Tag Archives: registered dietitian

Chocolate Cinnamon Date Balls

16 Mar

My mom asked for a healthy dessert for her birthday this year, and being short on time and looking for something she could also take home for snacks, this is what ended up happening. These no-bake cookie balls are delicious and totally customizable to your own taste!

Makes: 12 balls

Ingredients:

  • 1/2 cup raw unsalted almonds
  • 16 dates
  • 1 Tbsp flaxseed meal
  • 1 tsp cinnamon
  • 1/4 cup dark chocolate chips (at least 60% cocoa), chopped

Grind almonds in food processor until it is a coarse flour-like texture, not too fine. Place in a bowl and set aside. Place the dates in the food processor and blend until chopped well. Add cinnamon, flaxseed, cinnamon and ground almonds and blend until well combined. Mix in chopped chocolate chips by hand. Using a tablespoon measuring spoon, scoop the “dough” and form into a firm ball in your hand. Store in the refrigerator.

Nutrition Stats (per ball): 75 calories, 3.5gm fat, 0gm cholesterol, 0mg sodium, 10gm carbs, 2gm fiber, 2gm protein

Nutrition bonus: Almonds contain heart healthy monounsaturated fat and vitamin E, an antioxidant (also look here for more information about how to get more antioxidants in your diet). Dates contain fiber, antioxidants, potassium [helpful for lowering blood pressure] and iron for energy boosting. Dark chocolate and cinnamon also contain antioxidants and cinnamon helps to stablize blood sugars as well [important for everyone, not only diabetics]. Flaxseed is a source of ALA, an omega-3 fatty acid, and also adds fiber to your diet and contains lignans – more antioxidants!

National Nutrition Month :: Make a Rainbow on Your Plate

8 Mar

March is National Nutrition Month, a campaign sponsored by the American Dietetic Association to promote nutrition education; this year’s theme is Eat Right with Color.

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As a dietitian, I am often asked about multivitamins. My personal recommendation, however, is to obtain nutrients from eating a variety of whole foods as research is yet to conclude if supplementation has the same benefits as obtaining these nutrients through the diet. Each day and week, think about including fruits and vegetables from all color families to provide your body with a rainbow of vitamins, minerals and antioxidants, substances that protect the cells in your body. Aim for at least three different colors at each meal to obtain maximal health benefits.

Blue/purple: Anthocyanins, found in blueberries, black rice, red cabbage and cherries, are antioxidants which are touted to decrease inflammation associated with arthritis and heart disease. These foods also contain resveratrol, an antioxidant specifically linked to protecting against heart disease and maintaining eye health. Anthocyanins also contain anti-aging properties, may help with memory and promote urinary tract health. Blueberries, likely because of the anthocyanins, have been shown to improve insulin sensitivity and lower blood pressure.

Red: Red foods such as tomatoes, beets, watermelon and pomegranates contain lycopene, an antioxidant that in men with high intakes was linked with decreased risk of prostate cancer. These antioxidants also protect us from heart disease and may benefit those with exercise-induced asthma.

Green: Kale, spinach, broccoli, avocados and asparagus are nutritional powerhouses that are rich in lutein for eye health and vitamin K for bone health. Green fruits and vegetables are also good sources of vitamin C, folate, and magnesium.

Orange/Yellow: Sweet potatoes, carrots, pumpkin, and apricots contain a variety of carotenoids, which enhance immune function. Carotenoid-rich fruits and vegetables (not supplements) have been shown to possibly reduce the risk of cardiovascular disease and cancer. Orange and yellow foods are also high in vitamin A to help protect the eyes and are thought to fend off colds by boosting immunity.

White: The lack of color in these foods is not for lack of nutrition! Potatoes are high in potassium, an electrolyte that helps lower blood pressure, and vitamin C for immunity. Cauliflower, potatoes and mushrooms contain allicin and quercetin, substances that may defend against cancer and inflammation leading to heart disease. Red onions contain several types of antioxidants including quercetin. Onions and garlic are beneficial to the cardiovascular and immune systems and may also have anti-cancer effects as well.  

Brown: The brown group not only contain produce such as dates, but also whole grains including wheat, brown rice and wild rice are good sources of fiber to aid with weight management, maintain gut integrity and control blood sugars. They are also packed with B vitamins and iron to keep you energized. Almonds contain heart healthy monounsaturated fats and vitamin E, an antioxidant.

A few ideas to add color to your diet:

  • Add spinach to your fruit smoothies – you won’t even be able to taste it!
  • Add a spring mix salad topped with colorful bell peppers and red onion as an appetizer to any meal.
  • Mix fresh berries into your morning oatmeal.
  • Pack cut-up carrots to eat with lunch or a snack.
  • Make a homemade soup with pureed or chopped vegetables including celery, carrots, potatoes and peas. Or add extra vegetables to low-sodium, canned soups.
  • Each week or month, find a recipe for a fruit or vegetable that you haven’t tried before.

For more information about National Nutrition Month visit: http://www.eatright.org/nnm/

How do you add color to your diet?

Progress Report [or lack there of]

6 Mar

I haven’t given an update about my progress for my wedding shape-up goals…Well, it’s because there honestly hasn’t been much progress. I actually considered deleting this part of the blog, but I feel like it’s helpful for folks to see that even registered dietitians and certified personal trainers struggle to reach their goals as well! My weight has actually gone up since my last post, and I definitely feel like I’ve been eating a lot more (I attribute that to stress!). I really do have a lot going on in my life – working at two hospitals, planning a wedding, a few different writing opportunities, keeping up with my new blog and keeping in touch with friends and family! So it’s time to re-visit my goals and adjust my plan.

  • First, I finally gave in and got a membership at 24 Hour Fitness. We have the gym at our apartment, but if there are 3 people in there, there’s not much room left so it was easy to become unmotivated. I actually used to work at 24, and there are a few near-by with good group classes. I’ve discovered that actually paying for a gym membership is great motivation on its own!  At the beginning of the week, I plan the group classes that I’m going to go to for the week (2-3 + a yoga class). I also have my gym bag packed to stop on my way home from work. The only hard part is that the fiance gets off work after me, and I like to wait for him…but I NEVER know when he’ll be off work so it sometimes messes up our fitness schedule –> something for HIM to work on, I’d say! Some days, I’ll just have to get my workout in without him. I always have a snack packed in my gym bag as well – one of my biggest excuses for skipping the gym after work is because I’m hungry!
  • Weigh myself every Monday and Friday. Good way to see if you’re on track but keep in mind that your weight will fluctuate daily based on hydration, contents in your bowels and menstrual cycle. I will also take my circumference measurements monthly.
  • I feel like a lot of my time on my days off is spent catching up with friends and family. I’m lucky to have such active friends, so if I need to get a workout in I’m sure they’d be happy to join me! Otherwise, get the workout done first thing in the morning before starting errands (which I’m actually pretty good about).
  • FOOD JOURNAL!! This is one of the biggest keys to success with weight loss and weight maintenance, and apparently, one of the most difficult for me to do. It’s just something I need to do. Some days, I do my food journal the night before and plan my meals out – which is a GREAT plan. I always seem to fall off the bandwagon when I get home from work. So my plan is to JUST DO IT. My goal is still to journal 3 days per week. I believe that this will be my biggest key to success – I tend to snack a bit more than I think I realize.
  • Another thing I’m working on in my life (which is not really related to this, but it really is), is getting more organized and simplifying my life. Instead of writing my workouts down in three or four places (yep, sure do) I plan to get them all to one – just have to decide which method works best. I also currently have three day planners (one online, old-fashioned day timer and work Outlook planner). This month, I will downsize to one method for tracking each (except a day timer for both work and “life”).

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Some things I am doing well with:

  • I have been working out 4-5 days per week. I’ve been doing more cardio lately – thinking of training for another half marathon. Gotta make sure to stay on track with the weights too.
  • Planning dinners. I plan dinner and grocery shop on my day off for all the days until my next day off. This really helps keep us accountable because we’ve already bought the groceries and don’t want them to go to waste.
  • Buying a gym membership will be a great step for us also!

So this is where I’m picking up with the plan. Only 7 months to go!!

Question :: Anyone have any other tips for success? What keeps you on track?

The HCG Diet :: Worst I’ve Ever Seen

3 Mar

I was recently listening to a local Denver radio station where one of the talk show hosts was talking about the success she’s had on her most recent fad diet – the HCG diet. I instantaneously felt my skin burning, my blood pressure rising and acted before I could even think. I was so enraged that my community was hearing this ridiculous diet being promoted. As a registered dietitian, I fight these idiotic fad diets all day long and could help myself but to speak up. I found her on twitter and commented that I was upset that she was promoting this diet, and that it was the worst diet I’ve ever heard of. She replied, letting me know that the chiropractor that put her on the diet was going to be on the air and wanted me on as well. I declined, but offered an opinion via email. The chiropractor came on the air and honestly didn’t provide any evidence to convince me any differently, so I continued with my response. Well, here it is:

“I continue to stand by my initial statement that the HCG diet is one of the worst diets I’ve ever seen. Part of my role as a registered dietitian is to evaluate available research and the authenticity of data on various topics, including fad diets such as this.  

The original HCG diet restricts total calories to 500 per day, equally divided into 2 meals. Each meal can contain roughly 3.5 ounces (100 gm) of lean meat, one serving each of a specified fruit and vegetable and one breadstick or Melba toast. It’s relatively easy to see that this diet is deficient not only in calories, but vital nutrients including protein and fat, entire food groups, vitamins, and minerals!  The minimum diet of around 20 days is more than enough time to develop nutrient deficiencies. Even taking a multivitamin doesn’t guarantee health assurance; studies have shown that the whole food is more important than the sum of its parts.

This is a semi-starvation diet and doesn’t provide adequate calories to support normal brain function or muscle store of glucose. Such calorie restrictions can trigger the body to significantly slow the metabolism in an effort to conserve calories to survive. The body will very quickly begin breaking down muscle as a source of energy. Keep in mind that your heart is a muscle. Semi-starvation also affects hormone and electrolytes in the body. An Imbalance  of electrolytes can have serious side effects including heart arrhythmias, come and sudden death.

  A number of randomized controlled trials have been conducted on HCG and weight loss. The double-blinded, placebo controlled trials are strong designs because neither the researcher nor the participant knows which drug is given. Randomization mimics “chance”. Both of these factors limit bias. These studies demonstrate no significant difference in weight loss between the participants who received the 500 calorie diet and the HCG injections or the 500 calorie diet and the placebo injection. Placebos are look-alikes used to protect studies against bias.  Researchers concluded that the significant weight loss seen in BOTH the participants who received the HCG AND the placebo injection was attributed to the drastically low calorie diet.  Essentially, this has been shown to be a very expensive placebo.

HCG has been approved by the FDA for use as a fertility drug; it has NOT been approved as a weight loss agent.  In fact the Federal Trade Commission, an independent government agency that investigates and protects against deceptive and fraudulent claims, ordered the clinics that offer this program to post the following statement: HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or “normal” distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.

In summary, even medically managed, inpatient weight loss programs do not restrict calories to this extent nor do they use hormones whose long term effects are unknown. They do, however, have an MD or DO monitoring vital signs and blood values daily and a dietitian ensuring a balanced diet.

I feel very strongly that our community should be informed with educated opinions to enable them to make decisions. I realize that this is a short-term diet, although the above risks may easily occur even within the 20 to 40 day timeframe. This diet is appalling and, in my professional opinion, the potential risks greatly outweigh any temporary benefit.”

I hope that I can at least enlighten the public to consider the obvious way to a healthy weight – small lifestyle changes that make a big difference – and to quit looking for quick fixes to “get skinny.” There is NO quick fix diet or pill that will result in lasting health. So why on Earth would you waste your time with these fad diets? In half the amount of time you could have changed your life and gotten on the road to being healthy at a normal weight for the rest of your life.

The REAL Wonder Pill :: Vitamin D

27 Feb

The newest superstar supplement  (and I must say, I’m on board with the bandwagon) is vitamin D, which isn’t a vitamin at all as it can be synthesized by the body (when the skin is exposed to sunlight) – it’s actually a prohormone. Nonetheless, vitamin D is important to many bodily functions and research is finding that many Americans are deficient in it, which may be contributing to chronic diseases.

Vitamin D:

  • Helps calcium absorption from the gut and maintains normal blood levels of calcium and phosphorus. If not enough calcium is absorbed from the intestines, the body will take calcium from the bones to normalize blood levels – which we obviously don’t want!
    • Without adequate vitamin D and calcium, only 10-15% of dietary calcium and 60% dietary phosphorus is absorbed
  • Prevents rickets (soft bones) in children, osteomalacia (weak bones) and osteoporosis in adults [see above mechanism]
  • Recent research indicates that adequate stores of vitamin D may play a role in preventing many chronic diseases and conditions including cancer, hypertension, diabetes, allergies in children, multiple sclerosis
    • One study reported that postmenopausal women who increased their vitamin D intake by 1100 IU of vitamin D3 reduced their relative risk of cancer by 60 to 77%
    • Several studies have linked vitamin D deficiency and colon, prostate, breast ovary and esophageal cancer, with blood levels >20ng/mL reducing the risk by as much as 30-50% according to one study
  • Likely plays a role in optimizing immune function
  • May help prevent cardiovascular disease by inhibiting inflammation [chronic inflammation is a risk factor for heart disease]

Those that may be at risk of deficiency: elderly, obese individuals, dark skinned individuals, lack of exposure to sunlight, exclusively breast fed infants, diets that avoid dairy/egg products, those with limited sun exposure, after gastric bypass surgery, hospitalized patients.

Specific disease states that increase the risk of vitamin D deficiency include cystic fibrosis, inflammatory bowel disease, celiac disease, diabetes, pancreatic disease, kidney disease, cardiovascular disease, and liver disease

The test: Ask your doc to check 25hydroxyvitamin-D – there are a few different lab values they can check, but this is best indicator of vitamin D status in the body as it reflects the amount of vitamin D produced by the body and consumed (not in body tissues however).

How much do you need?

The Institute of Medicine recently came out with new [controversial] recommendations for vitamin D and calcium:

  • 0-12 months — 400 International Units (IU)
  • 1-70 years — 600 IU
  • >70 years — 800 IU

Many other health professionals (MD’s and RD’s) agree that this isn’t enough to do all the amazing things listed above. I get that the IOM is playing it safe, but with 30-50% of the general population being deficient, and the tolerable upper limit (maximum amount considered safe) being 4000 IU/day, supplementing 1000-2000 IU per day is my general recommendation for teenagers on. If you’re deficient [which I encourage all my patients to get checked] you actually would need 50,000 IU per month per week for about eight weeks and then a maintenence dose of 50,000 IU per month thereafter.

Sources of Vitamin D

Your body makes vitamin D when the skin is exposed to sunlight. However, it can be difficult to obtain the necessary amounts based on many variables affecting the amount synthesized including: season, length of exposure, sunscreen, skin color (melanin content – the more this pigment you have, the darker your skin is and more difficult to synthesize vitamin D), and time of day. Some researchers suggest that 5-30 minutes of sun exposure without sunscreen from 10:00 AM and 3:00 PM at least twice per week to the face, legs, arms or back should be adequate. However, you won’t find many health professionals recommending 60+ minutes of sunscreenless exposure per week due to risks for melanoma (skin cancer).

The best natural food source of vitamin D3 is fatty fish and some mushrooms contain D2. Fortified milk contains about 100 IU per 1 cup – meaning to meet the IOM’s recommendations, you would need to drink 6 cups per day (even of skim milk, that’s an extra 480 calories per day, or almost +1 pound per week – we won’t even talk about if it’s not skim milk); to meet my recommendations, 10-20 eight ounce glasses of milk per day!

 Test Results

Per the National Institute of Health, here’s what your blood test results mean:

<11 ng/mL (Deficiency) —  Rickets in infants and children 

<15 ng/mL (Insufficient) — Inadequate for bone and overall health

 >30 ng/mL (Sufficient) — Proposed as desirable level and disease prevention

>200 ng/mL (Intoxication) — Considered potentially toxic

Many experts recommend blood levels closer to 50-75ng/mL for optimal health.

D2 or D3?

Vitamin D2 (ergocalciferol) comes from yeast, while Vitamin D3 (cholecalciferol) is found naturally in cod liver oil and oily fish such as salmon and can be obtained from sheep’s wool. Studies have had varied results, but many tend to think D3 is more effective at raising blood levels of vitamin D. However, if you are a vegan/vegetarian, D2 may be a better option and will still have positive effects.

Note: Make sure to take your vitamin D supplements with a meal containing fat – it is a fat soluble vitamin meaning that it needs fat to be absorbed.

Sources:
http://ods.od.nih.gov/factsheets/vitamind/c
http://news.yahoo.com/s/ac/20110226/us_ac/7947328_kids_with_low_vitamin_d_levels_at_a_higher_risk_for_allergies
http://www.modernmedicine.com/modernmedicine/Dermatology/Vitamin-D-types-affect-serum-levels/ArticleStandard/Article/detail/708603?contextCategoryId=40160
http://www.kpbs.org/news/2011/feb/23/ucsd-study-says-people-need-more-vitamin-d/
Michael F. Holick, M.D., Ph.D. Vitamin D Deficiency. New England Journal of Medicine. 2007
Michael F. Holick, Rachael M. Biancuzzo, Tai C. Chen, Ellen K. Klein, Azzie Young, Douglass Bibuld, Richard Reitz, Wael Salameh, Allen Ameri, and Andrew D. Tannenbaum Vitamin D2 Is as Effective as Vitamin D3 in Maintaining Circulating Concentrations of 25-Hydroxyvitamin D J. Clin. Endocrinol. Metab. 2008 93:677-681 originally published online Dec 18, 2007
Maryann King, MPH, RD, CNSD, LDN The Expanding Role of Vitamin D The Support Line 2/2011 Dietitians in Nutrition Support Dietetic Practice Group p. 16-23 
http://www.medscape.com/viewarticle/516238_4 

Tofu Butternut Squash Tomato Sauce Over Spaghetti Squash

16 Feb

This dish was by far my favorite spaghetti squash pasta yet – and couldn’t have been easier!

Serves: 2

Ingredients:

  • 1 medium spaghetti squash
  • 1 cup sliced fresh mushrooms
  • 1 small onion, chopped
  • 2 garlic cloves, minced
  • 1/4-1/2 uncooked butternut squash, cubed
  • 1/8-1/4 block extra firm lite tofu (lite can be found at larger health food stores)
  • 1 jar reduced sodium spaghetti sauce (we like Prego Heart Smart)
  • Onion powder, to taste
  • Italian seasoning, to taste
  • Red pepper flakes, to taste

One. Cut squash in half lengthwise; remove seeds. Place cut side down in a 13 x 9 microwave safe dish. Add 1/4 cup water to dish. Microwave on high for 10-13 minutes or until tender. Can also bake in the oven.

 Two. While the squash is cooking, heat up a large nonstick skillet and spray with olive oil or canola oil cooking spray. Add mushrooms, onion, butternut squash and garlic; cook over medium heat until tender. Add sauce and seasonings; bring to a boil and simmer for 2-3 minutes. 

 

Three. Use a fork and run it across the spaghetti squash to remove the strands. Serve sauce over squash. (Mine is also topped with pine nuts, which I didn’t particularly like – but I think my nuts may have been rancid).

Nutrition Notes :: Spaghetti squash is a great way to make a low calorie pasta dish that tastes delicious and provides additional vitamins (good source of B vitamins, vitamin C, potassium, manganese) that pasta does not. Onions contain quercetin, an antioxidant and tomatoes (in the sauce) are also contain antioxidants. Soy (tofu) helps to lower cholesterol. Garlic is wonderful for the heart: it has been shown to lower LDL (bad) cholesterol and triglycerides, decreases plaque build up in arteries and may even lower blood pressure. And yes, jarred pasta sauce can be okay – I just make sure to choose a low sodium version (and if I have the time, puree extra peppers, tomatoes and onion in the sauce for my picky eater fiance). Also, my version is gluten-free – just make sure to check your sauce.

Last, but not least, this dish was great when paired with one of my favorite drinkable treats.

Ch-ch-ch-CHIA [seeds]

15 Feb

So I’ve been hearing a lot about how amazing chia seeds are lately and decided to try them for myself and do a little research on them as well. So far, I’ve only added them to my oatmeal, which I do enjoy! They do seem to “puff up” and increase the volume of it… and anyone that knows me, knows I’m a volume eater – it takes a ginormous pile of food to tame my hunger. Has anyone baked with them?

 source

Chia is a seed from a plant found in Mexico called Salvia hispanica, a member of the mint family. Just a few of the health claims I’ve come across include:

  • Weight loss: chia seeds are claimed to reduce food cravings by preventing some of the food we eat from getting absorbed. 
    • First, why on earth would not want the nutrients we put in our body to be absorbed?A small, recent study found that chia seeds did not decrease appetite or aid in weight loss. However, my professional opinion is that since they are packed with protein, fat and fiber, they should slow down digestion and keep you full longer. And because of that, as a part of a lower calorie, well balanced diet with an exercise program, they may help with weight loss.
  • “Chia gel” provides good hydration for athletes due to its hydrophillic (water-loving) properties
    • I wasn’t surprised to not be able to find any recent, reliable research on this particular ‘benefit.’ The chia seed is supposed to absorb 9 times the weight of the seed in water. If you let the chia seeds sit in water, they do form a gel (looks like furry seeds to me). Supposedly, it is difficult to remove the water from the seed so that it is a long lasting hydration source. To be honest – I have NO idea on this one. Sounds like a well thought out (made up) theory to me, but also couldn’t hurt. Anyone have any research on this?
  • Reduces blood pressure
    • Omega-3 fatty acids have been shown to help lower blood pressure (mostly EPA and DHA – below), but I did find one study that found no reduction in blood pressure when consuming 50gm of chia seeds per day.
  • Controls blood sugar by “slowing the conversion of carbohydrates into sugar”
    • Well seeing that sugar is a carbohydrate… this statement obviously wasn’t well thought out. I know what they most likely meant, but this is another red flag that this source probably isn’t backed with scientific information. But like I said above, the protein, fat and fiber will slow digestion, which does stabilizes blood sugars.
  • Contains omega-3 fatty acids therefore decreasing risk of heart disease, improving mood, improving inflammation of arthritis, etc.
    • There definitely is plenty of studies to prove the plethora of benefits that omega-3 fatty acids may offer, including the above. Chia seeds (as well as flax seeds, walnuts, canola oil) contain ALA, a type of omega-3. DHA and EPA are the two superstars as far as omega-3’s, with many studies showing prevention of heart disease; however, ALA is converted (inefficiently) to DHA and EPA in the body and may also contribute to some of the above benefits as well.
  • Beneficial to skin and hair.
    • Fats, protein and many of the micronutrients (vitamins/minerals) found in chia seeds are important components for healthy skin and hair
  • Used to treat colon cancer, IBS, diverticulitis, chronic constipation
    • Fiber definitely has a relationship to many GI conditions, including the above. It may help prevent colon cancer by keeping your bowels regular (if you drink plenty of fluid!), and it will help prevent diverticulitis flare-ups if you have diverticulosis (but during a flare-up, you may want to avoid high fiber foods).

Nutrition Stats (1 heaping tbsp) :: 56 calories, 5gm fat, 4gm poly, 0.5gm saturated, 6gm carbs, 6gm fiber (0.6gm soluble, 5.1gm insoluble), 3gm protein, 7% daily value iron

Also contains a vast array of vitamins (especially B vitamins) and minerals.

Just a note. There is a TON of information on the internet. Check your sources. If the site that is providing you with the information is also selling the product, do some additional research. Trust information from reliable websites (.org and .edu) and from trained professionals (RD, MD). Also, animal studies should be taken with a grain of salt; definitely a great research starting point, but humans anatomy is obviously different from any animal.

And my all time favorite advice: if it sounds too good to be true (whatever it is), it probably is.

Conclusion:: The bottom line is that chia seeds are no magic cure-all for every disease known to man (even though the internet apparently says otherwise). I did read a 2009 study that eating chia seeds had no effect on weight or various disease risk factors (inflammation, blood pressure, etc). But, in my opinion, I think they could be a good addition to a healthy, well-balanced diet due to the benefits of protein, fiber, polyunsaturated fats and many nutrients.

What do you use chia seeds in? What health claims have you heard about them? What’s your take?

Thought — “It’s never too late to be who you might have been” ~ George Elliot