Sunday, July 31, 2016

Half Crazy or Full on Crazy?

½ Crazy or Full on Crazy?

My friend and I have discussed running a full marathon now for a while.  We even signed up for the Miami ING a few years back with the intent to do the ½ marathon and then find a destination run for the marathon.  Injuries happened and we postponed the race till the next year.  My friend was still injured in 2015 and so I ran the ½ marathon by myself.  The running a marathon discussion is happening again.  We’re both approaching a semi-big birthday, ahem, age is just a number though really ;) and so we’ve revisited the idea again of “it’s now or never”.  A little background if you please:

I started walking with a group in 2007 to meet new people.  I had moved back to Miami from San Diego and thought I needed to get active and find some exercise I didn’t mind doing.  I had heard of this group of people that would get together early Saturday mornings and run or walk.  I had never run before in my life, so I thought that I would simply walk.  The walks became something I would look forward to.  We had a core group that would always meet and when I say we’d walk, we’d walk.  8 miles was the long distance of the day – we were supposed to do our shorter walks during the week to be able to do the long walks on the weekend.  I’ve always walked fast and 8 miles really didn’t seem that long when you’re talking about everything that goes on with each and every walker.  And that’s when the discussions first started that I should do a marathon.  I only fathomed half marathon at that point.  So sure enough we all started training.  We pushed to do 11 miles (some did the full 13 miles as practice) but I wanted to do the full 13 on the actual race day.   Sarasota, March 2008, I completed my first ½ marathon – 13.1 miles – I felt so great I even did a cartwheel over the finish line (there’s a picture somewhere to prove it).  After I returned the following Saturday the other walkers now began the discussion of, “What next?”  Would we do another ½ marathon or would we go for the full now?  Many of the walkers told me that if I had trained for the ½ then it was the best time to continue on for the full.  I took the challenge on.  What did I have to lose, right?  From March to May I trained and I trained a LOT!  I even was able to go out to San Diego (the destination I picked for my marathon!) a few times as my nephew was turning one.  I thought what better way to check out the race course and train in the elements.  It just all seemed to line up (in my mind).  I even after one of my trips kept my suitcase out since I was going to be going back so soon – I thought it was not only motivation but also a reminder for inspiration.  Little did I know that 10 days before the race I would stub my toe on that said suitcase.  Who does that??  This girl does, that’s who!  I went to the doctor and the doctor said the toe was not broken, but they did advise me NOT to walk in the marathon.  I told myself if the toe wasn’t broken then I was walking in that marathon.  I had to after all that training and time spent.  My dad has this famous saying in our family, “You gotta be tough if you’re dumb.”  I kept hearing his voice say this over and over.   I knew I’d be tough and overcome.   

My brother dropped me off almost exactly at my corral.  I was early but race ready – I had made homemade “energy” bars and had my fruit leather and water all ready to go.   Trained and ready.  I chose the Rock-N-Roll series for my race because I knew at least every mile I would have some form of entertainment.  26.2 miles is a long way and since I was walking I wanted to make sure others would be around as I was still walking!  I would say it was mile 9 or so I got a rock in my shoe.  Of all the things to happen during the race – I had not trained for that.  It had formed a small blister – I took my shoe off and saw it – the medic tent told me they could take me to the end and I didn’t have to finish the race or I could continue on.  Once again, my dad’s voice popped in my head, “You gotta be tough if you’re dumb.”  I figured if the stubbed toe didn’t stop me, what more could 17 miles do to an already formed blister?  They bandaged me up and off I went.  During my race there were signs everywhere from the Team In Training groups and others as motivation:

And there were even running Elvēs (that’s right, that’s the plural of Elvis) for entertainment.  Over 100 Running Elvēs were at my marathon – I’m not sure how they were in uniform and wig running in the heat.  San Diego in June normally has a marine later in effect till late morning, early afternoon.  The day of my marathon, it burned off at 9 am.  I had the worst sun burn ever!  San Diego was a great destination run.  And more than that, I had my family at the end – talk about motivation.  At mile 20 though I think you hit this wall (at least I did) and all I could think was there were 6 MORE miles left.  I look back now and it was a mix of adrenaline/heart/sheer will to get me through to the end.   Completing a marathon is like no other feeling that I can describe – you hear people try to describe it, but until you experience it you never know how you will react.  I was caught up with emotion and was just overjoyed to see my nephew (and the rest of the family)  I had done it, blister and all, 26.2 freaking miles.  6 hours and 10 minutes.  I always say I actually walked 27.2 miles – because where they made my brother park his car was definitely another mile or two – talk about cruel! 

Returning from the marathon left me with the “where do I go next” feeling with my exercise regimen.  I had just walked 26.2 miles, would I start running now?  I had never run before and never thought I could run.  I wasn’t sure what was next.  My friend Felix helped me start running.  We did intervals:  run 1 minute walk 4 minutes, until we worked up to run 4 minutes and walk just 1 minute.   I’ve been doing intervals ever since.  I have Felix to thank for introducing me to running and believing I could run.  Over the years I went from running literally barefoot on the beach to running with the minimalist type shoe (since I no longer run on the beach). 

4 years ago I broke my foot, the 5th metatarsal, the good old Jones’ fracture.  I didn’t break my foot from the minimalist shoes, but from running in the rain in flip flops – cue dad’s favorite phrase J  It took a long road to recovery after breaking my foot to even begin to run again.  After having running taken away, I knew the minute I could run again I would run.  Injuries are able to teach you a whole lot.  I never take for granted being able to work out.   A year and a half after breaking my foot I completed a half marathon (when I thought I’d be never able to run again)

Talk about an emotional roller coaster of a run that was!  It was November in Puerto Rico – no one was going to be pulling a PR (personal record) in PR (Puerto Rico) that was for sure.  After the first light rain shower passed over there was this rainbow and I stopped to take a picture:

I tried to savor every moment of that race, not caring what my time was like.  Finishing felt like such an accomplishment – thinking back to breaking my foot and thinking would I ever be able to do what I so loved?  Incredible moment for sure.

And that leads us to the present moment.  To run a marathon or not?  My running partner Marcela has never walked or run a marathon.  We’ve run a half marathon together and I know it’s on her bucket list:  run a marathon.   She’s downloaded the running schedule and is determined.  I’m training with her and tomorrow will be our official first day of training.   Say what?   I said after the first time around I’d never do this again??  Here's what I do know.  Marcela is my running partner. Through thick and thin, we're training for this marathon.  Marcela will be able to have that same feeling I had years ago - she'll be able to describe it to you one day.  Here’s to training and here’s to learning things along the way! 

Sunday, July 17, 2016

Extreme, Strict, or Simply Passionate?

Extreme, Strict, or Simply Passionate?

Summer in Miami is always hot and humid.  This past week it’s been extra hot since there haven’t been any of the afternoon rain showers to “cool” things down.  Not to worry, this week rain is expected every afternoon.   So now it will be a little steamier instead of just hot.  I’m not complaining, just stating the facts.  I wrote a blog about Hydration to help people stay hydrated.  All over social media sites, i.e. Twitter, Instagram, others are posting about hydration as well.  The truth is water is the best hydrator.  I teach a class at work, a general nutrition class, and the question always comes up, “What should I drink?  Crystal Light? Coffee?  Tea?”  My answer is always water and will always be water.  Sure I know it’s boring (to some people) but the truth is when you’re thirsty it’s the drink that will actually quench your thirst.  Eating fruits and vegetables can help as well as many of them have a high percentage of water. 

In certain situations, i.e. outside work, exercise, of course some form of carbohydrate replacement may be necessary, however, those are not the day to day examples for everybody.  Again, read the post for more information.  What’s come up more recently in class though is the question, “well what about juices and smoothies?”  This is where the debate always begins.  I try to keep it simple in class because I have a short amount of time and there are many other topics to cover.  The short answer?  Drink water.  And then the questions always begin, “but I thought smoothies were healthy?”  Believe me this is a trend that I wish would end.  Unfortunately it’s been around for a while and is only here to stay to continue to confuse people.  Smoothies have now progressed to smoothie bowls – so now not only are we having a smoothie full of carbs but we’re now loading them up with additional foods on top that contain carbs, carbs, and more carbs.  I try to explain to patients that in general the preference is to eat and chew your food – this takes time and allows for overall slower digestion (your body breaking the food down and receiving all the nutritional benefits, i.e soluble and insoluble fiber, vitamins, minerals.  When you blend the fruit up, the blade does destroy some of the fiber (kind of like doing the chewing for you), bypassing this critical step in digestion.  Furthermore, it not only “pre-chews” the food for you but you then have no buffer to slow digestion down – the end result being a larger load all at once for your liver to respond to.  Yes, smoothies have some fiber in them, so they’ll help in cleaning your intestines out (but that’s the role of the soluble fiber).  Smoothies are just like drinking a sugary drink – at least in how your body responds to them.  NOT recommended.  People always follow up in class by saying that they only do “green” smoothies, so only vegetable containing just to be clear.  9 times out of 10 when people are asked what they put into the smoothie at least one fruit is thrown into the mix.  The minute the fruit is thrown in it is now contributing sugar (carbs) to the mix, not to mention that the load of some of those green veggies (or even carrots and beets) now due to their volume can also elicit a response.  Here’s an article a few years back where Dr. Robert Lustig explains it a little more eloquently than I do - We don't mean to ruin smoothies

I’ve been told in class that I’m a little too strict in my thinking on juices and smoothies.  I like to think of myself as an educator that’s passionate about what she does.  I’m not always going to tell you what you want to hear, that’s for sure – this registered dietitian does NOT give her stamp of approval on juices or smoothies.  Smoothies and juices are a way for people who may have never eaten vegetables to begin to incorporate some vegetables into their diet.  I used to do it all the time for my nephews with spinach – but in my concoction I always added greek yogurt or some peanut butter for some protein and fat – and that was to get my nephews to see that spinach didn’t always contribute a flavor so they’d be more willing to eat something green.  Sure every now and then smoothies and juices might be able to fit, but they shouldn’t be a daily thing.  The bottom line is that people need to eat and chew their food to get the full benefits and help their body process food in a normal manner.  Over the last 2 ½ years while working at the Diabetes Research Institute, I have had an occasional sweetened alcoholic beverage, where before I used to have them all the time.  I’m more conscious of my food and drink selections now.  So call me “extreme” or call me “strict”, I prefer to think of myself as passionate about educating and teaching people about nutrition.

This then leads me to my next topic that always seems to come up in class.  The question is always asked of me, “What can I do to improve upon in my eating habits?”  I guess as a dietitian they see me as having it all together and again think I’m a little extreme when it comes to eating healthy.  But the truth is we are all at different stages of where we need to improve upon.  And while I might be farther along the path, there is always, and I mean always room for improvement.  I strive to practice what I teach and be an example – I believe that’s how people are able to learn.  But more than that, I try to implement what I do teach to see if it’s practical.   If I’m asking people to do something, then I’ll trial it out first.  Who am I to tell someone to go and do something – easier said than done.  Here are a few things I’m currently working on:

I’ve been making meals that contain 45g of carbohydrates – Is it possible to only have 45g and stay full for 4 hours?  What do meals look like with only 45g of carbs?  I’m part Italian and 1 cup of pasta = 45g of carbs, that’s a tough one - but that’s exactly why I’m trying it out.   

 I work with both Type 1 and Type 2 diabetes.  I teach overall general nutrition for all, but in regards to Type 2 diabetes, the focus is on the quality and quantity of the carbs at each meal (again, this is taught to people with Type 1 diabetes too, but typically I’m teaching them to match the insulin to their carbs, a little bit of a different approach).  Quantity of carbs is critical when it comes to blood sugar control as you want to limit the load at any one meal (and aim to distribute the carbs throughout the day).  Which brought me the idea of having meal examples of 45g of carbs for patients to see real life examples– 

So what’s the verdict?  Does 45g of carbs at meals keep one full?  YES – when they’re balanced with lean protein and non-starchy vegetables.  You HAVE to add in lots of non-starchy vegetables to the mix, otherwise you will  load up on carbs and more carbs – believe me, I used to do it!  When meals are balanced – carbs, protein, and healthy fats, we’re able to fuel and sustain ourselves.  Carbs are your preferred source of fuel, however, they do digest quite quickly and will not sustain you for a long period of time.  Enter the lean protein and non-starchy vegetables (that are full of fiber – which also helps to keep you fuller longer) – it sounds cliché, but it’s the truth:  variety, balance, and moderation are key when it comes to planning meals.  When I look around at many cooking websites, they’re not always balanced.  This message is then passed on to people as to what looks like an appropriate meal, when in fact there might be something missing or it might not be adequately balanced.    You know the whole zoodle craze?  They were created to lower the load of carbs at meals, they were NOT created to omit carbs at meals – which is what is often depicted.  So enters my pics, to illustrate healthy balanced meals with real life food that people will want to eat.  I’ve just started taking the pictures, but I think it’s something that I’ll continue doing – now I just need a catchy hashtag J

I’ve been making everything homemade!  While this may not be realistic for everyone, remember these are the things I’m doing to improve upon for myself.  My most recent items I’ve made:  homemade bread, pico de gallo, salsa, chimichurri sauce, blue cheese dressing, and those are just a few!  I will be the first to tell you that my bread making skills need improvement.  So any tips that you can send my way, I welcome.  I don’t have that much space in the kitchen, but I’m thinking a bread maker might be the way to go.  There have been many failed attempts – whole wheat bread, pizza dough, “cheeze-it” crackers, unfortunately none have made it to the “taste test” stage for people to experience.  I’ll get there, eventually.  That’s my project and I WILL keep improving.  I have to! 

Eat more non-starchy vegetables!  As a practicing vegetarian (technically a pescatarian as I will eat seafood every so often) there is some irony to this.   How do I not eat more vegetables, am I right?  Over the last two and a half years I have been working to improve upon this.  I’m the first to admit I had been loading up on carbs – it’s easy to do as a vegetarian. 

So now for meal prep I’ll roast lots of veggies up to include throughout the week.  It’s always the missing part of anyone’s meal most times.  This addition to my meals has helped me to cut back on the amount of carbs I was eating.  (Sure, I have a normal working pancreas that will secrete insulin when I need it, but the truth is that there is a family history of diabetes in my family and I am aging – no need to overwork my pancreas any more than I need to!  I’m all about prevention!)  Additionally I’m trying new vegetables I might never have tried before – Gai Lan (Chinese broccoli) is now a staple in my kitchen -  Also I’m trying to get a variety of colors within the vegetables that I’m trying – it’s hard to find different blue/purple hues of vegetables – purple carrots and purple cabbage are now mixed in on a rotation.  I still need to find a way that I’ll enjoy eggplant – I think it’s the texture that’s not my favorite.   So even me, the dietitian has problems eating more vegetables!

Decrease the frequency of desserts.  I love sweets – I often joke, “this dietitian eats dessert!”  I pride myself on saying that I have them in moderation and in portion controlled amounts, but the truth is they were starting to become a little too frequent.  So just in the last couple of months I have been cutting back.  I do make desserts, but I’ll share more of them now, so that I’m not having them daily.  I eat them in portion controlled amounts when I do have them and now the frequency is less.  They were starting to creep in as a daily ritual.  As part of the process of lessening the frequency I do still have a piece of dark chocolate daily – a nice 70 to 80% dark chocolate.  Not too sweet, but it still gives me the idea that I’m having “dessert”.  The portion has never been the issue, it’s more the frequency.  I teach my patients that desserts are meant for special occasions (and rightly so!)  Every day is not a special occasion.  I knew I needed to cut back and I have. 

Mindful eating – Breakfast and dinner are typically easy for me to be mindful about what I’m eating- I have time and it’s at my house.  Lunch, not so much.  Most days you’ll find me eating my lunch quickly at my desk.  Not super mindful at all.  This is definitely an area where I struggle and am honest in saying so.  The one thing that I have done is aim to leave the building for 10 minutes at lunch time.  I’ll go for quick walk around campus (even in this heat!) without my phone and try to practice a walking meditation.  This has been helpful.  So, while I’m eating rather quickly I do feel the walk outside helps.  I just need to figure out if eating outside and not walking would help me to be more mindful?  I wish in an ideal world I could do both.  Again, a definite area to improve upon. 

Remember, it’s important to constantly strive to improve – the moment you get too comfortable is when we start to inch back into our old ways.  While I’ve always eaten healthy, I too have room to improve – the desserts are a prime example of me becoming too comfortable and starting to eat them too frequently.  I really do try to practice what I teach and hope that others can see this is a lifestyle, it’s not just a one-week fix to lose weight – it’s all about establishing healthy habits, one at a time, to last a lifetime! 

Sunday, July 3, 2016

June in Review

Time flies.  How is it July already??  It’s been a month since I last wrote a post and life has been busy.  I saw a picture on social media the other day that summed up a few general wellness principles quite well: 
Sounds simple enough, but why is it always so hard to put some of these principles into actual practice?  Life.  It’s stressful!  We’re moving at a really fast-pace, we don’t slow down and like the quote says, we don’t “listen to our body.”  It’s easy to say, listen to your body.  But, knowing and doing are two separate things.  I’ve found that stress for me is the trigger to making poor eating selections, overdoing myself, as well as losing my cool at times.   This weekend I’ve taken time for myself, meditated, slept in, and worked some (more on that later).  It’s just what I needed after a month of non-stop on the go craziness.  A few things from this past month:

Four weekends a year we do a special program at work called Mastering Your Diabetes.  It’s a program geared towards people with Diabetes (insulin management).   With a multi-disciplinary team – nurse educator (CDE), dietitian (CDE), physician, and psychologist – our aim is to:

·       Optimize patients understanding of how their insulin works

·       Improve the decision making regarding the timing, dosage, and administration of their insulin dose for their insulin needs

·       Assist in identifying patterns in blood glucose management (with the use of continuous glucose monitoring – CGM)

·       Reduce risk for hypoglycemia and hyperglycemia

The month of June we have one geared towards kids and their families.  To say this 4-day program is life altering is an understatement.  I always go in to the program knowing that I will be teaching a lot of information to the kids and their families – carbohydrate counting, general nutrition for growth, etc – but the truth is I always come out having gained so much more from the kids themselves.   We did a section one day where the kids had to say one positive thing about having diabetes, one negative thing, one thing they’re grateful that their parents do for them, and one thing that’s annoying that their parents do.  The kids ranged from ages 8 – 16 in our group this year.  For this section though I had the younger kids, ages 8-11.  What they all had in common is that they wanted people to see them as normal children that didn’t have some label that comes with “diabetes” on their forehead.  Sure, they know they’re special they said and that they have to “think like a pancreas” but they’re normal kids that hate needles and want a cure for type 1 diabetes, like yesterday.   One child that especially touched my heart this time around was a child from Guatemala (he came especially for our program!)  When going around the circle, his fear is that his sister will have diabetes and his one thing that he was grateful for was that his parents buy him the things he needs to manage his diabetes.  At age 11, to be so reflective and able to see how supportive his family is for him and yet to be so thoughtful that he doesn’t want his sister to experience what he has gone through (even knowing that he is okay at the end of the day).  Okay, I’d say cue the tears, but I didn’t want to cry in front of the kids and get my ugly cry on in front of them!  So, I bit my tongue – maybe not the best strategy, but the kids knew their comments were getting to me – one came up and gave me a hug.  4 intensive days of teaching kids and their families how to “manage their diabetes” that not only changes the participants but changes us (the healthcare professionals) for the better.  Completely life-changing.

In between working the weekend for MYD I’ve also been working to prepare nutrition curriculum for a 300-hour yoga teacher training (YTT) coming up.  My yoga teacher, Marianne Wells, developed a 300-hr YTT and with collaboration with medical and therapy professionals that will help yoga teachers deepen their knowledge, expand their skill level, as well as foster their evolution as yoga professionals.  I’m excited to be a part of this YTT and have been working hard on creating the curriculum for the Nutrition portion.  I’ll be covering some of these topics:

·       Carbs/proteins/fat – What is the right balance?

·       Nutrition in diet and disease & prevention

·       Vitamins/Minerals/Antioxidants – Is supplementation necessary or will my diet provide everything that  I need?

·      Nutrition Trends – Paleo/Atkins/Macros/Juicing – What’s the right “diet” I should be following, if any?

·      Mindful Eating – How to be mindful in a not so mindful world (technology/social media/work)

Simple requirements – that you’ve already had a 200-hour yoga teacher training prior to taking this 300-hour training & it’s highly recommended that you’ve been teaching yoga weekly at least one year prior to the training.  Again, I’m beyond excited to join Marianne in teaching what I love and am passionate about, Nutrition!  I’ve really been putting a lot of time into creating the curriculum.  I’ve still got more to go, but each weekend I put in hours dedicated to the curriculum and will be ready to go come November!  Any questions, let me know.  Check out Marianne’s website for more details as well:  Marianne Wells Yoga School - 300 hour Therapeutically-Oriented Yoga

In the middle of all of this I decided to try a few no-carb meals.  It’s a really popular trend – just check your Instagram, Facebook, Twitter feed and you’ll see any and all kinds of “noodles” that aren’t really noodles…  I’ve spoken to a few doctors (endocrinologists that I work with) and the thought is that every now and then a meal or two can be carb free.  I decided to try it and put the experiment to the test.  I borrowed my mom’s “spiralizer” and began to zoodle away:

I randomly spaced the no-carb meals so they didn’t fall consecutively and I made sure to include one or two meals prior to the days I would run.  What were my findings?  This is not science based, simply based on my personal experience:  I was hangry after these meals – so much so that I was definitely eating things that were unhealthy.  I was beyond irritable and my runs were the worst runs that I’ve  ever had (according to Fitbit analysis).  Maybe it was all mental?  This has and always will be my recommendations to people – EAT CARBS.  Eat healthy, complex carbs and in portion controlled amounts.  Quality AND quantity are important when it comes to carbs.  We are a carb laden society and need to cut back on the amount of carbs we are eating.  Period.  No need to eliminate them completely, rather include them in the right size portions – which when you see a cup of pasta you’ll think I’m kidding.  1 cup doesn’t look like much.  Believe me, overeating pasta is easy.  The key is to balance your plate with the right amount of protein along with non-starchy vegetables.   There won’t be any more experimenting with no carb meals.  I’m good.  I know my body and I listen to my body.  Healthy and balanced.  I eat carbs J
I finally was able to check out the new restaurant here in Miami called Grown.  It’s a fast-food restaurant created by Ray and Shannon Allen (former NBA player) that brings “real food, cooked slow for fast people, fusing a farm-to-table concept using organic, local, and nutritious ingredients in a fast-food setting.”  They created this restaurant Shannon says out of frustration.  She has five children, one child with Type 1 diabetes, and cooks healthy food at home, but like most families is busy and wanted an option to have on those nights when she couldn’t cook and needed to grab “fast-food”.  Enter her idea for Grown.  I knew I had to check it out – it’s only been open for three months already!  The menu is nicely laid out – they have the option to pick your protein, grain, vegetable, and then your sauce.  I chose to go with the salmon (as I will eat fish occasionally).  Literally ready in under 5 minutes, my dish came out:

Healthy food, fast.  Delicious flavor and quite convenient – they even have a drive through!  While it is a fast-food concept, just go in knowing that the price isn’t equivalent to other fast-food chains.  It is a little more pricey – you are paying for the local sustainability and organic food.  I haven’t eaten out in forever as I make my own food all the time.  But I do love their concept and understand her frustration – what do you get in a pinch that doesn’t compromise eating healthy?  Enter Grown.  Here’s hoping they expand and others will catch on to their concept.  If only I had the means to open a restaurant of my own…hmmm.

This past Friday, all I did was rest.  It was what my body needed.  This past month has been busy and at times stressful.  So I did just what my body told it to do – I slept in (even if it was only till 7:07 am, I slept in!), I did a restorative yoga class, I meditated, I took a nap (and I am not one to sleep in the middle of the day – but I was out cold for 20 minutes so apparently my body needed it!), and I did just a little bit of cooking – because I wanted to nourish myself with home-cooked food.   I know that in order to give to others I need to give back to myself.  I was running on fumes for the past week and a half and I needed to rest and restore.  We all do.  The wellness principles I mentioned at the beginning of my post are simple reminders to us all to slow down and tune in to ourselves.  On the days that were so crazy busy I found myself skipping my meditation time – when it was what I needed most!  I’m reminded that meditation can be little bits all throughout the day and this is what I’ve been practicing since Friday – one minute intervals of breathing, re-connecting, and resetting my intention – to not let stress overwhelm me and to know that there still may be moments of stress.  Breathing just helps me refocus and restart with a little bit of a different vantage point.  I’m not here to say I still won’t get stressed or overwhelmed, but I know I have the tools to tap into and help manage the stressful times.  I'm ready for you July!