August Highlights

It's been a hot-second since I last released a post.  August has been BUSY.  Last weekend I was at the AADE's (American Academy of Diabetes Educators) annual conference.  The weekend before that I was teaching my Type 1 diabetes carbohydrate counting class.  And just this past week family was in town.  Phew.  I'm just tired of thinking about all that I crammed in these last few weeks.  Here's a few of the highlights from my life in August.  

Views for days - acting like a tourist in my hometown

Type 1 Diabetes Class - I used to work at a diabetes center that was focused on mainly diabetes, specifically Type 1 DM.  Here at my new job the focus isn't on 1:1 counseling but rather group education.  I received a request to teach a class from the community (based on a need) for people with Type 1 diabetes.  I jumped on the chance.  I always loved teaching carb counting and while it is a science it is also an art.  It also takes practice, time, and patience.  

In a study published by the Clinical Diabetes Journal they investigated carb counting accuracy.  So while the technique is super helpful in allowing people the ability to individualize their insulin needs based on what they're eating, it does take practice.  This particular study conducted a carb counting accuracy test in 18 different foods.  The results?  59% out of 100% - a failing grade!  Whether carb counting has become so routine people aren't really measuring anymore or whether people really did just guess, the study proved the point that people's carb counting skills needed to be brushed up on.  

My 1st first class was held in June.  And I just had my 2nd class in early August.  I'll be having another class coming up in November.  The classes are completely FREE, so if you know of someone that might benefit from this class, let me know!

Carb Counting Lab - how well do you carb count??

Instant Pot Crazed - I borrowed my mom's instant pot and I must say that even though I'm late to the ballgame on this here food trend, I must say I'm impressed.  I've heard many mixed reviews  (some either LOVE it and some just plain HATE it).  I figured I needed to try it out on my own and see what the fuss was all about (and you should too.  Not endorsing, just giving my review here and think you should make up your own mind too).  Here is why I think some people really do love it - it has a slow cooker, pressure cooker AND a rice cooker all in ONE device.  It's hard not to love something that gets rid of other gadgets in your house (I'm sure all the rice cooker and slow cooker makers in the world are not loving it, but you know what I mean).  And to make it even more user friendly there are certain buttons on the Instant Pot that let you cook various foods based on their settings (already programmed in the settings for you).  For example I made a pork tenderloin and I was able to sear the meat with the "sauté" function along with some onions and garlic.  Then I used the "meat" setting to pressure cook the tenderloin for ~17 minutes and then let the steam release for another 10 minutes.  While I don't eat pork I allowed a few people to taste test the end result and it was definitely tender.  Approved.

I've always wanted to make homemade beans, but truth be told, I never wanted to have to soak the beans overnight and then make a whole pound of beans up all at once.  It just seemed like such a process and a pound of beans just for me?  Too much even for this bean loving vegetarian.   But I figured since I'm borrowing my mom's Instant Pot and I'm on the "make everything homemade" kick I decided I should at least try to make homemade beans.  Guess what?  Simplest process ever.  I didn't even soak the beans (Shhh, don't tell your grandmothers - for them it might be a tradition/process, but seems to me everyone is too busy these days to have to wait for the soaking, so I wanted to try it without soaking the beans.  I'm here to tell you, it worked!)  No final pictures of the beans, but believe me when I tell you they were delicious.  And just so I wouldn't waste any food, I froze the extra beans.  Talk about meal prepping at its finest - after my trip I had two ready made meals just waiting to go.  Win.  Win.  Now to see if my mom will let me "borrow" her Instant Pot for just a little while longer...Let me know if you want the recipe!

AADE - American Academy of Diabetes Educators - Let me first start off by saying that as a Certified Diabetes Educator (CDE) we are required to have 75 hours of continuing education units/hours (CEUs) every 5 years.  I'm in my 3rd year and only have 15 hours.  Talk about being behind!  In my previous job I had 12 hour days and the last thing I wanted to do was spend a weekend immersed in learning when my brain was already fried.  Glad to say I obtained 30 hours at this conference and now am back on track.  Note to self, never fall behind on my CEUs ever again.  Seriously.  

The conference was held in Baltimore

So what did I learn?  I did learn a few things, rather reiterated a few points that were important and so I will share those with you.  While these may not be new to you facts, I do think it's important to share.  I'm not going into great detail here, just simple statements (based on research).  Each point could truly be a blog post on its own (and maybe I will do that).

Gut Health:   Our microbiome - We depend on a vast army of microbes (bacteria) that protects us against germs, breaks down food to release energy, and produces vitamins.  Other core functions of our microbiome include regulating our immune function, modulating GI hormone release, and even regulating our mood and behavior.   The microbiome is a living dynamic environment where the relative abundance of species may fluctuate daily, weekly, and monthly, depending your diet, medication, exercise, and a host of other environmental exposures.  So yes, you can see now why there is so much research geared towards improving our microbiome - it's linked possibly to so many different disease states.

Sourdough Starter aka Flor

Let's cut to the chase:  what can you do to keep your microbiome in good shape?  This is where prebiotics and probiotics come in (thinking you've probably heard of these terms before).  Prebiotics are substances like inulin (fiber) that help microbes to thrive (think of it like food for the probiotics).  Prebiotics are not digested or absorbed in the small intestine, but rather fermented in the microbiota.  Whereas the probiotics are microbes, live organisms, as well that are thought to be beneficial to our health.  Two specific species are the Lactobacillus and the Bifodbacterium.  

Prebiotics are found in foods such as the Jerusalem artichoke, chicory root, raw dandelion greens, leeks, onions, garlic, asparagus, whole grains, beans, green bananas, wheat, oats, soybeans, and psyllium husk.

Probiotics are found in sauerkraut, kimchi, tempeh, soy sauce, miso, kefir & yogurt, sour dough bread, & kombucha.  Think fermented foods - live bacteria.

My 1st sourdough loaf made with the starter Flor

Where does that leave us?  More research is needed.  One of the conundrums is how and why the different strains of bacteria have different effects.  Researchers are also developing studies to explore how the microbiome influences our response to food, and how different diets can tweak the microbiome.  Plant-based diets are looking quite promising, so stay tuned!

Telehealth - Technology is passing me by sometimes (or at least I think it is).  And if it's passing me by just think about all the people older than me and how they must feel.  Telehealth is definitely the future.  I used to see patients 1:1 and would try to follow-up with them via email, whether it was in regards to their blood sugar levels and/or their food recalls.  Enter telehealth:  Now there are digital portals where their blood glucose meters can sync as well as their diet recalls.  I can review them all online and either contact them virtually or just email/call them back.  All outside of your typical doctor office visit.  That's definitely one way to improve diabetes management.  Care within their scheduled appointments, because we all know 3 months in between appointments is too long to make changes/adjustments.  What I dealt with?  Lots of "I don't have my meter with me today."  "I didn't bring a diet recall.  Nobody told me to do that."  And then we'd have a wasted hour of teaching theories without the application.  Yeah, telehealth has only just begun.  I'm excited to see where it's going.

Not the best picture, but if you look close you can see a gentleman gave himself 8 units of insulin with the meal and adjustment for starting above target.  After two hours he saw his blood sugar went up to 243 mg/dL.  He proceeded to give himself 6 more units of insulin.  Two hours later and he was 56 mg/dL - while he did need a tad more insulin he did over inject.  Having these downloads make for teachable moments.

Plant-based Eating - I teach a whole class on defining what plant-based eating is.  It can get confusing with all the new classifications out there.  But in terms of the studies presented at the conference and as they were aiming to look at better glycemic control, I will be referring to a vegan diet for this discussion here.  VEGAN - meaning NO animal products whatsoever.  None.  Zero.  And additionally not only vegan but also low-fat.  In terms of ratios we're looking at 70% carbs, 20% plant-protein, and 10% fat.  That's high carb, low-fat with all of the carbohydrates coming from complex carbs (mainly) and no refined carbohydrates (so no white bread, white sugar, etc.)  We're talking high-quality carbs here.  Some of their fiber intakes increased from 18g of fiber to 36g of fiber and some of the highest intakes were even up to 65g of fiber.  

Yes, with that much fiber you will be a pooping king/queen.

What did these studies ultimately show?  Improved beta cell function with not only an increase in insulin secretion but also a decrease in insulin resistance.   For anyone that's curious, that's basically the whole premise as to why diabetes occurs.  Why aren't we promoting this more then??

This led to a reduction in overall incidence of diabetes occurrence as well as even in some patients looking as if the diabetes was reversed - I don't like to use that exact term as I never want people thinking diabetes just disappears.  But again these studies are improving the beta cell function which in diabetes is ultimately impaired.  If the beta cells are working then it could appear as if the diabetes disappeared.  The key would be to keep it functioning properly in order to stave off the diabetes.  My mind was definitely blown away by some of the research.  The key underlining theme is they have to be completely VEGAN and low-fat.  The patients were only allotted a 1/4 cup of nuts.  They couldn't switch back and have fish or meat for once a week for that matter.  Completely VEGAN.  This appears promising and should be an option when talking to patients.

Vegan cuisine

While it's always important to learn at these conferences and stay up-to-date on the latest research, I always find it important to explore the neighborhoods and go out and talk to the community.   You can learn a lot just by being present and seeing what the needs are.  

Baltimore's Farmer's Market blew me away - amazing wild mushrooms

My nephews and brother were in town this past week.  They were doing all things touristy - airboat ride, science museum, beach, and more.  I joined up with them on most days.  I enjoyed being a tourist in my own city.  I posted about this concept on Instagram the other day, but it's the truth.  How many times do we get so busy that we don't even enjoy our free time - we're too busy running errands, grocery shopping, cleaning, whatever it is, that we don't take time to explore.  Sure I had a list of things I thought I needed to do.  But the truth of the matter is that most of it could and did wait.  It was just my routine, what I'm so used to doing.  Besides being a little tired because of a lack of sleep, I actually felt renewed and energized all from a visit from loved ones and spending time in nature, forgetting about all the stresses of daily life, and being present in the moment.  We could learn a lot from kids.  I know I did.  Go explore and feel like a tourist again.

Frost Science Museum Aquarium

Yes, You Can Cook

I've heard it said before, "I can't cook.  How do you expect me to eat healthy?"  If I had a nickel for every time a patient had told me this, well I'd probably be a millionaire.  Okay, maybe not, but you get what I'm saying.  It's a common problem.  I completely get it.  Cooking can seem overwhelming and intimidating in the beginning.  But I am here to tell you that anyone can cook.  All it takes is a little time, patience, and practice.  There will be mess-ups (we all have them, even I do to this day).  But as you begin to practice, you'll see that with a little quick assembly of items, you'll be on your way to eating healthy, great-tasting food!

Proof in the pudding - all of these are easy peasy!

There was research done to show that cooking at home improves people's health.  Said summary of study can be read here.  But then more recently they looked again at this cooking at home to see if in fact it really did lead to a cause and effect of improving health.  You can read this study here.  Their conclusion was that while it did lead to overall improved dietary quality and lower adiposity, i.e. obesity.  The study went on to say though that in order to identify if cooking at home really did have causal effects on diet and health more studies would need to be conducted.  Okay, so there went the proof that I so proudly boasted to my patients now blown out of the water.  Or did it?  I included these studies here because this is nutrition.  It's a science and we always want the proof with research.  But I can tell you that by seeing patients one-on-one for many years, people's health improved when they simply began to eat healthier, one change at a time, whatever that looked like for each individual.  And for some that meant simply cutting back on the frequency of meals that they were eating out.  

Having a go-to sauce to add to food can take a meal from ordinary to out-of-this-world.  Ingredients for homemade chimichurri.

And part of that conclusion goes back to the original reason for my post - people didn't think they can cook.  There were other reasons as well, i.e. time, time, and no time - I mean isn't that the truth??   But the biggest complaint I would get is people would just want me to tell them what to eat.  They didn't want to have to think about it.  Creating menus back in my college days was the bane of my existence.  While I did love creating general menus, making a menu for someone in particular is not so glamorous.  How am I supposed to know what each person is going to eat/have time to make?  And the whole point of a menu is to make sure that they are nutritionally sound.  If you have someone that isn't willing to vary his vegetables up, then Houston we have a problem.  It all goes back to what I like to think is the most important part of my job.  Giving patients the tools in order to be able to fly on their own.  I teach you and you put it into motion.  Am I right?  Unless you want to hire me as a personal dietitian and chef (for a nice sum of money) then we can talk.  Until then, let me educate away.

So this is what I thought I would do.  I'll take you through a few steps of how to make a simple wrap with a few step-by-step pictures.  I definitely want to do videos in the future, but until then, this will be a start/new feature I think that people have been asking for and also need.  How's that sound?  Are you ready?  Here we go!

As I've said before, my keepers may not always be your keepers, but that's the beauty of cooking.  Finding what you like in flavor and bringing it to life.  So, here we go.  

Kale and Mushroom Wrap.  The hardest part of this recipe is prepping the kale.  No, seriously.  In total this recipe took me about 30 minutes to prepare including all of the chopping and cooking.  I doubled this recipe today in order to use the whole bag of kale and also to have enough (that kale does shrink down like spinach does to almost nothing) for a few wraps this week.

Step 1 - Thinly slice your leek.  If you're not sure what a leek is, it has a more mild flavor than an onion.  But you can definitely use an onion if you prefer.  Remember I am making double and this is actually two leeks (I just forgot to take a picture of the whole leek).  Cut off the green leaves of the leek.  Slice in half so you can slice them in these round moons.

Step 2 - Thinly slice a shallot.  Shallots are also a part of the onion family.  Less abrasive in flavor, but again you can simply use an onion in place of the leek and shallot if you like.  I think that the leek and shallot do provide a little more flavor than just onions.  But you do you.

Step 3 - I wanted all baby bella mushrooms but alas they weren't on sale.  I opted to get one of each as I was going to be making double.  I use a damp paper towel to clean the mushrooms.  If you use too much water to clean them they do absorb the water.  Paper towel for cleaning it is.  Then I diced them into tiny pieces.  My preference.  You can always just slice them as well.  8 oz of mushrooms total.

Step 4 - I bought a bag of curly kale this time.  If I buy lacinato kale then I use the whole bunch.  But this bag of kale is 16 oz. and it is a lot of kale.  This recipe only needs about 8 oz. of kale.  I sift through the kale and pick out the hard rib pieces (over on the left side there) and leave only the curly part.  This is what I told you is the time consuming part.  But to me it's worth it.

Step 5 - I used my dutch oven pan here instead of a non-stick skillet.  This had a white bottom and it actually helped with pictures, but you can definitely use a non-stick pan, but you still need the olive oil.  Heat over medium-heat for a minute or two.

Step 6 - Add the shallot, leek, mushrooms, and a dash of black pepper to the pan. I typically never use salt in my recipes.  Occasionally I will, but never the amount called for in a recipe.  I find it too salty.  You can add some here if you like, but I'm used to less sodium in my food.  Less sodium doesn't mean less flavor.  This kale/mushroom mixture will be placed in a wrap.  Typically bread has a lot of sodium and it can all add up.  I think the mixture has enough flavor all on it's own.

Step 7 - Cook the shallots, leek, and mushrooms, stirring frequently, until the vegetables are soft, about 8 minutes.  The first picture is when it began to cook.  The second picture although steamy from the heat is after it has cooked for 8 minutes.

Step 8 - Add the kale and cook until wilted, about 8 minutes.  Looks like a lot, but it will shrink aka cook down.  Totally a technical cooking term. Ha!

Step 9  - Once the kale has cooked down, add in 1/4 cup of chicken broth (or vegetable broth).  Sprinkle with a few dried cranberries.  I used the dried cranberries here, but almost never used dried fruit.  I thought about it after, but I should have just used fresh cherries (and not cooked them) and then added them into the wrap.  Didn't think about it quick enough.  For next time.  The broth will come to a boil and you'll scrape the brown bits that cling to the bottom of the pan with a wooden spoon.  If you thought you were burning the leek and shallot mixture, that was really just another way to add more flavor to the dish.  

Step 10 - Remove the pan from the heat and stir in 2 oz of goat cheese.  Divide the filling among your wrap.  I ate mine like an open-faced sandwich.   So even though the picture shows my filling in the center of the wrap, I ended up spreading the mixture all over the wrap and eating it with a fork and knife.  Sorry, didn't take a shot of the final final.  I was too hungry.  

And that my friends is how to cook a kale/mushroom wrap.  Voilá.  I didn't do an exact cost analysis for this recipe, but I did use the whole bag of kale as I mentioned earlier in order to avoid food waste.  I could have used the leftover kale for a salad during the week, but I opted to have more filling for the wraps.  In quickly doing a rough estimate for the cost, each wrap would cost $4, making enough for 4 wraps and still having one flatbread leftover.  And yes, I know the time it took me to go to the store, cut/prep all the veggies, etc. were not included in this "cost", but I will tell you this.  I had a $10 salad the other day that definitely wasn't worth $10.  (I ate out for social interaction once again, but hear me when I say I will NOT pay $10 for a salad ever again in my life that I could make for a fraction of the cost.  Nope.  Not gonna do it...well, maybe if it's for recipe inspiration, then maybe).  

The morale of the story is that Yes, You CAN cook.  Start with simple recipes that make you feel like a rock star.  Use Instacart to deliver your groceries if that will help cut down on time you don't have to go to the store.  What might even be better are some of those meal delivery services that bring the ingredients with a recipe to your house.  Yes, you have to cook them, but they're giving you tried and true recipes that people have already taste tested.  Not to mention they're giving you recipes that you can use over and over.  Bonus.  I know we don't have a recent study for proof to tell you that if you cook at home you'll improve your overall health status.  But I'm here to tell you that you will.  Not to mention in the long run you'll end up saving yourself money - eating out is expensive and doctor visits/medicines are expensive.  Invest in yourself now!  And as I said earlier, I'm not here to tell you that you have to cook every meal at home.  Remember, baby steps.  Maybe it's simply cutting back on the frequency of your meals eaten out.  And just remember, you CAN cook.

Just a little more inspo in case you needed it.