Monday, February 28, 2011

Common Challenges: Dreaded Dinner Decisions

Making good decisions for meals starts with what I have on hand in my pantry and kitchen.  Basically, if I don’t have the food or the organization, I struggle with ideas and get stressed with the little time I have to make dinner for my family.  Between the end of the work day and daycare pickup, all of a sudden I’m ordering out again which is an added expense and an added frustration.

In my house both me and my husband work with commutes, and struggle daily with the tag team event of who’s picking up the kids and getting dinner started.  It is imperative that I have food in the house and have an organized menu put together to prevent going into crisis mode and calling for delivery or running to get something quick before bath and bedtime is upon us.  For those of you who have homework and team sports, I can imagine dinner time is an even more stressful event.

I’ve found the following tactics work for me and my family.  If we sway too far from the plan we end up off track, so it’s important that all the adults are aware of the plan and able to make the commitment to make it a success.

  • Every Saturday morning while the kids are watching some cartoons or playing a game a five day menu is put together for dinner meals.  Five days is for five fresh dinners, one leftover dinner, and one weekend event which is left open as we usually grill with friends or visit a restaurant.
  • Sunday is our big meal.  The recipe is doubled so this meal acts as a leftover meal during the week.
  • Based off the menu, a grocery list is made and coupons are researched through www.coupon.com.  I only cut the coupons for what I was planning to buy.
  • On our designated grocery shopping day, one of the adults grocery shops by themselves or with one of the kids to divide and conquer.
  • Once the food is home, it is immediately packed up into portion sizes and either frozen or put in the refrigerator dependent on the menu.
  • Every morning the meat or meatless frozen item is taken out of the freezer to be thawed and ready for use by dinner time. 
The first adult home starts dinner and has a snack ready for the kids as we enter transition mode, the craziest part of our day.  We then eat our dinner, relax a bit and get ready to do it all over again tomorrow.  I truly feel it’s my responsibility as a parent and dietitian to provide good substantial meals for my family. If I don’t make it a priority or a commitment, it won’t happen and my family is too important to me to move this down the priority list.  What commitments do you make to your family to provide them with healthy meals? Please share I’m always looking for new ideas.  Good luck and be well.


Wednesday, February 23, 2011

Common Challenges: Eating on the Go

I am a very organized individual. I plan ahead and get things done, however since I am on the road for long periods of time, I have to admit there are days where I forgot to pack my lunch, didn’t have time to pack my lunch, or realized my lunch was spoiled because I forgot to put the ice pack in it.

Most of my clients will tell you I am a realistic dietitian. So if any of you are like me and need to eat on the go, I think it’s pretty realistic that you may need to drive through a fast food restaurant at times.  Of course subway would be a better option, well depending on what you get, but until they get a drive through I don’t have the time for it. I’ve got places to be and people that depend on me.

A lot of the fast food restaurants have started to display nutritional information right in house, but if you can't find the information you are looking for in the restaurant, the web is also a great resource.  Here are some options I pick when I am in crisis mode and need to eat.   Remember, it is always better to eat something and fuel your body rather than skip a meal. 

Restaurant/Item
Calorie
Fat
McDonalds Hamburger
250
9
McDonalds Honey Mustard Snack Wrap (Grilled)
260
9
McDonalds BBQ Snack Wrap (Grilled)
260
9
McDonalds Fruit and Yogurt Parfait
160
2
McDonalds Medium Smoothie
260
1
Arby’s Regular Roast Beef
154
11

Wendy’s  Small Chili
220
7
Taco Bell Fresco Chicken Soft Taco
170
4
Taco Bell Chicken Soft Taco
190
6


Do you have a favorite you choose when you are on the road? What is it and what are the calories and fat?  If you don’t know, look it up. Were you surprised? 

Tuesday, February 22, 2011

Food Trends: EGGnificant!

This weekend I was so excited to get some farm fresh eggs.  I always mean to purchase them at the farmer’s market but they are always sold out before I get there.  I was lucky enough to receive eggs from both my cousin who has chickens in New York and my neighbor who’s mom has chickens right here in Maryland.  I received both brown and white and let me tell you I could definitely tell the difference between fresh and commercial.  The yolks were bright yellow, almost a deep orange, and the consistency of the egg was much fluffier as compared to the commercial eggs I usually get from my grocery store. 

Eggs have gotten a bad rap in the past but I have to tell you I am a big fan of them.  An egg is about 70-80 calories a pop and about one half to one third of a protein serving.  Speaking of protein, egg is one of the highest biological available proteins out there, meaning it is hard to find another source, besides milk, that your body will absorb and utilize the most efficiently. 

When I did some further research I was shocked to find that farm fresh eggs as opposed to supermarket eggs have one third less total cholesterol, one fourth less saturated fat, twice the omega 3’s, three times the vitamin E, and seven times the beta carotene and Vitamin D.  This is because chickens on farms are allowed to roam outside and eat grass in addition to other food supplementation. 

I have to say, I am all in when it comes to farm fresh eggs and I will definitely be going this route from now on.  Try them out if you get a chance and let me know what you think.  Good luck and be well.

Friday, February 18, 2011

Food Trends: Can’t Stop Poppin'!

I am a registered dietitian, but I have a major secret.  My favorite foods in the whole world are fried chicken and potato chips.  Yes it’s true. If I have either in my house, I’m likely to hear them both talking to me. 

I don’t have a hard time controlling my portions with the fried chicken as it tends to fill me up quite quickly, but the potato chips, oh boy that is a different story.  I am always excited to find new potato chips that taste good and aren’t so horrific from a nutrition composition.

Boy was I glad to find all natural pop chips!  Their slogan states never fried never baked and I am here to tell you; they are very tasty, crispy, and do not have that fatty oil after taste that just makes me feel guilty all over.   Twenty three chips, or one ounce, of pop chips original only provide 120 calories and 4 grams of fat.  Compare this to other potato chips and it’s amazing. 


Brand Name
Serving Size
Calories
Fat
Lays Original
1 oz/15 chips
150
10
Utz Original
1 oz/20 chips
150
10
Ruffles
1 oz/15 chips
160
10
Cape Cod Kettle cooked
1 oz/ 15 chips
150
8


If you like potato chips and are looking for an option with less fat but great taste. Try them out.  Let me know what you think.  Be well.

Thursday, February 17, 2011

Food Trends: To Be Organic Or Not To Be, That Is The Question

I recently purchased Netflix and have been watching all the food documentaries.  If you’ve watched any of them and are like me, you may have felt quite nauseas by the end of most of the movies.  Shortly after watching all movies I have been known to say “that’s it we’re eating all organic.”  Honestly, I do not purchase all organic right now.  It becomes quite expensive and also research can still not prove that organic is healthier from a nutrient composition. So, I pick my battles. Being a registered dietitian has its upsides when reading food labels, but when I speak to clients, friends, or even my husband, the labels can be quite confusing. 

The term organic references the way farmers grow and process dairy, meat, fruit, vegetable, and grain products.  Instead of farming the conventional way, utilizing pesticides, and such or regulating where livestock lives and matures, organic farmers utilize crop rotations, mulch, manure, compost and such to prevent disease.  Animals are given organic feed, allowed to be outside, and live in a clean household.

The USDA (United States Department of Agriculture) regulates and certifies organic products and different foods have seals that state where they stand organically.  It is important to realize that the seal is voluntary and that producers who sell less than five thousand dollars of product a year are exempt from certification, but still need to follow USDA standards.

So what does each seal or statement mean?

Seal/Statement
Meaning
100% organic
Everything plus ingredients is organic. Usually a single ingredient food
Organic
95% - 100% of everything plus ingredients is organic
Made with Organic Ingredients
70% of ingredients are organic
Contains Organic Ingredients
Contains less than 70% of organic ingredients


A lot of times meats will utilize different terms instead of organic. Here's some clarification.


Terms
Meaning
Natural
Minimally processed, no artificial flavors or coloring but may still receive antibiotics
Grass Fed
Fed grass or hay, access to outside. Usually healthier/leaner
Free Range
Not caged, allowed to be outdoors, however this label is unclear. Best to call to get clarification
No Hormones Added
No growth hormones are added. Keep in mind by law poultry and pigs cannot be given hormones

To be organic or not to be is the question.  Research is inconclusive regarding if organic foods are healthier from a nutrient composition, but I feel there is an argument worth stating that organic foods are free of hormones, genetically modified organisms (foods that have altered DNA), food additives, food coloring, and many more. 

If on a budget it is always worth checking out your local farmer markets, food co-ops, and community supported agricultural farms as prices may be more reasonable.  Do you do organic? What’s your trick to the trade? 

 

Monday, February 14, 2011

Family Nutrition: What's the Story with Food Allergies

The CDC reports that pediatric food allergies increased by eighteen percent from 1997 to 2007.  Although the cause of increase is unknown, it is hypothesized that this increase could be second to the ‘Hygiene Hypothesis’ which is a hypothesis that suspects our children have an underdeveloped immune system cause by being raised in more sterile conditions.  The hygiene hypothesis is thought to increase allergies to mold, dust, and food. 

There are two types of food allergies, fixed and cyclic.  Fixed food allergies are those that stimulate an immediate response upon eating.  The symptom is very apparent with lip swelling, throat swelling, difficulty breathing, or immediate hives.  The cyclic allergy is more common but less understood and this allergy can have a delayed reaction of up to three days.  The child has a hypersensitivity to a particular food, the body creates antibodies against the food, and as soon as the threshold of intake is hit, your child exhibits allergy symptoms.

Symptoms of food allergies are itching, difficulty swallowing, diarrhea, abdominal pain, difficulty breathing, nausea, vomiting, hives, eczema, or even asthma.  Twenty seven percent of children with food allergies also have eczema.  The most common allergies in children are cows milk, eggs, peanut, fruits (mostly strawberries and tomatoes), soy and wheat.

Your child has an eighty percent chance of developing food allergies if both parents have or had food allergies and a forty percent chance of developing food allergies if one parent has or had food allergies.  The American Academy of Pediatrics recommends avoiding introduction of solid foods before four to six months and cows milk until twelve months of age.  If your child has any allergies or family members with food allergies it is suggested to avoid introduction of wheat until twelve months of age, eggs until two years of age, and peanut butter and shellfish until three years of age.

If your child exhibits signs of allergies remove the food from the child’s diet.  If you are unsure of what the specific food is, keep a food and symptom record to stimulate your memory and assist with assessing the culprits.  Make an appointment with an allergist who will review the food diary and ask lots of questions.  The doctor will most likely order a RAST (blood test) or skin prick test, dependent on your child’s age.  Once you find out which food is the culprit, eliminate it completely from your child’s diet for at least six month. This is labor intensive and requires looking over food ingredient lists, calling companies to insure there is no cross contamination during manufacturing, and understanding ‘key words’ that may indicate the culprit is included in the food.  There are times when you still may not know exactly what is triggering an allergy response. When this is the case it is recommended to only eliminate one type of food at a time and review clinical symptoms. 

A registered dietitian has a lot of knowledge when it comes to food allergies and can help assess diet records and assist with elimination diets.  Ask your allergist for a recommendation.  If you are having trouble finding a dietitian in your area, ask Amy and I will help you find a dietitian in your area. Good luck and be well.

Thursday, February 10, 2011

Miraculous Misconceptions: A Reflection on “Heavy” on A&E

I watched Heavy for the first time this Monday and haven’t been able to stop thinking about it since.  Heavy chronicles two individuals every week airing their life struggles, depression, anxiety, and how they got to their current weight.   Each individual is given a complete medical exam where the physician talks about their health and discusses the dangers that are associated with their obesity.  After first meeting with a physician, each individual is assigned to a personal trainer and shares a dietitian.  The goal is to lose a significant amount of weight in six months.  The first month is in a controlled environment and the last five months is in a “less controlled” environment.

Being a dietitian, I was very happy that they spoke and aired a dietitian on the show but I have some concerns with the way the dietitian’s involvement was edited for the show.  I was happy that they showed a dietitian providing a grocery tour  and felt they accurately portrayed how much this can be an ah-ha moment for an individual, but  I was absolutely appalled at the meal they aired for dinner.   There are many ways you can minimize calories without the portions being so incredibly small.  In my opinion, showing such a small, unappealing meal, puts a bad taste in people’s mouths and stimulates the anxiety individuals have when thinking about making dietary changes.  I was not shocked when I heard Rosie O’Donnell and her crew speaking horrifically about this diet the next day and thought to myself, “millions of people are listening to this right now and they all have a bad taste in their mouth about dietitians.”

I was also ill that the majority of the show seemed to air constant anaerobic exercise. Where was the cardiovascular exercise?  At one time the female trainer did say they were exercising five to six hours a day.  Do the individuals have jobs? Will they have time to exercise this much once the six months is over?  How realistic is this?

I always take into account editing effects but I have to say I have my doubts that the individuals I watched on Monday will be successful.  Perhaps I will be wrong but until the media highlights the appropriate changes that need to take place to minimize the obesity epidemic, I think America will be stuck thinking there are quick fixes.  I am hoping that future episodes focus on lifestyle and dietary pattern changes and will keep an open mind.  I am also looking forward to hearing how everybody does with keeping the weight off. 

Did you watch the show? What do you think? 

Tuesday, February 8, 2011

Family Nutrition: Picky Toddler - Dinner Ideas

Feeding my toddlers feels like an additional full time job.  My son, who is three, has been very picky since he was an infant and coming up with new ideas to introduce nutritious foods is exhausting.  If you have or have had toddlers you know most are picky specifically to textures which can ultimately decrease protein, fruit, and vegetable intake.  I try to mix as many vegetables and proteins as I possibly can into dinners such as meatloaf and chicken pot pie.  Sometimes I get away with it and sometimes this brings on meltdown 911 but to my surprise, last night I made my homemade "garbage bread" and it was a great success!  Here's the recipe:

1 "package" of Whole Wheat Dough (from your local grocery store)
8 oz Crushed Tomatoes
4 oz part skim mozzerella cheese
1 cup of frozen spinach
4 oz Ham Cold Cut
1/2 cup chopped red peppers
1/2 cup chopped onions

Roll your dough until it is flexible and about 1 inch thin.  Spread Sauce in middle third of the dough. Spread cheese and veggies over middle third of dough.  Slice up ham and spread on dough.  Fold dough to create a closed loaf. Bake in oven for 30-40 minutes on 375 degrees until dough is golden brown. 

This easily fed my family of four. I paired this with a glass of milk, blueberries, and salad.  You can easily add many things to this "garbage bread" such as chicken, brocolli, peas, or mushrooms. Give it a try and let me know what your kids think!
Enjoy and be well!

Monday, February 7, 2011

Spotlight: Dietitian or Nutritionist What’s the Difference?

Both terms are used interchangeably but can mean very different things. I for one do not have a preference of what I am called: nutritionist, dietitian, and food lady what have you but there is a point of differentiation that is worth discussing to help an individual decide who is best to work with.

A dietitian must have a bachelor of science in nutrition or dietetics from an accredited school and enter a post graduate internship program that usually lasts nine months to a year.  In the internship program the individual will work in a hospital, medical institution, government, or community focusing on medical nutrition therapy.  After completing the required hours in the internship, that individual is then able to sit for the national registration exam governed by the American Dietetic Association.  Once passed most states require licensure and the dietitian is required to take at least fifteen continuing education credits a year to maintain their registration and licensure.

A nutritionist is not governed or accredited.  Essentially anyone who is interested in health, fitness, or nutrition can call themselves a nutritionist.  This is not to say that the nutritionist does not have personal experience or some training and knowledge of the subject, it just means they are not governed by a national governing body and most likely did not work in an internship dealing directly with individuals and different disease states that present themselves in medical nutrition therapy. 

Most physicians will refer patients to a registered dietitian as they have specific medical nutrition therapy experience. Also registered dietitian’s can work with insurances as nutritionists can not.  To find out if you are working with a dietitian or nutritionist you can always ask for the individual’s accreditations and you can also look for the acronyms behind the name.  RD means registered dietitian and LD means licensed dietitian.  Some states have a LDN meaning licensed dietitian and nutritionist.  You can also ask the individual for their registration number and check with the American Dietetic Association. 

Your insurance company can usually guide you to a registered dietitian in your area as well as the American Dietetic Association at http://www.eatright.org/.  Good luck and be well.



Thursday, February 3, 2011

Family Nutrition: Iron –A Good Mineral to be Familiar With

The World Health Organization states that an iron deficiency is the number one nutrition disorder in the world and that eighty percent of people are iron deficient, with thirty percent having Iron deficiency anemia, an advanced state of deficiency. 

Females at child bearing age, pregnant woman, preterm and low birth weight babies, infants, toddlers, and teenage girls are all at risk for iron deficiency second to an increased need but it is also proven that low intake of iron rich foods, inadequate absorption of iron, or excessive blood loss, such as during a menstrual period can result in iron deficiency.

If you are an athlete who runs intensely, swims, or cycles your need for iron supplementation may be increased as well as gastrointestinal blood loss can be greater after events or training and it is thought that red blood cell turnover can be thirty percent higher than the normal individual.

Iron is derived from two sources in the diet, heme and non heme products.  Heme products are products that come from animal sources and non heme products are sources derived from plants.  Sources of heme iron are meat fish and poultry and non heme sources are lentils, beans, oatmeal, tofu, spinach, raisons, and whole wheat bread.  Many of our cereals are fortified with iron with non heme products.  Heme iron is absorbed the best and research shows that an addition of vitamin C with non heme iron sources increases iron absorption.  For example, add some strawberries to your oatmeal and a tomato and spinach on your sandwich.

Some foods inhibit absorption of iron when eaten at the same time such as tannins, an ingredient in tea.  It is also thought that if iron is supplemented at the same time as zinc and calcium that iron absorption can be affected. The recommendation is to take supplements with food as this seems to correct absorption issues.

Symptoms of iron deficiency are feeling tired, weak, decreased social development with children, difficulty maintaining body temperature, decreased immune function, and an inflamed tongue known as glossitis.  Deficiency can be measured through blood work where your practitioner will review hemogloblin and serum ferritin.  When both are below normal ranges, your practitioner will most likely provide an iron supplement.  Ask your practitioner for the research behind their recommended supplementation and make sure they address any upper tolerable limits to prevent toxicity.

If you have any of the symptoms below, are in any of the high risk categories, or are a vegetarian, discuss with your practitioner and request a work up at your next appointment.  Until then focus on eating iron rich foods. If you are a vegetarian focus on eating vitamin C with your non heme iron sources, and if you aren’t taking a multivitamin start one now, making sure it contains both iron and vitamin C.  Be sure to eat with your supplement.  Good luck and be well.   

Tuesday, February 1, 2011

Family Nutrition: Decoding the Dietary Guidelines for 2010

Since 1980, the USDA has published dietary guidelines every five years based on previous research. Yesterday, January 31, 2011, the USDA and Health and Human Services (HHS) published their dietary guidelines for 2010. 

After reading the document there is a common denominator that is the foundation of all recommendations and that is the epidemic increase in overweight and obese individuals in the United States.  Incidence of obesity in children has doubled from ages two to eleven since the early 1970’s and it is thought that adults from the ages of twenty to sixty gain a pound a year.

The guidelines focus on mindful or conscious eating focusing on portion control, and a variety of nutrients to get you to your goal.  It is recommended to focus on appropriate calorie consumption, decreasing solid fats and added sugars, and reducing sodium to less than 1500 mg/day.  It is also recommended to continue physical activity as it helps balance calorie expenditure. Americans have sustained physical activity or even increased activity, leading one to believe that overconsumption in calories plays the largest role in weight gain.

The statement I agree with the most in the Dietary Guidelines for 2010 is that this is a lifestyle approach.

Check out the Dietary Guidelines for 2010 at http://www.cnpp.usda.gov/DGAs2010-DGACReport.htm and let me know your thoughts. Good luck and be well.

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