5 Reasons to Get Referred to a Registered Dietitian

There are all sorts of people in the media offering you diet advice. Doctors, celebrities, naturopaths, chiropractors, holistic wellness coaches and other self-proclaimed nutritionists. Most of them focus on foods that you absolutely must eliminate (with an unsubstantiated focus on “organic”, “natural” and their perceived ideas about conventional foods). In some cases, supplements are sold (for high profits) with the pitch. How do you know how qualified they are?

When you see a registered dietitian nutritionist (RDN) you know that a minimum, standardized qualification has been met in the science of food and nutrition. If you are perfectly healthy, and only need to lose weight, a nutritionist or personal trainer can probably help you. But if you have any existing disease (e.g. high blood pressure, high cholesterol, diabetes, heart disease, gastrointestinal disease), it’s important to have an RDN overseeing your diet. If you have a strong family history of diabetes or heart disease, or are over the age of 40, it’s also a good idea to skip the fad diets and speak with a trained professional.

When a registered dietitian evaluates a patient, he or she considers multiple factors: their medical and social history, lab work, medications, what/where they eat, as well as their weight-change and fitness history. RDNs help you figure out what diet plan is best for your life. They can do the planning work for you, and help you set goals.

Don’t Take Diet Advice from Just Anyone

When your friend says “I heard [insert food or ingredient] was bad for you”, don’t take it for fact. If you are using “doctor Google”, be sure to look for quotes and articles written by registered dietitians (RD or RDN will follow their name). When you scan a nutrition topic in the news, check more than one source. RDNs are trained to read the research, interpret the results, and create sensible advice based on the whole body of research, not just one study. Most dietitians take a “non diet” lifestyle approach. We combine a background in medicine, food, nutrition analysis, and eating behavior and patterns, and combine this into personalized advice.

While I recommend the DASH Diet and a Mediterranean style of eating, keep in mind the term “diet” here doesn’t infer weight loss, but instead simply describes a diet plan and a way of eating – a lifestyle. Long term weight maintenance and health depend on day to day behaviors. You can’t just eat well for a few weeks, and call it a year. Nor can you exercise for three months, and sit on the sofa for the other nine. 

Ask Your Doctor to Refer You. Find A Good Fit.

Just like you choose a doctor based on qualifications and bedside manner, you want to find a dietitian that you are comfortable with. If your visit doesn’t go well, or you’re not comfortable, ask to see someone else.

A healthy diet isn’t just about food choices, but it’s also about the “how” and “why” you eat. In addition, there isn’t one meal plan that would fit everyone. What you need to eat depends on what you like (nobody is going to sustain a diet of food they don’t like) and what you need. While basic nutrition can be generalized as far as nutrient needs go, there are many ways to get adequate amounts of the nutrients you need into your diet.

Some doctors forget they can refer their patients to a dietitian, so ask for a referral. Most insurances cover a minimum amount of visits with a dietitian.

Here are 5 reasons to see an RDN over other nutritionists:

  • If you schedule an appointment with a dietitian he or she is going to help you with your habits, and provide you with science-based dietary advice
  • Diet therapy offered by registered dietitians is based in science. Dietitians have a broad understand about diet and disease, and how to evaluate your nutrition status based on your medical history, lab results, and diet and weight history
  • If you have diabetes, gastrointestinal disease, or heart disease, you should definitely check in with a dietitian regularly to help you manage your disease and feel your best
  • Registered dietitians are trained to evaluate your health status, your diet, and help you create a lifelong plan. Sorry, no quick fixes or fad diet plans work, and are especially harmful if you are treating life-long diseases such as diabetes or heart disease.
  • Once you have a relationship with an RDN, it’s a good idea to check in with your dietitian once every couple of years too, or when you are experiencing a transition or shift in your life. Plus, you can rely on that dietitian to answer any questions about “that advice your friend gave you about…”

Happy National Nutrition Month!

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You May Be a Dietitian If…

March is National Nutrition Month® and March 14 is Registered Dietitian Day. The Academy of Nutrition and Dietetics is the world’s largest organization of food and nutrition professionals. The number of registered dietitians has grown five fold since 1969, and there are now 100,000 registered dietitian nutritionists! About half of those hold advanced degrees, and many specialize.

Registered Dietitian Nutritionists are the food and nutrition experts who can translate the science of nutrition into practical solutions for healthy living.

Confusion in the Nutrition Space

As an RDN it can be frustrating to hear non-nutrition professionals spout nonsense about diet, food and and nutrition. Unlike popular pseudoscience-pushing personalities such as the Food Babe or Dr. Mercola, RDNs have to adhere to ethics standards. We can’t just “say anything” or make empty promises. 

RDNs complete a standardized education and training, that include formal education in the science of food, nutrition, and human physiology (RDNs minimally have a Bachelor’s Degree, undertake a supervised practice internship, and have to pass a rigorous nutrition certification exam). These experiences makes them a dependable resource for nutrition information. 

So I beg you, stop sharing random diet or nutrition posts on Facebook by uneducated personalities. You are just funding their vacations.

Let’s Get Real

I love what I do, but there are times when I get annoyed with both the lack of understanding for what a dietitian is trained to do, and also how easily consumers believe everything they hear about food from non-credentialed nutritionists, or really, just about anyone.

Often the public views all dietitians as someone who wants to “put you on a diet”. In addition, those seeking lifestyles that focus on looks, and a sexy body (not health) bash dietitians as being clueless or claiming their advice doesn’t work. People who only seek advice from their gym, their pal, or someone on the Internet telling them what they want to hear (or that it’s going to be easy) most likely will relapse with weight loss. Worse, they are missing out on science-based information about medical conditions that can benefit from a particular diet therapy.

RDN’s come at it with a “big picture” philosophy. Our advice works for the long haul, it’s not a quick fix. We help people personalize their diet and make positive lifestyle changes. We are honest, because frankly, it’s going to be difficult to maintain healthy habits for a lifetime. We don’t offer empty promises such as, “this is easy, lose 10 pounds this week, have great abs by Sunday”.

We are for real. And real takes effort on your part. Long-term effort. But it works, can improve your health, doesn’t backfire, and it’s safe.

You May Be a Dietitian If…

In celebrating Dietitian Day, I thought I’d add some of my pet peeves about common misconceptions about dietitians.

Just because I’m a dietitian doesn’t mean…

  • I am constantly screening your meals, what you have in your grocery cart, or what you choose at a party buffet.
  • I am judging you when you eat French fries or a candy bar.
  • I eat kale every day (and BTW, I really don’t like smoothies much).
  • I wear a white lab coat.
  • I work in a hospital. This is a common misnomer. I did work in a hospital setting early on in my 30 year career, and some dietitians are employed by hospitals. But, I’ve been a consultant now (work-for-hire, freelance writing, adjunct teaching, nutrition communications, advisor) for over 20 years, yet people in my town still come up to me and swear I must have worked at the hospital here. Nope.
  • I don’t get food cravings, struggle to maintain a reasonable weight, or am challenged to keep up my exercise routine.
  • I can’t enjoy a cocktail or a sweet whenever I want (but yeah, moderation).
  • I need you to proclaim to me that you eat “real food”. (Potato chips are made from real potatoes, real oil and real salt). Please stop with the food fad words.

And, yeah, if you’re still wondering, we “went to school for that”.

Registered Dietitian Nutritionists have degrees in nutrition, dietetics, public health or a related field from well-respected, accredited colleges and universities, completed an internship and passed an examination.

Happy RDN Day!

I’d love to hear from other RDNs. Leave your pet peeve in the comments.

 

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Headlines Change, Habits Can Too

You probably read something in the news everyday about diet or what you should or shouldn’t eat. I can understand how frustrating it is to read these headlines every week. One day they proclaim coffee is good for you, the next it isn’t.

Sorry – There’s No Quick Fix, Only Empty Promises

I know it’s not a popular message, but I’m sticking to it – you have to change your behaviors in order to lose weight and maintain it. This is true, no matter the age. 

In the case of feeding children, it’s really essential to start them off right. Obesity in a child is not the same physiological picture as obesity in a 40 or 60 year old. Children that have weight issues at a young age are set up for a lifelong struggle to obtain a healthy weight. Set limits, and create a regular meal schedule for your child.

Losing weight is always difficult to do, which is why preventing, or controlling, weight gain is the best strategy. It’s known that many people experience weight gain as they age. This is normal physiology, but being overweight as a child makes lifelong weight maintenance an even bigger challenge. Even for those who hadn’t been overweight, a few pounds may creep on every year and add up. Metabolism slows down for most people in mid-life, so this is a time that eating well and exercising regularly is really important. Just avoiding weight gain is a win, even if you are struggling with losing those ten or fifteen pounds. 

Correlation Does Not Mean Causation

Most headlines you read are reporting on a “correlation”. That is, a study that suggested that “X might be related to Y”. Nutrition is an evolving science. Ethical practitioners only make recommendations based on the data we have. There is a lot of good published nutrition research, but research studies about diet and disease is difficult to do. Unlike research on specific substances, such as a drug or one particular isolated nutrient, proving that a dietary plan directly impacts disease or health is a challenge (which is why so may studies use rats, and rat ≠ human). The supplement industry, for instance, banks on the preliminary correlations found in research to sell an unproven outcome. This doesn’t mean we should disregard every nutrition study that’s published, however, it’s important to understand how to interpret them.

Spotted this at the store recently. While a quick fix looks appealing, it’s not healthy and doesn’t provide the promised health benefits.

Eating Less and Moving More

Some argue that you don’t have to actually eat less, you have to eat more of the right foods (while this is true, calories still count). Foods higher in fiber are important because they literally fill you up faster (plus have lots of gut-healthy properties). Including more fruits, vegetables and whole grains into your side dishes and meals, will add more bulk (volume) but not at a high calorie cost.

This is just one more reason the DASH Diet is beneficial – it encourages you to eat more fiber (fruit, vegetables, nuts, whole grain side dishes). It also include healthy fats (olive oil, avocado), 2-3 servings of dairy daily (for potassium, calcium, vitamin D), and smaller portions of meat and refined carbohydrates. This high fiber diet helps with weight control by providing important nutrients and controlling hunger and satiety.

As you work on adding nutrition through food to your diet, you also must find ways to move your bodies more – every day. You may enjoy sedentary activities such as reading, sewing, or watching Netflix, and that’s fine. You just have to be aware of how much time is being spent sitting. Using a sport watch or smart watch may help you with this. You can set cues that remind you it’s time to stand up, or that you haven’t moved enough today. Often people overlook daily activity, but it’s as important as exercise. The movement in your routine day counts.

A regular exercise routine is important to both weight management and health. Find an activity you will enjoy doing every week – walking, a yoga class, an aerobics class, bicycling, kayaking, zumba, an exercise video – anything you can stick with. Find a friend to pair up with so you can keep accountable. Very few people who are managing their weight are doing it without regular physical activity.

Get moving – set new goals for eating well and moving more every day. Some days, you won’t meet goals, that’s normal! Just keep setting them every single day. Add more veggies to meals. Make snacks nutritious and “unpackaged”. Snack on fruit, raw veggies, yogurt or small amounts of nuts or cheese. Move more daily – do extra housework, take the stairs, walk instead of ride. And find a weekly exercise routine you can schedule 3-4 times a week, and sustain.

 

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It’s National Nutrition Month® – Go Further with Food

March is National Nutrition Month®, sponsored by the Academy of Nutrition and Dietetics (the world’s largest organization of food and nutrition professionals).

Every National Nutrition Month® I try to highlight the Registered Dietitian. Everyone eats. For that reason you may commonly hear nutrition advice from just about everyone you meet. While you can definitely learn something from someone who, for example, has been successful losing weight and keeping off, or from a person with diabetes who does a great job controlling blood sugar, that person shouldn’t be giving people medical advice. What worked for him may not work for you. My advice: Don’t relay on non-trained, non-educated diet advocates to assess your diet and health – ask for a referral to a registered dietitian nutritionist.

It’s always a good idea to check in with yourself about your personal health. We all get busy or get off track with our diet or exercise, and we always have room for improvement.

How Can You Go Further with Food?

The theme for National Nutrition Month® this year – Go Further with Food – aims to increase awareness about food waste. Eating well isn’t just about what you eat – it’s also  about knowing how to grocery shop, keeping your kitchen organized, storing food properly, using leftovers or what’s left in your pantry, or knowing that it’s okay to eat something with an expired “best by” date.

Waste Not Want Not

My mother used to say “Waste not want not”. By this, she meant that if you limit waste (whether is was food or other resources) you will need less. We have a food waste problem going on in our country. Think about your own kitchen. How much food do you throw away every week? How can you do better? Here are some ideas.

  • Don’t throw away food because the “best by” or “use by” dates are passed. Foods such as bread, rolls, rice, pasta, and canned goods are still safe to eat even if the “best by” dates are passed. The quality in some cases, may be less than perfect, but safety isn’t an issue.
  • Consider what’s in your pantry or freezer before you stock up on more items from the grocery store.
  • Get creative. Restaurants are famous for reusing ingredients. If there’s ham or grilled chicken leftover from a large party, it’ll get repurposed into soup or tacos the following day. You can do the same. If you have a half a loaf of bread at home in your breadbox that’s past date, make a French Toast casserole or bread stuffing with it.
  • Sour cream is two days expired? Bake it into a cake.
  • Store foods correctly. We all get busy and forget about the yogurt cups that get pushed to the back of the fridge. Check your fridge every week, and do your best to keep it organized.
  • Learn more about use by and sell by dates.  Sell By and Best By only indicate that the food is at highest quality by that date. It does not mean you should throw away the food, or that the food will no longer be safe to eat after that date. So if you have a package of buns, a box of rice, or a condiment, in which the “Sell By” or “Best By” date is passed, you can still consume it.

    This mustard was “best by Sept 2017” but it’s still in my refrigerator. It’s acidic and not very perishable, therefore it’s fine. It’s quality may be reduced, but in the case of yellow mustard, not by much.

  • The “Use By” date may be indicative of food safety (in products such as milk for instance), so it’s a good idea to pitch any food that’s passed the “Use by” date.

Consider how much food you waste. Do your best to avoid over-buying, use what you have on hand wisely, only pitch food that has passed the “Use By” date, and waste less.

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Grains: The Misunderstood Food Group

I attended a food and nutrition conference in which Julie Miller Jones spoke about popular weight loss diets in a session sponsored by the Grain Foods Foundation, but the following thoughts and opinions are my own.

With the popularity of the “keto diet” fad and other low carbohydrate diets, grains are getting lost in the shuffle. Many people are avoiding grains for no good reason. Over the past several years, several books have shunned bread and other grain foods as the cause of obesity or diabetes. The truth is, while these books have some grains of truth in them, they are very misleading and base claims on poor scientific studies.

If you are a regular reader, you know I promote balance and realistic dietary goals. And, I’m a carb fan. Not only do carbohydrate foods provides lots of nutrients and energy, they make a diet delicious to eat. The recent news this week about low carb diets not being any more effective for weight loss than low fat diets, has people thinking. Maybe bread isn’t so bad after all?

Julie Miller Jones is a board certified and Licensed Nutritionist and holds a bachelor of science degree from Iowa State University and a PhD in Home Economics/Food Science and Nutrition. She is Professor Emerita, Foods and Nutrition, St. Catherine University, and a Scientific Advisor to the Grains Foods Foundation. I recently had the chance to chat with Julie, and asked her these questions:

Q: How are diet books such as Whole 30, Wheat Belly, and Grain Brain misleading the public about carbohydrate foods?

My concern about these types of books, is the net result is stating “carbohydrates are bad” and cause all the health problems. As long as we do this we won’t address the whole problem. The issue isn’t about one particular food, it’s that we eat too much of one thing and not enough of another.

These books misleads the public. They do have some truth in them (correlating increased consumption with increases in weight) but they’re riddled with pseudoscience. This idea people are “addicted to wheat” is based on an in vitro experiment in 1979 using test tubes with foods treated with enzymes then placed on the opioid receptor of a frog. These books try to give their theses some academic rigor with these correlational studies that don’t actually prove anything.

Bottom line: Any diet that suggests abandoning an entire food group is unhealthy.

Q: What are the hard data about grain foods and weight loss?

We have data that shows when comparing groups who ate 200 grams of carbohydrate versus 260 grams, those who ate the least carbohydrate had the highest BMI. Those on both extremes don’t have healthy weights.

Q: Many consumers are eliminating (or restricting) bread from the diet. Is this justified?

We seem to want a scapegoat instead of identifying the real eating problems. When you eliminate this food group, you are missing out on important nutrients, and not getting adequate fiber into the diet. If you can lose 2 pounds a month you can lose 20 pounds in a year, which in the long run is going to be more sustainable.

Q: What does the evidence show about low carbohydrate diets and fiber intake?

The data is there that shows we need a variety of fibers. While we want people to include fruits and vegetables in their diets, they alone aren’t going to provide the variety of fibers our guts need. This is an issue with GI cancer risk. Fiber provides the fuel for the microorganisms in the bowel, and are broken down to produce short chain fatty acids. Consuming grains results in more short chain fatty acids (the result of fermentation of dietary fibers) supporting gut health with ‘good’ bacteria colonizing.

Q: What are your thoughts on the DASH Diet, Mediterranean, and Flexitarian diets?

I love these diets because they promote BALANCE, eating all foods in the right amounts. Mediterranean and Flexitarian diets are both reasonable. I love the DASH Diet, and we should be dashing to use it because it has so much data behind it. It’s perfect for the American lifestyle. It’s easy to maintain for the long haul.

Somehow though, we’ve not been able to make DASH readily transmittable to the general population.

Q: What about gluten? Is “today’s wheat” really different than the wheat flours used 30 or 40 years ago?

The gluten-free diet craze is really just another low carb diet. The University of Saskatchewan (1857 wheat), and Albany, and UK, track data on wheat at their Ag experiment stations. They’ve evaluated wheats in the seed bank for years and have grown them in controlled conditions. While there are slight variations with growing conditions, they don’t see a significant difference in the starch, protein, and carb of the grain.  
William Davis has said “short straw wheat” is an issue. The genetics of length aren’t effecting the quality of the wheat kernel. And keep in mind, there is NO GENETICALLY MODIFIED WHEAT!

Norman Borlaug experimented with this short straw to avoid lodge, because the head is larger and straw is short. The head of wheat that “lodges” is heavy so it falls to the ground, and it’s more ideal to have more energy and soil nutrients to go to the wheat kernel rather than into the straw, so breeding a tall straw wheat is less efficient. Borlaug developed this wheat for countries such as India and Mexico. This advance shifted them from being importers of wheat to exporters of wheat.

The consensus on gluten is simply, if you don’t need to eliminate it, you shouldn’t.
 

Q: What are your thoughts on ketogenic diets (Keto)?

They can be used safely for short term weight loss needs (getting to a certain weight for a surgery, or other immediate needs). A few studies show that short term weight loss with ketogenic diet can improve diabetic control. These are also “therapeutic uses” not intended to be used without medical supervision. But this isn’t a safe and sustainable diet for the general population.

Conclusions

Our portions are often too big. It’s not the bagel, it’s the fact that a bagel in 2018 weighs two to three times what it did in 1980. Consumers need to understand that a balanced diet includes foods from a variety of food groups, but in the right amount. Eating the proper amount for health and weight control (or weight loss) is about the recognizing that your diet may not be balanced for carbohydrate, protein and fat.

So instead of having a giant submarine sandwich, have a sandwich on a small roll or two slices of whole grain bread, and have a piece of fruit or a cup of vegetables with it. Or instead of having a giant 450 calorie 3-cup plate of pasta, have a 450 calorie plate with 1 cup of pasta along with 3 ounces of chicken, lean beef, or fish, and a cup of vegetable or salad.

It’s not the foods themselves, but the portion and balance of those foods across food groups, and how you balance your plate.

 

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Food Allergy is no Laughing Matter, but Cartoons Should Be

When my children were young, I read books to them daily. This was a time to relax and have fun, and sometimes have a teaching moment. The Peter Rabbit series, by Beatrix Potter, was a set that I read over and over. We had a book set that included a little plush Peter, and a ceramic watering can that I still use for spring decorating.

The Peter Rabbit movie just hit theaters this week. I loved the previews I saw, and am looking for seeing the film at some point (even though the film is not on my children’s list anymore). I was shocked to hear that there’s a scene in the film creating a huge fuss, where naughty Peter and his friends shoot blackberries at Mr. McGregor (a new neighbor with a big garden). Mr. McGregor in the film is apparently allergic to blackberries (not a common allergen) so the bunnies invent a scheme to do him in (so they can have free reign to his abundant, but overprotected, garden). Mr. McGregor has a severe anaphylactic reaction, which causes him to use his epi-pen in the film.

There’s no question that severe food allergy is no laughing matter, and that in some cases (even with an epi-pen nearby) can cause death.

The Asthma and Allergy Foundation has issued a warning about this movie, perhaps at the request of parental complaints. They caution parents raising children with food allergy that some scenes in the film may be disturbing for young viewers with food allergies. I reviewed some of comments on the AAFP’s Facebook page, and saw that some parents claim that the movie is not just poking fun at those with food allergies, but worse, downplaying the seriousness of some food allergies. Some parents feel that a student could “reenact” the actions of Peter Rabbit at school, and target an “allergy kid” by somehow giving him or her the allergen.

Cartoons VS The Real World

Movies are meant to entertain. I can see that this scene might be disturbing to a child with a severe allergy, who wasn’t prepared to see this in the movie. But, there are all kinds of movies that we choose see (or not) that have potentially sensitive content in them. There are many scenes or plots in animated films that could be viewed as disturbing. In the Lion King, Simba’s father dies at his own evil brother’s hand. Snow White “goes to sleep”after biting a poisoned apple, and is on her death bed. I had a Snow White book as a child, and I remember literally being afraid to turn the page where the evil witch showed up. But my parents helped me understand the difference between real and not real, while at the same time teaching me that there are evil witches (or villains) of sorts in the world.

While bunnies are real, and food allergies are real (in humans), the outcomes in real life, are not always as cartoons depict them.

As with any situation, it’s great to find the teaching moment. In this case, you might tell your child that bullying or playing pranks isn’t very nice. But it does happen in life. And some pranks can be funny, if they are not ill-intended and cause no real harm. You could also be sure your child understands that some people do have food allergies, but not all food allergies include anaphylactic (inability to breathe due to swollen airway) symptoms. Those who do, require special monitoring of their diet and surroundings.

The Facts and the Stats

I am not undermining the seriousness of food allergies here. I had childhood allergies myself (it’s one of the reasons I decided to study food and nutrition). I just want to put things into context. Food allergy affects about 4 to 6 percent of U.S. children.

The most common food allergies are milk, eggs, peanuts, tree nuts, soy, wheat, and fish/shellfish. Food allergies are common in young children, and, allergies to eggs, wheat, milk and soy are often outgrown. Allergies to nuts and fish typically last a lifetime however. In addition, children with food allergies are more likely to have asthma, or other allergies.

Allergy occurs when the body’s immune system sees a substance as harmful and overreacts to it. Symptoms can vary, and range from hives (or other skin irritation), itchiness, watery eyes, runny nose. There may also be GI issues (stomach pain, diarrhea). A more severe reaction involves trouble breathing, or swelling of the mouth and throat, which can lead to a life-threatening situation. People may be allergic to drugs, foods, bugs, mold, plants, pets or pollen.

It’s also important to note that not all people who react to a certain food, have a food allergy. It may be a food intolerance or sensitivity.

A Rabbit with a Blue Jacket and No Pants

This animated film is a modern take on the classic storybooks. Peter was always getting into mischief and doing very naughty things. And in the original books, Mr. McGregor is essentially “the villain”. So in that context, the audience usually wants something bad to happen to the villain.

There are even some edgy descriptive scenes in the original Potter stories. Mrs. Rabbit (Peter’s widowed mother) warns her bunnies early on that they are to stay away from Mr. McGregor’s garden because  “your Father had an accident there; he was put in a pie by Mrs. McGregor”.

Well, that’s a scary thought isn’t it? But we shouldn’t’ be worried that daddy will be made into pie should we?

Laughter is Good Medicine

I wonder how the Brits are reacting to the movie boycott over this issue? The Brits have a great (and sometimes crass) sense of humor and make light (or you could say make fun) of just about everything. In my life, laughter is good medicine, and almost everything we laugh at is at someone or something’s expense. This doesn’t mean we are insensitive, it means we need to laugh to keep real life in check.

Laughing at the scenes in the Peter Rabbit movie (including when the hedgehog, Mrs. Tiggy-Winkle, is almost electrocuted) is okay in my mind. Laughing at real-life tragedies is not. I’ve taught my sons to treat all people with kindness and respect. Through at some points in life, every child is challenged to do this (peer pressure, insecurities, etc), so we keep reminding.

Be sure to let your children know that some people do have severe allergies in real life, and probably have a medical plan in place for when or if they occur. And, that it would be very wrong to do what Peter does in this movie. Help your children understand the difference between the movies, and real life, and use movies and books as teaching moments.

 

 

 

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High Blood Pressure: Know Your Numbers

The guidelines for high blood pressure have changed. Hypertension, or high blood pressure, is now defined as a blood pressure of 130/80 (stated “130 over 80”). The first number (130) is the systolic pressure measurement, and the second number (80) is the diastolic pressure.

There may be disagreement over exact blood pressure numbers, but there’s no disagreement that walnuts are good for you.

There’s some disagreement about the new guideline in the medical so the best thing to do is to check in with your physician during an annual visit, and let him or her determine what your blood pressure means. Blood pressure rises with age and with body weight. For this reason, checking in with your doctor is the first step to managing blood pressure. The next step is asking for a referral to a registered dietitian to discuss diet therapy.  And, if you are overweight or obese, losing weight is a first-line treatment for lowering blood pressure.

 

Knowledge is Power – Know Your Numbers

You should know what your blood pressure is. Checking in each year with your physician is a good idea. At your visit, you’ll get your blood pressure checked. If you have high blood pressure, you are at twice the risk for heart issues as those without high blood pressure. You may, or may not, require medication, but you do want to know what your numbers are.

According to the American College of Cardiology, blood pressure categories in the new guideline are:

  • Normal: Less than 120/80 mm Hg
  • High Stage 1: Systolic between 130-139 or diastolic between 80-89
  • High Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg
  • Hypertensive crisis: Systolic over 180 and/or diastolic over 120 (may require immediate hospitalization if there are signs of organ damage)

And what about your blood cholesterol numbers? These are also important. Having multiple risk factors increases your risk for heart disease. A normal blood cholesterol is <200 (200-239 is borderline high, and >240 is high). In addition to the Total Cholesterol numbers, your doctor may review multiple factors, including other fats in the blood, called lipoproteins (HDL and LDN – sometimes referred to as “good” and “bad” blood fats), in determining what your risk is, and whether or not you need a cholesterol-lowering medications. You complete risk is dependent on considering all of these risk factors, including your family history, weight, and whether or not you have diabetes and high blood pressure.

Lifestyle Changes

The DASH diet plan is a good fit for anyone with either known heart disease, diabetes, or at risk for either. Remember, this eating plan isn’t just a low salt diet. DASH has been proven to lower systolic pressure, whether it’s low salt or not. A lower sodium diet does help control blood pressure, but nutrients like potassium, calcium, and magnesium are important too.

Rather than thinking about the DASH Diet as a “diet” (the preconceived notion that you are going “on” a diet), think of it as a lifestyle. Making lifestyle changes means creating a different environment in which you live. It’s not just eating well, but moving more, not smoking, setting up an annual doctor’s visit, preventive care and stress management. It’s also helps to change your perspective on healthy eating and healthy living. Rather than focusing on a food as a magic bullet, consider how your whole diet can impact your health. Consider how taking weekends off to relax and do something fun, can improve your stress level. Consider how sitting at a table together with family and friends (instead of in front of the TV), can improve your lifestyle and food choices.

Small changes every day can make a difference. Know your numbers. Know your risk. Live well.

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Eat Fish, Stay Sharp: Make Omega-3s Part of Your Weekly Intake

You’ve heard fish is part of a healthy diet, but are you eating it regularly? What’s stopping you? The smell? The taste? Bad experiences with poorly prepared fish? Or do you just ‘think’ you don’t like it and haven’t really tried different varieties? Maybe you love canned tuna? Or only salmon. Great! Eat what you like! It all counts.

February is heart month, and including fish in your diet is heart-healthy, but it’s also brain-healthy.

This open-faced fish taco is smothered in juicy sweet mango , red cabbage and lime juice.

Here are some quick fish facts:

  • Seafood high in omega-3 are good sources of DHA and EPA. Studies show that omega-3 fatty acids can reduce the risk of cognitive decline, Alzheimer’s disease, and dementia.
  • The Dietary Guidelines suggest a supplement of 250-500 mg of omega-3s (DHA+EPA) per day, or a variety of seafood twice a week.
  • In fact, studies have shown that people who eat fish every week have more grey matter in their brain (the part that regulates emotion and memory). Stay sharp, eat fish!
  • Salmon, anchovies, sardines, trout (>1000mg omega 3s per 4 ounces cooked) albacore tuna, mussels, squid, sea bass, and walleye (500-1000 mg) are good sources of omega-3 fatty acids. Other fish and shellfish also provide some omega-3s, just smaller amounts per serving (shrimp, mahi-mahi, lobster, scallops, tilapia, cod, all offer <250 mg omega 3s per 4 ounce serving)
  • Shellfish are very low in saturated fat.
  • Ounce for ounce, fish provides as much protein as beef, pork or poultry.
  • Fish is a good source of Vitamin D.
  • If you’re worried about mercury content in fish, keep in mind that a recent joint study by the World Health Organization (WHO) reported that the health benefits of eating seafood outweigh the risks. Pregnant women should avoid high mercury fish (tilefish, shark, swordfish) but there any many other varieties of fish that are perfectly safe for pregnant women to consume. In fact, since EPA and DHA are so important to brain development, it’s highly recommended that pregnant women consume fish 2-3 times per week.
  • Eating fish may even help with depression.

Here are some easy ways to incorporate fish twice a week into your diet:

  • Add cooked shrimp to your salad or use cooked frozen shimp for a quick meal. Saute freshly cut bell peppers, broccoli, and snow peas in 1-2 TB olive oil until cooked crisp-tender. Add the shrimp to heat. Toss over whole grain rice or pasta.
  • Pair fish with fruit. Try grilled salmon with pineapple chunks over a salad or rice. Or try adding chopped apples into a tuna salad.
  • Purchase convenient tuna pouches to incorporate into a quick snack or lunch.
  • Add smoked salmon to your bagel or eggs for breakfast.
  • Make fish tacos for Taco Tuesday. Use frozen cod or tilapia. Place fish in glass baking dish. Drizzle with olive oil, and add 1/4 tsp chipotle powder and a shake of salt. Bake the fish for 15-20 minutes. Flake and add to whole grain tortillas. Add chopped veggies, sour cream, mango salsa, and shredded cheese.
  • The Seafood Nutrition Partnership has lots of easy recipes that even the “non-fish-lover” may like! Try more fish – it’s good for you!

Supplements

If you really don’t think it’s realistic for you to consume fish twice a week, then consider an omega-3 fatty acid that provides 500 milligrams of EPA+DHA.

  • Look for a supplement that contains both EPA and DHA.
  • Check the nutrition facts for the amount of EPA and DHA. The front of the label may say “1000mg of fish oil” but it’s the amount of EPA-DHA that you want to know about. You are looking to supplement 250-500mg EPA-DHA per day (check with your health professional, and consider the EPA and DHA you are also getting from food in your diet).
  • Check the expiration date, as fish oil supplements can go rancid.
  • Good choices should have the GOED seal (Global Organization for EPA and DHA) which ensures both quality ingredients that are sourced in an environmentally responsible way. For more information check out GOED

 

 

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Down and Dirty for Heart Month

You hear a lot in the news about “eating clean”, going “plant-based”, and avoiding “chemicals” in your diet. Well, here’s the thing, food IS chemistry. We eat chemicals. We are made of chemicals. They aren’t all scary.

The ingredients here may seem scary, but they aren’t. This label is the nutrition facts for a popular healthy nut bar.

Nutrition Facts

Instead of focusing on tiny details, and reading food labels with a paranoid obsession, step back and look at your diet and lifestyle from a different perspective. There is no magic in eating certain foods, brands, or supplements. There is value in balancing your diet, so that you get a little bit of everything through the week, and then benefit from a variety of nutrients. And hey, food should taste good!

Nutrition science is not an exact science, and the truth is, really good, well-controlled human studies are limited because humans are difficult to keep captive. There is also the problem of controlling nutrients. No two tomatoes are exactly the same every time. The nutrient values assigned to foods are good estimates, because we can’t always control for every variable. Foods can vary a little from harvest to harvest (think of how wine is different every year with every harvest depending on sun, water, etc).

This doesn’t mean that we should ignore the Nutrition Facts. These values are based in science, and are good estimates. They just aren’t exact, and your daily eating doesn’t have to be exact either. Overall, you should limit your saturated fat intake. Include some good fats every day like olive oil, avocado, fatty fish, nuts, and seeds. The best advice – eat a wide variety of fruits and vegetables that you enjoy every week, include more whole grains (fiber), eat smaller portions of meats, cheeses, and packaged food, and exercise regularly. And don’t judge a food just by an ingredient that you may not be familiar with.

Do I have to go Vegetarian?

Short answer, no. “Plant-based” and vegetarian diets are currently trending, but you don’t have to go vegetarian to eat a heart-healthy diet. A vegetarian diet is not always better (but of course, if you choose a vegetarian diet, that’s fine. Be sure to consult with a registered dietitian to be sure it’s adequate). You can however add certain foods to your grocery cart this month to make some simple changes that can impact your overall heart health.

For heart health specifically, there are definitely plant foods that research show are important. We can’t control our destiny, but we can control how we live our lives.

Do Add Soluble Fiber to Your Diet

Soluble fiber can help lower blood cholesterol, keep your gut healthy, and keep you full longer. You can easily add soluble fiber by eating more vegetables, canned beans, apples, blueberries, oats, barley, and nuts to your diet.

  • Cook barley as a side dish, or add it to a vegetable salad.
  • While overnight oats and steel cut oats may sound “better”, old fashioned oats are great too, especially if you are short on time. Have quick oats for breakfast (don’t add too much sugar, try slicing a banana or adding blueberries and walnuts to your oatmeal).
  • Use beans differently. Don’t like kidney beans? Add pinto beans or black beans to your chili. Add black beans to prepared salsa to give it a big vitamin and fiber boost. Make your own bean dip with cannelloni beans – just add a can of drained beans, a garlic clove, some seasoning to a food processor and blend.
  • When time is short, pick up some prepped veggies such as bagged green beans or snow peas for a quick side dish. Make use of frozen vegetables too. Keep a bag in the freezer to add to soups or stews or for an easy side dish.
  • Love pasta? No problem. Pasta is a great base for lots of healthy add-ins. Consider vegetable “noodles” with pasta. Begin boiling linguine in water. Add vegetable noodles (sometimes called “zoodles”) during the last 2-3 minutes. Top with your favorite tomato sauce or an olive oil dressing.

    Half Zoodles, Half Linguine, plus a handful of spinach.

  • Apples are a great source of soluble fiber. Of course apples make a great snack, but you can also add sliced or chopped apples to salads, serve thin apple slices with a cheese tray, and use them in cooking. Top a 4 ounce pork loin chop with thinly sliced apples in baking dish, pour 1/2 cup of apple cider or low sodium broth over pork, bake for 25 minutes.

Down and Dirty for Heart Month: You Don’t Have to Eat Clean or Extreme

The notion of “clean eating” prevails in the popular press, but it has nothing to do with diet quality. There’s nothing magic about a food that “has only 4 simple ingredients” nor is there anything evil about a food with “ingredients you can’t pronounce”. Often food additives and preservatives are a good thing. Here is a good read on that topic.

Here are some great ways to improve your diet quality:

  • Use the MyPlate visual. It’s a simple lesson in balance. Fill half of your plate with salad or some other veggie for lunch and dinner as often as possible. 
  • Eat what you like. By this statement I don’t mean “eat anything”, I mean don’t obsess over all of the packaged foods you buy. Yes, buy less packaged food, but enjoy the ones you eat. Rather than comb over ingredient lists on bread or cereal boxes, choosing the one that is “clean”, that you hate, choose the ones you actually enjoy. If you don’t enjoy the taste of something, you aren’t going to stick with it. You are better off choosing a cereal you enjoy, even if it has a bit of added sugar (<11 grams is okay) or has some additives. A serving of quick oats that you are willing to prepare and eat is way better than any organic steel cut oats that sits in the back of your cupboard.
  • You can include “red meat” in the diet, in addition to poultry and fish. Beef is an excellent source of iron, and iron is essential to carry oxygen and carbon dioxide within the red blood cell from one body tissue to another. Iron is also necessary for the production of energy and immune system support. As far as fat goes, a 3-ounce serving of beef sirloin has only 8 grams of fat (2 saturated), about the same as a skinless chicken thigh. And, Today’s pork has been bred to be leaner, and a 3 ounce portion of pork tenderloin has only 3 grams of fat, and only 1 gram of saturated fat (just as low in fat as skinless chicken breast).
  • Get Omega-3 fatty acids into your diet. The research is strong that these fatty acids are good for our hearts, brains, and maybe even our mood. Balance out the red meat by choosing fish, twice a week when possible (this includes canned or packed tuna, sardines, or salmon). Add walnuts to your diet (chop them into oats, top your yogurt parfait with them, add them to salads or stir fries).
  • Create a delicious meatless dinner once a week. It doesn’t have to be on Mondays, and it doesn’t have to include tofu. Cooking Light has some great ideas. Your goal here is to include lots of vegetables, beans, and grains. These homemade veggie sliders include beans, quinoa, pistachios, and dried cranberries. 

Finally, be sure to stay as active as you can. Check with your doctor about any physical limitations, and get moving. Walking, jogging, resistance exercise, tennis, Zumba. Just like choosing the healthy foods you enjoy helps you sustain a good diet, choosing an activity you enjoy will help you stick with it too.

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Add Some Healthy to Your Super Bowl Spread: Berry Walnut Crisp

Another year, two more “other” teams. I’m not too jazzed about this year’s Super Bowl, so I’m not even picking a team.

But face it, for many folks, Super Bowl Sunday = Party Food.

If you are attending or hosting a Super Bowl Party, here are some quick and simple tips to balance out the wings and chips with some healthy grub that everyone will like:

  • Beans: Just add beans in any form to any table, and voila, you just added a nutrition powerhouse. Beans are loaded with fiber and B vitamins. Try this crunchy garbanzo bean snack from Bush’s for this weekend’s spread, or just mix a can of drained pinto beans into some prepared salsa from the deli. You’ll feed twice as many, and they won’t even notice all of the extra nutrition they are scooping onto their chip.
  • Fruits and veggies: My take is that people really do want to eat more fruits and vegetables but they don’t want to do the food prep. I find that any time I put out a bowl of sliced fruit, or a platter of ready-to-eat veggies, people eat them all up. So be the best-mom-ever and take the time to cut some melon, chop some sweet peppers, and put them out for your crew.
  • Nuts: Nuts are worth the cost. A little goes a long way. Put a bowl of mixed nuts on the table, or add a few walnuts to your cheese tray. All nuts offer your body healthy fats, and walnuts are a good source of omega-3 fatty acids.
  • A Healthy Dessert: Most everyone enjoys that sweet ending to a meal or a sweet treat on the party buffet. Why not incorporate some fruit and nuts into your dessert repertoire? Try Cindy Kleckner’s DASH Diet Very Berry Walnut Crisp from Hypertension Cookbook For Dummies®

May the best team win!


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