balanced snack – cracker for the whole grain, cheese for the protein, and some fruit for some more carbohydrate, but hey it’s still balanced.  I use ricotta cheese sometimes with tomato and basil with a drizzle of balsamic vinegar.  And when I’m really in a pinch a simple smear of a nut butter does me just fine.  Here are a couple other crackers I also have in the rotation, you know for variety.


Here is another cracker that has been around for awhile now and Trader  Joe’s just recently surfaced with one that’s quite simple as well – where they mixed in seeds, they are quite delish as well.    Simple, minimal ingredients, that’s what you’re looking for.  Challenging when it comes to crackers, but the goal is to aim away from anything with “partially hydrogenated oils” – while that does provide flakiness to a cracker it also provides trans fat and that is not dietitian approved.
I have recently been making my own bread and have been successful (and didn’t think I would be!)  But as back-up sprouted breads are my go to – again forget the brand, think sprouted bread.  So what is sprouted bread?  They are made from whole grains that have been allowed to sprout – germinate before being milled into flour. Enzymes are released during the sprouting process, which breaks down proteins and carbohydrates – this helps aid in digestion and is helpful in absorbing nutrients.   As there are no preservatives added in they will get moldy.  I keep mine in the freezer and use as needed – the perk of bread in general, it can be frozen!
I eat nut butters daily.  I rotate which nut butter that I’m eating to get a variety, not only for flavor, but also for different vitamins and minerals.  These are my standard nut butters in my rotation.  I recently made my own nut butter and that was similar to the mixed nut one I recently found at Trader Joe’s.   I also splurge occasionally on a walnut butter that is divine.  I have tried pecan butter as well, but found it to be quite bitter – I’m not sure if the jar I got was already rancid?  But it was definitely not my favorite.  I’ve wanted to make my own and recently got a new food processor, so I’m thinking I’ll need to try it.  This recipe has some cinnamon and vanilla, maybe that will help with the flavor – update:  I did make it and it was delish.  I’ll admit I added just a teaspoon or so of maple syrup.  Yes I know that is added sugar, but there’s something about the pecan that leads to a little off flavor.  The cinnamon helped, but it still wasn’t right.  Next time I’ll try vanilla instead of the maple syrup, but in all honesty I had the control over how much maple syrup I added in and it was barely any at all for how much I made, and yet just the right amount to remove the bitterness.  Score for a new nut butter in the rotation!
I eat canned beans.  There I said it.  People often look to me as a dietitian and question why I don’t make my own beans.  Real life answer?  Have you ever made a pound of dried beans?  Do you know how much it makes?  As a single person, canned beans work just perfectly.  For quantity and not to mention allowing me to have a variety.  These canned beans are cost effective, BPA free, and bonus?  They have NO added salt.  That’s right, NO added salt.  If companies can make the beans without salt then why aren’t more companies doing this since most times canned products are uber loaded with salt?  There are more options these days – just the other day in the supermarket tour I saw three other brands that had NO added salt.  Less sodium is starting to catch on and companies have responded.  The whole rinsing the beans to take some of the sodium off is a good notion, but I think it’s best to start with none (as these beans are) and as you begin to build your meal you have more control over where the sodium comes from (in my humble dietitian opinion).  The other thing recently I’ve been experimenting with is the liquid from these chickpeas.  It’s called aquafaba.  It’s gaining ground in vegan baking.  I did it just the other day where I whipped the aquafaba as if they were egg whites with a little cornstarch and folded it into my cake batter
While you can’t see the inside of this beaut, the aquafaba definitely provided a level of lightness to this cake (and without having any off tastes – I knew what you were thinking – leftover bean residue?!  No off flavor, I promise – just ask my friends!)
So canned beans are definitely a viable option and can be deemed healthy.  Just watch the sodium content and aim to go “No Added Salt” if possible.
If I were a sparkling water fan, these would be one I would drink.  (I’ve heard La Croix makes a few good flavors as well, but these actually have some actual fruit juice in there!) There’s just something about the bubbly that makes me burp…so, yeah, sparkling water isn’t my jam.  Hydration is key in the summertime and  patients tell me all the time how “water is boring”.  For me, water is life and I have NO problem drinking plain old boring water.  But I do understand how people want something other than water and something that doesn’t contribute too many calories.  This would be an option. 
My job as a dietitian is to educate people on how to make better food choices with the ultimate goal of helping people become healthier.  It’s a hard job to do with so many food options available., not to mention sifting through all the marketing confusion, i.e. "No Cholesterol" - when it never had any cholesterol to begin with.  As a dietitian I don't want to be a part of the confusion.  Promoting a product and being sponsored by a food company might seem like a good way to bring in a few extra dollars to some, but to me that only creates even more confusion for the consumer.   I'll continue doing #TasteTestTuesday and showing different products on the market that are #dietitianapproved.  Keep in mind, I'm not being sponsored and it's not an ad, it's just me doing my job as a dietitian, promoting health and awareness.  








Sunday, July 30, 2017

That's A Keeper 7

One of these is NOT a keeper!
The last installment of “That’s A Keeper” was from December 2016.  How did so much time go by again in between posts?  Two things – I post a lot of ideas on my social media and thus forget to do a round-up of sorts of the recipes and two, I’ve been a little cookbook obsessed.  Just a little.  I used to vow that I wouldn’t buy cookbooks – there are too many recipes online these days and I’m used to moving so much I tend to not want to accumulate so much stuff (that you’d have to pack up).  Well, I’ve caved.  I follow all these food bloggers online and their recipes look and sound SO amazing, I started buying their books.  I started with HowSweetEats.  She’s my girl crush if you will.  Her food combinations are out of this world.  Never doubt when she puts flavors together.  They taste AH-MAZ-ING!   And since then, it’s just kind of snowballed.  I follow too many people to tell ya - but the truth is it’s where I find my inspiration and aim to find the recipes that are “keepers” – because again, they are not all ones you’d want to repeat.  Remember, I do the work so you don’t have to.  Here are the latest recipes that are keepers:

Breakfast: Kale and Goat Cheese Frittata

This recipe is good for brunch, breakfast, or brinner (breakfast for dinner – we all do it sometimes and eggs are my go to for a quick and easy dinner).  I love Real Simple’s recipes because they are just that, Real Simple (pun intended).  The hardest part of this recipe is getting the stems off of the kale – if you have kids you can always make them do that.  Sauté the onion and the kale for a few minutes.  Whisk together the egg mixture.  Bake for 15-20 minutes.  Couldn’t be simpler.  Now if only it didn’t require turning on the oven in this summer heat.

Salad Dressing or aka Jack of All Trades Dressing: Basil Vinaigrette

Make this, thank me later.  Yeah, it’s that good.  And not only is it that good but it’s quite versatile.  Whip up a batch and use it as a drizzle on almost anything.  Turkey burger, caprese salad, grilled corn – I mean I always joke that it’s all about the sauce, but this is the truth.  I adjusted and didn’t use as much of the red pepper flakes.  Call me a wimp when it comes to spicy, but I used just ¼ teaspoon and it had just the right amount of kick – remember you’re also drizzling it over other food items, you’re not just straight drinking it from the spoon.  I mean you might want to and I won’t judge, but its best when paired with all the food items you can think of!  Perfect summer sauce!

Condiment: Coconut Bacon

Many might find this hard to believe, but I have never liked bacon.  Yes, I am a vegetarian and I know that might make sense, but I mean I have never liked bacon.  Never. Take that in for a minute.    More recently I have started including seafood, which would technically makes me a pescatarian, but I’m not into the whole classifying me as to what I eat thing.  When it comes to meats – red meat, chicken, turkey, pork – I have a distinct memory of not liking the texture of the meats.  I would chew the meat as a child over and over and over and then eventually spit it out.  I just didn’t like it.  Period.  And bacon?  Forget it, unless it was crispy I wouldn’t even touch the stuff.  These days there’s always a way to mimic an animal based food as a vegetarian/vegan option.  Enter coconut bacon.  I didn’t try the coconut bacon to include because I liked bacon, I was trying it to see if I simply liked the crunch added in recipes where bacon was called for – because let’s be real, there are a TON of people out there that are bacon aficionados.  The coconut bacon did provide crunch to many recipes.  I even found myself just munching on the coconut when I needed something salty – it’s hot and humid as all get out here in Miami these past few days and I think I need to make some coconut bacon, STAT!  There are many recipes out there for coconut “bacon” so find the mix of flavors you like and have available.  This is my go-to recipe (and I actually leave the liquid smoke out to keep it even simpler).  My only recommendation is to keep an eye on it – it can go from crisp to burnt REAL quick.

Snack: Macadamia “Cheese”

While I don’t love bacon, I do love cheese.  I mean, I can overdo the cheese.  It just tastes so good.  However, I do have heart disease in my family and am always looking for ways to transform any nut into a “cheese”.  I won’t go so far to say as that they taste as good as cheese does, it does at least serve as a substitute and as a way that I can include to help me reduce the frequency of my cheese intake.  You can take virtually any nut and transform it into “cheese”.  I typically will use cashews or almonds, but I upped my game and used macadamia nuts this time.  (Yes, I know macadamia nuts are expensive, so try a cashew or almond the first go-around).  The flavor is delish.  I definitely need to try the macadamia nuts as a version of a ricotta cheese next time.  So many possibilities.

Main Dish: Veggie “Meatballs”

I get a magazine in the mail as a health care professional called Diabetes Self-Management.  I always peruse the magazine to read some of the articles and keep up on the latest information in regards to diabetes.  I admittedly have never tried a recipe…until now.  This recipe simply sounded amazing.  A mix of bulgur, mushrooms, zucchini, sun-dried tomatoes, & cheese?  Okay, maybe I’m geeking out as a vegetarian, but the combination sounded like a perfect mix for a vegetarian “meatball” and well, I’ve been trying to find one that’s a keeper.  There have been some recipes that claim to stick together and taste good, but this one lives up to the hype.  I roasted a spaghetti squash to go along with this recipe (as the “meatballs” already contained my carbohydrates) and use as the spaghetti noodles and believe me when I say so darn good!  I gave a sampling to a few people as my quality assurance and they too loved the flavor.  Keeper status for sure. 


I have never made homemade sushi nor do I ever intend to take the time to make homemade sushi…but this!  Just call it deconstructed sushi if you will.  All the components of what would be sushi, the flavor of sushi, and without having to roll it into what would look like sushi.  Score!  I broiled my salmon ahead of time to have ready for the week.  The best part about this recipe is you don’t have to warm it up (sushi is cold, right?) so that means I won’t make enemies with my co-workers – no-one will like you if you heat up smelly food in the microwave.  Don’t do that to your co-workers.  This bowl will save you and you can have your fix of sushi all while saving time.

Main Dish: Halibut with Lemon,Herbs and Sautéed Asparagus

This recipe comes from Williams Sonoma.  I use their balsamic vinaigrette recipe to this day and should’ve thought to reference their website for other recipes before now.  Why I haven’t before today I’m not sure why.  But no need to question this, but rather know to keep going back and using some of their recipes.  Phenomenal.  Their description of this recipe is advertising their versatile pan:

The versatile fry pan does triple duty here in this springtime weeknight meal. First it’s used for sautéing the asparagus, then for steaming the fish, and finally for simmering the sauce. Serve with steamed fingerling potatoes tossed with butter and parsley, and pour a light, crisp white wine to serve alongside.

And I didn’t even realize it when I was making it, it was a one-pan dinner.  Love that!  Less dishes, sign me up!  And since they were giving instructions I decided to use just one more pan and roast up some potatoes.  I might have even paired it with a glass of white wine.  I follow directions and I’m glad I did.  Perfect combination and balanced dinner. (If you’re thinking halibut is too pricey, simply use an alternative fish like cod, haddock, and/or sea bass).

Dessert: Almost Raw Cherry +Almond Butter Caramel Bars

There’s a lot of talk recently on social media using the terminology “naturally sweetened” when referring to the use of maple syrup, agave, molasses, and honey.  I hate to break this to you, but even if they want to reference it as “naturally sweetened” as opposed to using sugar, it is still added sugar.  So, while it might be a tad healthier (because of different nutrients it might provide) you still have to be careful of the quantity used when added into a recipe.  There is definite interest in lessening the amount of sugar (in whatever form) in our diets.  And while desserts are meant to be enjoyed, I think in general people are eating desserts way too frequently and that is where the actual problem lies.  We need to be conscience of the added sugar and where it sneaks in – this could be a whole blog post on just added sugar by the way – so I’ll stop my soapbox for now to simply say, that this recipe is actually naturally sweetened with dates and has NO ADDED SUGAR.  I repeat NO ADDED SUGAR.  And that’s the honest truth (yes dates are quite dense in their sugar content, however it is just this dried fruit as a sweetener throughout the recipe).  I have gotten used to using no added sugar throughout my day, through my coffee, through my yogurt, and in my nut butter toast in the morning.  So when it comes to desserts I do tend to splurge occasionally.  I did start the hashtag #thisdietitianeatsdesserts #inmoderation.  And I do.  But I was pleasantly surprised to stumble across this little gem that literally only used dates to sweeten each portion of the bar.  The almond butter caramel is so freaking delicious I wanted to eat it from the spoon.  If you’re used to super sweet desserts, this one is not.  I found it to be delectable and fit the bill as dessert.  You might think it could pass as breakfast or a mid-afternoon snack, and it could.  It’s just that nutrient dense good.


So there you have it.   My latest round-up of recipes that have made it to “keeper” status.  I’ve found the more and more that I trial recipes the pickier I become.  I think that’s a good thing – for all my readers out there, you’re only getting the best of the best!  If you try some of these recipes, let me know.  I hope they make it to “keeper” status for you too!

Sunday, July 9, 2017

My Week Off

I start my new job tomorrow!!  To say I'm excited is an understatement.  I'm super excited for this next chapter and all that awaits me.  But before I start, I knew I needed some time off in between jobs.  I had a week, actually 10 days off (including the weekend).  Some might see that as an opportunity to go on a trip, but the reality is I simply needed time to decompress and help transition from the old job to the new job.  Call me an old fart, but I call it like I see it.  If I want to get off on a good start, I knew I needed to really truly rest and relax.  And that I did.  Here's a little peak into what I did.  Might not be exciting by your standards, but it's exactly what I needed.

I went to the dentist.  Seems uneventful, but the truth is a few years back I didn't have dental insurance.  So I'm grateful that I do have insurance and wanted to use up my 2nd visit before the new insurance kicks in!  I used to drink sugar in my coffee (gasp, the horror as a dietitian!!) and well, I got a few cavities during the time I didn't have the insurance.  Flash forward to present day and I'm all about my check-ups.  I go four times/year just to keep up and monitor and make sure no cavities pop up.  I had to get my second check-up in before the new insurance starts.  I call that smart thinking if you ask me!

Again, not the most exciting, but I literally cleaned out all my closets.  I moved back to Miami in 2005, so we're talking that I've been back for 12 years now.  I had clothes I haven't worn since 2005 in my closet.  I had old teaching materials from my teaching days, old nutrition notebooks (filled with stuff from my internship days circa 2000), and even Chicken Soup for the Soul books that I had read only god knows when.  So, yes, the closets were cleared and minimalized as much as possible.  It literally felt like the weight of the world was taken off my shoulders once I dumped some of that junk.  I promptly bought myself some macarons after this dreaded chore because I have yet to make these successfully and deemed them my reward for a completed job.  Caramel sea salt was my favorite in case you were wondering.

I had a broken toe a few weeks back and while it was almost 100%, it just wasn't there. That left my running out for at least a few more days.  But what I did do daily was a little bit of meditation and yoga.  Many poses in yoga were not possible (I needed to still rest that toe), but yoga for me is simply about showing up and spending time on the mat, simply being PRESENT - whether that's 10 minutes of savasana (resting pose) or an hour and a half of hard-core poses.  This week off was about me showing up as I said and committing to spending time stretching, breathing, and just being.  Exactly what I needed.

My mom's birthday was on the 3rd.  We did a day trip to Naples .  I compromised.  I mean I didn't want to have to recuperate after a long trip, but I thought if we could do a quick get-away that'd be nice to celebrate her birthday.  She does love Naples and those white sand beaches.   I do believe that many times instead of giving gifts you should give experiences.  She'll remember this birthday more because of the experiences we had - from the botanical garden, to nearly missing a thunderstorm, an epic seafood dinner, and to a breathtaking sunset (because those sunsets NEVER get old).  Happy 72nd birthday mom!

Baking bread.  It's been my hobby as of recent.  The patience it takes to make some breads is beyond me, but this bread making has definitely been teaching me a lot.  I am forever thankful for my KitchenAid mixer - I mean how did they knead bread for that long in the old days??  Being precise and accurate in your measurements all the way down to the temperature of your water for the yeast - I think you should know this is why bread is so expensive in the stores.  All jokes aside, I've found a few go-tos that are SO simple, I might never have to buy bread again.  Here's my latest creation this week, Anadama bread.
This year our mangoes taste a little watery.  I think from the early blooms to most of the blooms being blown away, there's a little thing called global warming effecting our crops - but who am I to say?  At the end of the day, I do know that our mangoes tasted different this year.  But then were some that were just so spot on sweet, you had to get to using those mangoes all the ways - mango bread, mango ice cream, mango salsas...I mean the possibilities were endless.  Just look at how pretty those mangoes are!


Today I ended with getting a manicure/pedicure.  It's just one way I have been treating myself to some self-care over these past few years.  But today's felt more special for some reason.  Maybe because I know I'm starting a new chapter in my life tomorrow, who knows.  Throughout the week I also reflected on this new job I'll be starting.  I know that I want to be open to all the opportunities brought before me.  I am willing to learn as much as I can all while bringing as much to the table as I know I am able to.  I have a lot to offer through my nutrition knowledge and can't wait to get started with the team.  And of course, I'll keep you posted on my journey...here's to jumping in 100%, no fears!

Sunday, June 25, 2017

The Next Chapter


The Next Chapter

It’s not my birthday.  However, it is a new chapter.  A new chapter in my career.  I am leaving my current position and moving on to something new.  I’ve shared recently in various blog posts about creating a balance between my work and life, so it should come as no surprise.  My previous job prior to this one required a 150-mile daily commute - amazing views of the Everglades, but it was a long commute. 
Snake Road - Big Cypress
And while my job was 8-5 the day ended up being 6:30-6:30 (or later, depending if there was an accident).  I went against traffic, so my 75-miles in an hour and a half was sometimes quicker than people’s 10-mile commute in traffic.  Regardless of the distance, it was the time that was taken away from me.  Moving forward I vowed I would stay with the job (as I loved teaching the kids) until I found something I truly, truly loved.  After three long years of searching I found my current position, a dietitian at a diabetes education center, 5 miles from home.  I thought what could be better?  Teaching about diabetes?  Close to home?  I’m in!  In my first year at my job I learned more than I could have ever imagined – insulin to carb ratios, insulin sensitivity factors, and that old notion of three meals/day, three snacks/day was based on an older insulin not often used anymore!  It truly was and has been an amazing opportunity and experience.  But with the good comes the bad.  And shortly after starting, that short commute didn’t really matter.  I was leaving so late there was no traffic to speak of.  My normal 8-hour workday was back to 10 and 12 hour days.  I love teaching about diabetes and how to manage it through diet and exercise.  I had a patient the other day who attended our diabetes class ~2 months ago.  His A1c at the time was 8.8% (well above goal) and upon his return to see me one on one, his A1c was down to 7.0%.  I asked him what he did to help improve (as medications had been removed and not added per his chart).  He said, “I followed what you and Lory (the nurse educator) told me to do!”  That my friends, that is what is rewarding.  He literally made my day!
Year 1
Teaching about diabetes is what I know I love.  There’s nothing better than helping a person count their carbs and match their insulin to what it is they’re eating to adjust a dose.  Maybe I’m a numbers geek?  Science nerd?  Not sure.  But what I do know is that I do not love teaching a person with a sole diagnosis of “obesity”.  Sure I understand that within diabetes the weight loss talk comes up.  How can it not?  If a person does lose weight it only helps their insulin work that much better.  But I know what my strengths are and teaching/coaching/being a cheerleader to help people lose weight is not my forte.  I had a patient come in the other day and stated that she gained 80 pounds in one year and there was nothing medically wrong with her (as she had everything checked out, thyroid, etc.) and she was asking me why she gained weight.  Um, I don’t know?  I feel helpless at times in talking to the patients and ultimately feel that I’m not helping them.  Food is so much more than just the science behind it.  I should’ve been taught more psychology in my college years in order to be able to better assist patients.  Sure I’ve gained knowledge over the years and sure my yoga background helps me to teach them to be mindful.   But at the end of the day, I haven’t been coming to work happy anymore.  And that my friends, is critical (in anyone’s job), to find what you love and love what you do!
Year 2
And so I move to the next chapter in my career.  I will be doing group nutrition education at various events all around South Florida.  I will be teaching about prevention mainly and there will be some pilot type programs that are geared towards some of the most common disease states within nutrition – diabetes, heart disease, and yes, weight management.  I think the thing that excites me the most is actually being able to reach a LOT of people all at once.  Teaching one on one can be rewarding (do not get me wrong…I will miss that to a certain extent). but it can also be taxing when you repeat the same thing over and over.  Group education with the premise of prevention…yes, I get excited just thinking about it.  Nutrition dork?  Maybe just a little too extreme when it comes to nutrition?  I prefer to think of it as being passionate – passionate about helping people to be healthy.  Isn’t that what you’d want from a dietitian??
#TeamPineapple


So as my time winds down,  I started to reflect on my patients and what they’ve taught me  over these past three years.  A few stood out and here’s a few ditties that I pass on to you:

Working where I work, we get many international patients.  Patients from all over, i.e. Venezuela, Trinidad, Colombia, Brazil, etc., come to the United States for their care.  Pause just a moment and think about that for a minute – how lucky are we to live where we do have access to progressive thinking, state of the art healthcare?  (I will not get political in this post as to the state of insurance with healthcare…just keep thinking that we have access where many others do not).  There really were too many to recount.  The international patients were something special.  Appreciative of everything we could teach them in order to improve their health upon returning back to their country. 

The marathon runner/yogi. I’ll never forget the first day we were doing a program that she was attending.  Her continuous glucose monitor (CGM) was buzzing that she was “low”.  I nudged my nurse educator and we looked at each other communicating without speaking, “should we do something?”  It was in that moment I was taught a valuable lesson - patients know their bodies better than anybody else.  She immediately took out a cracker and kept watching her CGM – it was her way to nudge the blood sugar in the right direction, not to over treat, but simply to steer it in the right direction.  Sugar surfing at its finest.  She’s one of those patients that already knows so much, I often wondered if I was ever teaching her something or was she the one really teaching me?  Learn from others and look around, there’s always something new to learn. 

I used these measuring cups for every session I taught patients.  They were my special gift.  I received them from a kid with Type 1 diabetes that used these cups on repeat.  He wanted other kids to not have to go through what he went through and help transitioning to “counting carbs” to be as easy as possible.  He donated a whole box of these measuring cups for us (the nurse educator and myself) to pass out to newly diagnosed kids with Type 1.  Read the note.  You’ll see how special a kid he was.


This particular patient was sugar surfing before she knew she was sugar surfing.  We do a 4-day intensive program with patients in teaching them how to manage their diabetes.  Teaching them all the key concepts about real life situations and how to manage their diabetes, i.e. insulin adjustment guidelines, how to check their basal, etc.  This patient came in pretty much on the brink of giving up (as she described) because all of her doctors had told her that what she was doing wasn’t “right”.  The truth?  She was doing exactly what we were going to teach her to do – manage her diabetes, sugar surf, and make in-the-moment decisions about how to better control her diabetes.  She gained the confidence to know that she was in fact managing her diabetes and doing it to the best of her ability.  She has since communicated to us that through the use of the CGM and using multiple daily injections (versus a pump) her last A1c was as low as it’s ever been (without having hypoglycemic episodes).  She was writing to thank us.  Giving patients the tools to better manage their diabetes, yeah, that’s the rewarding part.

The local grocery store here in Miami has a program to give some medications free of charge and with others at a minimal cost.  Think that’s not a big deal?  For many of my patients it’s a REALLY big deal.  I had this one particular patient that kept continuously calling me in regards to her low blood sugar levels.  After various probes, I finally realized what was going on.  Her medication (for her DM) could induce lows as it was working for 24-hours.  This patient only ate once/day as she didn’t have enough food to have more meals than just one.  BINGO.  Her lows were due to lack of food access.  I found a food program here locally that the patient was able to get one free hot meal/day due to her age.   I taught her how to use the “Buy One Get One Free” at the local supermarket in order to get more food for the money that she did have (so she could have food for the month).  I was teaching her smart shopping and showing her ways to extend the money that she did have.  And at the end of the day, I taught her not to take her medicine if she wasn’t going to eat.  This patient taught me that it’s really easy to tell someone what to eat, but at the end of the day what do they really have access to in order to make that happen?  Compassion and empathy are key.
I wish I could give ALL the needy patients free food!
To all the kids with Type 1 DM – you are amazing, resilient, and capable beyond your means – you CAN do anything you want.  For whatever reason your own body decided to attack it’s beta cells so your pancreas doesn’t work anymore, but that should NOT stop you from doing anything your little hearts desire.  In one of those 4-day programs this one particular kid was thanking his parents for buying him his supplies.  What 12-year old has to think about where he is going to get his supplies from?  And yet he was here thanking his parents for being selfless and giving him what he needed before buying things for themselves.  These kids, surprise me every time.  Sometimes the kids would call us super heroes, when in reality they are the real heroes.  In case you're wondering, I was Super Girl.


In addition to the international patients, I receive what are termed VIP patients.  While I should preface and say that to me ALL patients are VIP, these particular patients are deemed to be a little more important (whether it’s their financial contribution to the university or whether they truly are famous).  There are some that come in and demand to be seen yesterday, when my schedule is booked for the next three months.  And then there are some that don’t want a big fuss at all made about their VIP status.  I think what the VIP patients have taught me is that no matter what your background might be or where you might progress to be, always remain humble.  Fame and fortune shouldn’t make you think you’re any more important than someone else.  We all need to be educated and helped at some point.

Last but certainly not least, my co-worker.  We started within in a few months of each other.  Who would’ve known that we would get along as well as we did?  Luck of the draw?  Not sure, but what I do know is that I’m beyond grateful for having met Lory.  I describe her as THE best nurse educator around.  She’s been given the nickname, “Flo” and “Wonder Woman” because she is just that, always going above and beyond in helping patients in their care.  It’s hard to put into words just what Lory means to me, but I know that I am forever changed having met Lory.  I have had other great co-workers (don’t go getting jealous out there Jill or Lance!) but when you have just each other to rely on, we were truly lucky to have had each other.  So glad you were my co-worker, but beyond that, I'm truly blessed to call you my friend.
WBFF4L
I am truly grateful for these past three years and all that I’ve learned.  As I said, I’ve felt in these last few months that it’s time for me to move on.  Sometimes people look at change and are fearful.  For me, I’m hopeful of what’s to come and look forward to all the opportunities that lie ahead!