Sunday, February 22, 2015

National Nutrition Month® - 2015

National Nutrition Month® - 2015

“National Nutrition Month® is a nutrition education and information campaign sponsored annually by the Academy of Nutrition and Dietetics.  The campaign is designed to focus attention on the importance of making informed food choices and developing sound eating and physical activity habits.  The theme for 2015 is “Bite into a Healthy Lifestyle,” which encourages everyone to adopt eating and physical activity plans that are focused on consuming fewer calories, making informed food choices and getting daily exercise in order to achieve and maintain a healthy weight, reduce the risk of chronic disease and promote overall health. 

My job as a dietitian is to educate people about how to eat healthy, balanced diets.  Just this week again I had a few patients come in to see me that astounded me as to how unhealthy they are eating.  I’m not saying this to judge people, I’m saying it because I think sometimes I must live in a nutrition LaLa land hoping people aren’t really eating this unhealthy!!  I ask people for a 24-hour recall as part of my initial assessment.  I simply use it to see if people have a schedule to their eating.  I don’t use it typically to look at what people are eating, because let’s be honest people almost always lie when they’re telling me what they’ve eaten the day before (kind of like, let me eat better because I know I’m going to see the dietitian effect).  I ask other questions to get a little further in to the frequency of their eating out and how many times a day they’re eating fruits and vegetables, etc.  But here’s the thing, my patients are just like most Americans, they’re following the S.A.D. diet, the Standard American Diet:  high fat, high  refined carbohydrates, low in fiber, and low in plant-based foods, sad literally.  We eat too much, plus we eat too much of the wrong stuff.  We often tell ourselves that we don’t have time to prepare and eat decent meals.  And when we do cook, it’s all too tempting to just open a box and nuke something in the microwave.  And especially after a long hard day at work, we deserve a break, don’t we?  Our bodies need a break from what we’re putting into them:  high-carb foods, especially those low in nutrients; manufactured Trans fats in the form of hydrogenated or partially hydrogenated oils; sugar in all its forms; refined flour.  This S.A.D. diet is contributing to epidemic levels of obesity, hypertension, heart disease and diabetes.  This S.A.D. diet is filled with unhealthy fats, hormones, and chemicals created in a lab.  Our bodies need a break from trying to break all of this stuff down.


Here are 6 ways to begin to upgrade your Standard American Diet.  It goes along perfectly with this year’s theme for National Nutrition Month®:  Bite into a Healthy Lifestyle”:

Eliminate Processed Food – I tell my patients to start looking at their pantries/cupboards/freezers.  Truly take a long hard look at how many foods that they have and be honest with themselves at how often they’re eating these foods.  One patient this week was literally eating a sandwich for both breakfast and lunch 5 days a week all with processed meat from the deli.  (His other 2 days were the weekends and of course, those meals he was eating out).  I asked him if he’d ever roasted a chicken.  Could he maybe use that for his sandwich instead?  I understand the cooking part takes time, but seriously has anyone ever stood in the deli line at Publix before?  That takes time!!  All joking aside, the goal is to begin to limit the amount of processed foods we’re consuming.  Reflect and be honest with the frequency of how often you’re really consuming these foods.  Start cutting back.  It’s not natural to eat things from a box/can.  And don’t get me started on all the names of the ingredients you can’t pronounce or understand.  The Center for Science in the Public Interest (CSPI) has a chemical cuisine chart that is helpful to begin to know which additives/preservatives to avoid, but better yet, start eliminating them all together.

In case you weren't aware, Splenda® is now listed on the watch list!

Buy Organic – To help reduce the amount of toxins, pesticides, and chemicals that we ingest.  They have adverse effects on our health.  This one is tough even for me.  It’s expensive and let’s face it, we can’t buy all things organic.  Check out the yearly Environmental Working Group’s Dirty Dozen Report to find out which foods are recommended to buy organic. 


If You Eat Meat – be sure it’s grass-fed, hormone and antibiotic free.  Again, more expensive, but the quality can’t be beat.  ~4-6 ounces in a day is a rough estimation of what is recommended for people to eat.  Yes the new dietary guidelines will be updating their restrictions on cholesterol; however, there still is caution in regards to saturated fat.  Saturated fat comes from animal products, is solid and is the kind of fat that leads to clogged arteries.  So it’s not an unlimited amount of meat that you get to eat.  The committee recommends that a plant-focused diet not only promotes health, but is also more environmentally sustainable. 

Eat Your Greens – Half of your plate should be veggies, no two ifs ands or buts about it.  No debating this.  Vegetables, especially the leafy greens are rich in phytochemicals (the good kind of chemicals), vitamins, minerals that prevent heart disease and cancer, increase your energy and provide fiber for healthy digestion. 

Stop Eating So Much Sugar – Hands down the easiest recommendation for me to make to my patients but also hands down the hardest place for patients to begin to cut back (it’s addictive!)  You should be eating no more than 100 calories per day (about 6 teaspoons or 24 grams of sugar) for women and no more than 150 calories per day (about 9 teaspoons or 36 grams of sugar) for most men.  There’s no nutritional need or benefit that comes from eating added sugar.  The key is to cut back.  Check out the list of hidden sugar names:

Until the new nutrition labels distinguish between natural sugar and added sugar we’re on our own to begin to decipher the labels.  Or better yet, avoid those packaged products that have added sugar to begin with.

Break From Your Status Quo – and educate yourself.  Get in the kitchen and start experimenting with new recipes.  We’re not all going to be famous and featured on the Food Network, but maybe part of the reasons we eat out or go the easy route and used packaged products is because we don’t know how to cook.  Kids love to get in the kitchen and help too – it’s a great opportunity to allow kids to learn how to cook starting at a young age.   Make sure to put some thought into what you’re going to eat for the week.  The minute there isn’t a plan is when we start to go for the short-cut and that doesn’t always mean the healthiest option.  Planning is key.

I always tell my clients that I’m going to give them many ideas in their nutrition session; however, the key is to pick just one of the ideas that I give to them and really truly commit to making that change.  From there they can progress and continue working on all the other ideas that I’ve given to them.  One step at a time, one bite towards a healthier lifestyle, the goal is to create healthy habits that last a lifetime.




Sunday, February 8, 2015

Show Yourself Some Love

Heart Health

We often associate the human heart as a symbol of love.  So this month, American Heart Month, I challenge you to show yourself some love.  Learn about your risks for heart disease and stroke and stay “heart healthy” not only for yourself but also for your loved ones. 

Cardiovascular disease (CVD) – including heart disease, stroke, and high blood pressure – is the number 1 killer of women AND men in the United States!  Over 800,000 Americans died from heart attacks and other cardiac related-illnesses last year, but most of those deaths – four out of five – were preventable.  There are a number of risk factors for CVD that you can control:

1.       Diet

2.       Physical Activity

3.       Tobacco Use

4.       Obesity

5.       High blood pressure

6.       High blood cholesterol

7.       Diabetes

Diet – The question I’m most often asked is, “So what can I eat??”  I always think of each patient individually (and also what they’re eating at the present moment).  But here are some general guidelines to get you started on the right path:

1.     Make vegetables a main course – ½ of your plate should be vegetables.  The aim is to have 6-8 servings of vegetables/day.  The only way to do that is by making them the main focus of the meal and then building around it.  Stir-fried vegetables, vegetable curry, a main-dish salad – all of which can then have a lean protein source added in with the grains sparingly.  Make sure that the protein source is about the size of a deck of cards and then surround it with enough side dish vegetables or salad.  The key here is that by increasing your vegetable intake you’re also eating less of other foods.

2.     Limit unhealthy fats and cholesterol – Limiting how much saturated and trans fat you eat is an important step to reduce your blood cholesterol and lower your risk of coronary heart disease.  A high blood cholesterol level can lead to a buildup of plaque in your arteries, called atherosclerosis, which can increase your risk of heart attack and stroke.  The best way to reduce saturated and trans fat in your diet is to limit the amount of solid fats – butter, margarine and shortening – you add to food when cooking and serving.  You can also reduce the amount of saturated fat in your diet by trimming fat off your meat and choosing lean meats with less than 10% fat (and remember to watch your portion sizes when it comes to eating meat.  We tend to eat too much – a deck of cards for size reference).  Trans fats are added in to products to help extend their shelf life.  Check the food labels and look for the phrase “partially hydrogenated oil” in the ingredient list.  The labels may say they’re “trans-fat free”, however, they may still have trace amounts.   When you do use fats, choose monounsaturated fats, such as olive oil or canola oil.  Polyunsaturated fats, found in nuts and seeds, are also good choices for a heart-healthy diet.  When used in place of saturated fat, monounsaturated and polyunsaturated fats may help lower your total blood cholesterol.  Moderation IS essential.  All types of fat are high in calories.

3.     Select Whole Grains – Whole grains are good sources of fiber and other nutrients that play a role in regulating blood pressure and heart health.  Increase the amount of whole grains by making simple substitutions for refined grain products.  And just like with your fruits and vegetables try a new whole grain, such as whole-grain orzo, farro or quinoa. 

4.     Minimize added sugar – The American Heart Association suggests an added-sugar limit of no more than 100 calories per day (about 6 teaspoons or 24 grams of sugar) for women and no more than 150 calories per day (about 9 teaspoons or 36 grams of sugar) for most men.  There’s no nutritional need or benefit that comes from eating added sugar.  The key is to cut back.  While you can control what sugar you add on to the food that you eat, attention needs to be paid to packaged products:    cereal, sugary drinks, yogurt, cookies, etc.  Until the Nutrition Labels are more accurate in distinguishing between natural and added sugars, simply pay attention to the listing of the ingredients – they are listed in descending order.  Or better yet, pay attention to the quantity of packaged foods that you’re eating and begin to eat more whole, natural food.  I get a lot of patients that come in thinking that the instant flavored oatmeal is healthy.  While it might be a start in the right direction I always encourage my patients to go with the actual plain oatmeal and add their own ingredients.  Remember the key is to start to be aware of the choices that we’re making.

5.     Keep a lid on sodium - Healthy adults should have no more than 2,300 milligrams (mg) of sodium a day (about a teaspoon).  People age 51 or older, African-Americans, and people who have been diagnosed with high blood pressure, diabetes, or chronic kidney disease should have no more than 1,500 mg of sodium a day.  Reducing the amount of salt you add to food at the table while you cook is a good first step, however, much of the salt you eat comes from canned or processed foods, such as soups, salad dressings, and frozen dinners.  Eating fresh foods and making your own soups and stews can reduce the amount of salt you eat.  If you like the convenience of canned soups and prepared meals, look for ones with reduced sodium.  Another way to reduce the amount of salt you eat is to choose your condiments carefully.  Many condiments are available in reduced-sodium versions, and salt substitutes can add flavor to your food with less sodium. 

6.     Eat beans and nuts – These protein sources come from a plant and are heart healthy from the start.  If you think beans seem dull, think of some interesting ways to include them in your choices:  hummus, curried lentils, bean soup, or just throw some onto your salad.  Incorporate the seeds into your diet as well:  chia, flax, hemp – they are high in fiber and omega-3 fatty acids, which can lower your total blood cholesterol.  Nuts and seeds are easy to eat – often too easy.  If you can’t stop at ¼ cup, use them as a garnish.  Otherwise, the calories can add up quickly.

7.      Cut liquid calories – This is often the 1st place I start with people when their goal is to lose weight.  By making this small adjustment the average amount of calories eliminated is 350 calories – be it from soda, alcohol, juice, milk, or other drinks.  When people eat a piece of fruit versus drinking the fruit juice, they receive the benefit of the fiber for heart health (which the juice is lacking). 

Physical Activity - It’s easy to get discouraged about exercise.  It’s hard to fit into a busy lifestyle.  No excuses – like eating right, getting the exercise your heart needs is easier than it looks. 

If you’re not overweight, all you need to do to maintain a heart healthy lifestyle is 30 minutes of moderate physical activity five or more times a week.  And you don’t have to do it all at once –15 minutes in the morning and 15 minutes in the evening are fine.  The research shows being physically inactive is a major risk factor for developing coronary artery disease.

And exercise is the gift that keeps on giving.  Regular, moderate exercise helps:  control blood pressure, prevent diabetes, maintain healthy cholesterol levels, and can even put you in a good mood.

If you need to lose weight, it’s going to take a little more effort.  The recommendation is low to moderate intensity activities for 60 minutes per day.  To lose weight you have to decrease your calories in and increase your calories out.  If you just reduce your caloric intake your body slows its metabolism to compensate.  I’ve been challenging my patients to get moving and monitor their steps.  There are so many apps on our phones that track our movement (who doesn’t have their phone with them at all times??)  Monitor where you are baseline to get an idea of how much movement you get in a day.  From there the goal is to increase your steps.  Everyone has to begin somewhere.  The ultimate goal is 10,000 steps/day.  Regardless the key is to get moving – remember sitting has become the new smoking. Get moving!

Don’t Smoke! – Smoking is the single most dangerous thing you can do to your heart.  Alone, cigarette smoking increases your risk of heart disease and also worsens other factors that contribute to heart disease, such as blood pressure and decreasing the levels of HDL, your good cholesterol.  If you smoke a pack a day, you have more than twice the risk of a heart attack than someone who doesn’t smoke. 

Every cigarette you cut back matters.  While the goal is always complete cessation, even eliminating one cigarette a day can make a difference.  A big plus:  It doesn’t take long for your body – and your heart in particular – to reap the health benefits of quitting.  Your heart rate and blood pressure will drop, your circulation and lung function improve, and just one year after quitting, your excess risk of coronary heart disease is just half that of a smoker’s.

Maintain a healthy weightBeing overweight or obese can increase your risk for CVD.  Health care professionals will often use the body mass index (BMI) as a beginning step to see if your weight is in a healthy range.  Sometimes the waist to hip ratio can also be used to measure a person’s body fat.  Regardless of these levels, most people know if they have a spare tire that they’d like to lose.  If so, losing as little as 5% of your body weight can help lower your risk for CVD (and diabetes). 

Monitor your blood pressure – High blood pressure often has no symptoms, so be sure to have it checked on a regular basis.  I just got the Fitbit Surge and it monitors my heart rate 24 hours a day.  I used to think that I might have an issue with high blood pressure because every time I went to the doctor they were telling me it was elevated.  I most times didn’t think much of it just because I was nervous and anxious most time just by walking into their offices.  So I started checking more regularly.  Sometimes it was high, sometimes it wasn’t.  The Surge has helped me to see that my resting heart rate is within normal limits and that while my heart rate accelerates when entering a doctor’s office (this week they freaked me out and told me they thought I had a stress fracture – who wouldn’t have an elevated blood pressure because of that??) I know within a few minutes it returns to normal.  If you don’t know, have it checked.  CVS, Walgreen’s, they all have places near the pharmacy where you can check.  Do a little deep breathing if you’re anxious before checking.

Get your cholesterol checked – Again, if you don’t know what your cholesterol levels are, you should.  It’s important not only to know the total cholesterol level but also the HDL (healthy) and LDL (lousy) levels as well.    

Diabetes – Monitor your blood glucose regularly.  Know how to take action based on your blood glucose checks.  Know how to adjust your medication, exercise and meal plan if your postprandial level is unusually high (higher than 180 mg/dL two hours after eating or higher than 130 mg/dL before eating).  High blood glucose increases the risk for all other complications of diabetes, so it’s important to know your blood glucose levels.  If you need help in this area, I’m starting to think more like a pancreas every day.  Check my team out at the Diabetes Research Institute and schedule an appointment if you need help managing your diabetes.  You too can think like a pancreas!

Making small, gradual changes can make a big difference in your health.   You can greatly reduce your risk of heart disease – or slow its progress – by taking prevention to heart.  This month show yourself some love.


 #hearthealth #showyourselfsomelove #eatright