Cardiac Rehab Corner #2: Spring into Good Health

Every New Year about 45% of Americans make New Years’ resolutions, but only 8% of people actually keep them.  Now is a good time to check in with those resolutions.  Did you make any? Have you kept them?  What is standing in your way?

Take this as a moment to evaluate your progress.  Big changes take patience and little steps add up. March is National Nutrition Month so it is a perfect time to focus on your health-related goals.  Some goals to consider:

Move more- build up to 30-60minutes per day as long as your doctor is okay with you exercising.  Carve out some time every day.  Change your mind set.  It’s not wasted time, it’s time to take care of you and build up a healthy heart and body.  This doesn’t have to be a big chunk of time either.  Think about parking a little further, taking the stairs instead of the elevator, if you live near town walk to the store or the post office. Build exercise into your daily routine.

Eat more slowly-  pay attention to your body cues so you know if you’re really hungry and when you’re really full. Take the time to put your food on a plate and really experience the flavors and textures of what you’re eating.  Remember that it takes 20 minutes or so for your body to realize that you are full, so try to eat until you’re satisfied but not stuffed.

Try smaller portions-  start with less if you’re really hungry, you can always go back for more.  Keep in mind that half of your plate should be fruits or vegetables (you’re trying for 5-9 servings per day). A meat portion is about the size of the palm of your hand and a quarter of your plate should be fiber rich whole grains or other carbohydrates.  Drink more water.  Decrease your intake of high sugar/low nutrition beverages by cutting your portion in half, diluting your juice or eliminating them all together. 

Food is magic

Shortly after I went to work for WIC I gave up jam and juice. I prided myself on it.  “It’s wasted calories and sugar”  I’d boast.  “I only drink juice when I’m sick”.  And yet on days I hated my job, I’d stop and buy a piece of cake for two and eat the whole thing by myself, on the couch and call it dinner.  So in an attempt to reacquaint with food is magic I had a friend teach me to make jam.  We cut up apples and blood oranges and Meyer lemons and then threw them in a pot with sugar to brew.  We went for a walk, we caught up, we added some rosemary to the pot,  we talked about how hard it is to get together and talk and catch up and that once upon a time women gathered to do just this.  5 hours later we boiled some glass jars, funneled the marmalade in and reboiled the jars to get them to seal.  We tasted our creation and it was amazing.  It tasted like Christmas and friendship and work.  I think we often lose out when we forget the effort that goes into food. 

Reluctantly yours

Several years ago when I started blogging, I wasn’t quite sure why I was the reluctant dietitian but I was.  I felt it.  I love food.  I love helping people.  Health is important to me, so this path just felt like it fit when I was in school.  And, to be honest, I got an A in my first nutrition class.  But the more I learned the more I riled against it.  Nutrition takes the magic out of food.  Out of bodies.  You mean certain nutrients get absorbed in certain places? We’re going to spend the whole day baking cookies just so we can learn the effects of cook time, temperature, sugar, eggs, certain types of flour on the outcome? So I came out of school and took the first job I was offered.  Selling lettuce, nothing remotely related to nutrition.  And then I started talking to people about nutrition because that’s what happens when you have a nutrition degree.  So I came back to it.  Slowly, reluctantly.  It took me almost 5 years post bachelor’s degree to get into an internship then sit the exam to become a Registered Dietitian. Being a dietitian is hard.  Everyone knows something about food.  Your years of specialized training are often thrown aside for the quick and easy blurb by a certain tv doctor or anyone that has ever read a nutrition book or eaten.  And I am the first to say I don’t know it all.  I work as an acute care dietitian and in cardiac rehab this is what I know.  I don’t do sports nutrition (there’s a book on my nightstand I mean to read every time I run a half marathon). Or anything involving guts, gluten free or allergies. I'm moderately helpful when it comes to Diabetes. But as I stood in Target last night searching for a tortilla that didn’t have hydrogenated oils, it occurred to me that very few people in my age range are doing the same.  Being a dietitian makes grocery shopping take forever, on some subconscious level you’re almost always surveying what you’re eating, what others are eating, or what the food choices are.  I recently came across a book called Intuitive Eating By Evelyn Tribole MS, RD and Elyse Resch MS, RD and it resonated with me.  We are often called the food police as dietitians but I have to disagree. We are food lovers, food supports, promoters of GOOD food.  And not just food that is good for you but food that nourishes you.  That will make you feel better and be better.  If you are unfamiliar with the idea of intuitive eating it is the idea of reconnecting with what I’d like to call your inner toddler or your inner teenager. Do away with the voices that tell you you’re good or bad for eating one way or another.  These are moral judgments, you are not bad if you like to eat bacon, particularly maple bacon on Sunday at brunch with your girlfriends.  Eat what you want in the anounts you want. Think of food as part of your life experience.  Nourish your body and really listen to it.  How does it feel after you eat fast food or a bowl of fruit?  What are your energy levels like when you eat certain foods?  How does your skin feel? Your hair grow? Do you feel hungry?  Really hungry like the only things that will fix this is food hungry or are you bored, depressed, angry, or feeling social?  And on the other side of that how do you know that you are done eating?  What are your cues that you are full?  Take some time to get back in touch with you.  All too often I feel like our culture treats food as a burden. What I was initially afraid of becoming a dietitian was that I’d enjoy food less.  Growing up in an apple orchard filled with blackberry bushes and pear trees and friends in trees, I celebrated the seasons by coveting the newly budding apples, crawling all over the blackberry bushes for squishy finger staining berries. I knew where my food came from. It came from the top of that tree there the one we called the carousel or the tree by the road. Apple season was my favorite we'd wait all year for it to come. Store apples pale in comparison. So I work hard to eat locally and in season so good tastes like food. For a long time knowing what to eat and how felt like a burden, there was too much pressure to eat right all the time, to be the leading shining example, but food is just food and all I really want to do is help people feel better. So this year I’m trying to reconnect myself and my patients (and you) with the magic of food.

New Years Resolutions

The new year is approaching (4 more days left!?!) and as I prepare a class for cardiac rehab about weight loss I'm reminded about how many people try to start fresh in the new year.  This month has been a whirl wind for me.  I returned from Nepal the week before Christmas.  Fortunately my cookies were made and my presents were bought but between the jetlag and the return to work the only person I managed to cook for was a dear friend who lost her mom just 3 days before Christmas. I made her a chicken pot pie.  A good one with cream and butter that tasted like love and comfort.  And while I made it I laughed at how I couldn't help but "tweak" the recipe just a little.  Double the vegetables.  Add more nonfat milk, less cream.  White breast chicken meat only. Low sodium bouillon, no salt added despite the recipe calling for it.  It wasn't perfect.  Certainly not the healthiest thing I've made, but they loved it and that's what was important.  I feel all too often we try to make grand changes because we feel we have to change everything RIGHT NOW.  Why not ease into the new year by trying to make things just a little bit better?  Can you reduce the salt in that recipe just a little?  Change from 2% milk to 1%?  Change from white rice to brown rice?  Include just one more fruit or vegetable per day?  Little things add up.  They're accomplishable, sustainable and ultimately isn't that the goal?

Cardiac Rehab Corner 1

As a small portion of my real life job I work in Cardiac Rehab.  It's a nice break from the hospital and a chance to actually get to know people and feel like helping.  Recently I was asked to write a column for the newsletter. I thought I'd include it here.

 

With the days  turning colder, warm lunch and dinner options become more popular.  Heart healthy diet’s sodium restrictions make most soups out of the question.  Try this recipe from the American Heart Association as a hearty vegetarian lunch or dinner option.  Frozen mixed vegetables and low sodium broth and tomatoes keep the sodium low while the barley and kale boost the fiber to 5g per serving making this a good source of fiber.

 

Old Fashioned Vegetable Barley Soup

Serves 4  Serving Size 1 ¼ cup

Cooking spray

1 tsp olive oil

½ medium onion, chopped

½ medium stalk of celery, chopped

1 medium garlic clove, minced

14.5 oz canned, no salt added, diced tomatoes, undrained

1 ½ c frozen mixed vegetables

1 ½ cups low sodium vegetable both

1 c chopped kale

½ c water

¼ c uncooked, quick cooking barley

½ tsp dried basil, crumbled

½ tsp oregano, crumbled

1/8 tsp pepper

1 tbsp shredded or grated parmesan cheese PLUS

1 tsp shredded or grated Parmesan cheese

 

Lightly spray a large Dutch oven with cooking spray.  Add the oil, swirl to coat the bottom.  Cook the onion and celery over medium high heat until golden, about 3 minutes, stirring occasionally.  Add the garlic and cook for 10 seconds.  Stir in the remaining ingredients except the Parmesan.  Bring to boil over medium high heat.  Reduce the heat and simmer, covered, for 10-12 minutes, or until barley is cooked.  Ladle into soup bowls and sprinkle with Parmesan.

Calories: 129, Total Fat: 2g, Saturated fat: 0.5g, Cholesterol: 1mg, Sodium: 78mg, Carbohydrates: 24g, Fiber 5 g, Protein 6 g

Fundraising

I'm doing some shameless self promotion here. My last post mentioned that I'm training for a marathon with Team in Training and therefore raising money for blood cancer research and treatment. One way I'm going about this is surveysavvy.com I take surveys and earn money, plus if I refer others I get a portion of their surveys as well. Of you'd like to help me out link to them here: surveysavvy.com/?m=2659003 . I'm doing some reading up on sports nutrition so expect a post on that soon.

Running for a cause

I've taken some time off of blog writing for some personal reasons.  In the meantime I've signed up to run the Nike Women's marathon with the Leukemia and Lymphoma Society.  Team in Training is the largest endurance sports charity training program. Since 1988 Team in Training participants have raised over $1 billion to support blood cancer research and patient services. In exchange for coaching you through an endurance event you pledge to raise money for blood cancer research.  When I first signed up for Team in Training 5 years ago I didn't know how the disease would impact my family. I just wanted to run a marathon.  I ran two half marathons that years and raised $3,000+.  There are many benefits to training for an endurance event in connect with an organization such as Team in Training.  The coaching staff is incredible and there to answer your questions.  Local running stores have come out to discuss gear, tape running sessions so runner can review form and provide a discount to get you started off right.  On course knowing that there are other racers on your "team"  is an incredible mental boost.  And when you need It most as you are struggling up a hill or gasping on your last mile out comes coach to talk you through it.  Sports nutrition has always been an interest of mine so I'll add some handy tips as I study up on the subject.  Check out my fundraising page for updates and to leave your support: http://pages.teamintraining.org/SJ/nikesf13/shousman . I'm also partnering with Pampered Chef 10% of the total show earnings will go directly to the cause. 

To place an order, follow these directions:
1. Go to www. pamperedchef.biz/jessicamedina
2. Click on "Shop Online"
3. Type in "Sara" as the host and choose her name.
4. Start shopping! 
*You may have your items shipped to Sara (in Salinas) for a flat rate shipping of $5.25, or you can have them directly shipped to you for a rate based on how much you spend. Many thanks and much love to all of you.