Sunday, May 25, 2014

Consistency


Consistency

The year 2014 has been amazing so far!  I went to the National Championship game in Pasadena, I finally got a new job (that I love!) and my nephews were coming for a visit during their Spring Break.  The night before they came I was cleaning up around the house and then it happened.  I hit my foot in the SAME spot where I had broken it just two years ago.  It immediately began to swell and looked the same as when I broke it.  The only difference was that I could walk on it.  After a few deep breaths and a few panicked phone calls I iced and elevated my foot.  As I sat there a peace came over me.   Whatever the injury was I knew that I’d deal with it.  I had been down this road before and knew I could overcome it. The real question was, why was it happening again and smacking me right in the face (the same foot, really?!)  What hadn’t I learned and what was this trying to teach me?  I wish I was completely enlightened and could tell you that I saw immediately what it was, but as is too often the case, I take time to reflect and realize what I need to take away from these moments – and that lesson is,   consistency. 

In my yoga teacher training there was one yoga sutra that was THE one that everything kept coming back to:

1.14 - “This practice is firmly rooted only when it is cultivated with respect and skill                                    for a long uninterrupted period.”

The reason this sutra was THE one during my training requires a little explanation.  I was moved at work from one location to another and suffice it to say that my commute went from an hour a day to now 3 hours a day.  After a daily drive like that it’s hard to put into words, but it’s almost as if you’re a zombie.  Sure I needed yoga but when was I going to fit it in?  I left my house at 6:30 in the morning and didn’t get home till 6:30.  I sure as heck wasn’t going to drive another 30 minutes just to get to a yoga class (although sometimes I did and that made me all the more angry).  I got used to the idea of doing yoga on the weekends and began to blame work for my lack of yoga (this went on for a good 6 months).  During my teacher training I had a breakdown – I was blaming my commute as the reason I couldn’t have an uninterrupted daily practice.  I began to realize that yoga was so much more than just the asanas.  I didn’t have to practice in a studio, I could practice at home.  Yoga could simply be my meditation for the day or might simply be some sun salutations (it didn’t have to be an hour and a half yoga class in a studio).  And so after yoga teacher training I returned home and created my yoga practice.  I knew that I wanted to have an effective daily practice and knew that meant meditation, breathing, asanas, and yoga sutra study.  Just when I thought I was getting it all together, I broke my foot.  I thought I had come to terms with my newfound yoga practice, however, there was more to this sutra that I had to learn:  now that I wasn’t “firmly rooted” how was I going to not only be consistent but how was I going to grow?  During the time that I broke my foot everything came back to my breath.  There were times that all I could do was breathe.  MC Yogi’s song, Breath Control, became my mantra.  I knew that I was cultivating other aspects of my yoga practice and that with my breath I’d be able to go deeper into a pose or it might just keep me where I needed to be.  Simple breath control.  I also had a tendency to rush through things before breaking my foot.  I was learning patience.  Little did I know that my broken foot would pave the way for me to be patient in my search for a new job.  2 ½ years later, I’ve found a job that had I accepted another job in between I never would have been available for this one.  And so it was a little over a month ago that I was reminded of this sutra and that  I hadn’t learned all there was to learn.  My injury was there to remind me (and it will keep happening until I really learn it).  And this week at work, consistency continued to be the theme, allowing me to see that in all that I do (or that anyone does) steadiness, balance and patience are required. 

Throughout many of my sessions this week I kept noticing that I kept repeating to my patients that with Diabetes the main way to control their disease was with consistency.  I was teaching my “Domine la Diabetes” class and one thing that I mention to the patients is that they need to have breakfast, lunch, and dinner (& snacks if they’re going more than 4 hours without).  There shouldn’t be any skipping of meals (if you have diabetes or not!).  Our bodies are like cars and they need fuel; fuel being the food that we eat.  We want our bodies to operate efficiently and with that comes the goal of striving to have a schedule and CONSISTENT meal pattern.  There I said it.  My patients didn’t know why I had just chuckled to myself, but I knew why.  In all that we do consistency helps create a habit.  And like with anything this takes work.  I explained to my patients that if they were skipping a meal that might be the most important thing that they could do to change and help better control their diabetes.  The key is being CONSISTENT.  The following day I was teaching a newly diagnosed diabetic (adult-onset type 1) about the mechanism of action of the two types of insulin she was taking.  She was using her quick-acting insulin to help cover the carbohydrates at her meal time as well as correcting a high blood glucose value, but she wasn’t using her basal insulin optimally.  She was injecting it but at different times of the day/night.  I explained to her that we recommend to inject at the time same (whether she chose day or night) but to be consistent with that time (it works for 24 hours).  Again, a small little chuckle to myself at this whole “consistency” theme going on.   I continued to explain to my patient that unfortunately that would be the hardest part of her diabetes self-management, consistency.  She’d need to be consistent with her medicine, consistent with her meals, and even more consistent with the carbohydrates at each meal.  As I talked to her later on in the week she noticed an improvement in her blood glucose levels just by this consistency.  She thanked me and let me know that it wasn’t going to be easy.  I simply told her, “Consistency is our goal, but that it was going to take patience and lots of work.”  And just as my week was ending, I heard my co-worker explaining to a patient the use of foot cream.  We had a talk given by one of the podiatrists at work a little while back and someone asked him which foot cream we should use.  He replied by saying that it doesn’t matter how expensive or inexpensive the cream is, just make sure to use it DAILY.  Consistency. 

It took over a month for my foot to fully heal.  While my asanas were on hold it didn’t mean my meditation, yoga sutra study, & breath control needed to be.  The practice of yoga is meant to integrate ALL 8 limbs.  I realized that never before had I been able to merge all 8 limbs.  It was right around this time that I was slowly beginning back that my yoga teacher joined Instagram.  She launched a #reallyrealyoga campaign and it couldn’t have been more perfect timing.  This whole month of May has been me working on consistency with my practice (all 8 limbs).  I’m not looking for a perfect practice, but I am looking to grow from my practice.  And with a few words of wisdom from my yoga teacher (in regards to meditation) that really sums up what I am trying to bring to my daily yoga practice:

Consistency – a little is better than none, but the truth is, you’ve got to do this regularly and with devotion. 

Acceptance – accept that you are exactly where you are meant to be, accept that your life is unfolding exactly as it should. 

Patience – you already are who you are meant to be. 

Change – change is scary, try to embrace change, for without it, things would never grow, move forward, evolve. 

Free Will – you always have a choice, you must choose this inward journey in order to discover it.

As cliché as it sounds, I’m happy I hurt my foot again.  It stopped me in my tracks and made me realize that it was going to keep on happening if I didn’t change what I was doing.  It’s made my daily practice grow and for that I’m grateful. 

 


 

 

Sunday, May 11, 2014

How It All Started


 
 
How It All Started

People ask me all the time how I got into the field of Nutrition.  I give them the short answer –“I love food!  Who wouldn’t want to talk about food all day?!”  If I were to give them the long answer, well, it all started in my sophomore year of college.  It was spring semester and I had to declare a major.  I had thought about this major decision (pun intended) for a countless number of days and was not able to choose one.  Psychology, Nursing, and Spanish all were of great interest to me.  I often wondered how I could narrow it down to just one.  So one Sunday afternoon I called my mom for our usual weekly talk and as we were talking about some new recipe that she was trying out, that’s when it clicked.  I knew what it was that I wanted to be when I grew up. 

My mom studied home economics in college.  As kids growing up my brothers and I were taught how to eat healthy without ever having to think about it.  My mom strived to incorporate the Four Basic Food Groups (what they used to be called) and see to it that a wide selection of foods was always available.  My mom had 3 different kinds of eaters - I was the picky one growing up, one brother ate everything regardless of what it was, and my other brother couldn’t let any food touch another food on his plate (& he had a lot of allergies).  Let’s just say my mom didn’t have it easy.  And if you were to include my dad in the mix, well, don’t try and sneak anything too healthy in because he’d know!  Anytime there was spaghetti my mom would always try and mix ground turkey in with the ground beef.  My dad always knew and always let her know he knew.  And there was one time she tried to make tofu lasagna.  Well, needless to say, it didn’t go over so well.  My mom was ahead of her time in the field of nutrition for the 70s.  I’m thankful she taught me what a well-balanced meal  was without even having to tell me what it was – she simply  made dinner every night with proper portions and vegetables galore (in our family we’d eat our salad last.  I’m not sure why but as a kid growing up I used to always think we saved the best for last).  And so it was on that Sunday afternoon talking to my mom, I knew what major I would declare – Nutrition.

I learned a really simple definition of Nutrition in college that has stuck with me ever since.  I use this all the time when I teach kids as it allows for them to understand why their parents tell them they have to eat their veggies J.

Nutrition/ n(y)oo'trisSHən/:  the study (the science of) food and how it works in your body. 

I give them the example of carrots.  Carrots have Vitamin A.  One role/function of Vitamin A is that it helps with night vision.  Therefore carrots help them to see better at night.  (& I’m not talking the kind of Vitamin you eat that looks like a gummy bear.  Vitamins are in foods that we eat!)  Teaching our kids from a young age about nutrition is key in them developing lifelong healthy eating habits (and the reverse is true too, they can learn unhealthy eating habits that will last a lifetime as well).  Kids are sponges; they soak it all in, the good and the bad.  As I was growing up I learned 3 principles that are key for me now as I teach nutrition:  balance, variety, and moderation.

Balance:  I think my mom had a good balance in allowing us to feel like “normal” kids in the neighborhood.  We had hot dogs growing up and while I know she probably cringed giving those to us she also made sure that we had a vegetable with that meal.  It actually turned in to one of our favorite ways to eat hot dogs, otherwise known as “slaw dogs” (homemade coleslaw on top of our hotdog).  It was the subtle message that all foods can fit, but also allowing us to be kids at the end of the day.  Don’t get me wrong, we weren’t eating hot dogs every time we asked for them.  Hot dogs were for special occasions.  The other way we were taught balance was simply by all that my mom was balancing – going to school, being a mom, cooking dinner for us.  I sometimes wondered how she did all that she did in a day.  She made sure to make dinner for us to make sure we were getting the proper nutrition to do well in school and be healthy.  Life is truly a balancing act. 

Variety:  The sky is the limit when it comes to food preparation.  Back to the number one complaint I get from parents:  “What can I do to get my kid to eat vegetables?”  This is where variety is critical.  If you offer the same vegetables over and over it’s a given they’re not going to like vegetables.  There are TOO many vegetables for a kid (or an adult for that matter) to tell me they don’t like ANY.  Find the ones they do like and continue to build from there.  Encourage them to find a new vegetable at the store and figure out how to prepare it.  And always remember even with the same vegetable there can be variety in how you prepare it - Raw carrots versus cooked carrots.  Some kids might prefer them raw, but the minute you cook them they might gag.  I always tell parents to allow their kids to see what it is that they’re giving them.  Expose the kids and make sure the vegetable is on the plate.  But in the same token there are kids that aren’t going to eat it no matter what way you fix it.  That’s where you simply have to outsmart them and offer them another vegetable that gives them the same vitamin.  Vitamin A is in SO many other fruits and vegetables that you don’t have to get worked up if your kids aren’t eating carrots.   Variety not only in the way the food is prepared but also in the foods that are offered as well. 

Moderation:  I was allowed to have Kool-Aid as a kid and soda.  Ooohhh.  Many are surprised to hear that, but it’s true.  (Although now I pride myself on telling people that I haven’t had soda since the year 2000!)  My parents would buy a 2-Liter of soda and it would literally go flat before we could drink it all.  I’ve said it before and I’ll say it again, unfortunately nowadays soda is the norm and is the beverage of choice for many throughout the day (and while I’m picking on soda, you can substitute that in for coffee, tea, juice, fruit punch, etc).  Kids and adults don’t drink enough water.  We as a nation are consuming empty calories from sugared-drinks that are contributing to our obesity epidemic.  We need to flip it around and make water the everyday norm, utilizing soda (or the drink of your choice) in moderation. 

The other way that my mom taught me moderation was with desserts.  My mom loves to bake and if there ever was such a thing as a sweet tooth, well she’s got one (and so do I).  I have a distinct memory of including something sweet in my lunch bag every day when I was younger.  Whether it was a mini-Twix or whether it was a Little Debbie cake, we were allowed things daily but in a moderate amount – it wasn’t a whole Twix candy bar, nor was it both of the Little Debbie cakes.  We were allowed these things in moderation, so that we wouldn’t overdo these indulgences if we had gone without.  I still to this day have a hard time counseling people about the concept of moderation.  Some people are either all or none when it comes to sweets.  They aren’t able to do just 1-2 cookies, rather they end up doing the whole sleeve of cookies and so they choose to not even have any at all.  I try to explain to them that the deprivation can actually be worse.   They’ll still tend to overdo these foods in the end, but it’s finding that balance that will allow them these foods that might be a trigger for overeating.    

I’m just finishing up the book, Cooked, by Michael Pollan.  I mentioned it in a previous blog, but it’s worth mentioning again.  “Taking back control of cooking may be the single most important step anyone can take to help make the American food system healthier and more sustainable.  Reclaiming cooking as an act of enjoyment and self-reliance, learning to perform the magic of these everyday transformations, opens the door to a more nourishing life.”  And so it’s on this Mother’s Day that I say, “Thanks” to my mom for cooking for us when we were little and having instilled naturally in me the concepts of balance, variety, and moderation.  I know I’m a better dietitian because of this. 
 
**I wrote this letter applying to dietetic internships back in 1998.  16 years later I'm doing exactly what I said I would.**