That's A Keeper 6

I looked back at my last “That’s A Keeper” post and it was posted in January!   How did SO much time pass between me posting on some of my favorite recipes??  I’ll tell you how…life is busy!  Between training for my marathon, being crazy busy at work, and now the holidays, I’ve been trying to keep up with my blog every other week, but the truth is that hasn’t happened.  I haven’t been as consistent as I would have liked to, but as I always keep repeating, I’ll post when I have time and when I have something to talk about.  Which leads me to a few of my favorite recipes, that is definitely something to talk about.  There are always going to be hits and misses with recipes that I try, and I definitely wish I could read a recipe and know just by reading how’d it turn out.  I just don’t have that gift.  Nor do I have the gift of being able to concoct my own recipes.  So kudos to the people that do recipe development.  But I do have one favor to ask, can you really only post successful recipes?  I made some “Lemon Pistachio Shortbread Cookies” this morning – they do NOT stick together.  

Sure they look good...but you didn't see how many times they crumbled and fell apart!

When the recipe tells me to use my hands to roll them I just have to laugh.  I barely salvaged them by using a cookie scoop to try and get them to somewhat stay together.  The recipe should’ve read, “Be prepared to have them fall apart, all over you.  They will never really stick together, fyi.”  The flavor is okay, but truth be told:  these will NEVER be made in this household again and what a waste of all my pistachios.  Again, I wish I could read a recipe and just know if it’ll make keeper status.  Until that time, I keep trying so you don’t have to!

Breakfast: Vanilla Chai Overnight Oatmeal

It is December 18^th and it still feels like summer here in Miami.  I’m not complaining, I’m just stating the facts.  So having hot oatmeal in the mornings isn’t always my go to choice.  But I do love to have a breakfast that I can prep the night before and doesn’t take too much time in the morning.  This Vanilla Chai Oatmeal is full of flavor and just another way to put a spin on your normal oats.  The recipe calls for coconut milk – I’ve made it with both regular milk and coconut milk – and both turn out.  I used the regular milk for the extra protein.   Additionally I have cut out almost all added sugar in my diet (except for sweets like desserts!).  In this recipe it calls for between 3-4 tablespoons of maple syrup – I ended up eating this recipe 3 times, so in theory that’d be 1 tablespoon of maple syrup/serving – and that’s TOO much added sugar to start your day with.  Aim to start lowering the amount of sugar you’re using.  Your taste buds will adjust and get used to using less sugar.  Promise.  Other add-ons to this recipe – I always add nuts to my oatmeal to increase the protein content as well as increase my satiety from the healthy fats in nuts.  Get creative and switch up your flavors with your oatmeal.  This Vanilla Chai is delish! (no picture...all my overnight oats never look pretty!)

Salad: Pear, Parmesan, and Balsamic Salad

Whoever said eating their vegetables had to be boring was WRONG!  Dead wrong.  I think that sometimes people haven’t had a good experience with vegetables and therefore just write-off certain ones.  Or even worse, sometimes they haven’t even given the vegetable a try.  Salad is a good way to get your greens in – think spinach, kale, green leafy, red leafy, arugula, etc.  Not to mention add a few pieces of fruit and that always helps the vegetables taste better.  This salad combination uses pears and parmesan.  I also added in walnuts.  I’m always switching around the nut, the fruit, and the cheese.  The combinations are almost endless!  I have a persimmon waiting in the kitchen for my next salad.   And my go to salad dressing is this balsamic vinaigrette by Williams Sonoma. (I didn’t use the dressing in the recipe for the salad…too much sugar!)

My go-to balsamic vinaigrette!

Sauce:  Chimichurri

What more can I say but that this sauce is EVERYTHING!  And I do mean everything!!  For lunch I tend to eat grain bowls – whether it’s quinoa, couscous, farro, barley – whatever the grain is that’s the base of my bowl.  Then I’ll roast veggies for the week.  I do an assortment and rotate the veggies throughout the week to help get a variety.  For my protein I’ll rotate a soft-boiled egg, tofu, beans, and/or some nut concoction I’ve done – think cashew cream, almond “feta”, etc.  And lastly I add the sauce – this is where all the flavors come together.  I’ve been trying to build a repertoire of sauces to have on hand.  This way I can utilize a different sauce throughout the week and even though the essence of the bowl is the same, the sauce will let me think it’s a whole different bowl.  Chimichurri can be used in so many ways – even though I’m a pescatarian, it marries well with many flavors, not just meat.  Make this and you can thank me later!

Vegetarian – White Beans with Tomato, Spinach, and Rice

Leave it to Real Simple to create a quick weeknight meal.  Little did I know when I stumbled upon this recipe I’d learn how to make full-proof soft-boiled eggs.  Score a W in the win column.  I’ve said this before, but I’m not the best in the kitchen.  If I could have a Go Pro camera watching my every move it’d be one for the history books.  Epic fails – coconut macaroon crusts falling on the floor and crumbling before my eyes, burning my hand on many a pan, creaming butter and sugar and sugar flying everywhere, yeah there have been some fails in this here kitchen of mine.  I follow the recipes, I swear I do!  Needless to say I was pleased when Real Simple directed me to the perfect soft-boiled egg.  Oh yeah, and the rest of the recipe is a score for a keeper also.  Simple, yet so flavorful.  The only thing I’d improve upon is by adding even more tomatoes.  Delish!

Seafood – Honey-Glazed Salmon

My tried and true go to salmon recipe.  While I’d love to experiment with others, this has been the one I keep using over and over.  I know I’m going to need a new one soon, but here are the many reasons why I love it – I can make the sauce up and use it throughout the week.  Two – I can leave the skin on the salmon when I get it from the seafood department at the store.  Three – Broiling the salmon makes for a QUICK weeknight meal (6 minutes on each side).  Four – training for the marathon has been challenging to ensure I’m getting enough protein (I spot check it occasionally and without the inclusion of the salmon I was eating WAY too much cheese).  I don’t love chicken, beef, turkey, pork, etc, but this salmon I can eat and enjoy.  I’ve been eating this three to four times/week to help ensure my protein on my run days.  Five – did I already say it’s a quick weeknight meal?  Well, that is if I remember to defrost the salmon the night ahead.  And don’t you worry, if that happens, it’s a breakfast for dinner kind of night!

Dessert:  Raspberry Cheesecake Tartlets

I’ll start off by saying the picture doesn’t do these guys ANY justice.   I’m not exaggerating.  Not only am I a walking mess in the kitchen, I am also not the best photographer.  My skills have improved over the past few months, but this here photo was taken in my early days when I was just starting out.  The cheesecake in this recipe is a liquid cheesecake – it’s exactly what it sounds like – cheesecake, baked just enough for the batter to cook, but not enough for it to maintain its structure.  Essentially a no fuss cheesecake recipe.  Follow the step-by-step directions for the crust – at first you may doubt the process.  Don’t.  Hummingbird High gives THEE best directions.  I included a real dessert recipe here, not some of the paleo, low carb ones I’ve been trying as of recent.  It’s a week till Christmas.  It’s a holiday and holidays are meant to be enjoyed.  That includes desserts.  Just don’t get confused and think that every day is a holiday.  You know what I’m saying??

So there you have it – a few more recipes that have recently made it into my “keepers”.  I hope you see a recipe or two that you might like to try.  My stack of “recipes to try” keeps growing.  I wish they ALL were keepers!

Diabetes Awareness Month

Diabetes Awareness Month -

November is American Diabetes Month®.  The American Diabetes Association notes that 1 in 11 people have Type 2 Diabetes – 1.4 million people in the United States are diagnosed with diabetes annually.  In 2012, 29.1 million Americans had diabetes.  While more attention is focused on Type 2 Diabetes, the numbers are staggering, today’s focus will be on Type 1 – of the 29.1 million Americans, 1.25 million American children and adults had Type 1.  So what is Type 1 (insulin-dependent or juvenile) Diabetes?  Type 1 Diabetes can occur at any age, but most commonly is diagnosed from infancy to the late 30s.  In this type of diabetes, a person’s pancreas produces little or no insulin. 

The causes are not entirely known, but scientists believe the body’s own defense system (the immune system) attacks and destroys the insulin-producing cells in the pancreas.  People with type 1 diabetes must inject several times every day or continuously infuse with insulin through a pump. 

Symptoms – may occur suddenly, however, the process may have been going on for some years:

·         Extreme thirst

·         Frequent urination

·         Drowsiness, lethargy

·         Sugar in urine

·         Sudden vision changes

·         Increased appetite

·         Fruity, sweet, or wine-like odor on breath

·         Heavy, labored breathing

·         Stupor, unconsciousness

If you think that you or someone that you know has these symptoms, call a doctor immediately.  Drink fluids WITHOUT SUGAR, if able to swallow, to prevent dehydration.  (If there is not enough insulin to get glucose into the cells to use for energy, the body turns to an alternative source of energy, and burns fat.  Ketones are a waste product of the body using fat for energy and if ketone levels get high, this can lead to a serious medical situation call diabetic ketoacidosis (DKA).

There are an estimated 29 million Americans with diabetes; about 1.25 million have Type 1.  This smaller proportion of people with type 1 might be part of the reason that the condition is so misunderstood.

Here are a few common tales that will set the record straight and help gain a better understanding of Type 1 Diabetes:

Tale:  You must have OD’d on sugar to get type 1 diabetes.

Fact:  No one knows the exact cause of type 1 diabetes.  Researchers are still trying to get a clear picture about genetic and environmental factors that might play a role.  The one thing we DO know is that it’s NOT brought on by too much sugar.  Oh, and they CAN have desserts (more on that later).

Tale:  Could it come from getting a vaccine as a kid?

Fact:  Scientists have NOT found a link between vaccines and Type 1 Diabetes.

Tale:  You put on too much weight.  That’s what caused it.

Fact:  Weight is not to blame for this disease.  Obesity and inactivity are big risk factors for Type 2 Diabetes and many other health problems, but there’s no connection to Type 1.

Tale:  You have the “bad” kind of diabetes.

Fact:  This is often a common comment in my ‘Diabetes Made Simple’ class.  There is no “good” kind of diabetes, nor is it a matter of being better or worse.  Type 1 and Type 2 diabetes are different, and therefore have to be managed as such. 

Tale:  Do you really think you should be eating that?!

Fact:  People with type 1 diabetes can eat or drink anything they want as long as they take the right amount of insulin to balance out the carbohydrates.  Now as a dietitian I’m always teaching patients, type 1 or type 2, healthy, balanced eating.  It’s not a free for all when it comes to desserts.  However, people with type 1 diabetes should not be made to feel that there are foods that they shouldn’t eat.  They can and should.  I had a 7-year old child in my office recently diagnosed (spunky as all get out) ask me, “Can I have cake on my birthday?”  I promptly responded, “Of course you can!”  She then followed up with her spunkiness and told me that she had lots of friends and they have birthdays too.  Can she have cake on their birthdays?  I of course had to outwit this 7-year old and proceeded to ask how many friends did she have??  She wanted me to tell her she could have cake every day!!  I explained to her that cake is exactly that, meant for special occasions and she really shouldn’t be having sweets every day (and that other kids her age shouldn’t be either). 

Tale:  It’s probably not a good idea to play sports.

Fact:  Jay Cutler, Ryan Reed, Gary Hall Jr – all athletes with Type 1 diabetes.  If you pay attention to how you feel and closely watch your blood sugar levels adjusting as you need to, you can stay safe and play any sport you want to.  Kids blood sugar levels during practice might react differently than during their actual game (adrenaline can make their blood sugars elevate), so I always tell my patients to know that they can actually have different reactions from practice versus game day – the key is to always be monitoring and aware.

Tale:  You were feeling so good last week.  Why are you having so much trouble this week?  Don’t you have it all figured out?

Fact:  Managing diabetes can change daily.  Many things, including stress, hormones, periods of growth, and illness, can cause your blood sugar levels to swing out of control.  These ups and downs don’t mean you’ve done anything wrong.  Even if you stick to your meal plan and follow the same schedule daily, these other factors can affect your blood sugar levels.  Again, managing diabetes is a daily job and it’s not something that can be forgotten about – it takes effort daily.

We teach a program four times a year called Mastering Your Diabetes – it’s an intensive course helping patients to understand their diagnosis, the mechanism of action of insulin (CHO counting, Insulin to CHO ratio, Insulin Sensitivity Factor, Insulin Adjustment Guidelines), Technology in DM, Exercise, and MORE!  Diabetes is a 24/7 job that requires attention and management – there are no days off – we help patients learn to manage it, but the truth is that there will be days with hyperglycemia and hypoglycemia – our hope is that they learn to “sugar surf” J

Tale:  When can you stop the insulin?  Shouldn’t you be cured by now?

Fact:  People with type 1 diabetes make NO insulin and taking insulin keeps them alive.  They must have it, but it doesn’t make the disease go away.  This is one of the biggest misunderstandings between type 1 and type 2.  Let me repeat, Type 1 DM requires insulin, it is their life line.  There is no cure, but there have been lots of advances.  And as the research continues, there have been advances in treatment of diabetes as well as technology – insulin pumps, continuous glucose monitors and, someday, maybe even an “artificial pancreas”. 

DRI's BioHub Transplant Technique

Diabetes can be a complicated disease as it can affect all areas of your life.  However, it shouldn’t keep you from doing anything you put your mind to.  You can eat what you want, play whatever sport you want, have a healthy pregnancy, and travel the world…you simply have to be aware of your blood sugar levels and begin to think like a pancreas.   I always tell my patients that while they self-manage their diabetes daily, it’s important to have a nurse educator, endocrinologist, and dietitian that can help support you.  We’re there to help interpret your numbers, help adjust basal rates, and remind you that you’re doing an amazing job!! I have been working at the DRI for almost 3 years now.  I can tell you that I’ve been forever changed from the kids (and adults) that I’ve met. 

Nutrition in Marathon Training

It’s that time of year, when all the runners are out.  Whether you’re training for a 5-K, half-marathon, or marathon, special attention should be placed not only on training for your runs but also on your nutrition.    Maybe you’ve heard that you need to load up on your carbs, drink lots of water, and stay away from the fiber.  But the question is, are you doing the right thing?

The food that you choose to fuel you through your run can make a big impact on your performance.  Runners tend toward extremes:  overdoing food or drink, cutting back on foods that give them fuel, or eating/drinking foods that may cause digestive disaster (aka runner’s trots).  Here are some tips to not only help you avoid those common mistakes but also guide you in what to eat and drink.  Having the proper nutrition before, during, and after the race can help you perform at your best. 

At the end of each tip, I’ll share a few things that I’ve changed up or am consistently doing (trying to do) within my marathon training.  What works for me may not work for you, but that’s why there’s a training period – try it out and see if it works.  No surprises on race day.

The Mistake:  Eating a box of pasta

Runners like to feast on carbs the night before a race.  And why not, right?  You’re going to burn through them the next day.  But overloading your system with more carbs than it can handle may only lead to digestive problems  (I’ve actually seen it happen during a race.  Believe me, it wasn’t pretty).  Running to the porta-potty every mile isn’t performing at your best.

The Fix:

The key is to consume moderate amounts – not huge portions all at once – of carbs several days prior.  And make sure before the actual race that you’re trying this out.  What works for one will not work for all, but the key is to train this way (no one wants any surprises on race day).  You can have oatmeal for breakfast, quinoa for lunch, and whole-wheat pasta for dinner.  Make sure you pay attention to your body’s cues – eat to fullness so that you’re not bothered by indigestion.

I always eat whole grains – it’s just been something I’ve been working on to improve my health overall.  So daily, I’m rotating my grains – whether it be homemade buckwheat pancakes in the morning, a brown rice bowl at lunch, and then whole wheat pasta at dinner – what’s been working for me is the consistency of having my complex carbs daily and in a sufficient amount.  There was a work luncheon the other day in the office – I opted out and ate my own food instead.  May sound odd to some, but it was a Friday before my 10 miler, I wanted to make sure I had the right amount of fuel (and those work lunches never have a balanced meal for me) – I had made the whole week count, I wasn’t going to mess it up less than 12 hours to my run.  Consistency has been the key for me – it’s crazy to think my 5 and 6 mile runs are a breeze, but they are.

The Mistake:  Drinking Gallons of H₂O

If you’re drinking too much water before the race it can leave you feeling bloated and can also dilute your electrolytes (those minerals responsible for muscle contraction).  Other side effects from diluting your electrolytes:  muscle weakness or cramping, and in extreme cases, can lead to hyponatremia (a life-threatening condition triggered by abnormally low sodium levels).

The Fix:

The key is to stay hydrated days leading up to your race.  Make sure you’re taking in enough water (refer to the color of your urine to let you know.  The darker, more concentrated in color means you are dehydrated.  Urine should be almost clear in color).  On the morning of the race, you can have ~16 ounces of water two to three hours before the start, allowing your body time to process this extra fluid; drink another one to two cups right before the start (and of course hydrate throughout the race).

I do drink water and plenty of it (my urine is almost always clear).  Here in Miami it is fall, but it has been quite humid even still.  The humidity always requires extra hydration.  Additionally I talk a lot for my job – that too is dehydrating.  I’m constantly taking in water and aiming to stay hydrated, with an ever watchful eye on my urine.  What I have been trying to work on is the fluid replacement during the run – with a balance of my fast-acting carbs & then the fluid during – this has been what I’ve been working on, simply trying to have enough circulating glucose for energy but yet not too much to cause the ever loving GI distress.

The Mistake:  Loading up on Fiber

Eating healthy means including ~25-35 grams of fiber per day.  Fiber should be gradually included into one’s diet – otherwise uncomfortable gas & runner’s trots may ensue.  So if you’re used to having a high-fiber diet, all that roughage right before a race shouldn’t be a problem.  But if you’ve been living on pizza and burgers, now is not the time (a week before race-day) to try to have 25 grams of fiber in a day.  Mix the high-fiber foods with prerace jitters and well, accidents may occur.

The Fix: 

The truth is that one should be training with these foods during your practice runs and then you can see how your body reacts.  But if you think that fiber may be an issue cut back on those foods a few days before a major race.  If you’re racing every weekend, reduce your fiber intake only on race day to make sure you don’t cut all of the fiber out of your diet. (And if you’re doing races every weekend you really should be eating better).

Fiber is my middle name.  I’m a vegetarian and therefore eat plant-based meals.  Once when I checked my fiber intake I was taking in anywhere from 40-50g of fiber daily.  That’s my norm.  I’m use to the side effects.  I’d be honest in telling you that I don’t cut back on the fiber as it helps with my regularity – and I want that prior to my runs, otherwise that’s when I have a problem – during the run.  So fiber for me is the norm, not having enough fiber is actually what throws me for a loop.

The Mistake:  Skipping Breakfast

There are many reasons that runners skip breakfast before a race:  too nervous or worried about feeling full, don’t wake up early enough, and as is my case, burping ensues the whole way.  Without it, you’re likely to tank in any race.  Why?  Studies show that a prerace meal keeps your blood sugar steady and provides energy to power you through.  If you skip breakfast there’s no way to get enough fuel midrace. 

The Fix:

If you know you get too nervous to eat before a race, try waking up a few hours before the start.  This will allow you to eat slow, letting each bite settle before taking another.   Remember, most times the race is quite early morning and there will be some transit time to get to the race.  During your training mimic the same schedule – wake up early and wait that time before going for a run - you might lose some sleep, but the key is always to simulate and train to see what works. 

Prior to runs these days I’ve been rotating different energy bars/balls.  My go to one (because it’s so simple to make) are these Peanut butter balls by Paula Deen.  I just don’t roll them in all that extra stuff she does at the end.  I wake up and have 1 or 2 (depends on the length of my long run) and then head to my friend’s house to run.  That 20-30 minutes in between has been working well.  The other thing that I’ve been trialing out is a shot of expresso.  I’m not doing it for the possible energy boost it may give, rather I’m doing it to avoid the caffeine withdrawal headache.  I know I’m going to be running for a LONG time.  I know I’ll get a headache if I don’t have some caffeine.  The other reason why I’m testing this out now is to see if/when the laxative effect kicks in.  You all know your body.  In some people caffeine does exactly that (if caffeine doesn’t do this to you, consider yourself lucky?)  Regardless I’m trialing it out so there won’t be any surprises of sorts mid-way through the run.  Since it’s not much volume, it’s just a black expresso, it’s worked to help avoid the headache and not cause any GI motility issues.    

The Mistake:  Trying Something New

If you’ve never had a spicy tuna roll, don’t order it the night before your race.  You won’t know how a food affects you until you’ve tried.  Last minute experimentation could send you straight to the bathroom and might even leave you dehydrated.

The Fix:

Stick with what you know a week before the race.  You can also check the race website to see which drinks and gels (if any) will be offered along the course.  Test them out in advance.  Don’t be afraid to skip the prerace dinner or hotel breakfast.  Remember if you’re not used to it, stick with something you know. For my race in January it’s here local in Miami.  Regardless when I’ve been traveling for races, I always travel with food, just in case. 

Call me a creature of habit, but I have the same dinner every Friday night.  This training season it’s all about the spaghetti – maybe the obvious choice, but it’s the tried and true.  When I walked my previous marathon back in 2008 I had pasta the same way.  Since my race was in San Diego I figured I could find the same spaghetti sauce out that way (previous issues with GERD, finally found a sauce that didn’t cause said GERD, not traveling with the sauce GERD ensued).  I’m just glad the race is local this time around.  Traveling can sometimes create limitations.  When I was in Puerto Rico it was actually hard to find pasta.  I could have used rice and beans, but let’s be real, beans can be quite gassy.  I hadn’t trained with it, so it was definitely not the time to start (the night before the race). 

Eat better

If you can find time to train hard, you can also find the time to fuel-up right!  Competitive athletes that don’t show up for meals might as well not show up for training.  You’ll lose your edge with hit or miss fueling.  Make sure to fuel-up with good nutrition – you’ll always win!

I’ve always eaten well – I’m a dietitian, it’s in my blood J But as I’ve been training for the marathon here’s a few things I’ve done differently – added, changed, or taken away.  My work schedule is always depending on what patients show up – that determines what time I’ll get lunch as well as what time I head home for dinner.  So for meals I’ve been taking each day as it comes and plan accordingly – I typically have three main meals and 1-2 snacks – again I play it by ear, but I definitely don’t go too long without eating – where before I’d just keep going and not eat.  It’s best the patients don’t see me hangry! 

Additionally what I’ve been adding into my diet is seafood.  I think of myself as a vegetarian and will have fish when eating out (as many restaurants don’t always offer the best available vegetarian options).  But eating out is rare, so again I default and most times say I’m vegetarian, even though technically I’m a pescatarian.  Training so far has increased my total nutrient needs – carbohydrate, protein, and fat – and while carbs are easy to get, protein from a plant source has been hard for me to get a sufficient amount (I don’t use supplements and already eat nuts in enough creative ways).  So I’d say this is one area that I’ve changed in that I’m making salmon, tuna, and/or another white fish (mahi mahi/grouper/sea bass) a staple 3-4x/week – whereas before it was only utilized sparingly.  I know that this helps me not to worry about whether or not I’m getting enough protein.  I’m already using nuts 2-3x/day – whether in a whole form, nut butter, or a “cheese” of some sort, but that alone wasn’t hitting the mark (in addition to a glass or two of milk, some cheese, and/or eggs).  The addition of seafood I believe has helped me to ensure I’m getting an adequate amount of protein. 

I have omitted all alcohol.  I did have some alcohol a few weeks back (for my birthday weekend celebration), however, since then I haven’t had any.  I’ve never been too heavy a drinker, but I know that when I do drink it takes away from my eating – when I drink I can’t eat and if I eat I can’t drink.  May sound weird, but that’s the way I’ve always been.  So, again, I’d rather eat and not alter the amount of food I’m consuming.  I’ll make sure to celebrate after finishing the marathon! 

I’m getting ready to enter week 7 of 20 of marathon training.  My runs so far haven’t been too difficult – we’ll talk after the 18 and 20 miler!  What I know is this:  when the right foods are eaten, at the right time, recovery time is reduced, energy is sustained, and the muscles work better.  You might have your running training down, but if nutrition is the missing link, definitely take some time to put things in motion.  Make the time to eat wisely and well – your body will thank you.  Happy running!